By JILL MALCOLM
Dr Mary Birdsall, tall and slim with a toss of thick black hair and wearing clean theatre garments, emerges from the direction of the operating theatre a little later than she planned.
"Sorry I'm late," he says. "I've had appointments back to back. The first patient wasn't on time and from then on things kept crashing into each other."
The delay has given me time to absorb the nuances of the plush clinic at the private Ascot Integrated Hospital in Remuera where Birdsall is part of the medical team of Fertility Associates. The carpeted floor, domed ceiling, buttery walls hung with huge abstract oils and the leather couches make for a hushed and inviting environment. It's the sort of place that instills confidence in clinical competency, but a certain amount of anxiety about the cost.
Birdsall orders flat whites from the cafe next door and leads the way to her office, which is comfortable and orderly.
She has the air of someone who could be a lot of fun, but today any banter is brief. I sense the concentration behind her smile the minute we focus on the subject of Cordbank. After all, it's her baby. And, of all the babies she has helped to deliver, this, in some ways, is the biggest.
Her brainchild, New Zealand's Cordbank, is the first dedicated collection and storage facility in Australasia for stem cells from the umbilical cords of newborn babies.
"Cord blood holds millions of stem cells," she explains, "which ordinary blood does not. These are the building blocks for our entire blood and immune system and they only exist in bone marrow and the blood of the umbilical cord at birth.
"The reason for storing them is that cord-blood stem cells provide the child, and then the adult, with their own backup immune and blood system. At present this can be used, without any fear of rejection, to fight about 50 serious diseases if they occur later in life.
"For instance, if a child develops leukaemia the stem cells would be able to be used instead of a bone marrow transplant. A bone marrow transplant, even if a compatible match is found, is invasive, painful and dangerous, but feeding stored stem cells back into the blood is a simple procedure with no dangers."
Birdsall's voice is softly pitched but, as she winds into the subject which has been consuming so much of her time, it develops a measured intensity.
"The future of stem cells could be enormous. There's a huge amount of research going on worldwide. In the not-too-distant future, stem cells could be turned into brain cells, heart cells or liver cells. If someone develops some disease, such as Parkinson's or Alzheimer's, and they have stored stem cells which express their own DNA, they might be turned into replacement tissues.
"I really wish there had been the facility for this when my own children were born."
Birdsall lives close to the hospital with her GP husband, Dr Rob Wallace and their children, 10-year-old Georgina and 7-year-old Harry.
She was always deeply interested in sciences, and in 1987 graduated from Auckland Medical School with an MBChB. Next she took a six-year post-graduate course in Obstetrics and Gynaecology (FRANZCOG) and, when she graduated, started delivering babies. "I loved that role. It appealed to my strong maternal instinct."
In 1993, Birdsall received a three-year Nuffield Scholarship from Oxford University, where she became fascinated by in vitro fertilisation (IVF). At the end of three years she had completed her Master's degree on aspects of human reproduction, and back in New Zealand her work is now more about making babies than delivering them.
The Cordbank venture came about as a result of the growing number of her patients asking her if such a facility existed here.
"They'd heard of the advantages. Cord blood banking has been around in places like America, Canada, the UK, Japan and Hong Kong for almost a decade. More than 1500 cord blood transplants have already been performed for a range of illnesses."
The process of stem cell collection and storage is simple. Parents wanting to store their baby's cord blood call the Cordbank, which sends them detailed information.
If they decide to proceed, parents are sent a collection kit in a container about the size of a pizza delivery box. They take this to the birth. Cordbank sends a trainer to whoever is going to deliver the baby and shows them how to collect the cord blood. When the baby is born the cord is clamped and cut in the normal way and the blood taken from it by syringe. It's painless and no danger to mother or child. The blood has 32 hours to reach the bank for processing so that almost anyone in New Zealand, the Pacific Islands and Australia has access.
When the blood arrives at the bank in Parnell, it is processed and frozen in long-term liquid nitrogen.
There are the ethics, of course. How can parents guarantee their babies' blood won't be used for other purposes - for reproduction say, or cloning?
Birdsall: "It really isn't much of an ethical issue but I'm glad you asked. Cordbank has been established to process and store umbilical cord stem cells, nothing else. I'll clarify some things for you.
"There are stem cells from embryos called embryonic stem cells. There is a great deal of controversy around those because to get them you have to kill the embryo. But stem cells from cord blood are just thrown out at the moment.
By setting up Cordbank we are giving parents the option of storing them for their children instead. Even the Catholic Church has come out in favour. And there is no way you could clone or reproduce from cord stem cells.
"Also, the law in New Zealand is very clear. The only person who can use these cells is the person from whom they were taken: and the blood can only be released to you or your child for a purpose approved by your doctor. In future it may be that first-degree relatives could use it, but at the moment the Minister of Health would have to be approached for an exemption for that.
"Detractors - and there are a few - ask why would you want to store these cells when the chances of using them are very small. I tell them that the chance of your house burning down is very small too, but most people take out insurance for that. The potential use for stem cells is going to be far greater than it is now, and storing them might mean the difference between the life and death of your baby in the future.
"So far stem cells have been stored for 15 years and they are in perfect condition at that point. So it can be presumed at this stage that longer-term storage, say over 60 years, is going be the same."
Mary Birdsall is not coy about the cost to patients for the service. It costs $1650 for the collection, processing and first year's storage, and then $150 a year after that. There is no cost for release.
"I'd really love to see it free and available to everyone. I mean if the government came to the party some day and it became as commonplace as immunisation is, that would be fabulous. At the moment not all parents are going to be able to afford it."
She looks wistful. "I'm sorry about that, but we've tried to price it so it's available to as many people as possible. The costs here are the lowest in the world. In the States, for instance, the collection fee is around US$3000."
The cost of setting up Cordbank has been hundreds of thousands of dollars. As well as equipment imported from the US, establishing a training scheme and hiring specialist haematology technologists, there has been a rigorous and costly auditing and licensing process to ensure integrity and safety. This ongoing process is carried out by a division of the Health Department called Medsafe.
The set-up has been financed by a handful of sponsors who strongly believe in the lifesaving potential of Cordbank, but don't want to be named. Birdsall admits to using a sizeable chunk of her own capital because that's how important she thinks it is. And all the work she does for the bank is unpaid.
And will the Cordbank make a profit?
Birdsall laughs: "It would be great if we did, but that day is a long, long way off."
She says the early response is encouraging - "from parents, doctors and midwives, extended families."
"A small part of me feels a bit nervous, but I believe in it so much that I am confident that other people are going to feel the same.
"Certainly most of my medical colleagues have thoroughly endorsed the idea. So now, I have to wait and see how many New Zealand parents are interested in taking out what is effectively their child's first insurance policy."
By JILL MALCOLM