EXCITING NEWS: Get Prepared

The publishers have nearly completed their work: editing, book cover and exterior design, interior book design, artwork and graphics, proofing, typesetting . . . and now the book is in the hands of the talented book manufacturers and printers!! (Nothing more I can do!)

It’s the book I always wanted to write about the discipline of ECONOMICS. The title is: 

Better Off: How America Got Wealthy and You Can Too. 

In the book I deal with investigating my curiosity as to why some countries are abundantly wealthy and some countries are stuck up to their ears in abject poverty, sickness and misery. Why? 

I discuss the phenomenon that throughout history insecure people have turned to governments to take care of them from cradle to grave. And those in leadership wieldlegitimate authority and power to compel obedience from the same people who empowered them. No wonder leaders with unlimited power will do practically anything to retain that power. 

In nearly 250 pages I try to share what I have personally seen, heard, and experienced in the over 150 countries where I have traveled and worked. The study of economics deals with how to make good choices. I want to share what I have discovered about making good choices. 

I passionately want to get back to sharing with you more excerpts from the actual travel journals I have written while traveling over the past thirty years. So many of you have been so kind to respond and tell me how the stories from the journals have helped enlighten and encourage you in your personal lives. 

I will get back to sharing those travel adventures in a couple of weeks. But I also want to keep you informed of the exciting things that are happening with the new book. 

Thanks for being my traveling partners.
 

© Dr. James W. Jackson   

Permissions granted by Winston-Crown Publishing House


Journal Highlights: Roads I Have Traveled ... Excerpt # 6 Nagorno-Karabakh, 1998

(continued): Nagorno-Karabakh: August 19,1998: This morning our delegation traveled north and east out of Stepanakert to the city of Martakert. It is near the Karabakh-Azerbaijan border where incidents of sniper fire and land-mine explosions are still occurring. The hospital there serves fifty-seven smaller villages in the region. Immediately upon arriving at the hospital I met a young soldier and photographed the wounds he had just received. 

The thought flashed through my mind that I could have easily been the one in the cross hairs of the sniper’s sights. The sniper’s bullet had entered his upper-left chest cavity, collapsed his left lung, and exited out his back. The shot had somehow missed his heart, and the doctors assured us that the young man will survive and heal successfully.

 All the hospitals we had visited in Stepanakert needed everything. In Martakert, they simply needed more than everything.

It kept blaring inside my head, These are the brave doctors on the front lines of this ongoing conflict, and they have nothing to work with. Just the donation of a little would go so far

Dinner, again, was very late, and by the time I headed for my room, the wind had begun to blow and it was trying to rain. The last thing Baroness Cox told me was that Zori had informed her there will probably be no possibility of taking the helicopter back to Yerevan, Armenia tomorrow. The storm that has moved in has brought with it very dense clouds that are totally blocking the mountains. I asked Lady Cox what the difference in travel time will be if we have to drive back over the mountains. 

“They have repaired some of the bombed-out places in the roadway,” she said, “so now even in good weather, we are probably looking at fourteen hours as opposed to an hour and a quarter or an hour and a half by helicopter. 

I went to sleep thinking about the probability of returning over the mountains to Armenia tomorrow in a caravan of vehicles, bouncing over rutty roads and sitting on metal seats for at least fourteen hours. I awoke in the middle of the night and listened to it rain. Then I fell back to sleep singing a little ditty I had composed in the dark: “No caravan to Yerevan, Lord. Let me fly by chopper.” 

Thursday, August 20

In the morning the clouds had lifted a bit, but it was still raining. At breakfast Dr. Tony Peel and I discussed our presentation to the prime minister. Even around the table, it was the consensus of opinion that the pilots will probably not chance flying the chopper across the rugged mountain peaks in the storm. We all moaned at the thought of a fourteen-hour ride back to Armenia. I kept humming, “No caravan to Yerevan, Lord. Let me fly by chopper.” 

Our meeting with the prime minister could not have gone better. He guaranteed personally that the medical goods from Project CURE will be received under his watchful eye, free of any tax or duty requirements. Dr. Peel and I laid out our recommendations that they not put any more expense or effort into trying to salvage four of the hospital buildings in the city of Stepanakert. Rather, contrary to the old Soviet model, we recommended they choose a new location for a unified hospital that would include separate departments for each specialty. That way each department could take advantage of a centralized laboratory, a modern radiology department, and common surgery facilities. We pointed out that they would be able to cut down on the number of beds in the combined hospital and would have better cost control over the supplies and staff. 

The prime minister just beamed. He had been thinking about the same things but was certain he would encounter opposition from the heads of the separate hospitals because they would be losing “turf.” We pointed out that he and the minister of health could reassure those directors that they would still have control over their individual budgets for their departments, even in the unified hospital. 

One of the members of our medical team had talked to me a couple of days ago about making an anonymous gift of $1.5 million toward the construction of the new hospital if I could get the minister of health and the prime minister to go along with the idea and agree to certain guidelines. I presented the prime minister with that possibility, and Zori, Baroness Cox, and the prime minister all just about took off into orbit. 

The prime minister and Zori repeatedly thanked us for having done such a thorough job in our research and recommendations. Now they can start planning how to totally change their health care delivery system and dump the old inefficient Soviet nightmare. It was about noon when we left the prime minister’s office. The rain had stopped, but the clouds were dense and low over the mountain peaks. Zori just shook his head and announced at lunch that there would be no helicopter. “No caravan to Yerevan,” I hummed as I enjoyed my lunch of greasy, fried eggplant and beans. 

About 1:00 p.m., a strange thing happened. As we were ready to load up the vans for our caravan trip, the sun broke out, and the clouds began to lift. I actually watched the dense cloud line move up the mountain peaks. As we finished loading the luggage, word came to Zori from the helicopter pilots. They now felt it would be safe to fly! The caravan of luggage and passengers headed to the airport instead of the mountain pass. “No caravan to Yerevan,” I continued to hum. 

As we flew back to Armenia, I once in a while caught a glimpse of the winding road traversing its way up and over the mountain range. I smiled and told God, Thank you. 

Friday, August 21

Today was a whirlwind day. At 10:30 a.m., I had the privilege of meeting with Viken Aykazian, bishop of the Armenian Orthodox Christian Church. At 11:30 a.m., the foreign affairs minister of Armenia met with us. 

