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New head of AAP global, life support: Disparities don’t have borders :

May 30, 2018

Our life circumstances can significantly affect our outcomes, as Janna Patterson, M.D., M.P.H., FAAP, the new senior vice president of AAP Global Child Health and Life Support, knows firsthand.

While living and working in Tanzania, she became pregnant with her first child. She planned to deliver at the local private hospital where she was able to pay for quality antenatal care. But complications arose during labor. When it became clear that an emergency cesarean section was necessary, staff discovered the oxygen machine was not accessible. They prepared to move her to another hospital, but the ambulance was not available. Instead, she and her obstetrician were driven to another hospital in her husband’s pickup truck. There, the hospital was about to lose power due to rationing. Lying on the stretcher, she heard staff on the phone, negotiating to keep the power on so they could complete the operation.

Janna Patterson, M.D., M.P.H., FAAP, with her sons Jamal, at right, and Karim. In the end, the outcome was positive — a healthy baby and mom. But Dr. Patterson recognized her personal resources had a tremendous impact on her outcome. Two decades later, that experience still drives her motivation to improve the health and well-being of all mothers and children, regardless of their circumstances.

As the new head of AAP Global Child Health and Life Support, Dr. Patterson oversees neonatal and child resuscitation training as well as maternal and child health intervention programs. She also aims to amplify voices of members to advocate for children here and abroad.

She credits the Academy for helping to shape her foundation as a neonatologist, from studying for boards as a medical student to managing maternal and newborn health programs at the Bill & Melinda Gates Foundation.

In the following Q&A, Dr. Patterson discusses health disparities and the Academy’s role in global child health.

Q: Your experiences in Tanzania helped deepen your focus on health disparities. Would you say that stories such as yours are common among pediatricians?

A: Personal experiences drive a lot of us who are engaged in public health. Sometimes, it’s the first baby you see die when you’re in a country lacking the resources that could have saved their life. There’s nothing harder for a pediatrician than to think that something else could have been done and it cost a life.

Many U.S.-based pediatricians can relate to the disparities that arise when culture and language barriers are an issue. In my resident continuity clinic, it was common to use an interpreter for 80% of patient visits. Pediatricians in many cities across the U.S. are confronted with multiple languages in a single clinic day. It can be hard to deliver effective care across these language and cultural differences.

Q: Why devote AAP resources, time and energy to global child health?

A: Our days as an insulated citizen of one country are past. We are all global citizens now. What’s happening in another country can affect us here and now. When children in other parts of the world lack access to adequate health care, we are all at risk. More importantly, I believe it is our moral obligation to work toward a world where our birthplace does not determine whether we live or die.

Q: What sensitivities do AAP members and staff keep in mind when doing global work?

A: When we go to support health care professionals in other countries, we should go as invited guests. We may offer technical assistance, but we don’t make the rules and often we don’t even know much about the context. To be effective, we must fit into the systems already in place and work alongside our peers who have expertise in taking care of patients in that setting.

Q: How do AAP policies trickle up to the global level and down to the community level?

A: The AAP can have an important voice in advocating for children in settings like the World Health Assembly, where ministers of health come together to set global health priorities. Over 200 governments are in attendance, and we can have face-to-face conversations about evidence and programs for newborn and child survival, prevention of noncommunicable diseases and expansion of vaccine coverage. These in-person conversations can have a real impact on policy and actions in-country when the Academy connects in a meaningful way with decision-makers.

The AAP also helps amplify the voice of pediatricians in other countries by sharing the strategies we use to influence members of the U.S. Congress on issues of child health. This may not be a familiar approach for pediatricians, so we hold trainings for them to practice this advocacy.

We also can’t lose sight of the fact that many of the people caring for children are not pediatricians. This is why the Academy’s Helping Babies Survive training curriculum for low-resource settings is designed to be appropriate for midwives and nurses, too.

Q: How does global migration play a role in the Academy’s approach to immigrant child health?

A: Global migration affects us here and certainly is a pressing issue in many other parts of the world. Children who come to our country fleeing violence have needs that may be similar to children affected by violence elsewhere. We can learn from each other’s experiences. Ultimately, by learning from and advocating for each other, we can reach a day when all children can lead a happy, healthy life.

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