I want to thank the conference organizers for the invitation to be with you today on this tenth anniversary of Doctors for Global Health. I had hoped to be with you most of yesterday, but enroute back from a human rights mission to Guatemala earlier in the week I experienced some bone rattling chills and drenching sweats the likes of which I haven't had since El Salvador.

I thought, "Uh oh, what is this and how is it going to declare itself?" Fortunately, it just turned out to be bronchitis and I'm on the mend. That was a lovely film last night. The blend truth telling about tragedy and hope was done with such grace.

Speaking of sweating, the speeches which I sweat the most over are commencement speeches, because I feel the graduates deserve my best shot. I labor over those for months. The task is pretty clear—you have to be inspirational, funny and short and it's the only time in life where you are expected to give advice. I've actually tossed and turned more over what to say today than over most commencement speeches. That's a compliment to you. It's because you have done and are doing the same things I have done. It's because your peers are the hardest audience in some ways. So in the spirit of commencement addresses I'll try to be short, inspirational and funny, but avoid giving any advice.

I don't recall the specifics. Maybe Lanny can remind me during the Q&A, but I do recall talking to him on a number of occasions about his project in Morazán, both early on and certainly over the years. I think that what you've done and what you're doing there and elsewhere is incredibly important on many levels. DGH and I both have our roots in El Salvador, in witness, and in accompaniment. Enroute to El Salvador I ran out of money in the sixth week of language school—that's before the all important subjunctive.

In one of the villages I served there were a group of old men that were always sitting in front of the bombed out church. Because I had graying hair they immediately adopted me as one of the own. Once I thought I asked them, "How many years do you think I have?" They all laughed hard and said, "Well, down here most of us have one, but you Yankees probably have a lot!" The word in Spanish for year is anos with a squiggle over the n. I had asked them how many assholes do you think I have? News of that traveled around the volcano like a fast wind and entertained people for weeks on end. We were bombarded or rocketed or strafed every day, so whenever possible I made myself the object of humor and enjoyed their laughter and mine.

As I mentioned I've just returned from a human rights mission. There were a dozen people on the mission—all activists. One of them regularly attends Nation magazine seminars loaded with powerful speakers, she religiously participates in the World Social Forum, has traveled in solidarity exchanges, and is a lifelong activist. She said that week was the most powerful experience of her life. Imagine how much deeper it could have been had she worked side by side for several weeks or several months with the Mayans with whom we visited.

Looking in the rearview mirror of my own life, I believe that we grow and get far more from these experiences than we give. They change us forever in ways that continue to unfold throughout our lives. At UUSC we call them 'experiential education' and I intend to greatly increase the opportunity for our members to participate in such life transforming experiences.

The Board of Trustees of UUSC expects me to be in a pulpit twice a month, so I'm getting exposed to a lot of church. My wife is an atheist and I've claimed the Quaker faith for years, but fortunately in Unitarian Universalism we've found a place where we both feel comfortable. Slightly more than half of Unitarian Universalists are atheists, but it is a broad tent under which people of many beliefs find community. This is all a lead in to the title of my talk today, which comes from the refrain of a UU hymn called, "Come Sing a Song with Me."

The words to the refrain are, "And I'll bring you hope when hope is hard to find, and I'll bring you a song of love and a rose in the winter time." It's a lively song and has become one of my favorites. I'll come back to it in a moment.

This year I returned to El Salvador for the first time since just after the Peace Accords. On that trip in 1992 I had hoped to visit Lanny and Maruca, but the military didn't forgive or forget that easily. Though their Ambassador at the U.N. had personally issued my visa, the military pulled me into an interrogation room and read my yard-long 'rap-sheet.' They reminded me that the Ambassador lived comfortably in NYC and hadn't fought the war. I was able to meet with some of the demobilized guerrillas from Guazapa. Unable to clearly read the signals of security forces that continued to watch and harass me, I cut the trip short.

I returned this year for the 25th memorial of Archbishop Oscar Romero's assassination. It a was very powerful occasion—the memorial of Cuscatlan, which is the wall of names of civilian dead reminiscent of the Vietnam Veterans Memorial; meeting with many people I hadn't seen since the war, whom I wasn't sure had survived; meeting a college student whom I was told by his father I delivered under difficult circumstances under the noses of a military garrison atop the volcano; seeing a thriving cooperative of ex-combatants that includes men who fought on both sides of the war; seeing how very little has materially changed for the lives of peasants and urban poor.

