|Championing maternal care
Dr. Bob Walley
Over 40 years ago, Bob Walley first came to Newfoundland for an elective with the Grenfell Medical Association. He spent three cold winter months traveling up and down the coast seeing patients, doing deliveries, and even becoming stranded on the ice for 24 hours with the Mounties looking for him. Little did the young medical student from Westminster Hospital Medical School, London, suspect that Newfoundland would subsequently become his home and base of operations for most of his professional life.
Dr. Walley did his postgraduate training in obstetrics in Toronto, returning to England for several years before deciding he would prefer to work back in Canada. In 1973 he was recruited by Memorial; more than 30 years later he has retired from academic life, but not from his commitment to improving maternal care internationally.
This interest was honed by a master’s degree in International Health in 1976 from the Harvard School of Public Health, followed by a month in Haiti where Dr. Walley first began to see maternal mortality. He wanted more extensive experience and spent 1981 in Nigeria at St. Mary's Hospital in Akwa Ibom State.
"My year in Nigeria was an extraordinary experience. Coming from a teaching hospital with everything, I had to learn to cope with a hospital where there was nothing, not even running water or electricity. It was isolated and lonely, and very stressful. I saw maternal deaths for the first time many from, die from ruptured uterus. Prolonged and unrelieved obstructed labour usually causes the death of the child and/or mother in small remote villages where the local midwife can't perform a caesarian delivery. If the mother survives, the obstructed labour, injury is caused to her bladder and/or rectum and she is left permanently incontinent, of urine or faeces, which leak out through her vagina. She is constantly wet, filthy and smelly and is shunned by her husband and village.”
Dr. Walley returned to Memorial determined to do something to help the situation. With Sister Dr. Anne Ward, a project was launched to improve the health of mothers in Nigeria by developing a primary prevention program through training birth attendants in the villages to recognize high-risk mothers and refer them to the hospital, and to establish a treatment and rehabilitation centre to help women afflicted with obstetrical fistula and train Nigerian doctors and nurses in the management of these patients. He credits Memorial's Faculty of Medicine with its support. To help publicize the problem of obstetric fistula, in 1992 Dr. Walley led a team from Memorial to film at St. Luke's Hospital. Kay Matthews, Nursing, joined the team to help set up the training program for birth attendants. The documentary was produced by Dr. Annette Felix Briones with Eugene Ryan and Terry Upshall of the Health Sciences and Information Media Service.
Dr. Walley said the experience in Nigeria changed his life. "It created a lot of emotion, seeing so much maternal death. It doesn’t need lot a lot of money to do something about it. ."
Frustrated with the lack of interest and support from traditional funding agencies, Dr. Walley spearheaded the formation of a nongovernmental organization. Eight concerned obstetricians met in Liverpool, England, in October of 1995 and founded MaterCare International, dedicated to improving maternal health care world-wide. The six nations currently involved are Canada, Ireland, the UK, the EU Australia and the U.S.A. MCI is a small central core agency, linked with national groups supporting flexible reference centres distributed throughout the world, all linked together through the most modern communications technologies.The organisation is made up of health care professionals, obstetricians, neonatalogists, general practitioners, midwives and paramedical workers.
The MCI's first project devised with Kay Matthews has been the West African Maternal Health & Fistula Hospital Project, based in Ghana, begun in 1998 to prevent and treat obstetric fistula and to train local doctors and nurses. A similar obstetrical program is also being planned for East Timor.
Every time he thinks it's time to stop, Dr. Walley finds himself being asked to visit yet another part of the world where maternal health is constantly at risk. And he can't help helping.
Dr. Walley has received many honours for his work, including the prestigious Man of Faith and Science Award from the International Federation of Catholic Medical Associations in 1998. From 1985-2003 he served as a consultant to the Pontifical Council for Health.
As an obstetrician, Dr. Walley said it's easy to measure accomplishments - the number of deliveries and operations that go well. As a leader in the effort to prevent material death, it's harder to measure success. "Research and writing proposals doesn't appeal to a lot of people but I do it because it needs to be done to improve maternal health worldwide."