P aa January jtith, 1'01 : t Moved to iiashington Piotel - Taxi $3.50 I! 31st, jr' 340 L!IiLL %.3U5 p.m. to 1JY ar. 4% \ -2, f[ 114 AAH hr.730 p.m. to iz&iL ar. 11% on Feb. 1. Pebruary 2nd - Home. Feb. 5th, 6tn and 7th at LFtti-LLiiI. Feb. 8th iiS 100 ;i~ Iv. 700 to DACCA (ar) 13.30 Feb. tSth, 9th and 10th with Jti. ii'eb. 11th Moved to Momin iiouse. i;he& Chase-DC Taxi - 350 P-Y 30 50 4 4.00 3oJ :tome ihls CJOO Taxi 3.52 3.14 803 DUS 300 Taxi 3.00 3.05 :J 1 0 o 1 9 January 3Otn : @loved in the iate afternoon to the &shington Hotel; returned in the evening to close trle house at 4104 fiose e January 31st : kecheck baggage and take 17 ib3. back to the house. Spent the morning at Nazos Cash and Carry grocdrs making pzchases for Dacca. ( Lome 030 gounds at $ 150.00 ) 'I'& Hous auth Puffer and the rierrs take us to the n; there we find . 01% the de Silvas, I-`, Owens, and Piis. Tito d%Llva. February 1: - Left W#RT`W(: DC .c& 15~05 ix. LAY lo:50 ~?US to i'A,i $ 0.53. Left LUY 14:30 i'idi i) 114 ar. Bom 11 :30j siee~ 2.m. ($1=622) 13~s 'Taxi - (2) $ 2 63 ????? ? ??? o February 2 : ? Visit Dr. L;. i"iijS;l~..~ Wrector of the imtituteSuperiore de SanitaJ h/cwi LTV3 c%Ad aiid 3r. Corradetti; Dr. PiOSria takes me to the Listit!it& GWMll&. de /&la- 7-c 5 pjclogia pf marc~~iafava -where A&3%X I met Dr$, l;uido fJ:siri;; eI,d ColLss$i AZe iilteresting discu ~s;si~n of sdlat h~,s hapdenod irk 3ardinia: in ltaly, in i&rica : both Corradetti and Casini feel that they have been neglected by i*;iS although Cor. has been used once or ttice as a consultant and Caaini \+as given a chance not too long ago to take over malsria control in Ghana. ln Sardinia and in certaiii Parts of Italy itself, some dangerous anopheles have disappeared from their usual haunts after DDT and have never returned. &A-aria itself has practically disa' .;aeared from Italy although there are occasional cases of malarial infection many of -&ich seem to have been transmitted oy injection. it is very interesting to note that labranchiae has disappeared from areas where it '&as very heavy in groxth and has not returned in qite of the continued absence of all control measures. PUTT+ Gel + swell repaid for the visits to the two institutes even though the payment I got comes in ,iart from tile inactivity to be seen in each piace regarding malaria; &viously the central authorities are not any more afraid of malaria and the instit3utes are d,ing on the /v- AL ,.y 20 new young m&n are ccming in azd the older men are doing nothing. Casini @J iZk.4 has a great deal of MJ t:je reduction of labranchiae in Sardinia which I should be pub has {Ilore information which is biologically of great interest but it may be difficult to get all of those responsible ..id.ESltz.. for bringing the inforrration to' b to Join in a single publication. ,;> ._ .* { Colussi also has observations on the dlsa;;;jearaixe of atropar#& from Corsica.) ,ia/wf Casini says he leacjersn-&%hat w ) tishaele#-& in \ today alLd may not be in tomorroy etc, ( Cascini is 53 but iooks much younder ad should be at tiork in the field some place, ) i J =i Lunch with the Lexises at lo Viaie =ounocampa@c Boma. LA must be 76 years old; seems pleased with Italy +c5 6s a place where.anti-coronary W ;re almost autorhatically available. ( 'Taxis $*tOd j The QperG, &rder in the Cathedral, Febru&y 3; dzave i-tome - On 1'~ Flight 114 at 12:45 2.m. krr. Beirut 16.00 $5 p.m. - Left Beirut i-j.45 p.m. after visit to :sfa+ Rug siiopO Taxi 5.50 (21; 0~s !;;2.&Jj Luarcation Ta.x (2:) 2.,%. L4'ebruary !+ : arrive aarachi. Kilitary IGq~ort 92&O - not met but fO~UXl room in &----.---..- >,Letro,clitan hotel. ; Find Dr. and Pirs. Go'xens of Belgium on tbe &ane; tileg are leaving for New Delhi for the A-c\ L+lhAbJA+ on ;' SU~.S:`.. j c: btochard and Cassanos arrive in the 2.m. to wreck us on us since ii:e had been expected here two days earlier than we ceme. uirner at Cassano+ a,artment. ;tnd xas a noisy bit, February 5 : Hove to $aff ii0USe ( -3LL at the $1:.! Nas only d,75;i-. /- February 6 : ted &ens, Siegel, Fred Bunting, drig. Lherif and Assistants; irnpossibie to get sassage to see Surlti in Pilldi triis xeek and decide it is useless to try to compete with tile norse SiioW iii iahore, and the rains alid snows w:lich are now occurri;ig in the Pindi area. At the office of Dr. Lherlif we cet an interpretation of the ,caragraphs of the agreement with government wiiich agrees fully with ours; arrangements are being made for us to have the L:;5000.00 rotating fund and to have direct contact with the financial officer in Dacca regarding expenditure of other funos for the laboratqr. February 7 : Long talk with Cal, ti)okhari, the one responsible for the devel- o$ment of the iVaticAn& liealth Ceilter at .Baxaii;indi. b. laeaiizes he needs he12 in getting architects witIn exserierrce in iaboratory conSOructionb 1 suggest he write to Dr. LLLI' to getting name and address of su~ertisor of construction for &l-I during many years who is riow working xith Gorgas :j . Remorial in Y &A4 i **ihk-s+ . . . . . . . . . . ..v. ' Meet Dr. Saddique, the little man G-til the beard,who is inter- LG. .