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Amanpour
Interview With Judy Collins; South Africa Suspends Rollout of AstraZeneca Vaccine. Aired 2-3p ET
Aired February 08, 2021 - 14:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
CHRISTIANE AMANPOUR, CNN INTERNATIONAL HOST: Hello, everyone, and welcome to AMANPOUR.
Here's what's coming up.
(BEGIN VIDEOTAPE)
AMANPOUR (voice-over): South Africa suspends the rollout of the AstraZeneca vaccine. We will discuss with the WHO Regional Director
Matshidiso Moeti for Africa and the power of misinformation with social scientist Angus Thomson.
[14:00:10]
Then: recreating history. The legendary Judy Collins talks about restaging one of her legendary performances and how, at age 81, she is only better
with age.
Plus:
NIKKI KING, MARGARET MARY HEALTH: You lock them inside in isolation during a pandemic. That becomes really difficult.
AMANPOUR: A pandemic on top of epidemic. Health care advocate Nikki King tells our Hari Sreenivasan how her novel approach to combating drug
overdoses.
(END VIDEOTAPE)
AMANPOUR: Welcome to the program, everyone. I'm Christiane Amanpour in London.
Today, the British prime minister weighed in on global COVID vaccine messaging, declaring that he is very confident that all the vaccines being
used in the U.K. are effective at protecting against death and serious illness.
Now, this follows South Africa pausing its rollout of the Oxford/AstraZeneca vaccine. Why? Because a small study suggested that it
offers minimal protection against mild and moderate cases of the so-called South Africa variant.
Now the vaccine's lead researcher expects to have a modified version by the fall. But those important details could get lost in the maze of
misinformation and conspiracy theories that have flourished amid this pandemic.
So, in a world that's betting everything on science and vaccines, how do you keep people safe from the disease and deception?
Joining me are the WHO's regional director for Africa, Dr. Matshidiso Moeti, and Angus Thomson, a senior social scientist for UNICEF's vaccine
program.
Welcome, both of you, to the program.
Dr. Moeti, I wonder if I could start with you and have your analysis, as the WHO regional director, as to what you make of what's being called a
temporary pause of the AstraZeneca rollout in South Africa.
MATSHIDISO MOETI, REGIONAL DIRECTOR FOR AFRICA, WORLD HEALTH ORGANIZATION: Yes, thank you very much, Christiane, for having invited me to join you on
this program.
Well, first of all, South Africa had started -- had planned to start the rollout of this vaccine during this week, and we were all waiting with
great excitement. This is our worst-affected country. So, there is no doubt, as you said, to the news that the small study among 2,000 people at
this university showing the very limited effectiveness of the vaccine against mild to moderate disease is a big disappointment.
And the South African government has taken the decision to pause the rollout of the vaccine. What we say in WHO is that this needs further
study. At the moment, we have a group of experts convened by WHO looking at the data from this study, looking at the AstraZeneca vaccine data from
other studies to understand what are the next steps and what advice and guidance to give to countries.
So, there is no doubt that the study that was undertaken also did not look adequately at the older age groups, where they have more severe disease.
Other surveys on the AstraZeneca indicate that it might be effective here.
So, I think that we are disappointed. There is a pause on the start in South Africa. We need to look further into the data before decisions are
taken.
AMANPOUR: Just so that I'm absolutely clear, Dr. Moeti, you are disappointed, A, in the pause, but are you disappointed that a nation took
this drastic step, based on a very small study, as you say, and one that did not look at older people and those who might be affected with a much
more serious case of particularly the South African variant?
MOETI: No, we are disappointed that we couldn't have this rollout of the vaccine start in our continent's worst-affected country.
But we think it wise for the South African government to have taken the decision that they have taken to pause. That doesn't mean to say they have
stopped forever. They are looking with us at the data to understand it further, particularly because the sample size was relatively small, before
they take final decisions about what to do with this vaccine.
At the same time, we know that there are other opportunities for South Africa to have access to vaccines through the COVAX platform that WHO has
established with partners. We will be delivering them, as a first wave country, some of the Pfizer/BioNTech vaccines very soon. And they are
deciding to also use the Johnson & Johnson vaccine on a trial basis in the country to start vaccinating the health care workers.
[14:05:22]
AMANPOUR: Can I ask you, Angus Thomson, because you are specializing in the impact in vaccine hesitancy and the disinformation? You're a social
scientists with UNICEF, which has big vaccine programs around the world historically.
What does something like this in a country in the developing world, where already there are suspicions about people -- well, suspicions about
vaccine, as you know, what does a pause like this do for your program in general?
ANGUS THOMSON, UNICEF: Well, certainly, decisions like this that are -- that are fundamentally public health decisions and made for the health and
well-being of the population must be driven by science.
But, often, we see that governments don't also bear in mind the potential public health -- public trust consequences of these kinds of decisions. We
can imagine that it will be confusing for people who are already in a state of incertitude and anxiety within this long-enduring pandemic.
We know that people's decisions to vaccinate are influenced by safety questions around vaccines and efficacy questions around vaccines. But, as -
- or perhaps more importantly is the trust that people have not just in the vaccines, but in the governments that are providing those vaccines and the
health services that are providing them.
