Children's Circle of Care

May 5, 2001
Remarks by Melinda French Gates, co-chair

Good Morning. It's good to see you all. We're here at this conference this morning to talk about many important things. A year's worth of accomplishments for our hospitals that are due largely to your generosity. And advances in medicine and medical technologies that hold so much promise for the future they'll take your breath away.

But I think it's important to remember that when all is said and done, the real reason we're here is children.

I thought connecting with a few gorgeous kids face-to-face might be a good way for us to begin today, because I'm going to be talking about the children of the world and about how you and I are connected to them. Not just as supporters of children's hospitals but as members of the human family.

I think whether in the role of a parent or an aunt or uncle or some other close family member we've all experienced the birth of a child that is important to our lives.

As a mother I know that that first moment when they lay a newborn baby in your arms the connection you feel to your child defies description. Still, although it's hard to put into words, we can see the depth of the connection that exists between a mother and a child in that mother's eyes.

I've seen evidence of that connection in the eyes of parents all over the world as I've watched them interacting with their children. And it goes even further than that.

You can see that sense of connection to a child in the eyes of a grandparent.

Or the doctor who cares for it.

Or a volunteer at any one of our hospitals.

I read a newspaper article the other day that suggests that there may even be a scientific basis for that connection. It said that the mitochondria that inhabit our cells are helping scientists discover our origins. Scientists like Dr. Douglas C. Wallace of Emory University and a growing number of population geneticists believe that our family tree may be rooted in a single African mother they're calling "The Mitochondrial Eve."

Another investigator described the research this way. He said at the Y chromosome level "We are all Africans and we are really all brothers."

Of course you don't have to be a scientist to understand the connection that binds us to our children. We experience it holding the hand of a sick child. Or observing the expression on its mother's face.

I felt that connection administering the oral polio vaccine to a newborn baby in Chiang Rai, Thailand, a couple of months ago. And it is that same deeply human connection that's drawn us here, today.

My interest in Children's Hospitals began, in part, because my husband's family has been connected to Children's in Seattle for many years. My late mother-in-law, Mary Gates, was a long-time trustee of the hospital and one of the people who encouraged Scott and Laurie Oki's interest in Children's. So when Scott and Laurie provided the necessary support to help create the Children's Circle of Care, my husband and I becoming members was a natural extension of that family connection.

A lot of great things have happened, since then.

The Children's Circle of Care has grown. It's growth from the 566 members it had in its first year to the 2680 members it has today -- an almost five-fold increase that is impressive.

And the resources your generosity brings to bear today for Children's Hospitals -- this year totaling $188 million dollars -- constitutes another five-fold increase. Your gifts are what make it possible for our hospitals to remain true to the values that have sustained them through the years: treating every child regardless of their parent's ability to pay; providing the very best care to children; child advocacy; and research.

As I began thinking about speaking to you today, I thought it was interesting that child advocacy and medical research are also central to the mission that my husband and I have undertaken through our foundation, which supports health and learning and improving the lives of people around the globe, especially children. I couldn't help wondering if there was a connection between the research done by Children's hospitals with their research affiliates and the medical tools so important to the work my husband and I are doing.

And there is. A big one.

For reasons I'll explain in a moment, vaccines have become the cornerstone of what we're doing in global health. And it didn't take long for me to discover that that oral polio vaccine I administered to children in India and Thailand a couple of months ago was developed by Dr. Albert Sabin at Cincinnati Children's Hospital where he worked for more than 30 years.

As it turns out, Children's Hospitals and their research affiliates have helped develop vaccines for polio, rubella, measles, influenza B, chicken pox, whooping cough, pneumonia and meningitis. Vaccines that include many of the vaccines our foundation is trying to get to the children of the developing world.

My husband and I first became interested in vaccines when we read an article in the New York Times about how so many of the diseases we've considered long ago eradicated in this country are still big killers in the developing world, particularly of children. And, as parents blessed to live within minutes of some of the finest medical technology and care for children in the world it pained us to think how parents must feel when they have a seriously ill child and have no resources to turn to.

Since then, we've made a huge commitment to vaccines, because vaccines are one of the most efficient and cost-effective medical interventions, available. Right now about three million children around the world die each year from vaccine-preventable illnesses.

Administering vaccines a few times during the first year of a child's life can prevent millions of children from dying. And in many cases, a child only has to be vaccinated for a disease once to be protected for a lifetime.

