a steady dose of pragmatism. That is a powerful combination.
I hope you will find the macrotrends Steve outlines in this book as useful as I do when thinking about our collective future. And I hope you will find your own currents to guide and inspire you. We need each person engaged in our collective work to make a more just, verdant, and healthy world.
Dr. Tedros Adhanom Ghebreyesus
Geneva, Switzerland
May 2020
Introduction From Outrage to Activism
I am fundamentally an optimist. Whether that comes from nature or nurture, I cannot say. Part of being optimistic is keeping one's head pointed toward the sun, one's feet moving forward. There were many dark moments when my faith in humanity was sorely tested, but I would not and could not give myself up to despair. That way lays defeat and death.
—Nelson Mandela
A REFUGEE CAMP sprawling across a large patch of jungle in Thailand is not the first place most people would expect to enjoy a memorable pickup soccer game. Nor the likeliest wellspring for a life‐changing insight. But that is where I embarked on my journey as a practical activist. I wasn't there as a relief worker, just a 22‐year‐old teacher visiting a friend of a friend who was working for the United Nations. It was January 1980. The Vietnam War had ended only five years before, and thousands of families across Southeast Asia were still reeling from dislocation. They were living in camps and trying to recover, find relatives, and make their way to whatever place would next become home.
The phrase “fish out of water” hardly does justice to how out of place I was, with my backpack, travel guides, and long hair. The camp sat near the Mekong River. It was filled with Laotians and Cambodians living in tents connected by dusty roads, scattered wells, and temporary feeding halls. The air smelled of burning wood. Almost everyone around me was homeless, grieving, and confused. Most had no idea how long they would live there and no place else to go. I'd arrived as a clueless, but curious, American.
Two friends and I, on break from our teaching fellowships at Tunghai University in Taiwan, had decided to spend our lunar new year holiday traveling around Southeast Asia on a shoestring budget. We did exactly as you might expect from a trio of adventurous young Americans—hung out on the beaches in Malaysia, island‐hopped on fishing boats off the Gulf of Thailand, trekked across opium fields in the Golden Triangle, crashed in the bustling hostels of Hong Kong, and ate enormous prawns in the night markets of Singapore. One of my companions had a friend who was working at the United Nations High Commission for Refugees (UNHCR) camp in northeast Thailand, so we'd decided to drop in for an impromptu visit.
Because our host was tending to the camp's children through a makeshift education program, I volunteered to occupy the teenagers with a game of soccer, mostly to make myself feel useful. Despite our lack of a common language, we enjoyed an intense and competitive match, refereeing through hand signals and bits of Lao, Thai, English, French, and Chinese—though I was badly outplayed.
“Where you from?” asked the goalie after we'd been kicking the ball around for a while. He looked to be about 16 and had clearly appointed himself leader of the pack.
“America,” I said with some hesitation, given our recent history in the region. While the “killing fields” of Cambodia had faded, the resulting dislocation had affected every village and refugee camp across the region.
“Oh, U.S. We love U.S.!” he replied, grinning. “America's great. We all want to go to America!”
“Where are you from?” I asked.
“Luang Prabang. But I have no home now,” he said. “My parents are gone, but I'm okay.”
Though he was just a few years younger than me, I wondered how much this teenager could possibly know about the whereabouts of his family, the complexities of world politics, or the future that might befall him. Frankly, I was treating him like a child, a hapless victim, stumbling through my silly grade school questions spoken too loud and too slow. I'll say it plainly: my innocence and arrogance were obvious. Born and raised in small‐town Montana, educated at an Ivy League university, I was open to new experiences but wildly naïve about human suffering across the world—not to mention nuanced notions of justice, dignity, and grace. The teenage goalie seemed to understand and, thankfully, cut me off.
“We are survivors,” he said. “We'll make it.”
Our conversation had quickly veered into territory I was ill‐equipped to navigate.
“So, what do you want to do when you grow up?” I asked, awkwardly trying to guide it back toward benign, introductory questions.
“Become a doctor,” he answered with great confidence.
“Why a doctor?”
He pointed toward the camp. “Because we must help each other,” he said, then looked me directly in the eyes. “You and your friends probably also need doctors, so I can help you too.”
This kid moved me, and changed me. Though I'd been at the camp just a short time, I hadn't missed the determination of everyone there trying to create some sense of normalcy in their upended lives. Their optimism floored me. Not a single refugee I met—including the teenager who'd lost his parents—appeared to consider themselves victims. They seemed to be focused only on taking care of one another and finding a dignified path forward.
After the soccer game, I wandered over to the UNHCR processing tent, trying to get my head around the immensity of this place and the complicated issues it presented. Our friend was working with the U.S. State Department, and he'd said I could listen in on an immigration interview between a U.S. official and a refugee applying for resettlement in America. We sat in a small, airless tent—the State Department lawyer, a stout Hmong man applying for asylum, a translator, and me.
“I was a driver for the U.S. team at the embassy,” the refugee began, speaking through the translator. At the time, it was helpful for refugees to prove that they'd worked with U.S. forces during the war.
“Where did you drive?” asked the lawyer, checking off boxes on his clipboard.
“I drove officials around Vientiane,” the man responded, referring to the capitol of Laos.
“What kind of car?”
“A Ford truck.”
“What make?”
“F‐150.”
“Do you know how to drive a stick shift?” the lawyer continued with an officiousness that struck me as strange, considering the question.
“Of course.”
“How many gears did the Ford have—four or five?”
This was a trick question, as that model of pickup had just three gears, and I could see that the refugee was confused. His answer might determine the fate of his entire family, and he knew it. Would they be allowed onto the list for resettlement in the United States? Forced to remain in the camp? Or returned to Laos where they could be in constant danger?
“Four,” the man guessed. Immediately, he knew it was wrong. And the interview was over.
I walked out of that tent feeling agitated
