You probably don’t know the name Allan Rosenfield, but he was one of the giants in the world of public health, and his legacy can be found throughout the developing world.
Allan was long-time dean of the Mailman School of Public Health at Columbia University, but more than that he was a champion for maternal care around the globe. Allan started out as an ob/gyn, but practicing in South Korea and Nigeria led him to feel that the horrors of childbirth in the developing were too great to be addressed one by one on a doctor-patient basis. They were systemic problems and needed systemic solutions. He later moved more into public health by working on population issues in Thailand, where he promoted an effort to use nurses and midwives to insert I.U.D.’s, since doctors were unavailable in rural areas; that led him to think creatively about use of non-physicians in other parts of the world.
In a series of wake-up calls in medical journals, he forced his profession to face up to the appalling care that women face in much of the world, and he sought public health solutions. He helped found Averting Maternal Death and Disability, AMDD, an aid group that combats maternal mortality. He realized that you can’t save women in childbirth just with trained birth attendants and clean razor blades, and so he insisted on emergency obstetric services — meaning someone who can perform a C-section. Since there usually isn’t a doctor available in rural Africa, he advocated training non-physicians such as nurse-midwives to perform C-sections, and that approach is being implemented on an experimental basis in several countries and seems successful.
We tend to think of human rights as an argument to prevent governments from torturing citizens. But Allan argued passionately that maternal mortality was a human rights issue, and that governments had to be held accountable when they allowed women to die in vast numbers in childbirth, simply because they were poor, rural and female.
I met Allan shortly after I began my column, and I was a huge admirer of his. Indeed, my wife and I have a chapter on him in our forthcoming book on women in the developing world. Then in 2005, Allan was diagnosed with a pair of progressive diseases, and this once athletic man found himself forced into a wheelchair. Yet he continued to be everywhere and to send emails to everyone, day and night. He read our chapters on maternal health and offered excellent suggestions. He oversaw his innumerable proteges throughout the world (one of them is Josh Ruxin, now a guest blogger on this site). And he left us all awed with his courage and commitment to the less fortunate.
Here’s his obituary in today’s Times. But I’d suggest instead reading this article about him, written in 2006 after he was diagnosed; it is full of Allan’s wry humor and captures the power of his personality.
For those of you who know Allan, I’d encourage you to post your memories of him, or your interpretation of his legacy.
You can link to Kristof here, there are some interesting comments.