And, therefore, a decision like this certainly needs to be very clearly and transparently communicated to the population. We have seen examples where
that wasn't done, and where programs which were halted temporarily stalled for many, many years.
So, hopefully, we will see very clear and crisp communication, regular communication from the South African authorities to try to sustain that
public trust in the program.
AMANPOUR: Dr. Moeti, do you have any knowledge of that? Are you in touch with the South African government public health authorities? Because, as I
said, their main COVID advisory members in the government are saying it's a temporary halt. As you said, they need to do more study.
But are they communicating it to people?
MOETI: Yes, they are.
I followed the -- some of the communication yesterday, the Webinar that happened. And the South African government works with other partners and
has established now very good ways of working with grassroots groups, based on previous public health experience.
I think it's very clear that this is temporary while the data gets examined in more detail. They understand very well the tragedy that has been the
situation, many people have died, the level of anxiety among many groups in South Africa, and that people want to know more clearly if the vaccine is
safe and when this vaccine is going to be available.
There's a high level of anxiety for the situation to be turned around in South Africa, because it's been so severe.
And I might add that...
AMANPOUR: And, of course...
MOETI: ... working with partners, we are also in WHO creating a platform at the regional level with various groups, certainly UNICEF, our colleagues
in UNICEF, colleagues in the Red Cross, also preparing to support the work of communicating with people, not only in South Africa, but across the
continent.
AMANPOUR: Obviously, as you know, the idea of mutants and variants is pretty scary for people, and particularly the South African one, which has
come -- I don't know whether it's fully here in the U.K., but it's elsewhere, and people are concerned about it.
So, the British government, as you know, is about to impose a mandatory quarantine starting next week in hotels that have been tendered and will be
paid for. But some countries which apparently do have the South African variant are not on that list of people who are going to have to quarantine
if they come to the U.K.
So, I just want to read what the British government's own SAGE committee, its advisory committee, says: "No intervention, other than a complete
preemptive closure of borders or the mandatory quarantine of all visitors, can get close to fully preventing the importation of cases or new
variants."
So, given, Dr. Moeti, that some countries are off the quarantine list, what are your views? What does WHO say about this quarantine situation?
[14:10:00]
MOETI: We haven't discussed in WHO specifically this quarantine situation in the United Kingdom.
But we observed in the earlier phases of the pandemic that quite a few countries were insisting that people traveling in would quarantine. In
quite a few countries, this was soon converted to self-isolation of those who could manage to do that safely at home.
I think, in this case, there are countries where this virus has been detected, but it may be that it is not circulating at the level of
intensity, it is not so widely circulating as is the case in South Africa.
What we like to emphasize in WHO is that there is a combination of measures that can be used. Certainly, quarantine could be one of them. But the basic
public health measures are very important to sustain and to intensify and implement more effectively under such conditions, meaning, identifying,
testing cases, contact tracing very quickly, and ensuring that people are isolated while in quarantine or in self-isolation.
And monitoring and supporting people to sustain these measures themselves is important.
AMANPOUR: So, Angus Thomson, hesitancy and conspiracy theories and all of that goes on around these vaccines has been caused -- has been called a
shadow plague.
Some people are saying it's so bad that it could really be a major problem in trying to deal with COVID. You are helping or interacting with the South
African government. You have seen what these disinformation campaigns look like online.
Tell us what you're seeing in general and what kind of measures you at UNICEF or indeed others can take to, I guess, stamp out the disinformation.
THOMSON: So, vaccination programs have been shadowed by misinformation from the very first program that was in place.
We do know that we do have this -- what's been called by the WHO a parallel infodemic with this pandemic. Partners of ours, public good projects, have
detected a threefold increase in vaccine critical information in English across different social networks over the last -- the final 10 months of
last year.
So, we know that there's more of this misinformation. We're hearing from our colleagues in countries that they are concerned that it could be
impacting both new vaccine introduction, but also the routine programs that are in place at the moment.
The question really is, what impact is it having, and whether or not it really is affecting people's decisions? We know that misinformation thrives
on mistrust, on anxiety, on incertitude. And these are certainly plentiful at the moment.
And we do have studies that show a link between susceptibility to COVID-19 misinformation and hesitancy to vaccinate. So, there will be -- there is a
link. It's not the only reason why people will or won't get vaccinated. But it's something that we need to track, to monitor, understand how it
manifests in particular at a local level.
And then there are things we can do to address it.
So, for example...
AMANPOUR: I'd like to know what -- yes.
Well, let me just ask you, because I want to know what things you can do to address it. But, particularly, I want to say this, because there seems to
be a view around the world that countries are -- practically, half of them don't want to take it.
But the polls show a different story. CDC Africa over the past six months or so conducted a big, big survey. And they found that, for instance, 79
percent of respondents would take a vaccine. There were differences across regions. In Ethiopia and Nigeria, 94 percent, 93 percent would be willing
to receive them. Senegal and the Democratic Republic of Congo, it drops off to 65 and 59 percent.
