Karen Edmond, current United Nations Children's Fund (UNICEF) Chief of Health for Afghanistan, is soon to join the Department of Women & Children’s Health as Professor of Child Health.
Professor Edmond began her medical career as a consultant paediatrician and public health physician working in the deprived indigenous communities of northern Australia and has since held positions at the World Health Organisation (WHO), London School of Hygiene & Tropical Medicine and the University of Western Australia. She has over 100 peer reviewed publications and has led more than £23 million of research worldwide.
For the past 24 months Professor Edmond has been based in Kabul, Afghanistan where her work has focussed on delivering and evaluating care for women and children during humanitarian crises.
We sat down with Professor Edmond to discuss her career to date and plans for paediatrics at King’s.
When did you first know you wanted to be a doctor?
As a teenager I was clear; I wanted to be a doctor or a vet. I was successful at school, enjoyed science, particularly biology and chemistry, and found that I was good at solving problems in a scientific way. It wasn’t my only interest though as I’ve always loved literature, discussion and sharing ideas, so I knew I didn’t want a career without that human side.
From an early age I had the inclination to care for the vulnerable and I think this came from my family, where I saw up close the challenges of mental illness and the vulnerability it creates. Looking back, this is why I chose medicine over veterinary science. I decided I could solve bigger problems and make things better for more people. I made that choice in sixth form and, with hindsight, am delighted I did.
What do you wish you’d known as a medical student?
I wish our medical school had a greater focus on the importance of good data and how to interpret it. Medical innovation is guesswork without effective statistics and detailed epidemiology. These are the tools that we use to gather and understand the evidence so after my public health and paediatric training, I trained in epidemiology and statistics too.
I am, however, very pleased at how quickly I found paediatrics.
So, why paediatrics?
My first experience of it was in my fourth year of medical school, where we studied a series of three-month modules, and I loved it. A newborn baby is totally dependent and in no way responsible for their health. There are no grey areas; children are the most vulnerable and so, to my mind, the most deserving of care. It’s also such a positive field. You really feel you are able to make a difference and can see improvements with your own eyes day-by-day.
To come back to my choices at school, I also believe that paediatrics, of all medicine, has the potential to do the most good. My work has focused on infants up to one year old. The premise is clear – to save the youngest lives - plus I have always enjoyed being surrounded by new mothers, babies and toddlers. It’s a great leveller, enables you to see yourself and your work in perspective and reduces the hubris that some doctors are prone to. I never feel the need to justify the work I do. There is a moral imperative to care for children so to me it was always a no brainer.
What did you most want to achieve?
That’s a big question!
I suppose to generalise, I have always worked to improve primary care for the biggest number of disadvantaged children. Best to think of this as the front-line of a healthcare system. In richer countries normally a GP or similar but in low and middle-income communities often the only care available is from nurses and community health workers.
What I found particularly shocking early in my career, though, is the lack of primary care for disadvantaged women and children in rich countries with seemingly excellent healthcare. My first experience of this was the ten years I spent working with Aboriginal communities in Northern and Western Australia.
These communities are geographically isolated, marginalised and disenfranchised. Colonial history, racism, loss of ownership of land and culture all play their part. Alongside high rates of communicable diseases – like pneumonia and diarrhoea - there are many babies born malnourished, to mothers with poor mental health or substance addiction. I set out to design interventions and create “delivery channels” (ways of getting healthcare to where it’s needed) to reach the most disadvantaged mothers on the continent.
This led quite naturally to my ‘second life’, working internationally for the WHO in Geneva, the London School of Hygiene & Tropical Medicine in Ghana and later for UNICEF in Afghanistan. The big challenges to newborn survival have remained the same: prematurity, infection, breathing difficulties during and after labour. Reducing these has been my priority alongside improving neurodevelopment and nutritional outcomes.