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Remarks of Former First Lady Rosalynn Carter at the National Press Club, Washington, D.C.

MODERATOR, RICHARD RYAN: Good afternoon, and welcome to the National Press Club. My name is Richard Ryan, and I am senior Washington correspondent for the Detroit News and president of the National Press Club. I'd like to welcome Club members and their guests in the audience today and those of you who are watching on C-SPAN or listening to this program on National Public Radio.

The video archive of today's luncheon is provided by Connect Live and is available through the National Press Club Web site at National Press Club luncheons are also carried live by many sites on the Worldwide Web. Press Club members may also access transcripts of our luncheons at our Web site. Non-members may purchase transcripts, audio and videotapes by calling 1-888-343-1940.

Before introducing our head table, I would like to remind our members of a few of the upcoming speakers. On Thursday, we have Sergei Khrushchev, senior fellow, Brown University, and the son of former Russian Premier Nikita Khrushchev, who will be here to discuss Russia, Putin and the war on terrorism. And on Monday, December the 10th, Goldie Hawn, actress and a spokesperson for Words Can Heal, will be here to discuss "Building a Better Normal After September 11th." And on Tuesday, December the 11th, Kim Gandy, president of the National Organization for Women, will address the National Press Club. If you have any questions for our speaker, please write them on the cards that are available at your table and pass them up to me. But please remember to write so I can read it. If I can't read the question, I'll never be able to ask it. And then I'll ask as many as time permits.

I'd now like to introduce our head-table guests and ask them to stand briefly when their names are called. But please hold your applause until all head-table guests are introduced.

From your right and my left, George Edmundsen, Washington reporter for the Atlanta Journal-Constitution; Amy Miller of ELA; Jeff MacMurray, regional reporter for the Associated Press, who covers Georgia and Alabama; Kathy Lewis, deputy bureau chief, Dallas Morning News; Karen Fisher, Washington correspondent, the Charleston Daily Mail; Frank Aukofer, chairman of the National Press Club speakers committee and a former president of the National Press Club.

Skipping over our speaker for a moment, Lisa Zagaroli, Washington correspondent for the Detroit News and the member of the National Press Club speakers committee who organized today's luncheon. Thank you, Lisa. Dr. Greg Fashone, director of the Carter Center mental health program; April Taylor, Washington correspondent for the Detroit News; Muriel Daubin, Washington correspondent for McClatchy Newspapers; Maggie Fox, national health and science correspondent for Reuters; Annette Fishel, editor, U.S. Medicine. (Applause.)

Welcome back to the National Press Club, Mrs. Carter. The last time our guest stood at this podium, she was living just a couple of blocks away at the White House. It was 1978, and Rosalynn Carter was only the second sitting first lady ever to speak at the National Press Club. The first, Eleanor Roosevelt, had been here 40 years earlier. And Laura Bush became the third when she spoke here last month.

When the Carters left the White House in 1981, Mrs. Carter said she feared the couple would go home to Georgia and be bored for the rest of their lives. (Laughter.) But they haven't had the time. The two founded the Carter Center in 1982. Since then, the Center has, as you saw in the video, done a number of things, including monitoring 34 elections in 20 countries, helping farmers in 12 African nations double or triple grain production, and making great progress in eradicating the debilitating guinea-worm disease.

Mrs. Carter also has continued to work on her signature issue, mental health. Just last month, she convened a meeting of 200 mental health care leaders to examine failures of the health care system to address children's mental-health needs.

President Clinton awarded the Carters the Presidential Medal of Freedom two years ago for their humanitarian work since they left Washington. "Jimmy and Rosalynn Carter have done more good things for more people in more places than any other couple on the face of the earth," President Clinton said. (Applause.)

Mrs. Carter was born Rosalynn Smith in Plains, Georgia in 1927, the daughter of a garage mechanic and a dress-maker. Her father died when she was 13, and she helped with the family finances by working at a local beauty salon and as a seamstress while attending Georgia Southwestern College. Her good friend was Ruth Carter, who had a brother, Jimmy. Young Rosalynn fell in love with a picture of Jimmy, who was then away attending the U.S. Naval Academy in Annapolis. When Jimmy came home in the summer of 1945, she fell in love with the real thing.

After their first date, Jimmy Carter told his mother, Miss Lillian, that he had just gone out with the woman he was going to marry. And he did. The two celebrated their 55th wedding anniversary last July. (Applause.) On his 75th birthday two years ago, President Carter was asked to name the most important thing he had ever done. Without hesitation, he replied, "Marrying Rosalynn."

Mrs. Carter helped her husband run the family peanut business. And when he decided to run for the state senate in 1962, she learned how to campaign. She campaigned again when he ran for governor in 1970. And when he ran for president in 1976, she campaigned by herself in 41 states.

In the White House, she worked closely with her husband on several issues. She chaired the President's Commission on Mental Health and promoted child immunizations and refugee assistance. The two scheduled weekly meetings in the Oval Office to discuss their work. "There's very seldom a decision that I make that I don't discuss with her, either to tell her after the fact what I've done or, very frequently, to tell her my options and seek her advice," President Carter once said.