Here in the U.K., there have been concerns, and yet we see a huge uptake amongst the older populations that have been offered it, I mean, really,
really high uptake. You know, were some of those fears misplaced?
THOMSON: Well, polls are only so reliable, as I think we know well.
They give us an idea of what's going on at a country level. What's also interesting is to look at changes over time in these polls. And we have
other ongoing polls that are sampling month after month that are showing trends in different countries, which, in a sense, is more interesting to
understand.
At the moment, the January data suggests, across the 59 countries in this study that's being led by Johns Hopkins, that some countries are -- there's
an increase in acceptance of vaccination. In some countries, it's decreasing. It really is at the moment heterogeneous.
[14:15:01]
And I think this speaks to the need to really understand the local context, understand what misinformation is circulating, whether or not it's getting
traction and is spreading, and is having an impact on people's decisions. And then that allows us to decide whether or not we will react to it
rapidly, which may or may not just give oxygen to something that's not going to necessarily get traction, or whether we're going to watch and
wait.
But what we do have now is approaches that we know can potentially vaccinate people against misinformation, more general misinformation, and
also specific rumors that may be circulating. This psychological inoculation is kind of an exciting area of research at the moment.
We have seen it demonstrated in studies in other areas of science denial, and we're hoping that it's going to work in vaccination as well. And it's
predicated on the idea that there is misinformation, but there is also disinformation, which is deliberately engineered misinformation. It's
carefully engineered to grab our attention, to prey on our anxieties, to cast doubt on the truth, eventually to erode our trust in experts, et
cetera.
And what's important about it is that it is developed with both deceitful tactics and malicious intentions. And these are also levers that we can use
to potentially inoculate people, because nobody likes to feel fooled.
And so we have studies show that, by highlighting the tactics that are being used, highlighting those underlying hidden motivations of the authors
of disinformation, we can potentially provide a level of psychological resistance to misinformation.
AMANPOUR: That is really, really interesting, and it's quite optimistic.
So, let me finally ask you, Dr. Moeti, there are countries -- and I'm going to just name Tanzania, because it has declared that it is COVID-free, and,
therefore, up until now, as far as we know, it has no vaccination plan.
I mean, how dangerous is that? First of all, do you agree that it is vaccine -- that it is COVID-free? And we hear some governments are simply
not reporting illness and death tolls at all. What do you do when it's governments who are putting that kind of information out?
MOETI: Yes, thank you.
Well, first, I'm afraid we have had evidence from cross-border testing in the neighborhood of Tanzania of Tanzanian people who have been found to be
COVID-positive. And we have -- so, the virus has certainly been circulating in the country.
And we would like to advise that and have urged the country to work on acquiring the vaccine for its population. Even if the situation is very
good and there's very few cases and that the virus is circulating very little, it's certainly a wise decision to protect the population with a
tool like a vaccine that's available, and help to open up the economy and enable interaction with other countries and reduce that risk of exposure of
the population.
So, we are available, as WHO, with our partners to support the Tanzanian government to catch up and develop a national plan for vaccination --
vaccinating his population to enable it to interact internationally business, socially with other countries and for its economy to normalize
again, as is our hope for all economies in the world.
AMANPOUR: Dr. Moeti, Angus Thomson, thank you both very much for joining us.
Now, throughout the darkest days and months of this pandemic, there's been so much culture, art and music created. It lifts people's spirits, and, of
course, it provides much, much needed inspiration.
The legendary folk singer and songwriter Judy Collins is joining us tonight. Over the course of her 60-year career, she's made 42 albums, had
five top 40 singles, and she's given concerts all over the globe, perhaps her most famous, her first solo appearance at The Town Hall in New York in
1964.
She was just 23 when reviewers placed her in -- quote -- "the front rank of American balladeers."
Now, some 60 years later, Collins has filmed a new concert from The Town Hall to be streamed later this week.
Here's a clip from that performance.
(BEGIN VIDEO CLIP)
(MUSIC)
(END VIDEO CLIP)
AMANPOUR: Sounding as great as ever, Judy Collins is joining me from New York now.
And welcome to the program. It's great hearing you sing. And it's amazing that you're going to be streaming this.
What made you want to do this and reprise where you took off?
[14:20:03]
JUDY COLLINS, MUSICIAN: Well, I, first of all, want to thank you for all the work that you do, and how inspiring you always are.
And I have been inspired by you and by the times, of course, and what's going on.
But I'm curious. I was born with curiosity and also optimism, both of which I think are necessary in these days, but they have always driven me. And I
have always been a performer. I have always been singing, performing.
And in the pandemic, I have actually done a lot of writing. I have a bunch of new things that are coming out soon. But being at Town Hall again, which
was a theater, as you know, in New York which was founded by and opened by the suffragettes and at which I have sung many times, and at which my
teacher Antonia Brico conducted her own orchestra of women in 1937, so it's been a long time at Town Hall.
AMANPOUR: Well, it's an amazing pedigree.
I hadn't actually realized -- I'm glad you told us about the suffragettes and the female-led productions there. It's great and clearly wonderful that
you're doing that.
