Paul Farmer, MD, PhD, is Kolokotrones University Professor and Chair, Department of Global Health and Social Medicine, Harvard Medical School; Chief, Division of Global Health Equity, Brigham and Women’s Hospital; co-founder, Partners In Health; and UN Deputy Special Envoy for Haiti. Dr. Farmer and his colleagues have pioneered novel, community-based treatment strategies that demonstrate the delivery of high-quality health care in resource-poor settings. He has written extensively on health, human rights, and the consequences of social inequality.
2011 SESSIONS
Deep Leadership: Interior Dimensions Of Large Scale Change
Those working to change the world face obstacles rarelyaddressed in traditional leadership doctrines. Vision, risk and uncertainty take on new meaning in realms where lives are impacted by poverty, pandemics, conflict and injustice. Join Archbishop Desmond Tutuand other social sector leaders in this intimate discussion focusedon the interior landscape of leadership – a dimension where character rules, love and belief trump strategy, and resilience, renewal and patience are lifeblood for the long haul.
Speakers: Mabel van Oranje, Archbishop Emeritus Desmond M. Tutu, Joe Madiath, Cecilia Flores-Oebanda, Paul Farmer
Deep Leadership: Interior Dimensions of Large Scale Change
From: Deep Leadership: Interior Dimensions Of Large Scale Change | With: Mabel van Oranje, Archbishop Emeritus Desmond M. Tutu, Joe Madiath, Cecilia Flores-Oebanda, Paul Farmer
Good morning. My name is Mabel van Orange, and I am the CEO of an organization called the "Elders", which is explained on this lovely leaflet that you will find on the way out, or maybe distributed on the chairs. The chairmen of the elders is Archbishop Tutu, and we'll talk maybe about it a little bit more later.
This session is about a subject that I think has never been discussed, either at the school world forum, or in any forum like this. We often talk in the context of social entrepreneurs, of people who are trying to lead great change, about the external challenges that we face, how we can grow our organization, how we can scale up our work, how we can better use social media, how we can become better leaders of our teams.
But we talked very little about the internal dimensions of leadership. Maybe because these are sensitive issues, they are personal, we might have to show our weaknesses. Yesterday, Jeff, in his opening remarks, referred to the fact that social entrepreneurs are often very courageous people,very determined but after all, we're all human.
And so I'm wondering, where do we go when we get frustrated? How do you stay sane when you see human tragedy happening around you every day, how do you stay motivated when you see that change is not happening as quickly as you had envisioned it? What do you do when everybody around you says that you are absolutely mad to follow that big vision, that dream that you have.
What do you do when your kids ask you, "Why are you again trying to help others, and why are you not there on my birthday?" Who supports you? How do you stay balanced and energised? Those are some of the questions that we would like to discuss this morning. We have an amazing panel to do so. Let me quickly tell you a little bit about them.
Cecilia Flores Oebanda is the founder and also executive director of the Visayan Forum Foundation from the Philippines. She has a amazing life story. She was a child. She founded her foundation to help other people achieve freedom and to be able to lead decent lives and her foundation has done absolutely amazing work in the piece of human trafficking.
Joe, who's sitting here comes from India, He runs and founded an organization called, "Gram Vikas". He has an amazing life story, like, I guess everybody in this room. He grew up in a State in India that had the first Marksist government that ever empowered anywhere in the world. He was a troublemaker at school, his parents decided to send him off to boarding school, but he quickly decided to use these rebellious energies to help others. So, in 1971 he start helping communities that were raged by a cyclone at the time and 1979 he found Gram Vikas which was initially focused on the renewable energy for rural communities, but fairly quickly changed into a more holistic development model and his work has affected hundreds of thousands of people.
Paul Farmer, for everybody who was here last year, who remembers his amazing speech. I can not remember if it was the open or closed session, but it brought many of us to tears. He is the founder and one of the co-leaders of Partners In Health. Which is basically trying to prove that cost effective high quality health care can be delivered even to those are living in a most hopeless of situations, and he founded Partners in Health in 1987, and they keep working on a community based healthcare system and he's a great advocate for global health equality as well. And then the man next to me, Arch, the chairman of the Elder. I don't think he really needs an introduction and even if I try to give an introduction those people who are introducing him tonight when he gets his award probably get very upset because I might be taking some of their words away.
So I'm just going to tell you one or two things about him. Others call him South Africa's moral conscience. He's described as the worlds most famous champion for human rights I know him as the man, the only man I think in the world, only person in the world who can herd cats, who can keep order in an unruly bunch of ten former heads of states, former Secretary Generals, which is was the elders is. People like Jimmy Carter, Kofi Annan, Gracia Michelle, Lakdhar Brahimi. He keeps them in good order. You know that, he never forgets any birthdays of any of them , or their wives, or their wedding anniversaries and always congratulates them.
That's the heart he has. That's how amazing he is. Now, these panelists are going to be brief, and they're going to be brilliant. But we're not going to have them talk all the time, as i mention these questions of inner Leadership, I'm convinced that all of us struggle with them at times. So we want to involve you as much as possible in this discussion.
But that means that even though they are going to be brief and brilliant when one of you gets the floor you can try to outshine them which but you have to stay shorter than their interventions. Anyway, we have a lot of ground to cover but lets get started with the following question. Every every social entrepreuner every social change maker had one and more movements in the past where you said look I am going to do something completely different.
I have this vision. I want to create this kind of change. These initial moments of motivation. Now, I guess we can all, after what I said a bit about your backgrounds, know a little bit about what motivated you at the beginning. What I am very curious about is, to which extent are you still driven by that vision of change, by that drive that you had
10, 20, 40, 50 years ago. Cecelia, would you like to start?
I think my passion start when I was actually in prison, and living in prison with my children, and of course separated from my son. I thought that our life in prison is really the worse life that everybody can have. But after the rescue, victims of human trafficking I realize that actually our life, it is really nothing compared to them.
From them I really resolve that freedom is very important. I will never give. I will continue to do it. And, how can I give up? How can they betray the girls that actually traffic from the Far Pang community in the Philippines and sold into prostitution. And sold to slavery. I don't know, but for me, my vision and my passion is always consistent, and my belief,
in the goodness of God and and my belief in freedom is always in tact so I would say that maybe the life is changing and you know the situation is changing but that passion and the vision is always consistent and always with and will never give up in any difficult circumstances. Because it means a life of a girl.
It means the life of eighty percent that I rescue before I come here it means the future of Philippines to explore opportunities without the risk of being sold and enslaved it is the future of next generation and I offer my life, until the last drop of my blood to continue that vision. Paul.
When I was thinking about the question I realized that you can back the answer up. A long way. Anyone can perform autobiographical tricks to do so. So I was thinking not when I first decided I wanted to be a doctor who focused his attention on people living in poverty, but when I realized it was too late to go back.
And and I'm glad some of you chuckle, because it's a pretty frightening feeling, actually. I'm sure others in this room have felt it and for me it was in the course of several months. I can't remember how many, when I was in my early twenties, and my mid twenties. I had started medical school and was going between Harvard in Haiti.
My friends, in Haiti who were my age mates they were peers. We worked together on a health survey, traveled all over villages in that part of central Haiti. And one of them died of perforation due to typhoid. Disease before he ever saw his 30th birthday. Another one who became the record keeper in the clinic we just built died of puerperal sepsis from having a baby under poor conditions.
And the third of these friends I lost, died of cerebral malaria, misdiagnosed as having a psychiatric illness because she went crazy with cerebral malaria. And that determined many things. I decided what kind of doctor I wanted to be, where I would focus my energy. And yeah, I feel as passionate about those kinds of tragedies and medical errors now as I did then.
The difference of course is that in those places where I first saw them, they're gone. We don't have those kind of errors really. Women don't die in childbirth. They don't of obstructed labor. They don't die of a little perforation because you put in clean water and the Cholera that is spreading across
Haiti is not, they are referred to us from other places. But we see this all over the world. And as a result we've tried to move our energies around the world too, because we are hoping as people believe in basic rights, social and economic rights, civil and political rights that anybody in the world can understand what it might I like to be
sick and alone. And we find that people like this quest for freedom, people understand that every one of God's creatures needs accompaniment and help when they're sick, so I do feel just as passionate now.
I was always thrilled by the notion of equity. So I was appalled to see when I was a small boy, at one time I was a small boy, 10 years that I come from that time. My family comes from the state of Kerala My mother's father, grandfather, he would line up the people who were working in the field and would have a hole in the ground, and then would pass a banana leaf over fire so it becomes very supple, push that in, and then would pour rice into the leaf which is in the hole.
So one day I saw this I went up to him and said this is the way might treat dogs, not human beings and he turned to me and asked me, Are they any better? I was shocked. How could a human being say about another human being even if he is my grandfather. In this manner. So I think it was at that time if I begin to trace.
I cannot say that I made the most certainly a decision, but that was the moment when i said this is not right. If i can do something to right to make it right i will do it but how i did not know, so i went i was i began to organize the laborers of my father. He kicked me out. I went to the boarding school, there i thought, i mean i am god's so an answer to the organizational of all these school's.
So i began to organize the students. So i was kicked out from school, came to the university became also the president of the university. But this thing of inequity that prevailed in our society, there there was this untouchable ability of the people who were so called untouchables or low casts, people who were tribal, separated from the society and I said, OK, this is where I will work and did not take up career, I went to villages.
There was a cyclone. I started working in Orissa, but always this idea of equity, and today after many years of travel, if we are in the field of water and sanitation that is gram vikas. Because I see that water and sanitation is needed by everyone. If there is even one family which does not practice proper sanitation it can defile everyone else's water so we took that as a point to come together for the entire community and total inclusion, and then proceed further.
This is how that search for equity and there's still continuing there's tremendous inequity: economic, social, any sphere that you take in India and the journey continues still.
Now its your turn. Thank you so very much may I, first of all, pay a very, very warm tribute to all of you? You are amazing people and you you awe me. I mean, as I listen to the incredible things that you do. All of you. You make one so proud of being human, and thank you for that. Thank you, thank you on behalf of the many, many, many who want to thank you, who often do not have that opportunity, and thank you on behalf of God, because I think there must me many times when God says ... whatever got into me to create that lot?
And then God sees you and others like you, and God says they have vindicated you. You have vindicated God, and that's for real. please know that there are many in the world who wish to be eloquent enough to say thank you, thank you, thank you, thank you, thank you and I also wanted to thank you for the very warm welcome that you gave me and sort of making me think i was something when they learn I got on a train in Atlanta, and somebody that they recognized me and so they take came and they were asking for autographs and i try to look suitably modest as i, as I was signing, as i was signing these autographs, and one lady came up and pushed a piece of paper in front of me, and as I was signing she turn to these people and says "who is he"?
So, I thought it was very good for the soul. One day, one day, I was I think maybe seven or eight I went with my father who was headmaster of his school, and so in the Black community, a very important man and we went into town, segregated of course. And we got into the shop , and there was the slip of a girl behind the counter, a white girl, and when it was our turn to be served, I was standing next to my father.
And this girl said to my father, "Yes, boy." I wondered how my father must of felt being humiliated in front of his small boy. But i got to know because several years later our last child was born in London and she knew nothing about South Africa's apartheid and she was free and i am walking with her and I've got her by the hand and she saw some children on swings on round a bouts and she said, "Daddy, I want to go on the swing." and i said, "No, darling. You can't" she said "But there's other children" and all this, but how do you tell your child, you are not like other children, you are a Black child. I knew then how my father must have felt.
I wished the ground would open up and swallow me and then a little later still in the same town I was riding a bicycle, I was the only black priest who had his own bicycle. My father used to send me to town to go and buy newspapers and things, and i went past a school for white children, again they're all segregated, and saw three kids from my ghetto and they were scavenging in the school rubbish bin, getting out perfectly lovely apples and think because the government was providing school to white kids who didn't really need it.
They preferred their mother's lunch packets and much, much later [sp] was to say why Black children who needed it, were not being supplied with school feeding, he said, because we can't feed all, we won't feed some. Imagine Paul saying "Well, I can't cure all of you here, so I'm not going to try and cure any"... I can't say that that made me really get sort of hot under the collar very much, no, but it was later Laia and i were school teachers and the same Vervood [sp?] introduced something called bond for education, an education deliberately designed to produce docile, unthinking Black children.
They said, "Why do you teach black children mathematics? What they are going to do with mathematics, they must know enough English and African to understand instructions by their White masters and mistresses, don't let them hear anything about the American War of Independence or the French Revolution, these are going to put bad ideas into their heads and then I said I am not going to collaborate with this , this cruel thing, cruel things said to our children but I was inspired by some incredible human beings, Trevor Hartleston [sp?] and then I was into this really by default because the Nelson Mandelas were in jail, others were in exile and nature does not allow for vacuums and so I just happened, well I just happened to be the first Black person to be Dean of Johannesburg.
And was given a platform and as they sometimes say, the rest is history. The speakers are not allowed to bring the moderator to tears, thank you. I would like first talk a bit about one set of questions, which is the question of, how do you keep going? Where do you turn when you feel that the challenges you're facing are too big?
