ABOUT THE PROJECT

Football games, potato salad, dogs on restaurant patios, a president’s funeral, evening wear, astronauts, the odd Olympics or two or 10. Those are the pictures I usually take as a newspaper photographer. I didn’t get into journalism to save the world. I was having fun and winning awards, and for a long time that was enough.

Then, one day in 1996, I got assigned a story that would change my life and give my career meaning and fulfillment, things I didn’t even realize were missing.

The assignment: Go to Romania on next-to-no notice with a team of health care professionals from the Texas Medical Center. So off I went.

“How did you get assigned to this?” Dr. Mark Kline asked me during some down time on that first trip. “Honestly,” I answered, “because I shoot good football pictures, and that’s how my boss keeps score.”

Mark was confused, but there you have it.

I was professionally prepared, as a photographer, for my first international assignment. I’d pored over William Snyder’s Pulitzer Prize-winning photos about the horrors the Ceausescu regime had left in the orphanages and hospitals of Romania. I knew I would encounter street kids, and human misery, and AIDS.

I wasn’t prepared for how it would affect me.

It’s one thing to see pictures of kids living in sewers. It’s another thing to crawl through darkness with them to get to their little nest, where they let you take pictures of their baby. You can look at pictures of homeless kids in the snow, but the full impact of their reality pierces your heart when you stand there and feel the cold.

Nope, taking pictures was the easy part. It wasn’t until the flight home that it all started to sink in. My god, all those kids. What do I do?

That’s when I looked across the plane and saw Mark Kline with a yellow legal pad. He was filling it up so fast I thought smoke would start rising from it. Obviously, he knew what to do! He was hatching a plan that would become the Baylor International Pediatric AIDS Initiative and now drives the Texas Children’s Global Health program.

For the first time in my career, I was in the midst of a story that desperately needed to be told. Not a ball game or a political speech about nothing of consequence. The desperation and death surrounding those kids in Romania haunted me. As bad as that was, it was exponentially worse to witness the disparity between their world and mine and feel I’d done nothing to help.

When we got home, my employer, the Houston Chronicle, ran an eight-page special section written by Ruth SoRelle, titled Born to be Forgotten. Not much happened. There were no cries of outrage. No money poured in.

Meanwhile, Mark began to build the program he’d outlined on his yellow pad. My involvement continued when he called to ask if he could use some of my pictures in his academic lectures. He’d also launched a clinical trial in Romania.

During these early days, Mark and I talked often about the disparities in care between his patients in Houston and those children in Romania. These conversations led to the development of a story comparing the life of sick children in Romania with one of Mark’s young patients in Houston: bubbly, healthy Janie Queen.

Just over a year and two trips to Romania later, the Chronicle published a 24-page special section titled Worlds Apart, written by Leigh Hopper. This time, people noticed. The morning after Worlds Apart ran, Mark landed his first big donation, which provided funds for a Romanian clinic that would deliver world-class care to children infected with HIV.

Worlds Apart also revealed what became a calling of sorts: To document the disparities between children born with HIV in a fortunate country like the U.S. versus what happened to children elsewhere. That’s how I met the inspirational figures in this book: the Queen family in the U.S., Ingrid and Liam Kealotswe of Botswana, and the many doctors, nurses, administrators, and donors who joined forces to try to erase these disparities.

Just over a year and two trips to Romania later, the Chronicle published a 24-page special section titled Worlds Apart, written by Leigh Hopper. This time, people noticed. The morning after Worlds Apart ran, Mark landed his first big donation, which provided funds for a Romanian clinic that would deliver world-class care to children infected with HIV.

Worlds Apart also revealed what became a calling of sorts: To document the disparities between children born with HIV in a fortunate country like the U.S. versus what happened to children elsewhere. That’s how I met the inspirational figures in this book: the Queen family in the U.S., Ingrid and Liam Kealotswe of Botswana, and the many doctors, nurses, administrators, and donors who joined forces to try to erase these disparities.

The newspapers where I worked soon lost interest, but I couldn’t let go. I began following this story using the bulk of my vacation time and dipping into the family’s bank account.

Over more than 20 years, I’ve photographed this effort as it grew from Romania, across Africa, and then South America, first tackling HIV, then maternal health, tuberculosis, malaria, malnutrition, hepatitis C, and now children’s cancers and blood disorders.

There are so many heroes in this story.

The Queen Family — who opened their heart to a little girl nobody wanted and changed not just her life, but countless others, by having the courage to join a clinical trial and be open about Janie’s HIV status.

Ingrid Kealotswe — who didn’t hesitate to step through that white door to get her son, Liam, and herself the drugs they needed to live, and who continues to advocate for people with HIV.

Dr. Rodica Matusa — who even in retirement continues fighting to get the children of her community, Constanta, Romania, the help they need.

Steven Doyle — who gave up a comfortable life in Ireland to work with homeless kids in Romania, and who became a surrogate father to Nicu Bordian.

BIPAI’s staff — a group that began as a handful of committed visionaries on separate continents that now numbers in the thousands.

The donors — the first major funder, the Sisters of Charity of the Incarnate Word, who were quickly followed by Jeff Richardson and Melissa Walsh of AbbVie, John Damonti of Bristol-Myers Squibb, and later Houston philanthropists Dan and Jan Duncan, among many others.

And the kids — the countless young people and their families who are brave enough to fight a potentially deadly virus and even braver to share their lives, hopes, and dreams with me in the hopes that their story can make a difference.

After over two decades following this story, here’s what I know: We can all make a difference.

It might be in a way you never expected. It might be in an arena you never explored before now. Or, you might have been preparing for it all your life and never knew it. But when your chance to make a difference lands in your lap, I hope you’ll grab on.

This is a story about some people who stared at unbelievable disparities in health care and decided to get up off the sidelines and do something about it. I got to take their pictures.

- Smiley Pool