A couple of years ago, we started The Global Fund for Children's Vaccines, which led to the development of what is now known as The Global Alliance for Vaccines and Immunization (GAVI). GAVI is a collaboration among governments -- groups like UNICEF, WHO, the World Bank, the International Federation of Pharmaceutical Manufacturer's Association, and foundations like the Rockefeller Foundation and our foundation. Its charge is to raise money internationally for vaccines, then buy vaccines and get them to children in the 74 poorest countries in the world.

Just last month my father-in-law, Bill Gates Senior, traveled to Mozambique where the first vaccines were distributed.

When we first got into vaccines we learned that 30 million kids in the world weren't receiving the basic vaccinations we take for granted in this country. Also newer vaccines, such as the one for hepatitis B which we've had in this country for 15 years, weren't being offered to all those who were being reached. And little was being invested in research and development efforts for vaccines for diseases like malaria which kills a child every 30 seconds.

So our foundation is focusing on getting existing vaccines to the children who need them. And we're making investments aimed at encouraging the development of new vaccines for diseases like AIDS and tuberculosis and malaria.

This past January I had the opportunity to travel to India and Thailand to visit some of the children you just saw in those pictures and to see the work being done by the groups that we're supporting.

The night before I was to leave on that trip, I was preparing my four and a half-year-old daughter Jennifer for the fact that I was going away. I told her I was going to visit these children who don't have clothes and don't have homes and don't have medicine when they're sick. She asked me a lot of questions.

Then I went off to pack. And pretty soon Jennifer came running out of her bedroom and down the hall toward me, with this whole stack of things in her arms.

I said, "What's this for?"

She said "Well, these are my special blankets and this is my doll and I thought you could take them to the kids who have no blankets."

And after that every time I called home during my trip she would say to me, "Have you seen the kids? Do they like my blankets?"

I think we adults can sometimes learn a lot from children. I say that because my own feelings as I prepared for my trip were different from Jennifer's. Maybe you feel this way.

Intellectually, I knew the needs of the world were huge. And what my husband and I could do was comparatively small. And I was afraid that when I really saw those needs I'd feel a loss of hope because what little we can do isn't enough to make a difference.

Boy, was I wrong. The needs are great. But so is the hope.

There's a lot we can do to make a difference. There is a huge gap that exists between the way that our children live and the way children in the developing world live. I saw children living in conditions that are virtually unimaginable to us. And sometimes you could see that reflected in their physical appearance.

At the Well Baby Clinic in Kanchanpuri, India, on their immunization day, I saw babies there that looked like what a 10 month old baby looks like here. But they were really much older than that. They were just malnourished. In some ways, it's surprising they survive at all.

I hiked into a place in the Himalayas, Dehradun, India, where infant mortality rates are among the highest in the world. And it's easy to see why.

In rural India as in much of the developing world there are rarely doctors or clinics nearby. And women are forced to give birth in unsanitary environments like barns that they have to share with the family's animals. The implement used to cut the umbilical cord is often the same machete that was used that day in the fields. This puts both mother and baby at risk of diseases like tetanus.

Tetanus often sends babies into convulsions and they die anywhere from within 5 days to two weeks. Tetanus also kills a lot of mothers. (That is if something else doesn't get them first.)

You see, the risk of a mother dying in childbirth or of pregnancy-related causes during her lifetime in the United States is only 1 in 3500. But it's one in 37 in India, and higher than that in the rural areas. And it's one in 16 in Africa. Every minute of every day one mother is lost to pregnancy-related causes that are entirely preventable or treatable. (Like the need for a cesarean section.)

Statistics show, by the way, that women in the developing world have fewer children once they're confident that the children they have are going to survive.

In some developing countries, if the mother dies, the risk of death for her children under age 5 is doubled or tripled.

That's the dark side.

But there is an enormous light side.

There's a Columbia University program underway that we're supporting that will -- among other things -- train midwives in emergency obstetric care. And vaccines can protect babies from things like tetanus and a lot of other diseases.

Twenty years ago, we were losing three million children a year to measles. Today we're down to losing a million. That means tonight and every other night 5000 children around the world are having a dinner with their families they would never have lived to enjoy were it not for a measles vaccine developed by Dr. Sam Katz at Boston Children's Hospital.

