House on Fire

House on Fire ✯ [BOOKS] ⚣ House on Fire By William H. Foege ✼ – Heartforum.co.uk A story of courage and risktaking, House on Fire tells how smallpox, a disease that killed, blinded, and scarred millions over centuries of human history, was completely eradicated in a spectacular tr A story of courage and risktaking, House on Fire tells how smallpox, a disease that killed, blinded, and scarred millions over centuries of human history, was completely eradicated in a spectacular triumph of medicine and public health Part autobiography, part mystery, the story is told by a man who was one of the architects of a radical vaccination scheme that became a key strategy in ending the House on eBook á horrible disease when it was finally contained in India In House on Fire, William H Foege describes his own experiences in public health and details the remarkable program that involved people from countries around the world in pursuit of a single objective—eliminating smallpox forever Rich with the details of everyday life, as well as a few adventures, House on Fire gives an intimate sense of what it is like to work on the ground in some of the world’s most impoverished countries—and tells what it is like to contribute to programs that really do change the world.

Is a well known author, some of his books are a fascination for readers like in the House on Fire book, this is one of the most wanted William H Foege author readers around the world.

House on Fire  Epub ☆ House on  eBook á
    Import EPUB to the Program Import EPUB describes his own experiences in public health and details the remarkable program that involved people from countries around the world in pursuit of a single objective—eliminating smallpox forever Rich with the details of everyday life, as well as a few adventures, House on Fire gives an intimate sense of what it is like to work on the ground in some of the world’s most impoverished countries—and tells what it is like to contribute to programs that really do change the world."/>
  • Hardcover
  • 240 pages
  • House on Fire
  • William H. Foege
  • English
  • 03 August 2019
  • 9780520268364

10 thoughts on “House on Fire

  1. Gwenyth says:

    This is a tricky book for me to review, as I'm unashamedly biased, but I'm going to try anyway.

    When you think about the vast volume of literature written about any major war, it's somewhat remarkable that smallpox eradication - a campaign to end an illness that killed half a billion people in the last century - hasn't received more attention. The other day I was on a bus with some med students and one actually asked, what was that disease we eradicated? Was it polio? (Fail, future doctor! Fail!!!)

    That is one reason House on Fire, a first hand account of a massive, organized human effort to end a major cause of human suffering (an anti-war?), is such a valuable book.

    The main weapons required in this effort, it seems, were collaboration, coordination, and diligence. This is a story of many, many fieldworkers keeping grueling schedules; epidemiologists tracking cases; and prime ministers and ministers of health putting politics and ego aside (long enough) to complete a common goal. The overall lesson of the story? It's possible.

    This probably isn't the first book I would recommend to someone with only a passing interest in global health, as the tone is fairly dry and Foege spends a lot of time explaining the work that different people played at different moments (Have you attended a meeting where hours are spent working out who is going to gather data, who is going to collect and organize it, who will analyze it, who will interpret the analysis, and how everyone will act on what they find? Like that.) However, to a student of public health or global health, it is indispensable.

  2. Jim says:

    after reading schlosser's book about the atomic bomb i needed something uplifting. a book about smallpox.

    read the subtitle the fight to eradicate smallpox. the goodguys, author william h. foege among them, WIN the fight. going into this book we know smallpox lost, that's a good book to read.

    the postscript;

    Over the years, on every return to India, I have searched the faces of people on the street, looking for pockmarks. Soon I could find no pockmarked face under the age ten, then twenty, and now, no pockmarks are to be found on people under the age of thirty-five.

    to be able to read that postscript is amazing, to have been one of the diseases destroyers, Foege and his teams should be given parades whereever they go.

  3. Meepspeeps says:

    This is part documentary, part autobiography of the amazingly successful worldwide work to eradicate smallpox. Call me a geek, but I found the statistics climactic and the developing world experiences funny or sobering, depending on the story. It reinforces my belief that we peeps can accomplish almost ANYTHING if we have the political will.

