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June 9, 2022 37 mins

Despite feeling the impacts of a global pandemic, many people still view health as a personal issue. But what would happen if we began to look at health from a worldwide lens, one where health is not a luxury, but a fundamental human right? 
In this episode, hear from Kim Goldsmith-N’Diaye, Director of Development at Doctors Without Borders and Amanda Ryan-Smith, Chief Development Officer for the Trevor Project. Both guests operate from the philosophy that all people – regardless of location or economic background – deserve quality healthcare. With a scarcity of healthcare access around the globe and a rise in mental health issues amongst younger people, both guests are a testament that a sort of ‘collective caring’ and awareness is the first step towards solving this massive and complicated issue.  

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Episode Transcript

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Speaker 1 (00:05):
Hello and welcome back. As you know, this show is
all about deconstructing these big issues that affect all of us.
We're highlighting ways we can work together to create positive change,
and today we're taking on the absurdly massive issue of
global health. It's complicated, as the kids used to say,
and made even more so by the constraints of access, geography,

even stigma. Health is one of those things that most
of us don't think about until we don't have it.
Like I think a lot about my health when I'm
sick or injured. Otherwise it's not top of mind. And
we're encouraged to think about health on an individualistic and
personal basis. My health, my life expectancy, my step counts.

All the apps encourage that individual self and not so
much consideration of the collective self, our health. It's hard
for me to be healthy when we aren't healthy. COVID
seemed like it would have been the perfect place to
jar us into this space of more collective consideration. But
those individualistic tendencies, they are so hard to leave behind.

I mean, just picture airline passengers cheering with the end
of the mask mandate midflight, with no concern for the
person sitting next to them. So what happens when we
begin shifting conversations about health to a collective one, beyond
the individual and beyond our own national borders. Today's guests
they do just that, working with people both domestically and internationally,

based on the belief that access to health care is
a fundamental human right. Joining us today is Kim Goldsmith
and Diet Director of Development at Doctors Without Borders. This
organization is known for its efforts to bring medical humanitarian
assistance to people based solely on need, regardless of race, religion, gender,

or political affiliation. Kim has a huge task at hand,
responsible for developing the many income streams within the nonprofit
that allow more than sixty thou staff to provide over
ten million medical consultations in more than seventy countries every
single year. So what did you do last year? Our
second guest also works in development as the Chief Development

Officer for the Trevor Project. Amanda Ryan Smith is a
part of the world's largest suicide prevention and crisis intervention
for lgbt Q plus young people of whom have considered
suicide in the last year alone. Amanda and her team
take on this challenge through different programs that center around
crisis services, education, and advocacy. Let's dive right in. Welcome

Kim and Amanda. We're we're exploring a lot of issues
with this series and in particular with your two organizations.
And on the surface, there's a lot of uh cultural differences,
you know, domestically and internationally with Doctors Without Borders with
the Trevor Project, but you share this universal belief that
access to health care is a human rights issue, Kim,

Doctors Without Borders has been providing emergency relief to communities
all over the world for more than fifty years, and
y'all typically focus on war and conflict, climate disasters, epidemics, pandemics,
refugee crisis, you know, the really chill stuff around the world.
Right now, it seems like all of those things are

happening everywhere at the same time, and more people need
your help than ever before. So with that overlapping set
of demands that are also increasing, how do you prioritize
who gets your support and for how long. Doctors Without
Borders is a medical humanitarian organization and we provide medical

care on a basis of needs without discriminating. Sian and
so our decision to respond to crises is based on
our independent assessment of medical needs, and we currently work
in more than seventy countries, and we are continually assessing
where we're needed the most, both over the long term

and in response to humanitarrity and crisis. So what I'd
like to do is highlight three examples. One is Haiti,
a country where we've worked in for thirty one years
and we have unfortunately seen many disasters there. Last August,
amazing earthquake struck in southern Haiti, but because of our

longstanding work, our Haitian surgical team was already working in
our hospitals in the capital of Porto Place and they
departed for disaster zone. Within hours, local hospitals were overwhelmed
with patients traumatic injuries from falling walls and roofs, and
our team started doing worth ap surgery pretty immediately. The

