A Mighty Purpose (15 page)

A local advertising agency created a cartoon mascot for the campaign: a doughy, smiling, obviously healthy little boy named Pitín (pronounced “Pee-TEEN”). His jovial image, with big, horseshoe-shaped eyes and a lick of hair sticking up, ran in
El Tiempo
and other newspapers throughout the country and was usually accompanied by basic health advice.

Pitín was part of a strategy to convince the most crucial stakeholders of all: the parents. Some were wary of immunization, especially since the injections could cause fevers. It was also a huge hassle, particularly in remote rural areas, to lug kids several miles to an immunization post. They had to be persuaded it was worth it.

Organizers tried to make the experience easy and even enjoyable. In urban areas, a carnival-like atmosphere pervaded the streets on each of the three days: musical troupes, theatrical
performances, fireworks, and puppeteers entertained the kids and parents waiting in line.

The immunizers were government employees or volunteers, deployed by the Ministry of Health. The vaccines, syringes, cold chain equipment, and promotional materials were supplied by UNICEF and other UN agencies, including the WHO’s regional arm, the Pan-American Health Organization (PAHO). PAHO was pivotal and became one of UNICEF’s most dynamic partners in the years ahead, in large part due to its dogged immunization chief, Ciro de Quadros; the Brazilian epidemiologist would play a seminal role in the eventual eradication of polio from the Americas.

In the lead-up to the crusade, resistance percolated from medical and technical staff at health centers. Some resented being told to alter their procedures and panned the idea as unrealistic. Many cited weak cold chains as a reason the campaign world never work, says Jara. UNICEF had to prove them wrong and show that a cold chain would hold, even across formidable geographical terrain.

The vaccine’s journey started at the site of the manufacturer and had to snake its way across the globe to the airport in Bogotá and then to a government storage facility and then to the regional health center and then to the local health outpost and then into a syringe (unless already in a dropper) and then into an often wailing child—and all the while, it had to be kept cold. But not too cold—between 36 and 46 degrees Fahrenheit, to be exact. If the temperature strayed too much above or below this range, the batch of vaccine could be ruined. The doses were stored in refrigerators (many powered by kerosene, in case of
electrical outages) and transported in insulated Styrofoam “cold boxes” lined with ice or ice packs.

The country’s civilian air patrol was a crucial link in the Colombian cold chain, lending its planes and helicopters to transport the doses to the hardest-to-reach places in the Andean mountains. Once they reached the airfields, the cold boxes were immediately unloaded and strapped to mules. They then began the next leg of the journey farther into the mountains. When the vaccines finally made it to their designated villages, health workers immediately had to test the temperature to make sure they had not spoiled. In some of the country’s Amazonian areas, cold boxes were transported on boats.

On the second day, when officials in a town in northeastern Colombia heard via radio that a plane carrying forty thousand doses of vaccine was on the way, they realized they had a problem: the plane would be arriving after dark, and the small runway had no landing lights. The town was flanked by mountains. So they sent a radio message to local residents: please bring your cars and trucks to the runway right away. More than one hundred drivers responded, parking their vehicles in even rows on each side of the runway. They turned on their headlights. The last-minute, makeshift landing lights allowed the plane to land safely. The vaccines were unloaded and the plane immediately climbed back into the murky sky.

At the end of one of the vaccination days, the UNICEF team gathered in the Caracol radio studio to listen to the results. Microphones protruded from desks, and a red “on air” light glowed above them. The number of children originally targeted
was 917,000; they had hoped to reach at least 80 percent. On this evening, the tally came in around 10:30 p.m.: the goal had been met. When everyone learned they had actually succeeded, “it was an explosion,” says Jara. People howled and hugged each other and wiped away tears. UNICEF staffer Juan Aguilar recalls that Grant was so happy, he jumped into the air. The UNICEF chief then took a moment to thank everyone and proclaimed giddily, “We did it!”

In numerous speeches, he would equate the triumph in Colombia to “putting a man on the moon.”

Now he had to repeat the performance.

