Dr. Gretchen Roedde, an empowered woman to know.
In Dr. Gretchen Roedde’s book, “A Doctor’s Quest” (2012, Dundurn publishing), the Canadian anthropologist and doctor writes about her adventures and challenges in maternal and child health in some of the most impoverished, remote communities in the world. She has traveled to over 30 countries in a 25 year span, in addition to the work that she does with Canadian aboriginal people in her northern Ontario home of Haileybury. Roedde takes us along with her to those haunting places, from which no one, not even readers, can escape unscathed.
This is not a book for the weak of heart, or stomach. There are some phrases I encountered while reading her book that can never be un-read. I can’t go back and un-imagine what her story brought to life. Particularly as a mother, I find this piece of nonfiction more compelling than anything that can be written from the imagination; in fact, if it had been fiction, the author would surely have come under criticism for exaggerating the plight of her characters so much as to make it unbelievable. The fact that Roedde was a first-hand witness to the conditions in these far-flung places, then had the strength of spirit and grace to come through the tragedy to the other side and write this book, is a testament to the depth of her dedication to making a change. Roedde shines a light in those forgotten corners, clears out the obstructions, and begins the practical work of bringing immunizations, prenatal care, basic nutrition, and other lifesaving primary care interventions to the people she encounters.
“We look at the world today that seems like it’s descending into madness and chaos, and it’s not hard to feel despair,” said Canadian House of Commons member Charlie Angus, introducing the author at her book launch on September 13th, 2012. “But what you have to hear in these moments are the moments of hope: that on the ground all over the world there are seeds blooming. She has been there for the little bits of change that have brought phenomenal transformation [to] the lives of people from Uganda, to New Guinea, to Laos, around the world.”
That is what makes reading this book worthwhile; understanding Roedde’s career is of utmost importance to global health. Her involvement in these areas of the world has spanned over 25 years, so you can actually mark the signs of tangible, concrete progress, no matter how excruciatingly slow and small the changes may be.
“Poor countries can save the lives of children under five by bringing simple low-cost interventions to poor people,” writes Roedde. She estimates that death of children under age five can be reduced by at least a third by simply bringing immunization to the communities, teaching mothers to watch for signs of grave illness, making available basic life-saving drugs, and other inexpensive, relatively easy fixes.
In the countries that need assistance the most, there is usually corruption and bureaucratic red tape preventing these simple improvements from taking place. Roedde wrote that oftentimes, progress in the developing world can be two steps forward, one-and-three-quarters steps back.
There are plenty of frustrating setbacks she has encountered. In the July 2009 Journal of the Canadian Medical Association, she wrote a heartwrenching letter to a beloved deceased colleague, Jens, whose work she continued in Papau New Guinea in his stead. All of the money that was promised to improve delivery conditions disappeared due to corruption and mismanagement. “We met hundreds of community members, in health centre after aid post after district hospital and provincial hospital, asking, ‘What happened to the plans? Where is the money?’” Roedde wrote the year after her friend’s death. “Now, they deliver on the cold cement floor, in the dark, with no medicines. Really no point in leaving the comfort of home. Small simple things are not here. No light, water, bed, simple medicines.”
Another thing that bogs down progress is that the first world is painfully slow to respond to the needs of the developing world. Following the United Nations Millenium Summit in 2000, all of the UN member countries agreed to take on eight Millenium Development Goals (MDG). MDG number five is at the heart of Roedde’s work — to reduce maternal mortality by 75% and achieve universal access to reproductive health — but all eight goals are interdependent. Eradicating extreme poverty and hunger, for example (MDG #1) would go a long way towards freeing up resources for women to devote to the health of themselves and their families. Achieving universal primary education (MDG2), promoting gender equality and empowering women (MDG3) — Roedde’s work spans the MDG categories to show that women’s issues are at the heart of the challenges that face the developing world.
However, the goals still have a long way to go. The UNPF reports that 14 countries have made “insufficient progress”, and 11 are characterized as having made “no progress” and are likely to miss the MDG target unless accelerated interventions are put in place. In a 2009 article in the CMAJ, Roedde lambasts the developed world for investing in economic bailouts rather than scraping together the 0.07% of gross national product needed to meet the MDG.
Culture also has an impact on the rate of improvement of the welfare of women and children. In a 2010 video of an interview by Bandana Singh, Roedde expresses frustration at the way the economic underpinnings of a society work together with societal structure to keep women “on the bottom.” She says that maternal health is a complex cultural issue where just investing a lot of money will not necessarily fix the problems. There are problems in the healthcare systems in the developing world, where the United States’ user pay model has been exported: “The child is dying of malaria — the family is being asked for money, and if they don’t have the money, the kid dies,” Roedde laments. “The woman who is hemorrhaging dies, so the family doesn’t even go [to the hospital] because they know the woman isn’t going to be looked after.” Roedde also describes examples of societal constructs that can lead to a situation where it becomes an economic incentive to allow a woman to die in labor, because then the man will be able to get a new bride with a dowry, or families decide to sell their young daughters into marriage before their bodies are ready for childbearing.
“It’s not a situation that men are to blame here,” Roedde explains in the video. “It’s the woman in Sudan or Somalia who takes her daughter and says she must be clean for her husband, and that’s why she has to be circumcised. Even if her more educated husband says ‘I really don’t think this is a good idea,’ the woman and her mother and her sister take that young girl off and have her circumcised. What is it about us that perpetuates the oppression? I think that’s something that we have to deal with as women. We’re part of that — and how we raise our daughters and how we raise our sons. Do we raise our sons that they also share the caretaking, or do we do all the caretaking of them and teach our daughters they should be looking after them? We’re part of that — the hand that rocks the cradle rules the world. It’s a whole set of social constructs that we have to take responsibility for — and if we want to change it, you can start with yourself.”
Dr. Gretchen Roedde has also shared a piece of poetry that had inspired her writing. A section of a poem from the “Elemental Odes” series from Pablo Neruda:
Give me for my life
give me all of the suffering
of the whole world.
I am going to turn it into hope.
all the joys,
even the most secret
because otherwise how will these things be known?
I have to tell them.
Give me the labors
of every day,
for that’s what I sing.
-Pablo Neruda, “The Invisible Man”
by Emma Lamson Edirisinghe
☆ Thank you to Bandana Singh and “B is for Blog” for permission to quote from her video interview of Dr. Roedde.
What can you do to help Dr. Roedde in her quest?