Newsweek Magazine said Mrs. Carter was, quote, "probably the most influential first lady of modern times." (Applause.) And Southern Living Magazine said recently, in an article about Mrs. Carter, that despite her worldwide travels, her experience, she retains her pure Georgia peaches-and-cream accident. (Laughter.)

Well, we're about to find that out. Please join me in welcoming Mrs. Rosalynn Carter to the National Press Club. (Applause.)

MRS. CARTER: Thank you. Thank you, Richard. And thanks for telling everybody how old I am. (Laughter.)

Well, it's nice to be back in Washington. I don't get here very often. And it's been fun to see a lot of old friends. And I'm really happy, too, that you could see the film, because it tells the story of the Carter Center better than I can. But I want to talk to you more about it.

First, though, I bring greetings from Jimmy. He's on a book tour promoting his new book. He always has a new book. (Laughter.) This is his 15th one, "Christmas in Plains." And he would like for me to tell you that they're all still on sale. (Laughter.) And "Christmas in Plains" is a sequel to the one he wrote last year, "An Hour Before Daylight," which described growing up on the farm during the Depression, except this one is Christmases then in his childhood but Christmas up to the present, too.

Well, we have an interesting and adventurous life. We still live in Plains, Georgia. We have an apartment at the Carter Center. And Jimmy says we spend a third of the time at the Carter Center, a third of the time traveling with our projects, and a third of the time in Plains. But I don't think we spend nearly that much time at home. I know we haven't this year.

Our family has grown. Amy has a little boy two years old. His name is Hugo, and he's already way above average. (Laughter.) He's not our only grandchild. We have 11. Our oldest grandson, Jason, got married this summer after spending two years in the Peace Corps in South Africa. And he's now writing a book about his experiences for National Geographic. And it's going to be a good book. I read the first draft of it.

And we stayed in touch with Jason when he was in South Africa, in the boon docks of South Africa, by e-mail. It was just really amazing to me. And he'd not been there very long when we got an e-mail message from him that said that he wanted us to come to see him on our trip to Africa and he wanted us to take him to see Nelson Mandela. He said, "I want to meet a politician who went to jail before he was in office." (Laughter.)

Well, I've chosen for my subject this afternoon our work at the Carter Center, which, of course, includes my mental-health program. Can you believe that next year we celebrate the 20th anniversary of the Carter Center? It doesn't seem possible that we've been gone that long. (Applause.)

When we left -- as Jimmy always says, involuntarily retired -- (laughs) -- we pondered what we would do with the rest of our lives. We knew we wanted our library to be more than just a library. And at first we envisioned something like Camp David, where we could go to resolve conflicts or prevent conflicts, where you don't just go out and resolve conflicts.

And so the first thing we had an opportunity to do was to work on an agriculture program in Africa. And being a farmer, that appealed to Jimmy. So Dr. Norman Borlaug, who won the Nobel peace prize for the Green Revolution in India, came to be our partner in that program.

And then Dr. Bill Foege, head of the Centers for Disease Control when Jimmy was president, came to be -- became our executive director. And he is preeminent in international health, public health. And he attracted really important health programs to the Carter Center. And I think one reason we've been so effective is because we have the best possible people in every area of our work, in health and agriculture, in peacemaking, in diplomacy.

And our health and agriculture programs give us an entree to the leaders in the country. And because we're in their countries doing good things, if there is a conflict or a potential conflict, Jimmy can say, "Maybe I can help you with this problem." So, as you've seen in the video, our programs fall into two categories, peace and health. And agriculture is part of health is because it's nutrition. We only work with farmers on food grain programs.

And what we've learned is that all of the programs are connected. They address conflicts, but they also address the root causes of conflicts. And we build hope with our programs where none exists and give people a feeling that the future is going to be better for them. And we think this is the best way to work for peace in the world.

Well, when we go into a country with our health-agricultural programs, Jimmy negotiates a contract with the head of state and we enlist his whole cabinet. And the government of the country then provides all the workers, and we only send one health or agriculture expert into the country. We teach their workers. And so when we leave the country, as we do in agricultural programs, we say, "We'll be here five years and leave." We leave hundreds of agricultural extension workers who can then work with the farmers in the country. So we've had great success.

The farmers, for instance, in these villages have one hectare of land. That's about two acres. And we can triple their food grain production almost every time the first year. And when the neighbors see this, then they want to plant the same way. And so our work is multiplied over and over. We now have about 600,000 small farmers in our program in 12 African countries.

And I remember being in Ethiopia once when we were honoring the farmer of the year, and we drove down this long, straight road through wonderful fields of corn and wheat. And for us, they had put little signs in front of these little plots that said, "Copy Global 2000." Global 2000 is our program. "Copy Global 2000," "Copy Global 2000," "Copy Global 2000." Every once in a while there would be one that said, "Global 2000." It was really quite wonderful.

