{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/dn3zs2nb27/manifest","type":"Manifest","label":{"en":["Zandra Maffett "]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine.  Disclaimer:  The views presented in this broadcast are the speaker’s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. \u003c/p\u003e"]}},{"label":{"en":["Date"]},"value":{"en":["2008-02-20 (created)"]}},{"label":{"en":["Type"]},"value":{"en":["Oral History"]}},{"label":{"en":["Agent"]},"value":{"en":["Don Ivey (Interviewer)"]}},{"label":{"en":["Format"]},"value":{"en":["audio file"]}},{"label":{"en":["Keyword"]},"value":{"en":["family medicine","family physician","American Academy of Family Physicians"]}},{"label":{"en":["Subject"]},"value":{"en":["Zandra L. Maffett (personal name)"]}},{"label":{"en":["Language"]},"value":{"en":["English (primary)"]}}],"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153748/file/282857","type":"Canvas","label":{"en":["Media File 1 of 2 - Mafett_Zandra_08_a.wav"]},"duration":3615.42423,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153748/file/282857/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153748/file/282857/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/282/857/original/Mafett_Zandra_08_a.wav?1752674589","type":"Audio","format":"audio/wav","duration":3615.42423,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153748/file/282857","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153748/file/282857/transcript/81709","type":"AnnotationPage","label":{"en":["Zandra Maffett interview transcript [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153748/file/282857/transcript/81709/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"I would like to begin by getting a little background information. Tell us about your current position. Where do you work and what do you do there? \n\nI’m Zandra Maffett and I work for McNeil Pediatrics, one of the Johnson \u0026 Johnson family companies. Johnson \u0026 Johnson is actually 200-plus separate companies. Most people don’t know that. Johnson \u0026 Johnson is just a corporate name. I’ve been with Johnson \u0026 Johnson for 26, going on 27 years and most of my time with the company has been with McNeil. My current position is that of record advocacy meaning that I work with external organizations, professional societies such as the American Academy of Family Physicians and its Foundation and patient advocacy groups. And my role is to represent McNeil Pediatrics for those organizations. And wherever it is possible, to look at where we have interests that are mutually beneficial, perhaps collaborate on projects, be a face of McNeil with its organization and its leadership and its members. If there are issues that we as a company or an industry would like to bring to the attention of a society or a patient advocacy group, that is my role. Also, to interpret any issues that organizations may have with the company, with our medications, how we’re marketing. In other words, I’m sort of interpreting the external organization to McNeil and McNeil to the organization. In my prior role with McNeil, I started actually back in 1981. And many know McNeil because of the Tylenol tampering. And I was actually an employee to look at the tampering. I help numerous physicians, patient assistants, professional education, patient education. So basically develop a wealth of background and experience working with physicians and health care providers.\n\nCan you tell us when you first became involved with the American Academy of Family Physicians and its Foundation? \n\n\nI can’t recall exactly the specific year. I just know that in my early years of working with McNeil, and McNeil has had numerous names: McNeil Consumer Healthcare, McNeil Consumer Pharmaceuticals. In my early years of working with McNeil I used to hear about the American Academy of Family Physicians. I did a lot of work in the convention arena and I worked with what we call thought leaders. These would be physician healthcare providers who did a lot of professional education. And somewhere down the line I heard about the American Academy of Family Physicians and its Foundation and I heard that individuals from industries met with the Academy. And with Johnson \u0026 Johnson having over 200 companies, I learned through one or two of the J\u0026J companies that they were involved with the Academy and the Foundation. And through that, at some point I started attending the corporate meetings that the Foundation would hold. I used to hear the name of Sandy Panther. She used to sign many of the letters that would come to us at the company. So I was familiar with her name and with the information I had received in the mail. So I can’t really pinpoint the exact time. But I would say easily 15, 20 years ago was when I first got involved with the Academy and its Foundation.  \n\nWe primarily want to talk to you about your involvement with Physicians With Heart. Can you tell us how you got involved with that project and just tell us a little more about the project itself? \n\nSure. Around the early 1990s I remember receiving just general mail from this organization called Heart to Heart. And quite honestly, initially I thought it pertained to cardiovascular disease because it was Heart to Heart. I didn’t really pay much attention to it. And one day I decided to really look at the correspondence. And they were talking about doing an airlift with the Ameri- can Academy of Family Physicians and its Foundation and they were looking for donations of products. And most likely I probably set it aside because donations were really not something I dealt with. And probably after getting two or three of these letters, I thought why not just nose around J\u0026J and kind of find out where in J\u0026J somebody would do something like this and maybe we could donate some products. And I was able to locate a group from J\u0026J corporate in New Brunswick, New Jersey that handled product donations and product donations interna- tionally. I spoke with them and they informed me that you really have to have an agency that has been approved before they would donate products for international distribution. And at that time our company was very, very small and nimble and not a lot of layers. So working with J\u0026J corporate contributions, got them interested in perhaps approving Heart to Heart as one of the companies to put on their list that could accept products. And they in fact actually sent a corpor- ate jet down to Kansas City. And they sent some folks who were skilled in finance and inventory control and they really looked at Heart to Heart with a fine-tooth comb and realized that Heart to Heart was in its infancy stage but they had a lot of belief that they could handle our product. And basically they approved our product for this airlift and later they approved it for some other projects as well. I didn’t think much about it. Dr. Gary Morsch who founded Heart to Heart actually called me one day and thanked me for the product donation and told me how much product had been donated. And again, I don’t remember the amount but it was a significant amount of J\u0026J product and a significant amount from a dollar standpoint. And I jokingly said to him, maybe I should go with you and see what happens to this product. And he wrote a letter to my boss at that time basically inviting me to go on the first airlift which was going to be in 1994 to the Ukraine. This must have been around September and I think the airlift was late September or October. My boss said do you want to go, and I said sure. And that’s how it all got started.  \n\nWere you the only corporate representative…?\n\nPrior to that, in 1993, Dan and Gary had gone to Russia and that’s technically the very first project. But in 1994 the project went to the Ukraine. And Dr. and Mrs. Coleman, Jeff [Altwies] who was the photographer/PR person for the Academy, Don Ostergaard, Gary Morsch, myself and a woman physician from Cincinnati. So I was the only corporate person. And the woman physician from Cincinnati was the only family physician outside of the leadership. So it was a very, very small contingent of us that went to the Ukraine. And keep in mind, this is right after the fall of the Soviet Union and also this is right after Chernobyl. So many of the people in the Ukraine were suffering the effects of Chernobyl, so this airlift was providing product to these people in this area. And as I recall, the original intent was at the Annual Assembly, and some- thing tells me the Annual Assembly was in Boston that year, that immediately after the Annual Assembly this plane would take off. And I think they encouraged doctors to bring product, samples that reps left in their offices, equipment, things of that nature. Just bring it to the meeting and it was loaded on pallets and put on this plane. And we left almost immediately after the Assembly with the idea that we would arrive in the Ukraine at about the same time with the product as well as those of us flying commercial as the delegation. We arrived after the fall of the Soviet Union. So there weren’t the comforts that you would find today. It was pretty rustic, pretty basic. Things were crumbling. Buildings were not in the greatest shape. The roads were not in the greatest shape. The airport runways were not in the greatest shape. And there wasn’t much available in terms of food. We stayed in an old Soviet bloc hotel. And we were actually down by the Black Sea. We flew in down towards the Black Sea. The hotels were fine, they were clean. But they were just very old, in the old Soviet bloc style. Not many choices in food. It was whatever they were able to find in the markets that day, that’s what they served. And you were eating borscht soup everyday. I remember the chicken, you literally would cut the chicken and your knife went from the skin to the bone, the chickens were so skinny. There really weren’t too many options. And we were anticipating the plane arriving with the product and it was delayed a good two or three days. We would go out to the airport and wait. We did this for a couple of days. And then finally we got word that the plane was arriving. Heart to Heart had arranged for some local Peace Corps individuals to help us. And I remember going out to the airport, it was late at night. There weren’t a lot of lights on the runway. And I remember we had flashlights that we were holding up to help guide the plane in. Before the plane landed we met with several of the officials from the country, like the Minister of Health and various officials. And there was a ceremony at the airport where Dan Ostergaard presented them with some AAFP clocks, gift exchange. Once the plane landed, we noticed that officials immediately went on the plane to inspect the cargo. And we suspected they just wanted to be assured that what we had promised, that that product was there. We then went into a dinner. And I remember that the plane’s engines, one engine was still running. And I spoke with the pilot and the pilot explained to me that the reason why the plane was late, they had to get permission through Moscow and the Kremlin to bring the plane in. And there was some diplomatic action that took place and they had to come through Munich and deal with the Embassy there. And that was part of why it was delayed. And the reason why they kept the engine running was because of the condition of the airport and also because of the diplomatic relations that were involved, once the plane was unloaded they basically had to take off and move on. I do remember the writing on the airplane was Evergreen. And later in reading things in the newspaper, I realized that Evergreen was actually an airline that the U.S. government used in fighting drug trafficking like in South America or something like that. So that was kind of interesting.  \n\nWhy was there that kind of delay that they had to go through the Kremlin to get permission? Was it because drugs or pharmaceuticals were involved? \n\nMy limited understanding was that the flight plan and the ability for the plane to be landed needed approval through the Russian government. And so dealing with that process. The next day we were sitting in our little hotel and our interpreters were watching television and basically were saying “Oh, my gosh, oh, my gosh, oh, my gosh.” And we asked what happened. And it turned out that overnight there was a silent coup, a bloodless coup. The government had been overthrown and all of the officials that we had met with the day before had basically been ousted. So we were basically told that we were going to have to hastily gather up our belongings. They were going to put us on a train and take it back to Kiev and that train was going to be 22 hours. I remember they said that there was no food on the train and that we would have to have our own food. And at that time, they had something called dollar stores. These are like little corner, hole-in-the-wall kind of stores that sold American products. They were really tiny. And on the shelves you would find like small sizes, maybe three cartons of Lipton tea or two jars of instant coffee. They were American products and they would take dollars. And I remember buying three liter bottles of Coca-Cola. They cost me $3 each back in 1994. The thought occurred to me, I spent ten U.S. dollars on three bottles of soda and that was the equivalent of what people earned in a month in that country. Many of us had heard all these stories of what happens to Americans on Soviet trains and we didn’t know whether to believe it or not. So the Colemans and I, we had a sleeping car with the woman physician from Ohio. We kind of worked out this knocking sys- tem between our train cars just to let each other know we were okay or if there was a problem. And basically we thought that we would hide our suitcases and luggage underneath our beds and basically always sit on the beds and just be very careful about what was going on. At one point we went out to stand in the corridor and watch what was going by. There were these two Soviet men, very well-dressed, very unusual for that time in the Soviet Union. And they basically had undressed down to their skivvies. We went back to our car and a gentleman, a poet came into our car and several other Soviets came to our car and they started singing Soviet ballads and they were drinking vodka. And the woman physician and I were getting a little bit nervous. Jeff Altwies from the Academy came in, sat with us as they proceeded to basically drink and sing and get drunk. And they kind of stumbled out. And then one proceeded to start beating up his wife and Jeff basically had to stop all of that. And that’s when we realized we were only one hour into a 22-hour train ride – and there was quite a bit of drama. So that’s the Ukraine.