An Epidemiological Expedition Into the Interior of Africa

By Paul Theerman, PhD (New York Academy of Medicine)

Reconnaissance for Yellow Fever in the Nuba Mountains, Southern Sudan, 1954 is one of the several dozen films that Dr. Telford H. Work created during his distinguished career in arbovirus (“arthropod-borne virus”) field research. Born in 1921, Work attended Stanford University and Stanford Medical School, and after graduation went into the U.S. Navy in the last months of World War II. After the Navy he attended the London School of Hygiene and Tropical Medicine, taking a degree in tropical medicine in 1949, and after a stint studying filariasis in Fiji, a Masters of Public Health at Johns Hopkins, graduating in 1952.

Work was hired by the Rockefeller Foundation in its arbovirus research program, and soon found himself in Cairo with Dr. Richard Moreland Taylor, director of the Foundation’s International Health Division. Both were stationed at “NAMRU-3”—the Naval Medical Research Unit 3, established in 1946 to support U.S Navy personnel in that region—an outgrowth of the war, where disease caused more casualties than combat. In 1954, Work and Taylor traveled to the Sudan to look at an outbreak of yellow fever, one of the most virulent of the arboviruses (which also include dengue fever, encephalitis, and Kyasanur Forest Disease). Flying to Khartoum, they prepared their expedition and then took their equipment by train to El Obeid, and by jeep to the Nuba Mountain region. (This area, in the recent political division of Sudan, spans the southern part of the present-day post-partition Sudan and the northern part of South Sudan.) Accompanied by Dr. Mansour Ali Haseeb, professor of medicine at the University of Khartoum, they wound their way through several villages, collecting blood samples from people and primates, and ended at Wau, from which the samples were airlifted back to Khartoum.

This film lies at the juncture of home movie and documentary. Originally a silent film, it was produced in its current form in 2006 by Work’s wife, Dr. Martine Jozan Work, using Taylor’s diaries of the expedition as the basis for the narration. It is not the only film that documents mid-20th-century Sudan: the Sudan Archive at Durham University in England has several collections of films; while the governmental Film Unit of the newly independent nation of Sudan produced many documentaries up through the 1970s. But as an insider’s look at the entry of Western epidemiology into remote rural Africa, the film has no peer. Work, Taylor, and Haseeb (called “Dr. Mansour” in the film) mount the expedition with military efficiency. They negotiate with local powers to accomplish their task—getting blood samples from villagers to test for yellow fever antibodies. This was no small thing: Haseeb was of Arabic-speaking Muslim background and the Nuba Mountain villagers were black animists; two groups that have historically often been at odds. Work and Taylor systematically kill and take blood from monkeys and other primates. But Work is as much a fascinated tourist as a skilled epidemiologist. People and places occupy his lens, not just his team’s activities.

This short expedition proved to be one of the opening salvos in a coordinated world-wide attack on arboviruses. Between 1952 and 1964, the Rockefeller Foundation established seven tropical research stations on three continents, in addition to New York and California operations. These joined military research labs (such as the Cairo NAMRU) and NIH units around the world. In 1960, the World Health Organization organized a Study Group on Arboviruses, for which Work served. His own career was stellar, with jobs at CDC and NIH, an academic appointment at the UCLA School of Public Health, as well as a term as president of the American Society of Tropical Medicine and Hygiene; in 1981 he received the Richard Moreland Taylor Award of the American Committee on Arthropod-Borne Viruses. Work was a dedicated film-maker from his days at Stanford Medical School through a virus expedition to the Galapagos in 1988. He died in 1995; his films and personal papers are at the National Library of Medicine, including the silent version (Yellow Fever in the Sudan; also in NLM’s digital collections) that provided the footage for Reconnaissance for Yellow Fever.

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