Vaccinating Mali: Posters, Pamphlets, One Slave, One Vampire Bat
by Robert Baker
The flight from Le Bourget outside Paris to my new post, Bamako, Mali was alarming, once we began flying over Africa. I did not know that the Air France Caravel aircraft, on long routes in 1968, routinely saved fuel by cutting back the engines and drifting down, then throttled up to gain altitude before drifting back down again. Alarmed, changed to charmed, but only after I figured it out. It was very French, logical and peculiar, much less monotonous than the straight-ahead flights across America.
Africa was like that, too, sometimes amazing and often charming.
Mali had great people and wonderful art: wood carvings, beautifully decorated masks, great pottery and hand-woven carpets and centuries old music. Some musical griot families were like European minstrels, but when they sang at a Malian nobleman’s wedding they recounted three or four centuries of the family history, an amazing feat of memory. The rich who paid them to sing were usually related somewhere down the line to tribal kings, so a lot of history was held in common. It was not uncommon for the griots to tell stories from a dozen generations in several days of singing. Their well- paid and honored performances, left Europe’s minnesingers in the dust as repositories of history. The University of Illinois has a vast collection of Malian traditional music thanks to an academic whom I met there as he collected recordings.
Mali is mostly a vast, (about the size of Texas) land-locked, usually very hot, reddish plain covered with scrub and sand. Some hills and low mountains give hiding places to rebels. There is a single outstanding feature seen from the air, a river. The Niger wends across Mali in long curves from its source in the rainforest in Guinea to the Atlantic a couple thousand miles distant. The Niger fed most of Mali’s desperately poor in 1968 five millions, providing fish and irrigation water along its shores. Winter rains also flood Mali’s Niger plains, which suddenly become wide green swathes of grass.
Smallpox and measles were carried by the nomadic Peuhl tribesmen who in each year follow the rains for a thousand miles, crossing several national borders in West Africa, including a passage through Mali. Their herds of skinny cattle have the same broad, sharp horns that appear in ancient Egyptian paintings.
The mostly peasant Malian population sweated daily to produce a subsistence diet. Per capita cash income then was about $60 per annum (1969 figure), lower than that of India. The nomadic Peuhl were hard to spot to vaccinate against smallpox and measles. Mali, had, of course, its own outbreaks of other diseases.
When I arrived in Bamako, President Modibo Keita, whose family had been tribal rulers before the French took over the country, ruled as a Marxist dictator with lots of communist helpers in Bamako. He had secret police advisors from East Germany. Czechs helped to run the mass media. Several thousand Communist Chinese peasants worked on model farms; a North Korean ceramics factory turned out dinner sets (which your knife went through as you sawed on a piece of tough meat). Several hundred Russians helped to train Malian political cadres, built an African Olympics center, etc.
Few African countries embraced socialism and communist influence so much as Mali, so communist help poured into it. Malian official anti-American rhetoric was a small price for Mali to pay for communist help. Very rarely did anything good about America appear in the media which daily called Americans: racist, imperialist, exploitative, capitalists.
By contrast with the Communist Embassies in Mali, the American Embassy had six officers and a few staff. The Malian Foreign Minister deliberately kept our Ambassador waiting hours for scheduled appointments, and then simply sent word out that he was not available. Our Political Officer was not permitted by the government to speak to Malian officials, but got most of his information second hand from French or other foreign Embassy officials. Our Ambassador forbade our lone CIA guy to speak to Malians, so he also pumped the foreign community.
Each American officer had an East German-trained Malian spy who followed us about and camped outside our homes. Mine was almost a dwarf, always in a rumpled brown suit. He sat on a stool next to my front door and took down the license plate numbers of any visitors. We could only leave the capital rarely, with written permission from the Foreign Ministry, and with our spy in the back seat.
My job in the American Embassy, Bamako, Mali, was to make the Malians like or at least understand the United States and our policies via radio and press stories. I was the Information Officer, charged with getting something favorable to America, anything, into the media. Our official good works in Mali, to the tune of several million dollars a year, were mostly ignored in the radio and press. America had given lots of money to develop better cattle breeding, to spread the benefits of chicken production, etc. Mali’s official Marxism and close ties to communist countries meant daily attacks on the U.S. in the local media and total rejection of my official Embassy press releases. I was not permitted to enter any Malian official building without a Malian Foreign Ministry ok, rarely granted. My Malian assistant charmed his way into them to deliver our ignored releases, but got in some VOA top of the pops tapes weekly.
Our biggest foreign aid achievement in Mali was to inoculate the whole population against smallpox and measles. Those endemic diseases often killed or blinded. Dr. Pat Imperato, an American epidemiologist, administered the program and trained Malians to do the work. His successful campaign used U.S. donated equipment (big Dodge trucks to bring Malian inoculation teams to remote villages, simple pneumatic injection devices, etc.). It took several years, but by 1968 all Malians had been inoculated against smallpox and measles.
My press releases on American other aid programs in Mali were ignored. However, by playing on a legitimate public information campaign and the Minister of Health’s vanity we let all Malians know about American help in the vaccination campaign.
