A Mighty Purpose (24 page)

The van crawled its way through the cacophonous congestion of Agra’s evening rush hour, horns blaring and tires screeching and people hollering—and all the while, Rohde kept pumping.

Only a few hours earlier, Rohde had posed for a photo with Jim and Ethel inside the ancient red-stone city of Fatehpur Sikri. In the picture, the three are grinning widely in the blazing sun as the magnificent, intricate Mogul buildings rise up behind them. After everybody had toured the site and returned to their van to rest, John Grant had said he wanted to explore some more. Jim, Rohde, and everybody else had replied that they were too tired, and that it was too hot—everybody, that is, except Ethel. She had eagerly bounded off with her son for another hike around the ruins.

The hardy mountain girl from Skyforest, California, had never shied away from physical challenges. In November 1946, after surprising Jim by arriving unannounced in Beijing (traveling by plane and freighter), she had joined him in working for UNRRA. She even volunteered for a trip down China’s Grand Canal via barge to oversee a big delivery of milk powder and other aid. The shipment was going to Communist areas in Shandong province, south of Beijing. Ethel was with her boss, a woman named Gladys, and their plan—once the delivery was complete—was to return to Beijing in a jeep that had been loaded onto one of the barges. But when they arrived, they
discovered that someone had forgotten to put antifreeze in the jeep. It was late November or early December at this point, and the engine block had frozen solid. When Christmas came and went with no sign of Ethel, Jim began to worry. He went looking for her, visiting an UNRRA office in Tianjin. While he was there, Ethel miraculously stumbled in, depleted and, in Jim’s words, “bedraggled.” She had just walked 150 miles. She happened to be pregnant at the time and suffering from morning sickness. She would eventually lose the baby.

Later, after Ethel had returned to the States, she would lose yet another baby, this one stillborn. At the time, Grant, who was still in China, “never felt … so helpless,” according to his oral history. These intense personal tragedies would later fuel his determination to combat infant mortality many years later.

Now, as night encased the ambulance carrying his dying wife in Agra, India, Grant faced another rare moment of total helplessness. He sat there and watched as Ethel lay disconcertingly still and as their eldest son, John, desperately tried to keep her alive.

Finally, they made it through the throng and arrived at the cardiology office in the warren of a packed, teeming bazaar. It was dark, but they could make out a small shack with a sign posted out front announcing that medical services were available. They hoisted Ethel’s stretcher out of the van and wheeled her in.

The place was low, narrow, and practically bare—save for a few paper scraps scattered on the grimy floor. A lone lightbulb hung forlornly from the ceiling. They lifted Ethel onto a table.
The taciturn cardiologist emerged, carrying what he said was a defibrillator. In an instant of sudden horror, Rohde realized that the device was, in reality, “a fake old radio set with tubes in it that lit up.”

He looked at the contraption, baffled. Then he got mad. This quack had wasted precious time. Had he actually used this on patients in cardiac arrest? Was he even a real doctor? Rohde didn’t have time to contemplate the implications. “This will not do!” he said, as he continued to pump Ethel’s chest and as rivulets of sweat trickled down his face. John Grant was still giving his mother mouth-to-mouth. Her pupils were still responsive. They could still save her, but they had to move. They had to try someplace else. Ethel’s chances ebbed with every minute that passed. There must be a working defibrillator somewhere, anywhere. “Get us out of here!” Rohde yelled.

They wheeled her back to the van.

“Take me to the university hospital!” Rohde commanded. Sweat soaked his shirt. His muscles burned, but his hands never stopped moving. If they did, Ethel would die.

After more interminable traffic, they pulled into the university medical school and stopped in front of the main door, but were told they had to try another entrance. They drove around the campus in the dark, looking frantically, slowing, speeding up, until finally they found the right building. They brought Ethel in and were directed to the emergency room. Rohde and John Grant had alternated pumping and breathing, and they were each still working feverishly. The second they stepped into the room, Rohde knew they would have to go elsewhere.

“It was a filthy, blood-spattered, equipmentless hole in the wall,” he says.

Exasperated, he pleaded with a nurse.

“We’ve got to get a defibrillator!” Rohde told her. “There must be one in this hospital somewhere.”

