These days, besides teaching at the University of Washington's Maternal and Child Health Leadership Training Program and the Extended MPH Degree Program, and seeing babies in the High Risk Infant Follow-up Clinic at the Center for Human Development and Disability (CHDD), Marcia Williams is working in Tanzania, her first foray into global public health. She is part of a team gathered together by the Seattle Biomedical Research Institute, a nonprofit health research organization located in Seattle, Washington, to develop a program to prevent malaria in pregnant women. Marcia's role is to ensure that the drugs given to pregnant women to prevent malaria do not contribute to any adverse outcomes in their babies. She is presently working with a Tanzanian psychologist to adapt a developmental assessment tool currently used in the United States to Tanzanian culture.
The scope of Marcia's work encompasses research and data analysis as an epidemiologist, as well as hands-on clinical work with babies as a pediatric physical therapist (PT). Marcia began her professional career in the 1970s as a PT and worked with infants and children born with conditions that cause physical disabilities, such as cerebral palsy, muscular dystrophy, and some birth defects. She typically provided individual treatment to children after their conditions had been diagnosed. But she became curious—what was causing these conditions in the first place? And in the 1980s, when she was seeing babies who had been exposed to cocaine and other substances in utero, and babies living within complex social situations (eg, more single-parent homes, adoptive parents, kids being raised by grandparents), she realized that the problems she was encountering were broader than what she could address as a physical therapist. As she says, "Children are the vulnerable population who suffer the consequences of what adults do." Her motivation to pursue epidemiology in maternal and child health came from her desire to improve the health and development of children. Marcia earned her MPH degree in 1992 and her doctorate eight years later.
Marcia's combined skills as a PT and an epidemiologist enable her to not only help infants and children once they have developmental problems, but also to help prevent these problems from occurring in the first place. And, as she points out, because children can't protect themselves and are dependent on their adult caregivers to do so, her work also involves working with adults. Marcia's doctoral research in epidemiology examined the hypothesis that intrauterine infections in pregnant women could lead to cerebral palsy in their preterm infants. Her results showed that there was an association between evidence of infection in mothers and a higher risk of cerebral palsy in their babies. If that infection could be avoided in the mother, so might cerebral palsy in the infant.
One constant in Marcia's dynamic career is her physical therapy work with high-risk infants every Wednesday at the CHDD. She thinks of this clinic as a microcosm of the real world, since it is there where she sees the personal manifestations of the problems we hear about, such as very premature births, childhood obesity, and inadequate infant vaccinations. She doesn't know what work projects are next, and she never could have predicted where her career has taken her so far, but she knows that working in public health means she will respond to whatever needs arise in the population she serves, and she will greet the challenge with the same enthusiasm she has for every child she meets. She continues to view each child as an individual—with a unique personality, family situation, and set of skills—and her eyes light up when she talks about them and their victories.