After 51 years working in public health in the Delta, Dr. Alfio Rausa is retiring this month.
Rausa has dedicated the bulk of his 81-year-long life to identifying the region’s health problems, educating the public about them, and finding ways to control or eradicate them.
Diphtheria, West Nile virus, cancer, childhood obesity, malnutrition, HIV — the proliferation of diseases has changed over the last half-century, but Rausa’s dedication has not.
As District 3 health officer, the Greenwood physician’s job carried him regularly around the Delta to the nine counties in his charge: Leflore, Carroll, Bolivar, Washington, Sunflower, Montgomery, Holmes, Humphreys and Attala.
Now, facing repeated rounds of state budget cuts, the Mississippi Department of Health is reorganizing to reduce administrative costs. Changes at the state level will eliminate Rausa’s position in Greenwood and move leadership to a centralized office in Tupelo, which will oversee the northern third of the state.
Two other regional offices in Jackson and Biloxi will oversee public health initiatives in the central and southern parts of the state.
“It’s a reduction in the workforce, and it’s a hellish thing,” said Rausa, who is recovering from recent hip replacement surgery and now gets around with the help of a cane.
He likens the cutbacks to 30 years ago, when the Health Department’s district offices lost funding for environmentalists — health officers who conduct inspections of water systems, nursing homes, day care centers and restaurants.
The Health Department centralized environmentalists then, as it is centralizing supervision of district health offices now as a way to adapt to steep reductions in state allocations. The agency started the current fiscal year with $36 million in state funding but had $5 million in midyear cuts. It is budgeted to receive $24.6 million in the new year that begins July 1.
“They’ve lost $13 million, and they’ve done a yeoman’s job stretching the money they have,” Rausa said.
Although he’s retiring, Rausa is not planning to go anywhere soon. He’s been asked to come back in 90 days to help with a study on human papilloma virus.
“I’ll be training doctors in that study,” he said.
Rausa said he also will stay involved with the Deep South Network for Cancer Control and continue to keep records for the American Association of Public Health Physicians. He points upward toward the ceiling, indicating that those papers are stored in the attic of the district health office on Yalobusha Street.
“You’re not gonna miss me.”
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When the New York City native got out of medical school, Rausa’s ambition was to be an interventionist radiologist. But the year he applied for a radiology residency on Long Island, there were no positions available.
“The doctors there told me to come down to Mississippi for a year to do public heath work while I waited for a position,” he said. “At the end of the first year, I had changed my plans.”
Rausa found big problems in his new home. People starving to death and poor health in general among the poorest people in the area.
“I came down from Memphis on July 7, 1966,” Rausa said. “And when I got to the ‘Welcome to Greenwood’ sign, there were houses just across the road with privies in the front yard, leaning this way and that.
“One of the first things we did was get those people indoor plumbing.”
That same year, a diphtheria outbreak in Leflore County led to Rausa’s department inoculating some 20,000 people with vaccines.
“There was tuberculosis all over the Delta then,” he said. “They had stopped X-raying people and testing for it.
“We set up a mobile unit that went around identifying people with the disease.”
This required contacting landowners to identify all the people living on a plantation, then going out in a specially outfitted Silver Stream trailer to take blood samples. The mobile unit continued working until the yield of positive tests was too small to warrant continuing the effort.
Now, finding a case of tuberculosis anywhere in the district is a rare occurrence.
Dental health — such as teeth rotting due to malnutrition — was a huge concern in the Delta when Rausa first arrived.
That problem, he said, was vastly improved with the advent of the federal Special Supplemental Nutrition Program for Women, Infants and Children, or WIC, which is still widely utilized in the area.
The Health Department’s job then was to locate people who needed WIC and to enroll them in the program.
“That’s a stand-alone program now,” he said. “It’s their responsibility to enroll and to deliver the program.”
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As with the delivery of WIC, many other things have changed over the time Rausa has overseen District 3’s public health.
“Overall, the most satisfying thing over the years has been our ability to see a problem and do crazy stuff,” Rausa said. At one point when he recognized the need for sanitary septic systems for people still using outhouses, he hired a “jackleg” carpenter to construct indestructible cypress structures and enlisted landowners to dig the holes for septic tanks.
Or there was the time the Health Department devised a program to bus handicapped kids to schools and the elderly to places where they could get healthy meals.
Now, he said, projects regularly require jumping through so many bureaucratic hoops that innovation and quick intervention are far more difficult.
“The biggest change is the process. It has gotten very hard to do good.”
Rausa has seen the problem of starvation due to nutritional deficiencies evolve to an epidemic of obesity, also based on poor nutrition. Plenty of other public health problems remain as well, he said.
But the work of delivering solutions remains and continues in the hands of dedicated people, Rausa said, such as those associated with the Fannie Lou Hamer Cancer Foundation, or the Magnolia Clinic in Greenwood that offers HIV testing and treatment.
For the good doctor, a strict realist whose thick New York accent has barely lessened over the past half-century, it’s all about focus and determination, qualities he has drawn on in abundant supply.
All in all, as he would say, not bad for a Yankee in the most Southern place on Earth.
• Contact Kathryn Eastburn at 581-7235 or keastburn@gwcommonwealth.com.
The original version of this article misreported Dr. Alfio Rausa's age.