The brief note was typed on a small scrap of paper with a simple
M
anchored at the bottom. It was handed to UNICEF’s Washington, DC, lobbying chief, Kimberly Gamble, over lunch. It instructed her to work toward two goals: increasing the US contribution to UNICEF and establishing a “US Children’s Survival Fund” of between $100 million and $200 million. The letter dictated that the new fund would “support global type initiatives … not less than 50 percent of which shall be contributed to multilateral activities and the remainder to be administered by USAID.” The note’s brevity was inversely proportional to the challenge it posed—especially during a time of across-the-board budget cuts in Washington. It was as though Gamble had been handed a ten-dollar bill and had been nonchalantly asked to pick up some Chinese takeout—for the entire population of Washington, DC.

The author of the note was Michael Shower, Jim Grant’s speechwriter and close aide. Trim, balding, and often grumpily serious, Shower was known for passing out notes like these, quick missives all signed with a typed M. Whenever you got one, you knew it had come from the musings of Jim Grant.

Gamble did not hide her reservations. “I’m not going to live long enough to see this happen,” she told Shower.

Recruited by Grant from USAID, Gamble (who now goes by Gamble-Payne) had developed a finely honed political pragmatism. She knew the Reagan administration well. She knew how little regard it had for the UN. She knew factions within USAID would resist this goal for fear it would siphon away their already threatened resources. She also knew that everything was being slashed everywhere, and that any new proposal would mean the money would have to come from some existing budget line.

She asked Shower how serious Grant was about the idea. Shower answered by raising his eyebrows and nodding his head.

“Oh God,” Gamble said.

As with many of Grant’s plans, one of the first steps was to get the Catholic Church on board. Gamble won the cooperation of Representative David Obey, a Democrat from Wisconsin—a well-known Catholic—and eventually wrangled the support of the US Conference of Catholic Bishops.

UNICEF’s coziness with the church made many people uneasy. “The women’s groups were saying UNICEF is in bed with the Catholic Church,” recalls Gamble-Payne. “A lot of women inside UNICEF did not like it.”

But Grant was willing to sacrifice the “gender issue”—at least temporarily—in order to get Catholics in his corner. A lot of women and men in UNICEF would increasingly pressure him to take women’s rights and family planning more seriously; this did not include support for abortion (an issue UNICEF has diligently avoided), but rather “birth spacing.” Ethel, who was a staunch feminist, nonetheless reminded several staff members that her husband was “a man of his generation.” Grant would eventually acquiesce and take up family planning, in part as a result of pressure from the UNICEF board. The Vatican would protest and would later (after Grant’s death) cancel a paltry two-thousand-dollar annual contribution to the children’s agency over unfair allegations involving UNICEF and birth control.

For now, Gamble knew what her marching orders were, and she followed them. She and her team then began cobbling together votes, gathering experts for testimony, and assembling a bipartisan consensus behind the scenes—at a time, she notes, when genuine bipartisanship was still possible on the Hill.

Then, at Grant’s request, she got him an official, twenty-minute meeting with the Speaker of the House, Thomas P. “Tip” O’Neill Jr. A liberal New Deal Democrat from Boston, O’Neill was big and boisterous, a consummate, old-fashioned Washington insider—and a counterweight to Reagan’s swelling pro-business conservatism.

Getting on O’Neill’s calendar wasn’t just about meeting the powerful political Mandarin—it was about showing everyone
you meant business. “If you are on Tip O’Neill’s calendar, everybody in Washington knows it,” says Gamble-Payne. “That means that everybody knows you have access.”

Grant knew O’Neill—he seemed to know everyone in Washington—and the affable Speaker even affectionately called him “Jimbo.”

It was Gamble’s first time in the Speaker’s office. “I felt like Alice in Wonderland,” she says now. “The room seemed so big.”

The two men wasted no time. “What can I do for you, Jimbo?” O’Neill bellowed.

Grant pulled out his props, likely including an ORS packet. He probably told O’Neill that forty thousand children were dying needlessly every day. He may have even used his closing line: “This is
obscene
.”

As he was speaking, O’Neill nodded and said, “Yeah, yeah, yeah.”

Grant told him he wanted $100 million for a Child Survival Fund, which would be run by USAID and would provide money for simple things that could save kids’ lives. It would be good for foreign aid, good for the United States, and a strategic choice that made economic sense.

When Grant became stubbornly determined about something, says Gamble-Payne, his eyes appeared almost to change color. “They were normally blue,” she says, “but they would turn a certain shade of gray.”

Sitting in the Speaker’s office, his eyes seemed to go steely.

Finally, O’Neill stopped him.

