tv Charlie Rose PBS May 15, 2013 12:00pm-1:01pm PDT
>> charlie: welcome to the program. tonight paul farmer talks about haiti, global poverty and global health. his new book is called "to repair the world. ". >> and the biggest trouble, the big challenge for medicine, a big human rights challenge for medicine in the 21st century and on is the outcome gap. that is, we have these things coming down the pipeline, right, the discoveries, diagnostics, the tools, but until we can deliver more effectively to everyone, we're going to see outcomes that diverge. >> charlie: disparities. we conclude this evening with jessica buchanan and her husband erik landemalm. their new book tells the story of her 93 days held captive by somali pirates. >> i think there are different layers emotionally that you experience in telling this story. yes, i mean there is part of it that is very cathartic and very
therapeutic but it can be very difficult. every time i tell my part of the story, i maybe remember something different that i hadn't remembered before. it's a good reminder of where i'm at now and how things could have gone. >> i had never faced that kind of evil before, that someone takes what you love the most and not just that, they also try to destroy for anyone that is connected to that person, they try to take whatever they can, monetary. they try to make you feel as bad as possible so that you're willing to go ahead and give them what they want. >> charlie: the challenge of global health and global poverty and what it's like to be held captive by somali pirates and
captioning sponsored by rose communications from our studios in new york city, this is charlie rose. >> charlie: paul farmer is here. he's one of the few to hold the title of university professor at harvard university. he's the chief at brigham and women's hospital in boston. his impact as a medical anthropologist spans the globe. he helped found partners in health to deliver health care in haiti in 1987. he was united states deputy special envoy for haiti when the earthquake of january 12, 2010 devastated the country. he serves as u.n. special advisor on community based medicine and lessons from haiti. his new book is called to repair the world. he speaks to the next generation. he is the collection of some of his most memorable speeches. speaking of speeches here is melinda gates giving the commencement at duke university on sunday where she spoke of him. >> i first met paul in 2003.
i went to travel to his clinic in haiti. what struck me about that visit was, first of all, it took us about... it took us so long to get the 100 yards from the vehicle to his clinic. and the reason for that was that paul introduced me to every single person along the way. every single person. and he introduced them by first and last name. he told me something about their family. he asked them about their lives. and when we arrived at the clinic on the outside there was this beautiful little trellis with morning glories growing on it. when i asked paul about it e. said i built that myself. i built it because i wanted the people here to see the beauty in the world that i see. i also wanted them to have a little bit of shade in the sun while they wait to go in the clinic. the very next day i traveled to another clinic in haiti in port-au-prince, set up for the same reasons, to give great health care to the people of haiti. the doctors there went for all
the right reasons but i noticed something very different in that clinic. the doctors thought of themselves as health care providers. they thought of theaitians as recipients. consuelyven though health care was good quality health care was going on there there was a lot of resentment in that clinic between both patients and doctors. >> charlie: what questions should young people be asking themselves today as they leave a university environment? >> i think one of the things is to just think back on the privileges to step out of all, you know, the swirl of everyday life. i didn't appreciate that when i graduated from college. up went the next year to haiti the year before i went to medical school. and i often found myself in situations in haiti where i wish i could stop and think about this or read about it. and understand what i'm seeing more. it sounds like a ridiculous message to give because it's what all the professors are saying as well. but the other thing that i...
the point i try to make in this book is that these really complex problems like health disparities here in this country or in any other are not just problems for experts, for physicians like me, for example. they're everybody's problem. so is climate change. so is the fact that so many people, over a billion people live on less than a dollar. >> charlie: they're everybody's problem because they effect everybody or they're everybody's problem because they have to be part of the solution? >> well, i think they're everybody's problems for those and other reasons. they do affect everybody in one way or the other. either in minor ways or in devastating ways. you could argue, looking back at what we discussed when i was last on your show, the earthquake in haiti, that affected obviously the haitians most directly, the injured among the haitians most drctly but if more than all households in the united states responded in some way, it affected everyone. it also affects people because of the famous story about the
good samaritan. i mean we're not doing... we're not asked to do everything we do because we know the people in question. this was a stranger that was the idea in the parable. i think young people in the united states are well advised to remember that. i think a lot of them are interested. >> charlie: is there an increasing sense of commitment to give back, to make a difference, to lead a life that is not necessarily about commerce? >> i think there is. i mean, you know, if you look inside my arena, medicine, it's quite clear to me that compared to 30 years ago when i began my medical studies at harvard, again i've always stayed at that institution and so i know it best. each year there seems to be more and more students interested in health disparities, interested in health protection, interested in integrating protection and care. and interested in the problems of people living in poverty and facing ilhealth.