What do you do when your child is accusing you of not being there at important moments in his or her life? And, before we open this part of the discussion up, i wanted ask you, Joe, when we spoke a little while ago you said, "I started 30 years ago, and the change that we have achieved is so far away from what I had envisioned at that time.
There's still so much to do. How do keep going when you have the feeling it's not going quickly enough? And how do you tackle so much, do with some of these, these internal questions of frustration of doubt.
Unlike the Archbishop, 35 years ago I was not so modest. I thought that in a few years I am going to change India. So I set out and well India is almost where it was. But my colleagues and me, we have been struggling on a path of justice on the path of equity, on the path of well being for the poor, but often it is hard, i remember my first child was born and i was in a remote village and i was there for 10 days.
Only after 10 days when i come back, i realized i'm a father. So i thought anyway, I'll try again. The storm was working overtime , so, my second child, the daughter was born, again. I think my wife, I told her, I want to be there, but then she miscalculated the date I was again in a far off indigenous village.
And I was very happy to come and see "oh, I have a daughter". I said, Okay, I must try once more. The third child, again, I was not there. And each time, on one side I used to laugh at the irony that the more determined I got that I should be there in these big moments the further I was away. This can bring you down now and then.
There are times when I come I wanted that change that that village where they will forget their differences where the rich will show some assemblance of concern and care for the poor, and it didn't happen, maybe the tenth meeting ... nothing happened. There will be times when I would just take the pillow and cry into the pillow.
So how do we go on? Then I discovered this terrific elixir, this tonic when ever my battery was down, really really low, then, and I realized that if the battery is beyond that, a certain level and is down it need what is called a bench charge. So I would go out into the villages. Where the people have come together worked among themselves, we were a part of that and they built, whatever it is, whether it is a a good agricultural system, total inclusion, total sanitation, a water supply system for which they would say "we have done it, we could do it"!
Yes, you helped us a little bit, yes, but we did it. One or two villages and living two or three days or nights with those people further living in their ambition, further dreaming up with them, that would give me a complete battery charge, bench charge. You see, usually a battery gets a bench charge in a few hours, but my battery is a very poor battery and so it needed two to three days, but I got charged, came back... a new person. Fully charged up!
Because of that, I always took some extra charge with me so that I could also plug into my colleagues batteries, so they would also go. So this, ultimately for me, my staying power, how I can go on, is because of the people with whom I work. I agree. I had set out to change the whole of India, and there is a hole in India now.
We have not managed anywhere near that. But, when I see what did I set out for and where have I reached, then I remember what Mother Theresa said. "I may be a drop in the ocean. I mean, I may be a drop in a bucket. But without that drop, the bucket will be poorer by that drop". So I only want to be that drop.
And I do everything possible to be a good drop. That's all. Thank you.
So Celia how do you keep going?
Well, to be honest there are times that I also got in the crossroads, the first time and the last times that I actually almost gave up is when I received the first death threat, from the traffickers. Living in prison and a single mother of four it is really very hard for me, because I need to make a choice for the safety of my children and the freedom that I fought for the other girls.
Well, our friends are talking about other things and would like to concentrate as a mother, and how I balance my life because honestly speaking, I have never balanced life. I have, a life in prison, a husband who left the four children, a single mother, running after traffickers. Filing cases, heal with the victims ... phew! I thought I can never have that kind of life.
But I would say that yes, indeed, I think I'm managing well because I believe that I cannot survive alone. We have people that work with us. My children love my work and take pride of my work. They make an extra effort to make my difficult life easier they help in whatever they can. My colleagues are always there to support me.
We always journey together and that makes my life balance, because I don't think that balance is just a thing that you really .... balance is a gift. It's the gift that you can give to yourself. It's the balance that keep you going. At the same time, how can I give up when a girl, when a 14-year-old girl was sold to prostitution.
First to insert cotton dipped in the pigeons blood, in her sex organ just to be marketed just as a virgin many times. How can you give up? When the girl is only 14-years-old was sold in Syria, the worker is a domestic worker and sold to multiple employers and put them to jail, and they never give up.
They still have hope in their hearts. They still want to go on. So that kind of victory, that kind of trust, I cannot I cannot be selfish and just bring my children and be safe. Because, that's not me, I'm a very stubborn girl. I'm a stubborn women. And with all the harassment and with all the death threats and everything I find it now more exciting, especially that I have this cool community.
I know Jeff Skoll, I know Sally, you know, before I come here, my goodness, I am like a kitten who is really afraid. I don't know what to do. I am struggling as a person because the problem is too big, but I have my community, I have the trust and I have the power of the people, especially the women that we saved, to continue fighting, and for me that keeps me going.
And I will have a high energy, as always. And beyond everything I think I am still very lucky that I was called and I follow and serve given the opportunity to make my life worth, and given the opportunity to serve and make this life really worth living for, and I am really grateful for that.
This session is about a subject that I think has never been discussed, either at the school world forum, or in any forum like this. We often talk in the context of social entrepreneurs, of people who are trying to lead great change, about the external challenges that we face, how we can grow our organization, how we can scale up our work, how we can better use social media, how we can become better leaders of our teams.
But we talked very little about the internal dimensions of leadership. Maybe because these are sensitive issues, they are personal, we might have to show our weaknesses. Yesterday, Jeff, in his opening remarks, referred to the fact that social entrepreneurs are often very courageous people,very determined but after all, we're all human.
And so I'm wondering, where do we go when we get frustrated? How do you stay sane when you see human tragedy happening around you every day, how do you stay motivated when you see that change is not happening as quickly as you had envisioned it? What do you do when everybody around you says that you are absolutely mad to follow that big vision, that dream that you have.
What do you do when your kids ask you, "Why are you again trying to help others, and why are you not there on my birthday?" Who supports you? How do you stay balanced and energised? Those are some of the questions that we would like to discuss this morning. We have an amazing panel to do so. Let me quickly tell you a little bit about them.
Cecilia Flores Oebanda is the founder and also executive director of the Visayan Forum Foundation from the Philippines. She has a amazing life story. She was a child. She founded her foundation to help other people achieve freedom and to be able to lead decent lives and her foundation has done absolutely amazing work in the piece of human trafficking.
Joe, who's sitting here comes from India, He runs and founded an organization called, "Gram Vikas". He has an amazing life story, like, I guess everybody in this room. He grew up in a State in India that had the first Marksist government that ever empowered anywhere in the world. He was a troublemaker at school, his parents decided to send him off to boarding school, but he quickly decided to use these rebellious energies to help others. So, in 1971 he start helping communities that were raged by a cyclone at the time and 1979 he found Gram Vikas which was initially focused on the renewable energy for rural communities, but fairly quickly changed into a more holistic development model and his work has affected hundreds of thousands of people.
Paul Farmer, for everybody who was here last year, who remembers his amazing speech. I can not remember if it was the open or closed session, but it brought many of us to tears. He is the founder and one of the co-leaders of Partners In Health. Which is basically trying to prove that cost effective high quality health care can be delivered even to those are living in a most hopeless of situations, and he founded Partners in Health in 1987, and they keep working on a community based healthcare system and he's a great advocate for global health equality as well. And then the man next to me, Arch, the chairman of the Elder. I don't think he really needs an introduction and even if I try to give an introduction those people who are introducing him tonight when he gets his award probably get very upset because I might be taking some of their words away.
So I'm just going to tell you one or two things about him. Others call him South Africa's moral conscience. He's described as the worlds most famous champion for human rights I know him as the man, the only man I think in the world, only person in the world who can herd cats, who can keep order in an unruly bunch of ten former heads of states, former Secretary Generals, which is was the elders is. People like Jimmy Carter, Kofi Annan, Gracia Michelle, Lakdhar Brahimi. He keeps them in good order. You know that, he never forgets any birthdays of any of them , or their wives, or their wedding anniversaries and always congratulates them.
That's the heart he has. That's how amazing he is. Now, these panelists are going to be brief, and they're going to be brilliant. But we're not going to have them talk all the time, as i mention these questions of inner Leadership, I'm convinced that all of us struggle with them at times. So we want to involve you as much as possible in this discussion.
But that means that even though they are going to be brief and brilliant when one of you gets the floor you can try to outshine them which but you have to stay shorter than their interventions. Anyway, we have a lot of ground to cover but lets get started with the following question. Every every social entrepreuner every social change maker had one and more movements in the past where you said look I am going to do something completely different.
I have this vision. I want to create this kind of change. These initial moments of motivation. Now, I guess we can all, after what I said a bit about your backgrounds, know a little bit about what motivated you at the beginning. What I am very curious about is, to which extent are you still driven by that vision of change, by that drive that you had
10, 20, 40, 50 years ago. Cecelia, would you like to start?
I think my passion start when I was actually in prison, and living in prison with my children, and of course separated from my son. I thought that our life in prison is really the worse life that everybody can have. But after the rescue, victims of human trafficking I realize that actually our life, it is really nothing compared to them.
From them I really resolve that freedom is very important. I will never give. I will continue to do it. And, how can I give up? How can they betray the girls that actually traffic from the Far Pang community in the Philippines and sold into prostitution. And sold to slavery. I don't know, but for me, my vision and my passion is always consistent, and my belief,
in the goodness of God and and my belief in freedom is always in tact so I would say that maybe the life is changing and you know the situation is changing but that passion and the vision is always consistent and always with and will never give up in any difficult circumstances. Because it means a life of a girl.
It means the life of eighty percent that I rescue before I come here it means the future of Philippines to explore opportunities without the risk of being sold and enslaved it is the future of next generation and I offer my life, until the last drop of my blood to continue that vision. Paul.
When I was thinking about the question I realized that you can back the answer up. A long way. Anyone can perform autobiographical tricks to do so. So I was thinking not when I first decided I wanted to be a doctor who focused his attention on people living in poverty, but when I realized it was too late to go back.
And and I'm glad some of you chuckle, because it's a pretty frightening feeling, actually. I'm sure others in this room have felt it and for me it was in the course of several months. I can't remember how many, when I was in my early twenties, and my mid twenties. I had started medical school and was going between Harvard in Haiti.
My friends, in Haiti who were my age mates they were peers. We worked together on a health survey, traveled all over villages in that part of central Haiti. And one of them died of perforation due to typhoid. Disease before he ever saw his 30th birthday. Another one who became the record keeper in the clinic we just built died of puerperal sepsis from having a baby under poor conditions.
And the third of these friends I lost, died of cerebral malaria, misdiagnosed as having a psychiatric illness because she went crazy with cerebral malaria. And that determined many things. I decided what kind of doctor I wanted to be, where I would focus my energy. And yeah, I feel as passionate about those kinds of tragedies and medical errors now as I did then.
The difference of course is that in those places where I first saw them, they're gone. We don't have those kind of errors really. Women don't die in childbirth. They don't of obstructed labor. They don't die of a little perforation because you put in clean water and the Cholera that is spreading across
Haiti is not, they are referred to us from other places. But we see this all over the world. And as a result we've tried to move our energies around the world too, because we are hoping as people believe in basic rights, social and economic rights, civil and political rights that anybody in the world can understand what it might I like to be
sick and alone. And we find that people like this quest for freedom, people understand that every one of God's creatures needs accompaniment and help when they're sick, so I do feel just as passionate now.
I was always thrilled by the notion of equity. So I was appalled to see when I was a small boy, at one time I was a small boy, 10 years that I come from that time. My family comes from the state of Kerala My mother's father, grandfather, he would line up the people who were working in the field and would have a hole in the ground, and then would pass a banana leaf over fire so it becomes very supple, push that in, and then would pour rice into the leaf which is in the hole.
So one day I saw this I went up to him and said this is the way might treat dogs, not human beings and he turned to me and asked me, Are they any better? I was shocked. How could a human being say about another human being even if he is my grandfather. In this manner. So I think it was at that time if I begin to trace.
I cannot say that I made the most certainly a decision, but that was the moment when i said this is not right. If i can do something to right to make it right i will do it but how i did not know, so i went i was i began to organize the laborers of my father. He kicked me out. I went to the boarding school, there i thought, i mean i am god's so an answer to the organizational of all these school's.
So i began to organize the students. So i was kicked out from school, came to the university became also the president of the university. But this thing of inequity that prevailed in our society, there there was this untouchable ability of the people who were so called untouchables or low casts, people who were tribal, separated from the society and I said, OK, this is where I will work and did not take up career, I went to villages.
There was a cyclone. I started working in Orissa, but always this idea of equity, and today after many years of travel, if we are in the field of water and sanitation that is gram vikas. Because I see that water and sanitation is needed by everyone. If there is even one family which does not practice proper sanitation it can defile everyone else's water so we took that as a point to come together for the entire community and total inclusion, and then proceed further.
This is how that search for equity and there's still continuing there's tremendous inequity: economic, social, any sphere that you take in India and the journey continues still.
Now its your turn. Thank you so very much may I, first of all, pay a very, very warm tribute to all of you? You are amazing people and you you awe me. I mean, as I listen to the incredible things that you do. All of you. You make one so proud of being human, and thank you for that. Thank you, thank you on behalf of the many, many, many who want to thank you, who often do not have that opportunity, and thank you on behalf of God, because I think there must me many times when God says ... whatever got into me to create that lot?
