In the developing countries we are facing a massive surgical disease burden – and women are affected severely. From ever increasing trauma to obstetrics and gynecological issues and female cancers like breast cancer. Access to safe and timely surgery are imperative to keep women healthy and productive – as mothers, as breadwinners, as employees, as entrepreneurs. More and more families in South Africa depend on mothers and sisters to keep going – not just financially but also to act as moral back bone. Surgical disease, if treated promptly, does not have to be devastating. It is imperative that we return our women, and men, as quickly as possible to their roles as proactive citizens.
What are some of the challenges facing women working in surgery, and how is your organization working to address these?
I have been incredibly lucky to work in an institution where we have come incredibly far in empowering female surgeons – especially over the last 10 years. We have gone from a male dominant department to one where we have a 50/50 gender split in registrars and where we have seen female consultants slowly but surely rise through the ranks. Our head of department had never signed a maternity leave form in his long career until 5 years ago – he has subsequently signed 8!
There are however still pervasive perceptions among our medical students that surgery is a job for a man and that men are generally better suited for a career in general surgery. What is concerning is that even female registrars indicated in a recent survey that they feel men to be better suited for a career in surgery. This mainly stems from the fact that many of the men are still married to home makers while the women in the department are either single or trying to balance family and career.
We are seeing a slow but definitive generational shift though – more of the male registrars are interested in their quality of life and being more involved as fathers – several have been granted a few days of paternity leave. The possibility of job sharing has been discussed several times but we are yet to reach an agreement on this matter. We have come a long way – but much still needs to be done to make surgery a person friendly (not only women friendly!) career choice. We cannot continue on a trajectory where we call ourselves healers but are ourselves burned out, unhealthy and self-destructive to keep up the facade of the the “god-surgeon”.
The experience among many of my colleagues in training has not been so fortunate. We started PAWAS to address these concerns and to provide a supportive network for women looking to engage in surgery and provide a forum that addresses these concerns. Through our network we are able to address issues unique to being a female professional and the day to day challenges of being a woman in surgery. Role modelling is important and through our mentorship programs we hope to increase engagement and enrolment of women in surgical specialities.
What are some of the challenges facing women trying to access safe surgery?
Paternalistic and traditional family structures where decisions regarding a woman’s health is still left to the men in the family – this issue is far from solved.
Resource retrains – from lack of transport to lack of health care services in our rural areas poses a massive problem and leads to fatal delays in diagnosis and treatment.
In rural areas we are also still trying to overcome a lack of trust in western medicine – many will still seek out traditional healers and only present to health care facilities when terminal.
How can female doctors and patients work together to ensure access to safe and essential health care services including surgery and anaesthesia?
I think bringing a more feminine and empathetic face to surgery has done wonders for gaining female patient’s trust. Education and role modelling are key elements of the process. Many female surgeons are truly practicing in a socially conscious manner and has started non-profits or other organizations to address problems in the system. From nursing education to raising funds for timely cancer surgeries – we have great examples of female surgeons walking the extra mile to address the challenges faced by our public health care sector.
At PAWAS we aim to use our network to amplify these efforts and these resources and to share ideas and strategies that work for our continent and could hopefully be applied to different regions.
How have women’s roles in medicine changed over the years?
From the nurse in the back ground to the team leader, decision maker, policy driver and teacher! Women’s roles are continuing to evolve.
This year’s theme for IWD is ‘pledge for parity,’ what does this mean for professional women in African healthcare?
To be the best you can be, with all the passion you can muster. Not as a man or a women but as a person, a global citizen. To embrace the masculine and feminine qualities in each of us – because logic and drive and resilience and empathy and intuition – all of it – are needed to be an excellent surgeon.