  4. Piper Hale says:

    Dr. Foege looms large in my life (and not in the literal sense, as his unusual height would suggest) as the founder of the organization I work for, so, disclaimer, that may have influenced my experience reading House on Fire. It is, however, an extraordinary book documenting the years of grueling work that finally led to the worldwide eradication of smallpox. In relating the details of the smallpox effort's challenges and successes, Dr. Foege highlights the importance in disease elimination efforts of strong coalitions, adjusting strategies on the fly when needed based on the evidence, and being ready to deal with unavoidable political roadblocks. And regarding those roadblocks, it struck me as terribly sad that the greatest threats to the success of the smallpox eradication efforts were not biological or epidemiological, but were political. When the viral tenacity of a millenia-old disease presents LESS of a barrier to eradication than politicians getting hung up on turf wars, power struggles and PR issues, humanity has really bungled something.

    Smallpox eradication is the single greatest public health success in human history, so it has perhaps the most valuable global health lessons at our disposal. In his conclusion, Dr. Foege says: Smallpox eradication did not happen by accident. Stephen Hawking, in his book, A Brief History of Time, says the history of science is the gradual realization that things do not happen in an arbitrary fashion. This is a cause-and-effect world, and smallpox disappeared because of a plan, conceived and implemented on purpose, by people. Humanity does not have to live in a world of plagues, disastrous governments, conflict, and uncontrolled health risks. The coordinated action of a group of dedicated people can plan for and bring about a better future. The fact of smallpox eradication remains a constant reminder that we should settle for nothing less.

    Also, I ran across this postcard in the CDC museum last year written in 1979 to Bill Foege from a health officer in Kenya who'd been stationed in Somalia (possibly Dr. Don Millar, who was one of the directors of the Global Smallpox Eradication Program and who would go on to become the Assistant Surgeon General, but I'm having trouble reading the handwriting well enough to be sure) to announce the official end to smallpox, and thought it was an interesting piece of history:
    Bill.

  5. Sophia says:

    Since the eradication of smallpox ranks as one of the most successful efforts in public health, or human endeavor in general, the story of how it happened already draws interest. House on Fire: the fight to eradicate smallpox is William Foege's attempt to tell this tale, through his experience in Africa and India. I found the beginning, as he described how eradication was first accepted as a feasible goal, to be more interesting than the foregone conclusion. The story was told in a very linear fashion, with due credit to collaborators. One memorable quote was You get what you inspect, not what your expect. In a way, it contradicts Margaret Meade's assertion to Never underestimate the power of a few committed people to change the world. Indeed, it is the only thing that ever has since it took a massive effort to defeat the virus in India. I think those interested in public health should read this book not necessarily for the quality of the storytelling, but for inspiration to think big and insights on what it takes to achieve it.

  6. Cameron Climie says:

    Despite only being 200 pages, this book is extraordinarily dense in terms of its content and its focus. It's a memoir of one of the architects of the greatest public health achievement in human history; it's a bird's-eye history of the fight to eradicate smallpox in West Africa and India; it's a deep-dive on public health bureaucracies and their organization and ticks. If anything, it might be too dense, packing too many years and too many things into too few pages, but Foege's writing is concise enough that it didn't feel dense. The eradication of smallpox ranks as one of history's genuine miracles. To hear Foege's telling of it is refreshing and eye-opening and moving.

  7. Laura says:

    I found this interesting, if not fast paced. It is indeed a book about a war, fought viciously by both sides, with numerous problems and pitfalls. While Foege is obviously passionate about smallpox and his experience (and rightly so), the book is so heavily scientifically based and loaded with facts and numbers, that the people behind the scenes got lost for me. That's a minor complaint - I was reading this to learn about the methods and successes, not so much for personalities, but it may put other readers off.

