Emory Report

August 3, 1998

 Volume 50, No. 36

The Carter Center: a special report

When Jimmy and Rosalynn Carter boarded Air Force One in January 1981 and headed home to Plains, Ga., their White House term had ended, but their careers were far from over. The following year they founded The Carter Center in partnership with Emory and dedicated it to waging peace, fighting disease and building hope worldwide.

The center has gone on to help people in more than 65 countries embrace democracy through fair elections, avert or end bloody conflicts through peaceful negotiations, reduce hunger by learning how to double or triple grain yields, fight crippling diseases, and battle the stigma of mental illness through education.

"The Carter Center has been successful because we recognize that many of the problems that cause suffering in the world are interrelated," said John Hardman, the center's executive director. "In addition to trying to stop fighting where it occurs, we believe that helping people attain adequate shelter, medicine, food, basic human rights and representative government must all be part of the package to ensure peace and improve quality of life."

Sowing the seeds of peace through health and nutrition

In 1986 The Carter Center established Global 2000 to fight disease and help countries in need grow more food. The disease has been recently eliminated in Pakistan, and by the end of 2000 the program expects to announce the eradication of Guinea worm disease (dracunculiasis) everywhere but in Sudan. Wiping it out there will take longer because an ongoing civil war hampers prevention efforts. Once fully eradicated, Guinea worm will be only the second disease in history, after smallpox, to disappear.

The disease infects people who drink stagnant water contaminated with water fleas carrying Guinea worm larvae. Once ingested the worms grow as long as three feet and emerge slowly a year later through blisters on the skin. The disease is so painful that affected children cannot attend school and farmers cannot work their land.

The Carter Center and other international partners are helping villagers from 16 African countries, India and Yemen rid themselves of the disease, which recently was eliminated in Pakistan. Villagers learn to filter their drinking water to disrupt the worm's cycle, the most effective way to prevent the disease. They also can use the nontoxic chemical Abate to kill larvae or drill bore-hole wells for fresh drinking water.

While visiting Mali this past March for the seventh African Regional Conference on Dracunculiasis Eradication, President Jimmy Carter praised efforts to prevent the disease but also warned against complacency. "We need to concentrate our efforts on nations that still have even one case of Guinea worm," he said. "I ask that all affected countries concentrate, at least for the next two years, on eradicating it."

Global 2000 is battling a second disease known as river blindness (onchocerciasis), a parasitic infection spread through the bite of black flies that breed in fast-flowing water. River blindness causes incessant itching, skin rashes and damage to eyesight. An estimated 18 million people are affected, 99 percent of them in Africa. But more than 120 million people in 37 endemic countries in Africa, Latin America and the Middle East are at risk, and more than 750,000 people have been blinded or severely visually impaired.

"River blindness causes the social and economic fabric of communities to unravel," said Donald Hopkins, associate executive director of The Carter Center. "Agriculture production drops, children must care for their sick parents, and adolescents, fearing they may become blind and concerned about social stigma, leave home."

To combat river blindness, The Carter Center and other agencies help distribute the only medicine known to prevent it--a drug called Mectizan. The pharmaceutical firm Merck & Co. distributes the medication free to all people infected with the disease, and one treatment per year prevents it. Last year alone Global 2000 assisted in treating more than 5 million people. Working with ministries of health and other nongovernmental organizations, Global 2000 trains health workers and residents in affected areas to set up Mectizan distribution programs.

Last year The Carter Center, Merck and nine other organizations joined the World Health Organization and the World Bank in promoting the African Programme for Onchocerciasis Control. This partnership seeks to raise $124 million to establish sustainable, community-based river blindness programs in approximately 19 African nations by 2007. "This initiative is important because it affirms the world's intention to help Africa get rid of this disease," Hopkins said.

In 1986 Global 2000 joined the Sasakawa Africa Association to form SG 2000 to address malnutrition through improved farming methods. SG 2000 works with 12 countries through their ministries of agriculture to establish a five-year program that becomes self-sustaining upon completion. Local agricultural extension agents work side by side with farmers to cultivate wheat, corn and other grains by using high-yielding seeds, moderate amounts of fertilizer, and more productive timetables for planting, weeding and harvesting.

