The Book of Gutsy Women

by Hillary Rodham Clinton

  I saw her again on my very first trip as secretary of state to China in February 2009, where I said: “Change really does come from individual decisions, many millions of individual decisions, where someone stands up like Dr. Gao and says ‘No, I am not going to be quiet.’ That’s what we have to encourage.” We were together again on November 30, 2009, in my office at the State Department on the eve of World AIDS Day. I pointed out then that “Dr. Gao Yaojie has been harassed for speaking out about AIDS in China. She should instead be applauded by her government for helping to confront the crisis.”

  Later, Gao told me that I reminded her of her mother (even though I was much younger than she!). She and I connected despite our different life experiences. Of our connection, she said: “I didn’t need to explain too much. I could tell how much she wanted to understand what I, an eightysomething-year-old lady, went through in China—the Cultural Revolution, uncovering the largest tainted blood scandal in China, house arrest, forced family separation. I talked about it like nothing, and I joked about it, but she understood me as a person, a mother, a doctor. She knew what I really went through.” I recently visited her apartment in New York City, where she has lived since May of 2010. Although confined to her bed, she proudly told me she was working on her thirty-first book. Her resilience in the face of almost unimaginable difficulties, and her insistence on speaking the truth no matter who tries to silence her, are a powerful reminder of what one determined woman can overcome.

  Dr. Hawa Abdi

  Hillary and Chelsea

  Hillary

  Imagine you’re an obstetrician-gynecologist responsible for ninety thousand people living as displaced persons on your family property in war-torn Somalia. And then, in May 2010, your office is overrun by hundreds of Islamist militants. “Women can’t do things like this,” they say. The militants hold you under house arrest, and take over the camp. Many people would be paralyzed by fear, or would try to escape in order to save themselves. Dr. Hawa Abdi was not, and she did not. Instead, she confronted the militants.

  “[Women] are not just the helpless and the victims of the civil war. We can reconcile. We can do everything.”

  —DR. HAWA ABDI

  “I’m not leaving my hospital,” she told them. “If I die, I will die with my people and my dignity.” Then she went a step further: “You are young and you are a man, but what have you done for your society?” Her captors stayed for a week, ultimately leaving after the UN intervened. Hawa promptly went back to work.

  Chelsea

  Hawa’s answer to the question she posed stretches back to her childhood. Her mother died when she was pregnant with her seventh child, leaving twelve-year-old Hawa to care for her younger siblings. She has said that because she couldn’t prevent her mother’s death, she decided to become a doctor.

  In 1983, she opened her first clinic on her family farm. As violence in Somalia increased, many people, mostly women and children, sought refuge on her property. She organized a camp to house and care for everyone she could. Hawa prohibited domestic violence and made it clear from its inception that the camp would care for all Somalis, regardless of clan, religion, or politics. She named the camp, appropriately, Hope Village.

  Years of violence drove many families off their land, and the drought made farming impossible for many others, leading to a catastrophic famine and causing widespread starvation that killed first the cattle, then children and the elderly. Hawa opened her heart and her doors. She took in more people and provided food, medical supplies, and other necessities. She was determined to save not only those in her care but her entire country. She kept going through every danger and obstacle—including threats on her life and removal of a benign brain tumor for which she had to leave Somalia. As soon as she recovered, she returned home.

  Hillary

  The threats against Hawa continued. Her brave refusal to give in prompted hundreds of women from the camp to protest against the militants and demand that they leave. This display of courage prompted Somalis around the world to condemn the militants, who eventually backed down. Hawa then insisted that the young militants apologize in writing. And they did. She writes about her experiences in her book, Keeping Hope Alive: One Woman, 90,000 Lives Changed.

  Chelsea

  When I met Hawa in 2010, one of the things that stood out most strongly was her pride at being joined in her work by two of her daughters. Dr. Amina Mohamed and Dr. Deqo Mohamed help run the Dr. Hawa Abdi Foundation, which raises money to sustain the hospital and camp on their family’s land. “I’m thankful for my daughters,” Hawa has said. “When they come to me, they [help] me to treat the people… They have done what I desire to do for them.” Alongside the hospital, Dr. Hawa Abdi Hope Village—as it is known today—now has a primary school, a high school, a women’s education center, and free fresh water, available to the 10,000 people who live there and others who come from outside the village. Hawa’s courage has proven that hope is so much more than a word—it is untold lives saved, babies born safely, children educated, and a different, more peaceful future beginning to be realized.

  Flossie Wong-Staal

  Chelsea

  While Yee Ching Wong was growing up in the 1950s in Guangzhou, China, and later in Hong Kong, none of the women in her family worked outside the home. Still, her parents and her teachers encouraged her interest in learning, especially when it came to the sciences. She excelled in school and decided to go to college in the United States. In preparation, her teachers urged her to change her name to fit in with her new classmates. She became known as Flossie, after a typhoon that had struck the area a week before. When I first learned that detail, it struck me as an extraordinary metaphor, given that Flossie would help us understand the greatest and most threatening public health “storm” in my lifetime.