I wanted to let Malians know about the U.S. role especially by visual means as many were illiterate. I asked for and U.S. I. A. headquarters sent me a still camera, developing equipment, manuals, dark room chemicals, etc. The Embassy built a tiny backyard shack for me. I learned how to take pictures and develop them. The developing liquid for prints became too hot in Mali’s blazing heat. The Ambassador let me have an air conditioner for the shack. (He kept all the other air conditioners in our warehouse because using them he felt would be inconsiderate in such a poor country).
Riding the red dust, washboard roads all over Mali with Dr. Imperato and the inoculation teams, I got photos of mass inoculations in towns and villages across Mali. They included Malians in all walks of life from teachers to raggedy cattle herders, holding up their inoculation cards. For dramatic shots of our big Dodge four wheel drive climbing impossible hills, I jumped out of the truck and into the roadside bush. Later, the good doctor asked me if I had not been afraid of the black mambas in the bush. Wish he had mentioned that earlier.
On the Sahara's edge, the Commandant du Cercle, put us up one night in the official guest house. It had become ruinous in the decade since the French granted Mali independence. He assigned two beautiful Malian school teachers dressed in their finest robes with their hair shining from oil and piled high on their heads to dine with us. Pat and I did not drink more than a glass of wine and just made awkward conversation with the two beauties. The supper was chunks of beef heart so tough it took lots of hard chewing before you could finally gulp down a bit. The beef sauce and rice were good.
After the somewhat strained supper, we walked to our guest house and tossed a coin to see who got the bed and who got the cot. I won the cot. The double bed mattress, no sheets, had a valley a foot deep in the middle, and was spotted brown by old blood stains from sleepers’ mosquito bites. The mosquito netting was full of rents. Bugs flew out of the nearby marshy water on the banks of the Niger River and attacked us all night. I had brought a light blanket against the chilly desert night air. Bone tired from the long bumpy drive, bundled and smeared with repellent, I finally dropped off to sleep with the drone of mosquitoes in my ears.
In the middle of the night, some really big mosquito began to land on or near my head. I sleepily brushed it off again and again, but it kept coming back and it was big.
I finally woke when my hand brushed it full on. It was huge. Shocked awake, I sat bolt upright. In the bright moonlight flooding through the empty window I saw fluttering around the ceiling, a vampire bat. I jumped up and threw my blanket at it until it flew out the window.
Jittery, I got up and went outside to take a smoke under the astonishing desert sky. The heavens over Mali's desert were a mass of diamonds joined together with just tiny bits of black in between the sparkling mass. I had seen vampire bats fluttered down onto the leg of a cow standing in a field. Their razor sharp teeth cut a vein. They licked up the cow’s blood as it trickled down a leg. Painless, but dangerous as bats sometimes carried rabies.
That guest house came with the only slave I had in Africa. The Commandant when we arrived pointed to a stocky young man, very dark and short, in only in a loincloth. He stood with downcast eyes by the entrance steps. The Commandant said the man did not speak French but could follow simple dumb show commands to make a fire, to fetch a bucket of water from the village well, etc. First thing we asked was for the guy to bring buckets of water to flush the vile toilet. There were no cleaning materials and no running water. We had brought our own drinking water. The man slept just outside the house on the ground on a thin reed mat. I never saw him eat or smile. For breakfast, he made a blue enamel pot of coffee on a tiny fire outside the house and gave us French bread for breakfast. No idea where he got the coffee or the bread, but excellent French bread was baked in Mali.
The Commandant was a big man about six feet and muscular, like most of the ruling Bambara tribe. They had enslaved lesser tribes for centuries. The French had decreed the end of slavery in all their possessions in 1794. The guy who waited on us must have had a great, great, grandfather who was set free by that declaration.
That ancestor spoke no French, had no money, no education, no clothes. Possibly his Bambara master told him he was free. The nearest town was 50 miles away across the scorching desert. I guess his descendants still lived in the tiny town in 1968 and still obeyed Bambara masters though by French law they had not been slaves for more than a century.
Back in the capital, Bamako, I searched for a Malian child to be the poster kid for our anti-measles, anti-smallpox campaign. I found him waiting in a line outside the Ministry of Health to be vaccinated. He was a really cute little boy with raggedy pants and shirt. He was holding his Mom by the hand. I gave her 200 Malian Francs, about fifty cents, and took a picture of the boy. The Malian inoculator pretended to give him a shot.
The inoculation guns were ingenious; the operator pushed down on a foot pump to make the inoculation liquid shoot into the patient. No external power supply was needed. That was important as very few towns had electricity. A swipe with an alcohol sponge made the gun ready for the next shot. I got the little boy to look up at the guy pretending to give him the shot. The kid had a trusting, angelic smile. Later he got his shot and cried. When I developed,. the photo I knew I had my poster boy. I edited everything out except the boy’s his upper body and the inoculation gun. Not quite right. Then I reversed the negative, shadowed his face a bit and had just what I wanted.