And when we got to the farmer of the year, she was a little woman about this high who had worked her plot with her two little daughters. It was so exciting to me, because in Africa the women do almost all of the work. And it was really wonderful for me to see this woman being honored as the farmer of the year. She was standing, she and her little girls, in the middle of a beautiful crop of wheat.

Well, our peace programs, conflict resolution, building democracy, monitoring elections, are probably better known to you than our health programs, because you've probably seen Jimmy in some highly-publicized situations like North Korea or Haiti that you've seen in the film, or in monitoring elections, which we do pretty often. And we never go into a sensitive area without permission from the president, which is not always easy to get. (Laughs.)

We worked in the Sudan, for instance, for a long time with our health programs, and actually we had an agriculture program there, too, in the north, a good many years ago. And we've been working trying to bring peace to that country for a long time. It's the worst, longest war in the world. Two million people have died in the Sudan. And Jimmy was able recently to get a peace agreement between the Sudan and Uganda over a border dispute, and our people are still there working on implementing the terms of that agreement.

We've monitored nearly 3,000 elections in 20 countries, as you've already heard; five this year. We only monitor elections when there's a change from an authoritarian government to a democracy when the democracy is very fragile. And we found that elections sometimes are a good way to prevent conflicts.

Jimmy says that politics is the art of self-delusion. (Laughter.) And sometimes when we can't get warring parties -- when they hate each other so much they won't sit down at the negotiating table, Jimmy can say to them, "Well, if you'll have a free and honest election, then the best man, I know, will win." And so they, of course, think they will be the best man; they're usually men we work with. And so they'll agree to an election when they won't agree to negotiate.

Well, our health programs have attracted less attention than our peace programs, but they play such an important role in giving people hope. It's so good to go and visit these people when they have food enough to eat. It's really wonderful. And more than half of our budget goes to our health programs. We're in 35 countries in Africa and some in Latin America. We're working, as you said in the video, to eradicate guinea worm, and we're almost there. And when we eradicate it, it will be the second disease in the world ever to be eradicated. Smallpox was the first, and I hope it stays eradicated.

When we first started, there were three and a half million cases of guinea worm, and today there are only about 70,000, a 98 percent reduction. And most of these cases are in southern Sudan, where the war is going on, and our workers can't get into the villages.

Jimmy did get a guinea-worm cease-fire in, I think, 1995. And we were able to get it because neither side wants to get this horrible disease, or river blindness, which we're working on too. But we got the guinea-worm cease-fire, and we had gotten the funding and we had all of our parties, NGOs, everybody, poised to go in if we got it.

So we were able to identify the endemic villages in the Sudan, and actually, while we were there -- it lasted about six months -- teach some of the workers. So we really don't know what's going on in some of the villages. But also, this past summer the Norwegians gave us 9 million filter pipes. This is something that we learned from the nomads.

The people are so innovative. We give them this fabric to strain the water to get the guinea-worm eggs out, and some people put a string in it and draw it up around the top of a jar so they can pull the water in. I've seen a baseball cap that somebody cut the bottom out and put the filtered cloth in, and then they could lean over and drink the water. But nomads took a reed and tied a filter cloth around the bottom of the reed, hung it around their neck so that anywhere they are, they can drink good water, safe water.

So the Norwegians copied this for us and gave us 9 million of them. It's not a reed; it's plastic, of course. But we this summer distributed enough through southern Sudan for every man, woman and child to have. And because we were there, the word has gotten around. They now know where guinea worm comes from. That was really difficult in the beginning, because people didn't want to believe that this horrible disease came from their water, which is precious to them.

Well, we don't put our name on our programs, because if the head of state is going to get credit for a great agricultural program or health program, then he works a lot closer with us on the program. (Laughter.) But the word gets around. Once we were in a guinea-worm village, and they always have a little stand for us, plush chairs, overstuffed chairs, sticks with palm fronds on the table, a little shelter. And I was sitting there looking out, and this little girl held up a sign that said, "You better go away, guinea worm. Jimmy Carter's coming." (Laughter.)

Well, we work directly in the villages with the people in need. There were 23,500 villages with guinea worm. There were. There are no longer that many. This year we delivered 7 million doses of Mectizan for river blindness.

Well, you can imagine, we travel a lot. We're not at home nearly enough. But our work is rewarding. And it's emotional, too, to go to a guinea-worm village and have half of the people who live there -- sometimes the village is 500 people, 700 people -- half of them on mats with guinea worm emerging from their body, too sick to get up. Go back a year later and nobody has guinea worm. It's really wonderful, or to have a farmer running out to greet us saying, "My son has come home from the city because now we can raise enough food grain on our land to support the whole family."

Well, when people don't have enough to eat, they move into the city to try to find a job or get work. But what happens is there's this ring around the city with the most dire poverty I've ever seen. So if somebody can come home from the city, it's really wonderful. And the people, the people in these villages are so grateful for anything we do for them, any little thing. It's really wonderful to see.

