Emory Report

 August 25, 1997

 Volume 50, No. 1


Brann wants world's mothers
and children healthy

Alfred Brann handed over for inspection a green statuette of a large woman cradling a child. "You know, grandmothers run the world," he quipped. "That's an African-American grandmother holding a child." The glossy sculpture felt warm from the sunlight of Brann's windowsill in Grady Hospital's Steiner Building, next door to the original 1892 Grady building. "Look at those arms; that child is holding on for dear life."

It is one among many such images in Brann's office-statuettes, paintings, drawings, photographs, each depicting a mother and child. Nearly all are gifts from Brann's former patients and colleagues, and they are fitting tribute to a man who has dedicated his adult life to providing mothers and newborns the chance they deserve. He leaned forward to place the Buddha-like grandmother and child back in the sunshine.

As director of the Atlanta-based World Health Organization/Collaborating Center (WHO/CC) in Perinatal Care and Health Services Research in Maternal and Child Heath, Brann has improved pre- and postnatal care in a list of countries even longer than his program's name. He's worked on every continent save Australia, studying public health as it relates to expectant mothers and newborns.

Reproductive health is a vocation Brann received the moment he entered the world; his mother died giving birth to him. Growing up in northern Alabama and spending his early years as a pediatrician in Mississippi, he saw firsthand the effect poverty and illiteracy have on the health of mother and child. And he also realized it didn't have to be that way.

"Children and women in Beijing, in Pakistan, in New Delhi (India), in Krakow (Poland), in Buenos Aires (Argentina), in Havana, in Atlanta, in New Orleans, New York, San Francisco," Brann began, "they're all the same. Women who are economically and intellectually disadvantaged have far more unwanted pregnancies and far fewer children who survive."

Inspired by then-Gov. Jimmy Carter in the early '70s and officially created in 1981, the Collaborating Center is a partnership between Emory's Woodruff Health Sciences Center, the Centers for Disease Control and the Georgia Department of Human Resources. The WHO took notice of the center's work and in 1982 designated it as one of its global resource centers in the area of perinatal and child health.

Among a host of other projects, Brann and his colleagues in the WHO/CC are using a grant from the World Bank to study Eastern Europe's Transcaucasus Region in hopes of identifying a prime site for a regional Children's Medical Center, probably in the Georgian capital of Tbilisi. First Lady Nanuli Shevardnadze is lending her support.

Part of the reason the Collaborating Center so impressed the WHO is the range of expertise the center is able to bring to bear on health problems. For example, one would expect the host of medical professionals involved-the other principal investigators from Emory are Luella Klein from the Department of Gynecology and Obstetrics, and Glen Maberly from the Rollins School's Department of International Health-but Brann credits Juliette Stapanian-Apkarian of the Department of Russian, Eurasian and East Asian Languages and Studies with helping pave the way for the Tbilisi project by educating the WHO/CC on cultural differences in the region.

"It's so helpful to understand culture, especially when you get to the children, to birthing practices," Brann said. "If you don't understand the culture, you're just walking on land mines."

But far from the exotic cultures of Uganda or the Philippines, Brann says both his and the Center's top priority is helping mothers and children right here in Georgia, "the laboratory in which we work." His face registered disbelief when he said the state is currently 48th in the nation in reproductive health. "We have one of the lowest unemployment rates in the country; we've had for a year now post-Olympic city status. What is it we don't understand? If [the system] doesn't work here, it can't even in my best and fondest dreams be adaptable to another country."

The situation only illustrates Brann's belief that geography no longer dictates where health problems will be the worst. "You can either be in a developing country, or in a developing section of a developed country. There are developed and developing sections of Atlanta, or at least similar settings."

And for Brann, the single most important initiative currently being undertaken by the World Bank-female literacy-is the solution. "The woman has always been able to control her reproductive outcomes if she is equal intellectually and economically. There are certainly medically limiting problems that have improved over the years, but given an individual woman who is economically and intellectually independent, in whatever age or culture in which she competes, she wins more times than the one who is not."

Hanging on Brann's office wall across from the shelf filled with maternal images is a charcoal sketch of a young girl blowing on a dandelion, the wispy petals floating out of the picture. The drawing is a gift from Brann's wife of 38 years, Peggy. Behind the girl's lidded eyes and pursed lips is a silent wish.

Brann's voice dropped to a whisper, as if he were sharing a secret. "I think her wish is that, if she has offspring, that she and her children will be able to survive and express themselves in the best way they can."

-Michael Terrazas

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