  8. Laura says:

    Favorite book of 2018.
    Life accumulates
    You get what you inspect, not what you expect.
    If a house is on fire, no one wastes time putting water on nearby houses just in case the fire spreads. They rush to pour water where it will do the most good -- on the burning house. The same strategy turned out to be effective in eradicating smallpox.
    He tells stories not about what he has done, but about what others have done (Foege)
    We lose histories far too fast.
    There was -- and is -- no cure for smallpox.
    Variolating the troops may have been Washington's most important tactical decision in the pursuit of independence.
    Our house was always intensely busy but well organized, and at the end of the day we children fell asleep to the comforting sounds of our mother playing hymns or classical music on the piano or violin, after which she often worked on correspondence courses. My mother was not only well organized and interested in everything; she was also quite resourceful.
    I would come to realize that the best mentors not only have qualities one want to emulate but also take a personal interest that often leads to involvement with their families and a relationship that continues through the years.
    two of the constants in India: heat and crowding
    what I expected to be a totally overwhelming experience turned out to be surprising as I saw how people could be cheerful, resourceful, and productive in situations that would have left most Westerners demoralized and unable to function.
    While village life in Africa offered a predictable rhythm and the benefits of community, I was also struck by its limitations. People with wealth and education in a country like the U.S. can read about a new idea in the New York Times in the morning and be applying it in the afternoon. Those without education or money, whether in the US or in Africa, cannot. Lacking the resources to change their future, they fall prey to a certain fatalism. Through the years I have come to see fatalism,t he assumption that you can't really change your future, as one of the great challenges in global public health.
    The problem with mass vaccination is that an exceedingly obsessive program is required to make inroads into the last 20 percent of any population...it becomes clear that herd immunity is easy in theory but not fully effective in practice.
    The standard response was to vaccinate everyone within a certain radius while attempting to determine the extent of the outbreak. However, we did not have enough vaccine to do this.
    Forced to look for another solution, we raised the question: if we were smallpox viruses bent on immortality, what would we do to extend our family tree? The answer of course was to find the nearest susceptible person in which to continue reproduction. Our task, then, was not to vaccinate everyone within a certain range but rather to identify and protect the nearest susceptible people before the virus could reach them.
    Life accumulates was a favorite saying of Jim Laney, former president of Emory University. In many ways the strategy that stopped the virus was a logical extension of the firefighting principle I was taught back int he summers of 1956 and 1957. By removing the fuel one step ahead of the virus, we had build a fire line around it.
    putting most of our resources into surveillance and containment
    Once a geographical area began the surveillance/containment strategy, smallpox rarely persisted there for more than twelve to fifteen months.
    Former US surgeon general Julius Richmond, commenting on the miracle of smallpox eradication in West Africa in such a short time, said that the smallpox workers sent by CDC were simply too young to realize they coudn't do it. In fact, they were well chosen for the job, people who proved they could meet any problem -- difficulties with vehicles, jet injectors, camels, communications or government officials -- with high spirits and humor.
    When surveillance and containment are made the primary strategy, mass vaccination can be dropped totally. In fact, it becomes a wasted effort.
    The smallpox eradication story contains many lessons, but giving up mass vaccination as a methodology for other diseases is not one of them. Rather, the lesson is that every problem has to be considered individually.
    eradication....it started that night in Ogoja province during a problem-solving discussion about inadequate supplies.
    Dr. David J. Sencer, then director of the CDC, had a passion for getting smallpox eradicated. He was a bright, dedicated physician who took delight in solving problems.
    Even living in Africa did not adequately prepare us for the adventure of life in India. During the twenty months we were there, the children never lost their fascination with it....Michael, now age seven, had his nose pressed tot he window. Suddenly he turned and said, This is the second best day in my whole life. Surprised, I asked him, What was the first best day? He said, Yesterday.
    India is overwhelming in its scope and confusing in its detail