Can I just ask you? Because, I mean, am I right that you sound better than ever or certainly as good as ever? And I want to know what you put that
down to, because not everybody at 81 has that clear pitch and those -- that fantastic strength and purity of voice that you still have. And you even
had an operation, I think, on a polyp or node on your vocal cords.
COLLINS: I did. Christiane, I did have a surgery for a hemangioma on my vocal cord, well, 44 years ago, it is now.
I got lucky, because, in the beginning, when everybody else was running down to Max's Kansas City and going to -- we were all going to fund-raisers
and marching, I also knew that I was losing my voice.
This was in 1965. And losing your voice in those days was not so unpopular. A lot of people lost their voices and continued to sing. And a lot of
people weren't worried about it. But I was terrified of it, because, as a classically trained musician, and as the person whose heroes were people, a
lot of people who were musicians who played until they fell over, conductors and violinist and pianists, and so I knew that I had to keep it,
because I knew that that's what I had going, was the voice.
So, I found a teacher. I asked Harry Belafonte, who would you recommend? And his guitarist said, oh, I know who it should be. And then I asked the
people who ran an arts camp in Lenox, Mass., well, who should I go to study to? And they both gave me the same name.
I went to see him. And he didn't want to work with me. He said, oh, you people are -- he asked me what I did. And I said, well, I'm a folk singer.
And he said, oh, you people aren't serious. And I said, oh, I'm very serious.
And I studied with Max for 32 years until his death. So, I learned the things that I had to know about singing. It didn't prevent me from getting
a hemangioma. And I had a very rare and unusual and early surgery, a laser surgery, which my doctor said to me, you can have it. It's very new. I
don't have any experience with it. Nobody does. But if you don't have it, you will never sing again. And if you do have it, you have a chance.
So I took a chance.
AMANPOUR: Well, and it worked out really well for you.
I mean, sadly, the very famous case of it not working out is the great Julie Andrews. And she wasn't able to sing as she would have liked to have
sung after her operation. So, it's wonderful that you have such a great voice still.
So, let's talk about some of the iconic songs, because I love the stories about -- you popularized "Suzanne" certainly before Leonard Cohen did. You
popularized Joni Mitchell's song before she did?
Can we just play a clip of you singing "Suzanne"? And then I just want to talk about it.
(BEGIN VIDEO CLIP)
(MUSIC)
(END VIDEO CLIP)
AMANPOUR: So, Judy Collins, tell us a little bit the story of how you came to discuss "Suzanne" with Leonard Cohen. And he had written it and why you
did it before he did it.
[14:25:10]
COLLINS: I got to know Mary Martin, who was his friend. She went to school with him in Canada. And she and I would go out to dinner with some friends
in New York. And she would talk about this guy she grew up with and how brilliant Leonard Cohen was. And I said, well, lovely. And she said, yes,
but we're all worried about it, because he's going no -- absolutely nowhere.
And I said, why is that? And she said, because he writes poems, and they're extremely dark and extremely difficult. They're obscure, is what they are.
And so I said, well, that's too bad.
And then, one day in 1966, she called me and she said, well, Leonard wants to come and see you. And I said, oh? And she said, yes, he wants to sing
you his songs. And I said, are they obscure? And she said, oh, yes.
And so Leonard knocked on my door. I was living in -- on the Upper West Side in another apartment before I moved to where I live now. And he said -
- I said -- but when he opened the door, I thought, I don't care if he doesn't write songs. We will think of something. And he came in.
And he said, I can't sing and I can't play the guitar, and I don't know if these are songs. These are songs. And then he's sang me "Suzanne."
And I said to him afterwards, I said, Leonard, this is a song, and I'm recording it tomorrow. He wouldn't sing. He thought that he had a terrible
voice. I said, it's not terrible. It's a little obscure, but it's not terrible.
And I pushed him on the stage a few months later, and made him sing in public, which then, after that, he always did. And then he asked me, after
my recording of "Suzanne" had gone viral, I suppose you would call it nowadays, he said, well, now you have made me famous. And I said, good. I'm
glad to be of service. And he said, but I really want you and all the others to sing my songs. And he said, I'm worried because I don't
understand why you're not writing your own songs.
And ever since then, I have been writing my own songs. So, we did each other important, life-changing favors. And I adored him. He was
extraordinary.
AMANPOUR: It's such a great story, because it talks about the generosity of people at the top of their game with each other.
And Joni Mitchell, she played "Both Sides Now" to you, right? Tell me how - - and then you recorded and you made it a hit. Tell me that story, because that's -- that launched her as well.
COLLINS: We were both lucky, because she was wandering around the Village. This was 1967. I had a very close friendship, not a love affair, but a
friendship without Al Kooper, who started Blood, Sweat & Tears. I used to go and hear the band at the clubs in New York. I just loved them. They were
so great.
And so he -- because we were such good friends, he had my phone number by heart, which he retained without problem. And so one night in 1967, I was
asleep, and the phone rang. I was probably passed out, honest to God, and the phone rang. And it was Al.
And I said, it's very late here. I was in the same apartment that I was when Leonard walked to my front door. It was a lucky apartment, I guess.
