In the first of a three-part series, we speak to the panelists from the 2014 Women in Global Health symposium, beginning with OB/GYN physician Adeline Boatin, MD, MPH, on her journey from Africa to Mass General – and back.
Born in Zambia, yet a native of Ghana, Dr. Adeline Boatin’s road to Massachusetts General Hospital has been as inspired as it has been circuitous. After leaving Africa at the age of 13 and receiving her secondary schooling in London, Dr. Boatin first moved to the United States as an undergraduate student at Harvard College. She was soon attending medical school at Columbia University and a masters in public health at Harvard followed. Now a physician in Mass General’s OB/GYN Department with a focus on maternal health, she is a Global Health Fellow, who spends half her time practicing in Boston and the other half at one of the hospital’s international collaborator sites.
Coming from Mass General, first impressions for Dr. Boatin were unsurprisingly stark. “The way you practice there is just completely different,” she begins.
Experiencing OB/GYN in Uganda
For almost four of the past six months, Dr. Boatin has been working at Uganda’s Mbarara National Referral Hospital, located 165 miles southwest of the capital, Kampala, and arguably a light year from the luxury safari lodges that surround its hinterland. Coming from Mass General, first impressions for Dr. Boatin were unsurprisingly stark. “The way you practice there is just completely different,” she begins. “You just don’t have a lot of have resources. Here at Mass General we can do lab tests at the drop of a hat whereas in Mbarara you simply can’t; patients can’t afford lab tests and the hospital doesn’t have the equipment.” This striking contrast was first met at Mbarara’s post-natal ward, a crowded dorm of steel-framed beds fitted with thin black mattress pads. “The ward has a capacity for 30 patients but there are usually 60 to 70 patients, either on the floor, in front of beds or behind them,” the OB/GYN doctor describes. “And nobody ever complains.”
Making an Impact in Mbarara
Dr. Boatin sees her position in Mbarara as one that is continually evolving. During her first trip last fall, her work was more clinical focused: rounding with the OB/GYN residents, learning how the system works and discovering the gaps where she could make the most impact. Her last trip, from which she returned in February, involved more time working on an outcomes database (a collaborative effort between OB/GYN, Surgery and Anesthesia), in order to try and establish a means to measure the positive changes they aim to achieve. “It was a challenge,” Dr. Boatin explains, “especially when you’re trying to take everything from paper files and make sense of it”.
While the burden of work may be overwhelming, Dr. Boatin is realistic, yet passionately positive about delivering on what she can do. “I have come to recognize the baseline that poverty is pervasive and infrastructure is weak, so one has to choose their impact,” she says philosophically, “and hopefully somebody else is choosing something else. I know I can’t do anything, for example, about the prenatal care women will receive when they’re up in mountain villages but what I can guarantee is that the health care they’ll receive when they come to me at Mbarara is exemplary.”
Role Model in the Making
While transposing her excellence within the medical field, Dr. Boatin has also found herself assuming an ambassadorial role in Uganda, a guise the OB/GYN physican sees as central to the Women in Global Health Program.
While transposing her excellence within the medical field, Dr. Boatin has also found herself assuming an ambassadorial role in Uganda, a guise the OB/GYN physican sees as central to the Women in Global Health Program. “There’s a major gender imbalance in Uganda,” she begins. “If you take the OB/GYN department in Mbarara as an example; there is not a single woman on the faculty, while within the residency program of 18, just three are women.”
Dr. Boatin believes this presence of women on the ground increases the gender profile, offering encouragement to both those female colleagues trying to pursue a career in medicine and to those female patients coming to the facility to seek care. “People tend to identify with what is similar to them,” she says, “so if you have more women on staff, it creates more avenues for women to speak up.”
That also extends beyond the clinic. One of Dr. Boatin’s most memorable moments was being able to go and speak to children at one of region’s rural primary schools. “For them, to see a female, African doctor is something which they had never seen before, so it’s something both the girls and the boys can aspire to,” she explains. “It offers that sense of possibility – that they can do it.”
Striving Towards Global Goals
“With Women in Global Health, I can really spend time on the ground working with both the people and the system.”
With one year remaining at her fellowship, Dr. Boatin displays an almost infectious ambition about the tasks ahead of her and moving the agenda of the Women in Global Health program forward. She’s adamant that her involvement remains vital and longstanding so that its impact ripples far beyond her time in Uganda. “This program allows me to be a clinician and to do work in a significant way, which means more than just one week every few months,” the OB/GYN physician says. “With Women in Global Health, I can really spend time on the ground working with both the people and the system.”
It’s this very commitment that has proved the keystone to Dr. Adeline Boatin’s progress. The longstanding relationships she has crafted with her colleagues in Uganda are something she feels would not have the same impact were she not on the ground continually. “I definitely don’t think we could gain that trust and make those connections and even begin to make those impactful changes otherwise,” Dr. Boatin explains. “Now I feel like I’m really getting into the system at Mbarara – and that change is palpable.”