I know how excited the family is about the global health effort. Can you describe how you got involved? In the fall of 1993, Bill and I traveled with a small group of friends to Africa. The trip was purely for pleasure. We had a wonderful safari, seeing the African countryside and the animals. What I didn’t expect was how moved I would be by the people. I came back and told a close friend that Africa changed me forever. It’s a place that gets under your skin. Seeing the women walking, walking, walking really struck me. We would go for miles and miles and see these women walking, and we’d always look to see if any had shoes. They didn’t.
In Zaire that year, whole towns had been literally shut down due to government corruption and inflation. Where there had once been small streets of shops, now the shops were completely boarded up and nothing was going on. Near town was a small open-air market where women were selling a few vegetables on the ground, but nothing else. Seeing such destitution and the plight of women–that certainly touched me.
The other turning point for us took place a few years later, after we read a Sunday New York Times article that showed a chart of the top diseases that kill children around the world. It was stunning. We just don’t face many of those diseases in the U.S. It’s the first time I remember talking with Bill about how tragic these diseases are for children: We asked ourselves what we could possibly do. After that, we approached Bill’s dad and asked him to help us start learning more about global health.
Can you describe some of the places you’ve visited and the health conditions you’ve seen? Can you recount one or two of the most memorable experiences you’ve had? Last January I traveled to Thailand and India on a foundation trip. I was both in the slums of New Delhi and in rural areas outside the city in the foothills of the Himalayas. In the city slums I saw tiny babies left on mats with flies landing all over them because their mothers had gone into the city in search of a job. I saw young children filling an old antifreeze jug with ostensibly clean water from a hole they’d punctured in a pipe. The pipe was about nine inches above a trough of raw sewage that ran the length of the slum. I saw young children playing on rooftops within a few feet of live electrical wires.
In New Delhi, people lived side by side in rows upon rows of houses. Each house was about 6 feet by 8 feet and housed an entire family of as many as eight people, as well as the family business, which faced the street. There were no toilets. Families bathed and defecated in the river behind the slum–a fetid stench hung in the air. A few pharmacies sold pills one at a time to families that could afford them.
After being in the city, I traveled to rural India. There I hiked down into a village that looked idyllic from the dirt road above. Hiking in, we crossed the main stream into the village. A herd of cattle had been in the stream earlier that day, defecating. Downstream, families bathed and cleaned their dishes.
Upon our entering the village, the surroundings came into focus. Families lived in one-room houses: the people lived upstairs and the farm animals lived downstairs. The “front yard” was a mud pen for the sheep and cattle. Women worked all day in the field and were still expected to draw water in the morning, feed the animals, feed the family and wash the laundry in the stream. After giving birth, the women are considered unclean and so are sent to live in the barn for 30 days until their husbands set a date for a purification ceremony. Only then are the women and babies allowed back into the house.
In India, the infant mortality rate per 1,000 live births is 43 (compared with 5 in the U.S.), and, in the rural areas of the country, more than one in 10 infants will die before their first birthday. Health workers can’t even get to these babies in their first 30 days of life.
I was there during the summer; the harsh conditions of winter there are almost unimaginable. When I asked one pregnant mother about a birth kit (consisting of supplies for a clean delivery, such as a new razor blade, a plastic sheet to cover the ground, cords to tie off the umbilical cord, a small bar of soap, a clean surface for cutting the cord, and pictorial instructions on how to use the kit), which I knew the local NGO health workers could sell her very inexpensively, she pulled us aside and assured us she knew of the kit, but to please not mention it in front of her husband. She had saved the rupees for the birth kit and intended to purchase it in the eighth month of her pregnancy. Then she would hide it under her mattress until she needed it. If her husband found the kit, she said, he would use the razor for shaving.
It seems unlikely that the whole world will enjoy adequate health care during our lifetime. Do you have any immediate goals for the foundation? Are there particular landmarks you would like to reach over the next year, the next decade, during your life? My immediate global health goals for the foundation all center on the desire for us to keep pushing for more childhood immunizations in the developing world, swifter trials on a microbicide–a product used vaginally to prevent sexually transmitted infections including HIV/AIDS–and a vaccine against AIDS.
During the next decade I’m hopeful that an effective microbicide will be produced and inexpensively delivered to put the power of stopping AIDS into the hands of women.
During the next 15 years, I hope we will have an AIDS vaccine–one that we can deliver worldwide–and that will turn the tide on this despicable disease.
I would like to see the number of childhood deaths from easily preventable diseases drop from 3 million a year to less than 100,000 in our lifetime.
I know you generally avoid the press. Do you feel torn between a need for privacy and a desire to advance the work of the foundation? Yes, I try to maintain a low profile so we can lead as normal a family life as possible. That said, I also care deeply about the work we are doing with the foundation, so maintaining a balance between these two is a challenge. As our children become older, I do envision increasing my role with the foundation. If a microbicide or AIDS vaccine comes along, if I feel I could really make a difference in furthering the distribution of these for the developing world in some way, I would likely give up even more anonymity to do so.
