Authors: Adam Fifield
Rohde interpreted medical information for his friend. After the operation, Rohde recalls that Grant asked his doctors how much time he had left but did not get a definitive answer.
Grant’s main physician was Dr. Murray Brennan, the affable, New Zealand–born chairman of surgery at Sloan Kettering. On the crucial question of time, Dr. Brennan avoided a specific reply. “I wouldn’t phrase it that way,” he says now. What he told Grant was that his survival would be “measured in months and not years.” Brennan recalls, “It was not a curable situation—he knew that.”
He adds that Grant “viewed that in his indefatigable way: What do we do to maximize the time I have?”
Grant did not share this grim news, of course. Some people at UNICEF knew he had had surgery but did not know why. Judging from a letter he received from his old friend John Sewell on May 9, 1993 (three days before his seventy-first birthday), Grant painted a rosy sheen on the issue whenever it came up—as he did with so much else.
Sewell wrote that Grant’s speechwriter and aide Mike Shower had “indicated that the prognosis was not as bad as we thought. In fact, he said you were raring to go!” Sewell added: “This was good news personally and professionally. You still have a lot of work to do, and these will be exciting times.”
In a letter to Grant’s sister Betty, sent after his death, a childhood friend from China named Eddie Hoo wrote that he had run into Grant in China at some point after his diagnosis. Grant had told Hoo that his cancer was cured. “I told him that cancer
would come back,” Hoo wrote, “and that he was committing suicide if he didn’t stop working so hard; I told him to write a memoir. He just shrugged his shoulders.”
Maybe Grant really did believe his cancer had been cured after his first surgery (though this was tantamount to announcing you had won the lottery when all you had done was buy a ticket). Or maybe he just wanted others to believe that. Maybe he knew that to get his job done—to consolidate all the progress he had achieved, to save even more lives—he had to make others believe he would be around for a while. Either way, he was determined not to let cancer get in his way or slow him down. It was one of those hurdles he would either vault over or simply knock down. In one of his notebooks, under a collection of Chinese fortunes, he taped a scrap of yellow paper with the typed words: “I have cancer, but cancer does not have me.”
Says Rohde: “He never admitted it could be anything but curable.”
But the unspoken knowledge that it almost certainly wasn’t—whether he admitted it or not—threw gasoline on his blazing zeal. There was still so much to do. Now, he had maybe a year, possibly a little more, in which to do it—if he was lucky. As a result, says Rohde, “he just went flat out.”
He worked harder, moved faster, stepped up his already frenetic pace. He lined up a torrent of trips and meetings. He pushed his staff more insistently. He fixed his attention on a question now imbued with a churning new urgency: Who was keeping their World Summit for Children promises, and who wasn’t?
The “national plans of action”—countries’ individual blueprints for reducing child mortality and improving child health, stemming from the summit—were pegged to a year 2000 deadline. But Grant would not have until 2000. He might not have until 1996. A series of ten “mid-decade goals,” growing out of several regional government meetings in 1992 and 1993, were hitched to the year 1995; these were created, not to accommodate Grant’s cancer, but to provide an incentive to political leaders whose terms might expire before 2000. Nonetheless, for Grant, they became the only goals that mattered—he focused all his energy, all his mania on 1995. The mid-decade goals were his ever-sharpening set of spurs, and he used them unrelentingly.
In August 1993, Gautam wrote Grant a confidential memo cautioning him to let up a bit. While most country representatives had felt “challenged” by the 1990 immunization goals, Gautam wrote, they were now “overwhelmed” by the mid-decade goals. The quiet and brilliant Nepalese man stated that some staffers felt the goals were “unachievable and unsustainable.” Then he got to the uncomfortable crux of it: “The timing is not helpful in that many staff feel that the current relentless pursuit of goals may very well slacken in a year or two with the change of leadership of the organization.” As a result, he predicted some staff would merely humor Grant, saying they would meet the targets, even though they had no intention of doing so. The potential consequence: “we might inadvertently plant the seeds of cynicism which undermine the end-decade goals and goal-oriented programming which have served UNICEF so well.”