And then God sees you and others like you, and God says they have vindicated you. You have vindicated God, and that's for real. please know that there are many in the world who wish to be eloquent enough to say thank you, thank you, thank you, thank you, thank you and I also wanted to thank you for the very warm welcome that you gave me and sort of making me think i was something when they learn I got on a train in Atlanta, and somebody that they recognized me and so they take came and they were asking for autographs and i try to look suitably modest as i, as I was signing, as i was signing these autographs, and one lady came up and pushed a piece of paper in front of me, and as I was signing she turn to these people and says "who is he"?
So, I thought it was very good for the soul. One day, one day, I was I think maybe seven or eight I went with my father who was headmaster of his school, and so in the Black community, a very important man and we went into town, segregated of course. And we got into the shop , and there was the slip of a girl behind the counter, a white girl, and when it was our turn to be served, I was standing next to my father.
And this girl said to my father, "Yes, boy." I wondered how my father must of felt being humiliated in front of his small boy. But i got to know because several years later our last child was born in London and she knew nothing about South Africa's apartheid and she was free and i am walking with her and I've got her by the hand and she saw some children on swings on round a bouts and she said, "Daddy, I want to go on the swing." and i said, "No, darling. You can't" she said "But there's other children" and all this, but how do you tell your child, you are not like other children, you are a Black child. I knew then how my father must have felt.
I wished the ground would open up and swallow me and then a little later still in the same town I was riding a bicycle, I was the only black priest who had his own bicycle. My father used to send me to town to go and buy newspapers and things, and i went past a school for white children, again they're all segregated, and saw three kids from my ghetto and they were scavenging in the school rubbish bin, getting out perfectly lovely apples and think because the government was providing school to white kids who didn't really need it.
They preferred their mother's lunch packets and much, much later [sp] was to say why Black children who needed it, were not being supplied with school feeding, he said, because we can't feed all, we won't feed some. Imagine Paul saying "Well, I can't cure all of you here, so I'm not going to try and cure any"... I can't say that that made me really get sort of hot under the collar very much, no, but it was later Laia and i were school teachers and the same Vervood [sp?] introduced something called bond for education, an education deliberately designed to produce docile, unthinking Black children.
They said, "Why do you teach black children mathematics? What they are going to do with mathematics, they must know enough English and African to understand instructions by their White masters and mistresses, don't let them hear anything about the American War of Independence or the French Revolution, these are going to put bad ideas into their heads and then I said I am not going to collaborate with this , this cruel thing, cruel things said to our children but I was inspired by some incredible human beings, Trevor Hartleston [sp?] and then I was into this really by default because the Nelson Mandelas were in jail, others were in exile and nature does not allow for vacuums and so I just happened, well I just happened to be the first Black person to be Dean of Johannesburg.
And was given a platform and as they sometimes say, the rest is history. The speakers are not allowed to bring the moderator to tears, thank you. I would like first talk a bit about one set of questions, which is the question of, how do you keep going? Where do you turn when you feel that the challenges you're facing are too big?
What do you do when your child is accusing you of not being there at important moments in his or her life? And, before we open this part of the discussion up, i wanted ask you, Joe, when we spoke a little while ago you said, "I started 30 years ago, and the change that we have achieved is so far away from what I had envisioned at that time.
There's still so much to do. How do keep going when you have the feeling it's not going quickly enough? And how do you tackle so much, do with some of these, these internal questions of frustration of doubt.
Unlike the Archbishop, 35 years ago I was not so modest. I thought that in a few years I am going to change India. So I set out and well India is almost where it was. But my colleagues and me, we have been struggling on a path of justice on the path of equity, on the path of well being for the poor, but often it is hard, i remember my first child was born and i was in a remote village and i was there for 10 days.
Only after 10 days when i come back, i realized i'm a father. So i thought anyway, I'll try again. The storm was working overtime , so, my second child, the daughter was born, again. I think my wife, I told her, I want to be there, but then she miscalculated the date I was again in a far off indigenous village.
And I was very happy to come and see "oh, I have a daughter". I said, Okay, I must try once more. The third child, again, I was not there. And each time, on one side I used to laugh at the irony that the more determined I got that I should be there in these big moments the further I was away. This can bring you down now and then.
There are times when I come I wanted that change that that village where they will forget their differences where the rich will show some assemblance of concern and care for the poor, and it didn't happen, maybe the tenth meeting ... nothing happened. There will be times when I would just take the pillow and cry into the pillow.
So how do we go on? Then I discovered this terrific elixir, this tonic when ever my battery was down, really really low, then, and I realized that if the battery is beyond that, a certain level and is down it need what is called a bench charge. So I would go out into the villages. Where the people have come together worked among themselves, we were a part of that and they built, whatever it is, whether it is a a good agricultural system, total inclusion, total sanitation, a water supply system for which they would say "we have done it, we could do it"!
Yes, you helped us a little bit, yes, but we did it. One or two villages and living two or three days or nights with those people further living in their ambition, further dreaming up with them, that would give me a complete battery charge, bench charge. You see, usually a battery gets a bench charge in a few hours, but my battery is a very poor battery and so it needed two to three days, but I got charged, came back... a new person. Fully charged up!
Because of that, I always took some extra charge with me so that I could also plug into my colleagues batteries, so they would also go. So this, ultimately for me, my staying power, how I can go on, is because of the people with whom I work. I agree. I had set out to change the whole of India, and there is a hole in India now.
We have not managed anywhere near that. But, when I see what did I set out for and where have I reached, then I remember what Mother Theresa said. "I may be a drop in the ocean. I mean, I may be a drop in a bucket. But without that drop, the bucket will be poorer by that drop". So I only want to be that drop.
And I do everything possible to be a good drop. That's all. Thank you.
So Celia how do you keep going?
Well, to be honest there are times that I also got in the crossroads, the first time and the last times that I actually almost gave up is when I received the first death threat, from the traffickers. Living in prison and a single mother of four it is really very hard for me, because I need to make a choice for the safety of my children and the freedom that I fought for the other girls.
Well, our friends are talking about other things and would like to concentrate as a mother, and how I balance my life because honestly speaking, I have never balanced life. I have, a life in prison, a husband who left the four children, a single mother, running after traffickers. Filing cases, heal with the victims ... phew! I thought I can never have that kind of life.
But I would say that yes, indeed, I think I'm managing well because I believe that I cannot survive alone. We have people that work with us. My children love my work and take pride of my work. They make an extra effort to make my difficult life easier they help in whatever they can. My colleagues are always there to support me.
We always journey together and that makes my life balance, because I don't think that balance is just a thing that you really .... balance is a gift. It's the gift that you can give to yourself. It's the balance that keep you going. At the same time, how can I give up when a girl, when a 14-year-old girl was sold to prostitution.
First to insert cotton dipped in the pigeons blood, in her sex organ just to be marketed just as a virgin many times. How can you give up? When the girl is only 14-years-old was sold in Syria, the worker is a domestic worker and sold to multiple employers and put them to jail, and they never give up.
They still have hope in their hearts. They still want to go on. So that kind of victory, that kind of trust, I cannot I cannot be selfish and just bring my children and be safe. Because, that's not me, I'm a very stubborn girl. I'm a stubborn women. And with all the harassment and with all the death threats and everything I find it now more exciting, especially that I have this cool community.
I know Jeff Skoll, I know Sally, you know, before I come here, my goodness, I am like a kitten who is really afraid. I don't know what to do. I am struggling as a person because the problem is too big, but I have my community, I have the trust and I have the power of the people, especially the women that we saved, to continue fighting, and for me that keeps me going.
And I will have a high energy, as always. And beyond everything I think I am still very lucky that I was called and I follow and serve given the opportunity to make my life worth, and given the opportunity to serve and make this life really worth living for, and I am really grateful for that.
2010 SESSIONS
Opening Plenary Of The 2010 Skoll World Forum
Excitement builds as guests gather for the first time in 2010 at the Opening Plenary. A gift of majestic song by Vusi Mahlasela, South African singer-songwriter and Poet Activist kicks off the Forum. Next, two warm welcomes from Colin Mayer of the Saïd Business School, and Jeff Skoll.
The first speech was by Lakhdar Brahimi, Veteran UN Envoy and advisor, and former foreign minister to Algeria. His talk focused on his life in conflict and his work in South Africa, Haiti, Sudan, Iraq and Lebanon. “What I have learned in these 20 years in trying to make peace is …that you come across a lot of courage and forgiveness…”
The opening plenary’s panel focused on Governance, Transparency And Collaboration and was moderated by John Ydstie, Economic Correspondent, National Public Radio. Panelists were Ann Cotton, Executive Director of Camfed International; Diana Good and Lance Croffoot-Suede, Partners of Linklaters LLP; Dr. Felix Phiri, Director of Planning and Information, Ministry of Education in Zambia, and Faith Nkala, Deputy Executive Director of Camfed Zimbabwe. The focus was on a report about the importance of educating African girls.
Later, Dr. Paul Farmer, co-founder of Partners in Health, gives a presentation called “Catalyzing Collaboration: Our Humanity at Stake.” During his talk, he shows a video about the January 2010 earthquake in Haiti, called “No words can describe what happened that day.” He later says that the images of the ill in the video were taken recently, three months after the earthquake, asking “What is the disconnect between great need on the one hand, and unstinting giving on the other?”
To end the opening plenary, Pamela Hartigan, director of the Skoll Centre for Social Entrepreneurship, thanked everyone who put the Forum together and asked them by name to stand for applause.
Speakers: Vusi Mahlasela, John Ydstie, Dr. Felix Phiri, Faith Nkala, Diana Good, Lance Croffoot-Suede, Lakhdar Brahimi, Colin Mayer, Paul Farmer, Ann Cotton, Jeff Skoll, Pamela Hartigan
The Disconnect Between Need and Giving After the Earthquake in Haiti
From: Opening Plenary Of The 2010 Skoll World Forum | With: Paul Farmer
Thank you very much. Thank you. It's a great honor, and somewhat intimidating, to address even such a kindly crowd from this rostrum. Jeff, I want to thank you especially for calling me, and Bill, there you are, Bill Drayton: rock stars. Those of you who know Bill Drayton would describe him in similar ways, owlish and bespectacled like me, and we're really more of a hip-hop kind of group actually.
But truth be told, I'm not so much intimidated as I am overwhelmed, to tell some of the stories of the January earthquake in Haiti, that I am tempted to tell tonight. They are difficult, for me at least, to recount, and I am not a reserved contained Englishman. This is in part because of the magnitude of the disaster, as Sally said, unprecedented in scope and scale in modern times, but it is really more to do with the rank familiarity of death and suffering in a place that is so dear to me.
So I will preface my comments with the words of some of our patients, and the images and interviews and translations that you will hear were recorded by two of my former medical students, who are now colleagues, who have served in Haiti for over a decade. As Sally suggests, 99 percent of our co-workers are Haitians.
These are two Americans whose voices you hear, along with the Haitians. It is difficult to watch but brief.
My name is Evan Lyon. I'm a volunteer doctor with Partners in Health and I have been working on health in Haiti for over a decade. You know as we first walked in, that first day, into the hospital, it was an incredible scene--there was very little going on in terms of medical care. There were two make shift operating rooms in the corner of the building that was left undamaged. There were hundreds of people lying around with big injuries, bad injuries: broken legs, broken arms, compounded fractures where part of the bone comes out of the skin. And so we went to work and have been working ever since, and have been watching things change, and watching things get a little bit better day after day. I think one of the biggest issues in terms of losing the chance to help people was our electricity: we didn't have enough electricity to work 24 hours a day so that cut our time in half, and we had less opportunity to work and potentially save peoples' lives. I wasn't here to see the many thousands or tens of thousands who died immediately after the earthquake. We know from our work and from driving through the city that tens of--hundreds of thousands of people are out of their homes and by the time this all settles there'll be hundreds of thousands more.
We have nowhere to stay. We were here in a tent and every time they tell us it's time to go, we become terrified. We went to a second tent, we were next to the hospital courtyard, when
they told us it was time to go again, we had no idea what to do, we have no were to go.
Since the earthquake on the 12th, we've been homeless.
The Haitian staff has been incredibly strong, incredibly dedicated to helping their hospital get back up on it's feet. The Haitian staff has also been incredibly traumatized, and it's a very few number that have been able to come back to work, after losing their homes and losing their loved ones. We don't even know how many people from the hospital staff have died, there've been--we don't even know. Can't put a number to it.
The
government needs to do something for everyone. The international community has to do something for everyone who has been affected, absolutely everyone. Everyone is a victim. If the Haitian government or the international community doesn't help the Haitian people, after a few months there will be an outbreak of menta illness.
So many people will suffer mental illness, from the rich to the poor. Everyone has been affected, and everyone is at risk.
The major next step I'm worried about just as a human being is all these people who are left out of their homes; they have to be given the basics of shelter, food, water, healthcare.
My foot has been amputated, and I know I can't work. And I wasn't raised to be a person to always be asking, "Please, can I borrow 50 gourdes, please, can I borrow 25 gourdes," if that's how I'm going to end up, if I have to ask for every meal or depend on the charity of others, I would have asked God to have taken my life. He just should have taken my life during the earthquake. I never want to be on the street begging, having to ask, "Give me 25 gourdes, please give me 50 gourdes."