\n\nThe next year we went to Armenia. And because of the experience with the plane being late, taking two days to arrive, asking whether or not anybody would be interested in going on the airlift, I responded and inquired whether there could be a problem with the plane being delayed. And they said that we had an option; we can fly into Netherlands and fly on the plane with the product. And I said based on what happened last year, I will do that. And I said as long as there are decent toilet facilities on the plane, I’ll be willing to do that. And to your earlier question, you asked if I was the only industry person, I was the only industry person for a number of years. So on this particular flight, we flew out of Maastricht, Netherlands and there was one other industry person on this particular one who came from my company because I invited him to come. Other than that, there was a dental group out of California and several FPs. And some of the group elected to fly with the plane and others elected to fly commercially. Those who elected to fly with the plane, we flew into Maatricht, Netherlands. And we had been told that this is going to be a cargo plane. Do not expect any heat. It can get very, very, very cold, rain – blankets, heavy jackets. And we complied with that. It was in the evening that the plane was going to take off. And when we went out to the runway, the plane was a Soviet plane in Antonov. And it was actually the same plane as Howard Hughes’ Spruce Goose. Just a very odd-looking plane. They wheeled our bags up through the rear of the plane. We got in – and it was a cargo plane. There were no seats or anything like that. And there were just the tracks that you rolled your pallets on. And we were just trying to figure out where we could find a place to kind of settle down because we were told it was going to be an eight-hour flight. The Russian crew motioned to us to come towards the front of the plane. And they had this little ladder, like you were going up into an attic. You climbed up this little ladder through a little hole. And that took us into an area that was like their crew room. It was really small. It had a couple of benches on either side of the room. And there were about 15 or 17 of us and two benches. And I remem- ber, I got a seat on the bench, Dr. Weber and his wife got seats on the bench and a number of the people stood. The plane took off. We just laughing and joking. And we had been promised that the State Department would put food on the plane and beverages on the plane. There were two cases of Pepsi in this little area. And we asked about the toilet facilities and the Russians kind of said well, we’re going to be refueling in about four hours, that’s probably when we’ll ... in other words, there was no usable restroom facility on the plane. We asked about the box lunches. It turns out that they had left them back in the cargo hold that had been sealed. And so here we were in this little space, 17 people, two benches, not everybody with a seat, no toilet facilities, two cases of Pepsi. The Russian crew was right below us and they started smoking their cigarettes which they hand-rolled and they were very, very strong. And all of a sudden you started getting this very strong cigarette smoke coming up through this narrow hole up into this area where we were. And then in front of us was a door that led into the cockpit. And the pilots, for whatever reason, somehow figured out how to pipe in heat. I remember I had leg-warmers on, earmuffs on, a winter jacket. And all of a sudden they pumped in this heat and the tempera- ture rose. So we had rising heat and the cigarette smoke and everybody started shouting “Oh, no” and started ripping off all our clothes. We landed four hours later. I forget where we refueled. It might have been in Kiev. But in the refueling, as we got off the plane we realized that they had expected us to be a cargo plane. They were not expecting people to be on the plane. And here these people came off the plane. These Russian soldiers kind of surrounded us and marched us into the airport. We were inside the airport and we then realized we had no way of communi- cating with anybody to find out when the plane was going to take off. We eventually figured that out. Took off a couple of hours later. Landed in Armenia in a rainstorm. And we basically had to off-load all of the product ourselves in the rain from the plane to the waiting trucks.  \n\nThat’s probably a couple of tons of product, isn’t it?\n\nIt was a lot. My most memorable experiences were in Armenia. We had a chance to meet the Catholicos. The Catholicos is the equivalent of the Pope in the Roman Catholic church. The Catholicos is the head of the Armenian Apostolic Church. And the Armenian Apostolic Church is the oldest continuous Christian church. And it obviously goes back to the beginning of Christi- anity. And several of the folks who came on the delegation were of Armenian descent and they had arranged for us to meet the Catholicos at the place where he lived. And it was a 2nd Century Monastery. So you’re talking about you’re getting as close to Christianity as you could possibly get to. We dressed up in our Sunday best. We were ushered into this very formal-looking room. We were sitting there all starched and dressed to the nines. And in he walked. And it turns out he was actually educated in the west, so his English was without accent. And we had a very delight- ful conversation with him. And I remember the night before we had been with one of the NGOs (non-governmental associations) that was Methodist-run. And somebody made a comment to the Catholicos, what do you think about the Methodists being here in your country? And the question was posed in a very positive way but the Catholicos kind of bristled and he basically said, “Who are they to bring Christianity to us?” So when you think about it, here we were sitting on the grounds of a 2nd Century Monastery. He showed us his