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Dr. Jessie Stone A couple million people at least dependent on these clinics to stay alive, you know, some of them had been treating patients for over 20 years, effectively, you know, keeping people alive, giving them a lifeline, closed, completely shuttered, and overnight, so there was no preparation, there was nothing, and that is a death sentence for millions of people. (...)
Sanam That's Dr. Jessie Stone, founder of the Soft Power Health Clinic in Uganda, and a six-time member of the U.S. freestyle kayak team competing in world championships internationally, on If You Were In Charge, with me, Sanam Naraghi Anderlini. Welcome, everyone. The show is brought to you by the Bijan Reisar Foundation and my organization, ICANN, where for 20 years we've been working with women peacebuilders on stopping wars and violence around the world. Each week, as you know, I talk with other doers and imaginers about the tough issues they tackle. This week, I'm really excited to be talking to Jessie, because not only she has this extraordinary life of training as a medical doctor, then going into kayaking at the age of 41, and then coming out and setting up a clinic in Uganda, where they provide care for malaria, reproductive health care, and recently tuberculosis, and to talk to her about how that happens, how on earth she went as an American and set up this clinic, and what it means to be working at the grassroots levels, and the essence of providing health care in such contexts. So I'm excited about that part of the conversation, but also the question of the effects of the cuts by USAID since January of this year. How do they see it on the ground? What are the implications that they're dealing with, and the effects in terms of people's lives? Basically, how does a clinic like hers deal with this problem? And I hope the conversation is interesting, and that you find it informative, as always. And I will see you on the other side. Thank you. (......) Jessie, hi. It's so great to have you on If You're In Charge. I'm so excited for this conversation.
Dr. Jessie Stone Thank you, Sanam. It's great to be here. Thank you for having me.
Sanam You're very welcome. So we have a lot to talk about, because you do extraordinary things. And the first thing is, I'm going to have like a little girl crush moment about talking to somebody who is in world-class sports and kayaking, freestyle kayaking. But you started at the age of 41. Is that correct?
Dr. Jessie Stone I started a little bit before then. It all goes back to university. During the summers, I did not want to have an indoor job. And I got a job. I went to college in California, UC Berkeley. And my summer job was working as a whitewater rafting guide. And so that was like the stepping point that was getting onto the rivers and discovering this incredible beauty and joy in being in nature in the water. And I saw kayakers, and I thought they were nuts. I was like, that looks way too scary. I am never going to try that. And then eventually, a few years into the rafting, or more than a few years, I thought, I am ready to try that. You know, I'm ready to get out of the big, giant rubber boat and get into the single boat driven by you. And so once I tried kayaking, I kind of fell in love with it. And I just thought, this is my sport. This is what I love. But I came to it later in life. And I saw freestyle kayaking happening. People were playing in little spots on the rivers, waves and what they call holes, or which are reversing piles of whitewater. Got very excited by freestyle kayaking. I met someone who was willing to kind of coach me. I was sort of the very annoying student that was like, tell me more, tell me more. Okay, I'm ready to practice, you know. And eventually, I did, I tried out for the US team several times, did not make it, and then finally made it when I was 41 years old and started my international, you know, world championship level competition at 41. Since that time, I've been on six US teams, which has been really fun.
Sanam That's extraordinary. That's amazing. And then, in the meantime, you were actually training to be a doctor, right? So, you had your medical practice, and you were practicing in the US, or how was that balancing?