This time everybody in the whole country has been affected. I think people around the world and people in the United States need to think about Haiti as a whole place that needs schools and water systems, needs the land to be rehabilitated so that trees can grow and food can grow. I'm a medical person and I care about healthcare but that's a very small piece of a puzzle compared to what really needs to happen.
All this stuff needed to happen before the disaster. All this stuff for those of us to care about Haiti, all this stuff was urgent before this catastrophe and now its even more urgent.
Now if that those images do
not square with what Sally described, that's because these are not, that is not the hospital, the hospitals in which we have worked. We have done what was recommended by our colleague from Zambia. We have worked with the government to build or rebuild a string of a dozen hospitals stretching from the Dominican boarder to the coast. And I think it is fair to say that we're very grateful that we did that, because that was what was standing between many people who fled north and to the west--were functioning hospitals. Some of the images you'll see here, which I hope you will agree are clean even though they will be crowded, are those in which we have spent 25 years trying to rebuild public sector facilities that serve the Haitian poor as a right. This is my 3rd visit to Oxford as a member of the Skoll family, and never has the notion of family meant more to me. Each year we're given the theme to help organize our reflections. All of them have been useful in my view, but our curent injunction to contemplate catalyzing collaborations has been especially apt as my own reflections, here or elsewhere, are jerked back to Haiti and what is happening there.
The word catalysis has a couple of common usages, including that learned by students of chemistry, like myself decades ago: the triggering or accelerating of a chemical change by the addition of a catalyst. A second and more common usage here at Skoll is an action between two or more persons or forces, initiated by an agent that itself remains unaffected by the action. But in truth this definition is misleading since no agent really remains unaffected by his or her actions, not in the realms in which we work. And then there is the definition laid out, fittingly enough in this city, in that unimpeachable source called the OED, which notes a rare 17th century meaning for catalysis taken directly from the Greek: dissolution, destruction, ruin.
Which definition will prove apposite to the coming hard years in Haiti is an anxious topic for me. But allow me to draw on the optimism native to the Skoll family, both because I confess I need it, and because there is so much we can do if we push ourselves to add up
to more that the sum of our parts. Every speech or paper or book begins with an empty screen. So did this one for me a few days ago in Haiti. Even if I had not been in Port au Prince. Even if I had not gone that morning to a meeting within sight of the ruined national palace and pancaked public buildings, I knew then what I know now: These days we project on all empty screens the same set of images. These are glimpses of what we have seen in Haiti the past few months. They are harrowing as you have all seen. Into any pause also come unbidden images of failure, for what do we make of a place like Parc JeanMarie Vincent where 48,000 souls are packed into a tiny space--a public park--named after a Haitian priest who I happen to know martyred for his role in helping to organize the poor in Haiti's parched north-west. And there are hundreds of such settlements by the way. Yes, there are some successes to claim: a regular tent clinic run by my colleagues including doctors who themselves lost their homes on January 12th and who now live in makeshift shelter. The slow transformation of these shelters from dun-colored to blue as cardboard is replaced by plastic sheeting. A score or so new latrines. A couple of new tent schools. Some minor improvements in lighting, requested by women's groups deploring the sexual predation fostered by the pitch-black dark into which the city was plunged on the nights following the quake. But, isn't it failure when the vast humanitarian machine cannot move quickly to move the internally displaced to higher ground. To make sure they have enough food to eat, and clean water to drink. Humanitarians are working as hard as they can, it's true, but none of us deserves high marks as we contemplate our failure to deliver enough clean water, food, and especially, safe shelter to those who needed it yesterday.
Here is the first of the challenges I will lay before you tonight: how can a gathering of social entrepreneurs like ours complement the efforts of the Haitian people and their government and the humanitarians who seek
to 'build back better', in the words of President Clinton. Time is running out, catalysis in the best sense of the word is an urgent task. In addition to the intrusive images of what has already happened, what will come all too soon is not hard to conceive.
I have only to close my eyes for a second to imagine strong winds, and driving rain, such as always arrived in late Spring in Haiti, that will tear from the battered and valiant people of Haiti, their tarps and tents and sheets, blowing these scanty coverings into the sea, and leaving the Haitians standing, assuming they are left standing, on acres of mud and waste.
Although I've seen this haunting picture mostly in dreams, it should not be hard to conjure up in your own minds, wind, and driving rain, assailing a million people in makeshift shelter, in a steep seaside city, that has faced mudslides and worse during every rainy season. What is the value here in comfortable and secure Oxford, the city of dreaming spires, of such a thought exercise?
Nil, a cynic might say, but I believe otherwise. In addition to the astounding fifty percent of all American households that donated something or other to earthquake relief in Haiti, households and governments in the United Kingdom, generous Ireland, and across Europe, and Latin America, have responded with significant sums.
For now Port-au-Prince is thick with NGOs and UN vehicles, and humanitarians of every stripe. Just as no previous natural disaster has been documented to cause such havoc in such a crowded place, so too has none yet prompted such an outpouring of solidarity and mercy. In light of this generosity, it may come as a shock to know, that some of the images projected tonight, were taken in recent days, three months after the earthquake leveled every single federal building in Port au Prince. So what is the disconnect between great need on the one hand and unstinting giving on the other? Why don't the NGOs and social entrepreneurs work better together with governments and humanitarians? Who and what are the catalysts needed to spark a reaction that will lead from mercy and pity and empathy, to their desired outcomes, which are safe housing, clean water, good school and healthcare, food security, and the dignity that comes from being liberated from the noxious cycle that some describe as under development, and others as structured dependence. The liberty that comes from generative and good jobs. Although our being here tonight indicates that we share largely similar definitions of catalysis, which definition will emerge from this rubble? Adding up to more than the sum of our parts, or still more dissolution, destruction, and ruin.
This matter of adding up, this question of sums, is not trivial.
Lets consider the 9.9 billion dollars pledged to Haiti at the recent donor conference in New York.
Many of us worked hard to bring together representatives of over a hundred countries, to pledge pragmatic solidarity with the people of Haiti. This sum represents $1,100 for each survivor of the disaster, a generous allowance to be sure. Why then would so many Haitians cast a cynical eye on these pledges? First there is the matter of both promises broken and threats honored. In a previous donors conference, in April 2009, close to $400 million--this was after hurricanes struck in 2008--was pledged to help build back better after an estimated 16% of Haiti's GDP was wiped out by these storms. President Clinton asked some of us to track the pledges to see how much, how many had been honored. We discovered that almost a year later, on the eve of the earthquake, only 12% of these pledges have been fulfilled. It is important, then to acknowledge that what we term the international community has failed Haiti.
We have been failing Haiti for two centuries. From the time Haiti and the United States were the sole independent nations in the western hemisphere, we've been at odds. Now is our chance to draw on all the resources here present to change the way we do business with Haiti. We need to build back better, it's true, but don't we also need to rebuild the way we do aid? Don't we need to rebuild humanitarian machine? Don't we need to create sound investments to end poverty in Haiti? Don't we need to rethink on how we might draw on social entrepreneurs who could and should help respond to the greatest natural or semi-natural disaster of our times? Many have called for the erasing of Haiti's debt, but don't we in fact owe huge death to Haiti?
All modern human rights movements,
traced their origins to the fight to end the slave trade and slavery itself.
Britains proudly claim that this fight began here when Thomas Clarkson and a small group that included Wilburforce--and I'm sorry he did go to Cambridge but you'll forgive me they both did I believe--that included Clarkson and Wilburforce used moral suasion and legal and political means to end the slave trade. But in truth the decisive blow against slavery was struck not in England but in Haiti in 1791.
A fourteen year long struggle culminating in the defeat of Napoleon's vast army, in the hills and plains of Haiti. For those who doubt the grand aspirations of the Victoria's former slaves to establish an independent republic free from slavery, we have only to consult the historical record. The discovery, just weeks ago, of the only surviving copy of Haiti's 1804 declaration of independence right here in the British national archives.
Haiti's military leaders founded the legitimacy of the first independent nation in Latin America on the fight against slavery, and used rights language unstintingly. Thus spoke Jean-Jacques Dessalines,
Haiti's first president, born a slave to the survivors.
So many cups to choose from.
This is really marked PF, so I assume thats me. I'm gonna use the Ambassador's, he speaks better.
Jean-Jacques Dessalines, and you a people so long without good fortune.
Witness, witness to the oath we take. Remember that I counted on your constancy and courage when I threw myself into the carrier fight the despotism and tyranny you have struggled against for fourteen years remember that I sacrificed everything to rally to your defense, family, children, fortune.
And now I am rich only with your liberty. My name has become a horror to all those who want slavery. Despots and tyrants curse the day when I was born. If ever you refuse or grumbled while receiving those laws that the spirit guarding your fate dictates to me for your own good, you would deserve the fate of an ungrateful people. But I reject that awful idea. You will sustain the liberty that you cherish and support the leader who commands you. Therefore vow before me to live free and independent and prefer death to anything that will try to place you back in chains.
Swear finally to pursue forever the traitors and enemies of your independence.
The Haitians payed a steep
price for this freedom. Dessalines was killed in a power struggle within a couple years, of years of these stirring words and his former masters soon orchestrated the first of many embargoes, against the troubled young nation.
In 1825, the French supported by other colonial powers and even the new republic to the north, my own country, demanded the Haiti pay France one hundred and fifty million Germinal francs, not only for the loss of the plantation but for the loss of their slaves. In other words the Haitians paid by force of arms and again by attempting to buy diplomatic recognition as the nation they had become.
They reimbursed the French for themselves. Never-before or since has a victorious nation indemnified the defeated in this manor. Despite the unjustified character of this indemnity and it's scandalous routing of money from the poor to the rich the Haitians paid this debt for over a century, well into the nineteen fifties.
Many adverse events and processes ensued: coups, invasions, military occupations, dictatorships, epidemics and no doubt Haiti was nudged over the edge from difficulty into crisis by the unavailability of public funds which were being shipped across the ocean. The nagging sense that nascent Haiti paid dearly for achieving the goals of liberty, fraternity and quality lives on to this day.
But some of the architects of this misery are today spared blame while others may receive too much. The Haitian anthropologist Jean Price-Mars, writing in 1953, blames the elites of his country for caving in to the extortion of the 19th century international community, arguing that, and I quote, "From a country who's expenditures and receipts were until then balanced the incompetence frivolity of the men in power had made a nation burdened with debts and entangled in a web of impossible financial obligations."
Some recent exercises seeking to arrive at a value for these transfers, including interest, have estimated this extortion at $20 billion. Divide that figure by 9 million citizens, and we see that were it to be returned today, each Haitian would be owed $2,222. What does all this bitter history have to do with catalyzing collaboration? To seek to heal those wounds and improve our world. Aren't social entrepreneurs supposed to be looking forward rather than back? Many of those who seek to respond to the earthquake insist that we stop dwelling on the past and focus on the unprecedentedly generous pledges made two weeks ago. Most speak these days of the need for new social pact, one that would allow us to draw rapidly on these commitments, to rebuild housing stock, clinical facilities, schools, and infrastructures both physical and social.
I am here to ask tonight: What novel technologies might help us to deliver on such pledges? I stand before you and answer with humility, I do not know, but collectively, we know. Not merely the we gathered here today but the broad we of humanity sharing the planet in 2010. One of the exciting things about the catalysis here at Skoll, the good catalysis not the bad, is that people come together to think of new ways to solve problems. Two years ago, drawing on the words of Paul Hawkin I argued in the closing session that we needed to bring together the environmental justice movement, bring it in to this broader social justice movement, so that concern for our wounded planet would be built on concern for our fellow human beings, particularly those living on less than 2 dollars a day.
In another words for my patients and their families. Does the devastation of Haiti, leveled by earthquakes, stripped of its trees, over crowded, always on the edge of risk, suggests that we will not succeed. Thomas Murden once said that we, humans are a body of broken bones, a powerful image, but let me describe a recent experience in a courtyard filled with people who were just that, bodies of broken bones. When we brought in orthopedists, and trauma surgeons, and physical therapists, and the tools of modern medicine, we were able to assuage a great deal of suffering.
In a place where a quarter of a million people were killed in the space of a few hours, a place where all of the government's buildings and a third of the houses were leveled.
Ours is relief on a modest scale. Many of you in this room have supported it in fact one of your students, I might add, from the business school has just sent us 500 wheelchairs, but the vision is to bring the fruits of science and innovation and the power of effective management to bear on the greatest natural disaster of modern times.
That modest effort can be multiplied. 100 fold 1000 fold to meet the need. Adopted by the Skoll family, let me make a humble plea: Let us elevate the definition of catalysis we now need desperately, in Haiti and in the world. An action between two or more persons or forces initiated by agents of change, bearing novel technologies. Some of these agents of change are gone now. So our allies such as Walt Ratterman who between last year's Skoll and this one had taken several of our hospitals to solar power and who perished in Port-au-Prince on January 12th.
Our doctors such as Mario Pagenel who died in his home as he prepared a PowerPoint presentation for Partners in Health, the entire second year nursing school class and their faculty. Many others we tried and failed to save, let us honor their memory, and the memories of the quarter million more who need us to rally in order to build back better.
