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AMERICAN DIAGNOSIS with Dr. Céline Gounder

KFF Health News and JUST HUMAN PRODUCTIONS

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“American Diagnosis” is a conversation about some of the biggest public health challenges across the United States, with insights on topics from teen mental health to opioids and gun violence highlighting the voices of experts and people on the ground working for the health of their communities.
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EPIDEMIC with Dr. Celine Gounder

KFF Health News and JUST HUMAN PRODUCTIONS

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Eradicating Smallpox: The Heroes that Wiped out a 3,000-Year-Old Virus One of humanity’s greatest triumphs is the eradication of smallpox. This new eight-episode docuseries, “Eradicating Smallpox,” explores this remarkable feat and uncovers striking parallels and contrasts to recent history in the shadows of the covid-19 pandemic. Host Céline Gounder brings decades of experience working on HIV in Brazil and South Africa, Ebola during the outbreak in New Guinea, and covid-19 in New York City ...
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In 1975, smallpox eradication workers in the capital of Bangladesh, Dhaka, rushed to a village in the south of the country called Kuralia. They were abuzz and the journey was urgent because they thought they just might be going to document the very last case of variola major, a deadly strain of the virus. When they arrived, they met a toddler, Rahi…
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The 1970s was the deadliest decade in the “entire history of Bangladesh,” said environmental historian Iftekhar Iqbal. A deadly cyclone, a bloody liberation war, and famine triggered waves of migration. As people moved throughout the country, smallpox spread with them. In Episode 7 of “Eradicating Smallpox,” Shohrab, a man who was displaced by the …
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Global fears of overpopulation in the ’60s and ’70s helped fuel India’s campaign to slow population growth. Health workers tasked to encourage family planning were dispatched throughout the country and millions of people were sterilized: some voluntarily, some for a monetary reward, and some through force. This violent and coercive campaign — and t…
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In spring 1974, over a dozen smallpox outbreaks sprang up throughout the Indian state of Madhya Pradesh. Determined to find the source of the cases, American smallpox eradication worker Larry Brilliant and a local partner, Zaffar Hussain, launched an investigation. The answer: Each outbreak could be traced back to Tatanagar, a city run by one of In…
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At noon ET on Thursday Sept. 14, Epidemic host Céline Gounder and her guests will come together for a live web event. Click here to register for the event. In Conversation With Host Céline Gounder: Helene D. Gayle, a physician and an epidemiologist, is president of Spelman College. She is a board member of the Bill & Melinda Gates Foundation and pa…
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Shahidul Haq Khan, a Bangladeshi health worker, and Tim Miner, an American with the World Health Organization, worked together on a smallpox eradication team in Bangladesh in the early 1970s. The team was based on a hospital ship and traveled by speedboat to track down cases of smallpox from Barishal to Faridpur to Patuakhali. Every person who agre…
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In 1973, Bhakti Dastane arrived in Bihar, India, to join the smallpox eradication campaign. She was a year out of medical school and had never cared for anyone with the virus. She believed she was offering something miraculous, saving people from a deadly disease. But some locals did not see it that way. Episode 3 of “Eradicating Smallpox” explores…
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By the mid-1970s, India’s smallpox eradication campaign had been grinding for over a decade. But the virus was still spreading beyond control. It was time to take a new, more targeted approach. This strategy was called “search and containment.” Teams of eradication workers visited communities across India to track down active cases of smallpox. Whe…
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In the mid-’60s, the national campaign to eradicate smallpox in India was underway, but the virus was still widespread throughout the country. At the time, Dinesh Bhadani was a small boy living in Gaya, a city in the state of Bihar. In his community many people believed smallpox was divine, sent by the Hindu goddess Shitala Mata. In Bihar people ha…
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"Eradicating Smallpox” is a journey to South Asia, the site of the last days of variola major smallpox. Many epidemiologists and global health leaders thought that ending smallpox was impossible. They were wrong. Dedicated public health workers made it happen. “Eradicating Smallpox” is an eight-episode, limited series amplifying their voices. Host …