Dr. Jessie Stone No, no. So, I had another slightly convoluted path towards where I am today. So, I had, in parallel, been, you know, going to medical school and working on my training and degree. And then, at the same time, I had this kayaking passion. So, I was taking these leaves of absence from medical school to paddle. I kept having these great opportunities. The dean of the medical school kept saying, just graduate. Just get your degree. Get out of school. I was like, okay, okay. And eventually, I came to this point where I had some really great opportunities. I could even support myself through kayaking. And I said, I will come back to medicine. It will always be there. I have my degree during medical school. I had a very amazing opportunity to work in a hospital in Kenya. And I spent about four months working at this hospital called the Kikuyu Orthopedic Hospital. And that really changed my view of medicine. Developing world medicine versus developed world medicine kind of planted a seed. And it made me think, you know, this is medicine that I'd really like to do, as opposed to working in the United States, per se. (.) So, anyway, back to kayaking. I got invited on an expedition-style trip to the Nile. It flows out of Lake Victoria. So, this was in Uganda. Just something I couldn't pass up. And so, I went with these three other people. And we were filming an instructional kayaking video and kind of scouting out this area. And about halfway into the trip, the person who had put the trip together was sort of like the leader of our little group, got malaria. And then I ended up having to treat him. And I thought, this is incredible. How did he get malaria? He's sleeping under a mosquito net. He's taking prophylaxis. And he got malaria. You know, what happens to the local people? And that was sort of, you know, planted the seed of my curiosity. And I was asking the people who we were staying with. We were staying in this very sort of ramshackle campground. And they said, well, we don't know anything about malaria. We don't know what's, you know, why this happens. We're not, you know, our business is tourism. We don't know, you know, much about this. But if you're interested, we'll put you in touch with a local woman who can help you. She's from the village. She speaks perfect English, perfect Lusoga, the local language.
Sanam You can go find out for yourself what's happening.
Dr. Jessie Stone And so I did that. I basically made a home-to-home visit with this woman and to find out what did people know about malaria? You know, if they understood transmission, if they owned any means of protection, like a mosquito net.
Sanam And this is what year? That was 2003. So, okay. So, I mean, long ago, but not so long ago. I mean, malaria and what we know about malaria and how it should be treated is, you know, goes back a long ways. But this is 2003 in Uganda. And you're in a village. And you're talking to people about malaria. And what did you find out? Or what surprised you?
Dr. Jessie Stone It was really shocking. What really was amazing was that not a single person we interviewed, we went to 50 homes, not one single person that we interviewed understood how malaria was transmitted. They didn't realize a mosquito was involved. And when, you know.
Sanam In 2003. Yeah. In a place where malaria is prevalent. It's endemic. //S02: It's endemic.// Exactly. Yeah.
Dr. Jessie Stone Exactly. And so, you know, that was, it was so eye-opening. Because I think even to this day, even when I talk to people, it's mostly in the developed world, you know. And I say people don't understand transmission because it's directly related to your level of education. And if you aren't getting correct basic education or you're not getting any education, then you're going to, you know, come up with other ideas about why you get sick. I mean, that just makes sense, right? To me, it's almost like there are two worlds that exist on planet Earth. There is the world that we live in of the developed world where we have, you know, these basic amenities that we take for granted. Like we can drink the water that comes out of your tap. We have plumbing and flush toilets. You can have a hot shower whenever you want, just about. Those kind of things that we just accept as normal are true luxuries for, you know, billions of people in the world. And Uganda is just a perfect example of that. But it goes, you know, so there are those amenities of basic living, you know. But then there's the education. You know, it's not a given at all that most people will even get their basic primary education. But I do think there is a broader level of knowledge distribution. I've seen it in the time that I've been in Uganda in the last 21 years. So more people understand transmission of malaria, for example. That doesn't mean everybody does. But more people do compared to when I first arrived and in our area and in the catchment area that we now serve. You know, many more people understand that. Many more people own mosquito nets and use them correctly to prevent malaria transmission.
Sanam So, okay, so you go there, you're talking to these people, they don't know about the transmission. And then you decide that you're going to take on this massive responsibility. Like, how does that? No, no, no, no.