I saw person after person who had a story that I hardly recognized about how I had saved them or their child or family member. It began to dawn on me that what had been important and perhaps lasting about my moment in their lives was that I brought them hope where hope was hard to find. Those encounters with them were usually brief. I walked a circuit of some dozen villages in a 225 square mile area, seeing patients form seven a.m. to about noon, then visiting those how couldn't make it to the clinic, eating a couple of tortillas and a few beans for lunch, and then walking to the next village, which might be four or six hours away depending upon whether it was the rainy season and whether I could hide amidst the lush ground cover. In those morning clinics, I would see fifty to sixty patients, so there couldn't have been more than a few minutes with each patient.

I would give them a little medicine, sometimes a placebo of vitamins and as much kindness and gentleness as possible. As I look back at their memories of those encounters, I think more than anything I offered them dignity, of which there wasn't a lot of in their lives. I think the gift of dignity is what also gave them hope. They remember those encounters in grossly exaggerated ways that would lead you to believe I was a Bernard Cooley instead of a young physician who had only completed the first year of a Family Practice residency.

I know what I say will have a resonance with your own experiences. And I think we can generalize even further. I think the act of accompaniment, the act of standing beside people in stress, whether the stress is violence, injustice, or poverty "brings hope to people in whose lives hope is hard to find." And, of course, as physicians we bring hope as well—even when hope is hard to find. I applaud Lanny, Maruca, Jen all the partners who have traveled from afar, and all of you, who have struggled to continue to provide not only the avenues for service and witness, but the opportunity for personal transformation that comes with the kind of work you do—and the hope you have brought to so many.

I previously mentioned the importance of your work "on many levels." One that we shouldn't discount is the power of witness. Quakers call it 'speaking truth to power.' There is incredible power in the stories we can tell as health care providers, because the language of health is universal transcending borders, cultures, languages and politics of all varieties.

I was on an emergency human rights mission to Iraq just prior to the outbreak of the current war. We were taken to a small pediatric hospital. We had translators with us from Jordan because we wanted to have our own translation, and they were used to translating everything both ways immediately. The pediatrician in the small hospital with 50 beds said the census was now 156. Of course there were mothers with each of the children at the hospital and two slept on the floor and they rotated the bed every eight hours so one of the mothers and children got the bed every eight hours.

We were taken to a mother who was holding her daughter of about three or four in her lap quite emaciated. The daughter was mewing like a kitten. The pediatrician explained that the mother had traveled eight hours because she had heard this hospital had the medicine to treat Kala Azar (leishmaniasis). It had been well controlled before the war, but when we prevented the import of pesticides with the embargo the sand fly that transmitted it began to cause an epidemic of this disease.

Then he said in perfect English, "I haven't told the mother yet there's no medicine. It would be kinder if we shot this little girl in the head rather than send her home to die the lingering death that awaits her." He had said it in English so the mother wouldn't understand but the translators, who were used to translating everything immediately, translated it to Arabic. And the mother's eyes overflowed with tears.

I believe pediatricians are the kindest physicians in the world and it was the sting of what that pediatrician had said that said a lot about pre-war Iraq.

I went back to an Internet Café in Baghdad that night and sent that story to about twenty friends whose e-mail address I could remember. You couldn't surf the Internet but you could send and receive e-mail from an address that was undoubtedly monitored. I encouraged my friends to share the letter with their colleagues. Within hours that story was ricocheting around the world. Within ten days I was getting responses from activists in the West Bank, Argentina, China, India, Austria, Kenya, and Vietnam. Some who knows about how to track there things estimated the letter was read my more than 350,000 people in more than a hundred countries within ten days, because of the number of web sites to which it was posted.

Our stories, our witness, the plight and lives of our patients have a poignancy that is at times transcendent. I hope you encourage participants in DGH opportunities to keep diaries. Had it not been for my diary in El Salvador, I don't think I could have written Witness to War. As we move from one stressful situation to another, one improvisation after another, one heartbreak to one triumph, it is easy for the details to fall by the wayside. Though I wrote WTW only six months after leaving Guazapa, I would read a page of my diary and twenty pages of memory would come flooding back, but without the diary those details might not have been accessible. I think a diary is also invaluable in documenting our own subtle transformations that we might not otherwise recognize or worse yet want to acknowledge.

