Dr. Noni MacDonald is a passionate advocate for child immunization and for finding community solutions to maternal and child health care problems.
The professor of pediatrics in infectious diseases at Dalhousie Medical School and the IWK Health Centre is the winner of the Canadian Institute of Child Health's 2017 National Child Day Award.
“We are delighted to recognize Dr. MacDonald for her impact on improving the health of children and youth in Canada and abroad,” says the institute's chairperson, Dr. Lynn McIntyre. “Over her career she has been a teacher, a leader and a mentor, while maintaining an active role as a clinician and researcher.”
The award is an even “greater honour,” says Dr. MacDonald, because it's not just for doctors but for anyone working in children's health and rights. Previous winners include singer-songwriter Fred Penner, Olympic medalist Silken Laumann, and Senator Michael Kirby.
A pioneer in child health and academic medicine
After receiving her MD from the University of Ottawa in 1975, Dr. MacDonald became the first pediatrician in Canada to be certified in pediatric infectious diseases.
She worked for 18 years at the University of Ottawa and its teaching hospitals — where she founded the infectious diseases division — before taking the post of Dean of Medicine at Dalhousie University from 1999-2004. She is the first woman to become a dean of medicine in Canada.
When asked what she feels is her greatest contribution, Dr. MacDonald says it was the journal, Paediatrics & Child Health. However, she notes, “this is a hard question… I have worked on so many issues in child health.”
Dr. MacDonald was founding editor-in-chief and editor of the journal for 20 years, which was considered radical at the time for emphasizing knowledge translation — the movement of research into practical use.
“This was new and uncharted waters. Now this journal is one of the most-read specialty journals in Canada and well respected internationally.”
Champion for health equity and immunization
A big health problem in Canada is inequity, Dr. MacDonald says. “Where you live very much influences what is available to children and youth — whether that's a lack of access to clean water, to quality education, or exposure to a heightened risk of serious diseases like TB. Huge disparities exist in our country and this is just plain wrong.”
Dr. MacDonald is passionate about immunization as “one of the major interventions that literally saves millions and millions of lives every year. But if we fall back, many of these vaccine-preventable diseases will return as major killers,” she says.
“The problem with vaccine-preventable diseases is, in many cases, we cannot treat the disease once it is happening nor prevent the complications, including in some instances death, even with the best care we know how to give. Prevention with immunization is the key.”
People fail to recognize that seemingly eradicated killer diseases can return. They also worry about vaccine safety, but Dr. MacDonald says vaccines are “incredibly safe — much safer than many drugs that are commonly prescribed for kids.”
Dr. MacDonald, a mother of two, gave up clinical work three years ago to spend more time on international health care.
She was appointed this year to the Strategic Advisory Group of Experts (SAGE) on Immunization which advises the World Health Organization (WHO) on immunization. She is also chairperson of the Global Vaccine Action Plan.
“Being able to contribute to vaccines and program recommendations and decisions that can affect every country is both daunting and inspiring.”
She is also a founder and co-director of the Centre for MicroResearch International, which since 2008 has helped interdisciplinary teams of health professionals and community researchers in eastern Africa find solutions to maternal and child health problems in their countries.
“It's the communities that decide what problems to tackle—many involve trying to decrease mortality and improve quality of life,” says Dr. MacDonald. “It is amazing and rewarding to see what smart people can accomplish with only a little money but with great questions, quality research and sweat equity.”
The program has recently been set up in Nova Scotia with support from the IWK and Nova Scotia Health Authority. MicroResearch NS has examined issues including the needs of suicidal youth following hospital discharge, and pop consumption in the Paqtnkek Mi'kmaw Nation near Antigonish.
“I am deeply grateful to the Dal faculty who have helped to teach in the workshops and/or been proposal reviewers and team coaches,” says Dr. MacDonald.
Her work is both satisfying and painful. “It is tremendously rewarding to be able to help, to see change over time, but there are many times when your heart breaks—for example, seeing babies in Myanmar dying of neonatal tetanus that is totally preventable with maternal tetanus immunization.”
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