Dr. Jessie Stone It was, it was, it was just, I really thought, because it was so shocking to me, talking to people, finding out that they had no means. They didn't understand transmission. They did not own a means of prevention, which would be a simple method to protect themselves, you know. And then asking them, are you interested about learning more? You know, in other words, would you be interested, for example, because we were asking this in our 50 home survey, would you be interested in learning more? Would you like to come to an education session, for example, to learn more? And universally, out of the 50 homes, everyone said yes. So that was, you know, very positive. And then, you know, we also asked them, would you be able to purchase a mosquito net? You know, and they all, everyone said yes, assuming the price was affordable for us. Yes, we could. And then the other thing that was interesting was we asked, I asked them, you know, how many family members have died from malaria that, you know, in your family? And how often are you going to the hospital for treatment? And so every single family reported at least one family member dying from malaria. And everyone reported spending a significant portion of their income each month on this dealing with malaria, you know, so transportation to the hospital, treatment for malaria. The problem is that in Uganda, around 98% of the cases of malaria are caused by falciparum malaria, which is the kind that can kill you. The other three species of malaria will not kill you. They'll make you very sick. But falciparum malaria will kill you. So you need to treat this in, you know, in the right amount of time. Otherwise, it'll be fatal. So for Ugandans in particular, this is a very heavy burden. And it's something that everybody experiences. You know, it's something that brings them together in one way, you know.
Sanam In Iran, in the Caspian region, many, many years ago, my uncle was, who'd worked for WHO, came and eradicated malaria. I think they DDT did it.
Dr. Jessie Stone Oh my goodness, that's amazing.
Sanam Yeah, that's, but I think they did it with DDT at the time. I'm not, I'm not entirely sure.
Dr. Jessie Stone No, no, which was common. Yeah.
Sanam Yeah, exactly. So, and I think it was a contained area and so forth. Is it possible to eradicate it in a safe way? Or is this something that people just have to live with? Like, is it, you know, in a place like Uganda?
Dr. Jessie Stone So, this is, so, so, this is, this gets, this is where, you know, the subtlety of malaria gets complicated. So, in certain regions, it's possible to eradicate it. There are places in the world, in Africa, and many other places that have what they call episodic or seasonal malaria. It depends very much on the climate. Like, they have distinct, long, dry seasons, and then they have a rainy season. And malaria usually rears its ugly head in the rainy season. (.) But in Uganda, because it rains throughout the year, you have malaria throughout the year. And you have a large population of people. Uganda now has 48 million people in a country that is roughly the size of Oregon, the state of Oregon. And so, it's, humans are the reservoir. You know, the mosquito is the vector. It's bringing it from, like, us as the reservoir to the next person to infect. It's very, very difficult to figure out how to eradicate malaria in a country like Uganda. What we can work on is control and reducing the burden of the disease. But, you know, it's a tough, tough thing to do in a country like Uganda. Other places, it's much easier. Lower population, seasonal malaria, much easier to deal with.
Sanam Okay, so here you are, you're talking to these 50 families. And people come and they're telling you that they're interested in helping themselves eradicate it. And as Rumi says, you know, you take a step and the path appears. You know, so one... Kind of like that, actually.
Dr. Jessie Stone I mean, it was kind of, that's, you know, really. With the help of the mayor of the village, we organized an education session. And with the woman I was working with, we had a massive turnout. The whole village showed up and we had made these posters, you know, sort of diagrams of, you know, this is what malaria transmission looks like. This is what happens in your body. This is what's going on when you feel sick. You know, just very simple, effective ways of communicating. So we did this education session and people were so interested. And then they asked a ton of questions and started saying, how can we get mosquito nets? We would love to buy mosquito nets. And then that was our next little project. How do we source mosquito nets? And then the village next door heard about the education session. They called us and they said, could you come to us? And then we did the same thing next door. And it was like that. It was just like the, you know, sort of the knock-on effect. And then after a couple of busy weeks of doing this, I was about to leave. And the mayor of the village said, you know, we have this community land and we would really like to donate it to you if you would like to build us a clinic. And I was like, sure. I know nothing about it, but it sounds like a great idea. Let's do it.
Sanam Meanwhile, your promo video for kayaking is what's happening to that.
Dr. Jessie Stone Well, what's funny is we did, we were continuing with that. But because the person in charge was so sick, you know, malaria laid him out. I mean, this was a guy who never missed a day of kayaking for anything. You know, he never got sick. He never, but he was down and out. He had, you know, five or six days of just being in bed. So that stopped the filming. That allowed for other things to go on. We finished the film, but he didn't feature in it as much as, you know, he had hoped to feature in it. But, you know, with this idea to go back to the U.S. and raise money to build a clinic and we managed to raise $25,000 and that was how we built the clinic.