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Over 70% of Indigenous people in the United States live in urban areas. But urban Indian health makes up less than 2% of the Indian Health Service’s annual budget. While enrolled members of federally recognized tribes can access the Indian Health Service or tribally run health care on their reservations, Indigenous people who live in cities can fin…
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Lanor Curole is a member of the United Houma Nation. She grew up in Golden Meadow, a small bayou town in Southern Louisiana. The impacts of repetitive flooding in the area forced her to move farther north. Louisiana’s coastal wetlands lose about 16 square miles of land each year. This land loss, pollution from the 2010 BP oil spill, and lingering d…
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Mending broken trust may be a first step for investigators who want to increase the participation of Native people in medical research. “There's such a history of extractive research in Indigenous communities, such that ‘research’ and ‘science’ are sometimes dirty words,” said Navajo geneticist and bioethicist Krystal Tsosie. Poor communication and…
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Correction: This episode was updated on July 27, 2022, to accurately characterize Dr. Charles Eastman’s academic milestone. In 1890, Dr. Charles Eastman became one of the first Native people to graduate from medical school in the United States. Today, one of his descendants, Victor Lopez-Carmen, is a third-year student at Harvard Medical School. He…
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Abby Abinanti is chief judge of the Yurok Tribal Court and a member of the tribe. While previously working in the California court system, she was discouraged and angered by the number of cases in which Indigenous families were separated or tribal members were removed from their communities because of nontribal foster care placements or incarcerati…
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Rachael Lorenzo works to address reproductive health disparities in Native communities. In 2018, they founded Indigenous Women Rising, a fund that provides financial help for Native people seeking an abortion. Historically, the federal government has restricted Native people’s reproductive autonomy. Between 1973 and 1976, more than 3,500 Native peo…
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In 2020, during the first wave of the coronavirus pandemic, Zoel Zohnnie was feeling restless. Growing up on the Navajo Nation, he said, the importance of caring for family and community was instilled at an early age. So Zohnnie wanted to find a way to help members of his tribe. One need in particular stood out: water. American Indian and Alaska Na…
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Editor’s Note: This episode includes descriptions of violence that some might find disturbing. Intimate partner violence, also known as domestic violence, can take the form of physical, sexual, or psychological abuse. If you or someone you know is experiencing intimate partner violence, help is available. StrongHearts Native Helpline provides cultu…
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People living on and near the Navajo Nation have been grappling with the legacy of 40-plus years of uranium mining. According to EPA cleanup reports and congressional hearings, mines were abandoned, radioactive waste was left out in the open, and groundwater was contaminated. This episode is the second half of a two-part series about uranium mining…
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On the morning of July 16, 1979, a dam broke at a uranium mine near Church Rock, New Mexico, releasing 1,100 tons of radioactive waste and pouring 94 million gallons of contaminated water into the Rio Puerco. Toxic substances flowed downstream for nearly 100 miles, according to a report to a congressional committee that year. In the 1970s, uranium …
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Reagan Wytsalucy was looking for a lost orchard. Martin Reinhardt wanted to know more about and better understand the taste of Indigenous foods before European colonization in North America. They followed different paths, but their goals were similar: to reclaim their food traditions to improve the health and vitality of their communities. Native f…
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Travel to the forests outside the Grand Canyon to follow Dr. Sophina Calderon and other Navajo Nation leaders as covid-19 tests the Diné people. Roughly 30% of the homes on the Navajo Nation rely on wood-burning stoves for heat. Many of those households haul wood from nearby forests. That’s what Calderon was doing when she realized the pandemic’s r…
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In the years leading up to the pandemic, Dr. Celine Gounder, the host of the EPIDEMIC and American Diagnosis podcasts, had the opportunity to care for patients part-time at several Indian Health Service facilities around the United States. Working on the “rez,” one theme came up over and over: resilience. In this latest season of American Diagnosis…
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In the years leading up to the pandemic, Dr. Celine Gounder, the host of the American Diagnosis and EPIDEMIC podcasts, had the opportunity to care for patients part-time at several Indian Health Service facilities around the United States. Working on the “rez,” one theme came up over and over: resilience. In this latest season of American Diagnosis…
