Starting a conversation about keeping babies alive

Grace Lubwama, the new chief executive officer at Kalamazoo’s YWCA, was eager to see the United States when she arrived in 1997 as a young student from Uganda. This was the land of milk and honey, after all.

"When I first landed here, I thought I would be walking on gold, with lights everywhere," Lubwama laughs.

Along with the stunning New York City skyline, Lubwama also saw such poverty in areas of New York City, her first stop, that poverty in Uganda at times paled in comparison. Infant mortality rates, she would later learn, were even higher in areas of the United States than in her homeland. She saw people living on the streets and going hungry.

Although Lubwama bachelor’s degree was in art and design, the young student realized her calling was elsewhere. Lubwama knew she could make a difference in the social and public health issues she saw in such profusion around her.

When coming to the United States, Lubwama had intended to return to Uganda upon completing her education. She received her master’s degree in public health at Boston University and her doctoral degree in policy, planning and development at the University of Southern California. Instead of returning to her homeland, however, she rolled up her sleeves to work on changing the world in which she now lived.

By then married and with two small sons, Lubwama learned about the infant mortality rates in Los Angeles, California, where, prior to coming to Kalamazoo’s YWCA in February 2014, she was the executive director of Antelope Valley Partners for Health, a public health planning and intervention organization, and national director of World Vision US, a Christian humanitarian organization working with children, families and communities, to take on the root causes of poverty and injustice.

"When I moved to L.A., I wanted to do something to improve the wellness of community," Lubwama says. "I learned that the infant mortality rate in L.A. was 32.7 percent. That’s higher than in Uganda, and I was struck by that."

Lubwama started an important conversation. "I was young and naïve, but I had lots of enthusiasm. I talked to everyone I could talk to at hospitals and all kinds of organizations. We created a community collaborative, assessed the needs of the community, mapped resources, and came up with a strategy."

It took time, but it worked. After about 10 years, 32.7 percent dropped to 9 percent infant mortality rate.

The YWCA in Kalamazoo noticed. Lubwama was hired to take over at the helm, and one of the many reasons to bring her to Kalamazoo was to reduce the infant mortality rate. On Friday, November 21, from 9 a.m. to noon at the WMU Homer Stryker M.D. School of Medicine, Lubwama is beginning yet another such important conversation. It will be the launch event for the Kalamazoo Infant Mortality Community Action Initiative.

Speaking at the event will be Catherine Kothari, a senior clinical research scientist for the WMU Homer Stryker M.D. School of Medicine; Arthur James, MD, pediatric expert and associate clinical professor at Ohio State University Medical Center, formerly an obstetrician and gynecologist at Borgess Women’s Health in Kalamazoo; and Cheryl Dickson, associate dean of the WMU Homer Stryker M.D. School of Medicine.

"We’ll hear what the numbers mean, the risk factors, what’s being done nationally," says Lubwama. "We will also hear by video from the team in Los Angeles that worked with me, talk about how to organize grassroots efforts. And then we will talk about where to go from here."

Lubwama cites the Kalamazoo numbers, and the racial discrepancy is immediately evident. According to the Michigan Department of Community Health, 19 infant deaths occurred in Kalamazoo in 2012. At a rate per 1,000 live births, 3.7 of those infant deaths were white and 16.5 were black. In 2011, the rate for white babies who died was 2.1, but 11.4 for black babies. The pattern holds all the way back to 2000, when rates were first recorded, with four to six times more black babies dying within their first year of life.

"Kalamazoo has the third highest rate of infant mortality in the state," says Lubwama. "Why the disparity between black and white infant deaths? This isn’t an issue of access. We have two big hospitals; we have a clinic right in the center of the areas where poverty is prevalent. We have the programs, the prenatal visits. This initiative is going to ask why? What are the social determinants?"

Along with mapping resources to find any gaps, Lubwama plans to bring together hospitals and providers; the Family Health Center; early childhood providers; community partners; county services; and faith-based services to develop a community action plan to address the infant mortality rate disparities.

"There can be many risk factors involved," Lubwama acknowledges. "Domestic violence is often a risk factor. Nutrition, maternal medical care, lack of social support, low education, are all factors. The YWCA provides a safety net for women who are abused--400 women come here annually for help, but many, many don’t."

Lubwama expects to have to study data collected through the new initiative for about a year before she is able to identify the reasons the high rate of infant mortality is occurring. A part of the year-long study includes connecting with young women expecting babies and learning their health histories, and that, she says, happens by first building trust.

"We need to build a relationship of trust," she says. "Churches can help us with that. People don’t want others getting into their lives, but we won’t be there to judge. We are here to hold these women’s hands. We are here to celebrate every birth."

While Lubwama says she has found that Kalamazoo appears to have all the necessary resources, the greater community does not have a collaborative effort in place to use them to their best advantage.

"The poor population tends to be invisible," says Lubwama. "But if you want to really know your community, if you want to know how you are doing as a community, look at the infant mortality rate. It should not be a problem in a developed country."

Zinta Aistars is creative director for Z Word, LLC, and correspondent for WMUK 102.1 FM Arts and More program. She lives on a farm in Hopkins.

Photos by Susan Andress.