EDD Young Leader 2015, Shakira Choonara, was recently awarded the Woman of the Year in Healthcare Award, South Africa. She recollects her journey and experience here.
As a young individual, I have one aspiration only and that is to bring healthcare to the poorest and most vulnerable, to bridge the inhumane, unjust gap and stark difference between public and private healthcare. Every sphere of our society is divided along lines of class, particularly our social spaces e.g. airplanes or railways, restaurants, shopping and even spaces which are meant to fulfill basic human rights - public healthcare and education versus private facilities/ organisations. A passion and lifelong dream for improving the health system stems from experiences intertwined within a midst of discrimination, stigma, vulnerability and at a very young age witnessing at first hand the dire state of public health services in South Africa (SA).
An early morning rise at 5am, packing a lunchbox as one dreads the long day ahead, followed by trying to find transport to the hospital to then standing in a cold and long queue before the hospital even opens its doors. Nothing is ever clear cut when seeking healthcare at a public facility, processes around payment (user fees) or accessing your file, your set ‘appointment’ with a medical professional or collecting monthly medications change at least bi-monthly adding to further frustrations coupled with bad staffing attitudes. I probably shouldn’t be admitting this, but I would take the patient file home just to avoid the filing line or because if you left your file at the hospital it is highly likely that your file would be misplaced and you would then be subject to the tedious and unbearable process of opening a new file each time. Our health system is not tailored to serve vulnerable populations, staff are not trained to aid those with either visual, hearing or physical impairments, in fact under such circumstances, patients have a double-burden of relying on a family member to navigate access, perhaps miss school to collect medications or require assistance in navigating health facilities and communicating with staff on behalf of the patient. In fact, I even recall preferring to be dehydrated to avoid the unhygienic patient restrooms. Then there’s dealing with the emotions of extreme sadness and concern as you leave a family member behind in a prison ward because of the unavailability of beds in the relevant unit and with linen which smells full of fresh urine. A patient is expected to sleep on that unsterilized bed the night before a huge operation, but what can one do? The answer is nothing, not when you have do not have any choice but to be confined to a public facility due to circumstances. The sense of powerlessness, injustice and lack of accountability has never left me, in fact it shapes every action and why I am committed to never having any patient or their families experience such conditions.
The reality is that there are even worse experiences with disastrous health outcomes, such as the 94+ mental health patients in SA who have been treated like animals and massacred due to poor leadership, inefficiency and no value for patient rights. I began to grapple and understand these challenges while pursuing a career in public health. Commencing a career in health systems took place in parallel to joining the Resilient and Responsive Health Systems project in April 2013. The past four years or so has provided a range of opportunities to learn at first hand the challenges facing the lowest levels of the health system, particularly the district level but also being part of a brilliant multi-country consortia led by remarkable health system gurus of our generation e.g. Lucy Gilson. Through being a part and parcel of the governance arm of the project which adopted an innovative learning approach, I have learnt and interacted with district/ local level staff to collaborate and partner to strengthen the health system. Involvement in the project has undoubtedly set me on the path to combining research with practice and trying multiple mechanisms to engage policy makers.
In a recent interview with Girls Globe, I was asked what emboldens me to use research and push for change in our health system. The answer is certainly linked to capacity building programmes. Participating in the Emerging Voices (EV) for Global Health Programme in 2014 led to being exposed to a network of young leaders who were moulded and propelled to be change-makers. Being recognised as the European Development Days Young Leader for Health in 2015 and having the platform to shape development discussions with high-level panellists such as Dr Margaret Chan from the World Health Organization provided courage to forge ahead, become and activist and participate in networks which demand accountability. Further participation in the Women Deliver youth scholarship programme also ignited an interest in advocacy, activism and changed career goals from research to action.
The most unexpected and life-changing moment was to be nominated alongside leading medical professionals, professors and civil society activists for the Woman of Stature, Woman of the Year in Healthcare Award. The nomination process itself was extremely humbling and I felt truly honoured. The process and build-up to the glamourous event was empowering by itself, including a fabulous dress by SA designer Mariska Phafl. A huge and welcome surprise was to officially be names the Woman of the Year in Healthcare 2017 at the annual awards ceremony held on 11 March. I would describe this not as a personal award but a collective award which would not have been possible without the RESYST consortia, the Ahmed Kathrada Foundation, the Public Health Association of South Africa (Junior and Gauteng Branches) the thousands of friends, mentors, colleagues, the communities I have lived and worked in and the broader public. This is truly our award and a mark in change of times in SA democracy, as both my paternal and maternal grandmothers were illiterate yet today women across racial groups are empowered and considered to be leaders within their respective fields. The greatest power of this award and previous accolades has exposed and taught me many lessons around the importance in reaching patients through engagement with communities, through radio interviews especially community stations and social media.
Moving forward, I am forever shaped by the experiences in the public health system, the continued suffering and struggles, learning from the consortia and I will not rest until health systems truly meet patient needs, thus my journey is far from complete. The greatest lesson I have learnt is the value of nurturing the next generation of activists and change-makers which is and will be critical to transforming our societies and our health systems, and any success I have enjoyed thus far is testament to this. As I continue the journey to achieving better healthcare I hope that you will join me and that together we build a better world and that we leave a legacy of continuous giving to uplift our societies. I live by the motto that true leaders are selfless and ensure that the poorest in society are cared for; as such I will be donating the R5000 of my prize winnings sponsored by Nedbank to;
South African National Council for the Blind
Woman of Stature Five Pillars of Empowerment Youth Programme
Ahmed Kathrada Foundation
Dorah’s Ark Local Orphanage
Princess D Menstrual Cup
As I move towards completion of my doctoral studies, I thank a consortium which has supported my vision and passion for the health system, provided constant opportunities, personal and professional development and learning which has attributed to any and all success. I thank colleagues such as Julie Jemutai who recently sent a heart-warming message, “You are an amazing woman, an inspiration honestly, been following a lot that you are doing and involved in and I am really proud of you”. Finally, I live with the fond words and encouragement of our colleague and upcoming leader in our field who passed on too early. On meeting Jane Macha for the first time at the Consortia’s annual general meeting held in Kilifi last year, she said ‘Shakira, if there is one person I follow on social media, it’s you, your work, your updates, your spirit, I am so inspired by you, keep it up!’ I certainly hope to live up to these expectations and achieve the realisation of health as a human right.
This blog was originally published at: http://resyst.lshtm.ac.uk/news-and-blogs/journey-being-woman-year-2017