Getting vaccines to children in some of the places I visited isn't easy. The vaccine has to be kept cold to maintain its integrity. And sometimes there are no vehicles, or even roads. Still, I met health workers who are so dedicated that they hike vaccines into these remote places in India, along with medicines and things like clean birth kits.

Here you see a health worker teaching women in a rural village how to use a clean birth kit. They are unbelievably simple by our standards. They contain a small cake of soap, a plastic sheet, a razor blade, a piece of sterile material to cut the umbilical cord on, and a piece of string to tie off the cord. But they go a long way toward improving the sanitation of childbirth there. They cost less than a quarter apiece and have been proven to reduce cord infection by half, which is the leading cause of newborn death.

One of the many hopeful signs I saw on my trip was all these young doctors of various ethnic backgrounds trained at places like Harvard and the Mayo Clinic, dedicating their lives to such endeavors.

I remember one doctor in particular who I met at an AIDS hospice in India. This doctor told me how in that home they bring people virtually back to life by "the simple act of treating them by our hearts." I was so inspired by him.

I think sometimes we separate our heads from our hearts. But if you trace words like "health" and "medicine" all the way back to their ancient roots they speak to the goal of maintaining a "right inward measure", an inner "wholeness" and balance.

So while I think we have a great many tools and advances to share with the people of the developing world and their children, I also think they have a lot to share with us and with our children.

I was visiting a temple in India with a woman who runs one of the rural agencies we support in that country. As we sat there I noticed that people were carrying fruit and other things into the temple as offerings. Then other people were coming in and taking things away.

I asked my companion why they were taking things away. She explained that even though you must bring an offering to God in the temple, if someone else needs that gift they can use it. She said "My teacher always tells us that all the things in the world belong to you. But they are not really yours. So do not become too attached to them."

A concept so sound and simple that Jennifer -- blankets and toys in her arms -- knows it, instinctively. But which we adults sometimes lose track of.

Your presence here today demonstrates your acknowledgement of that truth as well as your connection to all the children of the world.

I say that because Albert Sabin and his Children's Hospital are clearly connected to the children I administered his vaccine to in the developing world. As are all the doctors at your Children's Hospitals who have developed childhood vaccines. And the parents and children who participated in the trials that had to happen for those vaccines to be created.

And they are all connected to you. You and generations of others whose gifts have sustained our Children's Hospitals and all the lifesaving advances developed there that touch the lives of children, everywhere.

In my speeches, I often ask people in the audience to consider a question: "Is the loss of a child more tragic in one place on the planet than another?"

Sometimes I think we'd like to think that. But it just isn't so.

I learned the answer to my own question. Not in India. Or Africa. But at Children's Hospital in Seattle. From an Argentinean mother and father whose child was being treated here for cancer. They were close friends of my sister's when my sister and her family lived in Argentina. And so when their son Ignacio was diagnosed with cancer we worked it out for him to be brought to Children's along with his whole family.

I went to visit them, which gave me a chance to see Children's in action. They were just amazing. They embraced that family in every way. Still, I'll never forget that feeling of walking out of the hospital and being so glad my children didn't have to be there.

Anyone who saw the pain on that mother's and father's faces would know in an instant that the unspeakable sorrow of losing a child knows no boundaries.

It's universal.

That family, the Augileras, lost Ignacio. But they had the comfort of knowing he had the finest medical care in the world. In fact, they were so grateful for what they experienced at Children's that on the 10th of every month -- the anniversary of Ignacio's death -- they go and cook dinner for everybody living in the Ronald McDonald house in Buenos Aires (one hundred people or so). And they've created a new space there in Ignacio's name. It's their way of passing on to families journeying through a similar sorrow the gift they believe all of us here, today helped to give to them.

And so you see, we, our companion missions, and the destinies of all children are connected.

The poets always seemed to know that. Rabindranath Tagore, the Indian poet who earned a Nobel prize for his poetry, described it in this way. He said:

"Come then, come bear it.
This suffering with friends.

Don't hope that without it
Your life will shine.

Come out of thyself,
stand in the open;

And within thy heart thou wilt hear
the response of all the worlds."

Tagore also wrote something that I think is a beautiful image for a child. I'd like to close with it, today. It goes:

"You have burst the bond of darkness

But you are not little

For all the lights in the universe

Are your kin."

Thank You.