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House on Fire: The Fight to Eradicate Smallpox (California/Milbank Books on Health and the Public) Hardcover – June 6, 2011

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Editorial Reviews


“Dr. Foege’s book . . . remind[s] us how fragile life looks.”
(New York Times 2011-08-16)

“Bounces the reader along with him in his jeep, on motorbikes over rugged terrain and on bustling trains. . . . (And) shows what can be accomplished when governments and thousands of health workers focus on a single objective. “
(Wall Street Journal 2011-06-22)

“[Foege] writes a mixture of memoir, dry public health guide and riveting tale of an all-consuming mission.”
(Tiffany O’Callaghan New Scientist 2011-06-04)

“A readable and thorough account by a key player in this outstanding victory for public health.”
(Library Journal 2011-07-21)

“A reminder of the importance of preventive medicine.”
(Jama 2012-03-14)

“A great, quick, and intensely personal read about the inside story of Foege's revolutionary idea and powerful actions. . . . Foege was wise before his time.”
(Medpage Today 2012-06-18)

“Demonstrate[s] the enormous benefit that can accrue to mankind when a determined and ambitious band of individuals come together.”
(The Lancet 2011-09-13)

“Gives an intimate sense of what it is like to work on the ground in some of the world's most impoverished countries -- and tells what it is like to contribute to programs that really do change the world.”
(Scienceblogs.com/The Guardian 2011-05-22)

“Inspiring. . . . A fascinating human interest account that is expertly merged with scientific facts.”
(Pascal James Imperato Jrnl Of Community Health 2011-09-15)

“A fascinating account”
(The Bulletin Of The Royal College Of Pathologists 2012-03-27)

From the Inside Flap

“Bill Foege takes us inside the world's greatest public health triumph: the eradication of smallpox. It's a story of true determination, passion and courage. The story of smallpox should encourage all of us to continue the critical work of worldwide disease eradication.”--Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation

“Bill Foege is one of the public health giants of our times. He was responsible for the design of the campaign that eradicated smallpox—the most important global health achievement in history and possibly the greatest feat in any field of international cooperation. His insights into the nature of this major event will undoubtedly help to meet the global health challenges of the 21st century.”—Julio Frenk, M.D, PhD, Dean, Harvard School of Public Health

“The eradication of a disease has long been the holy grail of global health and Bill Foege found it: more than any other person, he was responsible for the eradication of smallpox from the face of the earth. This is a story told by a remarkably humble man, about the extraordinary coalition that he helped to build, and the most impressive global health accomplishment the world has ever seen.”—Mark Rosenberg, author of Real Collaboration: What It Takes for Global Health to Succeed

“I am thrilled that Bill Foege, one of the great heroes of the smallpox eradication campaign, has written this important book. It tells a beautiful human story of an incredible public health triumph, and is full of lessons that could be applied to many of the global challenges we face today.”—Helene D. Gayle MD, President and CEO, CARE USA

“Bill Foege’s House on Fire is the first-hand account of how a revised strategy to eradicate smallpox was tested, validated, and applied. Without the global adoption of this new surveillance strategy, the final deathblow to this longtime global menace might never have been dealt.”—Adetokunbo O. Lucas, MD, DSc, author of It Was The Best of Times: From Local to Global Health

“Smallpox is the most devastating disease the world has known, as it destroyed lives and shaped history over the centuries. House on Fire provides a day-to-day account by my friend Dr. Bill Foege of the battle required to defeat this wily and diabolic virus."--President Jimmy Carter


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Product Details

  • Series: California/Milbank Books on Health and the Public (Book 21)
  • Hardcover: 240 pages
  • Publisher: University of California Press; 1 edition (June 6, 2011)
  • Language: English
  • ISBN-10: 0520268369
  • ISBN-13: 978-0520268364
  • Product Dimensions: 6 x 0.9 x 9 inches
  • Shipping Weight: 1.2 pounds (View shipping rates and policies)
  • Average Customer Review: 4.9 out of 5 stars  See all reviews (15 customer reviews)
  • Amazon Best Sellers Rank: #910,730 in Books (See Top 100 in Books)

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Most Helpful Customer Reviews

19 of 19 people found the following review helpful By Billy Woodward on May 22, 2011
Format: Hardcover Verified Purchase
I've read four books on the smallpox eradication campaign, probably the greatest triumph in human history, and this is the best. The story is told from William Foege's personal perspective and the writing style flows easily.

