An Interview with Kate Kentfield-Kessner, President of the GPA Board

What I've learned at GPA is that you can make changes. They don't have to be great big ones. Just simple things can be incredibly impactful.

GPA's Communication Coordinator, Emily Felt, speaks with Ms. Kentfield-Kessner about the organization's journey over the past 22 years!

Emily: It’s an honor to interview you, Kate. Can you tell us a bit about yourself and how you became involved with Global Pediatric Alliance (GPA)?

Kate: When I was eight years old, one of the walls of my bedroom was wallpapered with a map of the world. I would look at it and dream about how amazing it would be to travel to Africa, or India, or other places, and help people who I knew even then didn’t always get help. Although I always knew I wanted to be involved in medicine in some way, I didn’t become a nurse until I was 37 years old.

During my last year of nursing school, I did my pediatric rotation at Alta Bates Hospital in Oakland, California. I was assigned to a very cute, very smiley baby who was diagnosed with reactive airway disease and failure to thrive. Dr. Scott Cohen, our fearless leader, was the attending physician assigned both to the baby and me.

A couple of years later, I was working the night shift at Marin General Hospital’s newborn nursery. I was happily surprised to find Scott was also working there. One slow night in the nursery I overheard him talking with a colleague about working in Guatemala and trying to get donations to start a nonprofit. I immediately thought of my stepfather, whose family had a charitable trust. I stuck my head in the door and said, "Wait, wait! I know how you can get a donation."

I wasn’t expecting to be involved, so I was Very excited when Scott invited me along to Guatemala. We spent downtime at work planning the curriculum for our first workshop. I wasn’t fluent in Spanish, and I was nervous about my ability to communicate.

What was it like on the first trip to Guatemala?

Kate: Amazing. There were many long hours on buses, followed by fewer hours on small boats before we arrived at our location, the Ak Tenamit clinic, in the jungle of Eastern Guatemala on the Dulce River. Previously, Scott had spent three months working with the health staff there. He slept in a loft at the clinic and became very familiar with the people (and the wildlife) in the area, and their health practices.

It was incredibly rewarding to see how many people attended our first workshop. There are no roads, so they walked, rode horseback or came by river.

Our goal was to teach midwives how to handle obstetric emergencies and post-natal problems with the resources they had on hand. We taught a modified version of neonatal resuscitation, as well as water purification techniques using bleach, as it is readily available in Guatemala.  

Initially, we focused on the immediate postpartum period when the mother is at risk for bleeding. A woman could have a perfectly normal pregnancy and then have a hemorrhage that kills her. Postpartum hemorrhage is an emergency and is especially difficult when it occurs in hard-to-reach areas. What do you do when you're high up in the mountains, and someone is bleeding to death?

(Pictured above: The AK-Tenamit clinic on the Río Dulce, in Eastern Guatemala)

GPA works with Traditional Indigenous Midwives. Can you explain what a Traditional Indigenous Midwife is?

Kate: Many Indigenous women become midwives because their mother or grandmother passed the knowledge down to them; others feel they are called to their job. They feel it is what they’re meant to do. While many traditional midwives in Latin America are illiterate and don’t necessarily have a formal education, they play a vital role in women’s health, and their communities rely on them, and have for thousands of years.

One of the problems GPA has been working on is discrimination towards Indigenous midwives by medical staff when the midwife brings a woman to the hospital for emergency treatment. GPA is dedicated to fostering rapport and respect between the medical establishment and traditional Indigenous midwives. When a midwife brings a woman to a healthcare center, their judgement should be respected and they should not be turned away, which happens far too often.

What sort of skills enrichment have these midwives gained from GPA?

Kate: The women learn the importance of stimulating the baby and keeping it warm; how to care for the umbilicus, as well as techniques to keep things as clean as possible during birth and the postpartum period. It’s hard, you now, when you’re giving birth on the ground, or maybe on a bench. You've got to do your best to keep things clean, which isn’t easy if you don't have clean water.

When did you become aware that there were additional issues to address in these communities besides just the obstetric issues?

Kate: It started when we began our Community-Designed Health Grants program. We were soliciting applications, and we started getting proposals to address these other problems at the community level. Of course, we always try to stay focused on our mission, which is to decrease the mortality of childbearing women and children in these areas. These other community issues, such as clean water and safe cooking, also play a big role in that.

You’ve touched a little on GPA’s grassroots style of organization. How does that contribute to improving the situation for the women and children in these communities?

Kate: The fact that we’re grassroots adds a level of personal interaction and trust. We're not some big, fancy organization. It's just us and the people in the office there. It’s been really cool to see that GPA has gained actual presence and is a respected entity in these communities. The personal connection is important. We don't have a lot of people.

Everybody works really, really hard all the time. And when you spend 20 years in these communities, word gets around that you’re sticking around. As we grew, we established an office in Mexico, and hired people living in Chiapas who were able to teach and run our programs. I think we’ve built trust and very personal relationships in these communities. I would venture to say that the team feels that too.

You’ve been involved with GPA for over 20 years. What are some of the things that still inspire you personally about GPA's work?

Kate: The team inspires me the most because they are tireless. It’s incredible to think that this group of people has stuck with us for all of this time, and they’ve all grown and learned. It reminds me that you CAN make changes. Not necessarily great big ones. It doesn’t have to be a giant extravaganza; you can come up with some simple things, and those things can be incredibly impactful. The growth of GPA has inspired me because I never expected us to be where we are now, 22 years later. We have this wonderful, deep presence in Mexico that would have been unimaginable to me when we first started out.

What are some of the dreams that you have for GPA and the people it supports?

Kate: I hope that our work continues. We’ve had slow, steady growth, and it has worked because we’ve been able to stay true to our mission. We’ve been able to grow without sacrificing our values. We try to work as economically, and efficiently as possible to reach as many people as we can, and I hope we can sustain our work far into the future.

I also hope that the Indigenous communities we work with continue to be autonomous. These women are so proud of the work they’ve done. I’d love to see a child we taught something to 10 years down the road and see what's happened.

For people who want to get involved in this work or support GPA in some way, what is the best way to do that?

Kate: Donations are always needed, and obviously, this is a wonderful way to contribute. I’d also love for people to reach out to us, ask questions about the work we do, and then share it with the people in their lives. We’ve got wonderful videos of our work, and just watching them, you can feel a connection. I hope people will donate, reach out to us, and spread the word about our work.

Kate, thank you for sharing your GPA journey with us! It has been an honor.

To learn more about GPA’s work and to donate, visit globalpediatricalliance.org