-L ested in nutrition -&th ~a,vcek from the Ud'.i xho is here to help &e &&rition Survey of Last and :#est Yaldstan ( PL4I r'roject. ) $i;lally talk with kr, r'red bunting and Pir. Cassanos. ( FL says he has told :' a*&i-iorities that he is interested in saving Cholera Grous here as weli as xrouP from University of Maryland: that he eqects to use us for consultation and in tne meantIme eqects to ilel,) US all he ca;;. j y6 i is (iorizied bp the re;xrts of tile develoixlent of tile large medical and '- health center in i-L:di s Lce the exhaustion of national fwds on one project leaves a bludget dei'icit to be illade us by ACA so,:iteMere else. aid ( AL is cjbvious tmt il;~ls atter:pt to/'&x tile ecorloqy of any country inus-t be studies in over all terms of .xhat is available and how all of it is Pmve to iiome of Sr, and Pirs. ;ItocXdrd. Gail same afternoon on l4r. iling, the ;ir;zericari Consulate L%xeral, and on hr. il;d,iards and Gr. riilleil hho is to leave shortly for USA. iLllen advises seeing the Minister of liealth,Burki,as soo12 as possible; asks ii' 1 lUiilcW afil ;-.`tj,imqJjst ( 1 give li. 1. a good recommendation j; I also speak most highly of 2 Sto:le ;tid Suggest that L pePyJib~ before ir& ieaVeS for ~:'a;;istan. February s( : '20 degartmed of health to discuss meeting in Razralpindi to -&ich 5 %- Ur. K%sur has been Livited without consulation xith Cholera Laboratory& ( I&. b* 11. ri tLld me in hartzCI;i that a mecthg had been called for I;'ei;ruary 13th in iiaktialpindi to discuss xays and meails of taking care of epidemic aiseases. fi?>are;ntly this meetin, * rlas been stimuiated by the authorities of ilest Pakistan who want to know &qi the diagnosis of cholera seemed So late and Ithy so iitl;le was aoile to Grevent itsqread and continued exis- tence in rrest .'akistan. ) Dr. PikSur showed us ti his instr&tions to go wnlch indicate that the meeting is really to be a zenera one on pe- ventibie d; Isoase with special emphasis on Cholera. 1 indicate to Dol. kaiiii; that I feel I should be at this Pindi L meeting and,aut20rize5:ne to make necessary arrangements for an invitation from the Minister. i 'Ynis fails to arive by Friday ,morning at 10 a.m.8 P'ebruary..lG and I cancel the trii;, ) P * After Axkkxgx talking with Cal. kia tit k J5 and I call on the Liaison officer who says that I should be surgrised to hear a man with a beard and ;;earing a traditional (kathan) Wmlim ( hoslirn ) ca,: talting our tihere he does! ilfter he has promised to solve all of/W administrat' *r"" d\.#J .I ,roblems to our satisfactki, he unex~ec?,edly risks c,uestions regacrding , r;uro$e arid the i;L:t lie agrees -tie must have a iL,5CGG.CG fund Sunday February 12th : First visit after installation was by kr. and Mrs. Cnaries kii. Edwards. ._ February rrP 12 : i4a j o !Sen. Ryder n& in his office; stili out of tos,ii. Leave list of changes asked for in house ;iith qafanoff: &so mention these needs to art. tiauer. February 9 : it leaves me worldering ";he:i ,ec$i.e xork here* l;'ail +"o fi,,d a=;?; " povlsion for .re;zration of my office; find hey5 to one siae of my desk but not to the other. $'ilid :,a 222jer . ;&or desk ec:,ui;me:lt of any i;ind; :;o tele&one, LO nm t s on the floor, no sixxies on the tidows, no cali bell, nolAng tit bare furhiture. < Learii from JLS that he i;aid I.,di)O.i)C ior tile floor mat in i-15-s room and that ne bought fr~rn r \ersonal funds the cane .@,/l&? . .