#SpeakerSpotlight: Joia Mukherjee
Across health journals, proposals and medical reports, I’ve found a common narrative; that of the clear parallels drawn between the key actors in health delivery. Policymakers play the deciders, global health programmes the facilitators, and governments, the financers. But to me this is to look at the problem after it has happened, to consider the solution before you target the starting point. Today’s UGHE Speaker Spotlight looks at education as one of the world’s greatest tools in challenging global health delivery norms, and the next generation as the catalysts to carry this forward. If education is the academic starting point, inequities in its access or delivery will perpetuate the imbalance you find in health leadership and in female health itself.
To understand why and where these inequities exist, I spoke to Partners in Health’s Chief Medical Officer, Joia Mukherjee, who unpacked her personal investment in education as professor at both UGHE and Harvard University. ‘My role is to train the next generation so that over time there will be more and more local infrastructure and capacity and systems to deliver ongoing and durable healthcare.’ she explains, adding that the unless this training is applicable to care for the most vulnerable, the curriculum is incomplete.
Joia’s Oxford University textbook, An Introduction to Global Health Delivery, serves as a mouthpiece to her mission; challenging definitions on health delivery with a strong equity focus. ‘We want to tackle the entire burden of disease, not just the low hanging fruit, not just what is easy. Secondly, we want an equity focus, which means getting to the last 10% of the global population- that has to be the focus of our work.’ She explained the final motive for her textbook was convey the simple, yet often overlooked message; that health is a basic human right and that to achieve blanket global coverage is to involve everyone - governments, policymakers, civil society and the next generation of health care leaders.
A focus on social medicine and the social determinants of health is critical. ‘Context is everything.’ says Joia. ‘There are still places in the world where the girls are not finishing high school, so how can we expect to have leadership from women if they can’t get the education they have a right to.’ You can look upon the current status of leadership as a distinct failure of certain systems to prioritize female development and opportunities. In the US and Europe, 50% of medical schools are women and yet the highest levels, the professorships and chairmanships, are almost exclusively men. A direct reaction to this, it was no coincidence that 70% of UGHE’s inaugural MBBS (Bachelor of Medicine, Bachelor of Surgery) cohort this year were women, representative of its commitment to addressing gaps in inclusive health leadership at the academic starting-point.
Diminished economic and educational opportunities for women and girls are the two biggest inhibitors to health access. It is education, after all, that gives young women the right to self-empowerment. Joia explains; ‘We know that lack of education results in higher teen pregnancy rates, and teen pregnancy results in higher rates of maternal mortality’, in the same contextual way that in some places breast cancer patients are refusing mastectomies because of what their husbands will think. Ensuring health education is channeled through and tailored to the most vulnerable pockets of society, in refugee camps for example, is crucial in allowing women the simple human right; choices about their bodies and informed decision-making for themselves. Universal health access, after all, should be universal.
Education doesn’t need to be constrained to the four walls of a classroom. It exists too within powerful female role models whose role it is to shake the system and challenge ideologies of what a woman can and cannot do. Joia’s advise to the next generation? ‘Never lose sight of the people you are trying to serve. When you think of what a feminist view of the world is, it is about a kind of sisterhood and collaboration; as women leaders we should not be emulating the hierarchical structures created by the patriarchy but look to each other instead’. Health, after all, is not a data set or series of reports. A progressive, feminist approach will instead address its social determinants, and a collaborative framework will give a voice to the most affected. ‘If we want equity, we need to have a representative leadership’ says Joia, ‘This year’s UGHE Women Leaders in Global Health Conference really broadens the thinking behind who gets a say, who creates the policy, which in turn has a ripple effect on the rest of the structure.'