Between 1:30 p.m. and 3:00 p.m., a news conference was held at the main government building in Yerevan. About twenty-five newspaper reporters and TV journalists assembled in the official press-conference room. Baroness Cox was really the star of the press conference. Nearly everyone in Armenia knows her and her tireless work around the world on behalf of Armenia and Nagorno-Karabakh. She introduced me, and I was able to talk about Project C.U.R.E. and its impact around the world, as well as our findings in Nagorno-Karabakh and our plans for the future regarding its health-care system and the medical institutions we had visited. 

We used our last dinner together to honor the helicopter pilots who had been so kind to us during our stay in Armenia and Nagorno-Karabakh, and all the other helicopter pilots who had given their lives to keep the corridor open between Armenia and Karabakh during the recent war years.

My research of the Armenians and the Nagorno-Karabakh situation had somewhat prepared me for a cursory understanding of the history of the Karabakh region, but I was in no way prepared for the emotional wrenching I experienced during my stay. I know I can’t keep up forever the pace of what I am doing now. My exposure is high, and the risks I am taking are, according to common sense, quite stupid. But while God gives me good health and high energy, I want to make my life count for kindness, justice, and righteousness. I truly believe those are the high objectives that will delight the heart of God.

© Dr. James W. Jackson   

Permissions granted by Winston-Crown Publishing House


Journal Highlights: Roads I Have Traveled ... Excerpt # 5 Nagorno-Karabakh, 1998

(continued): Nagorno-Karabakh: August, 1998: The archbishop is a strong man whom I judged to be in his late fifties. His slightly graying beard somewhat hid a classic squared jaw and chiseled features. He stood with strength and dignity, but his soft eyes revealed his kindness and gentleness of spirit. He knew some English, but he spoke to us through an interpreter. 

Our meeting with the archbishop was so meaningful to me that I asked if I could have my photo taken with the archbishop and Baroness Cox. Along with Zori, they had fought an impossible war and were not defeated. “The war showed many miracles. As with the miracles in the Old Testament, victory was not just because of the people of Karabakh; it was because of the Lord.” To illustrate his point, he told me the account of a battle during the war that took place close by in a village referred to as “Under the Rock.” 

A small group of thirty Karabakhi soldiers were dispatched to guard the village from a sneak attack. A battalion of at least three hundred Turkish and Azerbaijani soldiers surrounded the village and prepared for their offensive to completely destroy the village and all the men, women and children there. The day was completely clear and sunny. The group of Karabakhi soldiers realized they needed thirty minutes at least to get all the women and children out of the village before the deadly attack of the enemy. They prayed that God would somehow grant them the thirty minutes necessary. Out of nowhere in the sky came a bright-white vapor cloud. The fog was so dense that they couldn’t see in front of them. The cloud of fog passed between the villagers and the enemy and stopped for thirty minutes. When the women and children were safely out and away, the cloud passed on and evaporated. 

In the ensuing battle, which lasted the rest of the day, only thirteen Karabakhi soldiers were killed. The Karabakhi soldiers had won. Over half of the Azerbaijani forces lay dead, and many more were wounded. “That was a miracle,” insisted the archbishop. 

Tuesday, August 18

Our next stop was Stepanakert’s general hospital. The schedule was tight enough that we didn’t even have time for a lunch break. The thing I observed that both the children’s hospital and the general hospital need most is a total replacement of the buildings. Both hospitals had taken fifteen to twenty direct missile hits and a lot of mortar hits. The ceilings and walls still have not been repaired, and it isn’t unusual to find holes and bomb fragments in the wooden hallways. 

Next, we rushed to assess the maternity hospital where Dr. Arthur Marutian and his administration staff welcomed us. The maternity hospital received quite a number of direct and indirect missile and mortar hits during the fighting. Quite frankly, the building isn’t worth trying to salvage. The outside walls are collapsing, and the inside of the building sustained structural damage. On our tour of the facilities, I discovered that the hospital has been completely without water for the past four days. I kept asking myself how they can run a hospital without regular access to fresh water and electricity. 

Dr. Marutian responded very positively when I suggested that they think about altering the old Soviet style and philosophy of health care. As we walked down the dark corridors of the hospital, I told him about the many hundreds of hospitals I had visited throughout the old Soviet Union. 

“I am very aware,” I told the doctor, “of the idea of total central control of the health-care system by the Soviet government. Their idea was to place each specialty in a separate hospital location. Then they could more easily control the movements and procedures of everyone, because no one had an opportunity to communicate with anyone else.” He nodded his head in agreement. “The hospitals I have visited so far in Stepanakert have all needed everything. I am guessing that the other ones we will be visiting also need everything. But Project C.U.R.E. can’t fully equip five or six separate hospitals here in the city. It would be my suggestion that you abandon separate hospitals and combine all the medical specialties in one new hospital building with separate departments for the specialties. By so doing, you here at the maternity hospital would have access to a fully equipped, modern operating room, radiology department, and diagnostics laboratory.” 

To my surprise, Dr. Marutian really jumped at the idea and said there were others in Stepanakert who were in agreement about needing to dump the old Soviet system of medical care. To underscore the maternity hospital’s dire need for new equipment, the doctor took me into the main delivery room. There he walked to the metal delivery table and lifted up the pad that covered the tabletop. The entire end of the table where the delivery procedures took place was completely rusted out.

 “This is not just unsanitary with all this rust,” he said, “but if the end of the table drops off during one of my deliveries, we will all be in great trouble.” 

I told Dr. Marutian that before we leave Karabakh, Dr. Anthony Peel, the surgeon from England, and I will be meeting with the prime minister and making recommendations for Stepanakert’s health-care system. I told Dr. Marutian that since he is one of the doctors who would be willing to break away from the old Soviet health system concepts, I would like to be able to call on him or at least use his name to support our recommendations. He smiled broadly and gave me a “thumbs up.” I knew that somehow we were going to hit a homerun!

Next Week: No Caravan to Yerevan, Lord let me fly by chopper. 

© Dr. James W. Jackson   

Permissions granted by Winston-Crown Publishing House


Journal Highlights: Roads I Have Traveled ... Excerpt #4 Nagorno-Karabakh 1998

(continued): Nagorno-Karabakh: August, 1998: As we were being served dinner in the basement of the main government building, the four of us who had been assigned to stay at the bombed out downtown hotel began trying to figure out which of the dirty, tattered sofas in the lobby we would use as beds. As providence would have it a gentleman intervened and invited us to stay at a facility where there were latches and locks on the doors and running water in the sink, toilet, and shower. It was a miracle! 