next example I would highlight is Ukraine, again where we've
already been working in the country for many years, when
the war broke out in February. Historically, we've worked on
drug resistant tuberculous hepatitis C, advanced HIV, and just improving
access to primary care. But when the war broke out,

we had to really reorient our work to meeting the
emergency needs now. As Ukraine medical facilities are dealing with
large influx of wounded patients, we are they're providing them
with medical services, medical supplies, especially training on how to
treat large numbers of wounded patients at the same time. Lastly,

is one that's not really in the headlines. A lot
treating children for malnutrition, spiking during a lean period each year.
The malnutrition is particularly harmful for children between six months
and five years of age, who need highly nutritious foods
and so malnourished children have severely weakened immune systems and

are more susceptible to common childhood diseases, and their diets
have a profound impact on their physical and mental development.
As we know, Amanda, I want to give you a
chance to jump in here as well. The Trevor Project.
You all work seven. You've got this confidential crisis line,
this crisis services, and you're starting to expand into territories

beyond the US, starting with Mexico. So can you paint
a high level view of the current state of mental
health in the US. Here's what we know. We know
one point eight million lgbt Q plus young people seriously
contemplate suicide every year. We know it's the second leading
cause of death for those aged twenty four and under.

What's going whired things the way they are. Our mission
at the Trevor Project is to end lgbt Q youth suicide,
and what we're seeing right now is that the last
few years have just been incredibly difficult for lgbt Q
youth and taken a huge toll on their mental health.
Between a hostile political climate, unique challenges amid the COVID

nineteen pandemic, repeated acts of racist and transphobic violence, we
have seen that lgbt Q young people are more than
four times more likely to consider suicide than their peers.
It's a staggering difference, but it's not due to anything inherent.

It's because lgbt Q young people are faced with more stigma, discrimination, rejection,
and violence, which can compound and then lead to really
negative mental health outcomes. We just released our fourth national
survey at Trevor and the largest survey of its kind

with nearly thirty four thousand respondents and the most diverse survey,
and what we found is that fort of LGBTQ young
people seriously considered attempting suicide in the past year. Nearly
one in five trans and non binary youth attempted suicide,

and youth of color reported higher rates than white peers.
All of this really is exacerbated for folks who have
at least one marginalized identity, people of color, people with disabilities,
people with the lower socioeconomic status. There are really unique
challenges and stigma. There's very limited data on the mental

health of LGBTQ young people, and we think it's so
important for people to understand really what is happening from
young people themselves. These are sobering statistics, um and uh um,
and I think anyone hearing them for the first time
might just, on the basis of the data be compelled

to act, you know, to do something about that. Most
of us don't carry those numbers around. You've done more
than just act. You are part of this organization, You're
committed to this work in a deeper way. Is there
something more personal, you know, beyond the stats for you
that motivates your continued commitment to the Trevor Project's mission.
You know, I came to Trevor last year, and I

really thought about myself growing up as a young queer
person in Oklahoma. You know that I didn't have the
support I really wanted and needed. And within a few
months of joining Trevor, my own child came out as
non binary. They are ten, and their pronouncer they them,
and we have been working to make the world safe

and supportive for them, and our research talks about the
impacts of these attacks on young people. But what has
happened in Texas in February? I saw what happened to
my own child, and b was really a thriving fourth grader.
Their teacher described them as everybody's very witty best friend,

which is be they have never been a friend. They
did not love. And in February, the Texas governor called
parents like us child abusers and said we should be
investigated for child abuse for supporting our trans or non
binary children. And we had to create a safety plan
with our ten year old. They had to practice what

they would say if someone showed up at their school.
We consulted with an attorney, We delayed a scheduled pediatrician
visit for fear of what might happen, and we saw
the struggle with nightmares, being more withdrawn, less confident, less
Our witty fund B and we've been really working to

support getting them back to Center, and we've ultimately made
the decision to leave Texas because B does not feel
safe here with what's happening. And I tell this story
because this is a child that is surrounded by love
and support in every part of their life. Their school
is asking for our Trans and non Binary Youth Guide.