Sanam And it was enough. $25,000 was enough to build a clinic.
Dr. Jessie Stone Yeah. That's extraordinary.
Sanam First of all, I mean, that's congratulations. Did your friends and family, did they question your sanity at the time? I mean, what were people thinking or are they just used to you doing what you want to do and that's the way it is?
Dr. Jessie Stone I think a little bit of both of that, but I was extremely lucky growing up because I had a father who had chosen a very non-traditional path through life. So he was very supportive of that. You know, I don't think he loved the idea of me, you know, traveling off to Africa and being so far away from home, but he understood. You know, he definitely understood. And so he was very supportive. So anyway, we just, with the local building crew, and then there was lots of people who volunteered to help. I mean, I was laying bricks. I had, you know, a lot of my kayaker friends were coming over because they wanted to paddle the Nile and they were laying bricks and we just got, you know, all kinds of people to help. It was like a nice mixed crew of people. And then we eventually, the clinic got finished. The construction was finished. We opened the doors January 19th, 2006. And in the meantime, the malaria outreach program had continued. So that was going on and on. We had sourced mosquito nets. You know, we were selling mosquito nets to people. We were following up with people at home to see, are you using the nets correctly? Do you understand, you know, why and who's having the benefit of sleeping under the net and all that kind of thing. (....)
Sanam And did you ever have any issues with, I don't know, with the local government or the national government? Or was it that because it was so intertwined with the local community that they took control of it all? I mean, like, they were in charge of that side of the story.
Dr. Jessie Stone It was so interesting because, um, at that time there was next to nothing going on in terms of, um, any kind of outreach to support communities or work with communities in any way. I mean, it was so minimal. And, um, so I had, I had expected, and I, you know, this is why I was kind of like, this is a really one step at a time program because I was expecting resistance. I was expecting it to be really difficult. Like I, I remember going to the office in Jinja, the district medical office who we work closely with, um, to get our license and to figure out like, how do you actually get a clinic license and registered and do that? And I walked into this room. I met with this man. (.) It was, it was such an eye opener. He had this desk with like piles of papers on it. There was a chair next to me that was piled high with papers on it. There was the chair that I was supposed to sit in that had no seat. It was like a, you know, wooden, the cushion was gone. He sat across from me and he put on his glasses, one of which the glass was completely cracked and broken. And, and I was like, this is a whole other world. You know, they're, they're just like, there's so little to no infrastructure here. So the next day he came up and he saw where we were building. He saw the clinic building, you know, he was saying, okay, so the pit latrines, the toilets have to be, you know, this far distance, minimal away from the clinic, you know, things like that. Those were the things they were checking that were important. You know, where are you dumping your medical waste? You know, how are you taking care of that? And then, you know, pretty much all looks good. Okay. We'll give you your license. Good to go. You know, I mean, it was so easy. It was crazy.
Sanam How many people have you helped right now? Do you know? (.)
Dr. Jessie Stone Now and sort of, um, for the last 10 years, we have been, we've been helping around, um, and this is between the clinic and our outreach programs. Cause now we have six health education outreach programs in addition to, you know, the clinic. Uh, the clinic sees around 35,000 patients a year. Um, and then through the health education outreach programs, we see around 15 to 20,000 more people. So 50,000 people a year, 50, 55,000 people a year. It's a lot of people over a long period of time.
Sanam Okay. So I'm going to, um, just shift the conversation a little bit because meanwhile, as you're doing all this work, we have the new administration and comes January of 2025 and, uh, USAID is the first, um, on the chopping block of the, of the Trump administration. (.) You know, the numbers that we get, we hear publicly are $40 billion of, of, you know, international aid being cut back and, and so forth. But I know from my work that a lot of that assumed $40 billion never really reaches the ground. It goes to international organizations that sits in Washington and fancy buildings from where you sit. And especially on this question of healthcare, because that's been such a prevalent part of it. What is, what's happening? What's, what's been going on?