Let us pledge that no matter where we work that we will fight hard to render obsolete the ancient definition of catalysis as dissolution, destruction, and ruin. If I may be so brazen, let me give you the beginnings of a shopping list, Jeff and Sally. I look to you when I say shopping list, because between and among us lie the skills, the resources, the tools to support the people and government of Haiti, as they attempt to rebuild their country.
Already, the efforts and support of many partners, Skoll awardees among them, have strengthened our response. But a great deal more is needed. You have what we need, or can find it, make it, or figure out how to get it. We need money, sure, but we need to use it wisely and justly. We need smart ways to reforest Haiti, we need better technologies for safe drinking water and more of it.
We need to help create a proper disability rights movement, not simply for those who have lost limbs but for all those handicapped in any way. We need better shelter, seismically rated, hurricane resistant, safe and dignified. We need to reduce the risk of future disasters and mitigate their impact. We need new ways to cook that don't destroy trees, pollute the air, and sicken the people breathing smoke.
We need better means of delivering comprehensive primary care services and insurance systems that do not penalize the sick. We need a new scheme of education that is inclusive and truly available to all students especially to girls. We need technologies, programs and training to support small hold farmers to process what they grow and bring it to a market based on fair trade.
We need thousands of new businesses and hundreds of thousands of good jobs, green jobs, jobs with protection for workers. We need, above all, to honor the heroism of the Haitian people which is rooted in their long struggle for basic rights. As Steven Stole wrote recently in the Atlantic, "It's high time to give Haiti a chance to recover the best part of its history and to stun the world again with the genius of its freedom."
Thank you very much for including me.
But truth be told, I'm not so much intimidated as I am overwhelmed, to tell some of the stories of the January earthquake in Haiti, that I am tempted to tell tonight. They are difficult, for me at least, to recount, and I am not a reserved contained Englishman. This is in part because of the magnitude of the disaster, as Sally said, unprecedented in scope and scale in modern times, but it is really more to do with the rank familiarity of death and suffering in a place that is so dear to me.
So I will preface my comments with the words of some of our patients, and the images and interviews and translations that you will hear were recorded by two of my former medical students, who are now colleagues, who have served in Haiti for over a decade. As Sally suggests, 99 percent of our co-workers are Haitians.
These are two Americans whose voices you hear, along with the Haitians. It is difficult to watch but brief.
My name is Evan Lyon. I'm a volunteer doctor with Partners in Health and I have been working on health in Haiti for over a decade. You know as we first walked in, that first day, into the hospital, it was an incredible scene--there was very little going on in terms of medical care. There were two make shift operating rooms in the corner of the building that was left undamaged. There were hundreds of people lying around with big injuries, bad injuries: broken legs, broken arms, compounded fractures where part of the bone comes out of the skin. And so we went to work and have been working ever since, and have been watching things change, and watching things get a little bit better day after day. I think one of the biggest issues in terms of losing the chance to help people was our electricity: we didn't have enough electricity to work 24 hours a day so that cut our time in half, and we had less opportunity to work and potentially save peoples' lives. I wasn't here to see the many thousands or tens of thousands who died immediately after the earthquake. We know from our work and from driving through the city that tens of--hundreds of thousands of people are out of their homes and by the time this all settles there'll be hundreds of thousands more.
We have nowhere to stay. We were here in a tent and every time they tell us it's time to go, we become terrified. We went to a second tent, we were next to the hospital courtyard, when
they told us it was time to go again, we had no idea what to do, we have no were to go.
Since the earthquake on the 12th, we've been homeless.
The Haitian staff has been incredibly strong, incredibly dedicated to helping their hospital get back up on it's feet. The Haitian staff has also been incredibly traumatized, and it's a very few number that have been able to come back to work, after losing their homes and losing their loved ones. We don't even know how many people from the hospital staff have died, there've been--we don't even know. Can't put a number to it.
The
government needs to do something for everyone. The international community has to do something for everyone who has been affected, absolutely everyone. Everyone is a victim. If the Haitian government or the international community doesn't help the Haitian people, after a few months there will be an outbreak of menta illness.
So many people will suffer mental illness, from the rich to the poor. Everyone has been affected, and everyone is at risk.
The major next step I'm worried about just as a human being is all these people who are left out of their homes; they have to be given the basics of shelter, food, water, healthcare.
My foot has been amputated, and I know I can't work. And I wasn't raised to be a person to always be asking, "Please, can I borrow 50 gourdes, please, can I borrow 25 gourdes," if that's how I'm going to end up, if I have to ask for every meal or depend on the charity of others, I would have asked God to have taken my life. He just should have taken my life during the earthquake. I never want to be on the street begging, having to ask, "Give me 25 gourdes, please give me 50 gourdes."
This time everybody in the whole country has been affected. I think people around the world and people in the United States need to think about Haiti as a whole place that needs schools and water systems, needs the land to be rehabilitated so that trees can grow and food can grow. I'm a medical person and I care about healthcare but that's a very small piece of a puzzle compared to what really needs to happen.
All this stuff needed to happen before the disaster. All this stuff for those of us to care about Haiti, all this stuff was urgent before this catastrophe and now its even more urgent.
Now if that those images do
not square with what Sally described, that's because these are not, that is not the hospital, the hospitals in which we have worked. We have done what was recommended by our colleague from Zambia. We have worked with the government to build or rebuild a string of a dozen hospitals stretching from the Dominican boarder to the coast. And I think it is fair to say that we're very grateful that we did that, because that was what was standing between many people who fled north and to the west--were functioning hospitals. Some of the images you'll see here, which I hope you will agree are clean even though they will be crowded, are those in which we have spent 25 years trying to rebuild public sector facilities that serve the Haitian poor as a right. This is my 3rd visit to Oxford as a member of the Skoll family, and never has the notion of family meant more to me. Each year we're given the theme to help organize our reflections. All of them have been useful in my view, but our curent injunction to contemplate catalyzing collaborations has been especially apt as my own reflections, here or elsewhere, are jerked back to Haiti and what is happening there.
The word catalysis has a couple of common usages, including that learned by students of chemistry, like myself decades ago: the triggering or accelerating of a chemical change by the addition of a catalyst. A second and more common usage here at Skoll is an action between two or more persons or forces, initiated by an agent that itself remains unaffected by the action. But in truth this definition is misleading since no agent really remains unaffected by his or her actions, not in the realms in which we work. And then there is the definition laid out, fittingly enough in this city, in that unimpeachable source called the OED, which notes a rare 17th century meaning for catalysis taken directly from the Greek: dissolution, destruction, ruin.
Which definition will prove apposite to the coming hard years in Haiti is an anxious topic for me. But allow me to draw on the optimism native to the Skoll family, both because I confess I need it, and because there is so much we can do if we push ourselves to add up
to more that the sum of our parts. Every speech or paper or book begins with an empty screen. So did this one for me a few days ago in Haiti. Even if I had not been in Port au Prince. Even if I had not gone that morning to a meeting within sight of the ruined national palace and pancaked public buildings, I knew then what I know now: These days we project on all empty screens the same set of images. These are glimpses of what we have seen in Haiti the past few months. They are harrowing as you have all seen. Into any pause also come unbidden images of failure, for what do we make of a place like Parc JeanMarie Vincent where 48,000 souls are packed into a tiny space--a public park--named after a Haitian priest who I happen to know martyred for his role in helping to organize the poor in Haiti's parched north-west. And there are hundreds of such settlements by the way. Yes, there are some successes to claim: a regular tent clinic run by my colleagues including doctors who themselves lost their homes on January 12th and who now live in makeshift shelter. The slow transformation of these shelters from dun-colored to blue as cardboard is replaced by plastic sheeting. A score or so new latrines. A couple of new tent schools. Some minor improvements in lighting, requested by women's groups deploring the sexual predation fostered by the pitch-black dark into which the city was plunged on the nights following the quake. But, isn't it failure when the vast humanitarian machine cannot move quickly to move the internally displaced to higher ground. To make sure they have enough food to eat, and clean water to drink. Humanitarians are working as hard as they can, it's true, but none of us deserves high marks as we contemplate our failure to deliver enough clean water, food, and especially, safe shelter to those who needed it yesterday.
Here is the first of the challenges I will lay before you tonight: how can a gathering of social entrepreneurs like ours complement the efforts of the Haitian people and their government and the humanitarians who seek
to 'build back better', in the words of President Clinton. Time is running out, catalysis in the best sense of the word is an urgent task. In addition to the intrusive images of what has already happened, what will come all too soon is not hard to conceive.
I have only to close my eyes for a second to imagine strong winds, and driving rain, such as always arrived in late Spring in Haiti, that will tear from the battered and valiant people of Haiti, their tarps and tents and sheets, blowing these scanty coverings into the sea, and leaving the Haitians standing, assuming they are left standing, on acres of mud and waste.
Although I've seen this haunting picture mostly in dreams, it should not be hard to conjure up in your own minds, wind, and driving rain, assailing a million people in makeshift shelter, in a steep seaside city, that has faced mudslides and worse during every rainy season. What is the value here in comfortable and secure Oxford, the city of dreaming spires, of such a thought exercise?
Nil, a cynic might say, but I believe otherwise. In addition to the astounding fifty percent of all American households that donated something or other to earthquake relief in Haiti, households and governments in the United Kingdom, generous Ireland, and across Europe, and Latin America, have responded with significant sums.
For now Port-au-Prince is thick with NGOs and UN vehicles, and humanitarians of every stripe. Just as no previous natural disaster has been documented to cause such havoc in such a crowded place, so too has none yet prompted such an outpouring of solidarity and mercy. In light of this generosity, it may come as a shock to know, that some of the images projected tonight, were taken in recent days, three months after the earthquake leveled every single federal building in Port au Prince. So what is the disconnect between great need on the one hand and unstinting giving on the other? Why don't the NGOs and social entrepreneurs work better together with governments and humanitarians? Who and what are the catalysts needed to spark a reaction that will lead from mercy and pity and empathy, to their desired outcomes, which are safe housing, clean water, good school and healthcare, food security, and the dignity that comes from being liberated from the noxious cycle that some describe as under development, and others as structured dependence. The liberty that comes from generative and good jobs. Although our being here tonight indicates that we share largely similar definitions of catalysis, which definition will emerge from this rubble? Adding up to more than the sum of our parts, or still more dissolution, destruction, and ruin.
This matter of adding up, this question of sums, is not trivial.
Lets consider the 9.9 billion dollars pledged to Haiti at the recent donor conference in New York.
Many of us worked hard to bring together representatives of over a hundred countries, to pledge pragmatic solidarity with the people of Haiti. This sum represents $1,100 for each survivor of the disaster, a generous allowance to be sure. Why then would so many Haitians cast a cynical eye on these pledges? First there is the matter of both promises broken and threats honored. In a previous donors conference, in April 2009, close to $400 million--this was after hurricanes struck in 2008--was pledged to help build back better after an estimated 16% of Haiti's GDP was wiped out by these storms. President Clinton asked some of us to track the pledges to see how much, how many had been honored. We discovered that almost a year later, on the eve of the earthquake, only 12% of these pledges have been fulfilled. It is important, then to acknowledge that what we term the international community has failed Haiti.
We have been failing Haiti for two centuries. From the time Haiti and the United States were the sole independent nations in the western hemisphere, we've been at odds. Now is our chance to draw on all the resources here present to change the way we do business with Haiti. We need to build back better, it's true, but don't we also need to rebuild the way we do aid? Don't we need to rebuild humanitarian machine? Don't we need to create sound investments to end poverty in Haiti? Don't we need to rethink on how we might draw on social entrepreneurs who could and should help respond to the greatest natural or semi-natural disaster of our times? Many have called for the erasing of Haiti's debt, but don't we in fact owe huge death to Haiti?
All modern human rights movements,
traced their origins to the fight to end the slave trade and slavery itself.
Britains proudly claim that this fight began here when Thomas Clarkson and a small group that included Wilburforce--and I'm sorry he did go to Cambridge but you'll forgive me they both did I believe--that included Clarkson and Wilburforce used moral suasion and legal and political means to end the slave trade. But in truth the decisive blow against slavery was struck not in England but in Haiti in 1791.
A fourteen year long struggle culminating in the defeat of Napoleon's vast army, in the hills and plains of Haiti. For those who doubt the grand aspirations of the Victoria's former slaves to establish an independent republic free from slavery, we have only to consult the historical record. The discovery, just weeks ago, of the only surviving copy of Haiti's 1804 declaration of independence right here in the British national archives.
Haiti's military leaders founded the legitimacy of the first independent nation in Latin America on the fight against slavery, and used rights language unstintingly. Thus spoke Jean-Jacques Dessalines,
Haiti's first president, born a slave to the survivors.
So many cups to choose from.
This is really marked PF, so I assume thats me. I'm gonna use the Ambassador's, he speaks better.
Jean-Jacques Dessalines, and you a people so long without good fortune.
Witness, witness to the oath we take. Remember that I counted on your constancy and courage when I threw myself into the carrier fight the despotism and tyranny you have struggled against for fourteen years remember that I sacrificed everything to rally to your defense, family, children, fortune.