They want to do the right thing, and this is
what happens for them with these attacks. It is all
the more challenging for the one in three trans and
non binary young people who are not in supportive homes.
And I think it's important for people to know that
B is not struggling with their identity. B is so

clear about who they are. They are struggling with a
world that doesn't support them. And so I'm grateful to
be at Trevor to help create that world for B
and for all LGBTQ young people. It sounds like it's
the rest of us who are having the hard time.
Bees doing just fine, just being you know, Thank you

so much for sharing that. That was incredibly heartwarming. I
have no words behind that. It was just quite emotional
and sad at the same time. Yeah, I want to
talk about what y'all each do at your organizations. You're
both in charge of raising money, keeping the lights on

to be able to do the important, literally life saving
work that each of your organizations do. Kim, I'll start
with you, because so many of the challenges that Doctors
Without Borders is focused on are literally a world away
from your donors. They're far in space and far out
of mind. So how do you make that empathetic connection?

What messages are working to get people to care about
folks in circumstances so different from their own. So I
will say that, as everyone here knows, funding our work
is an enormous effort that is clear, and we currently
have more than a million donors in the US. Every
single donor makes a difference. I don't care how small

or how large the donation, and it's actually not hard
to get people to care about international needs they already do.
What's important to know is that our donors understand that
their dollars enable us to be financially independent and operational independent.
So what does that mean. That means that when there's

a crisis that takes place we're able to respond rapidly
using the resources that we already have. But that also
means that when we take and stand on contentious issues
or work in a conflict zone, it helps that our
funding does not come from governments. We can say that

funding comes from private donors like you and me and
Amanda and its donors who care about the international work.
Our donors don't get to visit our projects because they
are in conflict zone. So the fact that they can
imagine this is really incredible. Amanda, similar question for you,
how do you connect with people who may not have

a direct connection to the folks that the Trevor Project
is serving. One of the things that has been so
beautiful at Trevor is that the horrible attacks that have
been happening, particularly on trans and non binary young people,
have made so many people very angry and very upset

and hurt and just furious at what's happening in our country.
And to me, philanthropy is a tangible thing that you
can do that you can turn that into a positive
thing of really allowing us to exponentially grow our capacity
to serve more LGBTQ young people. So I'll give you

an example. We recently had our very first fifty mile
challenge on Facebook for folks to fundraise for Trevor, not
just to choose to give themselves, but to ask others
to support us. And our goal was maybe a hundred
new fundraisers. We had fifty seven hundred new fundraisers. We

create a Facebook group for them to communicate their stories
to each other. There were thirteen thousand people in the
Facebook group telling their stories of why they were supporting Trevor,
why they were walking fifty miles, and why they were fundraising.
We will communicate the stories of the young people we serve.
We will tell about our services, the importance of the research,

and all the stats. But I think there's also something
powerful for supporters connecting to each other to tell their
story of what their struggle has been or who they
love in their life that has inspired them to support Trevor.
In this way, every dollar makes a difference at Trevor
and supports a young person in crisis or helps create

a world where they won't be in crisis in the future.
Tell me about that world and that difference. The other
side of the stats that we started with today, what's
tangible progress? What does it feel like, what does it
look like? Maybe it's a person, maybe it's a town,
maybe it's a school. You know, there were more than
two hundred harmful policies legislation targeting LGBTQ people proposed this

year alone in the US, and for US, we have
seen success in striking those down in sharing facts, research advocacy,
working to give information to people on the ground to
help advocate against those bills, and we have been successful
in keeping some of that harmful gislation from moving forward.

It's important that we win, but it's also no matter what,
it's important for trans and non binary young people to
see us fighting for them. Our crisis lenes have continued
to increase, and it's not necessarily because there's more youth
in crisis. They have seen that, but it's that youth
know where to go if they need support. And we're

making sure that young people know about us and can
find us easily, and we're grateful to so many partners
who help make that possible. Macy's will soon be running
a round up at the register. And if you think
about Macy's all across this country, in all the communities
that they're in, they are asking people when they are

shopping if they'd like to support the Trevor Project, and
they are raising awareness about LGBTQ young people and asking
people to do a tangible thing to support us. Kim,
what does it look like for Doctors with Borders to
be successful well and what does it feel like on
the ground of the communities you serve. Paint that picture

for me. I'd like to share a story which really
shows the impact of what we do. A young man
who was critically injured in a suicide bombing in two
thousand and six. He was seventeen years old and he
was playing volleyball with his friends at the time when
the bomber struck the players and a crowd of spectators.