Dr. Jessie Stone Well, you know, certain really critical healthcare initiatives were defunded overnight. And so the network of HIV clinics that were providing HIV specific care, including treatment, testing, testing, counseling, were shuttered overnight. And Uganda had an enormous network of these clinics. And, you know, there were a couple million people at least dependent on these clinics to stay alive. And that's probably an underestimate. And overnight doors closed and people without access. Some people had been lucky enough to get medication that would carry them for, say, six months. But after that, who knows, right? That was totally devastating. You know, that was just gone, closed. In addition to that, TB testing, the testing the genetic strains of TB. So you know what's a resistant strain versus a non-resistant strain, which is extremely critical in treating TB. That was closed. That was shuttered, which is also another, you know, that really hampers your ability to treat TB effectively. And TB is very much alive and out there. And it's a horrendous disease. And not to mention the combination of HIV with TB, which we see a lot and deal with a lot. So that was another aspect that was terrible. In addition to that, family planning supplies, the ones that were paid for by USAID were cut. And we had anticipated that because it happened during the last Trump administration. So we were trying to prepare for that ahead of time. In that particular case, at least for this year, the United Nations Population Fund has stepped in to fund it, which is great. And then other things like mosquito nets that had been come through USAID. Not all mosquito nets, but a large number of them that were going to government facilities to be distributed to people were cut off. (.) I mean, overall, of course, there was fat that needed to be trimmed in all of this, as you're saying. There were plenty of examples of, you know, funding going to fancy buildings and not making it to the ground and not making it, you know, effectively. But on the other hand, in Uganda in particular, this network of HIV clinics that was countrywide and, you know, some of them had been treating patients for over 20 years, effectively, you know, keeping people alive, giving them a lifeline, closed, completely shuttered, and overnight. So there was no preparation. There was nothing. And that is a death sentence for millions of people.
Sanam It's one thing to say, oh, we want to cut back on expenses. And, you know, when you think that they're about to spend a trillion dollars on the military, I'm like, a billion, you know, $40 billion.
Dr. Jessie Stone Well, it's less than 1% of the US budget. I mean, it's like nothing.
Sanam Exactly. Nothing. It's nothing, right? And then, and then, as you say, there's, you can, there's ways of reforming it to make sure that it actually, the money goes down to the ground and is 10 times more effective if you, if you cared about making it effective. But it's just the cruelty that we don't, you know, it's fundamentally, it's like, we don't care. We don't care that they're dying. Is that the message that's in terms of how?
Dr. Jessie Stone Yeah, I mean, it is. I think it's, I think it's definitely, you know, it's, it's been a big shock, has been there for so long and people could say in some ways, oh, maybe people were taking it for granted. Okay. But on the other hand, you know, healthcare is a truly scarce resource in this part of the world. So the goodwill that, that, you know, this bought towards the United States and, and the ability to actually have a positive impact, one doctor for 25,000 people in Uganda versus one doctor for 340 people in the United States, there's a desperate need there.
Sanam Some people might listen or people that might be on the, you know, supporters of, of, of Trump and others might turn around and say, well, you know, we have a healthcare crisis in the United States, why should we care about what's happening in Uganda or, or elsewhere? Why doesn't the Ugandan government do it for them? Like, is that, has that been an issue that, that, you know, you think that, yeah, there is more that, that, that the governments of these various countries could do? //S02: I mean, I think it's, yes.//
Dr. Jessie Stone I mean, I think it's always a mixed picture. It's not like, um, I, I think there's, there is certainly more the Ugandan government could do, but there's still at the, you know, fundamental baseline, just basic primary healthcare is not available to the majority of Ugandans out there. You know, just first and foremost, the, the capacity to deliver it is not there. And that takes, that takes a while to actually build and, you know, implement. And it requires, yes, it requires the will of the government, but it also requires help. You know, we, we are a cooperative world in theory, right? So we want to work together to make, to lift all of us up. If I look at the big picture of healthcare in Uganda, it's like a long emergency. So the planning, like, how are we going to plan to make this whole system much better? Hasn't really happened. What you're dealing with is kind of the fallout from the fact that there isn't enough right now to help people that are desperately in need, you know, that are really sick. And really, I mean, the things I have to say in all my time working in Uganda, you know, almost every single day that I'm there, I am seeing things that are shocking. You know, it's never like humdrum, like, oh, we've seen that before. It's, you see a lot of things that repeat, but you still cannot believe the kind of things that people live with on a daily basis. And because they can't afford healthcare, they wait and wait and wait until it's very late in the game to come get it, the care they need, you know? And it means mobilizing resources, not in our setting, but if they were to go elsewhere to a private clinic, to the government, you know, facilities, they would be paying a lot more. And often that means selling their most precious resources to do it. And it's just once, you know, that's one episode of, you know, bad health.