Well, we have a lot of partners who help with our programs. Major corporations have been wonderful, as have foundations and individuals, in giving medicines, supplies and funds needed to run the programs. DuPont gives us all the filter cloth we can use for our guinea-worm program.

Merck pharmaceutical company will give us all the Mectazin we can distribute in perpetuity to prevent river blindness. One pill a year will prevent it, or arrest the disease where it is so that a person won't go blind. Other pharmaceutical companies who have helped us are Glaxo-SmithKline and Pfizer. The Lions Clubs help us with our eyesight programs, glaucoma and so forth. We work with the Centers for Disease Control on all of our programs. The Gates Foundation is a great partner with us. We work with international agencies and other non-governmental organizations. In some countries, for instance, half of the Peace Corps workers are helping with our health programs.

In one village we went to in Mali, two Peace Corps workers, two young women, were working with guinea-worm, and they had drawn pictures -- everybody speaks different languages, even if a village is like seven miles apart, we've been where they've spoken different languages -- so you have to draw pictures. And these young women had drawn pictures -- a picture of a woman standing in water. Well, the water came up over her ankles. And she was standing, pouring water into a jar with a -- (inaudible) -- cloth in it. Well, everybody in the village had gotten upset because they said they would rather have guinea-worm than no feet. (Laughter.) That's how hard it is to get the message out.

Our annual cash budget is about $35 million, and we receive this much or more in in-kind contributions, mostly medicine. We have to raise all of the money for all of our programs, and if you know Jimmy Carter, you know we don't take on any kind of program unless we have the money for it. So, we always have a balanced budget.

Well, I'm involved in all of our Carter Center programs, but now to my special interest, which is mental health. And I have a whole other speech I could make, but I'll restrain myself this afternoon and just talk about a few things.

One of the challenges of the mental health community now is to get a parity bill passed through Congress, it's the Wellstone-Domenici bill, providing insurance to cover mental illnesses the same way it covers physical illnesses. The Senate has passed the bill. We have enough votes in the House to pass it, and we can't get it out of conference committee. I am so distressed about it. I came up last week for a press conference with Mike Wallace and Cathy Cronkite. Senators Domenici and Wellstone called this press conference. And Domenici, at that press conference, said that he was going to ask President Bush "Are you with us or are you not on this issue?" Well, I'm waiting to see. We still haven't got it out of conference. And it's tragic. After all we've learned about the brain, we now know that mental illnesses are physical. They can be treated as successfully as some -- even more successfully than some physical illnesses or some other diseases, because I don't think there should be any distinction between mental and physical. They're all physical. And it's so sad to let politics undermine this opportunity. It is the first time -- and I've worked on this issue for 30 years, since Jimmy was governor of Georgia -- and this is the first time that we have legislation that could be passed that will finally end the discrimination against people who suffer from mental illnesses. I just think it's going to be so terrible if we don't get it passed. (Applause.)

One of my Carter Center initiatives that you might be interested in is our Mental Health Fellowships for Journalists. Bob Myers, an advisor to our program, is here today, and also one of our journalists, Bill Skane. Every year, we give a stipend to journalists. They apply with a subject, a mental health issue. They come to the Carter Center and talk about what they're going to do. And they come back at the end of the year and make a report on that issue. It has been one of the most successful programs we've ever had. It's -- we've had so many articles in newspapers and magazines and television spots and documentaries. One of our journalists who is on the editorial board of The Oregonian said the year before he was a journalism fellow, they had six articles in The Oregonian on mental health. And last year when he was a journalist, they had 60 articles. That's just kind of typical of what's happened. Three are writing books.

And one of them is writing a book on the severe depression of Abraham Lincoln. Did you know that Abraham Lincoln suffered from severe depression all of this life? And this young man's name is Joshua Hume. And Joshua came to the Carter Center to interview Jimmy and me about the pressures of the White House because he said he couldn't interview Abraham Lincoln. (Laughter.) But don't you think that will help overcome stigma? If Abraham Lincoln was a great president and suffered from severe depression all of his life, it looks like it would be all right for anybody to say, "I suffer from mental illness."

I'm excited about that program. And it's so important because the media, you in the media, play such a powerful role in shaping attitudes. And I think we're building a cadre of journalists who know the issues, who hopefully can have some influences over their peers, and who can make a real difference in improving attitudes and knowledge about mental illnesses. You can all help.

Well, last month, we had our 17th annual mental health symposium, and we focused on the crisis in children's mental health. So many children suffer from mental illnesses, and very few ever get the specialized training that they need -- treatment that they need. Too often they're just dismissed as moody teenagers or bad children. Did you know that almost 10 children in the United States commit suicide every day? Thirty thousand, almost 10 a day. It's shocking. And it's critical that we do a better job of recognizing the mental illnesses and getting children into treatment, helping them, which can prevent so much unnecessary suffering, and also it can give these young people a chance to grow up to be good contributing citizens in the community.

