by Jimmy Carter
Rosalynn and I spend at least a week each month in Atlanta, where I work on the affairs of The Carter Center, meet with foreign leaders, enjoy supper one night with about twenty-five family members in the area, have extended discussions with a few Emory professors and deans on mutual interests, and Rosalynn and I have breakfast with the university’s president and spouse and the CEO of The Carter Center.
Pancreatic Cancer
My father had been fifty-nine years old when he died with pancreatic cancer, and my doctors at Emory University became concerned when, in 1983, my sister Ruth, fifty-four, died from the same cause and five years later my brother, Billy, fifty-one, suffered the same fate. The National Institutes of Health began to check all members of our family regularly, and my last remaining sibling, Gloria, sixty-four, was diagnosed with pancreatic cancer and died in 1990. There was no record of another American family having lost four members to this disease, and since that time I have had regular X-rays, CAT scans, or blood analyses, with hope of early detection if I develop the same symptoms. By the time it is detected, cancer of the pancreas has often metastasized to other vital organs and is usually fatal within a few months. A worldwide search has revealed a few other families like ours, and it is most likely that a genetic defect is involved, possibly triggered by smoking cigarettes. Being the only nonsmoker in my family may have been what led to my longer life.
The Carter Center
My most challenging obligation was to raise about $25 million in private contributions to build a presidential library. As a defeated Democratic candidate with no prospect of returning to public office and few wealthy friends or supporters, I found this task difficult and time-consuming. I finally decided to begin construction using architectural plans we had approved and go into debt for the amount still to be raised. I was not interested in just building a museum or storing my White House records and memorabilia; I wanted a place where we could work.
I awoke one night after a few hours of sleep, called Rosalynn, and said, “I know what we can do for the future. We can create a place in Atlanta near our presidential library and museum and invite people to come there like Anwar Sadat and Menachem Begin came to Camp David. I can offer my services as a mediator to help prevent or resolve conflicts, either within or between nations. If they prefer, I can go to their country.” This was the birth of The Carter Center. We expanded my concept of our Center by including conferences on important issues in which I had been involved as president, including peace in the Middle East, international security and arms control, business and the environment, education, and global health. Working with Emory, we established The Carter Center legally in 1982, and during the next five years I spent much of my time raising funds from private donors to pay for the presidential library, with adjoining buildings to house the work of the Center. Emory provided me with an office on the top floor of their library, and I began to make more specific plans with the help of Dr. Steven Hochman, who for the next year or so was my only assistant.
We adopted a few basic principles: Our Center would be nonpartisan; we would be as innovative as possible, not duplicating or competing with other organizations that were addressing issues successfully; we would not be afraid of possible failure if our goals were worthwhile; and we would operate always with a balanced budget. The Carter Center expanded its operations into eighty nations, including the promotion of peace, human rights, democracy and freedom, and better health care. We now have an annual cash budget of about $100 million with an equal amount of in-kind contributions of medicines and other supplies that are distributed in our health programs, primarily in Africa and Latin America. Our normal staff of 180 is sometimes supplemented with several hundred trained experts on our payroll plus thousands of unpaid volunteers whom we train to work on our projects in targeted countries. We have adhered to the original principles and met our goals during the past three decades, and I am still performing my duties at Emory University.
We expanded my concept of The Carter Center by including conferences on important issues in which I had been involved as president, including peace in the Middle East, international security and arms control, business and the environment, education, and global health.
Health Care
The most unanticipated development has been that global health has become our largest commitment, now encompassing a majority of our employees and expenditures. We concentrate on malaria plus five “neglected tropical diseases” that are no longer known in the moderately developed world but still afflict hundreds of millions of people in Africa and Latin America: onchocerciasis (river blindness), schistosomiasis, lymphatic filariasis (elephantiasis), trachoma, and dracunculiasis (guinea worm).
To initiate a project in the early years, I would go first to a country and meet with the president, prime minister, and ministers of health, transportation, education, and agriculture. I would inform them about our plans, outline what was expected of them, and we would conclude a “memorandum of understanding” that included a clear description of our mutual responsibilities. Our health programs are now known and respected throughout Africa and in the regions of Latin America and the Caribbean where we work. At Emory University, whenever I meet with groups of international students, I find that I am thanked for our contributions to health in the students’ home countries. We give the local people as much credit for accomplishments as possible. I spend a good amount of my time at celebrations, honoring the achievements of dedicated local health staff and volunteers. Our Carter Center staff plus those we train go into the most remote villages in jungle and desert areas to explain our goals, recruit volunteers, and train them and a few paid supervisors. Then we deliver donated medicines, water filtration cloths, and insecticide-treated bed nets and make sure that people know how these materials are to be properly used. We are treating about 35 million people every year. Over half of these are now for river blindness, and so far we have been able to eliminate this disease in four indigenous countries in Latin America and to demonstrate in Uganda and Sudan that the same goal can be reached in Africa. In 1986 there were an estimated 3.5 million cases of guinea worm in about 26,000 villages in twenty countries. In the entire world we had fewer than 130 cases in 2014. We are looking forward to having this disease be the second in history eradicated from all nations. (The last case of smallpox was in 1977.)