  Her academic journey in science started at age eighteen, when Flossie moved to California to study bacteriology at UCLA. Her natural talent combined with hard work led to her earning a BS in just three years. In 1972, before she had turned twenty-five, she earned a PhD in molecular biology.

  Flossie’s postdoctoral work took her to the National Cancer Institute, where she began a lifelong study of retroviruses, a group of viruses that insert their viral DNA into the DNA of a host cell. In 1983, she was a core part of the team that identified a retrovirus known as human immunodeficiency virus (HIV) as the cause of acquired immunodeficiency syndrome (AIDS). A French team at the Pasteur Institute had simultaneously identified the virus, and both teams published their findings in Science a year apart. After years of disputing who had made the discovery first, the lead scientists agreed to share the credit and work together to fight a scourge that was already infecting tens of thousands around the world and tens of millions today. Now it’s generally agreed that the French team first isolated the HIV virus, and Flossie’s team first recognized it as the cause of AIDS. What is not disputed is that in 1985, Flossie became the first person in the world to clone HIV. That breakthrough enabled Flossie and her team to map the virus, paving the way for the development of blood tests to detect the presence of HIV.

  “It adds to the joy of discovery to know that your work may make a difference in people’s lives.”

  —FLOSSIE WONG-STAAL

  After almost two decades at the National Cancer Institute, in 1990, Flossie continued her research on HIV/AIDS at the University of California at San Diego. She focused on the then emerging field of gene therapy, moving genes or parts of genes into cells that have missing or defective genes in order to help treat or prevent diseases. Flossie explored the use of gene therapy to repress HIV in stem cells. In particular, she focused on trying to better understand the relationship between a type of protein and the Kaposi’s sarcoma lesions found on some patients with HIV/AIDS. Her work was about more than science for science’s sake; it led to better treatments.

  Not content to make one major discovery, Flossie eventually moved on to another challenge. Later in her career, she began applying
her work in HIV/AIDS to hepatitis C, a virus that also spreads through transfusions, dirty needles, and sex (though sexual transmission is rare, unlike with HIV/AIDS). Left untreated, hepatitis C can cause liver damage, liver cancer, and liver failure, all of which can lead to death. Flossie founded a company focused solely on discovering and developing drugs to treat this deadly disease. More than seventy million people worldwide are believed to be infected with hepatitis C, and hundreds of thousands of people each year die because they don’t receive early diagnosis or the treatment that exists. More troubling still, hepatitis C rates are currently on the rise in the United States. Now in her seventies, Flossie is still hard at work confronting the virus. I hope she will have the same impact on hepatitis that she had on HIV/AIDS. She is remarkable not only for her talent but for her tenacity and unwillingness to let any virus go unchallenged.

  Molly Melching

  Hillary

  In March 1997, Chelsea and I visited a number of African countries, meeting with political and civic leaders in cities and villages to emphasize a message of respect and friendship on behalf of the United States. Our first stop was Senegal, the ancestral home of millions of black Americans who had been sold into slavery through Gorée Island off the coast of Dakar, the capital. At the small fort where slaves were held, leg irons and chains were still attached to the walls of musty cells. Innocent people, ripped from home and family and reduced to chattel, were herded through the Door of No Return at the back of the fort, dropped onto the beach, and loaded into boats to be rowed out to the anchored slave ships—all reminders of the human capacity for evil and of the original sin of the United States.

  In the village of Saam Njaay, an hour and a half from Dakar, I saw a revolution in women’s lives and health in the making. Molly Melching, an American from Illinois, was our guide and teacher. Molly had come to Senegal to study French at the University of Dakar in 1974. After completing her studies, she stayed in Senegal and served in the Peace Corps, working with children. She published books, started a center to serve children who lived on the streets, and used songs and plays to educate young people about health.

  In 1991, Molly created Tostan, a nonprofit organization committed to promoting democracy, community empowerment, and child development. Three years later, UNESCO chose Tostan as one of the world’s most innovative education programs. When Molly took Chelsea and me to Saam Njaay, we saw the organization in action. The word “tostan” translates from the Wolof language as “breakthrough,” and that’s exactly what started happening as women in Saam Njaay talked with each other and with Molly about their own power to fix injustices in their community.

  Molly did not initially plan to take on the controversial practice of female genital cutting, but, as she recounts in the book written by Aimee Molloy about her work, However Long the Night: Molly Melching’s Journey to Help Millions of African Women and Girls Triumph, she changed her mind because of what she heard from girls—and because of her own daughter, Zoe. Molly was stunned when nine-year-old Zoe, who had been brought up in Senegal, asked her mother if she could be cut in the same way her Senegalese friends were going to be. Molly saw the powerful pull of tradition and peer pressure, explaining, “It was a very decisive moment in my own understanding of the power of female genital cutting, and I knew now what I had to do.” She added women’s rights and human rights to Tostan’s empowerment programs, including the sensitive issues of female genital cutting and child marriage.