“Jimbo, Jimbo, Jimbo,” he said. “No, no, no. Times are a little tough right now. Tell you what we’ll do. Let’s just start with twenty-five. And you’ll get there, Jimbo, you’ll get there. It’s a good program, it’s a good idea. Let’s start with twenty-five and see how it goes.”

O’Neill’s aide then stood up, and, at the same time, the door opened. The meeting was over.

It wasn’t the answer Grant wanted, but it was a start.

The Child Survival Fund was established in 1984 with an amendment to the Foreign Assistance Act of 1961. The initial allocation was $25 million—funds to be used mostly by USAID to combat child mortality (as much as $7 million was designated for UNICEF).

Some UNICEF staffers groused that all the money should have gone directly to UNICEF. UNICEF badly needed it. Why was Grant raising money for his old employer, USAID?

“Jim never wanted the money in UNICEF,” says Gamble-Payne. “It wasn’t about the money.”

It was about placing the cause of child survival at the center of US foreign aid policy. It was about getting the United States government to join Jim Grant’s fight. By insisting the money go to USAID, “he created a vested interest in USAID,” says Kul Gautam. “Child survival became a big thing.”

As a result, the Child Survival Fund increased year by year, becoming a recurring expenditure (despite Reagan’s attempts to cut it). It eventually resulted in hundreds of millions of dollars in annual funding for child survival and maternal health
programs; the money was in addition to the US government’s regular contribution to UNICEF.

What had long seemed out of the question in many countries began to butt up against the edges of possibility. Immunization drives were launched in Senegal, Burkina Faso, and Nigeria, and Grant began planning a big campaign in Turkey—a country with daunting logistical and political challenges. In 1984, UNICEF increased its shipment of vaccines by 50 percent over the previous year, delivering doses to eighty countries. It also provided 65 million packets of oral rehydration salts and helped twenty countries produce the salts locally. By the end of 1985—as a result of expanded immunization and ORS programs—as many as one million children who would have otherwise died were now alive, according to UNICEF estimates.

There were wrinkles, some of them mountain-size. On October 31, 1984, Indian prime minister Indira Gandhi was assassinated by two of her Sikh bodyguards in the garden of her residence, cut down in a spray of bullets. The attack was in retaliation for a bloody military assault she had ordered on Sikh separatists holed up in a temple a few months earlier. Before her death, Grant had met with “Mother India” several times; he and South Asia regional director Dave Haxton had secured her commitment for a full-scale immunization campaign. Now, Haxton and Grant had to make sure the immunization campaign didn’t die with India’s leader. Haxton’s first order of business was to protect his eight Sikh employees from
vicious anti-Sikh riots that were roiling the country (he insisted they camp out in the UNICEF office with their families). Then he and Grant eventually approached the country’s new leader, Indira Gandhi’s forty-year-old son Rajiv. They proposed that the neophyte prime minister make the immunization campaign a “living memorial” to his mother. Gandhi agreed.

Grant accelerated his pace everywhere, visiting thirty-three countries in 1984, some multiple times. In the space of one month, he flew to Nigeria, then India for a week, then to Kenya, then Burma, then Thailand, and finally Algeria. After Algeria, he went to Italy for a week before returning to the States. Almost every trip to the airport was last-minute and involved a harried rush out the door, often with Ethel handing Jim his packed suitcase. He flew Pan Am and always took the same seat, 3A. He skipped in-flight movies—he either worked or slept. Once he lost one of his little brown notebooks, only to find it more than a year later under that same seat, 3A, according to his executive assistant Mary Cahill.

During one of his many trips to Italy in 1984, at a special board session in Rome, Grant welcomed one of his most important funders and fund-raisers, Prince Talal bin Abdulaziz Al Saud of Saudi Arabia. The half brother of King Fahd, Prince Talal had first been approached in 1979 by UNICEF’s liaison in Riyadh, Sabah Al Alawi, according to Maggie Black’s
The Children and the Nations: The Story of Unicef
. Grant had actively courted him and persuaded the UN secretary general to appoint him as a special envoy in 1981. More important than his much-publicized concern for children were the prince’s
bottomless, oil-slicked pockets. UNICEF’s director of personnel Manou Assadi once flew on Talal’s private Boeing 727 on a trip to Kuwait and remembers ashtrays made out of gold.