Editor's Note: In 2014 Capital City led a global grant providing almost $800,000 in medical equipment and supplies to support maternal and child health for five barely equipped clinics in sparsely populated rural Mongolia.
Julie Dockrill, recipient of Rotary’s People of Action: Champions of Health, led a team of midwives in training health care professionals as part of a comprehensive well-being program that’s saving mothers and babies
by Ryan Hyland

When Julie Dockrill was approached by the Rotary Club of Waimate, New Zealand, to train medical workers in Mongolia in safer childbirth practices, she wasn’t sure how much of a difference she could make — despite her 20 years of experience as a midwife and childbirth educator.

At the time, Dockrill wasn’t very familiar with Rotary’s work, nor was she aware of the high infant mortality rate in Mongolia, an Asian country located between Russia and China. But she agreed to participate if it meant saving the life of even one child.
Julie Dockrill, a member of the Rotary Club of Timaru, New Zealand, was a recipient of Rotary's 2021 People of Action: Champions of Health, for improving maternal and child health practices in Mongolia.
Eight years later, the project’s success has exceeded her expectations. Dockrill, now a member of the Rotary Club of Timaru, says she never imagined that the work she began in 2013 would lead to the adoption of a nationwide health care framework that has contributed to the steady drop in Mongolia’s maternal and infant mortality rates.

The project, facilitated by Waimate club member Gary Dennison, was originally conceived as an initiative to supply clean water to a remote area in Mongolia. Plans shifted when a community assessment determined that the terrain meant a water well wasn’t feasible.
Dennison explored alternatives. He learned through Rotary connections in Mongolia that maternal and child health services and updated and safer childbirth practices were needed. So his club and the Rotary Club of Ulaanbaatar, Mongolia, devised a new plan: a four-phase project in which a vocational training team would offer childbirth education to health care workers.

Dockrill, who came recommended through a colleague, was tasked with leading a five-person team of midwives from Australia, Mongolia, and New Zealand, and developing training materials for more than 100 university students and midwives, nurses, and other health care professionals in Mongolia.

The maternal and infant mortality rates in Mongolia were falling, but mothers and infants were still dying at alarming rates. In 2011, the government made a commitment to reduce the infant mortality rate to 15 out of every 1,000 live births, which would be a drastic reduction from its 2009 rate of nearly 27 deaths per 1,000 live births. Comparatively, the infant mortality rate in New Zealand that same year was just five deaths per 1,000 live births.

Causes of death frequently involved asphyxia, respiratory distress, and congenital defects, but Dockrill says the problem really came from poor prenatal care.
“Before the childbirth education course was embedded, there were only standard visits to hospitals and clinics for pregnant women,” Dockrill says. “The care was just focused on the physical well-being of the mother. The information mothers were given was very basic.”
Dockrill focused on topics that weren’t being discussed with expectant mothers, such as smoking, domestic violence, nutrition, exercise, breastfeeding, and contraception — all important to keeping mothers healthy. And when mothers are healthy, their children are more likely to be healthy. According to Dockrill, the health and survival of a mother directly affects the likelihood that her child will live to age two.

It’s overwhelming to know that you may have played a small part in saving the lives of hundreds of mothers and babies.
Julie Dockrill Member of the Rotary Club of Timaru, New Zealand

So Dockrill and her team were hoping to help health professionals take “a holistic approach — not just a physical approach” and see people come forward earlier with health problems. She adds, “If one child or mother was saved by what we shared, I considered that a success.”

Participants, who arrived with notepads and pens expecting a standard lecture course, received copies of Dockrill’s training manual translated into Mongolian and took part in interactive activities with plastic baby dolls and proper anatomical models.

One exercise, in which Dockrill discussed a technique that slows the labor process, drew lots of questions. The translator explained that general practice in Mongolia calls for labor to be as quick as possible — which can mean dangerous methods of hastening the baby’s arrival. “Explaining that it’s fine if the mother takes a rest, and that patience in childbirth is OK and healthy, that was new,” Dockrill says. Students were open to new ideas and enthusiastic, she says. “We had an incredible experience. We had fun, we laughed, we bonded.”
The course culminated in an evaluation of participants’ knowledge and a ceremony awarding them certificates endorsed by the local ministry of health. “This was an empowering moment for many of the participants,” Dockrill says.

Inspired by the project’s impact and the breadth of Rotary’s work in maternal and child health, Dockrill joined her local Rotary club shortly after returning home.