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"It's a really interesting question: how do we get closure in this pandemic? I think a lot of people have hurt and loss that's not been acknowledged. I think acknowledging that loss is very important." - Andy Slavitt In this final episode of season 1 of EPIDEMIC, we look back on the coronavirus pandemic and how we can move forward with one of our f…
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"Pregnant women who have SARS-CoV-2 are more likely to be admitted to the ICU, to need a ventilator and are more likely to die than women of the same age who are not pregnant. Pregnancy definitely makes getting COVID-19 much more dangerous." -Andrea Edlow Some of the most persistent myths about coronavirus and the vaccines developed to fight it hav…
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"The pandemic has given us an opportunity to finally change this and if we don't, the economic impact from the fallout of women in the workforce is going to be devastating." -Erika Moritsugu The pandemic has upended caregiving and what it means to be a working mom. More than 2 million women have left the workforce because of the cost and effort of …
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"When you're building a system like a vaccine passport you're potentially excluding millions of people because they don't have this thing that once was optional, but has now become indispensable." -Albert Fox Cahn How do you let people who are fully vaccinated get back to normal life without creating super-spreader events for those who haven’t yet …
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"You can't fight scarcity with scarcity. The only way out of the vaccine problem is by making a lot more of it." -James Krellenstein India is the world's largest supplier of vaccines but the government there suspended the export of all COVID-19 vaccines after a devastating outbreak this spring. This is just the latest reason why global health leade…
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"It's a triumph of science and engineering that we now have multiple effective COVID vaccines. We just need to find the political will to invest a bit more money and deploy them around the world." -Chris Morten President Joe Biden said the United States would be the world's "arsenal of vaccines" but critics say current plans to donate 80 million do…
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"They benefit from traffic no matter if it's good information or malignant misinformation. " -Imran Ahmed During the pandemic, disinformation campaigns have been targeting people of color with lies like African Americans can't get COVID or denying the pandemic is even real. In this episode, we’re going to hear more about how these disinformation ne…
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"What we really need to be doing is not belittle people. Don't wag your finger at them. Don't make them feel stupid or small for not having gotten the vaccine yet. Talk to them about why it's safe." - Gov. Chris Christie Conservatives have emerged as the group least likely to say they’ll get vaccinated. Getting more conservative Americans comfortab…
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"Disinformation is a deliberate falsehood put out to mislead an audience. But what we see more of are true bits of information where necessary context has been removed or manipulated in a way that makes it technically true but wildly misleading." -Bret Schafer In this episode of EPIDEMIC, we’re going to look at disinformation during the pandemic. S…
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"I don't think that herd immunity is a possibility for SARS CoV-2. I think there's going to be a different kind of equilibrium that we reach in the future where humans and SARS-CoV-2 co-exist in a much milder, more benign way." -Jennie Lavine The end of the pandemic might not mean the end of SARS-CoV-2. In fact, many scientists think COVID is here …
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"The messaging that we've done in West Virginia is, look, we are leading the country, and that has really given people a sense that we can dispel a lot of negative stereotypes. We can be a world leader in a positive way." -Chris Martin Rural America's vaccine rollout has bucked expectations. A recent survey from the Kaiser Family Foundation found t…
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"This virus does not discriminate. The vaccine is what is going to help to get us out of this crisis and stop the depth and the harm and the pain, which is what we're suffering two to three times more than our white counterparts." -Sandra Lindsay Reports show that Black Americans are less likely to get vaccinated than the general population but Bla…
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"We have to have a conversation where we take people's fears seriously and try to figure out what is going on there." -Vanessa Gamble Black Americans are twice as likely to die from COVID as white Americans. Despite this, polls show that African-Americans are less interested in receiving the vaccine than other groups. But for people of color who do…
