Global Health
Vol. 22 No 4 | Summer 2020
From the President
Dr Vijay Roach

This article is 4 years old and may no longer reflect current clinical practice.

The final issue of O&G Magazine for 2020 is dedicated to Global Health. The paradigm that surrounds this subject often focuses on the seemingly overwhelming dilemma of inequity, lack of resources and poor health outcomes. Recognition and quantification of the problems facing global communities around the world, particularly those in low-resource countries, is essential, but it’s not the whole story. In this issue of the magazine, our authors also highlight the many positive and constructive steps undertaken by RANZCOG members. Advocacy for improved funding, social, economic, and political change, is an ongoing struggle. Improving outcomes through education, systems development and direct delivery of healthcare is the key to sustainable change.

The authors in this issue share their experience working in countries in our region and further afield. Perhaps the most important message that we can take from their work is that opportunities that arise from engagement with other people and cultures are bi-directional. In other words, as small, wealthy countries, distant from the rest of the world, Australia and New Zealand stand to benefit enormously from our engagement with other nations. Sharing our knowledge and expertise creates an opportunity for us to listen, and learn, in return.

Charitable work is complex and the articles in the Summer Issue explore the work of large organisations, small NGOs and individuals. It’s important to go beyond superficial assumptions and gain a better understanding of how donations are spent, use and misuse of resources, and the potential unintended consequences of good deeds, including ‘voluntourism’. In a world often polarised, economically and ideologically, we need to remain respectful of other cultures, constantly reminding ourselves to tread lightly, asking, not telling, advising, not instructing, listening more than we speak.

The centrality of women in every community means that the impact of preventable conditions such as cervical cancer and genitourinary fistulae are far-reaching, affecting the entire community, let alone the woman herself, often at a very early age. Access to contraception, abortion and adequate care during pregnancy and birth are expectations in our countries. In a globalised world, every woman is our daughter, our sister, our mother and our friend. Surely we want the best outcome for them too. The suffering and grief associated with disease and death is only contextually different in Sydney, Auckland or Port Moresby. The human experience is the same.

As 2020 draws to a close, the impacts of the global pandemic have brought into sharp focus the fragility of human health in the modern era. High-resource countries have not been immune to a virus that does not discriminate. Having said that, COVID-19 has further exposed the inequities in health between socioeconomic classes, race and gender. The poor, people of non-white ethnicity, and the elderly, have suffered disproportionally. The experience of the pandemic has differed dramatically for our members. Swift action in New Zealand has meant relatively few infections and deaths. In Australia, Victorians have suffered a prolonged and arduous lockdown while other States have been spared. While I’ve been unable to visit Victoria, I have been acutely aware of the emotional trauma experienced by our staff and members there. Obstetricians, gynaecologists, general practitioners, nurses and midwives have been forced to confront illness, death, prolonged and difficult working conditions and, above all, anxious uncertainty. That they’re still standing is testimony to the human spirit. While we recognise their determination, words like ‘heroes’ and ‘resilience’ should be used with caution, if at all. Coming out of the pandemic will require ongoing understanding and support.

For RANZCOG this has been a year like never before. The challenges have been extraordinary but I’m actually not surprised that we have responded, adapted and, in fact, thrived. Adjustment to working from home, running webinars, exams, and meetings online, maintaining communication and camaraderie through a screen reflects an organisation with a deep, and genuine, culture. Articulation of our Organisational Values of Advocacy, Education, Excellence, Integrity, Kindness and Respect summed it all up. It’s what we do! These values are embodied in RANZCOG’s dedicated CEO and staff, Board, Council and Committee members, training supervisors, examiners, course coordinators and speakers. They’re evident in our trainees who continued working, studying, and striving for excellence, as the rug was pulled out from under them. Our values are why we are who we are, the leaders in women’s health in Australia and New Zealand.

As we head into summer and, hopefully, a time for rest and relaxation, uncertainty in global politics, the impacts of climate change, the risk of bushfires and the COVID-19 pandemic still hover above us. I thought that I’d leave you with a short story that reminds us of the value of the individual in front of us, the power of a simple act of kindness and the importance of generosity of spirit that transcends the vitriol of social media, harsh words and thoughts. Often we wonder what an individual can do when the issues seem so overwhelming.

On a wide and open beach, a massive storm has washed thousands of starfish on to the sand. An old man, tired and cynical, comes across a little child picking up the starfish, one by one, and throwing them back into the sea. Irritably he asks ‘What are you doing? You can’t save all of them. You can’t make a difference to everyone’. The child bends down, gently picks up a starfish, places it in the water and says ‘Well, it made a difference to that one’.

Thank you for your support, your guidance and your friendship during 2020. Take some time to hug your friends, and family, to enjoy the sun, and the sand, to savour life’s simple pleasures. Remember that you make a difference. You matter and, together, we can change the world, one starfish at a time.

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