You say was rushed to the hospital, but he suffered
severe damage to his face and he lost his sight forever. Um.
He struggled for years to live with his injuries until
one day he heard an advertisement for Doctors Without Borders
program in neighboring Jordan's and that provides reconstructive surgery for

patients with traumatic injuries from war zones throughout the region.
He spoke to one of our doctors by phone, and
within two weeks he was accepted into the program. It
took three years of surgeries at our hospital to repair
and rehabilitate the injuries to his face from his nose

so he could breathe. He became an independent person again,
able to take care of himself, and began to dream
again about his future. He was accepted for a refugee
resettlement program here in the US. He moved to Texas
Inner Tire Education and has become a motivational speaker. And

he really is an inspiration to us all in showing
how wounds and hardships can be overcome, what our services
can provide and really just change the life of one person.

Your listen into a podcast called Force Multiplier, Action meets Impact. Now,
I'm sure you've grown to expect ads baked into your podcast,
but we're gonna do something a little different to walk
the walk. We've donated our ad space to the organizations
that need it, most organizations directly tackling today's greatest challenges.

Be right back. The biggest threat to global health isn't
a virus, it's injustice. The same scenario the ones denied
life saving HIV medication to the world's poorest countries is
now on repeat with access to COVID relief. We must
act now to get doctors and nurses on the front
lines to help they need to save lives. Join Red

and learn how every dollar raised for the Global Fund
results in thirty one dollars in health gains and economic returns.
Visit Red dot org for the many ways your money
and support can become a force multiplier in the fight
against pandemics. Hey, I'm still Baritune Day, your host for
Force Multiplier, but I'm checking in with you with a
little different energy because if you're listening, you like the show,

and if you like the show, you might like my
other show, How to Citizen, where we take citizen as
a verb and find out from people practicing the ways
we can shape our community by showing up, investing in relationships,
understanding power, and valuing our collective selves. Check it out
at how to citizen dot com or wherever you get
your podcast. Both of your organizations, you have these frontline

workers who are directly interfacing with some of our worst nature.
You know, they're seeing people after their bomb has blown
parts of their body off. They are walking children through
the reminder that their lives have value and are worth continuing.
So how do your staffs manage their own mental health?

What are you all doing internally to stay centered, you know,
and to stay hopeful and even to stay effective and
functional given the weight of so many parts of the
world that you carry. I think this is such an
important thing to highlight, and as a mental health organization,
I believe and say this all the time. My first

goal is to have a happy and a healthy team,
and I think wellness starts with me. I think that
as a leader, I have to be an example of
the expectations that I'm setting for the team and taking
care of themselves and in enjoying their life outside of work.
I talk openly that my family comes first, and I

expect you all to do the same for everything important
in your life. We want to reinforce a culture of
self care and mental wellness, so we have pivoted to
remote work. Trevor is a remote first organization. Our staff
can live anywhere across the country. We've ensured that stafford
afforded additional paid time off for COVID related illness. It's

a continual conversation we're having about our commitment to supporting
our staff and living their best lives outside of work.
As well and supporting them through this critical work. Okay,
that sounds like a great place to work. Doctors without borders.
You're up. How are you going to top that? Are you?
What are you all doing well? Actually, it's twofold. If

we look at the international staff, the folks that are
going into these emergency situations, and you know, burnout can
happen really quickly. They're prepared with really understanding on their
first assignment. There's a lot of briefings done about falling
prey to those common risks to mental health because it

can happen very quickly. In the field, we talk about
the stresses people are going to encounter. We have something
called psychosocial care, which is integrated into their support that
we provide the staff. We also have peer support networks
that help people process their experiences after they've completed those assignments,

and those are really it's not just a one off conversation.
Those are intense to three weeks a month long conversations
about what they've experienced, what they've seen, and just how
they're feeling about it, which is incredibly important. Here's a
quick round for both of you. How's recruiting going. What