-; . , . . -q;j and armchair in his room. 4 ide- i;d Admihistrati~n~ that is in Learning about disease was as to do sornetning about getting rid yf disease. ( I insist on sticking to the i-r IL c , \c question of secretary rather than m. &z-x ug ori our other needs because this poillt I raised before 1. left two menths ago ! j JLS says lie spoke to drig. iiyder Illore specifically on De'cember t6tha Pn the afternoon ytiorir. with the typist we have and find he has some knowledge of r'itman s~~ortharid. iin the late afternoon with JS to the Commissary for the secozd t-me; ilk find no soda but everyLAng else we neyd, ( anti lots of c. peo$Le+H not Eil;e soda ! > - ?ebruarg lath : 'I - L.Jr, iGA3.r reports on nis treti t:; ?Lidi t.J atteiid the Cholera Pleetiixg callFd Oj: t,le i&xi.ster. `i'nose present zere : (1) C;ol. mih.ri,(L!) L)r. Pfajicl,:+de::,or of Bacterioioa- at iiLkitute of rrevehtive Xedlcine at Gilore, (3) Dr. rvazir :;hmed,Pi:rofess,or of S>idemioiogy and Yiostatlstics at Listitute of Preventive Nedicirie in Lahore, (I+) Dr. ikviab ~2.i Khan, nssistant Director General of Aeaith Services ( Deputy to Dr. Sharif ), (5) Dr. ii.ti. 'Palubda, Deguty Director , Heaith Services ( Uider drig, -:yoer j, it;) I)r. ' LL i;.ri. Mmsur , ('7) rng. ltafic,ue fihmed, with tne ,;est 1akistari Government. L!eeting;s on Ijth, li;tr~ and morniq of 15th: Cholera in .;iest Pakistan ; l'i`59 z 3 . I 3bO Naz - Diagnosed in Sialkot, close tc iidian border - DeLay In Diagnosis a&. delay in tELLrig goveriimedt O First official confirmation ;as on the 21st of Jwle - Zelieved tc; be ::ater bor:;e! LkrLtrai G,verhment a+ C, ~,arachi Lforxled of Cholera only about the middle of JLQ ! lagge scale vaccination as is usual in thBse si:;uatlons. Com.rrissioner in Lahore did not >Jailt to resort because of its effect on &xIustr;r and C;mmerce, :.otes on Ike meetkgs and learn that he has no doclirnezlts of ar;y kind. L;verytiling IS tr, be gut toptner by the Cnairmw including the recommen- datiofLs for goVerAnment. 1 ask ir:ti- to ge+re I'or me right &way a redort on the 'j-da3 meetings ,mttLg d.c;w~ as much as J' rle cai: remember of iJh2t tr2i:si:ired o 1. Lsture him that as time goes on rhe xi.l.i forGet certdkl of the details and that we can;lct afford to s;er;d be money and time f,or a tri, to kidi il, recent pars i;id.epild.erlt of a:, ~7 2~32 all ccr3,z;ll measures. 'i'he G2ister :ias declared tha.t he is cc:n~r,g to erad.icate mJ.aria i..'ILtil or ltiithout tii;? kie$ of iG!i; a 14iari.a Cmtrol 6sard has been set ;I,-` to s;l,ervise the job a;lcl tne irlatter is bei;;g taren e=;tirel;j; out of the Ink-ids of the regular health autnorities in the ,r;vii;ces, ( ,;fridi is, of course, on the Lhhml 3bard ). Thresholti 0Y vlsibilit~- P'ebnmr;r; hiL records mve been very slight but there is tl kkg hod for the Bacteriology rissistants to L.Q get tnepe instructions anci keep it recorsi i--t tkis ,oixt i Let distracted that a report m the effect of pseudirrnozas 4 1. cholerae. Li accord G.tii my instructions /J so f,ir;ished -;:or!; at home, XI6 a,ast ial;istaKl, L JfiGs assured that the ,xesent gxmmne,&, is a riiiitary Loveri-mer,t and has :lo desire to Lee, the xasteful ~lam211 cuctorn w; or otter important activity; i-~, fact the suzgesticx is made that we need i-at a ccjuiitrg fLlu&ed C)L-I reli$.ous ide:ititg! This I refuse to do. i ;oii;t out tkt it is dot :.XJ ,rivi&e t2 clclssify employees by the Degree of t:;eir reli$.ous dzvotisn arld tlxt at least during tile ~begiaxiq of the period we will start out 011 the basis ,roi,osec!; viz. 3&L to lcc`ii xit;? no t,me for iux!-L. the tid0tr.s retwx to the U.iLo, leave S~:.cca 03 t,le 21st. over the weexerld. &ll 0:; Xr Sordn Covell at the :nkAaria service; GC i:;dicstes sity at &li;re . Let the -Lssistant Director of the lllstitute ~10 is Lvolved i:i I;ecgii;g US ihiL,j>jp: ill r'irst,he says, he has the Pdnd~ assigned to ilim for xr creeds; (2j LLA 3 3, ne admits he cannot spend tilese funds iJji.thout spcific authorization i.;; our case; (3) he implies 1 have lio right to ~~~~~~ iiow mlxh has been s=;;ent for our needs and hobI muck is left; (4) he c,-uestis:,s our need for 1,. ty;;e\%riters; (5) he suggests that I should be wiliing to work in ai1 urider-develc,led-co';l,tr~~ is t.le ;)ea@ there do, fcr ;;tiLng arra.n;l;ements for xork of visiti:;~ ScieAists frslrt other cxkries Deca,use L;e did i>Jt nave the t linis needed for work (4) I ,;oi,lt out that olpr agreement is sith the GdL, and .de hzve beer1 ur,able to se-t a written ,rocedure for i;ettiq funds and materials; all arrangements betwee, the cTi#j and the 'X3: are unknown t3 us so xe have no way of knowing where Ad are to turn Iwhen ~;eed~suyiLies and staff/y,'& not fur,,ished. \5) i refuse to c-0 or1 j?is invitatio:l to XiAXE4 talk once more with Cal, I4allick and &< rr +.J* ik*der, sirice in the ,ast 13 days ; :lave t&L&d rtith him twice 1 -. ..? with fit iZ>.