Gautam suggested making the goals adaptable to the realities of each country. Some African countries, he pointed out, faced a much steeper and more arduous climb than countries in Latin America. He also addressed a long-simmering source of resentment, noting that there is a “perception that Reps and advisers who tow the party line and are good salesmen of their achievements are forgiven for their managerial shortcomings and even misconduct.” He urged Grant to reinforce the need for “high standards of personal conduct and organizational discipline.”
Gautam’s advice, particularly this last bit, would soon prove sadly prophetic. But Grant seems to have largely disregarded it.
He hurtled forward, gaining speed as his body began to betray him, and new and old crises—“loud emergencies”—vied for morsels of his coveted attention. A growing series of emergencies and violent conflicts—in Afghanistan, Angola, Haiti, Iraq, Liberia, Mozambique, Somalia, Sudan, the former Yugoslavia—persistently waylaid him. And the work of field staff in many of these places seemed to be getting more dangerous. At a UNICEF board meeting on May 7, 1993 (just days after Grant’s operation), Karin Sham Poo, then deputy executive director for operations, noted that five UNICEF staff members had been killed within the last year alone and that one more was presumed dead. In the early 1990s, the blue halo that had once protected many peacekeepers and UN staff had, in many places, become a target—and UNICEF and other agencies were completely unprepared for it.
“We were caught with our pants down,” says UNICEF veteran Fouad Kronfol, who then ran the personnel division.
“We didn’t have security in place for this. It was a big shock to us—we had seen ourselves as Boy Scouts.”
Kronfol had told Grant that UNICEF needed to do a better job of protecting staff. Grant “was very supportive” and backed measures to improve communications in the field and coordinate security with other agencies. UNICEF tried to evacuate staff from trouble spots, but for some, it was too late.
Former UNICEF Somalia representative David Bassiouni remembers Grant attending the New York funeral of Marta Pompalova, a UNICEF doctor shot dead while sitting at a café in Bosaso, Somalia, in January 1992. Grant had approached Pompalova’s husband, hugged him, and said, “She died for the cause of children.” A year later in January 1993, Grant would offer his condolences to the family of another UNICEF staff member brazenly executed in Somalia. Sean Devereux, a twenty-eight-year-old Briton, was shot in the back of the head in the southern port town of Kismayo as he walked near the UNICEF compound. “Sean did not die in vain!” Grant said at Devereux’s memorial service in New York, according to his prepared remarks. The enthusiastic and personable young aid worker, a Salesian Catholic missionary, became known as “the saint in shirtsleeves.” During the service, Grant called him “a frontline leader who toiled and died for a great cause.”
The mounting staff deaths dismayed Grant, according to several staff members, and dug at his guilt—perhaps echoing the torment of sending Americans into harm’s way during the Vietnam War in the late 1960s when he oversaw USAID’s programs there. But he didn’t hesitate to dispatch staff into
war zones; not when children were in peril. The circumstances would only grow more dire—the most catastrophic loss of UNICEF staff in its history was yet to come.
Grant’s portable pocket marketing arsenal—which usually included an ORS packet, a growth chart, maybe a syringe—gained a new prop later in his term. It was a small dropper filled with liquid. He used it at state dinners and formal functions. He would ask the president or prime minister to pass the salt. He would take a plate or a saucer and shake a little pile of salt into the middle of it. Then out came the dropper, fished from his coat pocket. As everyone around the table watched, Grant would raise it over the little pile of salt, squeeze out a few drops, and watch. If the salt turned blue, that meant that it contained iodine. If not, the sudden and stifling air of embarrassment was as conspicuous as a mariachi band at the opera.
Iodine is a natural chemical element, essential to human development. For children without enough iodine in their diet, the results can be calamitous and life-crushing: severe neurological damage, impaired speech and hearing, cretinism and goiters. Iodine deficiency also causes stillbirths and miscarriages and elevates the risk of child mortality. In the early 1990s, in remote mountain villages in Nepal and Bolivia and dozens of other countries, it was grotesquely distending children’s necks and silently strangling their futures. One way to stop this pervasive global plague was to put iodine in their salt (a remedy UNICEF had been promoting since the 1950s).