Sunday, August 16

At breakfast Lady Cox and Zori informed us that we would be going once again in the helicopter. As we shuddered and shook to a successful liftoff, our helicopter once again took us just barely over the tops of more burned and bombed-out villages. At one point the clouds parted, and I was able to get a spectacular view of Mount Ararat. As I sized up the mountain, I tried to imagine a puddle of water sixteen thousand feet deep, and the time Noah and his family must have had trying to make their way off the steep mountain with a menagerie of animals. 

The Armenians built their churches in the most inaccessible places you could imagine. There is no such thing as a church “on the way.” They are all very much out of the way. But I suppose that’s why they are still in existence today. The cathedral at Gandzasar, known as the Hill of Treasure, now conducts services on a regular basis. During the war the Azerbaijanis tried desperately to destroy the church. They encircled the building and fired missiles and mortar shells at it. The monastery next door was blown up, but neither the bombs from the air nor the mortar shells nor the rockets could destroy the small cathedral. All the shots missed the church, except one missile that penetrated one meter inside the building but did not explode. The people all talked about the miracle God had performed in sparing the church. Zori told me that during Stalin’s reign, all the priests and bishops in all the Armenian churches were either killed or shipped off to Siberia to be worked to death. 

Our helicopter had to dock about one and a quarter miles down the hill from the church. Dr. Scott and I decided to hike up to the church instead of waiting for a four-wheel-drive rig to take us. The priest and the people of Gandzasar had planned a spectacular feast in our honor. Two men led two young sheep through the ancient churchyard and back behind the monastery, where the sheep were butchered for our lunch. As some of the men cut the meat, others built the fires, and still others began stabbing the meat onto shish-kebab skewers. Mountain-village women prepared breads and salads and cooked vegetables to be placed on the nearly forty-foot-long table. By the time we were ready to eat, over fifty people sat down at the table. 

The generosity of the Armenian people is almost incomprehensible. They have nothing, and yet they will give you anything and everything they might have. The average Karabakhi makes only one thousand drams a month, and a loaf of bread costs one hundred drams. That equates to purchasing ten loaves of bread a month—and nothing else. Our interpreter, Irena, who speaks three languages and works for the health ministry, earns an income equivalent to twelve US dollars per month. She has to feed two teenagers as she tries to live on such a salary. Yet there is nothing she would not do for a guest or for someone she saw in need. 

After the feast Zori had one more surprise for us. We all got back into the helicopter and flew a ways farther down the mountain close to the village of Vanenka. Rafee, the pilot, set the big, ugly, orange bird down about one hundred yards from the cottage of a mountain beekeeper. As we walked from the chopper to the house, I noticed hundreds of blackberry bushes just loaded with ripe berries. The lady of the cottage had set a very long table loaded with bread and bottled mineral water. Between the small house and where the table was set in a tree-lined opening, we had to cross a small creek.

Set up alongside the creek was a beautiful antique samovar filled with boiling tea and a small burning log in the center chamber of the samovar keeping the liquid hot. I had no idea how old the samovar must have been, but it delighted me to see it in practical use out in the rugged mountains of Nagorno-Karabakh. 

Before we were seated at the table, the bee farmer directed us to the area where he kept his beehives. He gently shooed the bees away and opened the top of the hive. Then he carefully tugged and pulled one of the thin sections from the hive where the bees had built their honeycomb. He repeated the process until he was certain he had retrieved enough honey for our dessert party. 

Once seated, we were served piping hot tea, fresh bread, large platters of fresh honey still in the honeycomb, and generous helping of blackberries in thick, sweet juice. I don’t know what heaven is going to be like, but I think I will suggest to the Lord that he include in the venue something quite like that setting in the wooded mountains of Karabakh along the stream, with honeycomb, fresh bread, fresh berries, and hot tea. 

Monday, August 17

The health minister suggested we perform the needs assessments at the children’s hospital and general hospital today, and the maternity hospital, military hospital, and psychiatric hospital tomorrow, and then drive out to the region near the front lines of the war on Wednesday to a town called Martakert. That way we will have been able to assess six of the institutions by the time we have our next meeting with the prime minister. Additionally, we set our final meeting with the minister of health for Wednesday at 5:00 p.m. to bring him a complete report on our findings and deliver our recommendations for the region’s health-care system. 

On our way to the children’s hospital, I was watching the people of Stepanakert as they walked along the streets. For a two-block stretch, there were no people on the streets except women. I turned to the backseat where Irena, our interpreter, was riding and mentioned my observation that the streets were filled with only women and a few children.
 

“That’s because our men are all dead,” she replied. She then told us that her husband had been an antiaircraft gunner in the war. He survived being shot during the war but died a short time after the signing of the cease-fire as a result of some kind of head or brain injury. Now she has been left alone to raise her teenage son and daughter. “It is impossible to live on what we earn in Stepanakert. I earn the equivalent of twelve US dollars a month for many long hours. I have tried to find students who want to learn English, Russian, or American English. But the problem is that they don’t have any money either, so it is difficult for them to pay me.” 

She then went on to add, “But I don’t have it as bad as many in Stepanakert. Nearly 80 percent of all the families here do not have a husband or father in the home. They are dead, and the wife now has to raise a much bigger family than mine, by herself, and also try to earn a living.” 

For the rest of the drive to the hospital, all of us in the car just sat there stone silent. 

Why, I thought, are we the first ones to come and help the people of Karabakh?

Next Week: Astonishing Miracles

© Dr. James W. Jackson   

Permissions granted by Winston-Crown Publishing House


Journal Highlights: Roads I Have Traveled ... Excerpt #3 Nagorno-Karabakh, 1998

(continued): Nagorno-Karabakh: August, 1998:Stepanakert was our destination. It is the capital of Nagorno-Karabakh and houses the country’s government buildings. The helicopter pilots gently set our ugly orange bird down in the midst of its own tornado and dust storm. When the chopper blades ceased rotating, a pilot named Uri opened the door, and we were allowed to crawl out. The air was hot and muggy, and there was no breeze at all after the helicopter’s windstorms died down. Vans were at the airport runway to meet us at Zori’s prearranged direction. I already perceived that Stepanakert is a lot different than Yerevan. There was something of bleak solemnity that permeated the spirit of the city. I could feel it. No one smiled. The expressions on people’s faces showed neither happiness nor pleasantness; rather, their facial muscles drooped, which had the effect of making their eyes look even sadder.