private quarters. And in it they had relics going back to the time of Jesus Christ. He showed us one relic that he claimed incorporated pieces of the cross that had been carried by several women who had been there at the crucifixion and had carried it to this site. He had a challis that had belonged to one of the Disciples. And then also he showed us, there was a curtain that he opened up and behind it was a safe which he opened up and there were hooks. And on each hook were the letters of the Armenian alphabet in gold. And this is from gold that had been melted down by pilgrims, that pilgrims had left over the years. He told us that their oral history had said that, and I forget the name of the saint, had visited this site and saw pagans worshiping idols. And he struck his sword in the ground and said on this site I will arrest(?) a church, which was the beginning of the Armenian Apostolic Church. And the Catholicos told us that the prior year they were doing some excavation under their sanctuary and they found the original pit. He then took us down into this area and I just got goose bumps because here we were on a site that existed at the time of Christ and existed at the time that there was pagan worship. And he was now showing us the actual pit where this happened. So this was a very memorable time for me.  \n\nAny other memories you would like to share about the Armenian trip in ’95? \n\nOne of the things that we learned from the first trip, that we began probably on this trip ... I had observed on the first trip that the conditions were very poor for the people. The water quality wasn’t that great. We had infant formula and the water was dirty. I remember telling our inter- preters, please translate that they must boil the water before they mix it with the infant formula. And I remember during the first trip there was also cholera outbreaks. And so when we came back one of my recommendations was that for future that we include a medication update, that we pass out something in writing that would explain to the physicians and the clinics and the hospitals that were receiving the product what exactly they were receiving and how it was indicated for use based in the U.S. I believe it was in Armenia that we first unrolled that where there was a formal presentation at every clinic, gathering up the doctors and nurses and passing out something written in Russian, which is a common language among all the Soviet Republics. And I think it was an English version and then with a translator going through all the product and explaining exactly what the product was. And hearing their questions and being reassured that they had some familiarity with the product. Or if they didn’t just be sure that they were clear what the product was indicated for.\n\nLet’s move on to the next year which was in Kyrgyzstan and Kazakhstan. You were on that trip as well?  \n\nYes. Those two countries are back-to-back or side-by-side. The one thing that I remember from that trip, there was a physician who came on the trip, and I believe he was from Dallas. And as a result of going on that trip, and I’m drawing a blank on his name right now, he decided that he was going to sell his very good practice and actually relocate his family to Kyrgyzstan. And he did that. He basically sold everything that he had, relocated his young children. And he’s there to this day. And I stayed in contact with him. Maybe once a year I get a newsletter that he sends out to various people just documenting what’s going on. And he has been very much involved in instituting the concept of family practice in Kyrgyzstan. And when we went back in 2003, I had a chance to meet him as well as his wife. So that was a very nice time.\n\nHow about the following year in Georgia? \n\nI don’t recall too much about that. Those early years...the common theme was these countries were very, very undeveloped and in extreme need. And I think the best analogy is what I suppose our country was like after the stock market crash in the 1920s. You basically have nothing. In these countries, the Soviets pulled out and they basically took things with them and they left the countries on their own. Aeroflot is the national airline. And whatever planes happened to be in the country at that time, those are the planes that remained behind. And I remember somebody telling me that the Georgian soil was very rich as the soil in the former Soviet Union and highly desired to the point that during World War II Hitler used to take trainloads of the soil and bring it back because that’s how rich the soil was. And so what I remember is that in the Republic of Georgia as well as some of these others, the infrastructure was not there for them to do things on their own. They had relied so much on the Soviets. The hospitals were in decay. The equipment was in decay. You would go into operating rooms and they would just have wide open rooms in the operating room or a wall air conditioner. For many years I never even saw food in a hospital. The families had to bring in their own food. For medications, they actually had to go out and buy the medications somehow. Which is why it was very important for us that we document the delivery of our medications and got sign-offs that the medication would only be used for people in need, which is pretty much 99% of the country, and that it would not be sold. Because there was such a desire for medication, that the black market is how many people got medications for their families. When we would go into these clinics and look on the shelves, most of the shelves were bare or they might have had some Soviet-produced product and product out of Turkey. Or the last time the United Nations had brought in some product. That was it. And then whatever delivered, and we were sure that there wouldn’t be any more product until somebody else came along maybe months later.  \n\nOften with each of these airlifts, once we landed the media would greet us and film us and interview us. Therefore, the people in the country knew that we were there because of the newspaper and the television. And they would recognize on the street and ask us, do we have, and they would name the medication they were looking for. So on the one hand, we felt very good because we were bringing in millions of dollars of product. But it was just very scratching the surface of need.