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Trip Notes

“We heard moms say…”

What new mothers in Ethiopia told me and the foundation’s CEO.


Earlier this month, I went to Ethiopia with the Gates Foundation’s CEO, Sue Desmond-Hellmann. Sue joined the foundation earlier this year and already is making a big impact. She talked to Bridgitt Arnold, who works in my office, about her impressions from the trip, including what it was like to return to Africa after spending part of her early career there.

BRIDGITT ARNOLD: You’re no stranger to this part of the world, having spent some time in Africa early in your career. What kind of work did you do here?

SUE DESMOND-HELLMANN: My husband, Nick, and I both trained at University of California San Francisco. We were on the faculty there in 1988, when the school loaned us to Makerere University in Kampala, Uganda.

We sublet our flat and moved to Uganda, not long after Amin and Obote and some really difficult times in the country. Nick set up a sexually transmitted disease clinic. I worked in the Cancer Institute. The two of us taught in the medical school and took care of patients. We went to AIDS conferences and traveled to Kenya, Ethiopia, and Zaire as well. That lasted a little over two years. Eventually we transitioned the program to others, came back to the United States, and went into practice.

What’s it like to come back now? How have things changed?

Ethiopia and Tanzania in many ways have not changed, but both seem slightly wealthier, more crowded with traffic jams, and much more organized than I remember. Also, the impact of foreign aid and government commitment on health is striking.

I am especially impressed by the orderliness and commitment that the country of Ethiopia has to health and agriculture. They're making sure people get their vaccines. Since one of the big challenges we see in the U.S. medical system is all these health disparities, I'm particularly touched by the government's commitment to reaching people out where they live.

We went to health clinic and saw a super-thermos that keeps vaccines cold for 30 days without needing any electricity. What did you learn about the impact it’s having and how it needs to be improved?

We talked to the health worker who’s using it. She gave us one example that I just love. She needs to give two tetanus toxoid doses to pregnant women. Well, when she had to go out and didn't have this thermos, they would often miss the second dose. So now they can come to her and get their vaccine.

She did say she would like it to be a little larger so that it's got more room for ice. So from a very pragmatic point of view, if it lasted longer than a month, that would be great.

You’ve seen people in some very tough situations. Is there anything that leaves you feeling more hopeful than you expected?

The best part of the trip I think was going out to the village and seeing a mom who had given birth 45 days earlier. She had a chance to survive the childbirth—and have a healthy baby—because of the work done by the worker from the Health Development Army, who makes sure moms get the information they need.

We asked the health worker, “When was the last time you saw a mom or a baby die?” She said, “Years.”

We heard moms say they don't feel like they have to have more kids because they have to have spare children. Just the thought of having spare children is the saddest thing on earth. These moms can see with their own eyes that vaccination and maternal and child care makes that kind of impact. That gives me so much optimism that the efforts of the Ethiopian government are saving lives.