that's growing. l.see it outside of the medical i see it everywhere. >> charlie: i want to come to health too. let me stay with the speeches. how many of them are commencement speeches? >> i didn't count them. i would say the majority. 80% of are commencement speeches. >> charlie: always a different theme? >> well, the theme is always the same. >> charlie: which is what? a lot of unnecessary suffering in the world. we've got to stop it. >> charlie: just say that. i know. i should. >> charlie: you get up and say, i am paul farmer. there's a lot of unnecessary suffering in the world and you have to stop it and say thank you very much. you get roaring applause. >> i will do that this year. charlie: you really should. i try honestly and really hard... >> charlie: that would be the most famous commencement speech in the history of commencement speeches. too many undue suffering in the world and you have to stop it. thank you very much.
>> the stewed erchts would love it. i've gone over my time on many instances because the subject is always the same. but then finding ways to engage people. in issues like, you know, how to rebuild in rwanda after genocide or the subject of the earthquake or, you know, some of the pretty grim things that we've seen, you know, epidemic disease. finding ways to involve people. or homelessness, lack of education, all the kind of things i tend to think about. i think there has to be a way to tell these stories more compellingly. >> charlie: suppose that you are a religious man and you believe that there will be an opportunity to go to some after life and god stops you there or st. peter, whoever does this, and says, if you answer this question right, farmer, i'm going to let you in. >> i'm going to give you a green card. snairlts give you a green card. here's the question. do you know why you are the way you are?
i mean, the themes are the same and you do have this sense of commitment. and you're looking not only for justice and value, but you're also, you know, there is a real important, continuing stream through you having to do with the fact of the way we look at those who are poor and suffering. >> i mean, i see that potential in everyone. >> charlie: to be who you are. to be who they are, recognizing the depth of unnecessary... >> charlie: do you know why you are the way you are? >> i don't know. charlie: nothing happened. it wasn't the make-up, it wasn't the course or a professor? >> well, i can go into each of those arenas and say there were professors and courses. there were experiences and events. but if i had to choose one, i would say it was going to haiti after i graduate from college. >> charlie: what did that do? well, you know, i must have
been reading a lot about it and wanted to go there or i wouldn't have ended up there for a year. but i saw some things there that i had read about before. you know, someone who died of malaria, for example. or, you know, the impact of an injury. it could have been a minor injury. but it ended up being fatal because there wasn't a health care system. you know, i saw those things in that year before i began studying medicine. and i said, i want to do this. i think there's so much, you know, so much we could get done in a place like haiti where there isn't a bad system to dismantle in terms of health care. but you can start again afresh. when i think about, you know, if it's 30 years later, more than 30 years later, for example, with the boston marathon bombing, you know, then you know a lot of people suddenly know we
do need medical protection. we do need safety nets. we do need hospitals like the brigham where i am or the mass general. you know, for someone who is injured or seriously ill. and the idea that there would be places like haiti that don't have those institutions or other forms of social protection is suddenly people get it. so there's this revalatory power of event, back to your question, like an earthquake or, you know, an accident or a bombing in the case of boston. but i had it much more slowly and over the course of a year when i was 23 years old. of course there are other people who go to places. >> charlie: you've had a long-time involvement with haiti. where is it today? >> haiti is making progress. you know, i don't want to be overly optimistic. i may have been overly pessimistic last time i was on your show. and i understand why i felt that way. there was so much good will
turned to haiti after the earthquake but it didn't add up to... we didn't add up to greater than the sum of our parts. now, individual acts of expert mercy, for example, if someone had a crush injury in the earthquake and was taken to an operating theater and had, you know, the proper procedure which happened many times in haiti after the earthquake because people showed up to help, then they did have, you know, whoever was taking care of that person, did add up to the sum of his or her parts, if you will. but overall, looking at all of the interventions, it wasn't good enough. and then there were other complications. the cholera epidemic actually was not the result of the earthquake but a reflection of tremendous water insecurity. where are we now? i mean, i just came back from a terrific trip to haiti. i mentioned probably in passing