And now I am rich only with your liberty. My name has become a horror to all those who want slavery. Despots and tyrants curse the day when I was born. If ever you refuse or grumbled while receiving those laws that the spirit guarding your fate dictates to me for your own good, you would deserve the fate of an ungrateful people. But I reject that awful idea. You will sustain the liberty that you cherish and support the leader who commands you. Therefore vow before me to live free and independent and prefer death to anything that will try to place you back in chains.
Swear finally to pursue forever the traitors and enemies of your independence.
The Haitians payed a steep
price for this freedom. Dessalines was killed in a power struggle within a couple years, of years of these stirring words and his former masters soon orchestrated the first of many embargoes, against the troubled young nation.
In 1825, the French supported by other colonial powers and even the new republic to the north, my own country, demanded the Haiti pay France one hundred and fifty million Germinal francs, not only for the loss of the plantation but for the loss of their slaves. In other words the Haitians paid by force of arms and again by attempting to buy diplomatic recognition as the nation they had become.
They reimbursed the French for themselves. Never-before or since has a victorious nation indemnified the defeated in this manor. Despite the unjustified character of this indemnity and it's scandalous routing of money from the poor to the rich the Haitians paid this debt for over a century, well into the nineteen fifties.
Many adverse events and processes ensued: coups, invasions, military occupations, dictatorships, epidemics and no doubt Haiti was nudged over the edge from difficulty into crisis by the unavailability of public funds which were being shipped across the ocean. The nagging sense that nascent Haiti paid dearly for achieving the goals of liberty, fraternity and quality lives on to this day.
But some of the architects of this misery are today spared blame while others may receive too much. The Haitian anthropologist Jean Price-Mars, writing in 1953, blames the elites of his country for caving in to the extortion of the 19th century international community, arguing that, and I quote, "From a country who's expenditures and receipts were until then balanced the incompetence frivolity of the men in power had made a nation burdened with debts and entangled in a web of impossible financial obligations."
Some recent exercises seeking to arrive at a value for these transfers, including interest, have estimated this extortion at $20 billion. Divide that figure by 9 million citizens, and we see that were it to be returned today, each Haitian would be owed $2,222. What does all this bitter history have to do with catalyzing collaboration? To seek to heal those wounds and improve our world. Aren't social entrepreneurs supposed to be looking forward rather than back? Many of those who seek to respond to the earthquake insist that we stop dwelling on the past and focus on the unprecedentedly generous pledges made two weeks ago. Most speak these days of the need for new social pact, one that would allow us to draw rapidly on these commitments, to rebuild housing stock, clinical facilities, schools, and infrastructures both physical and social.
I am here to ask tonight: What novel technologies might help us to deliver on such pledges? I stand before you and answer with humility, I do not know, but collectively, we know. Not merely the we gathered here today but the broad we of humanity sharing the planet in 2010. One of the exciting things about the catalysis here at Skoll, the good catalysis not the bad, is that people come together to think of new ways to solve problems. Two years ago, drawing on the words of Paul Hawkin I argued in the closing session that we needed to bring together the environmental justice movement, bring it in to this broader social justice movement, so that concern for our wounded planet would be built on concern for our fellow human beings, particularly those living on less than 2 dollars a day.
In another words for my patients and their families. Does the devastation of Haiti, leveled by earthquakes, stripped of its trees, over crowded, always on the edge of risk, suggests that we will not succeed. Thomas Murden once said that we, humans are a body of broken bones, a powerful image, but let me describe a recent experience in a courtyard filled with people who were just that, bodies of broken bones. When we brought in orthopedists, and trauma surgeons, and physical therapists, and the tools of modern medicine, we were able to assuage a great deal of suffering.
In a place where a quarter of a million people were killed in the space of a few hours, a place where all of the government's buildings and a third of the houses were leveled.
Ours is relief on a modest scale. Many of you in this room have supported it in fact one of your students, I might add, from the business school has just sent us 500 wheelchairs, but the vision is to bring the fruits of science and innovation and the power of effective management to bear on the greatest natural disaster of modern times.
That modest effort can be multiplied. 100 fold 1000 fold to meet the need. Adopted by the Skoll family, let me make a humble plea: Let us elevate the definition of catalysis we now need desperately, in Haiti and in the world. An action between two or more persons or forces initiated by agents of change, bearing novel technologies. Some of these agents of change are gone now. So our allies such as Walt Ratterman who between last year's Skoll and this one had taken several of our hospitals to solar power and who perished in Port-au-Prince on January 12th.
Our doctors such as Mario Pagenel who died in his home as he prepared a PowerPoint presentation for Partners in Health, the entire second year nursing school class and their faculty. Many others we tried and failed to save, let us honor their memory, and the memories of the quarter million more who need us to rally in order to build back better.
Let us pledge that no matter where we work that we will fight hard to render obsolete the ancient definition of catalysis as dissolution, destruction, and ruin. If I may be so brazen, let me give you the beginnings of a shopping list, Jeff and Sally. I look to you when I say shopping list, because between and among us lie the skills, the resources, the tools to support the people and government of Haiti, as they attempt to rebuild their country.
Already, the efforts and support of many partners, Skoll awardees among them, have strengthened our response. But a great deal more is needed. You have what we need, or can find it, make it, or figure out how to get it. We need money, sure, but we need to use it wisely and justly. We need smart ways to reforest Haiti, we need better technologies for safe drinking water and more of it.
We need to help create a proper disability rights movement, not simply for those who have lost limbs but for all those handicapped in any way. We need better shelter, seismically rated, hurricane resistant, safe and dignified. We need to reduce the risk of future disasters and mitigate their impact. We need new ways to cook that don't destroy trees, pollute the air, and sicken the people breathing smoke.
We need better means of delivering comprehensive primary care services and insurance systems that do not penalize the sick. We need a new scheme of education that is inclusive and truly available to all students especially to girls. We need technologies, programs and training to support small hold farmers to process what they grow and bring it to a market based on fair trade.
We need thousands of new businesses and hundreds of thousands of good jobs, green jobs, jobs with protection for workers. We need, above all, to honor the heroism of the Haitian people which is rooted in their long struggle for basic rights. As Steven Stole wrote recently in the Atlantic, "It's high time to give Haiti a chance to recover the best part of its history and to stun the world again with the genius of its freedom."
Thank you very much for including me.
2010 SESSIONS
When Disaster Strikes: Social Entrepreneurs Managing Through Crisis
Social entrepreneurs tackle difficult problems in challenging environments, often working in places with weak infrastructure, fragile government and limited resources. When disaster hits, such as the earthquake in Haiti, social entrepreneurs often have the networks and processes in place to be effective early responders. This requires meeting the dual challenge of managing their own operations in a time of stress and coordinating relief efforts. In this session, social entrepreneurs who have managed through crisis will talk about what it takes to be effective.
Speakers: Craig Kielburger, Ray Suarez, Paul Farmer, Jenny Bowen
2009 SESSIONS
Healthcare: Early Detection And Prevention
Practitioner Showcase: The gap between rich and poor is manifest in any number of ways, particularly in healthcare, where governments and markets have failed the most vulnerable populations. Four passionate and gifted social entrepreneurs will discuss their innovations and demonstrate how lives can improve against seemingly insurmountable odds. Learn about the simple, scalable, and extremely successful approaches they’ve taken to healthcare delivery, prevention and education.
Speakers: Bart Weetjens, Nathan Wolfe, Gene Falk, Paul Farmer, Larry Brilliant
2008 SESSIONS
Closing Plenary Of The 2008 Skoll World Forum
Three days of insights and inspiration, and the Forum came to a close. Stephan Chambers, Chairman of the Skoll Centre for Social Entrepreneurship, said goodbye.
Paul Collier, professor of economics at the University of Oxford, talked about, “Social Entrepreneurship and the Bottom Billion: Why the poorest countries are failing and what can be done about it.”
The panel at the closing plenary was entitled: “Working Within Cultures and Contexts – Lessons Learned“. David Bornstein moderated, and panelists were Rupert Howes, CEO of the Marine Stewardship Council; Fiona Muchembere, program manager of institutional development at CAMFED; Vicky Colbert, founder and director of Escuela Nueva Foundation, and Jacqueline Novogratz, founder and CEO of the Acumen Fund.
Paul Farmer, MD, PhD, Co-founder, Partners in Health shared his reflections of his work, especially working cross-culturally.
Al Gore, 2007 Nobel Laureate, former Vice President of the United States spoke about his work on the environment.
Ending the Forum was Sally Osberg, President and CEO of the Skoll Foundation who mentioned the first Skoll World Forum in 2004, saying that one of the ideas behind it was “The legacy of past transgressions — on the environment, on human possibility, on the common good — should not be passed to future generations.”
Speakers: Fiona Muchembere, Paul Collier, Jacqueline Novogratz, Al Gore, Paul Farmer, Vicky Colbert, Rupert Howes, Stephan Chambers, Sally Osberg, David Bornstein
Reflections from a Cross Cultural Pioneer – Paul Farmer
From: Closing Plenary Of The 2008 Skoll World Forum | With: Paul Farmer
Thank you. I'm sure that some of you are thinking it's very unwise to use a Power point presentation. Presentation when your about to be followed by the man who should have been president of my country. So. And I do have to make one shameful confession. Yes, I'm from Florida, but we are all and I voted for president Gore.
So, it's an honor to be here with you. Unfortunately, on a serious note many of the problems that we've discussed. Would be different, had things been different in 2000. And I planned to say that well before you arrived. Here we are a new year in the third millennium. We are seeing new plagues. AIDS was already several times [xx] drug-resistant tuberculosis, but also drug-resistant super-bugs, of all sorts, that [xx] rapidly across vast swaths of land blurring national boundaries.
There are old maladies that should have been history as small pox is. And they are rooted in long-standing, and increasingly unjust economic and social structures. Malaria, Hookworm and other parasites claim lives or simply drain energy from hundreds of millions. It's hard to work when you're tired and enemic, or pregant a dozen times before the age of 30 people and poor people.
But most economists agree that social inequalities, both global and local, have grown rapidly over the past few decades. The Earth itself is tired and malnourished. Man-made environmental crises dry up lakes, wash top soil into the seas, and smother reefs, and from what we can tell, spark huge storms.
a billion people do not have safe drinking water. A war built on lies will cost, one Nobel Laureate economist tells us, 3 trillion dollars. So what cause have we for hope. As a doctor working in Africa in contemplating the problem [xx] of our wounded earth, i acknowledge that the butcher's bill is high, yet here we are, a gathering of what are termed social entrepreneurs and we are full of hope.
Some of that hope is tied to risk. Some of it is tied to an increasing awareness of the great world around us. There is as is often reported by cheer leaders of commerce vast and rapid growth in the global economy. China and India not so long a go poor and [xx] are our. Ready economic power houses and these economies continue to go rapidly, if unevenly, and if fueled by coal and oil.
With 50 years of peace, Europe is more prosperous than ever. In spite of trade imbalances, a recession, an imprudent war is built on [xx] The United States remains rich, current exchange rates a side. I, i thought that a cup of espresso was bad in New York, but i swear, You can pay 20 dollars for a cup of espresso here.
Our citizens if famously ill-informed about the world are less generous. Almost half of American households responded to the tsunami in Asia, more than any other nation. And even more tried to to the worst hurricane ever to hit our gulf coast. This is a time of great problems. Some new and some old.
And a time for not. all the solutions, it's a time of social entrepreneurs. When Sally and others at the school foundation called me to let me know that after through a workup. Diagnostic testing have proven was i of the special breed. I was driving along a road in southeastern Rwanda. I pulled over to express my thanks to the staff there and to Jeff.
I shared with them, including Johnny and Lance, my deep gratitude for the honor and the support of our work. My puzzlement I kept to myself. What exactly is a social entrepreneur? I know I'm a doctor and anthropologist, hence my invitation to speak about culture, but part of me winced as I acknowledge that yes, we live in an era in which simply seeking to provide high quality medical care to the world's poorest is considered innovative and entrepreneurial.
Thus the diagnosis comes with both honor and shame. Shouldn't we have offered such services to those who need them long, long ago? Shouldn't we have design systems to get around or solve the health problems faced by the world's bottom billions? I've learned a lot this week and made connections with others similarly diagnosed and i think i get it now.
Social Entrepreneurship means many things and those diagnosed do many things. But all of us carrying the diagnosis of social entrepreneur. From [xx] to the latest [xx] displays certain symptoms, that suggest not only the diagnosis but also that it may be infectious. Indeed, we may soon see a global pandemic of social entrepeneurship.
Here are some of the classic symptoms. Of the disease. Refusal to accept the world the way it is and the direction to which it's going and a willingness to. They know this can't be done. Persistance. A certain amount of righteous anger about the injustices done to others. especially the poor and marginalized, and a willingness to fight back against unjust systems and also hope.
Blood tests I've done this week - clandestinely, of course - show that all of us have alarmingly high serum levels of hope. And while you dozed in your rooms in Oxford, I was doing MRI's of your brains. And so I know you have, in fact, strategies to respond to the problems that bring us together. And I hope you don't mind that I did not have you sign consent forms.
I, for one, am not embarrassed by high serum hope levels. As long as our entrepreneurship remains grounded in solving real problems, especially the problems of those left behind, or worse, damaged by the unsustainable development that we have promoted and aggressively so over the past two centuries.
