如果想更深入了解蓋茨夫婦的領(lǐng)導(dǎo)風(fēng)格，可以看看廁所的例子。

提醒一下，或許只是個(gè)猜測(cè)，但全球可能很少有人像比爾·蓋茨一樣熱愛討論馬桶。世界衛(wèi)生組織稱，全球多達(dá)45億人沒(méi)有“安全衛(wèi)生設(shè)施”，將近9億人（大多數(shù)生活在農(nóng)村）仍然在戶外排便。其實(shí)既不需要自來(lái)水也不需要下水道，安全廉價(jià)又設(shè)施齊全的廢物處理設(shè)施是公共衛(wèi)生必不可少的部分。

為了強(qiáng)調(diào)該點(diǎn)，去年11月比爾飛往北京參加新世代廁所博覽會(huì)，也再次發(fā)表演講。在他旁邊小一些的演講臺(tái)上專門放著一罐人的糞便，也是演講主題的道具?！斑@么少的糞便里就可能有多達(dá)200萬(wàn)億個(gè)輪狀病毒、200億個(gè)賀氏菌和10萬(wàn)個(gè)寄生蟲卵。”

雖然現(xiàn)場(chǎng)觀眾報(bào)以大笑，但小容器里確實(shí)有很多致命物。對(duì)很多發(fā)展中國(guó)家來(lái)說(shuō)算得上大規(guī)模殺傷性武器，歷史上似乎不斷涌現(xiàn)的霍亂、傷寒、痢疾、肝炎和腹瀉病流行已無(wú)數(shù)次證明。

廁所博覽會(huì)展示了一些巧妙的設(shè)計(jì)，用比爾的來(lái)說(shuō)是“近200年來(lái)衛(wèi)生領(lǐng)域最重要的進(jìn)展”，目前蓋茨基金會(huì)已投入約2億美元。

但正如3月底比爾和梅琳達(dá)在西雅圖一次聯(lián)合采訪中解釋的，重新改造后的馬桶還代表著潛在更自由的意義。衛(wèi)生廁所直接關(guān)系到女孩和婦女的健康，最終關(guān)系到經(jīng)濟(jì)能力。根據(jù)聯(lián)合國(guó)兒童基金會(huì)提供的數(shù)據(jù)，在撒哈拉以南非洲，適齡女孩當(dāng)中有十分之一月經(jīng)期間不上學(xué)，還有很多女孩出現(xiàn)月經(jīng)開始后輟學(xué)?！跋胂胍粋€(gè)孩子五、六天不上學(xué)是什么感覺(jué)，學(xué)業(yè)會(huì)落后多少，” 梅琳達(dá)說(shuō)。有時(shí)暴力的威脅也會(huì)導(dǎo)致女性或女孩躲開公共廁所，而且因?yàn)橥ǔＳ膳詭Ш⒆由蠋?，該現(xiàn)象會(huì)產(chǎn)生連鎖反應(yīng)。

To understand how the Gateses lead, it helps to think of toilets.

This is just a guess, mind you, but it’s likely that there are few people on the planet who get more excited talking about commodes than Bill Gates does. In a world where as many as 4.5 billion don’t have “safely managed sanitation,” according to the World Health Organization—and of whom nearly 900 million (mostly rural) people still defecate in the open—a safe, affordable, self-contained waste treatment apparatus that requires neither running water nor sewers is the sine qua non of public health interventions.

To make the point, Bill again took to the podium, flying to Beijing this past November for the Reinvented Toilet Expo. Next to him, for their shared keynote—and resting on its own, shorter podium—was a jar of human excrement. “This small amount of feces,” said Gates, “could contain as many as 200 trillion rotavirus cells, 20 billion shigella bacteria, and 100,000 parasitic worm eggs.”

Despite the laughter in the audience, the container was filled with deadly stuff: In much of the developing world, in fact, it is a weapon of mass destruction, as proven by history’s seemingly unbroken epidemics of cholera, typhoid, dysentery, hepatitis, and diarrheal disease.

