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Some Positive Directions in Public Health?

This is not a new assessment, but it’s fairly clear that the well being of independent science and public health policies fluctuate depending on leadership in Washington. Will Obama make a positive difference? He has stated that an ideologically based science that predominated under Bush will end with his administration. It’s early, but maybe there are some optimistic signs.

Below is a narrative of my interactions over the years with the U.S. Centers for Disease Control and Prevention in Atlanta, Georgia, otherwise known as the CDC. The CDC, with all its many scientists, appears to be rather like the canary in the mine. Whatever happens politically, culturally and ideologically in America is in some way reflected in the CDC’s policies and public health outreach. And, a lot of secrecy seems to prevail in this work with occasional overt intimidation.

The CDC was created in Atlanta in 1946 as part of the U.S. Public Health Service to combat malaria. In 1947, it paid Atlanta’s Emory University $10 for 15 acres of land to create its permanent headquarters on Clifton Road in the Druid Hills area of DeKalb County. The benefactor of the deal at the time was the powerful and now deceased, Robert Woodruff, chair of the Coca Cola Company.

Starting with a budget of $1 million in 1946, the CDC’s budget is now $8.8 billion, has thousands of scientists and public health professionals and is engaged in a vast range of scientific pursuits and public health projects throughout the world. It is now part of the U.S. Department of Health and Human Services. On it’s website it states the CDC’s mission is “Collaborating to create the expertise, information, and tools that people and communities need to protect their health – through health promotion, prevention of disease, injury and disability, and preparedness for new health threats.”

Who’s to know all of what’s at the CDC or what harbors in its cracks and hallways, but in addition to all its health care outreach, programs on nutrition, its sexually transmission disease work, and much more, it has the smallpox virus somewhere in its laboratories and other deadly and dangerous germs and molecules are there as well.

One way or the other the CDC has featured in my life. While I have lived in many countries and many cities in the U.S. and the world, the one place to which I have always returned is the Druid Hills area of DeKalb County in close proximity to Clifton Road and the CDC, which even now is a ten-minute walk from where I live.

To begin the discussion of the CDC I, oddly enough, need to start in Kuala Lumpar, Malaysia. In the 1970’s I lived in Singapore. On one of my trips to Malaysia, I happened upon a British scientist who told me he was in Malaysia to study the deficient diet of indigenous Malays who lived in the Malaysian jungle.

Sitting with him in the old train station in Kuala Lumpar I was reminded of the English writer Somerset Maugham whose 1920’s trail I always seemed to follow in Southeast Asia, from Singapore to Vietnam. The train station with its high ceiling, overhead fans and large stuffed chairs evoked the British colonial architecture and mentality that also reeked in this scientist’s mission. He told me that his study of the deficient diet of the Malay aborigines had been aborted because, he said, it was one of the best diets he’d ever encountered.

The diet of these hunters and gatherers included nuts, roots and vegetation from the jungle that, combined, was incredibly nutritious and vastly superior to the English diet. No surprise there I must say. Most any diet would be superior to the English meat pies, fried fish and chips, and sweets. Because of this finding, my scientist friend told me he had to completely change his hypothesis to justify his research in Malaysia. I don’t know what triggered the research in the first place, but at least he was willing to admit the colonial arrogance of assuming, in the first place, that the Malay diet was deficient as if whatever came out the west was best.

My discussion with the British scientist revealed that we had something in common – the Centers for Disease Control. He was a friend of Dr. David Sencer who, at the time, was the Director of the CDC and who had recently purchased the house where I grew up in the Druid Hills area close to Clifton Road, of course. So here I was in Kuala Lumpar with, no less, a CDC connection. This discussion in Kuala Lumpar about the CDC was the first I’d had in depth, but that would soon change.

Once back in Atlanta later in the 1970’s, for one reason or another, I seemed to find myself at the CDC for forums or to visit friends. From the 1970’s up until the infamous September 11, 2001 attack on the World Trade Towers, the CDC was a fairly informal place to visit. Then, suddenly, everything turned upside down.

But let me describe how it was. The CDC building on Clifton Road is huge. It has floors above ground, but then there is the basement, the sub-basement and the sub-sub-basement.

At the time I was both a student and researcher in medical sociology, so I was always seeking experts in various fields at the CDC. You could go inside the building and meander around until you found who you were looking for. I would often find myself seeking people from floors high up and then down to the sub-basement without restriction. There were probably some areas where I couldn’t go that were filled with dangerous microbes, but I preferred to stay away from that anyway!

In the past, you could park your car outside the main CDC entrance on Clifton Road for an indefinite period. In fact, official or restricted parking at the CDC was at first not available. You just parked somewhere in the huge parking areas behind the building. Then there was ultimately a parking area set-aside for visitors separate from employees. You told the guard in the parking area you were a visitor and you were in. Simple as that!