are you actually experiencing in terms of volunteers and staff. Yeah,
we're continuing to see an increase in our volunteers. We've
grown to more than seventeen hundred active volunteers and they
go through forty hours of training that really prepares them
to be on the crisis lines and to be connecting

with youth on phone, chat or text. And then we
are continually recruiting for our growing team at Trevor and
have seen lots of folks really wanting to be part
of this organization and we're excited to see that it
has created the most brilliant team I have ever gotten

to work with in my career and it's really just
such a gift. So in terms of Doctors without Borders,
we're in a really good position that there's no lack
of interests of wanting to work with us internationally or
for doctors without Borders. Last year, you know, we received
an average of sixty four applications per month. This is

medical staff. And this year we see the impact of
the Ukraine crisis for example, where in March we received
two hundred and twenty applications. As you know, this is
really a difficult time, but there's still a lot of
interest and it just continues. Luckily, Amanda, You've already shared

some about you know, the impact on an l g
b t Q plus youth of the stories around them.
You know, about their belonging, about their value, about their worth.
And I'm curious your take on media representation in this moment.
Are we doing better? Are we getting it more right,
telling factual stories that represent this community? And if not,

you know, what more do you want to see? You know,
lgbt Q representation in the media is just essential for
young people. Over eighty percent of youth have told us
that celebrities who are lgbt Q has positively impacted how
they feel about being lgbt Q. And when young people

see their identities and their experiences represented in the media
and pop culture, it brings them hope and joy and
strength and lets them envision a bright future for themselves.
And it all so can foster empathy and acceptance among
people who are outside the LGBTQ community. There has been

such a promising increase in TV and shows representing our
beautiful diversity in LGBTQ identities, and with most things, you know,
there is always room for improvement. There is room for
more growth. There is room for more diverse representation. But
we feel that the news media in particular has been
really good about covering lgbt Q experiences, reporting on mental

health concerns increasingly, especially as we've seen lgbt Q identities
being politicized. I'm gonna ask you to do an unlicensed
diagnosis right now. So you're describing these positive stories and
the value of of belonging, But the counter to that,

one of the reasons you don't live in Texas anymore
is because there's another story. And so you have this
competition for narrative, one based in love and acceptance, one
which I was described, is based in fear ignorance. Where
do you think that other stories coming from? What's motivating
it in terms of its ability to still garner enough

people to its side to flip laws for example. Yeah,
I think unfortunately a lot of people think they don't
know a trans or non binary young person, and there's
a lot of misinformation and a lot of fear, and
just there's so much that they get so wrong. And

I want the folks who are politicizing young people's very
existence to know the young people that we serve, to
understand them and to know that kids like be are
very clear about who they are and that trusting them,
supporting them is life's aping. And I think there's just

so much incredible misinformation, and I think it's also been
politicized and used as a way to detract from different
things that were happening. We definitely saw that in Texas,
like inability to keep the power on in the winter.
I'm just saying, this show is so much about collaboration.
What are some unexpected partners or collaborators that you've been

able to forge at the Trevor Project, maybe in rural
areas where supports lagging. Do you have an example or
two of something we wouldn't expect that's been very effective. Absolutely,
we are really grateful for our corporate supporters. We've had
so many different organizations support us at Trevor. Or. Technology
partnerships have really been an innovative way that's been very unique,

in particular on developing a eye technology to train volunteers.
They do role plays in preparing to become a volunteer
and to understand their responses, and one out of four
is done through an AI chat bot. So I think
it's a beautiful thing when a corporation can take a

strength that they have and help utilize that in the
nonprofit world to make something even better. Yeah, I mean,
I'm always fascinated to hear tech being used for things
that don't destroy the fabric of democracy. You know, we're
really lucky to have a technology team of more than
forty plus talented experts across product engineering, AI, security and more.