One of the things that we worked on in our symposium was a list of warning signs that can help people recognize mental health problems or potential problems in children. There's a federal task force that has launched a study to develop such a list, and we made a lot of progress, because we had 200 of the top experts in this field at the Carter Center. We made a lot of progress in putting together this list.

We want it to go to schools. We had young people at our symposium, and I had never realized what an influence the schools, of children making fun of them, teachers making fun of them, everybody calling them bad children, nobody listening to anything -- they're getting, and having them get blamed for everything. Schools have a major influence on the lives of these young people.

And we -- so we want a list that we can distribute to school teachers, school counselors, primary care doctors who don't recognize -- primary care doctors don't recognize mental illness very often -- parents, even mental health professionals and people in the law enforcement profession.

Well, we've gone international with our mental health programs too. This year, for the first time, we had two journalists from New Zealand who are fellows. And that was really interesting. One of them wrote me a little note. He was really animated, he was jumping around and so excited about what he was doing because he had a magazine, which is the leading magazine of young people in New Zealand, and he's going to be writing now about mental health issues for them, which is so important. He wrote me a little note and said he hoped he was not distractive at one time because he saw this creature out on the grass looking out the window at the Carter Center. He had never seen anything like it. He couldn't take his eyes off of it. It was a squirrel. (Laughter.)

And also, my staff has been working with the planning committee of the World Health Organization, which is developing a global mental health initiative. And I have with the World Federation of Mental Health I chair, an international committee of women leaders for mental health. And there are 44 women leaders in the world, mostly first ladies around the world. And we called it the First Ladies' Committee at first, but we had to change the name because I had two Queens who wanted to join. (Laughter.) So now it's the International Committee for Women Leaders.

Well, we're proud of the Carter Center. Over the last almost 20 years, it's grown remarkably, more than we ever dreamed it would. It has a bright, and we think a permanent future long after Jimmy and I are no longer active. It's granted (?) to Emory University. Our work is shared with the world's leading experts. We have 28 trustees, and are developing a group of eminent persons that are helping us plan for the future. We have 32 heads of government working with us in this hemisphere, and an equally distinguished international group working with us on world conflicts, and another on human rights. And we're building an adequate endowment. Today, we are active in 65 countries. Our programs have impacted the lives of millions of the poorest, most vulnerable people in the world.

Many years ago, Margaret Meade came to see me. In fact, we became good friends. When she heard that I was working on mental issues when Jimmy was governor, she came to the governor's mansion to see me. And then she came to the White House, and I traveled with her some. And I'll never forget what she said -- and I heard her say this often as she said it to me -- the success of any society must be measured by the care it gives its most vulnerable citizens. Well, today ours is a truly global society, and our responsibility remains to attend to the needs of our most vulnerable citizens.

Thank you. (Applause.)

MR. RYAN: That did sort of sound like peaches and cream, didn't it? (Laughter.) A couple of questions just to start off with about the Carter Center, Mrs. Carter. One asked, we saw here beforehand the Waging Peace video, and people would like to know how else they might be able to see that. And then, I know you talked a little bit about how you raise the Center's funds in terms of in-kind contributions for medicines. There's a question about how -- more about how they are raised, and specifically how much is actually spent each year.

MRS. CARTER: Well, our budget is $35 million, which we spend. We always have a balanced budget, but we spend the money we get. The funding -- let's see, you asked about the video. The funding -- we spend a lot of time raising money, because ours is a non-profit organization. We have to raise all of our money. Foundations are really wonderful, and individuals -- we get a lot of contributions -- we have a direct mail campaign program, and we get funding that way from hundreds and hundreds and hundreds of people. So, if anybody wants to contribute to the Carter Center, we always welcome any contributions.

The video, I think you could write the Carter Center and get a video. We show them at civic clubs and things like that. We -- (inaudible) -- one has a tag on it when we are begging for money, as for contributions. But, the main purpose of the video is just to let people know what we are doing, because we don't put our name on our programs. And I think we get more support for them if people know what's going on. So, I think if somebody wanted the video, they could write to the Carter Center and get one.

MR. RYAN: Since leaving the White House, you and President Carter have done all the humanitarian work basically on your own. This questioner wants to know if you believe that there might be an official position where former presidents and first ladies to better represent the United States to do something in an official capacity?

MRS. CARTER: Well, we've stayed away from being part of the government, and having a government position, and I'll tell you why. When we go into these countries, most of these -- many of these people, I wouldn't say most of them -- but many of them, particularly if there is a conflict, don't want the United Nations involved, they don't want the United States involved. And so they can come to us because there are no strings attached to them from the United States or the United Nations -- they can come to us. As I said earlier, we do not monitor any elections unless we have -- I mean, we do not go into any sensitive places with our conflict program unless we get permission from the White House, but the White House is not -- we are not wedded to them. So I don't know -- I think it -- for us, it's better that we are not, don't have any official position with our country.

MR. RYAN: How difficult is it to convince people that an illness is an illness as you talked about it, and there's no difference between a physical illness and a mental illness? Is it a barrier that you have to overcome to convince people of that?