I sent the final version of the black and white photos from around Mali to our U.S. Information Agency publications factory in Beirut, Lebanon. I asked them to print the photo as a poster on Prussian blue paper (Mali’s favorite color for celebratory robes) as a poster. It came out two feet wide and three feet high. I asked for the boy's picture to fill the top 2/3. I ran a slogan in French under the photo, “Get Yourself Vaccinated Against Measles and Smallpox”. At the bottom of the poster, I asked Beirut to leave blank space. In that our teams could to write in white chalk the name of the village and the dates when our mobile vaccination teams would appear there. Beirut printed 5,000 copies, enough for dozens of copies for every town. Later, the Lebanese civil war made our factory close.
We mailed the posters to every town with a post office and gave them to the dozen inoculation teams to hand out as they drove around Mali. Malians from the Ministry of Health staffed the program as vaccinators, drivers and refrigeration specialists ( they kept the vaccine supplies cold).
Good thing we had so many copies made. Malian peasants liked the posters so much that they took them down from public places and hung them up in their huts. The government later based a postage stamp on the picture.
I sent copies of the poster to the 16 other American Embassies in West Africa, which were part of the regional vaccination program. Africa was part of a U.N. World Health Organization effort to wipe out smallpox worldwide. Those Embassies ordered thousands of copies in English or French. The program worked. Smallpox is contained today in a few laboratories but not raging among populations. Measles still exists.
We got help from the Army as well as the Ministry of Health. Hundreds of Peuhl herdsmen with thousands of cattle raised clouds of dust on the other side of the Niger River from where we waited with inoculation teams and a squad of Malian soldiers with rifles. They stopped only until they made camp each night in their thousand mile migrations. They followed the rain patterns and thus grass for their cattle, around West Africa crossing what now were many national borders. The Army squad forced them stop for the inoculation. It took all day to inoculate hundreds of the robed and turbaned Peuhl. Their skinny, long horned cattle, looked like the ones in ancient Egyptian murals. I asked them to wave their vaccination cards proudly and got photos of that.
The Peuhl were a major vector for both smallpox and measles because they went into towns to trade on their migrations and carried with them smallpox and measles infections.
Dr. Imperato reported to the Center for Disease Control in Atlanta, Georgia. He was also a fine amateur ethnologist. His research led our vaccination team to intercept the Peuhl at just the right spot on the Niger in their long migration.
With a passel of photographs ready, Dr. Imperato wrote text about the diseases, how to report them at once and how to get vaccinated. Reports sent to Bamako tracked where the diseases popped up. A team was sent immediately in Dodge trucks to vaccinate that area before the outbreak could spread. Mali is 487,000 square miles with very poor roads often washed out, so it was a big job.
Dr. Imperato wrote a text in French for the pamphlet to describe each disease and to tell how to notify health officials about it at once. The Minister of Health wrote the forward and mentioned U.S assistance prominently. The little boy’s picture was on both the posters and the pamphlet cover. The text gave major credit for the vaccination program to the Ministry, but it did prominently mention the American contribution. I could not get pro-American material into the radio or press, but it did show up in the pamphlet.
The Minister saw to it that the pamphlets were sent not only to village clinics but also to all secondary schools in Mali. The students were instructed to take the pamphlets home and tell everyone in local tribal languages about the vaccination program. The pamphlet helped greatly to educate Malians about vaccination. My photographs featured Dr. Imperato, identified as an American. The pictures of Dodge trucks showed plainly the U.S. AID emblem on their doors.
Among the remote tribesI decided not to include, showed the King of the Bozo, who was innoculated. The Bozo trade fish up and down the Bonny and Niger rivers and so were important vectors of smallpox and measles until they were all inoculated.
The Center for Disease Control in Atlanta ran the program expertly. It was financed by U.S.A.I.D. which paid for the program in Mali and the rest of West Africa. It worked. Both diseases were wiped out for the nonce, at any event. Though measles is back, smallpox exists worldwide only in laboratories.
After the vaccination of all Malians had been accomplished, the U.S. Surgeon General U.S. Surgeon General, Dr. W.H. Stewart, came to Mali to celebrate that. After a long day in Bamako, he and I were alone sitting over drinks on my front porch. I praised the work that had been done and said he must be proud of it. He replied the pity was that the children who were saved from smallpox and measles would mostly die not many years later from unhealthy water supplies, inadequate food and other diseases like cholera and malaria. He was right. Fixing those additional problems would cost huge amounts of money and effort from wealthy countries. They did pay the fairly low cost for inoculations, but had never yet given the massive aid needed to help the poor live longer and better. Sounds familiar.
However, many people in Mali learned the U.S. was helping to wipe out two terrible diseases in the country.
I requested an official U.S. Information Agency film team to make a documentary film about the vaccination program. They showed up and filmed the script I had submitted. I got to travel with the film team (just two guys a camera man and a sound man) and helped out a bit with the film shoot. I learned how hard it is to get on film a very dark African face. The dark skin absorbs light. You have to pour on extra light with a spot, even in daylight. I held a baby spot on Africans being filmed. The film was well received in Mali. And America got public credit for a very good medical assistance program. Public affairs work could be great fun and useful as well as hard work.