Bill Gates: Good Morning Hank! It's Tuesday!
John Green: Woke up very early in Addis Ababa a few weeks ago and began a long drive South.
Slums at the edge of the city gave way to beautiful vistas and then the road worsened
and I became a bobblehead until at last, we reached a rural healthcare center.
So Hank, here's a story I heard a lot in Ethiopia. Traditionally, Ethiopian women haven't named
their children for several months after they were born because the risk of losing the babies
was just too high. But lately, thanks to the astonishing drop in mortality rates due to
smart aid and good government investment, Ethiopian women have begun to name their babies
at birth.
It's a great story and it's one that tugs at the heartstrings and makes you want to
open your wallet. It's also - well, the truth turns out to be maybe less narratively interesting,
but, in a way, more encouraging.
So the Ethiopian health care system is organized into tiers. You begin with hospitals, but
with more than 80% of people living in rural areas, the next level, the healthcare center
is vital . Here there are lots of medications and vaccines, there's a lab technician who
can diagnose parasites and operate this centrifuge. Some healthcare centers even perform C-sections.
All this despite the fact that almost none of them have running water. When I asked center
manager, Abd Al-Kadir what he needed most he answered immediately - water.
While we were there, I also met Bill Gates, the founder of Microsoft and Sue Desmond-Hellman,
the CEO of the Gates Foundation. To be honest with you Hank, I kind of assumed that Bill
and Sue were visiting Ethiopia for like, a photo op. but yeah, no, they were there to
ask questions and lots of them - to ask how the lab tech typed malaria without a particular
type of microscope, which vaccines were stored in what quantities, how many workers were
needed to run the center efficiently and so on...
And watching Bill and Sue gravitate away from cameras and toward health workers, it became
clear to me that the Gates Foundation's fundamental principle, that all human lives have equal
value isn't just rhetoric.
So then I travelled to the next healthcare tier, the outpost where health extension workers
like Utagazu, with a tenth grade education and a year of training, provide basic care
in rural areas. Utagazu showed me her well-organized medical records, the delivery room in which
many babies are born and wall charts measuring vaccination rates.
But mostly, she and her coworkers were busy taking care of people, like this little boy
was being tested for malaria with a pin-prick test that has dramatically improved diagnosis
and treatment. When he was found to be positive, the health extension workers could begin treatment
immediately.
This little guy was extremely sick with diarrhea that was suspected to be a virus. Diarrhea
remains one of the leading causes of child death in Ethiopia, even though it is always
almost survivable if kids can stay hydrated, so this boy went home with a rehydration solution
that might well have saved his life.
And there is one last tier of the Ethiopian health care system, the women's health army.
My favorite army of all time! These are volunteers who take maternal and infant care into their
communities, talking about everything from family planning to how to get folic acid.
A member of the health army invited me into her home and showed me the map that she uses
to keep track of who's sick, who's pregnant and who has a small child, and this is how,
with limited resources, information and care travels the last few miles into rural communities.
Hank, I don't wanna minimize the amazing work that the Gates Foundation and other organizations
are doing in Ethiopia, or the importance of technologies like the easy to read malaria
tests or this amazing thermos that keeps vaccines cold for 50 days without electricity.
But the real heroes of Ethiopia's health successes are Ethiopian. The women volunteering in their
communities, health extension workers treating disease and compiling data, mothers fighting
to keep their kids healthy despite the immense challenges of poverty. Their progress has
been real and should be celebrated, but there's also much to do. Kids should not die of diarrhea
or pneumonia or malaria, and far too many still do.
So, about that naming at birth thing. I asked these women about it and they all agreed that
kids do get named at birth now which never used to happen. Some said that it might be
because child mortality is lower these days, but most felt that it was because now they
have to fill out birth certificates. That doesn't tug on the heartstrings in quite the
same way, but in the end, it's maybe an even better sign because good health records are
vital to good healthcare.
In short Hank, when it comes to healthcare, heart warming narratives and boring bureaucracy
are not always mutually exclusive. Anyway, then I rode in a helicopter with Bill Gates
which was terrifying and hilarious, and I will definitely tell you about it next week
unless I get meningitis again or something...
Hank, DFTBA, I will see you on Friday!