that partners in health and its partners, our haitian partners, the ministry of health and the many we've worked with over the years, we just opened a beautiful medical center in the middle of rural haiti, in central haiti. it's the largest solar-powered hospital in the developing world today. it has modern... five beautiful operating rooms, 300-bowed institution. it's really terrific. and it fits into a system that goes all the way from people's comeuntsz to clinics and other hospitals. it fits into a system. you know, that's very uplifting thing to see, that kind of progress in three years. what brought cholera to haiti?a. >> well, it almost certainly came with people with people who came out of cholera endemic region. thrtion cholera. just like h.i.v. was introduced so it's always a story like this. it's probably people from nepal, troops from
>> charlie: u.n. peace keeping troops. >> yes. and as i saw there was heavy rotation in the months or weeks just prior to the outbreak. but as we saw again with h.i.v., the same cycle of accusation and both local and international occurred there. i actually, you know, when i was a young man, wrote my first book about that topic. and called it "aids and accusation." because it's really inevitable in the history of infectious disease. >> charlie: the senior health and policy advisor said, quote, the united nations has a moral if not legal obligation to help solve a crisis it inadvertently helped start. it is wholly responsible for the outbreak of cholera that subsequently killed some 8,000 haitians and sickened more since 2010." she has a point. >> she does have a point. the question is really what can
be done now to slow it down and also what forms of remediation are possible? for example, nothing is going to bring back those 8,000 people, but there's still a lot to be done for all haitian families who have that water security, insecurity rather, and you know, we've only just started to move forward, the interventions that would slow down, for example, water and sanitation. if you look at our country, we spent 50 years building up municipal water systems in this country. and they're maintained. they've taken a long time to build. a lot of of resources to maintain. that hasn't happened in haiti. also just providing care to those already sick. finding them, identifying them, treating them properly. it's a lot of work to do still. i've actually worked with dr. ivers who wrote that piece, for many years. one of the things that we proposed right after the cholera
outbreak started was to introduce oral cholera vaccine for short-term protection while these longer-term interventions like building water security were to go forward. that happened, we did it in central haiti. and our colleagues in port-au-prince working with a group, they did it in urban haiti. now we know it's possible. that's all since i saw you last here. we've actually done that, rolled it out, shown that it's possible. nowm it needs to be done on a nationwide scale to protect the most vulnerable. >> charlie: do they believe that... >> you know, it's interesting when we interviewed a group of our colleagues interviewed haitians about how they felt about the future of the country there was actually a lot of optimism. not that it would happen. people felt that was a reason to have hope and a reason to fight to improve what was happening there. i think, you know, it's easy to pick up discouragement. certainly if you're talking
about people who are still in, you know, in camps, you know, i mean,... >> charlie: you mean like two or three years still in a camp. >> if you compare that to conflict in africa, there the mean duration in a refugee camp is probably over 12 years, a dozen years. >> charlie: 12 years? very long. on the scale of how long people stay in camps after political violence and war, it's much less but it should be less. it's right next door to the united states. and a lot of other countries that could help more, i think, with improving housing there. those are all chronic problems before the earthquake as you know. housing and secure, water and security, lack of medical care, lack of education. >> charlie: rwanda is meeting its millennium goals? >> looks that way. charlie: who else is meeting their millennium goals. >> in sub saharan africa i believe rwanda is the only
country on track to meet all its health-related goals. >> charlie: why are they able to do it? >> there are going to be a lot of competing claims of causality about that, right? i think a lot of it has to do with good leadership, a good plan, and rolling it out. i mean this is health care jargon but they're rolling out that plan in poor areas for people whose lives, you know, who have been so often neglected, rural areas, women. they have a good plan and good leadership. it's been very inspiring. >> charlie: makes a difference. does haiti have good leadership? >> haiti has... i think there are people, for example, i work with the minister of health. i think she's a great leader with a great plan. to automatically assume that there is not good leadership in haiti isn't fair either. my experience with the health minister has been great. to be a good leader though, you need civil service. you need in a way of having any fek in your nation, your...
