The Peace Corps job description provided to prospective volunteers explaining the Smallpox Eradication Program in Ethiopia seemed too good to be true. As I read it again and again, I became more and more excited about what sounded to me like a paid two-year hiking and camping trip in Africa:

Usually there are no roads to the infected area, so you must walk or go by mule. In fact, this is probably the most important qualification for the job—love of the outdoors and hiking. Most of the work must be done away from the nearest road, sometimes as much as a week’s mule ride just to get to the area. You will go to places where no health worker has ever been before. The job can be very physically uncomfortable, for instance, sleeping in the back of a car after just having spent two hours trying to dig yourself out of a mud hole. But, if you like seeing a full sky of stars, and not hearing a car or airplane for weeks at a time, then this could be a job you would enjoy. (Peace Corps Ethiopia, 1974)

I didn’t know the first thing about smallpox or of international eradication efforts, but I loved the outdoors and camping. After graduating from college, I had spent a year working as a medical technician in a small two-person laboratory serving a largely indigent community in inner-city Baltimore and knew that at some point I wanted a career in health care. This Peace Corps program seemed like a perfect opportunity to combine my love of the outdoors with getting experience as a health care worker.

After two seasons as a ski bum, I was in reasonably good physical shape and ready for a two-year adventure. So, in May of 1974, I sent in my application to the Peace Corps and was champing at the bit by the time I received my invitation to Chicago to learn more about WHO’s Smallpox Eradication Program and the Peace Corps’ role in its implementation.

In Ethiopia, however, WHO epidemiologists were bucking under the weight of the pressing concerns that had precipitated the very announcement I had found so exhilarating. The country’s Smallpox Eradication Program, which had begun operations in January 1971, was struggling to maintain a viable workforce. While WHO proudly and vocally supported the lofty goals of the program, the reality on the ground was that the program had just a handful of trained epidemiologists. Worse, there were only around thirty small teams of surveillance officers and vaccinators supporting those scientists. These thirty teams were charged with covering a country almost twice the size of Texas with a population in 1974 of almost 32 million people.

Before the program began, reports indicated that there were few cases of smallpox in Ethiopia and that the variety of smallpox in the country was much milder than that found in India and other countries in South Asia. As a result, WHO epidemiologists had arrived in Addis Ababa in late 1970 hoping their new post would provide some badly needed relief. The scientists had suffered traumatic experiences in their previous placement in India, where they’d found themselves in the middle of a civil war that ultimately led to the establishment of Bangladesh. Unfortunately, they would soon find that Ethiopia would not offer them the peace they craved. By 1974, they not only were contending with staffing issues but also were growing increasingly disheartened with their mission; the political situation in East Africa had begun to deteriorate around them, and persistent drought had created health and social issues that overshadowed WHO’s goal of eradicating smallpox from the world. Making matters worse, instead of the isolated pockets of smallpox they were led to believe existed in Ethiopia, they had arrived to find thousands of cases widespread throughout the country. So, it was only adding insult to injury when the program found itself constantly struggling to recruit workers willing to work in a desperately poor country under harsh conditions.

Eradicating smallpox from Ethiopia met with many early challenges. The country’s Smallpox Eradication Program was underresourced and understaffed. WHO epidemiologists found it particularly frustrating that the Ethiopian government never had much interest in smallpox. The Ethiopian Ministry of Health dedicated most of its resources to the pressing problem of malaria eradication, with the Malaria Eradication Program employing around 8,000 workers. Those in the malaria program viewed the smallpox program as a threat and openly opposed the sharing of resources or personnel.

In anticipation of manpower shortages, the director of WHO’s worldwide Smallpox Eradication Program, Dr. Donald Henderson, negotiated with the United States Peace Corps to provide volunteers to work with the Ethiopian program for two-year tours. The initial cohort of fifteen volunteers arrived in late 1970 and were sworn in, making them ready to begin field operations in January 1971. With annual reinforcements planned for each of the subsequent four years, the initial cohort would be reinforced by twelve additional volunteers in 1971, and seventeen more in 1972. By the time the fourteen volunteers of the 1973 cohort arrived, the program seemed to be running smoothly.

Meanwhile, however, the political situation around them was not faring as well. As conditions grew more perilous, the Peace Corps gave the members of its 1973 cohort the option to terminate early—after being in Ethiopia for less than a year—or to transfer to a program in a different country. Of the fourteen volunteers who arrived in 1973, eleven took the offer, leaving only three. At the same time, members of the 1972 cohort were finishing up their two-year tours, and only a couple of them elected to remain in their posts. So, by June 1974, the Peace Corps smallpox workforce had drastically dropped from more than twenty-five to just six, with a vast area of the northern highlands still unexplored. The program urgently required fresh recruits to join the distressingly small number of WHO epidemiologists, Ethiopian sanitarians and health officers, and the few remaining foreign volunteers.

The Ethiopian Smallpox Eradication Program had come so far, but there was an ominous sense of time running out amid a prolonged drought and worsening political turmoil. According to a 1974 report by the Food and Agriculture Organization of the United Nations, 300,000 people, largely rural poor in the northern provinces of Wollo and Tigre (also spelled Tigray), perished during the 1973–74 Ethiopian famine. The political instability and student protests provoked by the famine ultimately became catalysts for the overthrow of Emperor Haile Selassie in September 1974. There was a sense of desperation among the smallpox program’s leadership, even as the scourge of smallpox that had plagued the planet was on the run. The last vestiges of this once-dreaded disease were largely confined to remote areas of Ethiopia, but without a reinforced workforce, all progress gained might be lost.

How could WHO be sure that there were not hidden pockets of smallpox waiting to surge across the country once again? Many parts of Ethiopia were free of the disease, so the strategy had shifted to finding small outbreaks before they could spread or add burden to the country’s nascent health system. Most of Ethiopia’s population lived in tiny, scattered villages made up of small groups of huts scattered across the central highlands, an area of rugged mountains and deep ravines without roads. In addition, a huge area of mountainous terrain in northern Ethiopia was completely unexplored: Were there last vestiges of the disease there, lying in wait for the right moment to pounce? WHO needed to find out, so it organized a helicopter campaign they named “Operation Crocodile” that was set to start in late 1974. The success of this campaign would be in large part dependent on recruiting a new cohort of PCVs.

The 1974 Peace Corps cohort—my cohort—would be faced with the drudgery of spending weeks at a time encountering a never-ending list of diseases and illnesses brought on by a prolonged drought and an almost nonexistent health system. But, ironically, not encountering any smallpox. My romantic visions of hiking and camping in Africa would fade under the beams of the burning sun as I moved from remote village to remoter village, searching for needles in a massive haystack.