We are responsible for about a third of the world’s surgeries to correct trachoma, the major cause of blindness except for cataracts, and have assisted in the construction of more than 3 million latrines to reduce the population of flies that transmit the disease. We have helped to install two bed nets in each home in Ethiopia and Nigeria where malaria exists. The nets are treated with an insecticide that kills mosquitoes on contact. These insects are the carriers for both malaria and lymphatic filariasis. One of our newest projects is to eliminate the two diseases from the Caribbean island of Hispaniola, and the governments of Haiti and the Dominican Republic, not always compatible, are cooperating fully on reaching this goal.
Our Center’s unique International Task Force for Disease Eradication has assumed the continuing responsibility of analyzing every human illness to determine which ones might possibly be eliminated from a particular region or country or eradicated from the entire world.
Agriculture
In 1985 Nobel Laureate Norman Borlaug, Japanese philanthropist Ryoichi Sasakawa, and I met in Geneva, Switzerland, and decided to organize Global 2000, an agricultural program designed to increase production of food grains in several places in Africa. We began our project in Ghana, Sudan, Zambia, and Zimbabwe, and expanded it to fourteen African nations, eventually teaching 8 million African families how to double or triple their production of maize (corn), wheat, rice, sorghum, and millet. With Japanese funding, Dr. Borlaug’s knowledge of agronomy, and our help with organization and implementation, we taught them how to use the best seed, plant in contoured rows to minimize erosion, use necessary fertilizer, control weeds, harvest at the right time
, and store and market crops properly. We usually began with forty farmers in a country as demonstrators and expanded in three years to about sixteen thousand. In Ethiopia the number of farms using our simple but effective farming practices reached several hundred thousand as Prime Minister Meles Zenawi financed the expansion with his government’s funds. After I met with national leaders to conclude agreements on how we would share responsibilities, I would travel with Borlaug to monitor compliance with our instructions.
On one visit to Addis Ababa, I was sleeping in a Western-style hotel and was wakened by intense itching of my left knee. I went into the bathroom and saw two small perforations, rubbed on some ointment, then returned to bed and went back to sleep. The next day Dr. Borlaug and I went about 150 miles south to visit some farm plots, spent the night there, and when we returned to Addis my knee was swollen. I went to the U.S. embassy, and the medical doctor gave me some antibiotic pills to take. When my entire leg then swelled to almost twice its normal size, he put me to bed with an IV. The following morning he decided that my life was threatened, and he and the Secret Service agents arranged for me to be flown to a U.S. military hospital in Wiesbaden, Germany. The doctors there increased the strength of the medication, identified the probable species of spider from the puncture marks, and sent me back to Atlanta. By that time my body was covered with a rash, and I stayed in Emory University Hospital for five days while a team of doctors tried various treatments to reduce the swelling and intense itching. I recovered slowly but still have an aggravating rash that has to be treated regularly with prescribed salves and creams. Dermatologists say that the problem is permanent but manageable.
Peace
Although The Carter Center and I have engaged in conflict resolution efforts with the United Nations and the United States, we more often have addressed threatening situations where we were on our own. These choices are not always popular, because they put us in contact with unsavory people or groups. They have included Maoists in Nepal, the Communist dictator Mengistu Haile Mariam in Ethiopia, Mobutu Sese Seko in Zaire (now the Democratic Republic of Congo), Radovan Karadžić in Bosnia and Slobodan Milošević in Serbia, Kim Il Sung and his successors in North Korea, the Castro brothers in Cuba, Omar al-Bashir in Sudan, and leaders of Hamas in Gaza and other places. In every case we keep American leaders informed about our plans and the results of our efforts.
Rosalynn and I received the honor of wearing traditional garb during a visit to Tingoli village, northern Ghana, in 2007.
I have addressed numerous threats to peace on behalf of The Carter Center. As examples, let me describe some that occurred in 1994. For three years, President Kim Il Sung of North Korea requested that I come to Pyongyang to help resolve some of the antagonism between him and the government of the United States, but I had an initial aversion, derived from the Korean War, to accepting his request. I was eventually convinced that my services might be helpful, but my normal requests to the White House for approval of a visit to North Korea were rejected.