I remember when the CDC first started its “flex-time” in the 1980’s when they simultaneously implemented time cards. A friend of mine at the CDC commented, “If you’re going to have flex-time the assumption is you need to trust people, and not add more restrictions with time cards!” Then in the 1990’s, I was told that a policy was created requiring people to email memos rather then walk to offices to share information. I guess CDC officials thought emailing would be more efficient because people would spend more time at their desk working rather than socializing. But there were all kinds of complaints with this change. Many employees, I was told, wanted to talk with human beings rather than stare at their computers.

In the 1980’s I used to visit one of my sociology friends, Bill Darrow, who worked in the CDC’s “Sexually Transmitted Disease” (STD) division. Bill was a great-nephew of the renowned attorney Clarence Darrow of the Scopes or “Monkey” Trial fame from 1925. There were always great stories from Bill. Needless to say, STD research reveals enticing observations about human behavior. I remember one evening talking with Bill in his CDC office around 7PM when the phone rang. It was a man from California. Bill talked with him at length. He was in his 70’s and had managed to contract herpes, from sexual behavior of course, and wanted to know what could be done. As there is no cure for herpes, Bill told me later that he wasn’t sure whether to congratulate him or tell him he was sorry.

At that time I was seeking a topic for a master’s thesis. Bill advised me to use data from the CDC. He had access to the largest sampling ever compiled of questionnaire responses from older gay males (over 50) in America. I took his advice. Older gay males became my topic and I managed to dispel some myths associated with older gays. Older gays, for example, are generally thought to be socially isolated. But this, I found, was dependent on how long they’d been openly gay. In fact, these males tended to have social relationships in both the gay and heterosexual communities and generally have what appeared to be a far more engaging social life than gays who had not been open about their sexual orientation. As their social contacts tended to be impressively diverse,
I also speculated that these openly gay elders likely had a better social life than most heterosexual males their age.

Anyway, that’s some of what I gleaned from my CDC data. Had they known, the right wing in Congress would probably have dismantled the division or shredded the questionnaires.

While I was engaged in this research I seemed to become steeped in literature on a wide spectrum of sexual behavior, be it homosexual or heterosexual. This included on occasion research articles on abortion.

It was the 1980’s and to place this in context, Reagan was in the White House with a “pro-life” anti-abortion agenda. I knew there was a change at the CDC under Reagan. It was something you could almost touch, but I was not privy to all the political and policy changes at the CDC.

Then I came across a reference to an article in a Christian medical journal about delinquency and mental problems resulting when children are born and not wanted. The article inferred, and not overtly I might add, that because of the universal problems of unwanted children in which intervention rarely if ever works, women should not be denied abortion. There were a number of authors listed, one of whom was identified as a CDC scientist and I wanted to talk with him. But first I wanted to read the article as I had only seen the summary comments. So I went to the Emory University library for the journal and all issues were available, except the one with the article I wanted. I then went to Emory’s medical school library and the issue was missing there as well. I thought this was strange as I went back again and again to see if the issue I sought was back on the shelf and it never was. Finally, I ordered the article from the publisher.

As it turned out all copies of the article had been removed from the CDC (I was told that when making an inquiry) and I was not able to find the scientist. I don’t know if the Emory libraries were in league with this effort to deny circulation of the article, but it was nevertheless true that the issue in question was missing. What kind of freedom of expression was this? It felt like an inquisition of sorts and, as is often the case, issues regarding the health of women were central to this repression.

Only years later, when I shared my story, was I able to confirm from professors in Emory University’s public health division that this was, in fact, the work of the Reagan administration. I don’t know, however, what other research was denied the public, how many other researchers were impacted or the chilling effect these policies had overall.

The CDC has also served as a center for international sabbaticals and interactions for scientists and physicians. In the 1980’s during the Reagan years and the 1990’s under Clinton, I was involved in the anti-apartheid movement. During that time, one of my friends involved in the movement was Julie Cliff, an Australian physician living in Mozambique, who came to the CDC for a lengthy sabbatical. Others I knew from South Africa, Zimbabwe and, I’m sure, from throughout the African continent, came as well. But this was largely in the Clinton era when we saw more visitors generally from Africa who were touring the South or the U.S. generally. The international connections can be extremely important. Julie, I know, made invaluable contacts for her future work in Mozambique, including Helene Gayle who was at the CDC then and now heads CARE International here in Atlanta that fights global poverty with an emphasis on women.

One of Julie’s friends, who I met, was a physician from England who had worked for years in Africa. While working with the CDC she became involved in the CDC’s inoculation program in the rural South. I received a rather frantic call from her when she returned from one of these trips. She said that in south Georgia, where they were working with local physicians, they interviewed health care workers on public health conditions in the area. When she arrived home, she listened to the interviews and was surprised. In fact, when the CDC folks had left the room where the interviews were conducted, the recording machine had, unknowingly, been left on while the physicians and others continued talking. I gather this was information they did not want revealed to the CDC staff.