The nurse replied that there was one in the internal medicine ward upstairs. Again they were on the move, working on Ethel as they rolled her through the crowded corridor, praying that they would at last find a working defibrillator. They lifted the stretcher with her on it and carried it up a flight of stairs; all the while, Rohde kept pumping.

They barged into the internal medicine ward and found a large room with about thirty beds, almost all of them occupied. As they lifted Ethel onto an empty bed, a terrified nurse jogged in, carrying a defibrillator. A bolt of optimism shot through Rohde. Finally, they had found it. Maybe they could still bring her back. But when he picked it up, one of its wires dangled uselessly, disconnected from the paddle, almost as if someone had committed a calculated act of sabotage. Their hope crumbled. Rohde could not believe it. He had spent most of his career in the developing world, working in extremely daunting, austere, pathetic conditions. He was used to improvising, even when there was not much to improvise with, but there were certain things you could just not do without. And when someone had a cardiac arrest, a defibrillator was one of them.

Rohde knew that it was probably over, but he could see that Jim would not accept that. The head of UNICEF stood nearby,
his face ashen, his eyes pleading. He kept saying, over and over, “Don’t give up, don’t give up … please, Jon, don’t give up.”

Rohde looked at his boss. “There just isn’t a chance anymore, Jim,” he said.

“Just keep trying,” Jim replied quickly. “Please don’t stop.”

Rohde picked up the defibrillator. He could see that on both ends of the separated cord, a few loose threads of wire protruded. Pinching them between his fingers, he twisted the ends of the wire together until the cord was attached. He knew it probably wouldn’t work, but he was doing this as much for Jim now as he was for Ethel. He placed the pads on Ethel’s chest and gave her three jolts. The jury-rigged defibrillator worked, but barely. Ethel didn’t respond. She lay motionless on the bed.

There was one other thing he could try. He asked for an intracardiac needle—the kind of long needle used to shoot adrenaline straight into the heart. They didn’t have one. They did have adrenaline, which they gave him along with another type of needle—a needle that didn’t look long enough to reach Ethel’s heart. Rohde used it anyway, raising it up and plunging it into her chest. It was the absolute last hope of saving her. It might work, a small voice inside him said, it could.

It had been an hour and a half since Ethel’s cardiac arrest. Jon Rohde and John Grant were drained, debilitated, drenched, but they still kept trying to revive her. Finally, Rohde stopped. Ethel was gone.

Today, Rohde is tortured by the most wrenching kind of second-guessing. He thinks they might have been able to save
Ethel had they gone to the local army barracks and announced that the wife of an under secretary general of the United Nations was dying. The army would have had a defibrillator. “It never dawned on me that we could go to the army,” he says now. “If we had, things would have been different, because she was doing well for quite a while.”

Had Ethel’s cardiac arrest occurred in New York or in another, richer country, there is a very good chance she would have made it. She died for the same reason millions of people in developing countries die: the tools or medicines or vaccines that could have saved them were simply not on hand. As Grant had himself pointed out hundreds of times, it was a deadly gap between what was needed and what was available. It is a cruel irony that a man who had strived to bring lifesaving interventions to the poorest corners of the world could do nothing to save his own wife from what was most likely a survivable cardiac arrest. Grant and Rohde had both visited many bleak rooms in overrun clinics, not unlike the room they stood in now. And there, on the margins of the most marginalized places, they had met dull-eyed boys and girls lying in old, ratty beds, quietly dying from things no one—especially children—should die of. They had met parents who had faced the ultimate grief of surviving their own children. And for millions of these ostensibly doomed families, these two men had set about building an immense levy against loss and suffering and death—a medical bulwark to hold back the silent carnage of measles and tuberculosis and diarrhea and malnutrition.

None of this, of course, could help Ethel Grant.