>> charlie: you need civil institutions. >> you do. those are lacking. 20% of the... some people think that 20% of the civil servants, federal civil servants died or were badly injured just in that one way. as an american and as a physician i have to say that pet-far has been the most stunning exarm that i can think of, of human sol stater in the history of international health, period. yes, it has problems. yes it's too vertical. you can find all sorts of, you know, quibbles and things to change. but it's been... it's really opened so many doors. it's freed a lot of people to imagine a future where poverty and disease don't have to go together all the time. >> charlie: i don't know if the book gives appropriate credit for this. president clinton said when historians look back on george w. bush's presidency i'm inclined to think that they'll agree with me that his leading
contribution was pet-far. taking it from a concept which may sound like a dream to reality. with the bush administration began its due diligence on the draft policy. it called in (mumbling) with remarkable success in haiti. "it really is. when you go down to that new library, global health runs throughout it. >> i haven't been there. but it should. because again the failure of imagination i keep on ranting on about it in this book, people... because they're poor, they can't... and then you fill in the blank. they can't have good health care. they can't go to school. they can't have businesses. there can't be good institutions. the world is bad so we have slavery and racism and genocide. that failure of imagination, when you put resources like what the american administration put
in to pet-far. when you say it can't be true, that you can't treat people, the same species with the same disease in the place like rural africa. that can't be true. we said it wasn't true that you couldn't do i. but someone has to say, okay, show us. and once you had even a modicum of proof, that failure of imagination... that's ten years ago. i gave a lecture in boston, a medical lecture on friday, a few days ago. and it's the new england journal of medicine, the editor who invites one to give this lecture. sitting next to me was another editor of the journal, a physician at harvard also. and i said, hey, thanks for letting me write this piece some years ago. called "to treat... the major infectious diseases of the world: to treat or not to
treat." that was only 10 or 11 years ago we had nothing going on in treating these very difficult diseases like aids or drug resistant tuberculosis or cancer or congestive heart failure. nothing was going on for poor people in places like rural africa. i think there's a stunning reversal. >> charlie: you got a lot of criticism about that. when you look at that, i mean, you say, for example, not only should we be asking whether the poor are getting enough health care or compared to the rest of the world, they'll be getting more. they need it more. it will make a bigger difference. >> thank you. that's the fundamental idea that we crib from liberation theology, preferential option for the poor. that's from thee ol gee. >> charlie: i didn't know that. i didn't either. that is is where the diseases, they do the same thing. they go after poor people. why shouldn't medicine be he focused especially on the
problems of poor people. there's a lot of of talk of that in the 19th century. >> charlie: one thing is liberation theology. you also think that capitalism, that people argue too often using capitalism as a kind of... as an argument in the fight. yes? >> you know, i've been hearing about this argument or been involved in it ever since i was a high school student. people still talking about these same things. that's good. but i say to my students in medical school, never spend more than 12.4% of your time arguing because you'll never get any work done. there's so much work to be done again to provide basic medical services, to provide basic protection. again i think what a lot of people saw that in boston after the marathon. nobody who made it to the hospital died. because we have systems in p thn
the o.r. a lot of them... some of them are in the o.r. within 30 minutes. >> charlie: if you can do that, you can save lives. >> if you can do that, you can save lives. and if you can do that to prevent illness with, you know, vaccines, with family planning, with, you know, good, basic services, primary care, i think, you know, i think we're talking about being able to turn away from some of these, you know, diseases like tuberculosis and, you know, or h.i.v. disease or cholera or malaria. those are diseases that take a lot of lives early, young lives. we shouldn't be having to deal with those at this level for another decade. we should be able to take on the chronic diseases that affect people later in life. obviously there's always going to be cases of any disease in children or... but we have a lot of people dying young and unnecessarily. >> charlie: nobody knows what the balance is between developing new vaccines and
developing the ability to deliver what you have. >> or the aibt to deliver what you will have. that's what i'm say ing is that when we have the pipeline, preventives like vaccines or diagnostics, we can't do work without it, or treatments, when you have the pipeline open, it's still going to face a delivery challenge. you can't magic ale wave a wand and say ministry of health ought to be able to do this and we're done. that's what i like about people who actually go from their comfort areas and where they live and work and look at what it's like, go to rwanda, go to haiti, go to india. go to a village in malawi. go to a slum in a city somewhere in southern asia. see what it's like. what is i like to have to deliver? >> charlie: it was 2001 i think in a commencement speech at brown university. you know what's coming, don't you? >> i do remember that one.
