In 2004, when he was the Chancellor of the Exchequer in the UK, Gordon Brown gave a speech describing how the world was failing poor families – and poor babies in particular. One doesn’t often hear the person in charge of a powerful nation’s economy talk about such things. I am not sure who else carries these words inside of their head, but I think of them when I think about the terrible fact that thirty thousand infants still die every day in the poorest parts of the world.
Gordon Brown* made the case that these thousands of babies die because of our moral apathy and lack of political will: “And let us be clear: it is not that the knowledge to avoid these infant deaths does not exist; it is not that the drugs to avoid infant deaths do not exist; it is not that the expertise does not exist; it is not that the means to achieve our goals do not exist. It is that the political will does not exist. In the nineteenth century you could say that it was inadequate science, technology, and knowledge that prevented us saving lives. Now, with the science, technology, and knowledge available, we must face the truth that the real barrier is indifference.”
Babies live here. And die here.
This sentiment has shaped much of my journey in medicine and why I do the kind of work I do: We know how to prevent and treat most of the things that kill the children of the world. But we have not put the systems in place to ensure that children everywhere get what they need to have a chance at life.
This injustice is the inescapable lesson of a Kenyan hospital ward, as you stand over a peeling metal bed and watch a baby die. This is the lesson of a shanty clinic where a small team in a slum overflowing with garbage and one million people crammed together struggle to test people for HIV — and yet don’t have enough medicines available for those who test positive. You can’t avoid thinking about suffering in Kenya, and you certainly can’t avoid thinking about HIV. And you can’t avoid the realization that things do not need to be this way. Lack of political will. Indifference.
How can we let babies die because they live in a poor place?
What do you tell the mother who knows that there is medication somewhere else in the world that can save her child — but she can’t get to that medicine because she is poor and lives in a poor country?
I have to ask these questions because these children are my children. I cannot forget them. I have diagnosed them with HIV. I have given them medicines and food. I have watched them cry. I have carried them in my arms, with their legs and arms wrapped around me. I have wrapped their bodies in blankets after they died from diseases we could have treated, sicknesses we could have prevented.
Because I can’t forget, I keep coming back to work in a place where I have to squat in dirty latrines, where I can’t get a latte, where forgotten children lie sleeping in the gutters along the street. Even if you have not had the opportunity to do these things with your own hands, even if you don’t have to see the suffering, you can see it. You can open your eyes. You can see and read and hear. It is there for you to witness, all around the world and also right next door. And we each get to make our own decisions about how we will live in the face of this injustice.
(*A random side note about Gordon Brown, which also gives me a degree of fondness for the man: I actually met Gordon Brown a few years ago when he was still the prime minister of Britain. After one of our medical myths books was published in the UK, I got to go to London for a bunch of book promotional stuff. Anyway, I ended up on this popular British morning TV show, and the other guest of the day was the prime minister, Gordon Brown. As they were changing the microphone from him to me, I was struggling for something to say to him. So, I told him how I have appreciated his comments on global poverty and how I sometimes use this quote of his when I teach students and talk about my work with HIV in Kenya. His response was that this was evidence that I was “as intelligent as I was beautiful.” He is a politician, I know, but it’s not every day that the sitting prime minister tells you that you are intelligent and beautiful!)