They didn’t stay in Agra that night. Instead, they wrapped up Ethel’s body in a sheet, put her in a UNICEF van—not the “ambulance” in which they had spent the last harrowing hour and a half—and a UNICEF staffer drove them to New Delhi. During the trip, Jim talked as he wiped away tears, recounting his life with Ethel, giving voice to all the moments that now played vividly in his mind. He may have told of how they met at a fraternity party at Berkeley. Their wedding in December 1943, weeks before he was shipped off to the war. How she journeyed to China after the war to join him. How she made famous waffle brunches on Sunday mornings for visiting dignitaries. How they raised their family all over the world—in India, Sri Lanka, Turkey, and Washington. As the darkest night he ever knew scrolled by his window, it was almost as though Jim were trying to keep a part of Ethel alive.

When they arrived in New Delhi, they drove to the UNICEF office, where an official took Ethel’s body. Jim stayed at Jon Rohde’s house that night, and the next morning Ethel was cremated according to Hindu custom. Rohde held a reception at his house, which was flooded with diplomats and officials coming to pay their respects to Ethel—and not just because she was Jim Grant’s wife. Many of them had been to dinners she had hosted and some had been welcomed into the fold of the Grant family by its magnanimous maternal emissary. If Jim radiated extreme energy, she matched him in warmth. She had, no doubt, helped him win over many an ally.

The following day, Jim Grant flew back to New York, carrying his wife’s ashes in a small box. His executive assistant Mary
Cahill and a few other UNICEF staff members met him at the airport. “Ethel is no more,” he said in a low voice. His eyes had dimmed, and his skin had turned a pale gray—he was not the Jim Grant they knew. But in one respect, he was unchangeable.

Within a few days, he went back to work.

Big, sweet, and somehow knowing, her smile is bracketed by deep dimples. Her head is cocked slightly to one side and wrapped in a bright, colorful, poufy turban. Confident and unafraid and just the slightest bit playful, her expression radiates vivacity and possibility. Buttoned straps hang over her small shoulders. She seems to be wordlessly daring anyone whose gaze fixes on her to be as expectant and hopeful and cheerfully defiant as she is.

Selamawit Gebreyes was four or five years old when a photographer took her picture, and she unexpectedly became the face of the child survival revolution. Her blithe, pixieish image would be featured on brochures, stamps, and big posters seen by millions of people around the world. She would help UNICEF raise untold sums of money.

She was unaware of her fame at first. Indeed, people who saw her beaming face would not likely have imagined the arduous, austere struggle she faced every day. It was a typical existence for
a family in a cramped, confining slum in Addis Ababa, Ethiopia. She lived with her mother, three brothers, and grandmother in a garage—a dilapidated, windowless, one-room extension from the back of a bigger house. They had no electricity or running water. There was no toilet. There were no beds or furniture. The walls of their home were crumbling, and the tin roof leaked. It was almost always dark inside the cramped, tiny room, even during the day.

Selamawit’s mother supported them all by selling onions, peppers, and traditional Ethiopian injera flatbread in a nearby village market. Her father, a soldier in the Ethiopian army, had died before Selamawit had ever met him, according to an account of her life compiled by the UNICEF Ethiopia office.

His absence was painful. The quiet, watchful little girl saw the fathers of other children in her neighborhood. She watched them giving their daughters and sons bread, sodas, and candy. She did not have these things. She did not have a father.

The crying of young children all around was incessant. Many were sick with diarrhea and other illnesses. In urban neighborhoods like this throughout the developing world—where there was no trash collection, where sewage and garbage often mingled in the street or in tepid canals—deadly diseases raged. When small children died, Selamawit could hear their mothers wailing. She herself “felt an apprehension of death,” according to the UNICEF account.

To make extra money, two of her brothers shined shoes after school and guarded parked cars to make sure no one stole them. One of the boys’ customers was a staff member from the British
Save the Children organization. The woman and her male partner took a liking to one of the brothers, who would visit their apartment and do various errands for them. One Saturday, he stopped by for a teatime visit, bringing along his mother and little sister.

Staying with the Save the Children staffer at the time was a professional photographer named Louise Gubb. She was working on a freelance basis for several UN agencies, including UNDP and UNICEF. When she met the Ethiopian family, Gubb was immediately struck by Selamawit. “Her face projected the innocence and joy of childhood,” Gubb recalls in an email. She asked the girl’s mother if it was okay to take her picture for UNICEF, and the mother said yes. They went out onto a balcony to snap the photo.