charlie: you talked about a general anesthesia of the soul. >> is that over the top? charlie: (laughing) you are over the top. that's good to go over the top. go ahead. tell me what you meant. >> you know, it's just... first of all, in training medical students and working with med students and young physicians they don't really have general anesthesia at all. >> charlie: what do they have? they have the difficulty seeing the big picture outside of where it they are. it's not just doctors. but i was talking to people who that day would become doctors so what does that mean? if you're a surgeon you don't want him or her thinking about what's going on outside the o.r. we don't want that. and if you have a laboratory technician, you want him or her focused on their job but in none of us understands how all of it fits together and why some people have such poor health outcomes when they're living in
the same age as people who have better and even health outcomes if nobody's job is to think of that big picture we're in trouble. and the biggest trouble, the big challenge for medicine, the big human rights challenge for medicine in the 21st century and on is is the outcome gap. that is, we have these things coming down the pipeline, right, the discoveries, the dig sticks, the tools but until we can deliver more effectively to everyone, we're going to see outcomes that diverge. health care disparities. >> charlie: you've actually talked about the fact that they pay more attention to the bills they pay than need. >> this is a big pathology i think. i mean, i'm told that economists, who they study, i have a friend who is a health economist. he's a physician too. he trained with me and trained with jim kim. >> charlie: name? hris murray. harlie: all right. hris murray is a famous health economist and physician.
now this is 20 some years ago. i was asking him, i knew he had done a ph.d. in economics by very few doctors have done, right? i said what does w.t.p. mean. i was looking at this chart. he said it means willingness to pay. i said how do you calculate that? that's related to the g.d.p. i said isn't that ability to pay. this willingness to pay problem and this ability to pay issue are major issues for modern medicine. i mean, if you have a deliverable that is effective, a treatment, say, and there you are, you're in a setting where there are ten people with the illness and only one or two can pay for it. imagine how you feel if you've developed that therapy as a scientist or if you're a doctor or a nurse trying to deliver. it's a lousy feeling. we need better systems for protection again i want to go back to boston april 15. nobody who took at the emergency
rooms who took those people injured in the bomb blast is going to say, you know, what's your health insurance plan? is this person... we don't do that for a reason. >> charlie: do we do that in the emergency rooms now? >> it's supposed to be against the law for those who get in certain kinds of... have certain kinds of illness. is it done in emergency rooms all over the world? absolutely. there are tricks in the united states too where sometimes hospitals don't even have emergency rooms so they don't have to... >> charlie: explain to me one more time why we are, i think we're 37th in the world health organization's ranking of the world's health system. 37th. yet we spend more on health care than any other developed nation. >> i mean there are only a few possible explanations and i think we can strike several of them. it's not because we don't have good research-based medical institutions. >> charlie: probably the best. harvardschoolat are put into
basic science research are... >> charlie: it's not education. it's not the quality of the physicians and nurses. >> charlie: not the quality of the people. >> it's not the tertiary care institutions although they have their problems. >> charlie: what is it? it's that we don't have a good health care system. what mine by that is not just the obvious that we don't have a national health insurance program and that we don't... so there are a lot of insured people who get their care in emergency rooms. what i mean beyond that is for even people who have great insurance. >> charlie: what would you design if you were designing the best health care system in the world for america? >> if i could design the best health care system in the world for america i would gabbing to rwanda and say there are community health workers who work with people in their homes. their clinics where most people get most of their medical care. they're often nurse run and there are hospitals. they're all kinds of deficiencies and underinvestments there, but the
system is right. it goes from community-based care for chronic disease, right? because in the united states we... you have to think about... people have... the people who cost the system most, which is not my primary come. my primary concerns is outcomes. the people have multiple chronic diseases not just one. they don't have good health insurance or good primary care. they go to emergency rooms. i'm embarrassed to say it. sometimes doctors and nurses call them frequent flyers. there's even terms to describe people in and out of the hospital. it's very expensive to the system, to the federal or the state system. >> charlie: does obama health care. >> i think it moves in the right direction if it means by medical homes... >> charlie: why is there so much criticism? >> i don't know. i don't know. >> charlie: real he'll right now going through... people are saying the implementation of this was not thought through. causing all kinds of problems. >> i'm sure all those things are true.
implement takes hasn't been well thought through. there are preexisting problems. >> charlie: preexisting care supposedly was attended to here. >> i just think that we could design a system -- again i'm not an expert on this. but i think if we could design a system that did a better job managing care and prevention in the community we would have better outcomes. i'm not talking about what i'd like to do. but i'm talking about the system that could deliver. >> charlie: he's in fallujah. he's there. it was a terrible place for american solars. he's asking serious questions in terms of his mother. >> her story. charlie: what is my country doing to my mother, right? >> that's been part of it. again i'm not an expert in that area either. but it seems to me it's been used after that experience with the haitians back in the early '90s. >> charlie: paul farmer, the book is called "to repair the world.