-., t; ..; -* Gal. pal- i 1 &', vdth 3rii;adier ~Qd.,r allo with $der ;ri~ti ~~ia,llic~ to "b -~orw+ \ jJ ki ,',\ ("i _ ,*ci~,t out that rek~;cirdi,l~ the matter of tp,e..rl-ters, the Goorer c .' a "F-f $ sent frx~ the beginn;iig; (7) I i:noicate freely to our good friexIs that the Cholera itesearch ti,boratory cannot work at all and Slould close down if we cannot devise a metnod to avoid delays from wnich Dr. Stockard has suffered. (8) 1 indicate we want cans-wer to JS request for writing ,roced-ure ;'or Ciloiera Research ,.,aboratory. ;irrivdl jiQ! 4x3 1320, planflfrorri -- liaraclii of i'aul & Debbie Acol, and Drs. AcCrum, --& iiissman and $arnet,&re in Yathan caps. cr 3 J.& '~a:;es me on tour of American Coixulate Geaeral Commissary, \i\ Dacca Farms_, and l~ew Market. - 23s signed on their coi~ditions. ) (1) 'I'ne Erector of the Laboratory silouid have control over, and should gay, all ICC,; recurring operating costs of the laboratory aild Cholera .,ard, LhciudinT salary and allowai,ces of staff; 3 (2) LIt the be&xi.ng of ea;; fii?_ancial year, the totai butigeted amount for recurring costs should/depssitsd to the accou& of the labora- tory, subject to ,ost-audit only. The Director af the aboratory will' render molltilly report to the Director, AeJith Services, i$31x,, ai' expendi- tures from tllis fx;d; i3> Under his ad~nistrati~autrlorlt~~, the Director should appove d.1 staff before a,;A:i;intment and shculd have the $ower to discharge or rec.;fiest tEtr;sfer of unsatisLactory em&oyees; (41 The Director xi.11 establish xorking hours and conditions of ern$oyment ensbiing CL to em&oy the best available staff either Pakistaxi or of other nationalities. (Transcription of page 40) Sunday, February 19th: Day spent at home with antibiotic treatment. Notes prepared before meeting with wii$; Dr. Hyder, Malti\k, and Es&&ni~~@$. &44#* $A-G What do we want in CRL? Bilateral ICA-Pakistan project? If so, I am not interested! If there is an opportunity to create a truly international unit in which a number of countries are work- ing together to solve the problem of cholera, I am interested in working out conditions under which Pakistan, the USA, and the United Kingdom, and other fun+s and staff, can be at. 17 a joint effort. But there must be freedom of movement of staff and funds and planning, which cannot occur under the present system. (1) 'To iieelth Department to talk with 14. Islam, Hydesand Mallick about financing of CL. lifter an ilourls discussion in which I point out several facts regarding the failure of the Cholera Laboratory to popess during the Gast 22 months, I ask -mitten summary of what we have agreed as a matter of immediate krocedure until such time as another ----+a._. agreement can be pepared and negotiated. An attempt is made to dictate this summary in our rresence but tAs ;?ttem$ left us even inore confused as to just how we shculd move. It is obvious that we are $not speaking the same language in referring to administrative matters. Isil said tnat under i1o circumstances ;,Jould it be ,ossiole for - us to hire staff above the sweeper level except government sanctions; to i,ed this I re# that we were not ready to turn US Government fundS&er to be spent under loczl sanctions. , \ piI spoke th;j.t steps are already being t&an to ,jut-#W * C'R.L 3( finances in my hands but that even rfhen I have them I cannot spend them except after approvai of G-L@. I see 20 great $/&f- %*q iI in gut doiyyrn here more of the long discussion since we are surposed to receive a written report of procedure. I (2) laul NicoD, daughter B&E @ebbie and Nr. Towie call in the afternoon and discuss some of the difficulties ti inherent in trying tJ wzk in Pakistan. Ku is obviously fully in sympathy with my reaction to the original bilateral poposal s made by A& in Latin tlmerica in 1942. (3) l)r- r'red WcGrumb, Dr. Sissmann and A. Ccl Barnett call at the laboratory for a long discussion of local situation; discussion /u&i fcb< ? wrLch contiiiued at 'Momin iiouse until after 2-m. The Maryland Grou,n wanted to know ;&at we had to offer or to object in res,ect of the Mary- land pgram and aiso our o&?