visited doctors who had agreed to test the simple methods. Their results indicated a reduction from 70 to 20 pregnancies per 100 couples per year. On that first Asia trip, Clarence and Richard promoted birth control in 13 countries, including Singapore, Hong Kong, and Burma, and assisted local leaders in forming family planning associations in Pakistan, Bangladesh, Sri Lanka, Thailand, and Japan. From 1954 through 1956, Gamble visited over a dozen countries on each four- or five-month trip. Eugenics and forced sterilization Clarence Gamble and James Hanes were founding members of the Human Betterment League of North Carolina in 1947. The League supported programs of forced sterilization of both men and women, mostly poor, of assumed low IQ, and predominantly African-American, without their consent, with the goal of reducing the state's welfare burden and improving the gene pool. The program ended in 1977; the state government apologized publicly in 2002. In 2011 Governor Bev Perdue advocated for financial restitution to be made to 7,600 victims. Pathfinder Fund In addition to paying the salaries of visiting nurses and health workers to staff the clinics and office workers to manage offices, Gamble paid for and distributed print materials: posters in native languages, comic-book-style pamphlets, flyers, reprints of scientific articles, booklets and books, and contraception manuals. He provided anatomical models of the human pelvis, purchased film strips and movies, and supported their production. As he had when hiring field workers to open clinics in the United States, Gamble chose women in their fifties to be his envoys. Gamble and his fieldworkers adapted written materials and tailored their social interactions to local culture. In Puerto Rico, visiting nurses saw mothers at homes. Gamble advocated simple methods, allowing people to decide for themselves the number of children they wanted, and offered family planning methods that could be used without intensive medical supervision. However, he also provided the diaphragm and jelly when it was appropriate or requested. In 1957, at the suggestion of his attorney son-in-law, Lionel Epstein, husband of his oldest child, Sally, his philanthropic activity was incorporated into the new Pathfinder Fund, and Gamble was elected president by the board of directors on February 27, 1957. In 1991, The Pathfinder Fund was renamed Pathfinder International. In a typical report from 1959, The Pathfinder Fund listed its activities and expenditures: the fund was paying the salary of a nurse in Mombasa; a nurse in Burma;