It's very unique for a nonprofit to have those types
of resources and to be able to explore technology innovations
that support our mission of ending lgbt Q youth suicide.
Kim back to this collaboration point in unexpected pairings, are
there stories from your supporters, you know, new combinations that

feel non obvious or innovative in terms of who's supporting
doctors without boarders, Well, actually there is. One of the
most interesting partnerships that we have at the moment is
with Ukraine's National Railways. And because of the war UM,
many of the people in hospitals close to the front
lines in the East need to be evacuated to hospitals

in the West. The hospitals in the East are strained
by mounting needs as you can imagine, and the hospitals
in the west have more capacity right now. So the
railways provided the trains and we have provided the medical staff,
supplies and equipment that are needed for care to take
patients as they take this twenty hour plus journey to

the west. That's not an easy journey because one you
have to assess which patients can really handle this twenty
plus our journey. Trains don't go straight through the stop
for two or three hours while there's a bombing or
potential bombing taking place somewhere in the vicinity. So it's

quite an experience. Can you imagine when there was the
bombing of the train station in the east, our trains
had just pulled out and then it didn't go back
for quite some time. This is one of the more
interesting partnerships that we have going at the moment in
the Ukraine region. What's the what's the most pressing thing

you want someone listening to this conversation, Kim to know,
you know, as I reflect, I would like our listeners
to know that the majority, great majority of our staff
more than eighty percent, are from the countries and places
where we work, and it is our staff in places

like the Central African Republic, South Sudan, Yemen, in Afghanistan,
who makes so much of a difference on the front
lines of globe health. Together, we are all a part
of a movement to provide life saving medical care to
people who need it the most. And it's something we
can only do if we support each other and work together.

And that's really what Doctors Without Borders is all about, Amanda,
what's your one thing? I really want them to support
LGBTQ young people in their life. We know from our
research that just one accepting adult in an lgbt Q
young person's life can reduce the risk of a suicide

attempt by forty So if you see the warning signs
of suicide in someone, I want folks to remember care,
c A r E. Connect with that person, ask them
directly about suicide, respond with compassion and empathy, and empower

them with information and support. Wow. Thank you both for
giving us an opportunity to save lives. That's kind of
what this conversation has been about to me. You know,
there's there's a lot of fictional films out there with
superheroes who throw hammers into other galaxies and all that.
That's exciting, But here on Earth we can still save lives,

and we can do it through the organizations. Both of
you help move forward. So thanks for being so open, vulnerable,
sharing your stories, your data, and a bit of your hearts.
It's been a pleasure and a humbling opportunity for me.
So Kim Amanda appreciate you both. Thank you, Thank you
so much. Both Kim and Amanda play a similar role

in their organizations. They got to engage volunteers, raise money,
even figure out logistics associated with bringing health to people
that need it the most, and talking to them, it's
clear their ability to take care of themselves and their staff,
even their families is essential to being able to do
their work. I mean, who helps the helpers? This is

a question that the global health system increasingly has to
answer as we see a rise in physical and mental
health threats in our volatile world. Each of these organizations
is a testament to what collective power can achieve. Whether
it's halfway across the globe, in a remote village or
somewhere in the US, this movement isn't that complicated. At
its core. Kim and Amanda's mission is pushed forward by

their desire to help and the belief that everyone should
have accesses to resources that help them heal. We me
and you can be a part of this right where
we are by being in each other's lives, by using
tech to enhance that human to human connection, we can
show up to help save lives. To continue this theme

of collective caring, you won't want to miss part two
of this conversation, where we hear from doctor carry Jose
feelings as Urgin with Doctors Without Borders who's currently working
in Haiti. They'll talk to us about what the reality
is on the ground, what they see, how they manage
their different patients, and how they take care of themselves
while doing this very rewarding but difficult work. Are you

feeling inspired and want to check out more information about
the organizations we talked about in this episode. Learn more
about our guests and how you can support their work
by going to Salesforce dot org slash Force Multiplier. Force
Multiplier is a production of I Heart Radio and Salesforce
dot Org hosted by me Barretune Day Thurston. It's executive
produced by Elizabeth Stewart, produced by Ivan Schien, edited and

mixed by James Foster, and written by Yvette Lopez. A
special thanks to our guests Kim Goldsmith and Diane and
Amanda Ryan Smith. Listen to Force Multiplier on the I
Heart Radio app, Apple Podcasts, or wherever you get your
podcast m hm hm
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