How I made history as first female gynaecologist, brought ultrasound to Pumwani Hospital

When she came to Kenya to do research on women and HIV/Aids, she found a more dire need, Pumwani Maternity Hospital lacked an ultrasound machine.

Over the years, she has won a string of awards for being a women’s health champion. The East Africa Director, Centre of Excellence in Women and Child Health at Aga Khan University spoke to Lifestyle.

You found a spot in spaces that you shouldn’t have been in; university, gynaecology, politics... how did you do it?

I grew up in a lower middle-class neighbourhood where girls didn’t go to university. That was my first inequity. For my three brothers, there was no discussion, but for me and other girls, we were to be mothers and wives, take care of children, so we didn’t need to go to university. But I really wanted to help people. I thought of being a midwife or a nurse. I finally joined medical school in Belgium. Only five percent of the students in the university were women.

How did you get into gynaecology, a field that was male-dominated then?

One day I knocked on my professor’s door and asked for a residency slot in gynaecology. He said, “No way, who will take care of your family? Gynaecology is a 24/7 job.” At that time, there were no women studying gynaecology at that university. And it was indeed a 24/7 job. He told me, “Choose something else where you can work, say 9am to 5pm.” So the doors were shut and I became a general practitioner.

I liked it but the dream to do gynaecology was still there. It was in the 70s and 80s, so no computers. I started writing letters to university hospitals. I wrote letters for two years.

I finally found a hospital in the Netherlands. One of their two doctors had just passed away. They gave me a chance, and I worked very hard. We were only two doctors covering day and night. But we learned a lot. Two years later, I finished my ob/gyn course. I also did a Master’s degree in public health. I later became an assistant professor. But I kept on searching for opportunities.

You were among the pioneer researchers that came to the University of Nairobi to research HIV and women…

Yes, I worked as a researcher and a lecturer. In 1985, I was contacted by a colleague friend. He told me of an opportunity in Kenya. They wanted someone to join a small group of researchers in medical microbiology to look at sexually transmitted diseases. There was this new virus, HIV. There was very little known about it. Initially, they thought it was a disease only for men. My research project was on whether women can be infected with HIV and its impact on pregnancy.

I spent six years in Pumwani Maternity Hospital, where I did the research. While there, we’d see pregnant women dying of bleeding, and they couldn’t diagnose why it was happening. That was around 1987.

There was no ultrasound in Kenya. I started advocating for funding. We got the first ultrasound machine. We raised more money and got another one and the first incubator. I realised besides HIV, women were facing other problems: female genital mutilation, rape, and infectious diseases. We’d see many pregnant women who’ve undergone the cut. About 30 percent of the women were also HIV positive.

What gave you that push to keep on? Is it something that you saw in your mother or people around you?

Not really. My mom supported me, but you know, we were from a humble family. My mom was a housewife who worked hard. My father was an underwriter, working in Europe post-war. As a teenager, I didn’t take no for an answer. If something looked impossible, I’d think maybe I should try to do the impossible, and I tried.

You later went back to your old university hospital in Belgium, did they have room for women then?

They welcomed me with open arms. Why? They only had male gynaecologists, and women patients were asking for female gynaecologists. Suddenly, the university realised it needed women. I became the only woman in the department. There were nine professors, and I became number 10—the only female professor in the department.

But I kept doing work in Kenya. I created the International Center for Reproductive Health (ICRH) in 1994.

I wanted to continue the collaboration with Kenya, Mozambique, and other countries in women’s health and rights. Then I was asked to run for elections in Belgium. I did and I was elected as a Senator in Belgium. I continued worked for many organisations globally, and in 2015, I came back to Kenya as chair of the gynaecology department at Aga Khan University Hospital.

After hearing about the pains of life; sickness, rape, all day, how do you unwind?

In the old days, I’d go home and tell my husband or my son the terrible stories. But I think that’s not the right way to do it. I wouldn’t advise a young woman to carry work home. Now we have a small community where you can just talk about it. I’m also a people’s person. I love to talk with people. I go to a gender-based violence and recovery center in Mombasa, where we see thousands of people. I also swim every day when I can. I walk a bit, and then I work.

You’re a gynaecologist who went through cancer and IVF [in vitro fertilisation], did that change your perspective of how you treated your patients?

When I was working in Brussels as a young doctor, I’d seen all these women coming in for IVF and I’d ask myself, “do they desperately want a child? Is it really that important? There are other things in life if you can’t get pregnant. You know, accept life as it is.”

Then a few years later, I realised I have endometriosis, and I ended up in my own IVF programme. I became patient. Medically, I was good as a gynaecologist, helping do the egg retrieval and the fertilisation and we had very good success rates. But I had no personal experience. My journey made me understand better what my patients were going through.

I also realised when I got my own cancer diagnosis in 2008 that most of the stuff doctors say when telling a patient you have cancer, they don’t hear much of it.

When my results came and I was told it was cancer, the doctor was talking to me, but I didn’t hear a word. Then I realised that as a doctor, consider that most of what you’re saying at that time, is not even captured because the patient is already in grief.

You are in your 70s now, what makes you continue working instead of retiring?

I’m not really a person that can rest for the whole day. It’s not in my character. But what makes me keep going is really that women’s health needs are still huge.

What makes you proud of being a woman now?

We’ve progressed in some aspects, including women’s health...In 1985, there were few female students at the university, but now the numbers are really tremendous. Young women are everywhere. They’re very well educated; they raise their voices.

In many areas of the world, 70 to 80 percent of residents in gynaecology are women. Men are also good gynaecologists, but it’s easier for a woman to understand menstrual pain or labour. My PhD class [students that she supervises] has women too. I’m so proud of them.

People ask if there has been progress; why keep fighting for women? Is there still a need to have an International Women’s Day?

Yes, we have human rights; women are humans. So why should we then have special women’s rights and children’s rights? Because the rights of women and children are still more violated than the rights of men, with what we see now in the international context. We see maternal mortality in the US going up. We really have to continue the fight. It’s not only a fight for women. In the old days when I was teaching, I’d ask in class who was a feminist. Initially it was a good word, but it has now been considered by many as a negative connotation. I had to explain that feminism is about fighting for the same rights for men and women, for girls and boys.

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