And I said, hi. How are you? And he said, I'm fine. How are you? And I said, I'm awake now. And he said, well, I have a surprise for you.
And then he put Joni Mitchell on the phone. And she's sang me "Both Sides Now." And I said, well, I will be right over, which I literally was. By
dawn, I was knocking on her doorstep.
She was -- had arrived in New York. She was -- I think she'd just been divorced. She had -- was wandering around. The only person that knew her
songs and sang them was Tom Rush. And he had recorded a beautiful song of hers. "The Circle Game," it's called.
So, really, Tom deserves the credit for finding her and recording her. And I got to record "Both Sides Now," to my great pleasure and to her great
pleasure. So, it worked out pretty well for everybody.
AMANPOUR: Again, it worked out for both of you. We're just going to play a little clip.
COLLINS: Oh, good.
(BEGIN VIDEO CLIP)
(MUSIC)
(END VIDEO CLIP)
[14:30:00]
AMANPOUR: Judy Collins, when I listen you sing those songs, your voice is so pure. Clearly, "Suzanne" is clearly so much more -- I don't know what --
I don't want to say upbeat, but it's so much lighter in your voice than it was in Leonard Cohen's. And yet, you just referred to some of your dark
days. You said, I was clearly passed out at that point.
And you did have a period where you had -- you know, you suffered from alcoholism, pills, bulimia, you had tuberculosis, polio, your son committed
suicide, you tried to commit suicide. I mean, just one of those things would be enough to derail a mere mortal. And yet, you have overcome such
tragedy and hardship. Was it music that carried you through? How did that happen?
COLLINS: I had a DNA in the family where you had an optimist. I think most people have to be optimist to survive living on the planet. When we think
about our parents, you know, my dad was blind from the age of four and he became successful, a great musician and had a wonderful career in radio
business, but, you know, he said, you know, tomorrow is not guaranteed.
And if you don't prepare yourself, and if you are not willing and ready and able to do the things you need to do, he also was an activist, he was
outspoken, he was the voice of what trained me to feel very comfortable and at home with -- in the '60s with what was going on in the world, and in the
world today, because what he saw, and he did so beautifully, was that there was so much going on that was not right in the world, I suppose that you
could say it at any time in the world, but particularly in those early days.
And now, once again, we find ourselves embroiled in violence and pessimism. And then we get the sun to come out, and we get a change in our view, so to
speak. I won't speak at length at politics, but I think that what we all have to do is take notice of what is happening as you do, as point out, as
you are relentless and constantly making us aware of.
So, we have to listen to each other, and we have to stay on the planet. So, we have to stay healthy, which is how, thank God, I have been here in spite
of the rather dreadful sounding things that some of them have happened to me, but they happen to all of us in some way.
AMANPOUR: I know that you don't want to talk about politics, I'm just going to say that you sang for John F. Kennedy, Robert F. Kennedy, you sang
at President Clinton's inauguration. I kind of don't and do want to put you on the spot. Do you have anything that you'd like to burst into song with
us live on the air with right now.
COLLINS: Oh, you said that you didn't want to put me on the stop but --
AMANPOUR: "Turn, Turn," "Amazing Grace"?
COLLINS: Yes, yes. It's perfectly all right because --
AMANPOUR: I do and I don't.
COLLINS: -- I have always been there. I have ferociously, in some cases, and in some places incorrect and in my own case totally correct ideas. I am
dyed in the wool liberal, and I always will be, because I believe in human rights, I believe in equal opportunity, I believe in women getting paid as
much as men do. I certainly believe in the minimum wage, which I am outraged that it has not remained in this particular case, group of actions
that are being taken. It will come back. It has to come back.
We've lost the boat on so many issues that should have been apparent and easily handled. Immigration being one of them. I wrote a song a couple of
years ago called "Dreamers." I think I dare to say that it's probably the best thing I've ever written. It's certainly the most impressive song I
have ever sung in a concert. When I finish singing it --
AMANPOUR: So, let me play a little bit of it.
(BEGIN VIDEO CLIP)
(MUSIC PLAYING)
(END VIDEO CLIP)
AMANPOUR: That is so beautiful, Judy. And, you know, folk music has often been intertwined with activism. I tried to say in my last question, I tried
to ask you whether you would sing a little bit of something to us now. Would you?
COLLINS: Of course. What would you like to hear?
AMANPOUR: You choose. "Turn, Turn, Turn" or "Amazing Grace." Whatever you want to sing.
[14:35:00]
COLLINS: I will sing this, because it is so associated with the man who wrote it Pete Seeger who was kind of the teacher of all of us and a
beautiful song, a lasting song and also one that we can look to for courage, I think. To everything, turn, turn, turn. There is a season,
turn, turn, turn. And a time to every purpose under heaven.
AMANPOUR: That is lovely. Thank you so much for doing that. And we wish you so much good luck especially with your latest concert which going to be
streaming on Friday. So, thank you, Judy Collins, for being with us. And tickets and info are available on the townhall.org.