-ion on a number of doints. ;;ith regard to the cooperation w:iich might be possible between the CL and the Mary- land Groud,I point out that we never want to do anything we can get ii?I - me else to do for us, that our principal interest is Cholera and that +-if while we may have tc work fr;,~l time to.time*on ot 9 er pobiems+iaciden- tal,y, we do not expect to make major W of any of them. 1 refuse to do renounce anyt4ing coms7 ,etely but neither &e I ask the Naryland Grous to / , T-23. renounce Cholera if tlrieg should be working in an area where Cholera exists. i try to give picture of ~$p~p~&i$/'#~~#~~~~ live and let live. Day at the CL t@.iig to clear Up (1) Decide work in the CR; is not a hazardous to gass on to government request from the two . ' certain goints : occupation and hence refuse bacteriologists for ssec- ial $ayme:its as those in tuberculosis iqards get. (2) Cali L&L's attention to fact that notrling is to come out of through this iaboratory except $$#b/off- 'ice channels; all requests for outside assistance must be cleared. ( 1 use for my text for the sermon L%'s request for equipment fr3m !f ti Shortt; also Yam's request for repint from the Royal Ljociety of Tropical Medicine, for which he nuw wants reimbursement. ) (3) zi& n;&; to see what can be done about tracing his request for materials wnich went through Lis office on the 12 of Jan. A.API makes arrangement, c to go 9ersotill.y to the Medical Stores tomorrow to see about this order. ( See note on February 23rd. ) (4) The Thailand &AT0 Cholera Research Project has become the ;iirnTO Medic4 Iiesearch Laboratory under an agreement between USA and Thailand through waich tne US nrmy bed. Service ( vdalter Reed Army Institute of Hesearch ) and the Tnailand Kinistry of Defense are to be the two active initialjd &articipants ! C4 fte;,ort of ll$r Survey Team - SLATU Troti. and Sub-trogicai Agri- cult,ure Research institute - December 8, 1960: I1 Since each country is so dde;;ly irlvolved with the mainte,nance ,roblem of su,pdrting its owx research, there is little enthusiasm for MT any po,osal which would make the country a 1 EC& contributor 1 to such effort. tiach country wants to be a f net receiver t . . .p . . . . . . There was no enthusiasm $rhatever for a centralized facilit;i -rdth its i)buTi stafr. (. \I, Xe;ort discusses&basic types of international research (1) bY cerltralized institute; (2) by yiecemeal su$,ijort of research in iildi- vidual countries ccordinated b;! central office. ( Lo-Ah Pacific Commission uses second method. ) a3 ( InternaLonal iiice Research Institute to be set us)- ---------__-____-___---- :,ustralia gave lo electric autoclaves to ThaiGovernment ,,; ' for AATO. ; i Dr. v'. Etierjee, Indian Inst. biochem. (j, tip. Med.,Calcutta 13 i;apt. Juius flbersori, i`kg UCl\i s.,Ij~r. Ae~arch Laton tibo- r&or&s, t40VWi x=- , I AUY . T`i tire Svasti LIoengsvsng, &'Cector of the University of Medical Scierxes. - .- ---------~-------------- long term commitm4t for e4g ..~5OO$KIO annually for operation of poject f ! ) rziMoli;: ilizatlon. Secretary (1) 'U;erl;?;in?: budget of $ 3OyOO for Director,/and Travel. +' (2) Give away buqet of $2Oc),C0C, $300,090 and from /` I ;-:3@0,000 to $500,000 in iater years. 6. &i/Lc;@ - Februay 196O/bi:-i(vi fei;ort on Visce$tow to Pakistan December, rqSY, January, 1960 - L.LIWSY survey. 11 li'he ,revalence rate of ieposy in iast Pakistan will reach +4vkL. . . ,4 or 100,000~120,00i) czses. Gwens ti HobertS( iiater tingineer ) on Feb. 21. Send for &fGI volumes - (1) (2) Control of plnutritlon in man. 6 r> ---------I_ .I. LLk &#L*L hl,$L* T/ 4 ~ ,J' '-&~-W.&;~v~cci.E&% Control of Communicable Diseaseso A moixoon ( Jlaie lfhh vo September. &~Ljacca 60~$,ciCOjq Chittasong 3Oti,OOO ,.eter-borne doi;uLation l,OJO,OO'3. Smaii~ox - since recorded Ilistory the Indian Sub+z.ontinent "q never free ! 19.58 - 15OjOO cases. Smallpox in hast Fakistan . Cases 1957 24920 1958 7'9060 Treatments 11055 58573 Lleaths largely under 10 years' age - Institute of Hyg. ? - If{ , N$haLi#ali . , Usoil partition of tieigal in 3$&j++ 1347 k, ti' formerly Last ijengaljhad no 1'i-i Institute nor laboratories, but depended on Calcutta. Institute built 1955-56. _------ ------A xbove notes from sa,er. eiltitied II Re;jort on Smallkjox Co:k.rol in :'aAstan- 8 Jan, 1960 - 4 Mch. 1960 - ,,;iO kegional Smalli;ox Survey Team. lk. A. A. Sidhejr and Pjr. 2. ,edermagM , I -----I --- 'Thailand Sai'Tti Cholera itesearch i'rsject - LGuarterly ReFort 1 July, 1960 to 3C, tieit. 1960 - Problems and Transportation,S('lkaining and liesearch. ------- --- FLmJiilCY 22 colltd ; Nr, ud;ar it. ijwens2assistant program E L i;coilomist, Uk!&/P ( Aerachi ) , called with sir. i-;oberts, Seater gesources A$.neer from USGM/Z Ga&&e& I gave ut{ens the situation as I see it; cd ask him to reLiort to Pk. Fred 3Juilting but not to ask for any action at the presek time; whhile talking to 0 about the discussioii with the authorities yesterday, a copy of the decision reached Isas handed to me. 