Our vans and taxis rendezvoused at the government buildings in the center of Stepanakert. The hotel in which four of us are scheduled to stay is only one block away from the main government building. I grabbed my luggage and went quickly with the others to get checked into our rooms and freshen up a bit before our scheduled 5:00 p.m. meeting with the minister of health.

The hotel had known its days of glory and splendor in the past, I was certain. But that must have been over a hundred years in the past. Since then, I don’t think any maintenance had been performed at all. In addition, the building had taken some direct hits during the bombings of the past few years. As we entered, I looked up to the ceiling of the lobby area and marveled at the half-destroyed remnants of crystal chandeliers hanging precariously from the ceiling. Most of the crystal pendants were missing, and the few that remained closely matched in color the tarnished brass of the fixture. I guess I should have just kept focusing on the broken chandeliers, but I made the mistake of looking around at where we were expected to stay. Most of the rooms were uninhabitable, with collapsed plaster ceilings or broken walls or doors. I recalled all the terrible places around the world where I had been expected to lay my head down and sleep, and at first I figured I would just take a deep breath and make the present situation work.

A pudgy, unkempt woman met us as we came in and handed us a couple of keys. She then accompanied us to our rooms on the third floor. On our way upstairs, I began to notice that the hotel wasn’t just old and war damaged; it was grossly filthy. At the door to one room, the unpleasant innkeeper communicated to us in Armenian that she expected three of us to stay there. But there were only two beds. We protested, but she countered by showing us that it was the only room in the hotel that had its own bathroom. We stepped in to have a look-see—we shouldn’t have. She lost her sales point. The bathroom was a terrible fright. The floor had been torn up and not repaired, so there were piles of dirt and broken concrete to sidestep. The mirror consisted of just a few broken chunks that still stuck to the wall. The sink was crusty, but we were to discover that this didn’t count for much, since there was no running water available on floors two and three. Obviously the toilet wasn’t of much use, since there was no running water. But they had tried to compensate for that by filling the dilapidated bathtub with some drain water they had carried up in a rusty bucket and dumped.

I made signs to the lady as if I were turning on and off a water spigot, and hand motions as if I were taking a shower. She cracked about a half smile and pointed back down the stairs. We all then communicated to her that we wanted to see the running water downstairs. After all, we were going to be here the major portion of a week! She pointed to her watch and indicated that there would be no water even downstairs until after 5:00 p.m. We insisted on seeing the shower room anyway. I will let your own imagination paint the picture of what we found there.

Thinking we had no other options, we put our suitcases in the rooms, and as we walked down the stairs and out the door to our meeting with the minister of health, Dr. Scott Stenquest, Dr. Anthony Peel, and I talked about perhaps using the old sofas in the lobby as beds.

Our meeting with the health minister, Dr. Aleksander Petrossian, really got our visit off on the right foot. There was an instant bonding between the two of us, and I knew I would be able to work with him in the future. I explained to him all about Project C.U.R.E., why we had come, and how the needs assessments would be conducted in his hospitals with his cooperation and blessing. I was then perhaps a little more stern with the health minister than I needed to be in explaining my expectations for getting the containers into the country and the distribution process. 

While I was laying down my points in no uncertain terms, I had a flashback of my presentation in a similar situation in Benin, West Africa, when my snippy, little Baptist missionary, who had never had a meeting with a government official higher than the local traffic cop, chided me and told me I had no right talking to a cabinet minister in that tone of voice. Pushing that picture aside, I kept up with the pressure. I was demanding written assurances of getting the medical goods into the country without customs hassles, levied taxes, or transportation delays. I also demanded the right to distribute the goods as we see fit based on the findings of our needs assessment and not based on political determinations. I joked with him just enough to keep him smiling and his head going up and down.

I asked the minister to give me wise counsel as to which hospitals we should visit and in what order. He agreed that by Monday morning at 9:00, he would have all the answers ready for me, and the hospitals notified of my arrival.

At 7:30 p.m., Zori Balayan ushered our delegation into the office of the prime minister of Nagorno-Karabakh, Zhirayr T. Poghosyan. Baroness Cox was extremely gracious in her introduction of Project C.U.R.E. to the prime minister. We only had time to greet Mr. Poghosyan with a few words, because he had pulled himself from another scheduled meeting to meet briefly with us and greet us. It is certainly helpful having Zori make sure we receive our requested appointments with any of the government officials.

Dinner was scheduled at 9:00 p.m. in the lower level of the government building. At dinner Zori told us that this is Lady Cox’s thirty-ninth trip to Nagorno-Karabakh. I have watched in amazement while we have been in Armenia and Karabakh at the recognition and reception the local people give to Baroness Cox. Everyone knows her, or at least who she is. To them she is almost a patron saint. She was there all during the war and held nothing back within her ability, giving aid and comfort during the people’s darkest hours. My respect for her has grown by the day. She really has a gift of love for the oppressed and particularly those of the persecuted Christian church. I am not surprised in the least that she has been given nearly every international humanitarian award for her spirit and her work.

Next Week: Mountain Top Banquet

© Dr. James W. Jackson   

Permissions granted by Winston-Crown Publishing House


Journal Highlights: Roads I Have Traveled ... Excerpt #2 Nagorno-Karabakh, 1998

(continued): Nagorno-Karabakh: August, 1998: The road to the city center of Yerevan, Armenia, passed by a lot of evidence of poverty and deferred maintenance. But the closer we came to the metro area, the more impressive Yerevan loomed. In the distance the beautiful national football stadium, which has a seating capacity of seventy-five thousand soccer fans, could be seen. There were several new buildings, and construction cranes were in place erecting other buildings. Could this be the city that suffered so much from the catastrophic earthquakes in Armenia in 1988, when a quarter of a million people were killed or displaced? 

The downtown hub of the city of Yerevan is one of the most attractive I have ever seen. Buildings of coordinated architecture form a loose circle. Fountains, trees, and one building with a huge city clock grace the city center. But the streets were nearly void of people on this quiet Saturday morning. Business people were home with their families, resting from a busy week, and the majority of movement in the streets was from a cool breeze that wafted its way through the large green trees lining the freshly washed streets leading toward the city hub. I thought to myself, These people have a lot of personal and civic pride. What a welcome contrast to the thousands of dirty, unkempt cities I visit in the developing world. 