And that is from her story of survival overcoming hardship, we turn now to another woman who's determined to give suffering from addiction a fighting
chance. Nicky King was born in Kentucky where she saw firsthand the devastating impact of the opioid crisis. She then moved to Indiana where
she established an innovative addiction program, which was focused on treatment and support rather than instead jail. It's offered through the
community hospital, Margaret Mary Health. And it could serve as model for other parts of rural America. And here she is discussing it with our Hari
Sreenivasan.
(BEGIN VIDEOTAPE)
HARI SREENIVASAN, CNN INTERNATIONAL CORRESPONDENT: Christiane, thanks. Nikki King, thanks for joining us.
Nicky, I want to ask a little bit about your story. You didn't grow up in Indiana but yes, in Appalachia. And you came of age during this opioid
crisis. Tell me a little bit about what it was like witnessing this happening around you?
NIKKI KING, MANAGER OF BEHAVIORAL HEALTH AND ADDICTION SERVICES, MARGARET MARY HEALTH: So, I grew up in Southeastern Kentucky. I remember when
oxycontin first came to the area. I remember everyone talking about this medication for the first time. And, you know, when it really rolled in, the
big reaction that people had was, is it possible to be addicted or abusing a medication that came from your doctor?
Because up until then, crack was something that happened in the cities. You know, people have some sort of vague knowledge of what crack-cocaine was,
but nobody had ever really seen it or anything like that. You know, the big bad at that time was pot, and that was like the worst drug possibly
imaginable.
And so, you know, the thought that you could have something so much worse that comes through and it came from your doctor was unheard of. Doctors
helps people, they didn't addict people. And so, when people started get this medication, you know, you started to see people that just started
acting funny. Suddenly they were like really fixated on this medication. When was their next refill? Could they get a higher dose? You know,
different things like that. It started to dominate the conversations.
And then you would start to have people who, you know, have these various memories of people who were clearly in the early stages of the addiction.
And, you know, when they would walk away from a conversation, you kind of see people looking at each other like, that is weird. Because literally all
they talk about is their medication now.
And then before you know it, you've got people breaking into the houses trying to steal other people's medications or people trying to break into
the doctor's office and steal their medication. And it came on slow but fast at the same time, because, you know, it just felt like isolate
incidents. And I'd honestly compare it a lot to the pandemic.
Now, I think that a lot of people ask, you know, about the people that I saw, you know, who had suffered from drug addiction when I growing up and
it was in every single family who had someone who was struggling and, you know, some people were open about it. They talked about it. They saw it for
what it was. But honestly, even up to the point I was in high school, some families still didn't know exactly how to account for the behaviors that
they were seeing, which now in retrospect, clearly people who were struggling with a hidden addiction.
SREENIVASAN: Was this just normal for a kid going to school to know people or to see people who had overdosed?
KING: You know, the first time I saw an overdose, I already knew what to do, because we had talked about it so much at school with my friends, and I
was 13. At the time, I was proud of myself for knowing what to do and for listening to those conversations. And I look back and I thought, why did a
13-year-old know how to wake somebody up from an opioid overdose? Like that should not ever happen, yet that was just part of our normal day-to-day
conversation.
There were just friends that you know you couldn't go to their house, because their parents weren't safe and it was just given that they would
come to your house. And nobody ever said anything that loud, it was just sort of the social structure that kind of came up around, you know, this.
And I remember the big thing to me was, you know, I could have sat down and I could have told you everyone who would have been dead of an opioid
overdose and I would have been right 9 of 10 times.
[14:40:00]
SREENIVASAN: How many people do you think you know that have died because of this?
KING: Hundreds probably. At one point, I sit down. I actually tried to name them. I thought of 20 without having to actually look at Facebook. So,
I think that -- the thing that really stuck with me is if as a child, I can look around and I can see who the at-risk people are, how did we let them
fall through the cracks? How did we let them get that far?
Because if I'm picking up on it as a child, a professional would have picked up on it a long time before that. But there weren't any. You know
what I mean? There was no intervention, not really. I mean, there were some treatment programs here and there, there's a lot of really successful drug
courts that are going on in Eastern Kentucky and places like that. But by and large, their treatment interventions for people who have already
developed the problem. There was nothing that was addressing the underlying issues, the underlying mental illness which, you know, Appalachian counties
have a much higher rate of mental illness than the rest of the country. There was nothing addressing the childhood trauma.
Kentucky is like I believe the worst state in the union for child abuse. For kids in the foster systems, you know, just this really anemic services
to kind of head this stuff off. And I was really frustrated because if me and my friends could sit down and have a conversation while we were in high
school about everything that would need to change to stop the drug epidemic, which we would do. You know, we would go to these really campy
education things and we laugh about how dumb they were. And we would talk about what we would do if we were in charge. And if we could figure out as
children, how was everybody else not seeing this? To me it was so obvious.
And every time -- you know, by the time I got old enough for people to start taking me seriously on this, all I ever heard is, we can't do it.
There's not enough resources. Can't do it in a rural community. There is not enough people. There's not enough trained staff. There's not -- you
know, it's too expensive. It won't be very good program. Maybe you will have a program, but it won't be like what, you know, the rich people can
afford to send their kids to. It won't have that success rate. That was all I ever heard.