\n\nThe next year, Siberia, in 1998, that stood out because Siberia, you have these Dr. Zhivago images in your mind. And Sandy Panther, the former Executive Vice President of the Founda- tion, and I roomed together on that trip. And we took a train for most of the journey. It was part of the Siberian railroad. So that was really fascinating. I guess we thought we were going to have one of these Dr. Zhivago kind of experiences with the music in the background and the snow on the ground and seeing the sleigh and the horses and everything. But it was actually birch trees after birch trees after birch trees. So we basically slept for 20-some hours. The train just rocks you to sleep. The train cars are just absolutely something that you would imagine with the red velvet and the – bars for tea and just a very interesting experience. Where we ended up in Siberia, that year happened to be the same year that they found the remains of the royal family that had been killed early in the 1900s. So it was kind of historic to actually be in that town. And it was on this trip that we were in this very cold environment. It was fall. And also the area that we were in was where the Soviets had sent some of their brightest minds, their scientists. They had been sent to this area to be isolated from the rest of the world. So you had a very highly- literate, educated population in the middle of Siberia in this area. So it was just really interesting, interacting with them and meeting them. But this was the trip where we first encountered an orphanage and children without winter coats. And that was the birth of the Children’s Project.\n\nUzbekistan in 1999, I don’t recall anything specific to that trip. I did not go to Azerbaijan in 2000. But 2001 to Vietnam, that was a special trip. It was the only one that was not to the former Soviet Union.\n\nWhat was the reason why Vietnam was chosen? \n\nFor all of these projects, we worked with Richard Armitage. He’s now the Deputy State Department Director under Condoleezza Rice. But we worked with him. He was responsible for the -- that had responsibility for the former Soviet Union Republics. And I think this was either a special airlift...I don’t know if the State Department asked us to do this or this came to Heart to Heart’s attention. But the Federal Express wanted to open up a route into Vietnam. And so there- fore they provided the plane and they were going to use this as part of their marketing of opening up a route to Vietnam. So I’m just real sketchy on the real reasons for that. So the FedEx provid- ed the plane. Many of us remember the days of the Vietnamese War, so there were several family physicians who had served in Vietnam or had a connection to Vietnam who wanted to come back. And this seemed to be pretty typical of American soldiers, wanting to come back and kind of reconcile whatever their experiences were. And we also took a family physician resident who was of Vietnamese decent. His family had left Vietnam. And in Vietnam, among the Viet- namese people there are some very hard feelings towards those who left and went to the United States. So he was very excited because he was the first of his family to return. But he was also very nervous about it. So many times in the country, when we were changing planes or anything like that, we used to literally move as a group and put him into the middle of the group and sort of move forward until we actually got on the plane. And that was for his comfort level as well as our comfort, that there wouldn’t be any problems. The country is absolutely beautiful. We saw where John McCain landed or was shot down. We saw the infamous hotel where he stayed. It’s interesting, we refer to it as the Vietnamese War; they refer to it as the American War. And the Hanoi Hilton, is what they used to call it; it now has photographs of John McCain there. And there’s a lot of propaganda. As you’re reading the display, it’s from their perspective. And they talk about how well the Americans were treated at this Hanoi Hilton. It really jars your senses. They have a collection of dog tags and boots and things that they have taken from the various soldiers. As I mentioned, the country is absolutely stunning. One of our projects, we had a chance to actually go out to a leper colony. They still separate the lepers, those who are suffering from leprosy, from the rest of the population. And that’s, again, a very moving experience because we don’t have anything like that in our country or in the western world. And literally it’s the family member who has leprosy as well as the extended family lives in these isolated areas. And we brought bags of rice as well as medicine. And we were able to walk around and visit with the people and stop in their little huts or homes. I remember one was frying fish over just a little wood fire. But that just left a lasting impression on me because, again, that’s something that we just don’t encounter in this country.\n\nYou mentioned you were in the Hanoi area. Did you go into what used to be South Vietnam? \n\nYes.  \n\nDid you notice any differences in the different regions? \n\nThe whole country is beautiful. The north, Hanoi still has that French influence. As you’re going around the countryside, you see the water buffalo. You see the people out there with the cone hats and the rice paddies. You’ll see these homes that have been abandoned in the middle of fields. And they had that New Orleans, that ironwork, grilled kind of decoration on it, plantation style. When you went south, it was more urban. What’s interesting, they gave us some stats. And half the population now is under the age of 25. That means half the population has no knowledge or recollection. They did not live during the time of the Vietnam War. So that is truly something that’s in the memory. Nobody has any negative feelings towards Americans and that’s something that just happened in the past. They’re touch with the French culture is really gone. You’ll find some older people who still speak French. But the younger people have no knowledge of it at all. So it’s a beautiful country, beautiful people.\n\nWhat did you notice about their health system? \n\nI’m trying to recall. I just can’t remember at the moment. Definitely not like the Soviet system where everything was just literally falling apart. But still there was tremendous need.  \n\nLet’s move on to the next year which was Moldova. \n\nI didn’t go to Moldova. Uzbekistan, for some reason I’m drawing a blank on that. Kyrgyzstan, this is where we met the physician that I had traveled with back in 1996.   \n\nA little bit about Uzbekistan. About this time I started saying to the Heart to Heart logistics people, as they were putting together delegations, I said you can put me with the group that’s going to an area that’s fairly remote, not the best amenities or anything like that. And I remember that we traveled quite a distance across the country of Uzbekistan. And the people living in this area of Uzbekistan, Kyrgyzstan, they lived in yurts. These are rounded huts. They’re nomads and they can pack up and put their worldly possessions on the backs of mules and donkeys and move to the next area. They set up these yurts which are kind of round with like a dome kind of hut. And it’s got a hole in the middle similar to a Native American teepee, so they can cook inside and the smoke goes up through the middle. Obviously, not the best of conditions for you health- wise. But I remember, our little team got so excited. We were driving along a very, very rural road and seeing a yurt, we asked the driver to pull over and we went running to the field and probably scared this poor family to death – where did these people come from? There was a child who was playing outside. The mother was outside. The grandmother was inside. And I remember we kind of opened up the flap and through the interpreter said “hello.” And she invited us in, so we could see the inside of the yurt. And then at one point, she offered us horse’s milk. Fortunately, the translator saved us from that one because she offered to drink the milk. Otherwise, it would have been a cultural faux pas. And I don’t think our American stomachs would have handled it very well. And I believe it was also on that trip, Uzbekistan in 2002, the town that we ended up in, there weren’t any restaurants or anything like that. The restaurant where we were told we should go to eat, we went and sat down. And again, these restaurants are not like anything you would think of. These are like small mom and pop-kind of places. Wood buildings, maybe cinder block or plaster. That would really be a lot to have something like that. And we sat down, we placed our order and waited and waited and waited. And then finally the owner came out and apologized; he had no food. He knew he didn’t have any food at the time we came in. But for cultural reasons, he wanted to save face and didn’t say anything. One of our translators was able to scrounge up something there.  \n\nIt was either Uzbekistan or Kyrgyzstan, I can’t remember which one now...part of what we used to do was present stethoscope and ophthalmoscopes and otoscopes to the doctors or the head of the hospital. And for those of us going on these really remote trips where we didn’t have any of the leadership with us, we would designate the physician or one or two physicians in our group to be responsible for that little ceremony. And then, also, they would be the ones who would have a discussion about the medication at the clinic with the doctors and the nurses. And I re- member the doctor who was on our team. Dan had said to me make sure that he remembers to do the presentation. And then make sure that we get to where we were supposed to go to do the medication updates. And one of the briefings that we had received was that it was considered a no-no to blow your nose in public, in tissues or anything like that. It’s just culturally not right. And this particular doctor had a runny nose. And when we got to the clinic, we were just having a lot of fun with ourselves. Somebody kept saying to me to sit up on the stage with them, so I said okay. And his nose was running and I kept whispering to him not to blow his nose. So he’s trying to talk and present and the nose is running and all that. And we had two or three stops like this. And it was becoming like this running joke, sit up on the stage with him and make sure that he doesn’t make this blunder and forget and start blowing his nose. And the third stop, he makes it through the medication update. And the doctor who was hosting us said, through an interpreter, to the audience of doctors and nurses, turned to us and said we thank you so much for your medi- cation update. This is very useful information. Some of it was new information. And he said we have learned a lot and there are some things we may not have known. But one thing I do know, I think your doctor is suffering from runnyitis(?). Later we went to a clinic. We were out there by ourselves and we had sketchy directions as to where to find this clinic. You know, you’re work- ing with an interpreter and a driver who doesn’t speak any English. And we finally pull up to this clinic and we go in and through the interpreter we ask for who is the head chief and whatever, because this is only a stop to drop off the gifts. And so two people came out and we kind of stood in a circle around them. And the doctor in our group began to make the presentation. Offered the otoscopes, ophthalmoscopes, the stethoscope and presented them. And then when we were done, one of the recipients looked at it and looked at us and said, “What is this?” So we kind of ex- plained to him what it was and we made our goodbyes and we left. And it wasn’t till a while later we realized we had gone to the wrong place. And who knows who we had given these items to.  \n\nIn many of these countries there’s a level of hospitality. You are dealing with a country that over the years has begun to get back on its feet. The doctors and the nurses many times are working without pay. At best they may be making $10 or $20 a month. But no matter where we go, they find a way to have very nice hospitality for us. The local women would prepare a lunch that would rival anything you would find in a fine dining restaurant. Just lots of different dishes. Just very, very, well-prepared. They often have a ceremony. When you arrive at the hospital or somebody’s establishment, young women dressed in native garb are there waiting for you with a loaf of home-baked bread. Almost like a challah kind of bread, it’s kind of braided. It’s sitting on a cloth and it’s very ceremonial. And as you enter the hospital or the clinic, you’re supposed to take a piece of this bread, dip it in some salt, and have a sip of wine and then you enter. So that’s a memory from many of these visits.\n\nI think you have covered Uzbekistan and Kyrgyzstan in 2003.   \n\nThis is a return visit to Georgia. The anecdote here was actually before we got to Georgia. Because now we’re after 9/11. There’s a lot more security traveling to these countries. There’s a lot of questioning as to who you are. A lot of our product was taking longer to get into the country. Whereas before the plane would land, we were off-loaded and distributed to various clinics and we would disperse as teams either for the day or an overnight to verify that the product has actually been received. But now there were a lot more delays. There were a lot more concerns, is this the product? We need to verify, test the product beforehand. So that was causing some delays. But on our way to the Republic of Georgia, Steve Meyers and Will – and I agreed that we would fly from our respective cities and meet in the Paris airport and then fly together to the Republic of Georgia. And we both landed in the morning. We made it over to the terminal for the flight. We connected with each other. And I said to him, when we’re in France I’ve got to have my first cup of French coffee. And he said fine, go ahead. I went over to the little kiosk, I was getting my coffee. And he came over and said we need to hurry up and get down to our gate. I said fine. And started walking down to the gate and we noticed that there were literally hun- dreds of people in front of us. There was this huge throng of people and it was almost impass- able. And so he and I just elbowed our way through and said “excuse me,” because we had to get to our gate. And when we got through this mass of people, we realized that there was a barricade set up and you couldn’t go any further. And in front of us is just basically the empty corridor of the airport. And we were just standing there, trying to figure out what was going on. I speak a little bit of French, so I asked the French policeman there what’s going on. And he pointed out that there was a bag that had been left unattended. And we could see the bag in the distance. We were talking and all of a sudden we heard this loud explosion. And everybody jumped and we turned. And there was a second one. The immediate thought was, what’s going on in the airport? And then we realized, they had blown up the bag. I later found out this is typical in France. They ask no questions. If there’s an unidentified bag, it’s confiscated and then it’s blown up. So Steve and I have been telling that story ever since then.  \n\nThe Georgian, I don’t know if he’s a Prime Minister or President, was very well-liked. There had been a major overthrow of the government and he basically came in and cleaned out the govern- ment. And he’s often in our U.S. press. We had a chance to meet his wife one evening. She was not Georgian, but she had won her way into the hearts of the Georgian people. She’s from a European country. I want to say The Netherlands, but I’m not exactly sure. But she had won her way into the hearts of the Georgian people because she had learned the language. She was stun- ningly beautiful. And he had a lot of western ideas. But at the same time, our product was being delayed because of a lot of the counterfeiting that’s going on around the world. We, here in the U.S., have concerns about product that’s coming into our country that’s reimported, that may not be the product that it’s supposed to. And in many of these countries, they’ve been dealing with counterfeits for a long time. And our product was being held up because they wanted to test the product to be absolutely sure that it was what it was supposed to be. Coincidentally, the Deputy Minister of Health had been educated in the UK and also had been a former sales rep for one of the U.S. pharmaceutical companies. And so Steve Meyers and Will – and I asked if we could meet him for tea one afternoon, which we did. And we were just basically talking and I said to him, you were educated in the UK, you have worked for a pharmaceutical company, you know how our drugs are tested and approved through the FDA. Why is there so much concern about this, that our product is being held up, it’s being quarantined. He said you really make a valid point. Now whether they’ve actually changed that or not. Steve and I had talked about this – just a simple encounter of taking the time to have tea with an official and just pretty much stating our case in just very plain language that this is U.S.-made products from U.S. pharmaceutical companies. They have a reputation around the world for the quality of their products. So that was just a very interesting encounter with the Deputy Minister of Health.  \n\nAnything else you recall from the Georgian trip? \n\nNot immediately.  \n\nTajikistan is one of the poorest countries in the world. So there was tremendous need there. It was interesting because the U.S. Embassy stats talked about how poor the country was. But I came away impressed with the people. And I think it’s typical of the Soviet people; they’re very, very proud people. Very proud of their country. And in Tajikistan they just had this tremendous can-do attitude. Some of the physicians had been educated in the west, studied medicine, and then were coming back. And they were there to be part of rebuilding their country, using the skills that they had developed outside their country.  \n\nMoldova was in 2006. What I learned about Moldova is it’s known for their wines. And it’s interesting because I was just at the Union Train Station in Washington, DC and in one of the restaurants they were featuring the wines of Moldova. So while we were there, we saw all the vineyards and everything. The Minister of Health was just this wild and wacky character. We ended up in a town a good three- or four-mile drive from the major city. We did an overnight there. And as many Ministers of Health, he really wanted to make an impression on us. He was also lobbying some of the Americans, if there were ways for additional money to fund projects and things like that. So the thing that really stood out, he decided to accompany us back to our hotel which under normal circumstances should have taken about four or five hours. And he commandeered one of the police cars from the town with one of their policeman, and he had two or three of these. And basically they put on their flashing lights. And we’re traveling motor coaches. We’ve come a long way from the early days when we had these little vans and we worried about fuel and petrol and you could carry cans with your gasoline in it, with drivers who smoked. And now we’re actually in coaches that you would transport tours in. So we had two of these coaches and were led by these three screaming police cars with the sirens and the lights flickering. And it was one of these things out of a movie. We’re on these country roads, two-lane highway, one lane, one-way, one lane the other, that just curved through the mountains, through these little villages where there’s like two or three houses and that’s the town. And we are whizzing at I don’t know how many miles per hour. And we were just hysterical because the people go back to the times of the Soviets when the police dominated. And here are these three police cars, these two motor coaches at breakneck speed in the middle of the countryside, going through these villages. And people were standing at attention by the side of the road, not know- ing who we were. And I think we did that drive in about an hour and a half and it should have been a three-hour ride. It was a little scary at points. And then once we got to the hotel, he got out of his car, thanked us very much for everything we had done. We walked into the hotel and he went back.  \n\nI did not go to Tajikistan in 2007, last fall.\n\nDo you plan to go on any Physicians With Heart trips in the future? \n\nMy understanding, last year was supposed to have been the last one. The State Department’s funding that provided the plane was part of the Freedom Act and that funding had gone away. So last year, 2007 to Tajikistan, was supposed to have been the last one. But there’s talk that there will be one more in 2008 and that will be it. What the Academy and Foundation have done in the few years, with the, I guess, comments and suggestions that they have received, rather than trying to do a different country every year, start going back to countries to see if there’s progress that has been made. So I’m not too sure where they’re going in 2008. But it will probably be a repeat of where we have been before. And then my understanding is that the Academy really would like to look at another reach of the world. And it will be a totally different program than what it is right now.  \n\nThere has been some talk of possibly getting into Africa. I know from my discussions with Dr. Ostergaard. \n\nBased on your experiences with Physicians With Heart, where do you think the project should be headed in the future? \n\nI think there will be, at least short-term, an ongoing need to demonstrate what family medicine looks like. One of the things that we learned in these visits is that at least in the Soviet Union and in many parts of the developing world it’s a specialist system. And the idea that one doctor can take care of the entire family and every organ system is very difficult for them to comprehend. But as these countries are developing, it is the most cost-efficient way to treat patients and man- age disease. So I think the Academy is really in a good position to present that concept. So if there’s any way that they could continue with these projects. You know, delivering medicines is one thing and that’s the part from industry that I was most concerned about. But over years the Academy has really begun to talk about here’s how we manage diabetes or cardiovascular dis- ease. Here are some latest techniques in delivering babies. Yes, there are some cultural specifi- cities and country pride that may get in the way. But I think it can be done in a way with great sensitivity. I think there is a great need over the years to continue it. And if you just look in general with what’s going on with people and how they view their time, more and more people are looking at how can I commit my time to doing something of meaning and of benefit. And this fits right into that. People are saying I’ve done the vacations to Orlando to Disneyworld and Las Vegas and things like that and Europe. I want to take my vacation time and do something meaningful. And this fits into that sense of wanting to do something for the global world and then tying it into helping to manage diseases. Where here we take it for granted as to how to manage it and in other countries it can be pretty difficult. Whether it’s access to medicines, access to care, the insurance coverage situation – they’re just at the beginning stages of putting these processes in place. And I think the Academy and the Foundation is really in a good place to help move that along.\n\nOn a more personal level, how has the experience of being involved with these airlifts over the years changed or affected you? \n\nIt has affected me tremendously. The whole concept of global humanitarianism. As I look to my own personal future and retirement, I have decided that however I am able, that’s how I’m going to dedicate my life. I feel that I have been blessed that I’ve had the experiences with Physicians With Heart. Yes, I went as industry. But it opened my eyes to many cultures, to how people are living or managing to live in some pretty dire situations. And we just take so much for granted in this country. I would like to be able to build on my experiences with Physicians With Heart, build on my experiences of working in corporate America, in the pharmaceutical industry, and pull all that together and just dedicate my life and maybe three or four times a year do something in the spirit of humanitarianism. So it had a tremendous impact on me. I ended up chairing a committee for the Presbyterian Church, their Presbyterian Disaster Assistance Advisory Com- mittee. And that largely came about because of my exposure to this project. And I’m now getting involved in more mission committee work in my own church in Fort Washington, Pennsylvania. So I see how it has really become a part of the fabric of who I am now. I try to convey this to my three children. I have three boys in their early 20s. And hopefully that later on, when they’re in a position, that they will be able to do something to give back. I feel blessed that I had the exper- iences with Physicians With Heart. Those experiences that most people will never have in a lifetime. And I really want to build on that for the remaining years of my life and do something with it.  \n\nAny other thoughts or anything else that we haven’t covered that you would like to share? \n\nOne piece that I didn’t really touch on, because I was looking at it from my experience as an individual and all the funny anecdotes and things like that...but the mission of the Academy being there opening the eyes of physicians and nurses in these countries to the concept of family medicine. And there was the Children’s Project. In many countries, often we would visit what they were called orphanages. And orphanages are different from our concept of orphanages. In many of these countries the children may be abandoned because of a birth defect that is easily correctable in this country. Or some problems or disorders that are just not known or understood and the child will be ostracized in their community. Or for reasons that the family is not able to take care of them. And over the years Ruth Ostergaard has done a phenomenal job of pulling together many of the spouses of the physicians, and the spouses are male as well as female, to work on the Children’s Project to collect items not only from pharmaceutical companies but donated by individuals. Knitted and crocheted blankets and hats, monies that were donated. And the monies are spent in countries, so you benefit the local economy as well as get something that can be used or needed. So anything from cribs and beds for orphanages, kitchen appliances, putting in a complete bathroom. All of this has been done through the work of the spouses and Ruth Ostergaard as well as through the very generous donations that they have received from the Academy and Foundation community and its members. So I want to point that out as well.\n\nI want to thank you for your time. Anything else you would like to add? \n\nNo. I thank you so much for this opportunity to jog my mind and remember this and I appreciate the time and opportunity to speak with you.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153748/file/282857#t=0.0,3615.42423"}]}]},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153748/file/282856","type":"Canvas","label":{"en":["Media File 2 of 2 - Mafett_Zandra_08_b.wav"]},"duration":1026.81756,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/public/images/audio-default.png","type":"Image","format":"image/png"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153748/file/282856/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153748/file/282856/content/2/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/282/856/original/Mafett_Zandra_08_b.wav?1752674551","type":"Audio","format":"audio/wav","duration":1026.81756,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2195/collection_resources/153748/file/282856","metadata":[]}]}],"annotations":[]}]}