Another level of impact of accompaniment on me has been how I come to understand the U.S., its culture, and its impact on the world by living in another culture. Most Americans never have that privilege and so they are puzzled by how we are regarded in the world today. They are perplexed about the origins of terrorism. They are too often deluded by our own propaganda, which I think is one of the greatest dangers in the world today.

If the President can lie about weapons of mass destruction, of the President can fool the world that Saddam's toothless army was a threat to his neighbors, if he can convince the public that there was a direct link between Saddam Hussein and Al Qaida where there was none, if he can rationalize a war whose ultimate victims are largely civilian because we need to 'liberate' them in the name of democracy when we care one whit about democracy in neighboring nations with oil reserves, then we are seriously endangered as a culture and as the world's sole superpower.

I would be remiss if I did not acknowledge that today is the 60th anniversary of the nuclear destruction of Hiroshima. President Truman didn't tell the public about the atomic bomb until August 9th, after Nagasaki too had been destroyed. When he did tell them, here's what he said, "We thank God that is has come to us, instead of to our enemies; and we pray that He may guide us to use it in His ways and for His purposes." What a contrast Truman's public pronouncements compared to his diary entries after the Trinity test in July 1945, when he wrote, "We have discovered the most terrible bomb in the history of the world."

If we only spoke of Hiroshima in the abstract today, we would be doing both the victims and the survivors a disservice. An estimated 140,000 people died that day or within six months and over the decades an additional 60,000 died as a result of the radiation related illness, and we still don't know how many future generations will be affected. Let me tell the story of one-third generation child.

For some, each day has been a struggle against the deadly effects of the weapon that ushered in the nuclear age. On top of a hill overlooking the southwest of the city stands a nursery home for A-bomb victims with conditions too serious to be treated at home. The average age of the 99 patients is 83, but among them is 59-year-old Toshio Ueda. Ueda suffered "in-utero exposure," meaning he was in his mother's womb when the bomb unleashed its fatal combination of heat rays, explosive power and radiation.

His mother hid the fact that they had suffered the bombing until he was nearly 30. But Ueda, who had no visible deformities, said he had endured mysterious symptoms long before that, including persistent bleeding from the nose and gums. "I was week and often unable to go to school," he said, sitting in a wheelchair with plastic tunes supplying oxygen through his nose.

He developed kidney trouble when 15 and heart problems in his 30s before suffering multiples symptoms, including thyroid disorders and diabetes after turning 40. The effects of the radiation were not limited to Ueda—his son had to undergo surgery for cancer at the age of two. How many other generations will inherit the consequences of that fateful day?

During the last year of the Clinton Administration, the parties to the nuclear Non-Proliferation Treaty (NPT) agreed to 13 Practical Steps for Nuclear Disarmament, including an "unequivocal undertaking...to accomplish the total elimination of their nuclear arsenals..." It seemed to be a significant breakthrough. Yet five years later, in the fourth year of the Bush Administration, at NPT Review Conference, the United States had fulfilled none of its obligations under the 13 Practical Steps, and refused to allow an agenda for the conference that even made reference to them.

The Bush Administration wants funding for new nuclear weapons, particularly earth penetrating nuclear weapons, or "bunker buster." They want a world in which there is no place outside the range of their nuclear weapons. It is frighteningly dangerous world in which the United States would remain reliant upon nuclear weapons and continue to threaten their use for the indefinite future.

Though some of the people who are our role models like Jack Geiger, Helen Caldicott, or Vic Sidel were enmeshed in these matters for decades, they are not historical issues. Fifteen years after the breakup of the Soviet Union, the US and Russia have friendly relations. Yet both Russia and the U.S. have more than 2,000 long-range nuclear weapons targeted on the other on hair-trigger alert, ready to be fired in moments. Vladimir Putin recently said that he considers the break-up of the Soviet Union the great tragedy of 20th Century. We are fortunate that our colleagues in Physicians for Social Responsibility represent our profession's voice in nuclear-related matters.

In the U.S., we spend half of the world's total military expenditure, more than $500 billion annually, and we still are not secure. We seek inexpensive sources of oil, and we pay the price in blood, a little of our own but mostly that of others. Iraq costs us $4 billion a month but those are only the monies we are allowed to know about—we know the real costs of wars only come out when the 'black budgets' are revealed years later.

