Professor Emerita of Pediatrics at the Albert Einstein College of Medicine in Bronx, N.Y. and currently at Montefiore, Dr. Lobach has had a long and fruitful career in which she successfully combined medicine with advocacy. She has worked on several different issues throughout the years, both national and local to New York, including breastfeeding promotion, national health insurance, and promoting healthy early child development and the Nurse-Family Partnership.
Why did you choose the medical profession, and why pediatrics?
Back in the day, in the 1940s, really, when I was in college and before I was in college, I was a good student and I knew that wanted to have a professional life. I was very interested in the sciences, but also in people; between that and being a woman at a time when career options were very few, medicine looked like a good path for me. I went to college as a premed and ended up majoring in philosophy. As far as pediatrics is concerned, in 3rd year of medical school, I was going through the clerkships and specialty rotations and the like. The group in which there was the most humanity and compassion was in pediatrics. The pediatricians were a different breed.
As far as women are concerned, there were slightly more women in pediatrics, but not many anywhere. I went to Columbia at Physicians and Surgeons, and they had a quota of admitting 10 women a year. We had some wonderful faculty women at the time: Virginia Apgar, who was an obstetric anesthesiologist evaluating newborns in the delivery room, Hattie Alexander, who first described Haemophilus Influenzae, and Dorothy Andersen, who first described cystic fibrosis.
In what areas of advocacy are you involved in your life and in your career?
Well you have to understand that we’re not talking about ten years, twenty years – it’s been more like forty or fifty years for me! There have been certain themes that have been consistent throughout that time, and others that came and went – and came back again!
I was very much involved in the 70s in breastfeeding promotion (which was first and only time I testified before a congressional committee, which was chaired by Al Gore actually), and there was uproar about marketing formula in Africa. I was involved in my health center at the time with a big breastfeeding promotion grant (in the Bronx). Hospitals were giving out formula packages on discharge, which doesn’t help with breastfeeding promotion. A few things changed, and then the problem sort of receded out of the national eye and fell down on my list of advocacy projects as well for many years. Then this last month one of the advocacy organizations I’m involved with, Women’s City Club of New York ,decided to work with the Department of Health’s “Latch On NY” program to see how we could help promote breastfeeding. Nowadays, it’s not so much about convincing women that breastfeeding is a good idea – that’s all changed since the 70s! Now, the availability of lactation space after discharge from hospital is a major issue, among others.
One consistent thing throughout my entire life is national health insurance and that there’s universal coverage. FDR actually had wanted health insurance passed when he was trying to pass Social Security – the fight happened in such a way that if it was fought to the end, we would have lost Social Security, and so that got dropped. Truman picked it back up when I was old enough to remember, and I have been interested and involved with that ever since.
In terms of actual time and energy, I have been involved with NYC issues on a smaller scale. I’ve been retired for about 15 years now – so I’ve had a lot more time! I used to direct a community health center in the Bronx, and now I’m on the board of the Bronx Community Health Network, advocating for funding for community health centers. That mostly involved visiting elected officials, writing letters and making phone calls, etc. I’m also quite involved with two children’s advocacy organizations besides the AAP – there’s the Citizen’s Community for Children of New York and the Westchester Children’s Association. With the Westchester Children’s Association for example, we looked at daycare programs and saw that small children in daycare, especially with mental health issues were often kicked out because childcare providers didn’t know how to take care of them. We got enough funding for child mental health consultations at these sites, and a pilot to get training for childcare providers.
The two areas that from the standpoint of big picture needs that I’ve been involved with are promoting healthy early child development and the Nurse-Family Partnership.
What are some challenges you’ve faced while advocating?
In terms of overall challenges, the biggest challenge is in politics. We’ve got our bipartisan system, and often the other party is not interested in the things we’re involved with. As a person you can’t divorce advocacy from political support, although the advocacy organizations must be careful to be non-partisan.
From a more personal standpoint, there are different things – there’s the time involved especially if you’re still working: while working, most of your time goes into advocating issues at centers with which you’re involved. Another personal challenge: some people have the kind of personalities that can get ideas across to big groups and elected officials, while others are equally passionate but less good at getting things across. I don’t want to overstretch the feminist issues here, but I sometimes found that if a man spoke up he got listened to, but women didn’t really get heard. It’s gotten a lot better these days, but it’s not really gone away. In non-medical groups and settings especially, businessmen and politicians don’t respect our voices as much. As a woman trying to advocate, I have had to get past a certain curtain of indifference to be heard.
What wisdom might you share with other child advocates?
Right now, a lot of advocacy work is not with other doctors. One thing I would say is that if you’re going into this, it really helps to attach yourself to a group of individuals who are advocacy leaders. It’s important to learn from people who are doing this and doing it well. It’s important to know what you care about, what turns you on and gets you excited – it’s paramount to do what you care about and want to spend time on.