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Giving Money Towards Maternal Health Is Only Part of a Solution

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Press headlines covering the Maternal, Newborn and Child Health Summit held in Toronto May 28-30, 2014 focused on the money. $3.5 billion is enough to command the attention of the press. The magnitude of the financial commitment by Prime Minister Stephen Harper is easier to understand than the complex challenges in achieving the goals of the three day Summit: "Saving Every Woman, Every Child: Within Arm's Reach."

The focus on money gave way to star power as Prime Minister Stephen Harper did multiple press appearances with Melinda Gates of the Gates Foundation. We were made aware of the participation of the Secretary-General of the United Nations, Ban Ki-Moon, His Highness the Aga Khan, Her Majesty Queen Rania of Jordan and Dr. Margaret Chan, Director-General of the World Health Organization.

Summits which focus on money and star power make me skeptical that the media event is more important than the substance covered in the meetings. Just a fortnight ago I was a speaker at an international charity conference in China with headliners such as former First Lady of the Philippines, Imelda Marcos, and the current First Lady of Ethiopia, Roman Tesfaye. Reading about this international charity conference in the press might have given one the impression that more was accomplished in the actual proceedings than would be accurate.

However, reading Prime Minister Harper's Toronto Statement makes it clear that the problems of Saving Every Woman, Every Child are comprehensively understood and the challenges are being undertaken with great consideration and collaboration. I am proud that Canada is taking this leadership role and hope that it is not being done at the expense of our other global commitments.

My confidence in this endeavour was greatly increased when I learned that one of the participants in the Summit was Dr. Dennis Willms, an academic now with Salama Shield Foundation, who has worked in sub-Saharan Africa for over 35 years as a medical anthropologist. The discussion will get back to reality when someone with Dr. Willms' decades of confronting problems on the ground is among the participants. With the global academic standing to hold his own in a discourse with the most senior bureaucrats in the room, one can be confident that the priorities of the Summit will move beyond the political to the practical. Again, Canada can be proud of the individual players it is bringing to the challenge of enhancing maternal, newborn and child health as well as the dollars.

Dr. Willms would understand the limitations of simply speaking about "innovation" in technical and scientific terms. His decades of immersion in many of the different cultures in Africa has taught him that "innovation" can also be a return to traditional social-cultural vehicles of care, support, and help-seeking such as the paternal aunt or ssenga in the Baganda culture in Uganda. Canada would do itself proud if Canada was identified with "innovation" measured by revitalizing and strengthening indigenous institutions.

When we talk about gifts of international aid we usually focus on the magnitude of gift and whether the donor nation actually got around to delivering the cheque. This is consistent with the common law concept of gift which presumes a gift is complete as long as we deliver it. Our civil law cousins in Quebec have a much more sophisticated concept of gift which requires the recipient to legally "accept" the gift. If Canada's $3.5 billion is to be effective, we must not only deliver the funds, we must do so in programs that will be accepted by women and children in Africa. Because of its many different and conflicting social and cultural values, there is an acute need for medical anthropologists to design programs that reflect the divergent cultural and moral milieus in a continent as diverse as Africa.

Canada has taken the bold steps necessary to fund the worthy goals of the Summit. To truly succeed in accomplishing these goals, the delivery mechanism must be designed to be "within arm's reach" of the needy women and children. Canada needs its medical anthropologists to work with its scientific and government communities. The goal must be to ensure that the ultimate measurement of success is that our funding is appropriate and accepted by individual women and children in Africa so that we do indeed enhance maternal, newborn and child health.

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