MRS. CARTER: I've been working on it for 30 years. It's not easy, but, it's an exciting time right now in the mental health community because of research and what we've learned about the brain. Today, as I said in my remarks, mental illnesses can be diagnosed, they can be treated, and the overwhelming majority of people can lead normal lives -- living at home, going to school, working. And that's the purpose of my mental health program, is to get that message out to people, because when people know that -- and they don't -- the general public does not realize what we in the mental health community and experts know -- when we get the message out that all mental illnesses are physical and we have the proof because we have this -- we have done, the scientists have done the research and we know this for a fact, then I think people understand that. The most important thing is to get the message out. I think maybe now we're beginning to make a little bit of dent, but the stigma is still devastating.

MR. RYAN: I trust you're going to spend another 30 years working on that -- hopefully not have to spend that much time to convince people. Do you feel that the United States is behind other countries in their attitudes towards mental illness and mental health? And in your mind, what country is doing the best job?

MRS. CARTER: I think all countries are behind, some more than -- some, of course, in the countries that we go to there's very little mental health work, I know. Greg, who is the head of my mental health program, went to Togo with one of our health workers, and he was talking to some of them who help the people, and they still chain people to trees who -- which was done in our country many years ago. Queen Fabiola is really wonderful in Belgium. They have a good program. There's some good programs in some of the countries, too. And with my Committee of Women Leaders, we hear from -- if we hear something that's really good from them, we stay in touch with them -- we told them we'd never have meetings, but we have had some meetings -- but we stay in touch with them and send them any information we have, and get them to recognize World Mental Health Day, which opens the door a little bit in countries that don't have any programs, because often if we ask the first ladies to recognize World Mental Health Day in these really poor countries, they will. And it just kind of opens their eyes a little bit to the problem.

And also, by the year 2020 -- 2020, depression will be the second leading cause of burden of disease in the world, the second leading cause. In our country, mental illnesses are the second leading cause of disability. Heart disease is the first, and mental illness is the second. And it's so distressing, because people can be treated, and the earlier you get the -- catch the problem and begin to treat it, the less severe most often it will be, and it just can prevent so much suffering. And it can also bring costs downs for insurance companies and for businesses who have people who are mentally ill, who are depressed, for instance, as employees, because when businesses don't cover mental illnesses, there's more absenteeism, more turnover on the job, less of the quality of the work. There's just so many reasons that mental illnesses should be covered as physical illnesses.

MR. RYAN: This questioner would like to know what the Carter Center is doing to help lay people, those who are not trained in the mental health area, to identify mental health problems in young children?

MRS. CARTER: Well, I think I answered that. I tried to. We are trying to develop this list that can help people identify children with mental illnesses. And also, as I said, from our mental health program, we try to get as much publicity to get the message out so that people will know that these illnesses can now be treated. Mental illnesses in children are not easy to identify because people just say children are bad, bad children, and they don't really know sometimes that the children can be helped. But, in the mental health community we know, and this is so bad to me, we know what to do for children, and we don't do it in our country. We know in the mental health field that if children have good health care, prenatal care and then good health care, if they have good mind stimulation as babies and on up, if they have good nurturing and so forth, they grow up and they have a much chance of growing up to be well-adjusted young people. We don't do that in our country.

One of the things that I'm working really hard on is to get children registered for school at age two -- not enrolled, but registered. Georgia has pre-K, universal pre-K. We are one of the few states in the country that has universal pre-K. And so they're having to be registered at four, age four now. But, if you could get them registered at age two, you could get -- they'd have to go to the clinic, because they would have to have all their immunizations to be registered for school. So, they would get their immunizations, but you could also screen them for any physical or mental health problems. And if we could just get them early and take care of them when they are little children, we would be so much better off. We would have so few -- I mean so many lesser suicides and problems with young people as they get to be adolescents than we have now because we neglect them when they are little.

MR. RYAN: How would you compare the problems that the Carter White House, when you and your husband were in office, with today's crisis with the President and Mrs. Bush, and take this from the prospect or the viewpoint of the first lady?

MRS. CARTER: I don't think ours compares to what they are going through now. We had the hostage situation. And my mother used to always call me and say, "How is everything going? What are you doing? I'm so worried about you." And I always told her that it's easier to be in the eye of the storm than it is to be on the outside looking in -- (laughs) -- because we were there. When you are there in the White House you are working to try to correct whatever is not going the way you want it to do. You're working on it really hard, and so you don't see it as people looking in on you.

And so I don't think -- I think the problems today are very different from ours.

MR. RYAN: Can you comment on the decision that has been made not to allow tours of the White House over the holiday? Do you think there's an alternative that might be done to permit that?

MRS. CARTER: Well, I -- I think it's tragic that the situation has developed so that the White House thinks they cannot have it open for tourists. And it's so sad, because it was one of the happiest times and the best times for people to come see the White House -- always beautiful. And we loved Christmases. We didn't spend them all in the White House. I remember going -- well, we always went home for Christmas -- but we were always there ahead of time for all the events. And then one year when the hostages were being held, we went to Camp David, because Jimmy wanted to be close by in case something came up, to help with getting the hostages out.