Our plans had been to leave right away on our journey to Stepanakert, Nagorno-Karabakh. But somehow the personal communications network had tangled, and since our hosts had not yet arrived at the hotel to meet us, we retreated upstairs and ate a lovely breakfast in the hotel dining room. Eventually our hosts arrived, and we piled into some Russian-built vans and headed to a domestic airport on the outskirts of Yerevan. 

While in Yerevan, we were introduced to one of the most interesting characters of the entire cast of players in Armenia. The historic saga has included many colorful players, but perhaps none more enigmatic as Zori Balayan. Zori is a trained surgeon and has throughout his life been a master sportsman. He has written more than forty books, and during the Soviet occupation of Armenia and Nagorno-Karabakh, he represented his people in Moscow as a people’s deputy in the politburo. Now he is perhaps the leading member of Parliament in the Nagorno-Karabakh republic. In my estimation, Zori is the most influential behind-the-scenes leader in Karabakh. He has a godly old mother of character and wisdom, who prays for him daily, and he honors and respects her greatly. 

I might be mistaken in my personal evaluation of the situation, since I’ve known Zori Balayan for such a short time, but after reading some of his works, observing him up close, and watching the people around him, I judge that he is the kingmaker of Nagorno-Karabakh and perhaps even of Armenian politics. If Zori scheduled a meeting for Baroness Cox or me, the people at whatever level canceled everything else to attend the meeting. 

Zori led us from the downtown hotel to the airport. We passed easily through the heavy security, and our vans actually drove right down the runway to where the flying equipment was parked. 

You have no idea the delight I felt as I crawled out of the van. By going into that guarded airport facility, I had been suddenly transported back into the pages of recent Soviet history. The feeling of awe I felt as my feet hit the tarmac was supercharged as I looked up and spotted in the background another object with even more emotional significance to me. Imposing itself on everything within its influence was the gigantic, snow-clad phenomenon of Mount Ararat, where Noah’s ark had landed so many millennia earlier. The mountain towers more than sixteen thousand feet from its base, taller by two thousand feet than any of the majestic mountains in Colorado. 

Lined up on either side of the runway were pristine vintage Soviet aircraft from a bygone era. The Armenians are still using the large biplanes from World War II. Mixed in with the other planes were the Russian hot-rod Yak-40 military planes still used by many of the Soviet officers. The Yak-40, as you know if you’ve read my other journal entries, has become perhaps my favorite airplane. It seats about twenty-five people and is powered not by one jet engine but by three jet engines mounted at the tail of the plane. It’s like riding on the back of a rocket. 

Farther down the runway were parked perfect specimens of Russia’s famous MiG fighters. The Soviets had abandoned all the equipment in Armenia following the breakup of the Soviet Union. 

Our van had stopped right in front of two Russian Mil Mi-8 combat helicopters. One was painted in camouflage colors; the other was an ugly faded-orange color with blue-and-black trim. It was obvious that the helicopters had been used and abused during the war and in subsequent months. 

Zori told me, “We used to have to negotiate these rugged mountains with mules. Today the helicopters are our mules.” 

Our pilots jumped out of the vans and quickly began to scurry around performing the necessary preflight procedures. It quickly became apparent that we would be flying in the monstrous, ugly, orange-colored machine. At a later point, Rafee, one of the pilots, told me that they will only be able to use the old Soviet helicopters for a maximum of another two years. No more spare parts are available, and no one is making any parts for repairs or maintenance. I only hoped they had been diligent in their maintenance up to the present. 

Once I had satisfied my photo cravings to preserve in pictures the rare sight, I climbed on board the Russian-made bird. As I entered I looked up at the turbo engine that powered the Mi-8 chopper and noticed areas of fresh oil from the engine compartment on top that had run down over the old, oxidized paint. I prayed a brief prayer for protection as I found myself inside the padded cargo area. The seats were in a configuration around a command table in the center of the helicopter’s belly. Lady Cox went up and mingled with the pilots while the rest of our team slithered into the available seats. Zori sat at the head of the conference table, where I suppose he was most used to sitting. In Nagorno-Karabakh, the military people still refer to him as Commissar. 

It took a while to warm the engines up to operating requirements. As the massive blades on top began to rotate, the helicopter began to vibrate. The more I convinced myself to relax and enjoy the experience, the more the severe vibration made my teeth chatter. I decided it was better to be a little tense. 

The severity of the shaking intensified a great deal more as the giant bird tried to lift itself off the ground. But suddenly we reached the necessary height, and the nose of the chopper tilted forward. Immediately the long blades on top began to bite into the air ahead of us, and we took off like a shot. In no time at all, we were traveling not only up but ahead at terrific speed. It was a sensation and thrill I will not soon forget. 

In only minutes we were flying over very rough terrain and between steep mountain peaks to gain the necessary altitude required for our trip from Yerevan, Armenia, to Stepanakert, Nagorno-Karabakh. I was sitting close to a round porthole window and had a perfect view of the terrain below. I spotted a narrow, winding road below, the alternative passageway to Stepanakert for those not fortunate enough to have a helicopter available to them. Some recent repairs applied to the roadway cut about four hours off the regular travel time. Now it only takes ten to fourteen hours to make the journey. We would cover the same distance in about an hour and fifteen minutes. 

No more than twenty minutes into our flight, I began to observe the ravages of the destructive war. I didn’t know then that I was being introduced to emotions and insights that would change my life forever. Having been born just before the United States was plunged into the Second World War, I had seen plenty of pictures and newscasts of the devastation of war. I remembered the pictures of the Korean War and the Vietnam War, and I had subsequently visited all those war sites in my travels. I had also been up close and had personally seen the results of African tribal wars as they were taking place. But before Armenia and Nagorno-Karabakh, I had never been to a war zone on the front lines and felt the impact of loss and the devastation caused by modern weapons of mass destruction.

As I gazed from the windows of the chopper, I began to see whole villages where every building had been blown apart. Trees were uprooted, orchards were burned, and bones of livestock were still strewn in the abandoned farmyards. 

Mile after mile along the once-closed corridor between Armenia and Nagorno-Karabakh, nothing moved. Towns were totally obliterated. All was silent and left to ruin where families once lived in community, children had played, and old women had gathered to gossip. Now all was silent. 