The toilet expo showcased a number of ingenious prototypes—the “most significant advances in sanitation in nearly 200 years,” Bill called them—and the Gates Foundation has put some $200 million into the effort so far.

But as Bill and Melinda explained in a joint interview in Seattle in late March, the reinvented commodes represented something potentially more liberating still. The toilets were a direct link to girls’ and women’s health and, ultimately, their economic empowerment. In sub-Saharan Africa, one in 10 school-age girls don’t go to school during their menstrual period, according to UNICEF, and many drop out after menstruation begins. “Think about what it’s like for a child to miss five or six days and how far behind they get,” says Melinda. Sometimes it is the threat of violence that keeps a woman or a girl from a public latrine—and because it’s usually women who take their children to the bathroom, that has a cascading effect.

“我們必須在各種數(shù)據(jù)連接點(diǎn)之間劃上線，”她表示。“如果不強(qiáng)調(diào)聯(lián)系，如果我們只從人們健康的角度談?wù)撔l(wèi)生的重要性，”就無(wú)法深入理解錯(cuò)失的機(jī)會(huì)和挑戰(zhàn)。“我們從工作中學(xué)到的是，一定要討論性別因素，因?yàn)槊鞔_存在?！?/p>

事實(shí)上，梅琳達(dá)在發(fā)展中國(guó)家奔波20年后發(fā)現(xiàn)，幾乎所有限制人力資本的因素都能以某種形式與性別聯(lián)系起來(lái)。當(dāng)然最明顯的便是女性是否有權(quán)決定是否結(jié)婚與何時(shí)結(jié)婚，是否生孩子與何時(shí)生孩子。在世界上許多地方，女性無(wú)權(quán)在兩方面做決定，也由此產(chǎn)生毀滅性和跨代際傳遞的后果。

梅琳達(dá)是一位踐行信仰的天主教徒，她畢業(yè)于達(dá)拉斯一所天主教女子高中（還曾作為優(yōu)秀代表發(fā)表演講），但在推行生育計(jì)劃，包括向婦女提供避孕措施方面遇到了一些阻力。但駐華盛頓的聯(lián)合國(guó)基金會(huì)高級(jí)研究員吉塔·拉奧·古普塔解釋稱，蓋茨基金會(huì)在生育計(jì)劃上的立場(chǎng)跟其他事一樣，目標(biāo)都是“滿足未滿足的需求”。

拉奧·古普塔表示，該項(xiàng)目并不是讓發(fā)展中國(guó)家婦女少生孩子，“關(guān)鍵在于讓婦女掌控生育權(quán)。女性希望有避孕措施，不想生太多孩子，但并沒(méi)有能力也沒(méi)有工具做選擇?！?/p>

填補(bǔ)這一空白不僅要了解社會(huì)、文化或宗教障礙，雖然都很重要。“梅琳達(dá)發(fā)現(xiàn)，向婦女提供避孕用品存在供應(yīng)和補(bǔ)給方面的障礙。因此即便社會(huì)對(duì)相關(guān)想法態(tài)度開放，仍然存在挑戰(zhàn)，”拉奧·古普塔說(shuō)，他還為女孩和婦女創(chuàng)建了3D項(xiàng)目，關(guān)鍵在于提升經(jīng)濟(jì)能力。

性別方面還存在其他聯(lián)系，比如出生選擇與教育以及與兒童死亡率的聯(lián)系。蓋茨基金會(huì)首席執(zhí)行官休·德斯蒙德-赫爾曼博士說(shuō)，如果要看5歲以下的孩子存活率，“對(duì)兒童健康最大決定因素之一便是母親的教育狀況?！?他是一名內(nèi)科醫(yī)師，也曾擔(dān)任加州大學(xué)舊金山分校校長(zhǎng)。

“We have to draw the line” between all of these connecting data points, she says. “Because if people don’t draw the lines—if we just talk about the importance of sanitation in terms of people’s health,” we fail to fully comprehend the missed opportunities and challenges. “What we’ve learned in our work is that you have to talk about the gender pieces, too, because they are specific.”

