Dr. Vivek Murthy: How We Can Overcome the Opioid Crisis

 

Newscaster [00:00:02] Bill Clinton is expected to be named a special United Nations envoy to Haiti. A spokesman for the former…

Bill Clinton [00:00:08] The Haiti earthquake was really tough for a lot of us. I had been there a year working for the United Nations and a bunch of our people including the head of our delegation were killed.

Newscaster [00:00:18] January 12, 2010. A catastrophic earthquake ravaged Haiti’s capital Port-au-Prince, shaking whole neighborhoods to bits and leaving one and a half million people homeless.

Newscaster [00:00:31] Now the White House says it has asked former Presidents Bill Clinton and George W. Bush to help in the relief effort and President Clinton…

Bill Clinton [00:00:37] When we went down there about 10 days later, there was a park where in the good weather they had 10 after 10 after 10 of craftsmen doing wood and metal work. It’s a great place. Unbelievably we came down there in the middle of this wreckage and there was… I counted them, there were eight people who had their pictures up again. If it’s a typical time there’d be somewhere between 70 and 100. When I had this long kind of U.N. convoy, I said “Stop I want everybody to get out and buy something.” We gotta buy something from these eight people. We gotta support them.”.

Bill Clinton [00:01:08] So I went over and bought a couple old pictures. And this guy says “Wait, wait President Clinton, you can’t go. Come here, you have to come here.” So I came around and he said, “In 2003 when you came here,” he said, “You came here you stopped here and you bought a picture from me.”

Bill Clinton [00:01:24] So he said, “I hope you’ll do it again.” So I bought another picture. And I said to the guy, I said, “You know, I just, I cannot believe you guys are here. This must be so hard.” He said “It’s not hard for me I have nothing else to do I lost my wife and children. I’m alone now.” And I said, “How can you do this?” He said “It’s the only way I can honor them. Look around we’re a little family here. They know if I can be here they should be too. And we have to begin again”.

Bill Clinton [00:01:52] I mean that’s the kind of stuff you come up against. Just the unbelievable courage and goodness and decency. You know somebody that’s not all that different from you, is broken and still standing and still going on and sharing one more precious day of life.

Newscaster [00:02:09] A lot of these people are lucky to be alive but they don’t feel very fortunate.

Haitian [00:02:14] We need some waters, some food, everything that we need some medicine you know whatnot.

Newscaster [00:02:19] Along this short stretch of just this one street, we find disaster next to disaster where there used to be people’s homes.

Bill Clinton [00:02:28] So why am I telling you this? Because if you’ve never been in a natural disaster. If you’ve never been in a town that was leveled by a tornado or a hurricane if you’ve never been in a community that was totally flooded out, if you’ve never been there, you forget these are people just like you and me. They’re worried about their children or their grandchildren or their parents or their grandparents. You know they don’t know what to do. You go into a disaster area where people are flat on their back and their children are dead and they’ve lost every letter they ever saved from their loved ones, and they have no family pictures left, or you know, you name it. There’s a story everywhere you go.

Bill Clinton Montage [00:03:15] Now why am I telling you this? Because it is your future on the line. Why am I telling you this? Why am I telling you this? We can do this. Why am I telling you this tonight? Not to take you down but to keep you looking up. Why am I telling you this?

Bill Clinton [00:03:29] Welcome to Why Am I Telling You This, the Clinton Foundation podcast. In each episode of the podcast you’ll hear from me, Chelsea, or Foundation staff and partners. We’ll all share stories of the people, issues, and events that have shaped our work and our world. Today I’ll be talking with José Andrés who is an American immigrant success story.

Newscaster [00:03:52] José Andrés who’s already well-known to food-loving television audiences, is also becoming increasingly known for his work to help in the wake of natural disasters like Florence…

José Andrés [00:04:03] World Central Kitchen, which is an organization I created around the Haiti earthquake is a very simple idea. We make sure that where there is hungry people especially under very difficult circumstances, that people are going to have a decent plate of hot food.

Bill Clinton [00:04:19] You know, I always had this enduring image of José sort of standing with broken concrete blocks and wire and mangled metal all around him flipping fried eggs, just because it’s… somehow he always finds a way to find a kitchen. That’s why we’re speaking to him today. And José let’s just jump right in. How did you decide to become a chef?