Next Week: Meager accommodations

© Dr. James W. Jackson   

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Journal Highlights: Roads I Have Traveled ... Excerpt #1 Nagorno-Karabakh, 1998

Nagorno-Karabakh: August, 1998: Baroness Caroline Cox, the Deputy Speaker of Parliament’s House of Lords in London is the international head of the English-registered charity, and Stuart Windsor is the United Kingdom’s national director. They had requested the help of Project C.U.R.E. in Nagorno-Karabakh, a little-known but terribly distressed area of the old Soviet Union. 

As far back as AD 340, the Armenians can trace their Christian religious heritage through church buildings and monasteries located throughout the region of Nagorno-Karabakh. From the early 1900s to 1916, the Turks employed radical methods of ethnic cleansing and genocide against the Armenians in Turkey. Those activities all but eliminated the Armenian population from Turkey. Likewise, in 1905 Azerbaijan chose to eliminate the minority population of Armenian Christians from their country. In addition to the tens of thousands of Armenian Christians killed in Azerbaijan, over half a million more fled the country as homeless refugees. In 1919 and 1920, the Turkish and Azerbaijani military forces took land masses for their own that once belonged to the Nagorno-Karabakh Armenians. More ethnic cleansing of the Armenians followed. During the late 1920s and early 1930s, Joseph Stalin tired of the continual tribal fighting within his Soviet Union. He thereupon arbitrarily and capriciously declared the Armenian region of Karabakh part of Azerbaijan. Stalin paid no attention to the fact that there was neither moral nor historic nor ethnic reasoning behind his action to give Nagorno-Karabakh to the Azerbaijanis. He didn’t need a reason; he was Stalin the Supreme. He totally cut off the Armenian enclave of Nagorno-Karabakh from the geographical borders of Armenia. He also destroyed or closed down all monasteries and churches from that time on. 

As the Soviet system began to weaken by 1988, the people of Nagorno-Karabakh voted to secede from Azerbaijan. On December 10, 1991, they passed a referendum for independence and freedom. Azerbaijan’s answer was to impose a harsh and effective blockade around Nagorno-Karabakh, completely cutting off food supplies and travel from the rest of the world. Further, Turkey joined in Azerbaijan’s punitive efforts against the ethnic Armenians in both Armenia and Nagorno-Karabakh by imposing a choking embargo and total blockade around Armenia. They simply hoped to starve out the Armenian Christians. 

Moscow’s Soviet authorities then joined in the fray and once again declared Nagorno-Karabakh under the jurisdiction of Azerbaijan. The Armenians in Nagorno-Karabakh sensed the seriousness the looming death sentence. They endeavored to reopen a route to connect them once again with Armenia. The Soviet Fourth Army joined forces with the Azerbaijani and the Turkish troops and attacked Nagorno-Karabakh with tanks, armored personnel carriers and helicopters. In the early fall of 1991, the joint armies made their intentions known to annul Nagorno-Karabakh’s declaration of independence and autonomy and rename its capital city, giving it a Turkish name. 

Somehow the Nagorno-Karabakh forces were able to fend off not only the army of Azerbaijan but Soviet and Turkish forces as well. As all-out war raged, the idea of genocide in Karabakh grew as a final goal in the minds of the leaders of Azerbaijan. Former Azerbaijani president Abulfaz Elchibey pronounced in June 1992 that if there were still Armenians in Nagorno-Karabakh by October of 1992, the people of Azerbaijan could hang him in the central square of Baku, the nation’s capital. Now, President Aliyev has been reported as saying that the only solution to the problem is the elimination of all Armenians in Nagorno-Karabakh. 

Eventually, against all odds, the Armenians of Nagorno-Karabakh were able to recapture the town of Shushi and open, once again, a corridor to Armenia through Lachin. However, it was accomplished at an incredibly high price of bloodshed and loss of life. The Karabakhi loss was not limited to just the soldiers; thousands of women and children became the express targets of the Azerbaijanis, Turks, and Soviets. Today, the blockade could once again be imposed even though a fragile cease-fire is being somewhat honored. 

Thursday, August 13, I arrived from Denver at London Heathrow Airport. At 5:00 p.m., I was able to meet up with the other team members I will be traveling with to Nagorno-Karabakh. Lady Caroline Cox is the excursion leader. During the terrible war years in Nagorno-Karabakh between 1990 and 1994, she went at least once a month and rode with the helicopter pilots as they flew the dead and wounded out of Stepanakert, Nagorno-Karabakh, across the blockaded corridor into Yerevan, Armenia.

The people of Armenia and Nagorno-Karabakh view her as a hero for her work in bringing supplies and aid to the Armenians, as well as standing boldly before British Parliament. 

Stuart Windsor, a retired British military chaplain who lives in New Malden, Surrey, England, is the UK national director. Stuart went many times to the front lines of the war and prayed with the Armenian soldiers and held the heads of the dying men. Stuart and his wife, Ethel, will also join us on our trip from London as well as a team of five doctors from US and UK. 

It was a five-hour flight from London Heathrow to Tbilisi, Georgia, south of Russia on the Black Sea. Our delegation took British Airways flight 6711 to Tbilisi and then continued on with British Airways to Yerevan, Armenia, arriving at about 8:30 this morning. As soon as the luggage was collected and we cleared customs, we took vans directly to the Armenian hotel in downtown Yerevan where we will be staying. 

Next Week: From Yerevan into war-torn Stepanakert

© Dr. James W. Jackson   

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Journal Highlights: Roads I Have Traveled ... Excerpt #1 1998, Introduction to Baroness Cox Deputy Speaker of the House of Lords

Note: I want to share with you a bit of the life of one of my very dear friends from England. Baroness Caroline Cox is one of my heroes. This short introduction is taken from my soon-to-be-released book, “Better Off: Rediscovering the American Experiment.” In the weeks that follow, the JOURNAL HIGHLIGHTS series will include excerpts from my actual journals that cover our work together in the little country of Nagorno- Karabakh Keep an eye open for the new book release.

One Tough and Compassionate Lady
When it comes to personifying the economics of the interior, I don’t believe there is any finer example in our contemporary era than Baroness Caroline Cox. 

Caroline Cox became a registered nurse in the 1950s and met her future husband, Murray, while working at a London hospital. After marrying and starting a family, Caroline earned a first-class honors degree in sociology at the University of London and a master’s degree in economics. She went on to write several books on nursing and teach sociology at a London university, where she collided head-on with academic elites who forced their Marxist views on the students. 

