far out in the South Pacific a thousand
miles north of New Zealand along swells
burst on the reefs of Tonga one
supportive call for wandering Yankee
whalers this island group lies apart
from regular trade routes so for
centuries its people have been
relatively isolated with only occasional
visitors and a small trade in copra and
bananas the times are changing in Tonga
new markets for copra and bananas have
opened in Asia
there is a Tongan Merchant Marine with
modern vessels built in Europe the
planes will bring more and more tourists
to the friendly Islands more and more
Islanders will lead to study in other
countries under the leadership of Her
Majesty Queen Silla say and Prince
tungee the Prime Minister Tonga's
relative isolation is disappearing the
native government has been at once
prudent and progressive its benevolent
rule has brought prosperity without
destroying traditional customs looking
forward to the expansion of trade the
government carefully considered the
effect of increased contact with the
outside world it was realized that there
was a very definite than growing threat
to the Tongan people the population was
totally unprotected against smallpox and
smallpox is a disease which is rampant
throughout Southeast Asia
this was Tonga's problem to vaccinate a
highly vulnerable population of 70,000
against smallpox to do it effectively to
do it immediately to do it inexpensively
Oh
our party came to Tonga in March of 1964
in response to a request by the Tongan
government there were five of us from
the US for physicians and an equipment
specialist we were going to evaluate a
new rapid and inexpensive means of
giving smallpox vaccinations working
together with a team of Tongan medical
personnel we would begin immediately in
new coloful with capital city population
20,000 we plan to immunize everyone in
new coloful within a few days the
instrument that would make it possible
but jet injector gun this device can
deliver injections as fast as you can
pull the trigger the gun is simple to
operate and you're sure getting the
proper about a vaccine under the skin
the gun is operated by a foot pedal you
press the pedal and then pull the
trigger this model is equipped with the
new feature an intradermal nozzle for
giving injections into the superficial
layers of the skin as you must with
smallpox vaccine the gun is completely
portable the whole package weighs 12
pounds knowing that something would have
to be done to get the populace
interested at the immunization tribe we
appeared some informational material
films and posters telling about the
dangers of smallpox and the importance
of vaccination we delayed most of the
actual planning until after we arrived
our Tongan associates worked with us
closely they were very eager to help and
we could not have gone far without their
excellent advice and assistance from the
very beginning and throughout our stay
we were given a courteous and friendly
reception the first evening who were the
guests of Prince
tungee the Prince had personally flown
to Atlanta Georgia in February of 1964
to discuss the problem of immunizing his
people against smallpox at the
communicable disease center he met with
Public Health Service officers of the
smallpox unit it was a propitious
meeting for the unit had just completed
its study of intradermal vaccination
with the new gun developed by the army
the most suitable place in the world for
an evaluation of this new method was
Tonga a progressive country with a small
Intag population and no history of
smallpox during the princes visit to the
center we had photographed him getting
his smallpox vaccination this film was
to be shown everywhere we went to
encourage those who would be reluctant
the people enjoyed it immensely the next
morning the vaccination drive began the
posters with our message were put up in
Nuku alofa
smallpox is a dread disease vaccination
prevents small heart
every effort was made to inform the
people about the vaccinations and where
they could go to give them it did not
take long for them to understand that
this was being done for their protection
and they cooperated wholeheartedly one
of the things we immediately realized
was the importance of getting local
people help the teacher knows her pupils
she's the best one to reassure them to
keep track of her this laboratory
technician checks the children for skin
rashes or lesions we taught them our
methods and they performed many of the
vaccinations themselves the Tongans took
care of the administrative worker their
cooperation was invaluable we were
accomplishing a lot more than just an
immunization drive we were sharing
medical and public health knowledge and
experience
and
the children were curious not altogether
eager for the vaccinations but
well-behaved they were expecting
something unpleasant one look at the gut
and they were sure it was going to be
unpleasant but the gun is painless it
just looks a little unfriendly that's
all we use the dose of 1/10 CC of
vaccine deluded fifty to one year in
some other places we used to tend to on
dilution for comparison acetone was used
to swab the arm it dries faster than
alcohol and prevents the intradermal
head from slipping on the skin
Prince donkeys daughter took her
vaccinations along with the other then
downtown where we took care of the
government workers policemen nurses for
the rest of the week we went around new
Colo for setting up the convenient
locations processing thousands of people
a day after this we went out into the
countryside of the main island where we
attended a once here event the field day
for all the high schools it's quite an
occasion now major sports attraction
when he was younger Prince chungee held
a pole vaulting championship for 20
years
the Tongans are a strong healthy people
they had no problem with heart disease
malaria yellow fever cholera
we took advantage of the field day to
vaccinate people in the crowd we
vaccinated about 1,000 people that day
that night we were busy centrifuging
blood samples going over records and
periodically disassembling and cleaning
the gun with this remarkable instrument
a tremendous amount of time and money
was being saved
first smallpox vaccine is expensive with
a gun you can dilute it 50 times that's
50 shots for the price of one second the
conventional methods of vaccination
pricking concentrated vaccine into the
skin requires trained and experienced
people not so with a gun in addition the
gun virtually eliminates the
sterilization problems present in the
manual method all you have to do with
the gun is to sterilize the internal
parts it's then ready to administer
thousands of consecutive doses after
three and a half weeks on the main
island we've divided up into three teams
one team remain on the main island to
assess the results of the vaccinations
the two other teams went to the northern
and central groups of islands to
continue the immunization program
we went from island to island on a fish
collection boat owned by the government
and used to collect and refrigerate the
scattered catches from Tongan fishermen
these votes are the only means of
getting from one place to another
we were out for three and a half weeks
doing a population of 10,000 people in
the central island groups and this was
the smallest number of people that it
took us the longest time because of the
distance we had to travel for carrying
our equipment from village to village we
used the little vehicle which was called
the tote goat and was an attraction in
itself we went to two or three items a
day each evening we were the guests in a
different village with his word team of
Tongans who were part of the medical
department there was a dentist the chief
medical officer and other personnel who
utilized his trip to conduct their
normal medical calls around the island
in addition to giving protection against
smallpox to the people of the outer
islands we were evaluating the
effectiveness of the diluted vaccine and
the jet injector gun to do this we
vaccinated a certain number of people
that conventional way using the multiple
pressure technique we would later be
able to compare the results of both
methods and determine the amount of
protection various solutions of the
vaccine were giving
we made two visits to each other once to
give the injection and the other to
check the reactions two weeks later
time after time we were paddled to and
from our boat in a dugout canoe somewhat
loaded down but with a comfortable 2
inches to spare
you can't truly appreciate the
significance of the work done here
without considering the millions still
unprotected against smallpox we
succeeded in immunizing 80 percent of
the available population of Tonga we did
it faster far less expensively and more
effectively than would have been
possible with standard manual techniques
the results will read the vaccine had
taken 98.4% had satisfactory
vaccinations consistently better than
expected and unparalleled success when
you consider that was carried out by
such a small medical team also by
observing a large population after its
first smallpox vaccination we gained
valuable scientific information about
immunity
who worked closely with the Tong and
maple we shared a lot of knowledge and
experience but perhaps most important of
all Tonga and the United States
accomplished together something of great
promise to the world for what was
achieved here on the small Pacific
island can be extended to all people
Oh