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Making Health a Global Issue

by R. Lee Gamble Feature Writer

Dr. Margaret Larkins-Pettigrew was the director of Global Health Programs (OB/GYN) at the University of Pittsburgh School of Medicine (UPMC) when Case Western Reserve University and University Hospitals (UH) lured her to Cleveland. Her mission – create a new global health program at UH. Now three years later, UH's WONDOOR (Women and Neonates, Diversity, Opportunity, Outreach and Research) Global Health program is in the middle of a four-year mission designed to train citizens of Guyana in obstetrics and gynecology. Dr. Larkins-Pettigrew took some time to share her thoughts on the importance of global health with Phenomenal Woman.

For this program, Guyana was chosen because it is an English speaking country and its close proximity to the United States. I have also built a relationship with the government. They are committed to decreasing the morbidity and mortality rates in women and children by letting people come from abroad to educate their graduates so they can stay in the country and work. That is how I ended up in Guyana.

How long have you been doing WONDOOR? Three years. I actually put together the program when I first came to Cleveland three years ago and decided to call it WONDOOR because in my mind I cannot imagine women who do not have resources and great providers who can really take care of them and prevent their death and that of their children. I think all women should be able to enter the same door. They should be able to have access to healthcare and be understood as women, to have proper education, understand how to take care of their children and themselves. People talk about the program initiative all the time and how we take people and train them to do certain things or how we give them equipment to do things better. But a program like the one we have in Guyana, where we are actually training their providers to give evidence based care, gives us the opportunity to ultimately change the practice and the policy of their country. We are making people focus on women. We are making people focus on the care of women, which in many places had never been done.

Why a global initiative? With so much going on in healthcare within our own country why is it important for us to view it globally?

Dr. Margaret Larkins-Pettigrew

Tell me a little bit about your work in other countries and how did it come about? I am of course an OB GYN at Case Western and University Hospitals and I have been working in global health for about 20 years. I have had the opportunity to work in Nigerian rescue camps. I have also worked in Budapest (Hungary), Swaziland and South Africa. Over the years, I came to understand that it was much more important to build a sustainable relationship with countries abroad as many of the problems they have are similar to what we have here in the States. So I started working in Global Health to set up training programs. The first one I set up was at Magee-Womens Hospital of UPMC and then University Hospitals recruited me to set up a global health program in their OB GYN department. That is how I ended up in Cleveland. The program I created is called “WONDOOR” and it reflects the understanding that women should have access to quality healthcare both in our own backyard as well as abroad. As medical professionals, we need to understand that women here in the States as well as abroad have very similar problems and challenges. When I began coordinating this program, I was looking for a country that would give us some sense of stability and it had to have a decent infrastructure to work with. It could not be a war torn country and the minister of health and the government had to be pretty open to having people come from abroad. We wanted to help them decrease their brain drain, where their young and intelligent were leaving the country in order to get a better education. 22 ¦ MARCH/APRIL 2013

Everything that happens globally of course happens here in our own country. For some reason we have a very difficult time recognizing right here, in our own backyard, that we have some of the same issues around being humanitarian and being global citizens. Every single day we treat patients that have many of the same challenges that we see abroad, so I find it very difficult to educate our own trainees, even our faculty about the challenges that we currently have without them seeing how bad it is in other places. When we travel to other places and they really tap into what it means to be a global citizen, what it means to be a humanitarian, for some reason they are able to look back and say, “Oh my God this is what is happening here in Cleveland and Pittsburgh.” They begin to understand the importance of being a little more sensitive about the cultural differences and the challenges that we face as a nation.