And so, to me, like I said, the solution was right there. So, I put my money where my mouth is and five years of my life and a lot of my sleep.
SREENIVASAN: So, you grew in a place where you saw what the opioid crisis was doing, you're in a position where you can figure out how to help
people. Tell me a little bit about the specifics of the program that you've built.
KING: So, our program is basically a full-service mental health and substance abuse clinic, as well as medication assisted treatment. We have
several rural clinic locations, health center location in the rural Midwest. We generally consider our patient population to include 65,000
people in Southeastern Indiana.
SREENIVASAN: What do they get there? Just the fact that there is a center, that's the big difference?
KING: So, in our rural area, there really aren't any other comprehensive treatment programs. You might have a little bit of the individual therapy
or something like that here or there from federal centers but there's nothing like a real comprehensive treatment program. Those are usually --
and especially when you talk about a program that addresses all the social determinants of health and all the different aspects of population health,
so primary health, psychiatry, substance abuse counseling, job counseling, resume training, child care waver training, stipends for work clothing, et
cetera.
I have lived my whole life in a rural community. Other than a few years of going to school, I have never lived anywhere but rural. And all I've ever
heard from our hospital is, you know, maybe we don't have this amazing super qualified brain -- neuro brain surgeon that Harvard has, right? But
what we do have is community. That is our strength. We have a population that is ours. They go to church with us or they go to church with their
doctor. They see each other at Kroger.
And so, because we have a dedicated population, we can really leverage those relationships and they are genuine. You know, you really do want to
see somebody get better from substance use or really want to do -- you do want to take care of them because you went to school with parent or you
know, and you know how distraught their mom is. Every Sunday at church she is praying. Every Sunday at church she prays that, you know, this isn't the
week that her child overdoses. How can you not help? You know, how can you standby? You can't. You see them every week. They are your neighbors. They
are us. They are our community.
And so, that is all we've ever said. That's been our battle standard of rural health. This is what we do better than urban.
SREENIVASAN: Has the pandemic made it worse for the people that are getting these services?
KING: Oh, absolutely. So, when you have got folks who are already dealing with the stigma who many of them have already burnt every bridge that they
had in their life throughout their addiction, you know, they have alienated family members and friends and things like that. And then you lock them
inside in social isolation during a pandemic, that becomes really difficult reengage them.
[14:45:00]
In fact, you know, I know before I got into the mental health profession, I would have told you thought I thought that individual psychotherapy was
probably the gold standard and people who did not do individual psychotherapy and the group psychotherapy, so like group therapy
appointments, was because group therapy appointments were more resource efficient, not because they were better. You know, you got one therapist,
you got 20 people who needed this, you know, so just put them in a group, that's better.
But actually, what we know is that group psychotherapy is the most effective form of addiction treatment. And a significant part of that is
because it helps to reintegrate people back into a supportive community of people who have similar experiences.
And so, for people who really crave that social interaction and they really get a boost from that supportive community, locking them inside during a
pandemic has been horrific. And that is even besides the collective mental trauma of surviving the pandemic, being afraid for your life, being afraid
for your loved ones, not being able to visit the family members who are possibly at the end of their life, financial concerns. I mean, all of those
things, compacting with -- you know, trying to treat somebody who is suffering with mental illness beforehand, a significant mental illness is
really difficult.
That said, Telehealth also helped to overcome a lot of barriers that have been traditionally really difficult to overcome in rural communities.
SREENIVASAN: So, here you now with professional skills able to help people who probably remind you of people that you knew growing up. Tell me if you
can, do these leave an impact on you? What -- the ones that maybe did make it or even the ones that didn't?
KING: Oh, yeah. I remember them all. I know their names. I know their faces. I know where they work. It's really creepy but sometimes I'd go in
to where they work and I just watched them for a while and I think about how different they are. You know, they smile now, their faces aren't
hallowed out and gray and, you know, they play with the kids, they have a laugh again. I know all of them. They all leave an impact.
Honestly, I think the bigger ones that stand out to me, were the ones I weren't able to help. Before we started the program, there was a girl who
is already dealing with substance use disorders and she was a teenager. And I remember working for 16 straight hours with her to try to find some sort
of mental health treatment. And she had come in as a suicide attempt.
And I remember every hospital that I called arguing with me that it was not a serious enough attempt. And I remember thinking that this is where we
are. You know what I mean? When we are faced down with, you know, a person who is in that deep of despair that whether or not they are so serious or
not that they can't cope with their lives. And we come back to this place of arguing with them that they could just do better or maybe it wasn't that
serious or, you know what I mean? That one sticks with me a little.
SREENIVASAN: I just want to ask a little bit about kind of the wrap that Appalachia gets when you go could back as far as that image of war on
poverty and Lyndon Johnson. And it seems that the region has become almost a caricature. And here we are at a time when movies like "Hillbilly Elegy"
based on the book by J.D. Vance are really popular. What does that do to you?
KING: This is the hardest question I think I'll never an answer to. I have had to do a lot of soul-searching that there will never be enough studying,
that there will never be enough things that I know that I actually have the answer to this because maybe there is not one.