José Andrés [00:04:44] I always believe in following life. Life has a plan for all of us. Sometimes we decide to listen, and sometimes we follow and sometimes we fight it. I’m the type of guy that listens to life. And my father would love to cook, men cook in Spain. It’s like, if you are not the chef if you don’t feed your family if you don’t feed your friends you are not at the right social status. Cooking is part of who you are, makes you better. And I always helped my dad cooking at home, obviously my mother she was a great, a great cook and I was not doing very well at school let’s say in the traditional education system. But it’s not like I failed because I didn’t care. I was spending more time hands-on working in restaurants around Barcelona every hour I had three, than going to school again. The traditional educational system was not something that was the best way for me to learn and I always was trying to find other ways that I could be better.

José Andrés [00:05:50] That’s how I became a cook I became in love with food but probably the moment, Mr. President, was when helping my father in one of those Sundays that he will cook for all his friends. One day we could be 20, other days we could be hundreds. My father will put me always in charge of the fire. He will send me to the forest to gather the wood and I will make a fire. He will have these very big by a pan, a gigantic pan where we make rice dishes in Spain. And that day I wanted to cook. I didn’t want to make the fire anymore. I was doing the fire for too long. Say “Daddy, I want to cook.” My dad said, “No you have to make the fire. You’re the only one that knows how to do it. It’s a big paella.” He sent me away because I got very upset, said “We’ll speak later.” When the paella was made, he got me aside and he told me “My son, I understand you wanted to do the cooking to put the spoon to steer the pot but actually you were in charge of the most important which is making the fire and controlling the fire. If you control the fire you can do any cooking you want control the fire and you will be in control of your destiny.” I think that probably was the moment that they saw that yes, cooking was in my future, not just physically that was going to be my profession but understanding that if we all learn and understand what our fire is, we can achieve anything we want in the world.

Bill Clinton [00:07:21] What a wonderful story. You know we started working together about a decade ago in Haiti. Ever since then, when we come in contact it’s usually because somebody is in trouble and you’re there trying to help them.

José Andrés [00:07:33] It’s true that I began working with the Clinton Global Initiative right after the earthquake in Haiti, but not because I’m here and this is your podcast and you’re the president and this is your show and I’m trying to use to look like I want to impress you, but you had a huge impact on me Mr. President. I need to go back to 1995, 1996,  Washington D.C. I arrived Washington 1993 myself. And you were coming every year around Thanksgiving time, even you show up a few other times with Mrs. Clinton. You came to a place which is still is one of the most amazing organizations called DC Central Kitchen, where Robert Egger the founder one of the of the guys that has had a huge influence on me, created this kind of badly called soup kitchen because it’s much more. Feeds say 9,000 people a day. And you were there, peeling potatoes and cooking turkeys. But also we take homeless out of the streets and then we clean them and then we train them to be cooks and then we graduate them and then we find them jobs in the community. It’s a type of organization that we need to be telling America about because they are really effective and these organizations that they don’t throw money at the problem but they invest into solutions. And in one of your visits you were working hard like anybody else, but one time you kind of gave a speech because was senators and congressmen coming in also. And in your speech I was 26 years old, for some reason you put me in that speech and you mention José Andrés as an example of volunteers in America.

Bill Clinton [00:09:24] Every year, listen to this every single year here 5,000 volunteers roll up their sleeves and give something back to their community. People like José Andrés, one of the premier young chefs in America. Is he here today? Stand up here José. Despite the literally crazy demands of his job, he comes here every single week to share his passion and his skills with all the students. And he encourages other friends to join him every time he comes…

José Andrés [00:09:56] And I’m telling you that that had a huge influence on me because you know you did recognize me and I didn’t expect that I was just one more person. Because it takes a village to feed and empower a lot of people. And that I remember forever, the day that President Clinton kind of recognized José Andrés a 26 year old boy. So you had a big influence on me in that sense of service to the community and going beyond your duty to serve others. And I’ve never stopped quite frankly.

Bill Clinton [00:10:29] You just arrived before we started this conversation from Mozambique where you’ve been helping people in response to the terrible cyclone Idai which a lot of Americans I have the feeling don’t have any idea how truly horrible it is. Partly because it hit a lot of places in inland Africa and we haven’t gotten enough film of it, but it’s one of the worst natural disasters to hit the lower part of Africa in a very long time. So give us an update, what’d you do in Mozambique? How are they doing?

José Andrés [00:11:00] All right. So in the moment we heard about this cyclone, 72 hours later we had the team, we opened a kitchen, then we opened a second kitchen. We are feeding around fourteen, fifteen refugee camps, schools and hospitals.

