Mainstream Media and Global Health

by Mara Gordon

Published July 09, 2009 @ 03:35AM PT

Denise Grady

Global health news isn't exactly the mainstream media's strong suit. American publications are slashing their budgets for international coverage, and news about healthcare inequalities - when there isn't a celebrity face attached - is not nearly as common as it should be.

A recent New York Times series on maternal health in east Africa is, thankfully, an exception. Health and science reporter Denise Grady traveled to Tanzania and reported on topics like maternal and infant mortality, orphan care, and unsafe abortions for the "Death in Birth" series.

I highly recommend you take a look at the series if you haven't already. Ms. Grady's writing cuts to the heart of complicated issues, and Béatrice de Géa's photographs are beautiful and moving.

Ms. Grady generously agreed to answer a few questions about the series.

Mara Gordon: Public health issues aren't known for generating headlines in the mainstream media. The problems are chronic and, especially when it comes to an issue like maternal and child health, complicated and intertwined. How did you choose to write about maternal health in Tanzania for the "Death in Birth" series? What choices have you made to make this very important issue "newsworthy" for the New York Times audience?

Denise Grady: I've been interested for a long time in maternal health in poor countries, particularly in the fact that so many of the injuries, deaths and illnesses can be prevented by things that are essentially basic first aid for women who are pregnant or in labor. I chose Tanzania because it is among the poorest countries in the world and its  statistics are bad, but neither the best nor the worst in Africa. It has a stable government and so its problems cannot be blamed on war or a despotic regime. So it's a fairly decent representatitive of many other countries. I didn't have to do anything special to make this subject newsworthy.  It is inherently newsworthy.   My editors agreed. And I've had lots of response from readers.  People do care.

MG: Tell me a bit about how you prepared for the trip to Tanzania. How did you decide who to interview and which hospitals to visit? What kind of background research goes into a major global health story?

DG: I prepared for this the way I think most reporters would - I read everything I could find and began to call people. Jeffrey Wilkinson, an obstetrician from Duke University who is working in Tanzania, was extraordinarily knowledgeable and helpful, and also offered to provide introductions and share the many contacts he had made in Tanzania.   It can be difficult to make connections and gain access to people and places and institutions overseas, so when somebody offers to help, I seize the opportunity. Dr. Wilkinson helped open doors for me and Beatrice DeGea, the very talented photographer who also worked on these articles.

MG: What was most challenging about the reporting?

DG: The most challenging thing was selecting the stories to tell.  For every one we published, there are several others untold. There just isn't room in the paper for all of it.

MG: As your series shows us, there's no easy solution to a problem like maternal mortality. But where do you think we can start? Which strategies in place in Tanzania - like training more auxiliary health workers, incentive programs to attract health professionals to rural areas - do you think are the most effective?

DG: I think that educating girls would be an important first step.  I don't mean just teaching them about birth control. I mean providing a general education so that they could look forward to work of some kind and develop hopes and ambitions for themselves. Then they need access and information about birth control and childbirth. I spoke with young women in Tanzania who said they did not realize sex would make them pregnant, or who thought condoms or other types of contraception were dangerous. I think there is also a widespread misperception that sickness and death are inextricably tied to childbirth and are therefore women's lot in life, so people accept it with resignation instead of reacting with outrage.  Education could change that.

In terms of specific, practical solutions - you need more trained people at every level, and you need ambulances, and courses in emergency obstetrics, and maternity waiting homes for women who live way out in the bush. I got the sense that when nurses and medical officers were taught things like how to prevent a woman from bleeding to death, they came to believe it could be done, and that they could do it.  You need to instill a sense of urgency, and that depends on people believing there is hope, something to be gained by taking charge and dealing with an emergency.  If you had to focus on one single thing, I think it would be in preventing and treating postpartum hemorrhage, because that is the leading cause of maternal deaths.