Melinda Gates: Advocates must engage local communities in creating solutions to benefit developing countries

By Jill Warren Lucas

Melinda Gates is glad to see so many college students looking beyond their own earnings potential to focus on their ability to impact human potential in developing countries. Melinda Gates (Photo by Chris Hildreth/Duke University)

She is impressed by their scholarship, their commitment to research and their drive to create solutions for problems that prevent communities from achieving success – particularly in regard to basic elements of health and wellness.

“This is such a connected generation. They really see the problems of the world and they have access to them in a way that we didn’t when I went to Duke (University),” says Gates, who earned her undergraduate degree in 1986 and master’s in business administration in 1987, the same year she joined Microsoft. “I’d like to see them try to make things equal for all people.”

The Bill and Melinda Gates Foundation funds the training of future leaders through Duke Engage and other higher education programs to support the foundation’s core belief that every person deserves a chance to live a healthy, productive life. During a commencement address she delivered in May, she urged graduates to leverage the extraordinary opportunities they experienced in college to give something back to the world.

“Where ever I travel, I see young people on the ground, helping communities to gain the skills they need to become more secure,” Gates says during a media briefing before she delivered her message. “It’s easy for students to connect globally with technology, but it’s very different when you’ve seen first-hand the problems in global health. If you’re anything like me, you cannot turn your back.”

The Gates Foundation supports a wide array of programs focusing on global health and global development. With similar efforts being funded by such forward-thinking foundation leaders as Warren Buffet and Michael Bloomberg, Gates says philanthropy is creating exciting opportunities for meaningful career paths in the nonprofit/NGO sector.

Gates says their foundation routinely turns away requests from applicants who want to keep re-evaluating accepted findings or launch initiatives not rooted in community involvement. Without local buy-in, she says, even the best-intended efforts will fail.

MGShe cites an example in Somali, where a pilot project to provide latrines aimed to improve sanitation and reduce the incidence of disease. Relying on a parochial we-know-best assessment, however, it was a failure.

“The locals have very good reasons for why they are not being used,” Gates explains. “They were put in a place that is not safe for women and girls. They smell too much from sun exposure. And, frankly, they had better uses for the corrugated metal.”

Projects designed without the highest needs of the community in mind fail to take into consideration what its members view as top priorities – if they had the money to address them. Without funds, the local contribution typically takes the form of unified commitment to the designated cause.

“The community has to be engaged and have some skin in the game for these things to work,” Gates says. “For projects to take hold and succeed, a community must be deeply involved.”

Gates passionately details an effective project that the Gates Foundation funded in the Shivgarh area of Uttar Pradesh, a northern state of India. Rather than broadly examine why 7 million children under age 5 die each year around the globe, the researcher opted to look closely at one community’s piece of this very troubling puzzle. In doing so, he found that a staggering 43 percent of locally-born babies do not survive 30 days – a milestone at which they may begin to receive life-saving vaccinations.

“It’s one thing to know this academically; it’s another to say, ‘What are the tools we can use to change outcomes?'” Gates says. The lead researcher and his wife, both Indian, established residence in the community, one of India’s most poor and disease-prone, to build trust with residents. He asked community members to be involved with his research, shared details of his plan and incorporated their feedback.

Over a period of 18 months, the initiative taught pregnant women how to care for themselves to improve the likelihood of delivering healthy babies. After birth, the women were instructed on the benefits of “kangaroo” care, in which the newborn is kept close and warm. They learned about proper cord care and the benefits of breast feeding – conscious acts that should reduce the infant death rate.

“The community lined up and he was able to prove, in just 18 months, that those interventions brought down the death rate over 50 percent in the first 30 days of life,” Gates says, leaning in to make her point. “That is true innovation in working with a community, and it is innovation that can be modeled elsewhere.”

Remarkably, the community itself is managing much of the modeling. Regardless of where they reside with their husband, Gates says many women return to their hometown to give birth. When they leave with their baby, they share maternal health knowledge with other women, creating a train-the-trainer bump that is beginning to improve outcomes across the continent.

“Instead of us coming in and saying, ‘This is what you should do,’ the message is coming from one community back out to another,” Gates says. “They deployed very good cultural practices in this project, which is still ongoing. To break through like that and empower the women spread the message is so important.”

For more information about the Bill and Melinda Gates Foundation, visit

(Pictured above: Melinda Gates with a child who benefits from a program funded by the Gates Foundation.)

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