In 1975, smallpox eradication workers in the capital of Bangladesh, Dhaka, rushed to a village in the south of the country called Kuralia. They were abuzz and the journey was urgent because they thought they just might be going to document the very last case of variola major, a deadly strain of the virus. 

When they arrived, they met a toddler, Rahima Banu.

She did have smallpox, and five years later, in 1980, when the World Health Organization declared smallpox eradicated, Banu became a symbol of one of the greatest accomplishments in public health.

That’s the lasting public legacy of Rahima Banu, the girl.

Episode 8, the series finale of “Eradicating Smallpox,” is the story of Rahima Banu, the woman — and her life after smallpox.

To meet with her, podcast host Céline Gounder traveled to Digholdi, Bangladesh, where Banu, her husband, their three daughters, and a son share a one-room bamboo-and-corrugated-metal home with a mud floor. Their finances are precarious. The family cannot afford good health care or to send their daughter to college.

The public has largely forgotten Banu, while in her personal life, she faced prejudice from the local community because she had smallpox. Those negative attitudes followed her for decades after the virus was eradicated. 

“I feel ashamed of my scars. People also felt disgusted,” Banu said, crying as she spoke through an interpreter. 

Despite the hardship she’s faced, she is proud of her role in history, and that her children never had to live with the virus. 
“It did not happen to anyone, and it will not happen,” she said.

Voices From the Episode:

• Rahima Banu
  The last person in the world to have a naturally occurring case of the deadliest strain of smallpox
• Nazma Begum
  Rahima Banu’s daughter
• Rafiqul Islam
  Rahima Banu’s husband
• Alan Schnur
  Former World Health Organization smallpox eradication program worker in Bangladesh

Find a transcript of this episode here.

“Epidemic” is a co-production of KFF Health News and Just Human Productions.

To hear other KFF Health News podcasts, click here.

Subscribe to "Epidemic” on Apple Podcasts, Spotify, Google Podcasts, Pocket Casts, or wherever you listen to podcasts.

The 1970s was the deadliest decade in the “entire history of Bangladesh,” said environmental historian Iftekhar Iqbal. A deadly cyclone, a bloody liberation war, and famine triggered waves of migration. As people moved throughout the country, smallpox spread with them.

In Episode 7 of “Eradicating Smallpox,” Shohrab, a man who was displaced by the 1970 Bhola cyclone, shares his story. After fleeing the storm, he and his family settled in a makeshift community in Dhaka known as the Bhola basti. Smallpox was circulating there, but the deadly virus was not top of mind for Shohrab. “I wasn’t thinking about that. I was more focused on issues like where would I work, what would I eat,” he said in Bengali.

When people’s basic needs — like food and housing — aren’t met, it’s harder to reach public health goals, said Bangladeshi smallpox eradication worker Shahidul Haq Khan.

He encountered that obstacle frequently as he traveled from community to community in southern Bangladesh.

He said people asked him: “There's no rice in people's stomachs, so what is a vaccine going to do?”

To conclude this episode, host Céline Gounder speaks with Sam Tsemberis, president and CEO of Pathways Housing First Institute.

He said when public health meets people’s basic needs first, it gives them the best shot at health.

In Conversation With Host Céline Gounder:

• Sam Tsemberis
  Founder, president, and CEO of Pathways Housing First Institute
  @SamTsemberis

Voices From the Episode:

• Shohrab
  Resident of the Bhola basti in Dhaka
• Iftekhar Iqbal
  Associate professor of history at the Universiti Brunei Darussalam
• Shahidul Haq Khan
  Former World Health Organization smallpox eradication program worker in Bangladesh

Find a transcript of this episode here.

“Epidemic” is a co-production of KFF Health News and Just Human Productions.

To hear other KFF Health News podcasts, click here.

Subscribe to "Epidemic” on Apple Podcasts, Spotify, Google Podcasts, Pocket Casts, or wherever you listen to podcasts.

Global fears of overpopulation in the ’60s and ’70s helped fuel India’s campaign to slow population growth. Health workers tasked to encourage family planning were dispatched throughout the country and millions of people were sterilized: some voluntarily, some for a monetary reward, and some through force. 

This violent and coercive campaign — and the distrust it created — was a backdrop for the smallpox eradication campaign happening simultaneously in India. When smallpox eradication worker Chandrakant Pandav entered a community hoping to persuade people to accept the smallpox vaccine, he said he was often met with hesitancy and resistance.

“People's bodies still remember what was done to them,” said medical historian Sanjoy Bhattacharya.

Episode 6 of “Eradicating Smallpox” shares Pandav’s approach to mending damaged relationships.

To gain informed consent, he sat with people, sang folk songs, and patiently answered questions, working both to rebuild broken trust and slow the spread of smallpox. 

To conclude the episode, host Céline Gounder speaks with the director of the global health program at the Council on Foreign Relations, Thomas Bollyky. He said public health resources might be better spent looking for ways to encourage cooperation in low-trust communities, rather than investing to rebuild trust. 

In Conversation With Host Céline Gounder:

• Thomas Bollyky
  Director of the global health program at the Council on Foreign Relations
  @TomBollyky

Voices From the Episode:

• Chandrakant Pandav
  Community medicine physician and former World Health Organization smallpox eradication worker in India
  @pandavcs1
• Gyan Prakash
  Professor of history at Princeton University, specializing in the history of modern India
  @prakashzone
• Sanjoy Bhattacharya
  Medical historian and professor of medical and global health histories at the University of Leeds
  @joyagnost
   

Find a transcript of this episode here.

“Epidemic” is a co-production of KFF Health News and Just Human Productions.  

To hear other KFF Health News podcasts, click here.

Subscribe to “Epidemic” on Apple Podcasts, Spotify,  Google Podcasts, Pocket Casts, or wherever you listen to podcasts.