And some have far more damaged than others. Today, I would like to do two things. I wish to share with you some story About transformations. Personal, institutional, and political that I've had the great, good fortune to witness very recently in Rwanda of all places. Rwanda came back from the brink of hell but epidemiological studies there suggest a Endemic of entrepreneurialism that is breaking out in that country.
Then I will close with comments about the achilles heel of our nation movement as social entrepreneurs, and I promised to speak of culture although not in the way you'd expect. Hope in Rwanda. This will surprise some of you. If there's one continent, as Paul Colliar has said, on which economic growth is slowed or stalled or uneven.
It's Africa. This is also the continent with the highest burden of diseases mentioned above and accordingly the shortest life expectancy. The highest rates of maternal mortality. We've all heard the numbers before. There is no shortage of diagnoses and prescriptions for the ills of Sub-Saharan Africa, and many are discrepant.
But many [xx]and prescriptions are not discrepant. To the old question, "Can we break the cycle of poverty and disease?", we have an answer. Yes, we can. Paul Collier said it very well already today: science, innovation, sound policy, good governance, public-private partnerships, along with the needed resources and the offer, the promise of closing the gap between the rich and the poor.
Of promoting genuinely sustainable development; which means development with social justice and less inequality. And this will lead, some of us believe, to a dampening of the violence that continues to afflict hundreds of millions, most of them poor. Violence afflicts people like Faustin, a child I met in Rwanda, on March 22, 2006.
He was the victim of a violence which is never really local, and has almost nothing to do with his culture. On a Wednesday morning, two boys while herding cows, picked up a landmine. In Rwanda this is an increasingly rare event. As many efforts have been made to find and disarm such weapons. Unfortunately, it is still to common an event, elsewhere, within the past decade, as others have noted, it has been estimated that there are one hundred and ten million land mines in the ground worldwide.
And more than twice as many are still stockpiled. Today, thirteen countries continue to manufacture anti-personnel devices, though little as 15 years ago, that number was over 50 countries, and almost 100 private companies, 47 of which were in the United States.
Of those who detonate landmines unintentionally, 80% are civillians. And 1 in 5 are children. About half die, virtually all the rest are maimed, and many of them permanently. Both of the Rwandan boys survived, and I came to know quite well the one who was injured more seriously. As he spent more time in the hospital, needed physical therapy, home visits, and social assistance.
I met Fostant at 10 in the morning on that Wednesday. the hospital to a clinic a couple of hours away. The hospital was, I mean again, in front of the vice president, use power point. It is unfair, I will do my best. I have very little. Very few. The hospital was built and once owned by a Belgian mining company which left Rwanda decades ago having extracted what it came to extract.
After the war in genocide in 1994 the facility fell into disuse, essentially abandoned. As of May 2005, when we, and this is I think the kind of public private partnership that (xx) would prove up we XX help (xx) foundation and Rwandan Ministry of Health rebuilt and opened it as the sole hospital serving more than a quarter million people, most of them the settled refugees, internally displaced persons, and almost all of them living in poverty.
And, back to Jacquie Novogratz's comments about dignity - we did our best to make it clear that we wanted people to feel that this was a clean, safe place where we showed our respect. And as you can see, that, that, this was done in in less than, less than eight months, this transformation. And this is only one of the kinds of transformations I want to speak about.
By March 2006, when this event happened, we had cobbled together a medical and nursing staff consisting mostly of of Rwandan professionals and a handful of expatriate volunteers, some of them my former students. One of my colleagues stopped me that morning saying come quickly to the emergency room two children had picked up a granade.
That's what he said. At that moment I did not think it unlikely that someone in the region would pick up a grenade and pulled the pin. After all, ordinance hangs around for years. The boys told me that they merely picked the thing up and threw it towards the cows they were herding. The cows took the full force of the mine and 2 cows were killed.
It was an hour or so. So after seeing the boys, that I began to think about the thing itself, the landmine - what it was, where it had been manufactured, certainly not in Rwanda. In the meantime, neither I or my colleague were thinking about anything other than trauma care, which is of course precisely what trauma victims need most.
We worked attentively and in near silence. One of the two boys was not seriously injured. The other, [xx] sustained multiple fractures, and had many fragments blown into his skin. I had the privilege of splinting him, pulling the plastic fragments out of him and preparing him for transport. Although we had rebuilt the operating room and this is what we found, this is what the operating room looked like before... and this is what it looked like after.
Although we had rebuilt the operating room, we did not have an orthopedic surgeon on staff. And [xx] needed to have his fracture set in the operating room with what is called an external fixator. [xx] even in the course of interviews conducted at home afterthe device was placed. Did not wish to speak of his experience.
What I would most like to do, he said, only a few days after surgery, is to go to school. Turned out that he was not an orphan after all but that his mother poor and bereft after the genocide had struggled for years with mental illness and had finally placed him with another family in 2004. My mother's not well he told me later.
She can't take care of me so she brought me to a relative and I live here now. I would like to go to school but my adoptive family has no money, so I herd cows everyday, make them sure they eat, move them to new grass. When I asked him about the land mine he was astonishingly to me apologetic. I didn't mean to pick up the grenade.
I'm sorry I did it. I didn't mean to kill the cows. I'm sorry, it was an accident. We didn't know what we were doing, it was not our intention to kill the cows. To me, as grotesque as it is to hear a child apologize for a landmine built in God knows what developed country, this is still a story of hope.
For the desire to go to school is as hopeful as it is universal. Postan is in school, now. And every day we meet people who are sicker, much sicker than Postan, but they too have some hope or they would not have come to see us. Sometimes they are of course almost without hope and then, we go to see them.
This is John. Who has, at the same time, three of this centuries worst diseases: AIDS, Tuberculous, and poverty. We cured his TB with antibiotics of course and he will be treated for AIDS But he also received the only known treatment for hunger. Something called food. I've said this before, although this is a fairly recent couple of pictures that goes from looking like Skeletor to looking like he needs Lipitor.
Can you believe that we have to spend spent an endless amount of time arguing that food is the proper treatment for malnutrition. We waste our time, the doctors, the nurses, and health workers, arguing with our peer about this. I ran into John at the hospital last week and he reminded me that what he most wanted and in fact had been promised with a cow.
Again, John has hope because he feels well enough to work. It's what he wants to do. Jobs, as Paul Collier said. Now these are individuals stories which are not to be discounted and I will not apologize for sharing them with you but social entrepreneurs and our supporters are all obsessed it would seem with something called scale.
The fetishesation of scaling up our work is a source of both anxiety and hope. Bringing a new innovative project to scale often feels like the only. [xx] to leave a footprint of the good kind in an afflicted world of new ideas. Just so you know, we have worked with the Rowandean government [xx ] to scale up comprehensive health care not ace care but comprehensive health care in three of the four districts in which there were no district hospitals at all And from the North of Rwanda to the South.
And if i may brag, my Haitian colleagues have been with us from the beginning. In Rwanda our biggest obstacle is still scaling, is still funding the scale, up and again grotesquely the battle [xx] [xx] over paid community health workers. There's no real argument about paying ourselves and our peers.
We all [xx ] get paid for our labor. It's the poor who are being asked to volunteer and since we know that doesn't work we are searching... high and low for the modest funds to pay them. Indeed the Scholl [sp?] award would go a long way in helping us to see this model adopted more widely. I have been given the warning and so I'm going to close by saying, I know that medicine and public health will not solve the growth problems, but we can offer further solution, and what's been shocking to me over the past 25 years is the lightning speed at which policy makers themselves shielded from the risks faced by Fasten or John.
Decide that a complex intervention is to difficult, or not cost effective in Haiti or Africa, or not sustainable. In microfinance parlance, many of my patients are poor credit risks, but aren't they the very people we claim to serve in the first place and this is why I turned my speech a loyalists critique of our movement.
We need to be aware that each of the terms and concepts and tools we developed can be used to deny the destitute, access to goods and services that sometimes should be rights, not commodities. Does anyone really believe that a mother loves her newborn more if she had to pay some sort of users fees for prenatal care and obstetric care.
Such claims are piffle as you say in your country. I thought I'd throw that in, but there are also reflective ideology that has crept into our entrepreneur movement. This way of seeing the world has deep, deep roots but has been noted already by Jackie and by Karen. It's our culture that's hard to see.
It's our culture that needs to change. Look around you and you will see people of every hue but there are not poor people here and its not that they need an invitation to Oxford it's that they need us to include them in our movement and allow them to be social entrepreneurs. Let me close by reflecting on how social entrepreneur.
can be part of a genuine broad base social movement for social justice. I believe that when we look back over the next quater of a century, we'll be consoled most by our contributions to a movement that continues to grow not only in villages, slums and squatter settlements, but also on campuses such as this one.
It's a movement that will come to include a growing concern with the way in which the earth itself has been damaged, polluted by greed and war and feckless policies handed down by from on high. But it's a movement that pays heed not only to the environment, but also to the poor who are the chief victims of greed, war and unjust policy.
[xx] who is almost always right once argued that the compassion of the oppressed for the oppressed is indispensable. It's the world's one hope. I fear that at this late day, an additional kind of solidarity is necessary. A social justice movement that links the rich world and the poor. Mandela Auditorium at Oxford The village[sp?] in Rwanda, to which I return tomorrow, the movement that links concern with the Earth with respectful solidarity towards its poorest inhabitants is our last greatest hope for a world marked by less suffering and violence and premature death.
It's our last great hope for the generations to come and for our own children. Paul Hawken, in a book called "Blessed Unrest", wrote the following paragraph, "It is time for all that is harmful to leave. One million escorts are here to transform the nightmares of empire and the disgrace of war on people and on place.
We are the transgressors and we are the forgivers. We means all of us. Everyone. There can be no green movement unless there is also a black, brown, and copper movement. What is most harmful resides within us: the accumulated wounds of the past, the sorrow, shame, deceit shared by every culture passed down to every person as surely as DNA, a history of violence and greed.
There is no question that the environmental movement is critical to our survival. This is still Paul Hawkin. Our house is literally burning, and it is only logical that environmentalists expect the social justice movement to get on the environmental bus but it is the other way around, he writes. The only way we are going to put out the fire is to get on the social justice bus and heal our wounds because in the end, there is only one bus.
Entrepreneurs need to learn to be at time, at times quiet passengers on this bus. Sometimes we'll take our turn at the wheel. Sometimes we'll be the mechanic, but all of us need to get on the social justice bus. That's the bus on which on the real sustainable green movement will be traveling. It's on the bus that we'll have epidemics of social entrepreneurship.
Don't get on the chartered plane. We have a lot to offer in putting hope. As a friend of mine likes to say, hope is not a plan, but we need hope and courage and a plan to end for example, an unjust war. We need hope and energy to tackle the diseases that should have been wiped out decades ago or never allowed to spread so rapidly.
We need hope to counter the neo-Liberal policies that have weakened and even wrecked public sector institutions without ever delivering on the promise to lift all votes. We hope to speak to people in powerful positions whose hearts, unlike the polar ice caps, show little signs of melting. We need hope and we need each other.
To Jeff, to Sally, to all of you who share this diagnosis with me, thank you. Thank you for including me. In your ranks. I'll see you on the bus.
So, it's an honor to be here with you. Unfortunately, on a serious note many of the problems that we've discussed. Would be different, had things been different in 2000. And I planned to say that well before you arrived. Here we are a new year in the third millennium. We are seeing new plagues. AIDS was already several times [xx] drug-resistant tuberculosis, but also drug-resistant super-bugs, of all sorts, that [xx] rapidly across vast swaths of land blurring national boundaries.
There are old maladies that should have been history as small pox is. And they are rooted in long-standing, and increasingly unjust economic and social structures. Malaria, Hookworm and other parasites claim lives or simply drain energy from hundreds of millions. It's hard to work when you're tired and enemic, or pregant a dozen times before the age of 30 people and poor people.
But most economists agree that social inequalities, both global and local, have grown rapidly over the past few decades. The Earth itself is tired and malnourished. Man-made environmental crises dry up lakes, wash top soil into the seas, and smother reefs, and from what we can tell, spark huge storms.
a billion people do not have safe drinking water. A war built on lies will cost, one Nobel Laureate economist tells us, 3 trillion dollars. So what cause have we for hope. As a doctor working in Africa in contemplating the problem [xx] of our wounded earth, i acknowledge that the butcher's bill is high, yet here we are, a gathering of what are termed social entrepreneurs and we are full of hope.
Some of that hope is tied to risk. Some of it is tied to an increasing awareness of the great world around us. There is as is often reported by cheer leaders of commerce vast and rapid growth in the global economy. China and India not so long a go poor and [xx] are our. Ready economic power houses and these economies continue to go rapidly, if unevenly, and if fueled by coal and oil.
With 50 years of peace, Europe is more prosperous than ever. In spite of trade imbalances, a recession, an imprudent war is built on [xx] The United States remains rich, current exchange rates a side. I, i thought that a cup of espresso was bad in New York, but i swear, You can pay 20 dollars for a cup of espresso here.
Our citizens if famously ill-informed about the world are less generous. Almost half of American households responded to the tsunami in Asia, more than any other nation. And even more tried to to the worst hurricane ever to hit our gulf coast. This is a time of great problems. Some new and some old.