SG 2000 does not claim to be the sole determining factor influencing national food production, but statistics from countries where SG 2000 has worked for the past decade show significant progress. For example, northern Nigeria's maize production rose 50 percent from 1993 to 1996, and Ethiopia's cereal production doubled from 1992 to 1996. In addition, Sudan's wheat production increased 500 percent in five years.

"When the neighbors of farmers using SG 2000 methods see increased crop yields, they also want to use our techniques," the center's executive director, John Hardman, said. "SG 2000 is a 'friends teaching friends' approach that works."

Teaching the public the truth about mental illness

Every day nearly 50 million Americans strive to cope with mental illness, one of the country's most unrecognized and underreported health problems. For more than 20 years former first lady Rosalynn Carter has been a dedicated and outspoken advocate for those battling all types of mental disorders.

"Most people with mental illnesses can live at home, hold jobs and function as contributing members of society," said Carter, who chairs the center's Mental Health Task Force. "There is tremendous potential to improve the public's understanding of mental health issues and to reduce discrimination against people with mental illness."

In 1997 the Carter Center's Mental Health Program established the Rosalynn Carter Fellowships for Mental Health Journalism with the purpose of educating journalists about mental health issues and helping ensure more accurate reporting of related topics. In July the Mental Health Program announced its 1998 fellows, each of whom will receive $10,000 to study a mental health topic for one year. All five will travel to The Carter Center this September to meet with Carter and other members of the task force and to share information about their individual projects. Also attending will be last year's recipients, who will present their research findings and report on media coverage generated as a result of their work.

"Journalists in all forms of media play an increasingly important role in shaping public understanding and debate about mental health care issues," said John Gates, director of the center's Mental Health Program. "Activities, research and projects completed through this program will help promote awareness and combat stereotypical language and images that perpetuate stigma and discrimination against people with mental illness."

The 1998 fellowship recipients are:

  • Rita Baron-Faust, producer for WCBS News Radio in New York, who will explore cultural barriers to seeking mental health care and how to overcome them.
  • Susan Brink, senior writer with U.S. News & World Report, who will examine the medical and cultural impact of managed care's phase-out of long-term psychotherapy as a treatment option.
  • Joshua Wolf Shenk, a freelance writer and former associate editor for U.S. News & World Report. He will study Abraham Lincoln's battle with depression and his strategies for coping with the disease.
  • Stephen Smith, senior reporter/producer with Minnesota Public Radio, who will produce a series of reports on the challenges facing people with mental illness as they strive to stay employed or pursue an education.
  • Kathi Wolfe, freelance writer, who will investigate issues surrounding mental illness and aging.

When the fellows meet in September, the Mental Health Program and Emory's Journalism Program will sponsor the first annual Rosalynn Carter Lectureship on Mental Health Policy Issues. Jack Nelson, chief Washington correspondent for The Los Angeles Times, will address the group this year. Syndicated columnist Art Buchwald is scheduled to speak in 1999.

Strengthening democracy through human rights education

"If The Carter Center could be remembered for one thing, I'd like for it to be the innovative, unprecedented and effective promotion of peace and human rights," stated President Jimmy Carter in "Waging Peace," a video about the center's work worldwide.

To help deepen the initial roots of democracy, the center has sponsored workshops in Ethiopia and Liberia to create national strategies for human rights education. The workshops stressed using games, songs and storytelling in primary school and interactive skits in grades 7 through 12. "These methods show students the consequences of various moral choices' underlying respect for human rights, whether they are civil, political or social rights like those relating to the treatment of women and children," said Ozong Agborsangaya, a Carter Center human rights specialist.

Agborsangaya, who has trained primary and secondary school instructors in several countries how to teach human rights, believes "the education system is the best formal way to transmit society's values from one generation to the next, to educate citizens about their rights and to teach values such as diversity and respect for others."

In a game played by Ethiopian kindergartners, each child selects a rock from the schoolyard. The children study their rocks and place them in a pile. Later the youngsters revisit the pile and try to identify their own rock. "Always, they cannot find their personal rocks because the rocks are far more similar than they are different," Agborsangaya said. "It's a simple way to begin teaching children the concept of equality."

As a result of two workshops held in conjunction with Ethiopia's Ministry of Education, teachers there have drafted a human rights curriculum to be required for ninth-grade civics classes. These teachers join colleagues in the Philippines, South Africa, Guyana and Albania, whose governments have struggled to institutionalize human rights during democratic transitions.