Sanam So both on the preventive side, basically, there wasn't enough, and then on the care side, as you're saying, you know, on the sort of extreme side. So the cuts, the shuttering, fast, like overnight assistance from the U.S. stops. What was the reaction in Uganda? In a place like Uganda, how are people reacting to this? Or what's their perception of the U.S. now?
Dr. Jessie Stone I mean, I think it's interesting, you know, there's, at first it was like disbelief, like, this is really happening, you know? Well, this can't be, it won't happen. This is going to be a temp, because initially it was, you know, this is temporary. But I knew as soon as it started, I was like, this is not temporary. (.) You know, people were, there was a lot of disbelief, and there was anger, and there was, you know, I mean, all the people employed that overnight didn't have jobs, and they were, let's say, a lot of them probably the primary breadwinners in their families, and so many dependents. And it wasn't like they can just go look for a job somewhere else, you know, it's just those kind of jobs are very scarce anyway. (.) You know, so that that's one side of it, plus the, all the patients that were accounting on, you know, certain care. And the government then came in and said, well, we're going to roll HIV care into the regular care we're delivering in the hospitals. But they are very ill-equipped to do that. And you can't, that's not something you can do overnight. It's real specialty care. And, you know, one of the things that happened in our setting in particular is we have been asked to do all the TB testing. We were given a machine by the government to do the genetic testing for TB to help them, which we're happy to do, you know. But it means we're picking up the slack in this case. And, you know, the clinic has gotten much busier since this happened. And we've been seeing, you know, four to 500 more patients a month, which is a significant number, you know, for us.
Sanam And, I mean, here's the irony that I was reading some of the papers around how they're reconstituting aid under a State Department and what they want to do. And they say, we're going to carry on providing health care and emergency assistance and food in humanitarian settings. But one of the indicators of impact has to be that people's perceptions of the U.S. are good. You know, like, you know, you're in Sudan, we're giving you food and, you know, we're only going to do it if you turn around or the poor recipients suddenly say, yay, you know, you know, America's great. I mean, it's such a bizarre, bizarre thing to try and tie everything to kind of perception of the U.S. But the tragedy is that it was the soft power approach, right, that made people think that the America was, you know, had some benevolence. And now, and they've destroyed that, right? They've destroyed that trust.
Dr. Jessie Stone Definitely. You know, absolutely, definitely. And I think they have also sort of opened up a, you know, nature abhors a vacuum. They've opened up this space that's going to be filled, and it's not necessarily going to be filled by benign forces, you know, I mean, it's hard to say, but having seen the way China has behaved in Uganda and, you know, with their various building projects, complete disregard for human life and, you know, just decency, you know, this is my own personal observations and, you know, things with the big infrastructure projects that they've built. You know, it's not going to be good. If China comes in and fills, tries to fill those gaps, it's only going to be in some way confiscatory, beneficial for them and not for Uganda. (.)
Sanam I mean, we saw this also during COVID that when the international community pulled out, when you leave a vacuum, it was, you know, in Kenya, it was gangs. In other places, it was jihadi groups and things like that that were providing the basic services that people wanted. And, of course, that buys them loyalty. I mean, it's, you know, when, and health and education and food and these basic things are so obviously critical and we keep forgetting, like, we, I don't know, these are sort of, as you say, it becomes first world problems that, that we don't even reflect. I think, I think it's hard.