After enduring years of their intimidation, she coauthored The Rape of Reason, which courageously exposed their warped beliefs at a time when standing for democratic ideals was extremely unpopular. In 1977, Caroline embraced a new challenge as the director of nursing education research at Chelsea College, University of London. 

Prime Minister Margaret Thatcher was so impressed with Caroline’s indomitable spirit, high energy, and brilliant work that she exerted her considerable influence to see Caroline become Baroness Cox of Queensbury and a life peer in the House of Lords in January of 1983. Lady Cox became Deputy Speaker of the House of Lords in 1985 and served in that position until 2005. 

What did Baroness Caroline Cox do with her new title and position of influence? 

Instead of just parking herself on the red leather benches in the gilded chamber of the House of Lords, Baroness Cox began using the precious assets in her market basket to help other people become better off. Penetrating the Iron Curtain of the Soviet Union, she risked her life to deliver load after load of desperately needed humanitarian goods to Communist Poland, Romania, and Armenia. 

Lady Cox also sought to help the people of Nagorno-Karabakh. Mass murderer Joseph Stalin had arbitrarily separated the small country from its motherland, Armenia, and had given it to Azerbaijan to placate the violent Muslim extremists. Eventually Azerbaijan, Turkey, and Russia embarked on a plan of ethnic cleansing that would systematically annihilate the inhabitants of Nagorno-Karabakh. Baroness Cox stood up in the House of Lords and brought the situation to the attention of Parliament and the world. No one else seemed to care … except Baroness Caroline Cox. But Lady Cox didn’t just talk about the situation; she sprang into action. She traveled to Yerevan, Armenia, climbed into a military helicopter, and flew into the war-torn enclave of Nagorno-Karabakh to help evacuate the wounded and dying. Her nurse’s training also equipped her to provide essential medical care to the evacuees. 

I first met Baroness Cox in 1997 when she and her executive assistant, Stuart Windsor, came to Colorado to get better acquainted with Project C.U.R.E. After learning about our international experience, they had determined that we were the best organization to help them with their humanitarian work in Nagorno-Karabakh. 

I joined the baroness on her thirty-ninth trip to the decimated country, where I learned that she had once walked directly through the line of weapon fire, waving a white tablecloth attached to a branch, and crossed the Azerbaijan border to personally confront the Muslim thugs who had been murdering the Karabakh inhabitants and torching their homes. She was determined to meet these thugs face-to-face so they would take her seriously. They soon learned that Caroline Cox was one tough lady! 

Over the years her compassionate endeavors have led her into many zones of conflict throughout the world, including Sudan, Nigeria, Uganda, Myanmar (Burma), and Indonesia. She even injected goodness into the former Soviet Federation, helping government officials change their policies on orphaned and abandoned children and establish a foster-care system that would place children in families rather than institutions. (I would enthusiastically encourage you to read Andrew Boyd’s book Baroness Cox: A Voice for the Voiceless, which chronicles Lady Cox’s inspiring life story and the magnificent humanitarian work she has been involved in.) 

Baroness Cox has received many international awards for her humanitarian work, including the Commander’s Cross of the Order of Merit of the Republic of Poland; the prestigious Wilberforce Award; the international Mother Teresa Award; the Mkhitar Gosh medal conferred by the president of the Republic of Armenia; the anniversary medal presented by Lech Walesa, former president of Poland; and an honorary fellowship of the Royal College of Physicians in London, England. 

After all these years, Lady Caroline Cox is still investing her life, her unique abilities, and her influential position to spread goodness around the globe. She’s a classic example of how just one person, guided by the economics of the interior, can help others become better off. 

Next Week: Connecting with Project C.U.R.E.

© Dr. James W. Jackson   

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Journal Highlights: Roads I Have Traveled ... Excerpt #5 Ukraine and Atlanta January 1997

(continued): Ukraine/Atlanta: January, 1997): After sharing some other more generalized observations of international health-care systems, I began to describe the unique role Project C.U.R.E. plays in providing donated health-care products to newly developing countries around the world. I explained how we are presently shipping medical goods to over forty different countries. Then I related to them the way Pro­ject C.U.R.E. got started and a bit of its colorful history. The group was fun to talk to because of the extreme diversity of the individuals, combining the Ukrainian delegation with the board of directors of the Association of American Physicians and Surgeons (AAPS) resulted in a very interesting mix. 

While I was talking, one of the AAPS board members raised his hand. I stopped and acknowledged him; then he asked, “Mr. Jackson, just why are you doing what you are doing, and why are you here helping the Ukrainians rewrite their laws?” Dr. Ballantyne, who is famil­iar with my past, just looked at me and grinned. I knew he was wondering just how I was going to handle the question.

I began to tell them what a dramatic difference God had made in my life—how he had changed me from a person who was totally consumed with accumulating wealth for myself to a person devoted to sharing God’s love by helping hurting people around the world. As I glanced across the room, I saw Dr. Raisa Burchak, the wife of Dr. Fedir Burchak, the legal advisor and personal confidant of the president of the Ukraine. She had her lace handkerchief out and was crying. Perhaps it was the first time she had ever heard about the transforming grace of God.

I finished my part of the speaking agenda by challenging everyone there to consider moving from a personal position of success to a position of significance in their lives:“Do some­thing significant that will last forever.”

After the session, Dr. Fedir Burchak and Raisa came up to me and hugged me. Dr. Raisa said, “I learned many things during these hours, but perhaps the greatest thing I learned I learned from your heart.”

Sunday, January 12

It is necessary for me to return to Denver early, so I will be unable to personally say good‑bye to my new friends from the Ukraine when they board their flight for their return trip. But as I left the symposium and boarded my plane to fly home to Denver, I had to stop and thank God for allowing me to be a small part of such a historic occasion.

Who would have ever believed on December 17 that all the necessary elements for success would have come together in such a short time and allowed us to actually organize, offer, and present this economic symposium?

I don’t know at the moment how the newly proposed health-care laws will be accepted in the Ukrain­ian Parliament, but I rest in the fact that when Dr. Mark Johnson and I saw the need to help, we were able to respond in instant and complete obedience. I will always hold as extremely valuable the memory of how God blessed our simple efforts to help and brought together all the correct people in such a short span of time, and did it in a way that brought honor to God and dignity to the efforts. 