"back in a moment. stay with us. >> charlie: in october 2011 american aid worker jessica buchanan and a colleague were kidnappeddality gun point in southern somalia. for the next 93 days they were terrorized and held for ransom by a band of somali pirates. buchanan's husband erik landemalm worked tirelessly for his wife's rescue as her health rapidly deteriorated. navy seal team six was ordered to attempt a rescue operation. buchanan recounted their ordeal this past sunday. >> all of a sudden i feel all these hands on me roughly grabbing at me. and i try to protect myself. and i pull the blanket closer on top of me. then i hear my name.
but it's not a somali accent. it's an american accent. and i can't compute. like i can't understand that somebody with an american accent knows my name. and they say, jessica, we're with the american military. we're here to take you will home. and you're safe. they pulled the blanket down from my face and all i see is black. black masks. black sky. and all i can say over and over is you're american? you're american? >> charlie: the seals left on other helicopters. she didn't see their faces, didn't hear their names. they appeared and they were gone. the only thing left in the camp were nine dead bandits.
>> mr. speaker snot it all ended just hours before the state of the union address as the president walked in he had a secret with defense secretary leon panetta that almost no one understood until later. >> good job tonight. good job tonight. >> after the speech, president obama called buchanan's father, jessica met her husband eric at the u.s. base in italy. >> charlie: jessica buchanan and her husband erik tell their story in their new book. it is called impossible odds. it was. i am pleased to have them here at this table. they appeared last night or sunday night on "60 minutes." so telling this story to scott pele, to me, to editors, is it cathartic? is he harrowing? is it what? >> i think there are different
layers emotionally that you experience in telling this story. yes, i mean there is part of it is that very cathartic and very therapeutic but it can also be very difficult. every time i tell my part of the story, i maybe remember something different that i hadn't remembered before. it's a good reminder of where i'm at now and how things could have gone in the impossible situation that i really... i was facing. >> charlie: more likely you would be there than here. >> in one way or the other, yeah. absolutely. i think it's a positive experience. what an opportunity to get to tell it. >> charlie: you say the worst moments came when you thought you might be killed. you thought you didn't have a chance to say good-bye to erik. you did not have children that you looked forward to having. this book is dedicated to our
son august. before you even existed you helped us survive the most trying time in our lives. >> absolutely. i had this vision that kind of just kept me going for a large portion of the captivity. it was of erik and i together with a baby. i just kept visualizing that over and over and over again to try to help keep myself strong throughout the whole ordeal. it struck me actually during one of the interviews that we've done that... how many people actually really get what they ask for? and what they've envisioned? that's exactly what i have right now. >> charlie: when it seemed almost impossible to obtain. i said to both of you, i love the picture. this is you. obviously this is erik and this is the two of you on the beach on the wedding day in kenya. >> exactly. charlie: it often said that it is harder or as hard for
those people who had the role that you did for parents, for spouses, for loved ones. their pain is as hard to deal with as hers. >> yeah. i think that... >> charlie: the pain of the circumstances. >> i think that you have to find your way of surviving day. from the side we have no idea what's going on. >> charlie: she knows. you don't know. >> exactly. we know that even if the worst would happen, then it could take weeks. it could take months. we could actually never know what would have happened to her. during the kidnapping it could take two or three weeks between that we had... at least that i knew roughly where she should be or we had a proof of life call or anything like that. anything that actually told us that jess was alive.
they really played with us. they tried to play with us, i should say. >> charlie: meaning? the piate ras or the gangsters, they tried to exhaust us as much as possible. they tried to take out whatever little hope that we had for this to go down any other road than that they would get an enormous amount of money. >> charlie: that was the only out. >> yeah. and i had never faced that kind of evil before, that someone takes what you love the most and not just that, they also try to destroy for anyone that is connected to that person, they try to take whatever they can, monetary and they try to make you feel as bad as possible is a that you're willing to go ahead and give them what they want.
