Fearless PhD graduate strives to improve rural women’s health

By Clement Woo

Walking for days along Nepal’s steep mountainous paths, with no access to electricity, phone or internet, might seem like an unconventional way to conduct research. But for Cathy Ellis, who convocates this month as one of SFU’s oldest doctoral graduates this year, it was an essential part of her fieldwork.

A registered midwife, trained nurse and senior instructor in UBC’s midwifery program, Ellis has spent her career working with, advocating for, and supporting women’s reproductive health. She has taught and worked with midwives around the world, including in Mexico, Uganda, Bangladesh, South Sudan and Nepal.

“I have no doubt that she is personally responsible for saving many women’s and children’s lives as a result of her dedication to women’s health,” says her supervisor, professor John O’Neil.

Ellis enrolled in the PhD program in the Faculty of Health Sciences in 2012, working with her senior supervisor professor Craig Janes, along with O’Neil, professor Nicole Berry and emeritus professor Kitty Corbett. She was eager to supplement her considerable practical skills with the theoretical and research tools she needed for evaluating midwifery programs and improving global maternal health care policies.

Her research focused on the factors affecting pregnant women and midwifery services in Nepal. For her thesis, she conducted fieldwork in Nepal’s remote Solukhumbu area (also known as Solu). Traveling on foot to remote villages with a local nurse translator (who brought her five-month-old baby and a babysitter with her), a cook and a porter, Ellis often camped outside people’s homes. For her fieldwork, she interviewed mothers, female community-health volunteers and maternity care workers. She also conducted surveys with nurses and auxiliary midwives.

“I had a great translator, which helped with my research success,” says Ellis. “My translator, Bimala Rai, had recently given birth, so she could talk to the women about my research and was trusted by local women and families.”

Witnessing stories of both vulnerability and strength served as inspiration for her work. She recalls one case of a woman carried by stretcher on steep mountainous terrain for three-and-a-half days before reaching a hospital to receive medical care for bleeding in late pregnancy.

Ellis discovered that geographical distance, cost and a fear of certain medical interventions were barriers for many rural women in accessing health care. Many families living in the isolated Solu area routinely experience poverty and food insecurity. There is a shortage of skilled human resources and a lack of adequate infrastructure, supplies and medications.

Some women still prefer home births and rely on the local shaman’s rituals to help them prepare.

“With the shift from home delivery to facility-based birth, it is important to integrate the old and new by integrating a choice of attendant, and birthing positions, for mothers, and allowing shamans to work with skilled birth attendants when the women ask,” Ellis says. “This can help decrease some of the barriers to access.”

Fearless and compassionate, Ellis is dedicated to improving the lives of others. Over the years of working in Nepal, she strived to develop the midwifery profession and expand regulated midwifery services. Because there were no licensed midwives during her time there, her work focused on developing and improving maternity services in rural areas.

In 2015, she experienced an earthquake while teaching in a hospital with a group of midwifery students. While her students evacuated the country, she stayed and joined local health professionals and members of the Midwifery Society of Nepal to provide aid, including basic food supplies and health services, in several of the earthquake-affected areas.

Despite completing her thesis, Ellis is continuing her work in Nepal. She will return with students in the spring to work in remote areas that now have a new midwifery program. She hopes to serve as inspiration for students and other working professionals.

“I hope more midwives, nurses and doctors pursue further education and expand their knowledge,” she says. “They can help make a difference in the lives of disadvantaged families.”