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"I think a lot of people don't understand how fearful Chinese Americans and other Asian Americans are in this moment" -Toby Chow On March 16, a gunman in Atlanta killed eight people. Six of them were women of Asian descent. During the last 12 months, anti-Asian hate crimes were up 150% in the United States but the coronavirus pandemic is not the fi…
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"This is an invisible war and if we don't use our weapons we are not going to win it." -Ester Sabino In the fall of 2020, the Brazilian city of Manaus had the highest SARS CoV-2 infection rate in the world — possibly as high as 75 percent. Some speculated that with rates of infection this high, there would not be enough people left for the virus to…
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"We easily have never had as high a level of vaccination acceptance as we have now but we've asked a lot more of the public. The resistance that we see today is a response, in part, to that compounded request over time." - Elena Conis The vast majority of Americans accept vaccines but concerns about the effect vaccines could theoretically have on k…
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"Every generation has generated its own anti-vaccinationism based on very similar concerns." -Jonathan Berman Vaccines are a safe and critical public health tool. They prevent crippling childhood diseases like polio. They’re responsible for the eradication of one of the deadliest diseases ever — smallpox — and, today, they’re one of the most import…
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"When we think about a virus we don't think as much about the immune response to the virus but it is just so, so critical." -David Fajgenbaum Where do treatments come from when there's a new disease like COVID-19? The vast majority of drugs prescribed to treat COVID during the pandemic are actually old drugs. Some of the most effective have been ar…
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"It just shows how difficult it is to be reactive with this virus. By the time you've detected something and understood the significance of it you're already several steps behind the virus." -Richard Lessells This is the second in our series on variants of concern. Our previous episode looked at the UK variant, and today we’re looking at the varian…
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"I had been assuming that my life and everyone else's life would get closer to normal in March. This [variant] has me worried that it won't be March, that we'll have a spring wave and I don't know how big that will be." -Trevor Bedford This winter a new, more contagious variant of SARS-CoV-2 arose in the United Kingdom: B.1.1.7. The CDC estimates t…
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"Science is harmed when scientists don't take into account the bias that comes along with inherently being a human." -Kafui Dzirasa As a result of centuries of discrimination, and lack of access to education and opportunity, African Americans comprise only 5% of active physicians in the United States today. Former-Surgeon General David Satcher, who…
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"When we interact with nature there are unpredictable and weird mechanisms by which pathogens might be able to move between the species." -Tony Goldberg There’s a lot we don’t know about the origin of the SARS-CoV-2 virus but there is a consensus that it came from animals. This is called zoonosis. HIV, Zika, and Ebola were all viruses in animals be…
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"This is not like a lot of the other disasters that people have studied. It looks a lot more like what you'd expect to see in people who have lived through a war. " -Roy Perlis This is the second in our two-part series about deaths of despair during the pandemic. We speak with experts and review the latest data on how the pandemic is affecting rate…
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"When the pandemic hit, many of our recovery groups went online but that's really not the same. All that great work we had been building momentum towards came to a screeching halt." -Will Cooke Overdoses have spiked during the pandemic. One of the reasons is a breakdown in the community support so critical to keeping people off drugs. Social distan…
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"It's my responsibility as an owner to figure out how to afford to pay everyone an ethical, fair, livable wage but we have to start from the premise of paying them an ethical, livable wage" -Pete Ternes We’re revisiting restaurants as part of our series on industries disrupted by the pandemic. In this episode we speak with restaurateurs and a labor…
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"Nobody really wants to leave their community and I don't blame them because it's our culture and we shouldn't have to move just to have clean air to breathe. That should be God-given right to drink clean water, to breathe clean air.” -Hilton Kelley During the modern environmental movement of the late 60’s and early 70’s, landmark legislation was p…
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