Marc Ethiopia June 2011 519 edit

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I was invited to be a guest on 100 Huntley Street yesterday. I have to admit that I was rather nervous about how it would go. Yet, it’s always great to be invited to talk to a large audience about the issues that are important to our society. So I accepted the invitation.

In advance of the program I determined a few priorities. My hope was that I would be:

  1. Honest
  2. Humble
  3. Provocative

Provocative? Why provocative?  Of course I wanted to be respectful of the host and the audience. But I also wanted to be provocative in the sense of being inspiring and challenging. I hoped I could say something that would make people think twice about their daily actions and their purpose in life.

Well it turned out to be an enjoyable experience. You can watch the video here and let me know what you think. I was happy that I was able to insert a few provocative points. My favourite moment was the opportunity to give a plug for primary care.

The provocative plug came up when we discussed the famous Fistula Hospital in Addis Ababa. This is an exceptional institution that is widely known and well regarded. I particularly love their programs for training health workers. The centre has a focus on treating vesicovaginal fistula – a tear that developed during obstructed labour or traumatic childbirth – leaving the woman permanently incontinent. It is a horrendous health condition and these affected women all deserve access to treatment.

But it always shocks me that people don’t immediately think about prevention. When I hear “fistula”, my split-second instinct is: But this can be prevented! Resources should be focused on excellent primary care for women of child-bearing age so that obstructed labour is prevented, recognized and managed appropriately before a fistula is developed. This means health education, access to birth control, prenatal care and perinatal care. It also means great infrastructure in the publicly available health institutions; transportation systems of affected areas; and many other socioeconomic solutions that impact women’s health.

So one of my happy moments in the interview was when I could slip in the concept of prevention and primary care. Maybe someone was listening who has an interest in improving health in low-income settings. I hope my words provoked them to think about how we find and invest in the smartest solutions.

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