William Foege is one of the most unknown remarkable men of science. Working originally as a missionary doctor in Nigeria, he discovered and scientifically proved the surveillance and containment method of vaccination that reduced the number of people needing to be vaccinated from near 100% to 6%. As well as doing the science, then administering the strategy, he had to be an action hero, encountering many adventures in Nigeria during the Biafran Civil War and in hugely populated India.

There is lots of story here, not just dry science. In the African section alone I counted thirty-three interesting anecdotes. Here are two of my favorite quotes from the book.

* One had to be an optimist with a feel for numbers to be ecstatic at the same time that Bihar had over 5,000 known smallpox outbreaks and had just reported over 11,600 new cases of smallpox in a single week.
* It wasn't science that threatened to stop us. It wasn't even nature per se. Rather, it was human nature: the human factors that involve strikes, job security, political concerns, turf. I remembered those words from graduate school: "When you tangle with culture, culture always wins." As hard as the daily work had been, this was the only time I was discouraged and uncertain about the outcome. I thought we had lost the battle.

Four separate books should be written about Dr. Foege, a tireless promoter of global public health - his time in Africa, in India, as the head of the Centers for Disease Control (CDC), and his work with the Bill and Melinda Gates Foundation. This book covers two of those times and when I finished the book I was energized and itching to go out and help save the world.
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11 of 11 people found the following review helpful By Godfrey P. Oakley, Jr. on August 19, 2011
Format: Hardcover Verified Purchase
I am fortunate enough to know Bill Foege, to have worked for him at the CDC, to be mentored by his example, and to enjoy many lectures he has given. He is simply one of the great people of our time. Although I went to Nigeria for 3 months in 1969 to work on smallpox immunizations and worked at the CDC for 30 years (in birth defects), there was much about the smallpox eradication story I did not know. I found this book so exciting that it was difficult to put down. I think that all who work in public health will enjoy this book. New students in public health should be inspired by and learn from reading this story of public health action that made such and important difference for mankind. I suspect many a layman or woman will also enjoy this wonderful, readable book.

I draw attention to one of Foege's important messages. If you seek to improve a human condition, it is important to know that you have an intervention that works and that you can tell whether or not the intervention has improved the outcome. It is not just enough to throw good will and money at the problem. As Foege says: "this is a cause-and-effect world, and smallpox disappeared because of a plan, conceivewd and implemented on purpose by people."

On a lighter note, I enjoyed his saying never hire a pessimist. If you need one for a while, contract for one.
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8 of 8 people found the following review helpful By Mary Guinan on August 31, 2011
Format: Hardcover Verified Purchase
This is a wonderful account of the final phases of one of the greatest public health accomplishments of the 20th century, the eradication of smallpox. Bill Foege realized during the African campaign that the mass vaccination strategy which was successful in other countries would be unlikely to work in the remaining countries with smallpox. First in Africa and then in India he and others implemented the search (surveillance) and containment strategy based on the mode of spread of the smallpox virus. Using epidemiologic evidence they showed that this method was far superior and advocated for it to be the primary strategy for elimination in Africa and the India. It was a radical change, not embraced by many and vigorously opposed by others. The "Fight" in the title may refer to the political and scientific fight as well as to the arduous work by the multitude of people involved. The background story of how smallpox was feared from earliest history and how the countries of the world came together and planned its elimination is fascinating. The excitement and ingenuity of those involved in the elimination campaign was remarkable. The author credits the success of the program to these workers. Imagine millions of people in every country of the world working for the same goal for decades. What an accomplishment. More sobering are the conclusions and Appendix entitled "A Plan in the Event Smallpox of Bioterrorism" which should be required reading for those in the field. The author pleads for evidence-based decision making. Read the book to find out about the tallest man in the world, how General Washington's knowledge of smallpox helped win the American Revolution and how President's Lincoln's Gettysburg Address may never have been given because of his smallpox infection.
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11 of 12 people found the following review helpful By mmt on June 9, 2011
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You don't need to be a physician or a public health expert to appreciate the wonder and drama with which smallpox was eradicated from the world. When a nonfiction book about disease eradication reads like a mystery thriller, serves as a primer for public health, touches the heart, and transports you to singular achievement in history there is something remarkable going on in the pages.
I am a layman, no medical degree or public health experience, but this book allowed me to experience firsthand what it was like to be on the front line of a historical marker for mankind. I appreciated being allowed to glimpse through Bill Foege's len as he outlines the intricacies and importance of the data keeping, coordinates thousands of personal, manages the various agencies, governments and personalities while maintaining a sense of humility and optimism. A must read.
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