Gayle: Global poverty and poor health are symbiotic

Charlayne Hunter-Gault interviews Helene D. Gayle during the morning lecture on Thursday in the Amphitheater. Gayle is the president and CEO of CARE USA. Photo by Eve Edelheit.

Nick Glunt | Staff Writer

As a pediatrician at an inner-city hospital, Dr. Helene Gayle found herself treating the same patients over and over.

These children weren’t necessarily facing a particular disease — their visits had more to do with their family situations, events they couldn’t solve on their own.

“After a while, I realized that if I really wanted to have an impact on these children,” Gayle said, “it wasn’t by practicing individual medicine.”

She started practicing medicine to help people, but said that if she wanted to have a “long-term impact,” she needed to do more. Having a say in the policies that affected large populations would make more of a difference, she said. Public health seemed to be the next step.

NPR foreign correspondent Charlayne Hunter-Gault interviewed Gayle on stage during the 10:45 a.m. lecture Thursday in the Amphitheater. While answering a variety of questions, Gayle expressed her views on poverty abroad.

Gayle is now the president and CEO of the U.S. branch of the Cooperative for Assistance and Relief Everywhere, a secular non-governmental organization dedicated to fighting global poverty. CARE USA generally focuses on the empowerment of women as a means to eliminating said poverty.

Global health and poverty

When Gayle first entered the field, the phrase wasn’t “global health” — it was “international health.” It was looked at more as a comparison between nations. Now, she said, it’s viewed as the world as a whole.

“Global health isn’t about poor people over there,” she said. “It’s about, ‘How do we all work together in a way that enhances everybody’s health around the globe?’”

She said one of the driving forces behind this shift in thought was the realization that diseases can spread between countries seemingly overnight. To improve the health of populations around the globe, she said, there needed to be global cooperation.

By aiming to develop countries out of poverty, CARE USA can increase public health.

“Poverty is a consequence of poor health,” Gayle said, “and poor health is a consequence of poverty.”

Health in developing countries is slipping in part because of a mass “exodus of medical professionals,” Gayle said.

In many of these countries, Gayle and Hunter-Gault said, doctors and nurses see opportunities for greater incomes in more developed countries. As a result, few remain inside the borders of their homes.

If these countries are developed, doctors will have more incentive to remain, she said.

Development by empowering women

CARE USA’s efforts against poverty are mainly directed at the female population in countries. This is only natural, Gayle said, after looking at the statistics.

She said 70 percent of the people who live on less than a dollar a day are women, and women make up two-thirds of the illiterate population. Furthermore, she said women work 50 percent of the world’s farmland, but only make 10 percent of the world’s farming wages.

“If you want to go and make a difference in poverty,” Gayle said, “you have to focus on girls and women, because they make up the greatest number (of those in poverty).”

She said that if women are educated, their daughters are more likely to get educated. Thus, women are more likely to have fewer children and to get married later in life. These are qualities that contribute to the development of nations, Gayle said.

Countries with more women in their parliaments have more stable governments, less corruption and higher economic growth, Gayle said.

She added that furthermore, women with extra income provide more money for their families as opposed to men, who are more “egocentric.”

Focusing on women can even help to combat AIDS, Gayle said. Safe-sex campaigns can reduce the spread of AIDS, which in turn can reduce poverty.

“When you talk about safe sex and safe behaviors,” Gayle said, “you have to remember that people have sex for all kinds of reasons.”

Women, she said, can be performing sexual acts in exchange for food, water or money. This just increases the possibility that AIDS will spread further.

U.S. donations and aid

Gayle cited a survey of the American population that asked about monetary donations to global poverty. Americans believed the nation gave 25 percent of its worth to poverty abroad, but they said they’d be willing to give about 10 percent. In reality, Gayle said, Americans give less than 1 percent.

However, America is seen as the most generous nation because the U.S. gives more money than any other. Gayle said there’s room for more generosity. One percent of incomes isn’t enough, in her opinion; she said there is more Americans can do.

“Money helps,” Gayle said, “but I think what people often don’t think about is using their voice.”

Even if Americans aren’t donating money, she said, they can pressure their politicians to distribute more to developing countries.

“It really is about coming together and realizing that to be a healthy world,” Gayle said, “we have to look at it in a global nature.”

Question and Answer for Helene Gayle and Charlayne Hunter-Gault

Q: Reproductive health continues to be a political football here in America. In terms of global health, please suggest strategies that will make everything from basic birth control to safe abortion available for women in the developing world.

A: (Gayle) Well, you’re right. Reproductive health continues to be a very delicate issue in many places. What we’ve tried to do is to talk about it less from the standpoint of a woman’s right or reproductive health, but more from the standpoint of good health. We know that a mother who is able to space her children is going to both be healthier herself as well as have healthier babies, and I think for many people that’s much less controversial than saying, “a woman’s right to choose,” or some of the other ways in which people talk about reproductive health. So I think we, and others, have taken the stance that if you talk to people about the safety of a woman and a child, you’re more able to get some common ground around those issues.