'i'his document from Brigadier ti;der covers the folloVtig points (a) iL,5000 account is for contingency use only. jb) Under pesent agreement there is no xay to have freedom in hir- ing and firing sersonnei. (c) kecessary to set up autonomous 'body & in order to o;jerate / freely as Dr. Sopzr Gshes. (d) 'lo get results in the fi&d YLS should dralt; up tentative kroqam of operation outside the laboratory and ask for blanket sanction * which would prom e & free hand in F exseiditure and in appointment of personnel witn w laid down% Jr (e) If&. Nat&a 1 islam agrees to zz32& cons,*Finance Secretary re;;arding hiGher salary scale for Secretary Steaogr:q.Aier. if) ;$rd.ers are being issued for Director to becozle drawing and disbursing autnority for c~l;tL;ge~icy fund. Roberts assures me that all of the difficulties bie have had are irrherent in trying to .$fork in Pakistan. AS usual to ofTice with Dr. L ~`Naiailsur at 0830. (1) idud re;;orts on his survey of the sit-uatlon with regard to medical suijslies ordered Jan. 12 ; iti& says o`ur request &cas acted on rapidly by vt Jyyed Amqdls office and sent to Centralhedical Stores the next day after its recei;-jt. G.&i.;. the11 took its o-til time about doing a preference to those urgei& orders -m beneficiarie? were interested to come to C.N.2p and @ 4j&ii$? Since no one from ;CXL came>str,ne articles -udere set aside for us> some 2Gere &.$$f marked 11 not available 'I a;id t;lers the matter stood. &@I was able to bring back with him some of the sqqlies rleeded and will proceed to 5 ell JS how to go about getting the non-available items. ( I explained to JLS that pie ntnn had to take- an interest in tile movement of Rockefeller Foundation I;a;cers in B>azil and other countries of South Americay'. > `b) Try out a man who is VJorkiiig with the *malaria service as secretary ( j&, doss no.t Anow how to s;Jeii Lq$iish. ) (3) Taii: with JLS and tell him of qq feeling thti.t we are'not going to do anyti:ir;g useful here until we get the pesent agreelment modified. 1 suggest coi;ditions of the poblem of running the hoqital as gart of our poject, running the hos$Aal only- as wejneedk!Tp&nd not necessarily have f;ards for bo F h men and women ogerating at the same time. h' i4j Call on Nr. Chas. Awards by a Fpointment to give G the picture at the laboratory ; (aj Results ;tith authorities; a6 promised some conti,~ent funds from ;r~50G~.C)rJ fund'each month and some contingent money from regular Budget but no .rW$hire or fire '.l '3 t 3 to set heurs .and xages for employees. (1-I) I indicate that I nave not yet made firm decision but at the moment I am seriously considering recommending no further increase of activities until we nave a modified agreement with CO*: funds in the bank o In this w? Cii agrees comijletely. (e) ,earn that'F'L3 &.LS t4ls at high level.namely with Minister ;filc) sigped C$,;,;i'-$&'r () . Agreement,and has been pomised full su&ort from central government if needed. with h1s3 Cu offers full su>gort here $j@/~:5Z~ and offers X&XL 2$JQ2&& to take me to the Governor . ..n the near future. b id i ask CiS for assistance in our immediate adminis- trative needs and some one to help us xith problems of inventory, stock, records,book-keep$;g,etc. etc. i' A (5) Call on Sir Cordon Covell at ShaYlbagh H-,teljunder terramycin therapy. \ i t J Cordon ii;. ltunn +j%nd find he $$ has dermatitis ( eczema j about the k neck aild that N,~s. Dunn has a sinusitis, -------e--e-- # February 2.&i : (1) flan to attend my first staff meeting at i&/UX!!4. (2) Feb. 23 : rleceived first A?C Mail from Chevy Chase iost Office. (3) Learn Rusk is coming to S>iTd meeting in Bangkok in March, (4) Agar Owens becomes Chief of Local Currency and PL 4&J Funds Section in Karachi. 'The staff meeting 4;~s devoted C?iltilXl;T to internal affairs of the WA Coloi3y. 7 Dr. ji ,,ic 01 co,lzes to Momin Jouse far a,~ hour aid gives some zood advice so T-' regarc.ing working in tllis region. deceive 21'/ Lbs., 3 crates of .i,r i;'reight; i:;Cluding ty;e- a7 4, k. xriters, and two lrorelco Dictating NacLnes. & ( 2 sots dnma;e which su:seste th;t the shi.; freight will be cozdiderabl "t damqe~, ) 6 s3 r&k Dr. PIal?sur for details of : il> Cordon sanitaire for Cholera. (2j Details of +idemic Diseases 6Ct. Aat is I1 milage water I*? P r-f F~~NI&Y 25th : Dr. 5, xmted calls and assures me that everything can be i>rorr;e d out with a little ,latience. i indicate that i like the I.slam lad but SK says not to make a movI E u&i1 his &her candidates a,sear since he has had an advertisement in the pager this week. 