Dr. Jessie Stone I think it is difficult because the gap is so enormous to wrap your head around unless you see it for yourself, you know, a lot of times.
Sanam Okay. So, so this is the situation. You've got your clinic, which is now overburdened with, with this additional TB support and services that you're providing, if we take a step back and say, okay, what were, what would you do if you were in charge? If somebody said, Jesse, Jesse, come to DC. //S02: Okay. Okay. Okay. Well, I mean.// Or, or, or, or even on a global level.
Dr. Jessie Stone The first thing that I would do is make sure to get those HIV, all those HIV programs up and running again. Those are critical for saving people's lives. You know, the emergency food left in, you know, like a warehouse somewhere just to rot. That's the stupidest thing I ever heard of. You know, like talk about waste that's already paid for and done, get it to the people who need it, save their lives. I would do that for sure. I would really, I would try to evaluate where the stop gaps, where money is stopping and not getting to where it needs to go. I mean, I would really hire a team of people that could help evaluate that effectively, not a team of hackers that are just like cutting things off. Like you're done, you're done. And, and, and certainly not spreading more of this false information. Like USAID is a terrorist organization. I mean, give me a break. That's just so unfair and insane, you know? And I would, I would really try to, to direct money to grassroots organizations that are on the ground. So it's not getting stuck in the middle somewhere. You know, people that are doing the work. I know who they are. We work with them, you know?
Sanam They exist and they are, they, yeah, dedicate their lives to helping others. Yeah, absolutely.
Dr. Jessie Stone And they really, really do make a difference and they do it for not very much money. You know? Yeah. It really doesn't cost a lot to do all of this. You know, in Uganda, at the village level, they have village health teams, they have village health workers. All of those people can be very effective at helping to educate their communities if they themselves are educated, you know? And so that's a very low-hanging fruit and cheap to do. Education is a cheap investment and it can have very powerful returns, you know? So I think heavy on the health education investment and prevention, you know, preventative health, we used to have this saying that was on the back of one of our t-shirts, which was like, prevention is cheaper than cure, which is the truth. And it's true in the developed world. It's true in the developing world. And it's simple. It just means that you've got to work a little harder because you've got to get into the communities. You've got to be with people. It's not going to be a tech solution. Certainly not in this instance because most people do not have smartphones if they're lucky enough to have a flip phone at all. That's fantastic. Places that don't have regular power, they don't have regular roads, they don't have plumbing. So you've got to go back to the basics. And a lot of people in our world are like, what do you mean? That's like so hard to wrap your brain around. But you've got to meet people where they're at and start there. You know, that's critical.
Sanam That's exactly. I mean, again, in our world of conflict prevention, it's the same thing. Prevention is much cheaper than going to war and having to recover, obviously, right? It's, you know, and I'm sorry, the weapons industry is not going to make a lot of money out of prevention, but everybody else, you know, peace is good for everybody else. And yet these messages, it's as if we say them and it just bounces off deaf ears.
Dr. Jessie Stone I mean, that's also where, you know, I'm so heartened by the people that do work at the grassroots level who are committed and at least in Uganda right now are hanging in there through this period because they're, they're committed and they're going to help do what they can, you know, whatever it takes to, to continue their work, to continue to do this.
Sanam And, and, and exactly. And it's, it's not like they have an exit strategy. //S02: No.// Like it's, it's not like they're internationals and they rotate in and out of, I don't know, Uganda today and Colombia tomorrow. It's, it's their homes. It's their families. I mean, it's obvious that they should be invested in, right? And yet we, yeah, it's, it's crazy. Okay. So, so then brings, this brings us to the next question, which is that if you were Mr. Buster, if you had access to his, to his or other billions, you know, there are plenty of other billionaires out there, right? And many of the ex-wives are. //S02: I know, I know.//
Dr. Jessie Stone Got to get the foot in the door of those ex-wives. (..)