>> charlie: take a look at this. this is a conversation i never knew that i would meet you, either of you. this is a conversation on this program on january 26, 2012. the national security advisor to the president is talking about where the president was, the action behind the scenes. here it is. >> the president had been monitoring the situation of jessica buchanan for an extended period of time. real he'll shortly after she was captured on october 25. he got regular updates from us on this. as he would in the case of any american who was kidnapped. we became increasingly concerned about this over time. by the middle of january, it was reported to him that all the sources we had women concerned about her health. he decided that we needed to take a very close look at planning for securing her
rescue. the military had been doing that planning but he wanted it brought forward to him to take a look at. opportunity arose. on monday, the day before if state of the union address. they refined, the military refined if plan. we did have increasing concerns about ms. buchanan's health. that evening that plan was presented to him and he approved it. the operation went forward early in the evening washington time on tuesday the night of the state of the union at about quarter of 6:00. he was preparing his state of the union address. >> charlie: when he went into the house of representatives and saw leon panetta, he knew it was a success. >> yes. he knew that they had been able to get her. >> charlie: that's something. two questions come out of that. what was your health like? >> it had gotten pretty bad. as you can imagine, the hygiene and the conditions that we were kept in, we were kept outside
for the entire 93 days. there were no facilities for using a bathroom. i was washing with very dirty water. i have a thyroid condition. and i had a bit of medication with me when i went in, but they with held medication from me as kind of a negotiation tactic. so i ended up with a really bad urinary tract infection and that was going into a kidney infection. i knew that if it went into a full-blown kidney infection there was no way i would make it out without extremely strong antibiotics. they wouldn't give it to me. so my health was deteriorating very quickly. very quickly. >> charlie: why did the opportunity present itself? >> for? charlie: for the rescue? for the rescue. i think that the conditions had to be such that my healtheeded be in a state where i was not going to easily recover.
>> charlie: that's the motivation. >> right. charlie: they had opportunity too when they did it. >> sure. charlie: why at that particular moment? >> it was a really dark night. charlie: so it's dark. it was. it was very dark. it was a very strange evening in the sense that usually there was somebody awake. there was somebody on guard. that night there were nine guards on the premises. there was always someone awake. this night everybody was completely passedded ow. they were just completely zonked, completely asleep. i actually was the only one awake when the rescue took place. >> charlie: what was the first moment you knew something is going on? >> i heard gunshots. i had heard a little bit of scrub, scraping. i thought maybe there were bugs crawling on my mat or something but then i knew something was happening when i started hearing these gunshots. i didn't think it was anything good. it was the furthest thing from my mind that could be a rescue
operation for me. >> charlie: what was your role during the 93 days? >> well, one initially i wanted to go in after jess. i think that's the instinct we're born with. i was told by f.b.i. who came inality a very early stage. ey toldeo think about what would the best for jess so i decided that, okay, that will be the motive for these 93 days, for whatever. getting medicine for her, being the liaison. i had been working with somalia for ten years at the time. been living in the region for seven years almost. i had a very good knowledge about the region. everyday for example i tried to have five to ten questions to ask both the f.b.i. but
especially also the crisis management team that was set up to make sure that they made the right decisions on how to negotiate with these people. it was also of course to start preparing for what would come afterwards. what would our lives look like after? make sure that friends and family understood that we couldn't leak things to media. we couldn't try to find the opportunities from or ask for other people to do opportunistic things to do for us on our behalf. so i guess in many ways i acted as the family or our family's liaison on the ground. and at the end on the 18th of january, two days after we
had the last proof of life call, then i went to... i made the decision that i didn't think that jess would be able to come out of this alive if nothing happened. i went to a meeting with, where representatives for the f.b.i. was present and told them that i don't think she's going to make it. >> charlie: why did you say that? >> i recognized the conditions that she had mentioned. i went to her doctor. he said clearly that either she comes out, you get her out or she will die. until then we had been very hesitant for a military rescue because we knew that it could bo ps and herlleae in danger but it could also put
all these brave men would have to do it in danger. >> charlie: you were able to communicate during the capture. >> yes. i mean there were several weeks where we were kept together and several weeks where we were kept apart. sometimes we could communicate very openly. sometimes we weren't allowed to. i think for both of us, that was definitely the saving grace mentally to be able to talk and to chat and share stories and share coping mechanisms and emotions. >> charlie: how did you cope? for me, i think the most important thing especially in the times of solitary confinement was structuring some sort of routine so that i knew that when i woke up in the morning i was going to do a, b, c and d. i spent time reviewing my life and thinking about every memory i could between the ages of 7 to