There was a crisis in the spring of 1994. North Korea disavowed its commitment to the Nonproliferation Treaty, expelled international inspectors from their nuclear facility, and began processing spent uranium rods into plutonium. The U.S. government refused to talk to the North Koreans and went to the UN Security Council to secure a condemnatory resolution. Some Chinese friends told me that North Korea would attack South Korea if their government was branded an international outlaw and their worshiped leader a criminal. Having developed a strategy that I was convinced would defuse the crisis, I decided that I needed to go. When President Bill Clinton rejected another request to approve my visit to Pyongyang, I wrote him to say that I was going despite his disapproval. However, Vice President Al Gore intercepted my message and convinced me to modify the wording. He then sent the message to Clinton, who was in Europe, and he gave his approval. My one caveat to Kim Il Sung was that we not be routed through Beijing but enter North Korea directly from South Korea. He responded that even the secretary-general of the UN came through China, but he finally relented. Rosalynn and I were the first persons in forty-three years to travel directly from Seoul across the Demilitarized Zone and on to Pyongyang.
With my knowledge of nuclear engineering, I was able to discuss the issues competently. We found Kim Il Sung to be congenial and surprisingly familiar with all the topics. During a long boat ride from Pyongyang to the sea, we reached agreement on about a dozen important subjects, including the nuclear problem and the return of international inspectors, summit talks with South Korea, withdrawal of troops from proximity to the DMZ, and recovery of the remains of buried Americans.
I reported these agreements to the White House. Kim Il Sung died soon after I was there, and I received a message from his son Kim Jong Il that he would honor his father’s commitments. Official talks in Geneva resulted in approval by both sides of what we had negotiated, and Secretary of State Madeleine Albright visited Pyongyang in October 2000, to strengthen the mutual commitments. The U.S.–North Korea agreement was disavowed in 2002 by President George W. Bush, who branded North Korea an “evil empire,” and since that time Kim Il Sung’s successors have expanded their development of nuclear weapons and long-range missiles. The United States now avoids almost all contact with North Korea, and strict economic sanctions are still imposed on the often starving people.
Later in 1994 an emergency developed in Haiti. The elected leader, Jean-Bertrand Aristide, had been forced into exile in 1991. He was replaced by General Raoul Cédras, and both leaders had asked me to serve as mediator. I was very knowledgeable about Haiti and had a longtime personal relationship with both men. For years President Bush and then President Clinton had wanted to try other means for returning Aristide to power, but none of these had worked. By September 1994, President Clinton had decided to assemble thirty thousand American military personnel as an invading force. I, meanwhile, had asked former senator Sam Nunn of Georgia and General Colin Powell to join me in a peace effort, and we had conveyed our proposal to President Clinton. He approved our plan to go to Haiti and make a final effort at negotiation before sending in the military.
In Port-au-Prince we negotiated for two days with the assembled generals and found Cédras reluctant to accept any of my proposals. I called Rosalynn to tell her of our failure, and she said, “I have been informed that Cédras’s wife, Yannick, is extremely influential. Why not talk to her?” I took her suggestion, and the general’s wife was indeed the key to his improved attitude. We knew Cédras as a competent and admirable leader. He had been Haiti’s universally respected military commander who maintained security while Rosalynn and I headed Carter Center observers who had monitored Aristide’s previous election, and he had saved Aristide from an assassination attempt when he was deposed.
After long and intense negotiations, Cédras was finally ready to accept our proposals, prepared to stand alongside the American general and welcome U.S. troops if their arrival was peaceful and if the Haitian military personnel were treated with respect. I agreed to find an acceptable place in another country for him and his family to live. At this moment of apparent agreement, one of his subordinates, Brigadier General Philippe Biamby, rushed in and announced that President Clinton had launched fifty-two airplanes from U.S. military bases loaded with paratroopers, headed to invade Haiti. Biamby had received this report from a Haitian who worked at Fort Bragg in North Carolina. At this time there were thousands of angry demonstrators surrounding the building in which we were meeting.
Both negotiating teams rushed out a back door and drove to the office of the president, Emile Jonassaint, an elderly retired chief justice. General Powell got on a phone line and finally connected to the White House while Cédras and I presented our written agreement to the president. After reading it, he said, “I understand and agree, but it will have to be translated into French before I sign it.” This was done rapidly, and he and I signed the document. By this time the American planes were halfway to Haiti, but Cl
inton ordered them to return to their base and the crisis was resolved. As agreed, General Cédras and his family moved to Panama. Aristide returned to Haiti, proved a disastrous leader, and was again forced into exile in Africa, this time by pressure from Washington.
My last duty as a mediator that year involved the Bosnia-Herzegovina conflict with Serbia, after its declaration of independence from Serbian-controlled Yugoslavia. I was initially contacted by Radovan Karadžić, who expressed a desire to resolve differences peacefully between the Bosnian Serbs, which he led, and the Bosnian Muslims and Croats, the two other major ethnic groups. He made a series of commitments about peace, human rights, and a comprehensive cease-fire if I would agree to come to Sarajevo. I informed President Clinton and UN Secretary-General Boutros Boutros-Ghali and got their approval for the mission. I arranged for Karadžić to repeat all his commitments on CNN. Serbian president Slobodan Milošević asked that I meet with him during my visit, and I agreed. My goals were to orchestrate a cease-fire with guarantees of human rights and clear demarcation of geographical control, and to discuss some key constitutional issues.