I want to start with my perspective of maternal and child
health in the developing world, before the lecture at FHI360.
My cousin has come to the United States from Egypt, for a very
particular reason: not to gossip with her American relatives, not to see how
numb her extremities get in the Chicago winters, and not to admire the country
that made the Kardashians famous. She comes as a medical tourist to have her
children. Controversy surrounding the
logistics of this aside (yes this makes them all US citizens- added bonus) she
does this because she does not feel safe and does not feel her babies would be
safe being born in an Egyptian hospital.
The thing I would like to highlight here is that my cousin
is obviously not impoverished she is spending thousands of dollars to come to
United States to have her children, this means that she has the means to access
to best medical care in Egypt, and
even that is not dependable—or in a western mindset—up to a developed country’s
standard. The things that she fears and
the issues her friends and family members’ have faced all surround pre and
post-opp care. There are trained obstetricians that she has access to, but the
hospitals do not have the means to prevent and fight possible infections or
complications post childbirth.
With this I look to the research Emily, Caleb, and Seth are
conducting, and the similar model of research conducted in Ethiopia. While we cannot make direct comparisons
between developing countries’ medical infrastructure to support women and
children, we can compare them to predict and understand issues that keep these
women and children unsafe (note that as
we saw in the countdown to 2015 decade report, Egypt had 3 times the amount of
caesarian sections Ethiopia and Mozambique have, suggesting that Egypt is a
country with more access to high function medical care).
Do you think that this stretch is reasonable and that such
comparisons are telling of what issues should be highlighted? Basically, do you
agree that this comparison is one worth making or do you think I’m throwing the
wrong information in the wrong places?
Current status (Model 0) of Tier B catchment areas by
2-hour transfer time to a Tier A facility
We saw through Seth’s GIS model of Mozambique and the
article on Ethiopian access to care that there are certain regions that are
lacking access to a high functioning medical facility, and both Emily and Seth
referenced the long-term idea that if access is increased, this may encourage
more women to have their babies in a medical facility. Off the basis of what my
cousin has witnessed in Egypt, I think there might have to be particular emphasis
on post-operative care, not just medical resources. Even if more regions of Ethiopia and
Mozambique are in reasonable proximity to a high resource facility, risk of
infection is reason enough to stay away.
I recognize that maybe the first hurdle for these countries
is to have these greater resources, but maybe this post-op care and lowered
risk of infection can happen hand-in-hand instead of struggling to
retroactively establish strict anti-infection protocol into a running system.
What are people’s thoughts on the feasibility of
incorporating both of these qualities into health facilities in Ethiopia? There
has to be a reason why they’re not already in place, do we think these
obstacles are too great to expect high functioning, infection free facilities?