10 and then from 11-13. i thought about every date that erik and i had been on and every detail i could possibly conjure up. i would think about songs and lyrics and do math problems. i would make pictures in the sand. i mean whatever you can do to keep your mind... because you don't know how long you're going to be out there. >> charlie: and how did they treat you? was it... you are simply a bargaining tool? >> yes a big dollar sign. charlie: a big dollar sign. that's it. it's all about money. >> you're not a human being. you're just a means to an end. and so, of course, they're not going to let you die. but they'll let you get as close to that edge is possible. because they the don't care if you're in pain. and especially as a woman being surrounded by men, there was definitely lacking any kind of understanding about my personal
needs even understanding about emotions and how to express those. i wasn't allowed to cry. if i ever started to show any kind of emotion or distress, i was punished. i was screamed at. they came after me. to have to sit there and repress all that fear and frustration and anger and sadness even complicates the matter or at least it did for me. because how do you process through any part of it while you're sitting there if all you're allowed to do is just sit there stoically and not respond? emotionally? >> charlie: it's also extraordinary you never as scott showed in that "60 minutes" once you were rescued the seal team six team went on the helicopter and went away. >> they did. they just vanished. they came out of darkness and
disappeared back into it. >> charlie: do you somehow find that the way it ought to be? or would you want to have dinner with them tonight and express your deep gratitude? well, sure, i'd love to be able to say thank you. i mean, i said thank you as much as i could at the time but, you know, i was in so much shock that i think i would be able to articulate things better now. >> charlie: do they have a rule about no contact? >> i believe so. i mean, i guess it's a thankless job you could say. that's my perception of it. >> charlie: that they have a thankless job. >> they have a thankless job. charlie: i doubt that. i think they know the satisfaction of doing the job well. that's there. how did you find out she had been rescued? >> after afinogenov that discussion with f.b.i. notifying them what we as a family thought
would happen to jess that something needed to happen. i had the feeling in the back of my head that maybe something will take place or she will die. >> charlie: in other words, it won't be a ransom. it will be... >> no, it had come to a point where i had kind of started to take that out of the equation because these gangsters, they just used it as more of a pressure method. 6:41 a.m. local time on the 25th of january, i received a phone call from nairobi. i recognized the the number from the f.b.i. agent, matt. i knew that it could be a bad or good news. i hadn't heard anything. earlier that morning, there had been news that the pirates chopped off the hand of another
hostage they had in another pirate group. i started to fear for the worst. but he said that these free, they're free. they're okay. >> charlie: free? yeah. i can't remember the exact wording but they had been rescued. they're with us. >> charlie: so everybody wants to know how are you today? >> i'm very well. you know, i mean we still have some challenges. >> charlie: what's the challenges? >> well we have a lot going on. we have a seven-and-a-half month old baby boy. you know, there's a lot to process through. i mean this is... >> charlie: what you went through? >> i mean it's a long road. i mean i think there's a perception that once the rescue took place and i was back in my life and whatnot, that everything is okay. but that's really where the hard work begins. it's a different kind of work than surviving the actual... the
kidnapping. but i have a long road ahead of me but i have a lot of help. >> charlie: i don't want to invade your privacy but at the same time you wrote a book. what does that mean? i have a long road ahead of me? >> i still have a lot of nightmares and a lot of flashbacks and a lot of fear that i deal with. >> charlie: fear? yeah. you know, i have this little baby i have to take care of now. there will always be a part of me that worries, you know, there are bad people out there. and so i think your trust in the world changes a bit when you go through something like this. fortunately there are really good people in the world that come in and little by little restore that trust and rebuild it. i'm in the process of rebuilding that trust. so i have a lot of help and support along the way.
>> charlie: thank you for coming. >> thank you for having us. charlie: impossible odds, the kidnapping of jessica buchanan and the dramatic rescue by seal team six. you're familiar with seal team six also because of the mission in pakistan with osama bin laden. thank you, too, erik, good to have you here. thank you for joining us. see you next time. captioning sponsored by rose communications captioned by media access group at wgbh access.wgbh.org
a kqed television production. ♪ >> it's sort of like old fisherman's wharf. it reminds me of old san francisco. >> and you'd be a little bit like jean valjean, with the teeth, whatever. >> and worth the calories, the cholesterol, and the heart attack you might have. >> it's like an adventure, you know. you've got to put on your miner's helmet. >> it reminds me of oatmeal with a touch of wet dog. >> i did. inhaled it. >> people when they say sommelier or something. you sa