And so how do I tie this all together—your anniversary, the transformative work, and witness of DGH, the hegemony, arrogance, and abuse of the United States in the world today, the tragedy of Hiroshima and the trashing of the non-proliferation treaty by the U.S. as it seeks new nuclear weapons?

I think this is tied together by the incredible privilege and responsibility we have as citizens of the United States. We elect the men and women who rubber stamp or don't rubber stamp what the president wants. We elect the most powerful figure in the world. He is accountable only to us, the electorate.

Several days after the last election I got a letter from a dear friend in Lima, Peru, Bill Monning. He's a lawyer and co-founder of the Salvadoran Medical Relief Fund. Bill related his conversation with a taxi driver, who told him, "Everybody in the world should be able to vote in your elections since your government controls what happens in the world..." Bill then spoke of 'the global majority' who are not unlike most of the people DGH has and do work with throughout the world. What follows in what Bill called his 'post-election rant:'

"Living at poverty or below. Unrepresented by political parties or incumbent governments. The global majority is working to survive, uneducated, without political power, and without voice. We should regard them as our allies who deserve to be heard, to be included in the division of the global pie, globalization's dispossessed.

"Give them all the vote. Send the exit poll experts into the field. Conduct some exit interviews when workers leave the gold mines, the sugar plantations, the textile sweat shops, the high tech assembly lines, and the subsistence farmer's waterless plot of land. Ask the global majority whether they favor tax cuts for the rich or education, abstinence or family planning. Ask the surviving family members of innocents killed by precision smart bombs or car bombs if they favor more war like the massive assault about to begin in Fallujah or do they support negotiation and mediation that could lead to an American exit from Iraq.

"Give them each a vote, give them all a vote, expand democracy, build democratic institutions, expand the franchise. Include the immigrant workers forced to leave their families to cross armed borders as economic refugees.

"Since they can't vote, convince your dispirited colleagues to link arms, keep marching, and pretend they are voting for them. Yes, the forces arrayed against us won a short-term victory—but it was only that. They will not rest, but they will feel safe in their victory. We cannot rest, the global majority never rests, the working people only dream of rest.

"We will not rest. We will not mourn this election result. John Kerry may rest. The Democratic party may retreat to its reduced seats in the Congress, but the global majority is not allowed to rest, they look to us in the U.S. as their hope, their eyes, their voice. Push the media to hear their voice, promote the stories of the global majority, reach out to people of faith who voted for Bush and challenge them to understand the perspective of the global majority who now so disdain and resent American arrogance.

"Take strength from defeat. Understand the forces of power. Open our veins to the infusion of human resilience, vision, and commitment that carries noble ideas forward regardless of temporary impediment. Misfortune compels adaptation and shapes our conduct to more precise and focused application."

Whatever else we choose to do in life, we must attend to and take seriously our responsibilities as citizens in the global super power, because in reality we are voting for the disenfranchised of the world. They are counting on us.

In closing I want to share a few words with you that sustain me in times when I'm feeling overwhelmed. They were sent to me from someone in the West Bank as the war with Iraq was about to begin. I was distraught that we had not been able to quiet the drums of war and that 'shock and awe' was commencing. These words are from the Talmud:

Do not be daunted by the enormity of the world's grief.
Walk humbly now.
Do justly now.
Love mercy now.
You are not expected to complete the work, but neither are you free to abandon it.

I thank you and salute you for what you do as individuals and as an NGO. Happy tenth anniversary.

— Charlie Clements, MD, MPH, is a public health physician and a human rights activist. His MD and MPH are from the University of Washington, where he's a Distinguished Alumnus of the School of Public Health and Community Medicine. Charlie has been widely recognized for his humanitarian efforts working as physician in a 'free fire zone' in El Salvador during the civil war. He has served on the boards of both Physicians for Social Responsibility (PSR) and Physicians for Human Rights (PHR). He represented PHR at the treaty signing in Ottawa and a week later at the Nobel peace prize ceremonies is Oslo for the International Campaign to Ban Landmines. Charlie is the author of Witness to War, (Bantam, 1984) and subject of an Academy Award winning documentary of the same title. He is currently President and CEO of the Unitarian Universalist Service Committee in Cambridge, Massachusetts. Earlier in his life he was a Distinguished Graduate of the USAF Academy and was a pilot in Vietnam until his conscience led him to refuse further service.

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