But I think it -- I'm sorry that it has to be closed, but I think it has to be. And I think it's tragic that this situation has developed.

MR. RYAN: There are a couple of questions here that deal with Afghanistan. And thins one wants to know if the Carter Center would be interested in helping with the rebuilding of Afghanistan after the conflict. And what type of aid might you be able to provide to the area?

MRS. CARTER: I don't know when -- when our government is involved in something like that, if we have -- if the government has a program, then we step back. We can't be a government in exile or anything like that. So if we -- if we were asked to go into Afghanistan, we could work with people, in helping them with their food grain production, and health programs, because I am sure they haven't had any health care for years. And also there was an article in the Boston Globe just recently that said that 78 percent of the Afghan women in the Taliban area suffer from major depression -- 78 percent. Sixty-eight percent have persistent thoughts of suicide. In the refugee camps, 73 percent of women suffer from depression, and 77 percent contemplate suicide. Isn't that shocking? And so we need -- and we really, really need some good mental health care for these people -- in Afghanistan, and in the refugee camps.

And I am really excited about the World Health Organization's global initiative. And the Carter Center has -- we have some important programs that we can work with the World Health Organization on. One of course is the women's committee -- our Women's Committee on Mental Health. But one is our fellowship for journalists -- that program, because they are thinking that that would be a good way for them -- they could use that as a model for them in helping. And also we have been working in these countries in Africa, in many of these countries, with health programs. And, as I said, we send one person in, and we have network of health workers in 35 countries in Africa now. And we are also working to establish -- are working with the government of Ethiopia to establish five public health schools. The president, who is a friend of ours -- we knew him before he overthrew the Communists in Ethiopia -- wants to decentralize everything, so he can't do one public health school -- so we are doing five. And we are developing protocols for the diseases. And one of them I am going to make sure is mental -- is depression. And we think that when we get these developed we can distribute them throughout some of the other countries. So we have a lot of things that we can work with the World Health Organization on -- and also distribute them to the health workers who already know us and know about our programs in all of these countries. So we have a lot of things we can work on -- with people in Afghanistan on health care and agriculture. I am not sure we could work with anything like conflict resolution. We can work with human rights. We are even teaching human rights to the policemen in some countries. And so we could work on human rights issues. But as long as our government has a plan and they're working on it, we back off.

AUDIENCE MEMBER: Mrs. Carter, I would like to ask you please --

MR. RYAN: I'm sorry, we can't do that from the floor, because we don't have any capability of doing that. This questioner notes that even the most rewarding projects can leave a person tired at times. Have you ever had a moment when you might have felt discouraged or you felt like just kind of giving up?

MRS. CARTER: Yes. (Laughter.) I get really -- I think the thing that has discouraged me more than anything that I can think of recently is this mental health bill in the conference committee that we cannot get out. I think it's subverting the will of the people if you have the Senate already having passed it and the house with enough -- 245 people in the House co-sponsoring it. And yet it can't happen. That is so discouraging to me. But I get tired sometimes, and I turn down events. I don't make speeches much. I have projects that I work on. I was here yesterday -- I was working on a program called Every Child By Two. I have been working with Betty Bumpers, Senator Dale Bumpers' wife since our husbands were governors at the same time, on immunization. And when Jimmy was president, working with Betty, do you know that immunizations were required for only 17 states when Jimmy was elected for school, and 17 states when Jimmy was elected for president? We were able to get it in all 50 states. And then when the epidemics came along in 1989 and '90, Betty and I started this program, Every Child By Two. And that's frustrating too. We're working on registries in the state to register children when they are born some way -- through hospitals or some way -- and then you can check and see if they have their immunizations or getting their immunizations. But I have meetings like that.

And I also have the Rosalynn Carter Institute for Human Development, it is called. We work on care giving at our local state universities -- Georgia State University, which is my alma mater. And I do those kinds of events. But I don't go out and -- the only time that I normally go out and make a speech is if I am offered a pretty big honorarium, and I need some money for my mental health program or something is coming up -- (laughter) -- or my care-giving program.

MR. RYAN: I'll make it clear there was no honorarium offered here. But I do think that you ought to make more speeches -- you do a wonderful job oat it.

This questioner would like to know -- it's kind of personal -- do you ever miss living in Washington? What do you miss most about living in the White House? And do you ever miss just being the first lady?

MRS. CARTER: I haven't had time. (Laughter.) I haven't had time to miss it. I thought I was going to go home and be bored to death. It hasn't happened that way. I miss my friends. Yes, I miss my friends that I see when I come to Washington. I don't get to see them very often, because if I come to Washington, it's normally to come to an Every Child By Two meeting or something, and then go back home. So I would like to spend more time in Washington seeing my friends, I think, and maybe I can do that.

