Katherine Williams

I believe that health is a human right. Access to health knowledge and care cannot be viewed as a privilege or a perk that fits into some lives but not others. Health is the foundation of dignity and is what allows each of us to participate in our global community. This is why I took a position as Quality Assurance Officer at Reach Out Mbuya HIV/AIDS Initiative in Uganda. Reach Out clinics serve urban slum communities and provide holistic care, from antiretroviral drugs to sexual health and counseling services.

In my everyday work in Kampala, I encounter some of these women and am overwhelmed by the difficult realities they often face. I see the underweight children and review files of mothers who died in childbirth, and wonder if they might have been spared these adverse outcomes if they'd had better access to reproductive health care and information.

Reach Out clients and I share so many things: hope for our futures, love for our friends and families, and more overlapping relationships and experiences than we usually realize. And I've often wondered: What if I happened to be born in a lower-resourced environment? What if home was an urban slum in south Asia or a village in sub-Saharan Africa? What did I ever do or not do to deserve the privileges I've inherited that open up so many possibilities for my life? This kind of randomness that assigns us to doctors or no doctors, to an abundance or scarcity of health knowledge, is what drives me to work toward reducing such disparities and promoting a movement for health equity and justice.

I also care about reproductive health because of my personal history and what it could have been. I was born a mere 12.5 months after my older sister. Ample research has shown that mothers and infants face significantly higher risks of adverse health outcomes when a child is conceived less than six months after a live birth, like I was. Miscarriage is 230% more likely, newborn death is 170% more likely, and maternal death is 150% more likely. Short birth-to-pregnancy intervals contribute to inadequate child nutrition, often resulting in stunting, and lesser educational attainment and reduced economic productivity later in life.

Due to the timing of my birth, I should have been at risk for all of these setbacks. But I'm six feet tall, have an advanced education, and enjoy good health. How is it that my reality is so different than so many others born under similar circumstances? To start, my mother had the knowledge and resources to recognize a pregnancy early on, as well as access to affordable, quality maternal and child health care. The stability of a developed nation and an advanced healthcare system provided what we needed, and enabled my mother and me to beat the odds.

I'm thankful for the role that reproductive health information and services played in my mother's life and for the strong start I had as a result. But what about the children whose mothers aren't expecting them and don't know how to identify the pregnancy early on? What about the women whose pregnancies coincide with a dry season when crops fail and hunger prevails?

In my everyday work in Kampala, I encounter some of these women and am overwhelmed by the difficult realities they often face. I see the underweight children and review files of mothers who died in childbirth, and wonder if they might have been spared these adverse outcomes if they'd had better access to reproductive health care and information. I respond to these tough questions with hard work and intelligent hope. This kind of hope looks to evidence to understand gaps in health equity and justice, and maintains that change is possible when we're willing to pursue it with dedication and respectful collaboration. It learns from mistakes, and turns every challenge into a chance to overcome—adding each as a new rung on the ladder of progress. I choose to fight for more rungs to be added to that ladder.

Katherine Williams is a Global Health Corps fellow based in Kampala, Uganda, where she works to improve health for people living with HIV. She studied public health and social work at Washington University in St. Louis.