What concerned her was this: on the tape the south Georgia physicians and others said they were not sure what to do about some of the black workers on the large plantations in south Georgia. They said they knew that many of them had been kidnapped in downtown Atlanta by plantation managers and taken south to work in the fields. Similar to the conditions described by David Blackmon’s 2009 Pulitzer prize winning book “Slavery by Another Name”, these workers were paid meager salaries, kept in debt through accommodation and food expenses and found it next to impossible to leave. The physicians were confronted with moral and legal dilemmas, and, on the whole, my English physician friend understood that they were not going to risk their jobs or standing in the community by exposing the system.

I asked her if she wanted to talk about this on my radio show. It took some convincing, but she finally agreed. She was nervous, however, and used a pseudonym.

I had virtually no contact with anyone at the CDC during the Bush years and was not aware of anything-worthwhile happening. The only contact during this period was with the CDC communications department. In the late 1990’s agriculture and food security activists were aware that agribusiness and biotech companies, the likes of Monsanto and Cargill and others, had pooled millions of dollars to counter the anti-GMO movement throughout the world. Suddenly we heard criticism of organic production; that it was not safe to eat.

During the Bush administration a press release appeared from the CDC warning people about organically grown foods. I called the CDC communications department for an explanation. The press release was a fabrication, I was told, and was never released from the CDC. The poor woman had been inundated with calls. I asked her what she thought of organically grown food. Her response was that “there is nothing to say, but like any produce you need to wash it before you eat it.” Fair enough. I still don’t know if the release was, in fact, from the CDC. Like any agency in the government, there seems to be a variety of opinions and positions and those who will to comply to pressure against their will.

Now, since January 2009, we have the Obama administration and suddenly within Obama’s first 100 day period, I began to receive calls from the CDC that journalist Michael Pollan would be speaking, followed with a panel of CDC scientists. Author of “In Defense of Food”, “The Omnivore’s Dilemma” and other books, Pollan’s message is a radical departure from America’s agribusiness monopoly and food system propaganda. Pollan, in fact, says that America has produced a food system that makes you sick. He says if you’re shopping in a grocery store only purchase food in the periphery of the store where who you find the fresh fruits and vegetables rather than the processed food that makes you sick. In other words, eat like the Malay aborigines as much as possible. His presentation at the CDC was refreshing and what appears at the outset to be an encouraging sign. I venture to say that Pollan would never have been invited to the CDC with the “pro-corporate” Bush in the White House.

Following Pollan’s presentation I was then informed that the Senate Agriculture Committee would be holding a hearing on the “Farm-to-School Initiatives in the Child Nutrition Reauthorization” program. I attended. With Senate Agriculture Committee chair Tom Harkin and committee member Georgia’s Senator Saxby Chambliss asking questions, the packed audience heard from USDA representatives, physicians and a farmer about ways to improve nutrition in the school system and provide healthy nutritious food to our youth. Harkin said he wants to take soft drinks and unhealthy snack foods out of the schools. A good sign. We’ll see if he’s able to battle American business on that one!

But, as I said earlier, since 9/11, security changes at the CDC have been immense. Maybe being able to roam about the CDC where smallpox is in laboratories is not a great idea. But how much security is necessary? For one, the front of the building is completely blocked off. When I went to hear Pollan, I needed to drive my car to a gate, get out of my car so it could be searched inside, in the trunk, under the hood, and I needed to provide identification. Then I went through security again in the building where the lecture was to be held and where I signed in, received a visitor’s badge and then came to a telling me that I cannot precede any further without being accompanied. They didn’t seem to worry about that directive.

When I went to the CDC a few months later for the agriculture hearing I needed to do all the above with an added treat – driving close to the gate I was told to drive exceptionally slow as there were cameras installed on the pavement to look under my car.

What can I say? Is this progress? Did the CDC need more security? Maybe. But I admit I long for the old informality of hanging out with Bill Darrow in his CDC office at 7PM with my car parked in the front of the building. It seems clear that we’re incredibly paranoid of each other and probably will continue to be so for the indefinite future.

Overall, and not surprisingly, it also seems clear that science and pubic health policies are definitely impacted by who is in the White House and in Congress for that matter. So far, in these first few months of the Obama administration, though my exposure is yet limited, there appears to be encouraging signs at the CDC on both these fronts.

HEATHER GRAY produces “Just Peace” on WRFG-Atlanta 89.3 FM covering local, regional, national and international news. She has been a part of the food security movement for 18 years in Africa, Asia and the United States. She lives in Atlanta, Georgia and can be reached at hmcgray@earthlink.net.

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Heather Gray is a writer and radio producer in Atlanta, Georgia and has also lived in Canada, Australia, Singapore, briefly in the Philippines and has traveled in southern Africa. For 24 years she has worked in support of Black farmer issues and in cooperative economic development in the rural South. She holds degrees in anthropology and sociology. She can be reached at hmcgray@earthlink.net.

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