Yes, to your point, the war on poverty started for about an hour from where I grew up. And the biggest thing that has always hit me is one picture. One
picture hit the TV and suddenly everybody knew everything they needed to know about Eastern Kentucky. I really attribute this a lot to what
Americans think about work ethic.
You know, from the minute that we grow up in this country, we are fed this line about the American dream. We are fed this idea that if you work hard
and you are a good person that good things will happen to you and then you'll get a two-story house with a white picket fence and a golden
retriever, and we cannot in our soul come to terms with the fact that that is not true for some people. Because if it's not true for some people, it
cannot be not true for us.
And we really cannot -- as a culture, we can't deal with it. There's this level of cognizant dissonance where we need to believe that everybody has
the option to succeed, to grow up and to work hard and succeed. But the truth is, if that was really how it worked, every coal miner in the world
would be a millionaire right now, because they work harder than anybody, but they are not. They are struggling.
[14:50:00]
And I think that when they saw those pictures from the war on poverty, they needed to believe that there was a reason, that there was something wrong
with the American people because they can't come to terms with the fact that there is something wrong with the American society and that the
American dream does not exist. And I think that we have to call attention to that.
You know, for the few of us like me and, you know, say J.D. Vance who get out, and for people to listen to us and to put us on TV shows like you and,
you know, different things like that and ask us what we think, we've got a microphone and we have to use that to elevate the voices of the people in
our community and talk about the systemic struggles that they have and a deck that's been largely stacked against them. And I really get annoyed
when people use that platform to espouse how special they are.
If everybody would just be like them and just work harder like them, because plays right into the, you know, perception box that everybody has,
everybody wants to believe. Everybody wants to believe there is something wrong with the mountain people, and that is why they are not successful
because that is easier to stomach than some people in this country are not born in a position to succeed no matter what they do.
I will tell you I am not special. I am here because I got lucky time and time again. If I have said it once, I've said it a thousand times, if I
have seen further in my life, if I have accomplished one thing that was worthy, it is because I have stood on the shoulders of giants. But you have
to take a step back and look at a system where you have entire (INAUDIBLE) of people who were dying of unprecedented rates of diseases of despair, of
chronic health conditions, of poverty, just really intense poverty and all the historical factors that led up to those situations before you can even
begin to understand that one person's story.
SREENIVASAN: How did you escape being one of those statistics? How did you get out?
KING: My grandma and my mom beat me over the head from the time I was little with, get out, you know, see the world. Do what you want to do. Get
an education and then come back to live the kind of life that you want, you know. And it's OK if you want to, you know, be a wife and a mother and
things like that, but don't get yourself in a position where that is the only option that you have. Because, you know, my mama (ph), for example,
well, she married young. She never had a chance to go off to college, and she used to tell me that that was always her dream and that, you know, she
felt like she waited her whole life to get that opportunity and it just never came.
And she used -- you know, our -- the way we would bond at our playtime was going over multiplication tables. She made me learn Latin because she
thought the kids in the city were learning Latin and they would make fun of me one day when I go to college if I didn't know Latin, which in retrospect
is really hilarious, all the things that she thought that they were learning in city schools.
But, you know, I had her and I always felt like I owed it to her. It was her dream that I had to live the life that she wanted, that she had given
that gift to me when she passed and that it was my job to carry that baton. And so, I mean, that helped.
And honestly, I got lucky time after time. I had teachers who would go out of their way to, you know, foster something in me, to grow something in me.
I won the lottery 1,000 times over and it should not be that hard. It should not require that. But I am glad that it was me. And I feel like I
have a responsibility to pay it forward.
SREENIVASAN: Nikki King, thank you. Thanks for joining us.
KING: Thank you.
(END VIDEOTAPE)
AMANPOUR: And of course, all of that structural inequity and then disadvantage has also been highlighted throughout this COVID pandemic.
So, finally, we want to highlight a dance a palooza that's bringing joy to millions of people around the world during this pandemic. "Jerusalema" a
song by the South African musician, Mr. KG, has the world on its feet. Take a look.
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: It is the dance craze uniting the world. Separated by the pandemic. Everyone from monks in Israel to nuns in Africa from the
beaches of India to the supermarkets of France. Even animals have been bopping along with their keepers. And it is this 2019 South African hit,
"Jerusalme," by Master KG that's providing the uplifting soundtrack for difficult times.
MASTER KG, DJ AND PRODUCER: I'm so happy that I created something that a lot of people are able to relate to. It's something that, you know, it is
able to like speak to a source of different people in different ways.
[14:55:00]
UNIDENTIFIED FEMALE: And it is this group of friends in Angola who set the song to their own dance moves sparking a global trend while eating dinner.
And when the Swiss police decided to join in, they sent a challenge to the national police service in Ireland, the Garda, to come up with their own
version. A song and a song craze bringing global joy at such difficult times.
(END VIDEO CLIP)
AMANPOUR: You really have to laugh. That was wonderful. And that is it for now. Thank you for watching and goodbye from London.
(COMMERCIAL BREAK)
[15:00:00]
END