    Spread of vaccine throughout the country was not simple. When attempts to ship dried cowpox material on cotton threads proved unsuccessful, the decision was made to deliver the virus from place to place through a series of children. As lesion developed in their skin, they in turn became the donor of virus to the next susceptible child, in this way maintaining a chain of viable cowpox virus propagated in human lymph.
    A summary of countless pages of depressing statistics suggests that more than half a century after the introduction of the smallpox vaccine, the disease continued its relentless decimation of humanity in India.
    The euphoria of starting a new program had already run into the brick wall of reality.
    The study's pursuit of the truth set the tone for the frequent admonishment to smallpox workers int he 1973 campaign, borrowed from the American Management Association: You get what you inspect, not what you expect.
    bifurcated needle...incredibly simple...several advantages
    In the state of Uttar Pradesh alone, preparations for the first search required over 60 training sessions simply to get down to the district level, and an additional 930 training sessions at the district and PHC levels. I would sometimes think: this is a lot like the logistics of war.
    Looking through the records from those times decades later, I am struck by how often I was optimistic while simultaneously having no idea what I was talking about.
    The results of our trip were at first intriguing, then sobering, and finally scary. The search teams were finding far more smallpox cases than we had anticipated.
    we realized were were in fact facing a disaster. In September, via the existing reporting system, Uttar Pradesh had reported 437 cases of smallpox. Now, just one mothe later, searchers had found 5,989 new cases.
    At a time when we anticipated a low point in numbers, we found smallpox everywhere.
    The search had revealed what actually existed, not what we hoped existed.
    ...schoolchildren were some of the best informants. They knew what was happening in their own neighborhoods and were not as reticent as their parents.
    Perhaps most significant, the smallpox workers were learning and improving every month, while the smallpox virus, for all of its evolutionary success, could not respond with the same agility.
    It has been said that genius is seeing one's field as a whole.
    integrity, cultural sensitivity, optimism: indicators of a successful smallpox-eradication worker
    India's vast bureaucracy, often maligned, was ideally suited for an operation of this scale....once the power of the Indian bureaucracy was harnessed, there was not stopping the innovation and energy of the thousands who took on the challenge of defeating smallpox. Creating effective forms requires you to picture the desired results, how to achieve those results , and how to report on them. Forms proliferated, and in a very real sense we can say, in retrospect, that smallpox was suffocated by a mountain of paper.
    Once the pending outbreak list began to decline, it would do so at an accelerating rate.
    The fact that a single smallpox outbreak in a European country would be seen as an emergency, with untold resources deployed, provides some insight into the work required to address almost 5,000 outbreaks simultaneously in a single state.
    At last we understood the enemy...The intelligence gathered allowed us to outflank a virus that had the supreme confidence of thousands of years of finding new victims without a break int he chain of transmission.
    It seemed almost anticlimactic. A virus that for millennia had spread such despair, inspiring religious ritual and even the worship of a goddess, was suddenly gone from the country. In twenty months, the surveillance/containment approach had proved itself ideally suited for eradicating a virus that had eluded the best efforts of mass vaccination programs for 175 years. It was the right tool for the task.
    Two weeks later, on October 26, 1977, he developed the last smallpox rash that Africa would ever see. He recovered without transmitting the virus. The global chain of smallpox transmission was finally broken. Smallpox had been eliminated from the world because of a plan. It did not happen by accident.
    Coalitions are powerful.
    Be optimistic. . . it is the way to live.
    Thank you Bill Foege. Amazing.

  9. Aisha says:

    I was very skeptical of this book in the beginning. But, as soon as I finished the first 2 chapters I was hooked and couldn’t put it down. One could say this was a complete about-face. Foege’s writing was very easy to follow allowing even lay non-public health folks to appreciate and understand the immense efforts required by a multi-sector approach to eradicate smallpox.

  10. Stephanie McMillan says:

    A guidebook to good global health work, House on Fire describes the global collaborative effort to eradicate smallpox. It details the surveillance and containment method versus mass vaccination that ultimately proved successful. A must-read for those interested in international health work & history.

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