Doctor Takes on Plight of Women Around the Globe

Saturday is International Women's Day, which recognizes the contributions of women around the world. Dr. Helene Gayle, president of CARE, an aid group fighting global poverty, explains a movement in Africa to help women change their financial circumstances one dollar at a time.

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MICHEL MARTIN, host:

I'm Michel Martin. This is TELL ME MORE from NPR News. Coming up: more responses to Kosovo's declaration of independence from Serbia. The view from the Roma, a tiny ethnic minority that's waged its own struggle for respect and recognition. And what's on the fashion front for the guys. That's a bit later. But first, Saturday marks International Women's Day, where we recognize the contributions of women around the world and take a moment to think about the distinct challenges women face.

Since we generally devote Thursdays to international issues, we decided to focus on women in Africa, where there's a movement to help women change their financial circumstances one dollar at a time. Joining us to talk more about this is Dr. Helene Gayle, the CEO of CARE, one of the world's largest independent aid organizations fighting global poverty. Welcome. Thanks so much for talking to us.

Dr. HELENE GAYLE (CEO of CARE): Hi. Thank you, Michel.

MARTIN: Now Dr. Gayle, when people think about aid, they often think about people giving something to somebody else. But part of what you're trying to do is change the way we think about aid and moving into financial self-sufficiency.

Dr. GAYLE: Yes, exactly. You know, in kind of the parable of fishing, we're moving from an organization that gave people fish to helping people to be able to fish and to really look at how do you sustain that. So we're really looking at how do you give communities self-sufficiency and core to that is economic sustainability and economic viability and the power of having independent economics gives a family and individual. So that's core to our strategy.

MARTIN: We often think about women in the developing world as people who kind of run the markets. You know, I mean people who have shops, people who have stalls, who are sort of traders. What is it that you're trying to do? Are you trying to build upon that, or to sort of formalize those businesses in some way?

Dr. GAYLE: Well, what we're trying to do is to give women entree into the economic world livelihood and build on what is already there, as you said. And some of the women that we work with are some of the poorest women on the face of the earth, women who aren't even at the market women stage yet, who put together sometimes pennies collectively to be able to start small businesses, whether it's a tailoring business or buying some chicken so they can sell eggs or improving their farming, all of those things that allow women to start getting a foothold into the economy so they can continue to move along the financial rung, if you will.

We work with people where they are and try to connect more and more - connect people who are oftentimes outside of the formal economy who are doing things in the informal economy, more into the formal economy so that they really can take bigger leaps into gaining financial stability.

MARTIN: Can you give me an example? I mean, for example, what are some of the specific initiatives that CARE is going to be participating in or already is in order to help women achieve financial independence?

Dr. GAYLE: Well, one of the things that we're doing - one of the big areas that we're going to work on is expanding the work that we've done in a program called village savings and loans, to really expand that throughout Africa with a focus on women. We hope that 70 percent of the recipients, beneficiaries of this program will be women. So it builds on a program that we started in 1991 in Niger, a village savings and loan program where people save whatever they have, put that together in a communal pot, and then are able to make loans to each other to start businesses.

We then give them business training, so that they know how to more effectively run their businesses and that they learn which business is actually - are most likely to give them the best returns. It goes beyond just these saving to build businesses. It also goes into helping them to have other financial services like insurance. So if there is a drought, they actually pool their resources to be able to give a buffer in difficult times. So we're building on this, and now looking at how do we do more innovative programs, then take these kind of community owned and led savings and loan programs to link those to actual commercial banks so that they can actually be linked to the commercial sector, which is where there is going to be greater economic growth.

MARTIN: When you talk to folks in the developing world who are trying to help people achieve sort of more financial independence, one of the issues that comes up time and time again is corruption, that the efforts of people are sort of siphoned off in this kind of unproductive direction because in order to get permits, in order to get, you know, transportation, in order to get sort of services, there's this sort of constant drag in having to pay bribes. Is there anything that an organization like yours can do to address this, or is this just an issue of governance, that just somehow has to be taken care of by the political system overall?

