Gayle Force

by Jan Goodwin
Photograph: Photo: Olivia Arthur

Keeping up with Helene Gayle, MD, the CEO and president of CARE, as she makes a whirlwind visit to Africa requires the stamina and fleetness of Kenya’s international marathon champions. Today she is on the outskirts of Nairobi in an area called Kibera, reportedly the continent’s largest slum. For its estimated one million residents, the living conditions are deplorable. Thick mud sucks at our every step, but Gayle takes off at a near sprint down the fetid narrow alleyways, heavily rutted from tons of trash buried underfoot over the years. In this location, speed is a real feat. Slip, and you’re likely to slide into the open sewers that edge the labyrinth of lanes. Fall the other way, and you risk gashing your head on the rusting, twisted corrugated iron from the makeshift hovels that line these byways.

Since leaving America, we have been traveling for two days and are extremely short on sleep. But jet lag appears not to be a term in Gayle’s vocabulary. Her days are as scheduled as the average U.S. president’s, except that no head of state would accept itineraries starting at 4 am and continuing until 10 pm. There are no bathroom or coffee breaks factored in, although caffeine is desperately needed. Picnic meals are eaten out of cardboard boxes so as not to waste a minute as we drive from one location to another. Yet for all her Energizer Bunny animation, Gayle, 54, remains as fresh as she was when she left Atlanta, where CARE is headquartered, and as articulate and amiable as if she’d just had a nice nap in her own bed.

We are in Kenya ostensibly to check out maternal-health issues. Every year some 343,000 women and girls around the world die from complications of pregnancy and childbirth. But as the paramount multitasker—Gayle’s BlackBerry seems attached to her hand like a sixth digit—she is simultaneously co-leading, with a retired four-star admiral, what CARE dubs a “learning tour” for a group of American policy makers. These dignitaries make recommendations on government investments in global health, and Gayle hopes the tour will give them information they need but don’t normally get. The subtext is that such tours also raise CARE’s visibility in Washington and help in the fight for government money.

“The death of a woman in childbirth is one of the most inexcusable deaths on earth,” Gayle says. “Yet too often, when governments are asked for funding for women’s health care, people’s eyes glaze over.” When this happens, Gayle’s keen intelligence, encyclopedic knowledge of public health and natural authority, combined with her warmth, get their attention. She is passionate about every part of her mission. “Women need access to microfinance and savings programs so they can start businesses, so they can become more valued, so their girls can be educated,” she says. “It’s an overarching philosophy.”

Which neatly sums up how CARE, one of the largest private humanitarian organizations in the world, now operates. The agency has come a long way since it was founded in 1945 and started sending CARE packages to near-­starving Europe. Today CARE has about 800 poverty-fighting projects in 72 countries, addressing issues in agriculture, education, economic development, health and nutrition, water systems and emergency relief. (For more about CARE’s programs, visit With an annual budget of nearly $750 million, the agency earns a four-star “exceptional” rating for its effectiveness.

Gayle took the helm at CARE in 2006, the first woman and the first African American to lead the organization. “She may be the most trusted public health official in the world. People don’t necessarily trust the U.S., but they do trust Helene Gayle,” says David Satcher, MD, former director of the Centers for Disease Control and Prevention and former U.S. surgeon general. He was also her boss at the CDC—“to the extent that Helene Gayle ever had a boss, which I don’t think she did,” he jokes.

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