Indeed, as Melinda discovered in her two-decade journey through the developing world, for virtually everything that tends to limit human capital, there is a line connecting it to gender in some way. The boldest of these lines, certainly, concern the rights of women to decide if and when they get married, and if and when they have children. Both of these choices, in much of the world, have been taken away from women, with devastating and transgenerational consequence.

Melinda, a practicing Catholic who attended an all-girls Catholic high school in Dallas (where she graduated as valedictorian), has met resistance from some quarters on some of her family planning efforts, which involve offering women access to contraception. But as Geeta Rao Gupta, a senior fellow at the UN Foundation in Washington, D.C., explains, the Gates Foundation stance on family planning has been, as with everything else it does, about “meeting unmet need.”

The effort isn’t about telling women in the developing world to have fewer kids, says Rao Gupta: “It’s that women want to control their fertility. They’re asking for contraception. They don’t want this many children or too many children, and they don’t have the ability, the tools that are available to the world, to be able to make that choice.”

Filling that gap is not just about understanding social, cultural, or religious barriers, as important as they are. “What Melinda found was that there were supply barriers and logistical barriers in getting contraceptives into the hands of women. So then even when societies were open to that idea, there were challenges,” says Rao Gupta, who also founded the 3D Program for Girls and Women, which focuses on economic empowerment.

There were other gender lines, too—like those connecting birth choices to education, and then to child mortality. When it comes to the survival of kids under 5 years old, says Gates Foundation CEO Sue Desmond-?Hellmann, who is both a physician scientist and former chancellor of the University of California, San Francisco, “one of the best determinants of a child’s health is the educational status of the mom.”

“因此，雖然現(xiàn)在全世界很愿意投資于男孩和女孩教育，實(shí)際上投資的是母親的未來(lái)，以及孩子的健康。”

梅琳達(dá)曾在杜克大學(xué)獲得計(jì)算機(jī)科學(xué)學(xué)士學(xué)位，后來(lái)在杜克大學(xué)福庫(kù)商學(xué)院獲得工商管理碩士學(xué)位，接下來(lái)九年里她一直在微軟研究與性別障礙有關(guān)的數(shù)據(jù)。如果需要有些尚未整理的數(shù)據(jù)，她便通過(guò)基金會(huì)申請(qǐng)。但她主要還是通過(guò)人際交流學(xué)習(xí)，也是一種潛移默化。她聽印度自助團(tuán)體的婦女說(shuō)話，與孟加拉國(guó)到印度尼西亞的各地女孩和母親交談。她跟當(dāng)時(shí)17歲的女兒珍在坦桑尼亞小村姆布尤尼過(guò)夜，住在馬賽人夫婦的“山羊小屋”里，由此了解另一種生活。她跟兒子羅里在馬拉維的寄宿家庭里也一樣。

“基金會(huì)成立之初，性別問(wèn)題并不是著重考慮的問(wèn)題，”梅琳達(dá)說(shuō)?！暗蚁胝f(shuō)，過(guò)去六、七年里我們已經(jīng)真正開始討論性別問(wèn)題，也切實(shí)投資確保真正解決問(wèn)題?！?!-- cend -->

“And so when you invest in education for both boys and girls, which most of the world happily does now, you’re investing in the future of those women as mothers—and in the health of their children.”

Melinda, who earned a bachelor’s degree in computer science from Duke University and an MBA from Duke’s Fuqua School—and who spent the next nine years at Microsoft—has carefully studied the data on gender-based barriers. And the data that wasn’t already available, she has commissioned through her foundation. But mostly she has learned through in-person absorption—through a kind of human osmosis: from listening to women in self-help groups in India; from talking to girls and mothers everywhere from Bangladesh to Indonesia. The insights came when she and her then 17-year-old daughter Jenn spent the night in the “goat hut” of a Maasai couple in the Tanzanian village of Mbuyuni, as they did in her homestay with son Rory in Malawi.

“It’s not at all where we started as a foundation,” Melinda says. “But I would say in the last six, seven years, we’ve really started to talk about this gender piece and have put specific investments down to make sure we address it.”