A Doctor’s Quest

Dr. Gretchen Roedde, a general practitioner based in Haileybury, has seen it all: corruption, poverty, hunger and death. She has been caught in the middle of tribal fighting and riots, contracted schistosomiasis (bilharzias) as a result of a swim in the Nile and almost lost her eyesight after coming down with bacterial keratitis in Ghana.

“Papua New Guinea is one of the most frightening places I’ve been, where people are shot around you,” she said. “It’s a country that has 800 different tribal groups that are fighting all the time. There’s a huge underclass and a corrupt government. Nursing teams that go out and do mother and child health patrols are routinely attacked, raped and robbed, so these are not easy places.” Roedde, who specializes in mother and child health and HIV/AIDS, has served on medical missions in 30 countries in Africa, Asia and the South Pacific. After filling up more than a few passports during 25 years of service overseas, Roedde has written A Doctor’s Quest¬†– mostly out of frustration with the sad state of maternal health in the developing world.

A featured speaker at Rendez-Vous 2012 in Thunder Bay in October, Roedde hopes to inspire a new generation of doctors to follow in her footsteps and educate the general public about what can be done to improve the health and well-being of women and children in the poorest countries of the world.


A Doctor’s Quest is also an indictment against corrupt government officials who line their pockets with money meant for clinics and health-care equipment. “As I was pulling the book together, there was this huge level of frustration catalyzed by a shocking situation in Papua New Guinea, where government officials basically stole money that was targeted for upgrading maternities and building accommodations for midwives,” said Roedde. “This is a country where the death rate for pregnant women has doubled in the last decade, so I thought it was time to put what I know out there and see what kind of response there is.” But Papua New Guinea isn’t unique, said Roedde. “There has also been terrible corruption in Zimbabwe, where the death rates for pregnant women are worsening. On the other hand, there are countries like Zambia, where funding was frozen a couple of times because of corruption, yet the death rate for pregnant women is improving because at least some of the money is getting where it’s supposed to go.”

Some of the bright spots, she said, are Uganda, which has seen a decrease in teenage pregnancies and HIV/ AIDS, and in Nepal and Bhutan, where death rates of pregnant women and children under five have fallen, “so it’s not all bleak, and that’s what I tried to bring out in the book.” Female literacy, family planning and the alleviation of poverty are some of the most effective strategies for improving mother and child health globally, said Roedde.

“If there’s no family planning, then there’s more frequent child-bearing, and increased death rates, especially if teenage girls are getting pregnant.” Skilled birth attendants and access to C-sections also have a bearing on maternal and child health.


In Bangladesh, for example, community-based birth attendants with proper training are able to offer a higher level of care than traditional birth attendants and have a higher retention rate than midwives, who were often tempted by accept more lucrative opportunities in the Middle East, said Roedde. Health authorities in the country assumed that only obstetricians could perform C-sections, “but I piped up and told them that in Temiskaming Shores, we have a GP, Dr. Pace, who does C-sections, and if a GP in Canada can do them, so can a GP in Bangladesh.”

The government took Roedde’s advice and launched a program to train GPs to do C-sections. In most developing countries, the C-section rate is less than one per cent, whereas the World Health Organization estimates that between five and 15 per cent of deliveries require emergency obstetrical intervention,¬†noted Roedde. “In many countries, it can be a huge risk just giving birth.” According to a study by the Lancet, the maternal mortality rate for Canada in 2008 was 6.6 per 100,000 live births. In Bangladesh, the corresponding figure was 383.3 and in Afghanistan, it was 1,575. In Tanzania, said Roedde, one woman dies every hour because of pregnancy complications.

Economic gains and increasing per capita income in many third world countries are deceiving because the gaps between rich and poor are widening and the “hard core poor are getting more entrenched in their poverty,” she added. “There are huge inequities in access to service.”


Dr. Roedde, who was born in Thunder Bay and grew up on Toronto Island, received her MD from McMaster University in 1977 and moved to Temagami, then Haileybury, in 1981 and 1983, respectively. Unable to commit to a steady practice because of her frequent work in some of the most inhospitable places in the world, she does locums or short to mid-term assignments.

“Haileybury used to be under quota, so I was involved there more. Now, it’s up to quota, so I redistribute myself where there’s a need. Because we’re an underserviced area, there’s always work for me if I’m here,” she said. Earlier in her career, she worked with aboriginal communities in Northern Manitoba and Ontario, including the predecessor of the Nishnawbe Aski Nation. Roedde has also spearheaded a number of maternal and child health initiatives in Temiskaming, including a teenage birth control clinic and a well women clinic in the hospital.

Her travels have left her with a deep appreciation for the quality of health care in Canada. “I think we have a fabulous health-care system, and we should do everything we can to protect and preserve it.”

A Doctor’s Quest: The Struggle for Mother and Child Health Around the Globe, published by Dundurn, was released September 8th and should be available from most booksellers.

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