MR. RYAN: Of all the places you have visited in the world, do you sort of have a favorite place that you really like, and why is that so?

MRS. CARTER: Well, the places that we visit most of the time are almost all alike, it's with the most poverty-stricken people that you will ever meet. And to be able to help them, and just to see that hope on their face -- those are the ones I like to go to. (Applause.)

MR. RYAN: Can you talk a little bit about how perhaps the role of the first lady may have changed since when you were in the White House?

MRS. CARTER: Well, I think the role of first lady is changing as the role of women changes. And I think that was beginning to happen when we were in the White House, and maybe a little bit before that. But by the time we got there the role of women was changing a little bit. And I really don't know that it's changed very much since I was there, because I did the things I wanted to do. I sat in on the Cabinet meetings, because I wanted to know what was going on. Jimmy had been coming home -- every time he got off the elevator upstairs in the White House, I said, "Why did you do this? " "Why did you do that?" (Laughter.) And whether he said, "Why don't you just come to the Cabinet meetings, and you'll know why we do these things." (Laughter.) And so I started going to Cabinet meetings. And I worked on my issues, and I traveled and did press conferences -- and about not just what I was doing, but what the administration was doing.

And one thing to me that's good about the role of first lady is that it is so free and open -- you can work -- the first lady can work on anything she wants to work on, or she doesn't have to work on anything. Because I think she wants to -- because such a position of influence, the first lady can help with anything. She can go to a fundraiser for any charity, and the place will be packed. So I don't think anybody would want just to pour tea anymore, but --

But I was often asked if I thought first ladies should be paid. And I always said no, because if you were paid you would have to have a job description, and I liked being able to do what I wanted to do. (Laughter.)

MR. RYAN: That's great. Is there anything like a former first ladies club? Do you ever have contact with previous first ladies, such as Betty Ford or Mrs. Bush, Barbara Bush?

MRS. CARTER: There's not a first ladies club -- that I know of. I am not included if -- (laughter) -- (Applause.) But we have become really good friends with the Fords, and Betty Ford and I have been to Washington for instance to lobby money for substance abuse and mental health -- it's all in the same pot -- and she would take me to see the Republicans, and I would take her to see the Democrats. It's been a while since we did that. But we talk with the Fords pretty regularly, and see them. But they are the only ones really that we have any contact much with.

MR. RYAN: Does your husband have any contact with the current President Bush?

MRS. CARTER: Not really. We -- more than the previous administration. (Laughter.) We -- Jimmy talks to him. And when he -- when we go on a trip, whether it's monitoring elections, Africa to visit our projects -- he just got back from Mexico. And this is really interesting -- you might like to know that we have found -- well, let me say first Jimmy writes a trip report, and we send it to the president and to Colin Powell -- and we have done that ever since we left the White House. But the river blindness -- we have found that if you give people two pills a year instead of one that you might be able to eradicate river blindness. Well, if it's eliminated -- if it's gone from a certain part of the world, it's call "eliminated." He was in Mexico last week with health people from Latin America, because I think it's six or seven countries in Latin America that have river blindness. And we have been giving two pills a year to some of them. And now the children five years old and younger don't have any river blindness. And it's because so few people now have the illness, because they are getting the two pills, that the little black fly that bites that causes it has to bite I guess so many to get the germ to take it to somebody else, microfilaria. And so now we have got -- we are starting a real effort to see if we can eliminate river blindness from Latin America. It would just be a huge breakthrough if we can, because nobody ever dreamed it could be eliminated or eradicated. And also, those little five-year-old children -- they estimate they get 30,000 bites a year from that little black gnat.

MR. RYAN: Well, before asking the last question, I have a little bit of business I'd like to do up here. First of all, I would like to present you with a certificate of appreciation for your appearance here today at the National Press Club.

MRS. CARTER: Great, thank you. (Applause.)

MR. RYAN: And, secondly, I would like to present you with the famous National Press Club mug that is -- hopefully will grace your desk, wherever you may be -- you may already have one.

MRS. CARTER: I don't. (Laughter.)

MR. RYAN: Well, good. You don't.

MRS. CARTER: I don't think -- if you gave me one last time, it's in the archives. (Laughter.)

MR. RYAN: Well, don't put this in the archives. (Laughter.)

The last question. I mentioned in my introduction that after his first date with you, Jimmy Carter went home and told his mother, he said, "I have just gone out with the woman I am going to marry." What did you tell your mother? (Laughter.)

MRS. CARTER: I think I told them that -- told her that he had a beautiful uniform. (Laughter.) He was at the Naval Academy. But also, when he asked me to marry him then, I turned him down the first time. (Laughter.) He might not ever have admitted that. (Laughter.) It's been wonderful to be here. Thank you. (Applause.)

MR. RYAN: Thank you, Mrs. Carter, for being here. And I would like to thank all of you in the audience for attending. And I would like to thank those at C-SPAN for watching, and on National Public Radio for listening. Thank you very much, and we are adjourned. (Sounds gavel.)


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