Mary Cahill was with Grant in Beijing when the Chinese premier Li Peng hosted a big dinner in Grant’s honor in the early 1990s at the vast Great Hall of the People (adjacent to Tiananmen Square, where Li had ordered the infamous and ruthless military crackdown a few years earlier). During the dinner, Grant produced his salt-testing dropper and explained to his bespectacled, pudgy-faced, hard-line host what it was and how it worked. He may have said that a lack of iodine can shave precious points off a child’s IQ, and that it can hobble an entire country’s economic prospects. Stopping it costs just pennies. Then, in front of Li and other guests, he squeezed a few drops onto the salt on his plate. He examined it. Nothing happened—the salt did not turn blue. Grant then informed the premier that his salt was not iodized. “He would risk embarrassing the premier of China to make his point,” Cahill says.
Known for his frequent scowl, Li immediately summoned his chefs from the kitchen. Cahill recalls that two or three of them promptly appeared, wearing white jackets and standing at attention. The premier ordered that, from now on, only iodized salt would be used. Shortly thereafter, China embarked on a nationwide effort to iodize its salt.
Grant would do his salt test more and more frequently, embarrassing elite dinner hosts on numerous occasions. It became another obsession—another quick, cheap, demonstrable way to help children. Universal salt iodization was a mid-decade goal, and UNICEF would soon team up with Kiwanis International, a volunteer service organization, to raise money and awareness to try to make it happen.
As Grant ever more aggressively flogged world leaders, donors, and his own staff to make children’s health a priority, he shunted his own health aside. He saw his doctor and got radiation, but treated the appointments as a muddle of minor distractions—he would slosh through them and then shake them off his boots as quickly as possible. Adamson went with him once when he received radiation at Sloan Kettering. He was able to watch the procedure, as doctors marked his boss’s abdomen with a small ink cross—the target for the radiation—and then lowered a giant X-ray machine over him. “What I remember most,” he says, “is that both before and after, Jim was talking about work issues and planning and
The State of the World’s Children
. [The radiation] was just an interruption. It wasn’t the focus of his day.”
One focus may well have been how to get more mileage out of
The State of the World’s Children
, UNICEF’s flagship report written by Adamson and released every December. Grant usually kicked off the report in a different country each year, and it always garnered a barrage of media attention. How could he outdo all past report launches? Where could he unveil it in December 1993 that would trump all other locations?
There was only one place: the White House. George H. W. Bush—the US president who had skipped out on most of the World Summit for Children and almost didn’t show up in the first place—likely wouldn’t have been very receptive to the idea. But America’s affable new president, sworn in earlier that year, was. Bill Clinton warmed to Jim Grant instantly. In his first speech to the UN General Assembly on September 27, 1993, Clinton
repeated some of Grant’s talking points, noting that thirty thousand children die each day of disease and malnutrition. Then the president said: “Our UNICEF director, Jim Grant, has reminded me that each of those children had a name and a nationality, a family, a personality, and a potential. We are compelled to do better by the world’s children.”
Three months later, the president and the first lady stood next to Grant in the East Room of the White House, under a glittering Christmas tree, as he prepared to release the 1994 edition of
SOWC
. Most UN reports are usually released in obscurity and then quickly forgotten. It would be hard to ignore this one.
Grant stood to the side, clutching a copy of the report, grinning like a giddy kid, as Hillary Clinton introduced him.
“In Jim Grant’s fifty years of international service, he has extended his passionate and infectious enthusiasm for children to every capital and corner of the globe,” the first lady said. She drew laughs when she mentioned his penchant for brandishing packets of ORS. She then proclaimed that the earnest American head of UNICEF had “helped to redefine what we mean when we talk about global development, peace, and global prosperity.”
Applause frothed around him as he took the podium. His face looked thinner, the skin on his cheeks and throat a little looser. He put up both hands and said crisply: “Please.” He thanked the Clintons. He delivered a fairly smooth speech, not as riddled with awkward pauses as many previous addresses. He swayed from side to side as he spoke. At one point, when mentioning how many more lives could be saved with greater
political leadership, he turned around and wagged his finger at the president (as though telling him,
The ball is now in your court—you better pick it up
). He closed with a direct appeal to Bill Clinton, stating his “hope that the advancement of the great goals for the children of the world will become one of the defining moments of your presidency.”