© Dr. James W. Jackson   

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Journal Highlights: Roads I Have Traveled ... Excerpt #4 Ukraine & Atlanta 1997

(continued): Ukraine/Atlanta: January, 1997: Nowhere else could they have accessed the information, intelligence, and experience available to them in Atlanta this weekend. And perhaps most important, they are experiencing the gift of love and concern for the people of Ukraine and their future. They have been, for the most part, responding with appreciation; however, each has lived an entire lifetime under the old, centralized Soviet system, and occasionally I could see that it is difficult for them to break from the “security” of that system.

Dr. Mark Litow, the actuarial consultant, used his time to identify and explain some of the strengths and weaknesses of the US health-care system. He spoke of the types of systems involved and the six distinct market groups receiving health care in the US. He pointed out how, as the US has moved toward a more socialized, centralized health-care system, we have increasingly been pushed further and further into debt. Today half of the US deficit is caused by Medicare alone. He suggested three desirable elements to be included in health-care reform:

1. Reasonable cost

2. High quality

3. Access to treatment

Dr. Litow used a lot of charts and overhead projections to simplify the understanding of his facts. For the largest portion of his time, he presented concepts he feels are necessary for the reform process and package.

The openness of the meeting made it conducive for the Ukrainian delegation to freely discuss their present health-care system. They revealed that in 1985, the equivalent of US$180 was allocated per person per year for health care in the Ukraine out of the government budget. In 1994 it dropped to only $16 per person per year. Now the system has completely collapsed, and the state is completely irresponsible. They have eliminated over sixty thousand beds from hospitals throughout the system, and their doctors have not received their government paychecks (only the equivalent of US$50 per month) for four or five months.

The situation has made criminals out of nearly every doctor, since doctors are now forced to treat patients privately (from their back doors or in some secret place) in order to try to generate some cash on which to live. Presently such activity is punishable by imprisonment. The situation has presented the entire country with a huge moral problem. The state simply cannot come up with the necessary $1.8 billion to provide medical care for the people this year.

As we broke for the dinner hour, a whole lot of frustration was evident, but what had been presented to the delegation was making sense, and comments were indicating hope and the possibility of workable ideas.

Following dinner we combined the Ukrainian delegation, all of our presenters, and the board of directors of the Association of American Physicians and Surgeons (AAPS) for our final session of the day. I was chosen to speak during the first half of the session. The final portion would include a round-table discussion in which the Ukrainians would explain their present system and situation, and the entire group could ask questions or offer insights.

I had thought about what I was going to say for several days and had also used the flight time from Denver to Atlanta as an opportunity to crystallize my thoughts. I did not want to denigrate the Ukrainian health-care system and exclusively emphasize their problems. So I decided to share with the whole group some of the observations I had made in my hospital Needs Assessment Studies around the world. The Ukrainian delegation could readily identify with each of the problems, but I wouldn’t be pointing my finger directly at them. I titled my presentation “International Health-Care Observations.”

I am continuously crisscrossing the avenues of a bankrupt portion of the world, viewing the aftermath of the great social experiment of the past eighty years. It promised everything and ultimately delivered nothing. Why? Because you can only pursue the philosophy of redistribution for a limited period of time. After you have stripped the treasure chests of accumulated wealth from a nation and wasted it without any plan to replenish the coffers, it becomes impossible to redivide and redistribute “nothing.” That sort of set the groundwork in my presentation for the following observations:

1. In theory, you can argue that a centralized health-care delivery system has the advantage of efficiency, but lost-opportunity costs are unacceptably high. In my bookWhat’cha Gonna Do with What’cha Got?, I tried to explain the economic principles of scarcity, choice, and cost. Items are scarce because they have two or more alternative uses, but eventually you must choose one of the alternatives. The next highest valued other thing or other use you give up is the real opportunity “cost” of what was chosen, because you have to do without that. In North Korea, the health-care system is very centralized and very regimented. It appears to be efficient, but the rigidity of the system disallows any creative or altered approach to a medical procedure. The lost-opportunity costs are very high. 

2. A centralized health-care system does not allow for keeping pace with medical discoveries and new technologies. Example: The head doctor in one of Cuba’s largest hospitals begged me to bring in new medical procedural and research books. “We are so restricted,” he said, “we don’t even know current medicine.”

3. Health care that is freely available to all is the same as equally unavailable to each. Example: In Brazil and Peru, I saw people coming to a clinic in ox carts, in old buses, or on foot. They would stand in line all day only to have to return the next day and get back into line because they were unable to receive help.

4. A centralized health-care system produces overspecialization and undertraining in general family medicine. Example: In Uzbekistan, a young doctor told me, “I am trained to remove gallbladders. I don’t have to be responsible for anything else.” One man in Moscow told me, “I’m sorry the hallway is completely dark, but the man who is trained to change lightbulbs doesn’t work anymore, so we are in the dark now. I don’t change lightbulbs.”

5. In a centralized health-care system, there is a built‑in disincentive to take any risks or make any decisions to do anything new. Example: In Minsk, Belarus, I watched a medical team in a burn unit just stand and watch rather than deviating from the standard care procedure. In a centralized system, there is no way to experience a reward for doing something new or different, but there is almost a certain possibility of experiencing loss for trying something different.

6. When a centralized health-care system controls a single source of medical supplies and goods, the level of quality usually suffers, and the delivery system for those goods becomes inadequate. Many of the hospitals I visit around the world experience the same thing. Example: Doctors often tell me, “Mr. Jackson, we have not been able to get the medical supplies we need for several years now.”

7. A centralized medical system can seldom get the cost-versus-value ratio correct.Example: In countries where the value of the health care given is greater than the individual cost paid, people use too much health care. Long lines form, and the people who really need the care are excluded because of the long lines. If the cost charged is greater than the value received, then no one can afford the health-care services.

8. Hospital stays are longer where there is a centralized health-care system.Example: In Kazakhstan and Uzbekistan, it is not unusual for a patient who has experienced a heart attack to stay in the hospital seven or eight weeks. The hospital receives its budget allocation based on the number of patient days. There is no incentive for the patient to be sent home earlier.

After sharing some other more generalized observations of international health-care systems, I began to describe the unique role Project C.U.R.E. plays in providing donated health-care products to newly developing countries around the world.

Next Week: Change in more than health care.

© Dr. James W. Jackson 

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