Q: Could you please give us an update on Ethiopia since 1985, in terms of the government, tourism and overall sense of progress?

A: (Gayle) I don’t know if I can do it justice. I will say, I think Ethiopia has a very, very interesting plan to accelerate its economic development, and it has a president who, some may say is controversial, but he has been incredibly innovative in his commitment to things like a clean environment. He has a plan. He’s a man with a plan. He says by 2015, I think, he wants to be a middle-income country. So Ethiopia is one of these countries that’s on the move.

A:(Hunter-Gault) Actually I do have something to say about that. All of what you’ve just said is true. Those of us involved in the free speech and freedom of expression movement would hope that the president would be a little bit more progressive in that arena. I have been to jails in Ethiopia where journalists have been kept for many, many months because of their outspoken criticism of, or an attempt to balance the political discussion in the country by giving voice to the opposition, which has landed them in prison, so we want to just help ensure that the president, while he’s being progressive on those issues, also becomes a little bit more progressive, as he promised us when we met with him, on the issue of freedom of speech.

Q: This one has the salutation of “Dear cousin.” What role has religion played in your work as you travel from one country to another? Is society guiding religion, or is religion guiding society?

A: (Gayle) Well, first of all, I want to recognize this row of all my cousins here. I looked up and saw some that I hadn’t seen in years. I’m not sure how to answer that. We are a non-affiliated NGO, so we are not affiliated with any church organization and have taken that stance partly because we work in so many different countries in which being aligned with one faith or the other can cause problems, but our background has always been non-sectirian; it’s who we are. I don’t know if I would say religion — the question was religion leading — that’s a broad question, and I think it really depends on the country.

A: (Hunter-Gault) I was having a conversation with the priest, (CLSC author Uwem) Akpen … and in the northern part of Nigeria, that’s definitely a problem and to a certain extent in Sudan and some of the other places where you have some of the more militant Muslim extremists trying to determine the direction of the society, and I think that’s a real challenge. I think that’s a real problem, and it’s very worrisome in a country like Nigeria, which has more Muslims in it than in the Middle East, which is not to say that all Muslims are militant and want to do some of the things that the extremists do, but the extremists are tending to give the religion a bad name, and I think that the more outspoken clerics, and others who condemn this kind of behavior, there needs to be more of that in order to confront this very real challenge in some of the countries, particularly in Africa, that I am aware of.

A: (Gayle) And I was reading that in a slightly different way, and maybe because I’m here in Chautauqua, and there’s so much focus on bringing different faiths together. I think ideally in a society where there is freedom of religion and people can practice whatever religion speaks to their heart or to their culture, then I think you have a society that is going to be free in a lot of different ways. So I was thinking of it more from that standpoint, and I think if you look at different societies when there’s this kind of extremism and where there isn’t freedom of religion and freedom of thought, then I think you have a very, very different kind of society, and I think it cuts across not just religion, but I think it cuts across many other things. I think a world like you’re creating here in Chautauqua, where there’s actually opportunities for people to talk across religions — I think opens up freedoms of all sorts.

Q: Would you please talk about the reaction of men in communities where CARE focuses on assistance to women?

A: (Gayle) Yes, good question. In the countries in which we work, we work very, very closely with communities, and one of my very earliest trips to Afghanistan, I think it was the very first country I went to when I first started at CARE, I would talk to men in the villages and they would say, “We like working with CARE because we know we can trust you. Because we know you listen to us and that you’re not going to try to get us to do something because it’s your way.” I remember, again in Afghanistan, during the time of the Taliban, when you were not allowed to teach girls in school. It was illegal to teach girls and women. Well, CARE’s school was able to stay open because they worked with the community to come up with a way that it was acceptable, and the men said, “Well, if you call it sewing schools, you can keep them open.” Now the teachers were teaching girls reading, arithmetic, etc., but as long as they called them sewing schools, it kind of gave them cover. So the bottom line is, whether it’s working with girls in communities, or whatever might seem controversial, it’s by working with those communities to come up with solutions that they find acceptable.

A: (Hunter-Gault) Can I just add to that? Because I saw this happening in the CARE project, micro-financing, in Tanzania, where the men were telling me how grateful they were that the women were participating and becoming economically independent, and it was actually affecting even the interpersonal relationships within families. The men were so much happier because they had income coming into the house, even when they didn’t have a job, but men were also getting involved in the micro-financing, so it has both community-wide implications but also implications for within the family. A much more stable economic situation was leading to a lot more stable relationships.

A: (Gayle) And just to add to that. The same sort of question I had when I first went to some of our micro-finance programs, and you would assume that this would be a threat, and over and over again, men would say, “No, in fact, my wife brings value to the family. I now respect her in a way that I didn’t respect her before.” So quite to the contrary, again, I think this focus on girls and women has really helped communities, and as I always say, the girl or the woman wins, but so do the men and boys, because it does change the way that they think of their sister or their mother in a way that’s positive for them as well.