  As a result of Tostan’s work and, crucially, the local leaders who made its mission their own, women in Senegal began speaking up about the pain and terrible health effects—including death—they had seen or experienced because of female genital cutting. Tostan organized village-wide discussions, and one by one, villages started voting to end the practice. Imams and other male leaders joined the effort, traveling to neighboring villages, which followed suit. The movement’s leaders petitioned Senegal’s then president, Abdou Diouf, to outlaw the practice throughout the country. When I met the president and his wife, Elisabeth, I praised the grassroots movement and endorsed the call for legislation. Due to popular demand, Senegal passed a law banning female genital cutting, and more than eight thousand villages across eight nations in West Africa soon decided to stop practicing not only female genital cutting but also child marriage and forced marriage.

  “If I feel we are moving forward respectfully and peacefully, I am never afraid, and will continue on with confidence and patience. But that for me is not courage—just determination and perseverance.”

  —MOLLY MELCHING

  Making good on those pledges has been difficult, since deeply engrained cultural traditions die hard. But the determination of imams, community leaders, elected officials, and models like Tostan’s that empower communities to drive the changes they want to see, has helped to free hundreds of thousands of girls from female genital cutting, as well as both boys and girls from forced marriages.

  Dr. Mona Hanna-Attisha

  Chelsea

  By now, most people know the beginning of the story: In April 2014, the town of Flint, Michigan, switched its drinking water source from Lake Huron to the Flint River to save money. But the river water was more corrosive than the water from the lake, and the city did not add the right chemicals to the water to ensure the water was safe to drink by the time people turned on their taps.

  Soon after the switch, the people of Flint started to worry. Their new water smelled bad, and it was the wrong color. They complained to the city, but their concerns were largely dismissed. A few months later, the city advised residents to boil their water to eliminate fecal and total coliform bacteria. They began adding more chlorine to the water to kill the bacteria and assured the people of Flint that the problem had been fixed.

  Pediatrician Dr. Mona Hanna-Attisha saw hundreds of Flint kids at her clinic. When worried parents asked whether the tap water was safe to drink, wash in, and cook with, she said yes. She had faith in the city and state public health authorities to protect Flint’s families. She didn’t yet know how wrong she was. “My naïve trust in the government—local, state, and national—had made a liar out of me,” she wrote later in the New York Times.

  Then, one evening in the summer of 2015, over a glass of wine, a friend of Mona’s who had worked for the Environmental Protection Agency in Washington mentioned that because the city hadn’t treated the water with corrosion control, it probably contained lead. Mona hadn’t seen any symptoms of lead poisoning among her patients, but she knew that didn’t mean this dangerous neurotoxin wasn’t affecting Flint’s kids. The effect of lead on brain development could be devastating for children, leading to lower IQ rates and behavior problems. There is no safe level of lead in drinking water.

  Her friend urged her to do her own studies on the blood lead levels of the children she saw in her clinic. When Mona looked at her patients’ blood lead numbers, her stomach dropped. Afraid to put them in an email, she asked her friend to meet her at the soccer field where her daughter was practicing that evening. She printed out the results and stuck them in her bag, and with her friend, she pored over the findings. The percentage of kids with elevated lead had increased dramatically after the water supply switch. Flint kids were being poisoned. In that moment, everything changed. “I was becoming something new—an activist, and a detective. Huddled there on Field 3 with Elin, I felt that my life was beginning to resemble an episode of ‘Scandal.’ ”

  Mona reached out to the state health department, asking for their data. They refused. What she didn’t know until later was that they had already noticed a spike. Michigan authorities knew lead levels were surging in kids. And they did nothing.

  Determined to advocate for her patients, she held a press conference to warn families to not drink or use the water, particularly for kids. She hoped that her findings would sound the alarm within every level of government, and that her willingness to share the raw data rather than waiting for it to be published in a peer-reviewed
journal (a risky decision for a researcher) would underscore the urgency of her results. Instead, the state denied her claims and conclusions. Though it was painful, she pushed back, never doubting her methodology or her conviction that Flint’s kids had to come first. She knew all too well that she was witnessing not only a public health disaster but a failure of the democratic institutions that were supposed to protect the people of Flint.

  Born in 1976, Mona grew up in Michigan, in the proverbial shadow of General Motors. She is the daughter of Iraqi immigrants who were afraid to return home after Saddam Hussein took power. She has always held fast to the principles of social justice and democracy that she believed were rooted in her family’s adopted country.

  “What happened in Flint could happen elsewhere, as the push for austerity and a disdain for science are combined with antidemocratic measures like voter disenfranchisement, gerrymandering and state-appointed emergency managers. One of the lessons of Flint is that science and public health won’t save us without a functioning democracy.”

  —DR. MONA HANNA-ATTISHA

  Yet she knew that racism and generations of neglect had helped create the situation in Flint, a city that went from high per capita incomes, low unemployment rates, strong unions, good schools, and good public health indicators to the exact opposite in a matter of decades. By 2013, half of all black citizens in Michigan were living under emergency management control, compared to just 2 percent of the white population. The pattern was clear: Predominantly white state government officials had turned a blind eye to what was happening to Flint’s lower-income black residents. In 2011, the state-appointed emergency manager had taken control of the city away from the locally elected mayor, with a mandate of austerity to avoid bankruptcy. That mandate had led to the decision to switch water sources in the first place. In other words, without the state’s push for austerity measures, the Flint lead-poisoning crisis may never have happened.