Building futures: Gates and participants at a Sure Start Project initiative to promote maternal and newborn health in India’s Kathghara Village. © Bill & Melinda gates Foundation/Barbara Kinney.
Building futures: Gates and participants at a Sure Start Project initiative to promote maternal and newborn health in India’s Kathghara Village. © Bill & Melinda gates Foundation/Barbara Kinney.

Making a Commitment to Connect Deeply

Transforming global health
Writer: 
July 24, 2013

One of the hallmarks of getting old, I'm told, is thinking that everything is getting steadily worse. I must still be young, then, because I am confident that Duke has gotten better since I was a student. I arrived at this conclusion this past May, when I returned to campus to deliver the commencement address.

While I did my share of bathing in nostalgia about my college days, I spent most of my time being amazed by this year’s graduates. I spoke with about two dozen students during my visit, and I made two observations right away. First, they are very different from my classmates and me when we were their age. Second, that’s good news for the planet.

It's not that they're smarter than we were — though listening to them describe their cross-disciplinary double-majors (whatever happened to having just one major?) led me to question myself after a while. The crux of the difference between us is the breadth of their vision.

We also wanted to be successful twenty-five years ago. But the world in which we believed we could succeed was much smaller than theirs. They apply their ambitions to all seven continents and all seven billion people in the world.

During my time at Duke, the only issue that stood out that had anything to do with what I now call global development was the terrible famine in Ethiopia. The song “We Are the World” was recorded for and shown during a television special to benefit the victims. We saw lots of heartbreaking images of starving children with distended bellies, and we donated money to help them.

Maternal wisdom: Gates and Save the Children’s Evelyn Zimba, far right, talk with a midwife in Malawi’s Misi Village. ©Bill & Melinda gates Foundation/Barbara Kinney.

 This was a breakthrough in Americans’ awareness of global issues, especially those related to the poor. Before the mid-1980s, the fact that kids were starving somewhere was a guilt trip your parents laid on you when you didn’t eat your vegetables. After Ethiopia, hunger was a legitimate topic of conversation.

Looking back now, though, there was something missing. We felt pity for the Ethiopians. Their suffering moved us. But they seemed so different from us. We didn’t know them, and I’m not sure we believed we could ever know them. And the idea of trying—that is, visiting Ethiopia or learning to speak Amharic—didn’t occur to us.

When I contrast that to what I heard from the Class of 2013, the transformation is, quite simply, stunning. I was fielding questions from the students about the trade-offs between horizontal and vertical approaches to global development programs, which is the type of issue we talk about with world experts at the Gates Foundation. Many of the students I talked to had participated in DukeEngage, spending time in developing countries and seeing firsthand what life is like for people my classmates and I didn’t even know existed just a generation ago.

One student told me, “Once you’re exposed to these issues, you can’t turn your back on them.” Hearing that made me ecstatic, because that’s exactly what the Duke administration and the Gates Foundation were counting on when we worked together to start the program.

My husband, Bill, and I started our work in global development only after we’d come face to face ourselves with the terrible inequities that destroy the lives of millions of people.

About fifteen years ago, we saw a simple pie chart in the newspaper breaking down the major causes of death among children. One of the bigger slices of the pie, representing 500,000 dead children annually, was labeled “rotavirus.”

I had never heard of rotavirus. Neither had Bill. It turns out it is the leading cause of diarrhea, preventable with a vaccine that only children in rich countries were getting. Our reaction was somewhere between disbelief and disgust. How could we have known nothing about this tragedy?

Bill and I were just starting a family. We had plans to do philanthropy down the road, when there was more time. But all of a sudden it didn’t seem like there was any time to waste. We decided to do everything we could to get the vaccine to every child who needed it. Now twelve of the world’s poorest countries are giving the rotavirus vaccine to children, and that number is scheduled to climb to forty by 2015.

I told the students that my goal in supporting DukeEngage is to help many of them experience their own moments of transformation. The reason I believe it’s an achievable goal is that nobody’s trying to change what’s in the students’ hearts. The creativity and generosity and love required to take extraordinary action to help others are already there. All DukeEngage is trying to change is the aperture of the lens through which students see the world.

This question of what to do with that wider lens was the point of the speech I gave the morning after I met with students. I know from observing my own kids (whose primary means of conveying information is texting photographs) how rapidly technology is changing the way we communicate and expanding the universe of people we can reach. In short, graduates today can see more of the world than I ever could. I want them to understand what a gigantic opportunity these changes present for them and for the world. I want them to use all the tools at their disposal to connect deeply with as many different kinds of people as possible. Because if they connect to others, I have no doubt they’ll do something to make their lives better.

If the conversations I’d had with students were any indication, I realized it was possible I would be giving them a message they’d already internalized. At first, it made me nervous. Were they going to be bored? But then I decided there are worse things than giving a group of ambitious, compassionate, and talented people a little extra encouragement to use their ambition, compassion, and talent to do great things—to accomplish goals I never imagined when I was in a cap and gown.

Gates ’86, M.B.A. ’87, Hon. ’13 is co-chair of the Bill & Melinda Gates Foundation. In that capacity, she shapes and approves the foundation’s strategies, reviews results, and sets the overall direction of the organization. She is a former Duke trustee.