José Andrés [00:11:17] And I’m here in a camp called Peacock here in the city of Beira. Today we are serving chicken with rice. You see big lines for two, three, four hours. I think it’s around 1,500 people here. I see a lot of tents…

José Andrés [00:11:35] Yesterday, we reached almost 20,000 meals a day. We already reached over 150,000 meals. And that’s why I went there to make sure my team was doing good, that we were doing the right thing with the cholera outbreak. Actually I’m very happy because we are super clean the way we work, the way we make people wash their hands before they get the food et cetera et cetera. And in the process we feed as many people as we can. So we partner with World Food Programme, we partner, obviously United Nations and it’s going well. I don’t feel we’re helping; I feel we’re still learning. Every time I show up, I show up with all people that they’ve been before with us in missions but always we tried to bring new people. Why? Because it’s very important that we make people learn. How do you learn? By being there hands-on.

Bill Clinton [00:12:21] This is a truly global organization. And it’s with the World Central Kitchen and how you have been able to mobilize people. This has been a busy time for you because I want to come back to Puerto Rico in a minute, but after the terrible hurricane damage in Puerto Rico, José was there and we started working together again there. But he’s also been to the Venezuelan border to feed people, to the Nebraska flood lands to feed people, and one of his World Central Kitchens kitchens was in the parking lot of my presidential library in Arkansas. Because we had an unusual number of people in and around Little Rock affected by the government shutdown.

Newscaster [00:13:09] In Little Rock, furloughed employees get to enjoy a chef made meal. It’s part of the World Central Kitchen which sends food trucks to natural disasters or where there’s some kind of need. We’ve got the need here. All over the country for most KARK 4’s Rebecca Jeffrey shows us what’s on the menu for a lot of furloughed folks and for how long. Yeah…

Bill Clinton [00:13:27] So the government shutdown was a national emergency to a lot of people who weren’t getting paid and didn’t have any other way to feed themselves. How much trouble do you have getting adequate supplies to do what you’re supposed to do?

José Andrés [00:13:39] Well the truth is that…let me bring it to America. One place that I have nightmares because I wish I was there, is almost a place like I wish I was able to go back in time and be there and being able to call you and say, “I need your help.” Katrina the Superdome.

Newscaster [00:14:01] Thousands are still corralled here at the city’s sports arena. The Superdome. Soldiers from Oklahoma and Texas have piped in music but it doesn’t seem to lift the mood. One of utter despair.

José Andrés [00:14:17] We remember the nightmare stories were coming out of the Superdome. Thousands of Americans in that place without basic water, supplies, showers, food. Women being raped. All these stories we heard. Do you know what? Entire stadiums? Entire arena? A sports complex? Yeah, people will describe it as a place that you go to watch an NBA team or concert. But let me tell you how I describe it. It’s a gigantic restaurant that entertains with NBA. That means you send two trucks; you send a little army of cooks. In two hours we opened all the places that serve you the hot dogs and the burgers. And in two hours we are feeding every single person. America’s gigantic restaurant. The only thing we do is we go, we oversee. What is left? What can we activate? Do we have a kitchen? Do we have to bring a generator? Do we need to bring gas? It’s always something around you. What we try to do is maximize what is around us.

José Andrés [00:15:27] So when I go to more difficult places like Mozambique or like Venezuela or Colombia in the border it’s not any different. It’s always a restaurant somewhere. It’s always somebody with a generator that is not juicing. It’s somebody always with LPE. It’s always, it’s always the resources out there. Only you need to be very quickly in adapting. That’s what World Central Kitchen does. We don’t own hard assets. We don’t own hardware. We own software. We can go anywhere and adapt. If I am waiting for a kitchen that is supposed to be deployed by the military or by (inaudible) who knows who, sometimes it’s a week, two weeks, three weeks later and you’re still waiting for the kitchen. We don’t wait. We don’t plan. We don’t meet. We arrive, we find the kitchen we start cooking and we start feeding. In the process, the plan shows up.

Bill Clinton [00:16:18] When you go into a disaster zone is the first thing you do, ask for the assessment of what the cooking capacity is right now? Is that what you do first.

José Andrés [00:16:26] Yeah, we will very quickly assess where are we cooking. Who has control of goods, dry goods, any vegetables, anything that’s available. We’ll make sure electricity through generators is covered and obviously gas. Those are kind of the four areas and the fifth which is the most important. Besides the people that fly in first, who are the local… the local leaders that can help us. And the great thing is that as you know the world has to eat every day. So it’s millions, hundreds of millions of people that they are cooks and we realize that people love to come together and become one. And that’s what we do. So yes the cooking facility is very important for us and that’s just ready before we land we already know. Right now and thanks to your initiative Mr. President obviously for Puerto Rico and the Caribbean every time we have a better idea of what are the facilities we may use in case for example of another hurricane. So we have more than 20, 30 food trucks that we can be activating immediately. We have many kitchens around the island for example in Puerto Rico that we know which ones are the ones that indeed they are safe from the hurricane because you cannot just say “one kitchen,” you have to prepare for the worst of the worst. So you have to have many so you are safe from all of them been badly damaged. So very much, that’s what we are doing in places we’ve seen before. Now I know what to do around Antigua if the volcano explodes again. We know what to do in Puerto Rico if something happens again. We know what to do in Florida. We know what to do in Nebraska. We know what to do in the fires in California. So every time we answer to one of those what is very important for us is that all this information all this know how doesn’t disappear.