Sanam That's right. You know, what would you do if you had that billion dollars?
Dr. Jessie Stone Really, truly, it's got to be general education, you know, and health education, just to begin with, grassroots and again, primary, secondary levels and at the community level. (.) And because that's, you know, how else are people ever going to get a step forward, you know, and have a chance at a better life?
Sanam So, Jesse, so, so given where we are six months into the Trump administration and this decimation of the infrastructure that was there, but also seeing what it means to set up your own clinic and work, you know, sort of a weaving it together with the communities, what gives you hope now?
Dr. Jessie Stone What gives me hope is that we are hanging in there, you know, that we are able to accommodate what's happening for now. You know, it's not like we're able to do that. And even though we're seeing a lot more patients and things are much busier, for now we can handle that, if it keeps increasing like that, you know, I can't predict. And all of our local partners are hanging in there right now, too. And also because we can do something very direct. I don't have to get caught up in the horrible bad news parade, you know, which feels so large. We can protest and we can call our senators and our representatives and do those things, which is a great thing to do. But this feels very direct, the work that I'm doing and that I can do is like we can have direct impact in a positive way on people's lives. And that definitely keeps me going, for sure.
Sanam That's awesome. Thank you. And I suspect that if our billionaire friends entered the universe of giving, which is where you are, and I sit at some intersection of that, to see what it means to help people as opposed to just take, um, they'd realize that it's just priceless. It's forced. A hundred percent. You can't put a dollar amount. No, I mean, that's very well put.
Dr. Jessie Stone That's exactly, you know, it's, that is transformational for sure. (......)
Sanam Hey, Sosie, hope you're doing well. Um, sorry not to be with you. Uh, full disclosure to everybody that, uh, I'm recording this on Friday. You're going to be speaking to the podcast on Monday because apparently you're at some fancy, fun festival in Barcelona, uh, with your buddy. So, uh, you can't join us, which is fine. But anyway, I hope you enjoyed the, the conversation and, um, I'm really keen on hearing what your thoughts are about, about what you heard and, and the work that Jesse's doing. And also whether you're willing to come with me to go kayaking with her, if it's possible this summer. And I'll see you soon. Bye-bye. (......)
Soleh Hi. Um, yes, ship's passing in the night, I suppose. You know, I've, I know you're the one in, in Spain now, so we've just switched positions, but, um, I guess, you know, trying out something new with the podcast. In terms of what, like, stuck out to me, I think what was pretty crazy to hear about from her was how, almost like, how simple it was to set up this clinic and, like, her story for what inspired it. And hearing her talk about how, like, one doctor for every 25,000 people and how in their clinic they treat, like, 50,000 people a year and just how many people she's, she personally has treated is pretty crazy. And just the, I guess the impact, like, per person, per dollar really makes you think about how simple some of these interventions can be, which I think is sometimes a theme of our, of our podcast. And then, I guess the other piece that really stuck with me and is, you know, kind of everyone's talking about right now is the USAID cuts and how 2 million people or more have been cut cut off abruptly because of these cuts and, yeah, the continuing impact of that and who knows, you know, what else is to come and what the long-term effects of that might be as well.
Dr. Jessie Stone Um, yeah, this is a little bit funny.
Soleh I feel like I'm just talking to myself. Um, but, yeah, looking forward to next week with the final episode and hopefully we'll be back together and able to have a conversation. Okay. Yeah. See you next week. Bye. (.)
Sanam My thanks to the Bijan Reisar Foundation, my own organization, ICANN, and Africa Digital Audio for making these podcasts possible. If you have ideas for topics or for people that I should invite and have a conversation with, please let me know at info at ICANnPeacework.org. Info at ICANnPeacework.org. You can also follow the events on our newsletter, which is on the ICANN website, same address. I really hope that the conversations, the ideas, the solutions, the hope and the inspiration that you've heard in these conversations keep you going over the next week. And that you join us again. So stay well and see you soon. And I hope to hear from you. Thank you. Bye-bye.