Dr. GAYLE: Well, I think it has to be taken care of by both. But we've actually done a lot in this regard in a variety of ways. And this whole issue of governance and accountability is a key part of any program that we're involved in. And we have found that by the community-led approaches where people actually come together and develop strong groups around these savings and loans programs, they actually can then use those groups in a variety of ways. And one of the ways that they have been banding together is to tackle the issues of bribes and corruption.

And so we talk to these groups, and they'll say, you know, we recognize that if we're going to get services, whether it's access to water, whether education, we have to make sure that we make our officials accountable to us. So we band together and say that none of us will pay the bribes. So we attack corruption from the grassroots level, and we also work with policy makers at the national level.

MARTIN: Just one more question on this, because I do want to talk about some health issues before we let you go. Around the world, many organizations try specifically to support the elevation of women to positions of authority, both in business and in government, because they think that women are more honest and less likely to participate in you know, taking bribes, demanding bribes. In your experience, is that true?

Dr. GAYLE: It is true. And there's study after study that have shown the larger proportion of women who are in government, the less corrupt government is.

MARTIN: Dr. Gayle, in addition to being the head of this huge NGO, you are also a doctor. So I do want to ask about HIV/AIDS. HIV/AIDS has devastated women and girls in sub-Saharan Africa. President Bush recently returned from his, what has to be, I assume, his last official tour of Africa. And one of the things he talked about was his work over the years to address HIV/AIDS on the continent. I'd like to ask your reaction to this. Do you feel that these initiatives have been helpful? How do you measure their impact?

Dr. GAYLE: Yes. The initiatives have been hugely useful and it made a huge difference in people's lives, and particularly in the area of treatment, where for so long, the life-saving medications that we have in this country have not been available to people in poor countries where the epidemic is having its greatest impact.

You know, we applaud the leadership role that the Bush administration has taken. On the other hand, we think in the re-authorization of this program, the PEPFAR program, that there are someā€¦

MARTIN: Just to clarify, the President's Emergency Plan for Aids Relief.

Dr. GAYLE: Right. There are things that could be changed to really build on it. First of all, a greater focus on prevention, because in the long run, that's going to be the way to have the most sustained impact on this epidemic. Secondly, more, as more and more women are impacted by this epidemic, 60 percent in Africa of new infections occurring in women, we have to have strategies that recognize the reality of women's lives.

So for instance, the ABC, or Abstinence, Being faithful, and using Condoms, doesn't offer a lot for women who are oftentimes not in control of sexual relationships. They may want to abstain or become child brides at an early age and don't have the option for abstaining or are raped, et cetera. Being faithful - women are oftentimes faithful in the context of their relationship, but it's men who have multiple partners who then bring the risk of HIV home. And the condom use, we know, is not in control of women.

So we've got to look at what are the underlying reasons why women continue to get infected by HIV, lack of economic viability, lack of access to basic essentials so that they have to put themselves at risk in order to get food on the table for their children by transactional or exchanging sex for basic needs.

MARTIN: Finally, do you think we are making progress in this fight?

Dr. GAYLE: Well, they were making progress. There's still a long way to go. You know, we still have 2.5 million new infections every year, and even in this country, 40,000 new infections every year. But at the same time, there are more countries who are starting to see declines in their HIV infection rates. There are more countries that have had increased access to treatment. So we think that there is a lot of progress that has been made. On the other hand, we can't take our eye off the ball.

We need to make sure that we are continuing to give support to the other things that will support our efforts in HIV, so strong focus on maternal and child health, strong focus on other development programs that will help attack the underlying causes of HIV. So then we've got to make sure that we keep our eye on the ball for HIV, but we do it in a way that's sustainable and that it integrates with other issues that are core to ultimately having safe, healthy and economically productive societies.

MARTIN: Dr. Helene Gayle is president of CARE. She joined us from our bureau in New York. You can find out more about care and International Women's Day at our Web site: npr.org/tellmemore. Dr. Gayle, thank you so much.

Dr. GAYLE: Thank you.

MARTIN: Come back and see us.

Dr. GAYLE: I will do that.

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