And a time for not. all the solutions, it's a time of social entrepreneurs. When Sally and others at the school foundation called me to let me know that after through a workup. Diagnostic testing have proven was i of the special breed. I was driving along a road in southeastern Rwanda. I pulled over to express my thanks to the staff there and to Jeff.
I shared with them, including Johnny and Lance, my deep gratitude for the honor and the support of our work. My puzzlement I kept to myself. What exactly is a social entrepreneur? I know I'm a doctor and anthropologist, hence my invitation to speak about culture, but part of me winced as I acknowledge that yes, we live in an era in which simply seeking to provide high quality medical care to the world's poorest is considered innovative and entrepreneurial.
Thus the diagnosis comes with both honor and shame. Shouldn't we have offered such services to those who need them long, long ago? Shouldn't we have design systems to get around or solve the health problems faced by the world's bottom billions? I've learned a lot this week and made connections with others similarly diagnosed and i think i get it now.
Social Entrepreneurship means many things and those diagnosed do many things. But all of us carrying the diagnosis of social entrepreneur. From [xx] to the latest [xx] displays certain symptoms, that suggest not only the diagnosis but also that it may be infectious. Indeed, we may soon see a global pandemic of social entrepeneurship.
Here are some of the classic symptoms. Of the disease. Refusal to accept the world the way it is and the direction to which it's going and a willingness to. They know this can't be done. Persistance. A certain amount of righteous anger about the injustices done to others. especially the poor and marginalized, and a willingness to fight back against unjust systems and also hope.
Blood tests I've done this week - clandestinely, of course - show that all of us have alarmingly high serum levels of hope. And while you dozed in your rooms in Oxford, I was doing MRI's of your brains. And so I know you have, in fact, strategies to respond to the problems that bring us together. And I hope you don't mind that I did not have you sign consent forms.
I, for one, am not embarrassed by high serum hope levels. As long as our entrepreneurship remains grounded in solving real problems, especially the problems of those left behind, or worse, damaged by the unsustainable development that we have promoted and aggressively so over the past two centuries.
And some have far more damaged than others. Today, I would like to do two things. I wish to share with you some story About transformations. Personal, institutional, and political that I've had the great, good fortune to witness very recently in Rwanda of all places. Rwanda came back from the brink of hell but epidemiological studies there suggest a Endemic of entrepreneurialism that is breaking out in that country.
Then I will close with comments about the achilles heel of our nation movement as social entrepreneurs, and I promised to speak of culture although not in the way you'd expect. Hope in Rwanda. This will surprise some of you. If there's one continent, as Paul Colliar has said, on which economic growth is slowed or stalled or uneven.
It's Africa. This is also the continent with the highest burden of diseases mentioned above and accordingly the shortest life expectancy. The highest rates of maternal mortality. We've all heard the numbers before. There is no shortage of diagnoses and prescriptions for the ills of Sub-Saharan Africa, and many are discrepant.
But many [xx]and prescriptions are not discrepant. To the old question, "Can we break the cycle of poverty and disease?", we have an answer. Yes, we can. Paul Collier said it very well already today: science, innovation, sound policy, good governance, public-private partnerships, along with the needed resources and the offer, the promise of closing the gap between the rich and the poor.
Of promoting genuinely sustainable development; which means development with social justice and less inequality. And this will lead, some of us believe, to a dampening of the violence that continues to afflict hundreds of millions, most of them poor. Violence afflicts people like Faustin, a child I met in Rwanda, on March 22, 2006.
He was the victim of a violence which is never really local, and has almost nothing to do with his culture. On a Wednesday morning, two boys while herding cows, picked up a landmine. In Rwanda this is an increasingly rare event. As many efforts have been made to find and disarm such weapons. Unfortunately, it is still to common an event, elsewhere, within the past decade, as others have noted, it has been estimated that there are one hundred and ten million land mines in the ground worldwide.
And more than twice as many are still stockpiled. Today, thirteen countries continue to manufacture anti-personnel devices, though little as 15 years ago, that number was over 50 countries, and almost 100 private companies, 47 of which were in the United States.
Of those who detonate landmines unintentionally, 80% are civillians. And 1 in 5 are children. About half die, virtually all the rest are maimed, and many of them permanently. Both of the Rwandan boys survived, and I came to know quite well the one who was injured more seriously. As he spent more time in the hospital, needed physical therapy, home visits, and social assistance.
I met Fostant at 10 in the morning on that Wednesday. the hospital to a clinic a couple of hours away. The hospital was, I mean again, in front of the vice president, use power point. It is unfair, I will do my best. I have very little. Very few. The hospital was built and once owned by a Belgian mining company which left Rwanda decades ago having extracted what it came to extract.
After the war in genocide in 1994 the facility fell into disuse, essentially abandoned. As of May 2005, when we, and this is I think the kind of public private partnership that (xx) would prove up we XX help (xx) foundation and Rwandan Ministry of Health rebuilt and opened it as the sole hospital serving more than a quarter million people, most of them the settled refugees, internally displaced persons, and almost all of them living in poverty.
And, back to Jacquie Novogratz's comments about dignity - we did our best to make it clear that we wanted people to feel that this was a clean, safe place where we showed our respect. And as you can see, that, that, this was done in in less than, less than eight months, this transformation. And this is only one of the kinds of transformations I want to speak about.
By March 2006, when this event happened, we had cobbled together a medical and nursing staff consisting mostly of of Rwandan professionals and a handful of expatriate volunteers, some of them my former students. One of my colleagues stopped me that morning saying come quickly to the emergency room two children had picked up a granade.
That's what he said. At that moment I did not think it unlikely that someone in the region would pick up a grenade and pulled the pin. After all, ordinance hangs around for years. The boys told me that they merely picked the thing up and threw it towards the cows they were herding. The cows took the full force of the mine and 2 cows were killed.
It was an hour or so. So after seeing the boys, that I began to think about the thing itself, the landmine - what it was, where it had been manufactured, certainly not in Rwanda. In the meantime, neither I or my colleague were thinking about anything other than trauma care, which is of course precisely what trauma victims need most.
We worked attentively and in near silence. One of the two boys was not seriously injured. The other, [xx] sustained multiple fractures, and had many fragments blown into his skin. I had the privilege of splinting him, pulling the plastic fragments out of him and preparing him for transport. Although we had rebuilt the operating room and this is what we found, this is what the operating room looked like before... and this is what it looked like after.
Although we had rebuilt the operating room, we did not have an orthopedic surgeon on staff. And [xx] needed to have his fracture set in the operating room with what is called an external fixator. [xx] even in the course of interviews conducted at home afterthe device was placed. Did not wish to speak of his experience.
What I would most like to do, he said, only a few days after surgery, is to go to school. Turned out that he was not an orphan after all but that his mother poor and bereft after the genocide had struggled for years with mental illness and had finally placed him with another family in 2004. My mother's not well he told me later.
She can't take care of me so she brought me to a relative and I live here now. I would like to go to school but my adoptive family has no money, so I herd cows everyday, make them sure they eat, move them to new grass. When I asked him about the land mine he was astonishingly to me apologetic. I didn't mean to pick up the grenade.
I'm sorry I did it. I didn't mean to kill the cows. I'm sorry, it was an accident. We didn't know what we were doing, it was not our intention to kill the cows. To me, as grotesque as it is to hear a child apologize for a landmine built in God knows what developed country, this is still a story of hope.
For the desire to go to school is as hopeful as it is universal. Postan is in school, now. And every day we meet people who are sicker, much sicker than Postan, but they too have some hope or they would not have come to see us. Sometimes they are of course almost without hope and then, we go to see them.
This is John. Who has, at the same time, three of this centuries worst diseases: AIDS, Tuberculous, and poverty. We cured his TB with antibiotics of course and he will be treated for AIDS But he also received the only known treatment for hunger. Something called food. I've said this before, although this is a fairly recent couple of pictures that goes from looking like Skeletor to looking like he needs Lipitor.
Can you believe that we have to spend spent an endless amount of time arguing that food is the proper treatment for malnutrition. We waste our time, the doctors, the nurses, and health workers, arguing with our peer about this. I ran into John at the hospital last week and he reminded me that what he most wanted and in fact had been promised with a cow.
Again, John has hope because he feels well enough to work. It's what he wants to do. Jobs, as Paul Collier said. Now these are individuals stories which are not to be discounted and I will not apologize for sharing them with you but social entrepreneurs and our supporters are all obsessed it would seem with something called scale.
The fetishesation of scaling up our work is a source of both anxiety and hope. Bringing a new innovative project to scale often feels like the only. [xx] to leave a footprint of the good kind in an afflicted world of new ideas. Just so you know, we have worked with the Rowandean government [xx ] to scale up comprehensive health care not ace care but comprehensive health care in three of the four districts in which there were no district hospitals at all And from the North of Rwanda to the South.
And if i may brag, my Haitian colleagues have been with us from the beginning. In Rwanda our biggest obstacle is still scaling, is still funding the scale, up and again grotesquely the battle [xx] [xx] over paid community health workers. There's no real argument about paying ourselves and our peers.
We all [xx ] get paid for our labor. It's the poor who are being asked to volunteer and since we know that doesn't work we are searching... high and low for the modest funds to pay them. Indeed the Scholl [sp?] award would go a long way in helping us to see this model adopted more widely. I have been given the warning and so I'm going to close by saying, I know that medicine and public health will not solve the growth problems, but we can offer further solution, and what's been shocking to me over the past 25 years is the lightning speed at which policy makers themselves shielded from the risks faced by Fasten or John.
Decide that a complex intervention is to difficult, or not cost effective in Haiti or Africa, or not sustainable. In microfinance parlance, many of my patients are poor credit risks, but aren't they the very people we claim to serve in the first place and this is why I turned my speech a loyalists critique of our movement.
We need to be aware that each of the terms and concepts and tools we developed can be used to deny the destitute, access to goods and services that sometimes should be rights, not commodities. Does anyone really believe that a mother loves her newborn more if she had to pay some sort of users fees for prenatal care and obstetric care.
Such claims are piffle as you say in your country. I thought I'd throw that in, but there are also reflective ideology that has crept into our entrepreneur movement. This way of seeing the world has deep, deep roots but has been noted already by Jackie and by Karen. It's our culture that's hard to see.
It's our culture that needs to change. Look around you and you will see people of every hue but there are not poor people here and its not that they need an invitation to Oxford it's that they need us to include them in our movement and allow them to be social entrepreneurs. Let me close by reflecting on how social entrepreneur.
can be part of a genuine broad base social movement for social justice. I believe that when we look back over the next quater of a century, we'll be consoled most by our contributions to a movement that continues to grow not only in villages, slums and squatter settlements, but also on campuses such as this one.
It's a movement that will come to include a growing concern with the way in which the earth itself has been damaged, polluted by greed and war and feckless policies handed down by from on high. But it's a movement that pays heed not only to the environment, but also to the poor who are the chief victims of greed, war and unjust policy.
[xx] who is almost always right once argued that the compassion of the oppressed for the oppressed is indispensable. It's the world's one hope. I fear that at this late day, an additional kind of solidarity is necessary. A social justice movement that links the rich world and the poor. Mandela Auditorium at Oxford The village[sp?] in Rwanda, to which I return tomorrow, the movement that links concern with the Earth with respectful solidarity towards its poorest inhabitants is our last greatest hope for a world marked by less suffering and violence and premature death.
It's our last great hope for the generations to come and for our own children. Paul Hawken, in a book called "Blessed Unrest", wrote the following paragraph, "It is time for all that is harmful to leave. One million escorts are here to transform the nightmares of empire and the disgrace of war on people and on place.
We are the transgressors and we are the forgivers. We means all of us. Everyone. There can be no green movement unless there is also a black, brown, and copper movement. What is most harmful resides within us: the accumulated wounds of the past, the sorrow, shame, deceit shared by every culture passed down to every person as surely as DNA, a history of violence and greed.
There is no question that the environmental movement is critical to our survival. This is still Paul Hawkin. Our house is literally burning, and it is only logical that environmentalists expect the social justice movement to get on the environmental bus but it is the other way around, he writes. The only way we are going to put out the fire is to get on the social justice bus and heal our wounds because in the end, there is only one bus.
Entrepreneurs need to learn to be at time, at times quiet passengers on this bus. Sometimes we'll take our turn at the wheel. Sometimes we'll be the mechanic, but all of us need to get on the social justice bus. That's the bus on which on the real sustainable green movement will be traveling. It's on the bus that we'll have epidemics of social entrepreneurship.
Don't get on the chartered plane. We have a lot to offer in putting hope. As a friend of mine likes to say, hope is not a plan, but we need hope and courage and a plan to end for example, an unjust war. We need hope and energy to tackle the diseases that should have been wiped out decades ago or never allowed to spread so rapidly.
We need hope to counter the neo-Liberal policies that have weakened and even wrecked public sector institutions without ever delivering on the promise to lift all votes. We hope to speak to people in powerful positions whose hearts, unlike the polar ice caps, show little signs of melting. We need hope and we need each other.
To Jeff, to Sally, to all of you who share this diagnosis with me, thank you. Thank you for including me. In your ranks. I'll see you on the bus.
