Since I graduated with my Master of Public Health in 2012, I have been working at a community-based program in infectious disease epidemiology. It is not the global focused job I had originally hoped for, but I was newbie in the public health sectors (who were heavily walloped by budget cuts at the time) and was happy to get a job in public service that fell in line with my future goals. While I am still entirely content at my current position, I find myself frequently daydreaming about the day when I will return to Cambodia and continue to improve the health of those people I met during my public health field study in 2011. Needless to say, this experience transformed me into a more passionate person and is one of the fundamental reasons I find myself back at Maternova today.
Village to village we went for three months and inspected maternal and child health clinics for adequate and accessible management, services, resources, and hygiene. It did not take long for me to fall in line with the reality of the daily struggles of being a mother in rural Cambodia. Not only has access to these health clinics made an impact in maternal and infant mortality, they have also provided these Khmer mother’s an empowering place with medical supplies, medicine, and proper talent. The more we completed the Quality Improvement (QI) Assessments evaluating these measures, the more I realized just how far these clinics had to go, particularly in hygiene. We were told that this assessment was the first level of many more they would perform, the next being an assessment of the quality of care received. In order to progress to the next level, basic infrastructure requirements needed to be met, like running water in all sinks and proper disposal of biohazard materials (additional obstacles we found in many clinics).
The one thing we could not do throughout the duration of our field study is be quick to judge based off of low scoring items on the QI Assessments. This would be forgetting just how far they had come since the oppressive tactics used by the Khmer Rouge. During Pol Pot’s terrifying regime, most of Cambodia’s doctors and other intellectuals were executed. In addition, all hospitals and clinics were completely shut down, many abolished completely, and all Cambodians were sent to the country side to do manual labor without any access to modern medicine. All the clinics and hospitals that we visited were working from the ground up, 35 years later, still reestablishing their right to health care after many years of genocide in the once peaceful land of Cambodia.
The face of the first mother that came in while we were assessing our first clinic in Bakan, Pursat Province is one of many I met that has pulled me back to working with Maternova. As her husband parked their moto on the lawn of the clinic, she hoped of the back with her infant swaddled in her arms. As she approached, one of the clinic staff said she had just given birth two days prior. She glowed with pride as we admired her little one. I could not help but stare at her little 6 pound infant as she put her in the weight basket on the porch and think, “What could have happened to you if you were not delivered here? What could have happened if you if you and your mother had no health access to care?” These types of questions continued running though my head throughout the entirety of their check up. From that point forward, every face I spoke with echoed a similar thought and my heart became intertwined with the mothers, children, and all the people working to improve their health in Cambodia. It is these faces that have permanently changed my outlook on life and given me a cause to improve the life of mothers and children internationally.
What has brought be back to Maternova was not only the good they (we!) do in the field of maternal health, but all of the affordable solutions they offer that have the capability to save mothers and newborns around the world. During my global health experience, I saw how limited access to medical devices and other medical technologies affected the quality of care mothers and their children receive. I am not one that is willing to settle with the idea that access to technology is unattainable due to money constraints. To me this amplifies an initiative for more affordable devices to be created that can be purchased and used in low resource settings. The innovations that Maternova provides are proof that we do have the ability to integrate effective, low cost tools into these locations. I am back at Maternova because I believe strongly in improving access to these inexpensive but effective technologies and saving women and infants lives one innovation at a time.
photo by Sarah New; Busan Clinic Cambodia-- baby gets first immunization
The BiliDx is a novel system for diagnosing jaundice. The device uniquely meets the Target Product Profile (TPP) developed as part of the NEST 360 initiative in that it allows blood-based testing at the bedside. This initiative is part of an emerging global consensus in the Every Newborn Action Plan that countries need functional WHO level-2 inpatient units to care for "small and sick newborns."
Now as a next step, we ask what could be done to lower the costs of the implementation of the E-MOTIVE bundle? The most obvious answer is to consider displacing the tens of thousands of disposable plastic drapes with a purpose-built reusable device.
Fortunately one of the obstetricians involved in the E-MOTIVE study, Dr. Justus Hofmeyr, had been innovating around this very issue, designing a tray with wells that could fit under a woman’s buttocks, collect and accurately measure the. blood. This tray, theMaternaWellTraywas conceived as a device that could be sterilized and reused, and is manufactured in South Africa by Umoya.