An interview with Dr. Mark Walker on maternal and child health
Dr. Mark Walker is the founder of the Obstetrics and Maternal Newborn Investigations Research Group and a perinatologist at The Ottawa Hospital.
Dr. Walker recently returned from a trip to Kenya where he attempted to assess why so many women are dying during pregnancy or childbirth.
What was the reason for your latest trip to Africa?
I've always wanted to go to a place and make an impact on maternal mortality, because we know in the developing world it's a hundred times higher than in North America and the developed world.
And how were you received?
Incredibly well at all levels: at the political level, at the health level, and with the people themselves. They are very aware what a scourge maternal mortality is, and they're very welcoming to anything that would assist them in reducing it.
Every year, 500,000 women die from complications during pregnancy or childbirth.
Where did the majority of maternal deaths occur?
The majority are happening at home. Seven out of ten women we met weren't getting any antenatal care from a trained provider other than traditional birth attendants. When we interviewed the community workers, the traditional birth attendants, they had no medications to stop things like postpartum hemorrhage or treat postpartum infection. So they were delivering in suboptimal circumstances.
What impressions were you left with?
I feel very inspired. I think we have so much here in our health care system. I am very proud to be Canadian. I think it would be wonderful if, as good global citizens, we could help other countries to a certain degree. The interventions that we could do are not complex things, they are very simple things, that can have a huge impact.
"As president of the G8 in 2010, Canada will champion a major initiative to improve the health of women and children in the world's poorest regions."
Stephen Harper, Prime Minister of Canada
What are your thoughts on the Prime Minister Harper's initiative?
Well, again, it made me incredibly proud to be Canadian. It made me thrilled that our government would step forward with what I believe is such a responsible act. And to speak to why I think, of all the Millennium [Development] Goals, it's the most important one, if you look at maternal mortality, it is probably the single index of any country's health care system: if you know their maternal mortality, you pretty much know every other statistic about their health care system. And if you can reduce maternal mortality, the implications on the improvement of the family, the improvement for the next generation of children, are profound. So I was heartened, excited, and thrilled that our Prime Minister was taking that step forward.
What impact could this initiative have?
I think what it's going to do is it's going to improve the infrastructure of every developing country because it is going to improve the health of the nations. That would be an important step out of poverty, an important step towards developing their economies, and an important step towards the health of their nations.
What could this effort do for mothers, particularly if they have HIV?
It's going to decrease mortality; but equally, and as important, it is often the first and only time that they will contact a health care worker in their life, and when they get HIV-tested at that point, they can start retrovirals and prolong their lives by years and preserve the family. Also, they can prevent vertical transmission during labour.