Last July The Carter Center helped monitor national elections in Liberia, marking the end of a long, brutal civil war. The Liberian government then asked the center for advice on how to promote human rights. In December center staff sponsored a workshop involving Ministry of Education officials, teachers from teacher-training institutes, colleges, elementary and secondary schools and representatives of civic and human rights organizations. They identified best practices to use in their own curricula by reviewing other educators' experiences in countries struggling to institutionalize human rights.

"Teaching human rights in schools is an important achievement in putting children first on our national agenda," said Commany Wesseh, executive director of the center for Democratic Empowerment in Liberia. Following the workshop, the Ministry of Education urged Liberia's nongovernmental organization community to support government efforts to include human rights education in the nation's standard curriculum.

Monitoring world's elections to support self-governance

In democracies people make their will known at the ballot box. Because The Carter Center believes in the principle that free elections are vital to self-governance, it monitors voting and mediates the democratic process in Africa, Asia, the Middle East and Latin America.

This summer, as a result of the result of a landmark agreement signed by the Chinese government and the center this spring, a delegation traveled to the People's Republic of China to work with the government to establish a national system for collecting village election results and assessing the electoral process.

"We are very excited about this project," President Jimmy Carter said. "We hope the cooperation we develop with the Chinese government will help improve the village election process and serve as a foundation for direct elections at higher levels of government in the future."

The delegation and China's Ministry of Civil Affairs began installing the data system in nine counties in Fujian, Hunan and Jilin provinces in June. Under the new system, village officials will record election results and their assessments of the process on standard survey forms and forward that data to the county level, where it will be entered into computers equipped with specially designed software. The ministry will compile data from the three provinces and eventually from all 930,000 Chinese villages. This will help officials determine where elections have been democratic and competitive, as law requires, and where they were flawed. The data also will provide a basis for discussion between the center and the ministry about how the electoral system may be improved.

"Since the passage of the Organic Law on Village Elections in 1987, villages should have held direct democratic elections every three years," said Robert Pastor, director of the China Village Elections Project. "But no one knows how many villages are following the rules. The new data system will help determine that."

A high-level delegation from the Ministry of Civil Affairs and the three pilot provinces is expected to visit Atlanta this month to observe Georgia's primary runoff elections. A second delegation will visit in early November to witness general elections. Additionally The Carter Center and the ministry hope to conduct a three-day training session in China at the end of August on how to use the data-gathering system.

Last year a Carter Center delegation first observed local elections in China at the invitation of the government. A second delegation visited in March to observe village elections in the Jilin and Liaoning provinces. The center and the ministry signed a "memorandum of understanding" during the trip.

Besides China, The Carter Center has helped monitor elections in more than a dozen countries. One year ago a 40-person delegation traveled to Liberia to assist with its first election after more than a decade of civil war. Currently the center is working with the Liberian government advising officials on ways to further the nation's economic recovery and advance human rights through the educational system.

Last December the center's Council of Freely Elected Heads of Government served as the first and only international monitors in Jamaica's most peaceful election in 30 years. On election day the 60-member delegation, led by Carter, Gen. Colin Powell and three Council members, observed more than 1,100 polling stations in 90 percent of Jamaica's constituencies. Rosalynn Carter and boxing champion Evander Holyfield also were part of the mission.

Jamaicans persuaded the council to monitor the election because of fears it would be the most violent in the nation's history. It turned out to be the most peaceful, and most Jamaicans attribute this to the efforts of The Carter Center and national monitoring groups.

Democracy also grows stronger in Mexico. In July 1997 Mexico held mid-term congressional elections that allowed opposition parties to capture a combined majority in the Chamber of Deputies for the first time ever. A delegation led by Pastor and Harry Barnes, director of the center's Conflict Resolution Program and chair of its human rights committee, met for a week with high-level Mexican officials and observed those elections.

"The electoral system is gradually achieving greater autonomy and competence and therefore more credibility in the view of Mexicans," Pastor said. "The presidential election in 2000 will be a decisive moment for Mexican democracy.

This special section was compiled by Ann Carney, The Carter Center's assistant director of public information, and Melissa Moore, an intern in the public information office.

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