'Tries once more to convince me that I cannot expect to work uider ideal conditions in Xast Pa&Stan. ILL the U'S SA silki American wcrkers ask t;leir secretaries for certaii; documents aL2d receive them from the files in a matter of minutes. This is not ;jossibie &zxz here and even Brig. Ryder often has to wait tdo or three days for a $&$! document to ~je searched out and sometimes it is #$ never found. <- 3~ says I am to become a @overnment Disbursing Officer but i.;AA-mates that this may not hei> too much. I goint out to S:i that the (3-L is eAirel;v different in conce;?t from ail their pojects in tiLs ;>art of the VGorld; that it is essentially international in scope, is not :,akistan institute but to find with the Governments concerned no &an for doing all that has iP-=T. out how to get rid of Cholera and then lxork in eradicating this disease. There is :o be done in the study of cholera here, '4 but rather to do witk which can be done 'best in field, l$ving for better for tile +rpo;e of establishing a &ermanent eoqQ$ed labcratories eLsewhere the final aild more basic peliminary acti- vities. ~iso it is not i;i.anned to establish here a large permanent staff but rather to set a &ace where interested ,arties can work either under their own drososai or under invitation from the GIL for a specific job. n the tha Dr dnd'1-r evening at Dr. Stockard's darty for the i"L;;s, 1;:e learn t : s. Leroy Burney are arriving tomorrow .for a t-k?0 or three 3 day visit with the :ialdaries. 'The Stockards garty began at 03 C9which is incoixenient for the Moslems since x it is their habit to break their fast duri;,g R,amsan 18 just after sundown ( now just about 13CO ) Athey need a deriod for rest and grayer. L&s. .Iyder and 14& iii i k were not there but would have come later if invited for 2O3G or thereabouts. ,l;mong those tiresent were Mr. Lizlg,, H.r, &L Nrs. &-wards, Paul Shuler, Ralph ii'~ueil.1, Nr. a Nss. Bergelin ( ;rith Texas University Group ), i!ir. & Hrs. Blackie, Hr. & tis, &vidsorl, Xr. G Mrs. Yam Kor&, Art Bauer Mr. C; Mrs, agafanof, I'aitinieri and Schaxabe ? of the Wlaria Survey of ,AO, l+r. & Mrs. fioliinger, LA H$Lwr, 14, lslam, xlut the 1: tried to gut the story of $ Cholera Zroject really is before Nr, Lng and later got into a very interesting discussion; with Sollinger r and Islam. Eoliinger told islam that ii, Goverrzne;it must learil to say research men enough to get goc,d ones; (b) Since the sus&y of good research men is ahays too small,goverxument must be ready to make individual arrange- ments :dth each ildividuai according to his merits and needs. ic; Government must be xi.l-Aag to consider research pojects very much as e grants-in-aid pojects, and assign a certain amount @ii ' money to be spent '/aid in during the year as the Dire0tor of the pojecty, q $j$$by A-- I% * may decide. (dj "Icvernment must learn that funds can be gotten frcm other sources once for researchjfi$p the frame -work for research exists. ( IL give the example over ~503',0!20 with six countries investing only $105,CJOOo i `7 aba Mrs. i'aul 5chuler i.Sirso Sam I4orch fidvisory Capacity) ,abour advisor. jEbW5WW Ytatistician 57 m, 2.y. katiul Islam 1-ai;istali-Fi;la,;cial : _ lkx. ikl~ o nr. L;ray ~;~ricul.ture ,;dviser :rt dauer iCl-l ndviser. Ur. iiksur. --------_a----------- :' (1) bictatio;2 z (2) ilead 3ack Mctation. i ! i (3) sdrite out in long hand. \ \ -I--- - `,, \ Get ,,..!O ~,,;ider~olo~~cal lle,ort. -------I_----- (1) Learn from i,altinieri that,Lir Gordon Covall continued to impove and left today as planned. frm 6aracni. (21 ur, 'i'aba is expected Acre on the first of harch. be iie,re Oil tile first. rrt BaL:er, J;3 and the ,k:~ds. Halaria Bradication Service X%M in the June budget boginrxing wi-th some 2 KLLLon + tAs y-ear. The A'~iSQ IW5 fund ~z.3.L be sunk in tnis way! ( There are some special CJnsidera'ticns during the transitii;;lai j&& grlase wher:bx cou&ries buyiag a certain amount get 75 )$ credit against in otiler gayments but/any ,case ali countries are now goins to be assessed fzr an eradication I pogram for the first time in riistory, In the long ruri this is apt to be a stronger situation than if t?e 2~23 fun; were to be spread, > :;.e ra,ortei ic the Medical Yuperin~wcle~~t of the Civil I;0s&td. ,ater o.Ller cases fLi.lo-kaed. >'lrst at';ern$s to isolate VO choierse failed; ,ositLve restiits Vueri-: reported OLL.