Ten Lessons in Public Health: Inspiration for Tomorrow's Leaders

3. Forget the Job Description

15 LESSON 3 FORGET THE JOB DESCRIPTION Anyone who has spent a few nights in a tent during a storm can tell you: The world doesn’t care all that much if you live or die. anthony doerr On October 16, Dacca was warm and humid, but not unbearably so. We were hosting a dinner party that evening, but we thought nothing of the darkening clouds and wind that began to build in the late afternoon. It was a typical day during the late rainy season, and it began to rain just as the guests arrived. Soon the wind and downpour seemed heavier than usual, but dinner went well, and after our guests departed Jill and I watched the wildness of nature from the protection of our covered veranda. By early morning the storm had passed. The sky was clear blue and filled with the huge white cumulus clouds for which Dacca is famous. The storm had done little damage, at least to Dacca. Two days later, disturbing rumors, and awful photos, began to appear on local posters and in the newspapers. The storm had caused widespread death and destruction in the coastal villages to the south, bordering the Bay of Bengal. The southern half of Bangladesh has a barely perceptible 16 TEN LESSONS IN PUBLIC HEALTH gradient of 1 inch per mile. Much of the land on which rice is grown along the Bay of Bengal is submerged during the rainy season (June–October), none more so than the mud flats (“chars”) bordering the bay. People should never have farmed these low-lying fields, let alone lived on them, but intense population pressures ensured that they did. These mud flats had received the full force of a wall of water whipped up by a cyclone in the Bay of Bengal, the same storm that had given Dacca the memorable, if brief, downpour. Communications with the affected area were badly disrupted . A group of concerned Bengalis and expatriates collected food and relief supplies, which were loaded onto a small ferry leaving Dacca for the south. I and a few others went aboard as well, to distribute the relief supplies and lend a hand. We were soon headed south. At the end of the ferry line, our small band hitched a ride on a passing patrol boat. Its captain brought us deeper into the affected area. We finally arrived at our destination, the isolated island of Manpura , in the dead of night. Before the cyclone, Manpura had been a cluster of villages housing about 30,000 people. We arrived to see a shore barren of everything except bloated bodies—both human and farm animals. We found a clearing along the coast, unloaded our cache, and slept among the supplies (and bodies) to prevent looting. I’d acquired what few relief-effort skills I possessed second hand, from the reports of fellow EIS officers assisting refugees during Nigeria’s Biafra conflict. Regardless of “generally accepted principles of conduct,” most relief workers discover that the strongest (typically young men), not women and children, inevitably make their way to the head of the relief line. As a precautionary measure, we deputized local male villagers to assist us in organizing our efforts. We sorted our supplies, now protected by a circle of men with FORGET THE JOB DESCRIPTION 17 lathe sticks (long bamboo poles). Next, a large open area was cordoned off in hopes that supply planes might use it as a drop zone. Lastly, the local populace was lined up, women and children first, to receive our meager offerings. These were distributed without mishap. Around midafternoon a large, lumbering C-130 cargo plane passed high overhead. To our surprise it circled back, again and again, at lower and lower altitudes. This seemed so much like a rerun of black and white World War II movies that I couldn’t believe it was real. Finally, the plane began a low-level pass—at which point half a dozen villagers broke through the ranks of the deputized guards and ran to the center of the makeshift drop zone. I could only imagine the disaster if one of them tried to catch a 100-pound bag of rice dropped from 500 feet! The deputized guards rallied, the villagers were chased from the field, and sacks of rice landed without mishap. Within half an hour we received a second surprise. A helicopter pilot had been fruitlessly...