Bill Clinton [00:18:22] Let me ask you this when you leave a place…World’s Central Kitchen, and then I want to come back specifically to Puerto Rico because I don’t think still people in the United States fully understand the dimensions of the challenge and how we have responded poorly I think. But when you leave a place, do you do an inventory of the kinds of supplies that should be…I think the term of art is pre-positioned, that’s stockpiled so that if there is something else that happens someone who knows less than you do can show up and figure it out in a hurry?

José Andrés [00:18:55] We are, we are talking about that and specifically thanks to the different groups you’ve created around that issue. But sometimes I feel like and don’t misunderstand me with that but too much planning sometimes is too much. We need to do the right planning. And with that I mean the most important is obviously showing up. And the most important is to start doing what you’re supposed to do. Let’s say generators, a lot of the people that die in Puerto Rico Mr. President, they die because lack of electricity. Why? Because it’s many other needs that they had. Issues breathing… They needed machines to help them breathe. My mom had one. I know it needs electricity and recharging if she’s going away from home. When people had no electricity for weeks and months in different parts of Puerto Rico, high up in the mountains or they had a generator and somebody could provide them gas or those people were going to eventually get in trouble and maybe die. I can tell you that we had hundreds of generators piled in San Juan for weeks. But nobody was doing the distribution.

[00:20:11] Sometimes to have assets doesn’t equal a good response Mr. President. To have the assets alone is not good enough. Distribution is key. And distribution, you need people that really are very much willing to do whatever it takes to reach bring that generator, that plate of food, those medicines or whatever it takes to the people that need them. So distribution to me is more important than the pre-positioning of the assets. Even, don’t misunderstand me. Wilmington, we did a very good job I was very happy with my team. Why? Because before the hurricane came in, we already had four kitchens pre-positioned around the state. But more important, in Wilmington we had two tracks because we knew that the hurricane was coming that way. We had two entire trucks full of food worth 10 days for at least 10,000 people.

José Andrés [00:21:04] Hello people of America here… José Andrés already from our headquarters in Wilmington. We have another kitchen in Raleigh. We are going to be producing today between both kitchens on the north of 15, 000. If it’s needed probably we’ll reach 20,000. I think we’re gonna be feeding a total of around 25 shelters. We are doing the math…

José Andrés [00:21:28] So yes to understand the assets and pre-position those assets is very important. But what is more important at the end of the day is the willingness to adapt, and then the willingness to do the solution. If you don’t do the solution that’s a matter of how much, how many assets you have in hand. If they don’t reach the people, it equals zero relief.

Bill Clinton [00:21:49] Look let’s talk about Puerto Rico just a little bit. It’s amazing to me but apparently a lot of Americans don’t even know that Puerto Rico is part of the United States. It’s a territory, but as a territory it has different rules in terms of how it gets health care for example. They are not in Medicaid, they don’t get the SNAP food assistance programs, they get block grants. And lately there’s been a fair amount of confusion about how much aid they’ve gotten. So I mean we know about that, I don’t want to get into politics but let’s just talk about facts. I mean, you and I have been there. I’m interested in the people. The American people need to know this. Last year before the Democrats had one house of Congress, when both houses were Republicans they voted to give $600 million dollars in food aid to Puerto Rico which has still not been released. We still need help in Puerto Rico just feeding people because of money that has been appropriated by our Congress on a totally bipartisan basis has not been released so we need to think about going forward for Puerto Rico. How they cannot be hungry again and there are lots of other health and development issues. But this is crazy, they are Americans.

José Andrés [00:23:09] But they know that you believe as many that Puerto Rico is a huge opportunity for America.

Bill Clinton [00:23:17] It’s a rich island. It is rich in human and natural resources. It’s an ecological miracle and it should be a very prosperous place. And to go back to what you said I know there’ve been some problems in the past but recently we went to Puerto Rico together to look at what is being done that we’re helping on or maybe could help on. And you took me to meet this astonishing young couple who could be making a lot more money doing something else who decided they wanted to do environmentally sustainable farming.