~; x1 the ii.1 of JJme. ,.ie rLedicai lirectorate r~as ilotified a,d sdvised that xater- Lion to uiorki iC" _ ; .tours of goveriuner;t services; (2) iieiztiun to workLg :~!ours of ICri; (31 ilecpective reiil;im of coutry; jL+) E~St~LbilS!-1 same xurz for lmericar; and ;'ersoLxei, --------------- 31 February 27 1961. Dacca.. . . MS---. ,->*;- --_ Dr I.e.e-.--%,m-ey comes to the laboratory in the afternoon and is given a s).raight account of the present situation in the Cholera &search Laboratory,i.e; one of complete dead center stagnation. LB is shown a coopy of my repart to Dr. Smadel. At the end of theafternoon, after visiting the installation on the upper two floors, and at the moment of departure LB lets us #now that he is here on a consultant basis with the USPHS and will be reporting back to Washington. I then inform him that we had no notice of his coming and that we were at the air port to meet him on the basis of casual information from friands on the eve of his arrival. (It is obvious that LB is greatly disappointed at IThat he has seen here since he Fad been led to believe that this project might put the NIX in business somewhat on the basis of a NAMRU operation in Egypt or in Taiqan. I point out that the Seato Medical Research Laboratory in Thailand is to have a Walter Peed Unit of seven&an persons, whereas the plans for this operation call for a total of or&y three from the United States. By no stretch of the imagination is it going to be possible to become an effective operating unit in the near future on this basis.) To dinner at the Shabagh for the first time as the guests of Mr. and Ws.Davidson, who are here representing ILO. (&. kvidson was for mmny years with the Shell Oil Co, and has among his guests, Mr .a:!d tis, Kahn, the local chieP for Shell. Mr. Kahn assures me that he can arrange with & local garage to furnish me with the high test gasoline needed for the proper carburetion in the MB.; also informs me that two MB 220 S cars have just been im@ed by an impotiant family here.) *): 8th. Dacca. Early morning visit with LB t4f o the offices of Brig. Hyder and lick, where we also meet Dr. Sayyed Ahmed. LB expresses his disappointment with what he has seen at the laboratory and expresses the hope that this project may be activated in the near future..... I explain to Brig. &der that I must meet the Minister of Health in the near future; if it cannot be arranged during his visit this week, I ask him to set a date in the near future on which I may see the Ninister in Karachi or Bawalpindi. Leamthat LB has already made arrnngements to call on the Censul Gen. and on Mr. Edwards so do not insist on making an official p resentation myself. Talk with LB somewhat more f&y thah was the case yesterday, explaing that the situation here really requires drastic action involving the spending of $$$ if anything is to be done this year; that the total committment of the GOP is only some forty five thousand dollars a year; that this is the first experience I have had in an operation where the prestige of the United States Go::-erment was at stake in getting something done rather rapidly; that possiblby @ should con- sider using up the dollar fund which has been reserved to cover expenses until 1963 for such things as cannot be purchased with PL 4-80 funds and that we should be ready to use these funds faster than had be n planned in order to get the job done.. (I did not tell LB so, since it might cause an echo in his mind regarding previous discussions of ano&er prolem, but I personnally be'ieve the most import- ant thing the Gop has to contribh;$e is the oppplatunity to study cholera in its natural habitat; that this opportunity is invaluable and that we should not hold up operations because of the difficulties in financing what we need to do with government funds. Mr. Murphy from ICA Lahore calls and tells us something of the work he has been dning since 1195'7 in this country, and something of the situation in VP regarding cholera during the past year in so far as he has come to know it. ti:rte before maiLiris the rou;las of the bulkSi+ :is iie visit the office of JL & JL; ) 1 Lciicate that tae carpet and the easy chsirs ..ere gurcnaced tier~o~~aiiy by- JL (J,S), ..he;; we visit t:le third floor, i ,sir,t sut that ;;e iiave rio I:idiie;~ iiuitll v~iLCh t- 1 I'eed the a,&>ai,s ad. th;~~ ws nave LA3 dscent cqes for teem ~Ldmizietrative officer to foILloT;? us all requests through government chatiels Llrl-c.l such !Jb-.h% v&Jfi h :i 'r ]vp.:i,cri 6'rH - ( Contd. j ( Previous continuation r~as not firund in tne notes ) J' &3 '$T:: he has talked ;;ith LX and has lc;ard, that