Franco [00:23:50] FRANK. Right. Natalia. Welcome to Lafayette.

Bill Clinton [00:23:58] How much land do you farm comfortably here?

Franco [00:24:01] So we have an acre and a half of land. We started only cultivating half an acre. And after Maria we have taken our commitment even further and we grow to the other acre we have available. So now we have an acre and half.

Hillary Clinton [00:24:17] And who are your customers?

Franco [00:24:18] My customers are basically direct consumers. So we have been growing the business on the farm through word of mouth. So now we have like a big network of people, family and people that know people have come to support us and buy our products locally.

Hillary Clinton [00:24:34] Are they a subscriber to your….?

Franco [00:24:35] Yes, yes. So basically we deliver direct to them either in their houses or their…

Bill Clinton [00:24:42] I thought a lot about that young couple you took me to see.

José Andrés [00:24:45] Yeah that was.

Bill Clinton [00:24:46] Franco.

José Andrés [00:24:47] Franco and Natalia.

Bill Clinton [00:24:47] Franco and Natalia. And we were out. They were so fit and he was tall and skinny as a rail and they were young but they were well educated. You know the people I help in Africa; they want their children to go to school so they can do better. And all they’ve got is a half-acre of land or an acre of land. And it’s a joyful thing. But the thing that was encouraging about the Puerto Rico project is these people were young and educated. They were taking a hit to become farmers for the first two years of their married life, their family life. They won’t do as well probably as they would have if they done… there were probably ten other things they could have done. They did it because they know that they had to learn to feed themselves on an island. They know that sustainable agriculture and small farmers are the future of the region which is one of the two most vulnerable in the world to climate change and rising sea levels. They know this. And that’s something you should be really proud of, that you’re involved in something where young, articulate, educated, far-sighted people say, “I’m going to stay here and we’re going to make this a farm just a place on the side of a hill”.

José Andrés [00:26:01] And what you saw Mr. President is what we call “Plow to Plate”. Where we did in the first eight, nine months during 2018 and give grants between 5,000 and 25,000 to around forty farmers. And then just recently after your trip to Puerto Rico with your foundation, we announced with partners that we are going to increase the total number up to four million dollars to impact another 200 farms. So those two farmers you’re talking are a big family of farmers all across the island that we hope to make sure that those farmers are part of a new Puerto Rico. Where Puerto Rico will stop importing 90% of the food they consume. This is crazy. We’re going to try to reach at least 25-30% of the foods Puerto Ricans eat to be produced in Puerto Rico. Creating a local economy. Creating jobs. Creating an identity and make sure that in the process we keep pushing Puerto Rico forward.

Bill Clinton [00:27:05] First I want to thank you, because I know how much you do and so many places you’re always there but I thank you for also being willing to stay in places until they don’t need you anymore. So bless you for that and all else and thanks for everything you’ve done.

José Andrés [00:27:22] Thank you Mr. President.

José Andrés [00:27:25] Farms like these, show us the way for Puerto Rico being fully independent. So right now World Central Kitchen has invested giving grants to more than 40 farms. Very soon we’re going to be announcing many more with CGI as our partners. And I want to make sure that World Central Kitchen in a way exists because we’ve seen the work of CGI over the years. How CGI goes community to community, country to country and use partners with local initiatives to make them stronger. (Inaudible) World Central Kitchen what we are is a food arm of many of these initiatives CGI does. We are chefs for the people. So we help to make sure that the places we are they become fully independent. After Hurricanes or well beyond where food is the agent of change to give farmers like them a better future.

Diandra Haynban [00:28:16] I’m Diandra Hayban. Here at the Clinton Foundation, I’m part of the team that’s supporting places like Puerto Rico, U.S. Virgin Islands, Dominica, and the wider Caribbean region, as they build back better and prepare for future inevitable storms. Since 2017, we’ve brought together more than 1,100 people through our action network resulting in more than 50 Commitments to Action that help create sustainable energy, support small businesses and farmers, grow the economy and provide housing, education, access to clean water and health care. To learn more about how we’re helping people across America and around the world, head to Clinton Foundation.org/podcast.

Bill Clinton [00:28:55] Thanks for listening. For more, listen on Apple Podcasts or wherever you listen to podcasts. Next on Why Am I Telling You This?

Chelsea Clinton [00:29:04] Could you talk a little bit about the gross inequity in book access in our country for kids.

Susan Neuman [00:29:10] So for example in one community 833 children would have to share one book. That’s all that was in the community, that’s all we found. Books are incredibly important for children’s achievement, and we’ve got to make sure that we level the playing field.