Visibility matters: She Cuts the Path

What do ‘I look Like, The Changing Tides, The all-male Panel, RCSI Women on the Wall and Greys Anatomy’ have in common…

A blog post by Dr. Fridah Bosire

August 2019, Tenwek Hospital Kenya. Dr. Fridah Bosire with her Attendings- Dr. Andrea parker and Dr. Angela Martin, performing a complex Trans-peritoneal repair of a ruptured infra-renal Mycotic Tubercular Aneurysm.

In August of 2015, thousands of female surgeons took over social media platforms with the catchphrase ‘#ILookLikeASurgeon’ to challenge gender stereotypes across a largely male dominated workforce. This was in response to the example set by Isis Anchalee, a female software engineer from San Francisco who created #ILookLikeAnEngineer. This trend gained global recognition, fueled by the fact that women are still under-represented in some professions worldwide.

Traditionally, the journeys of women towards leadership positions across various fields of work were stifled by systemic biases, created by institutional, societal, and cultural barriers. Leadership was generally perceived as a male perquisite, and women who dared to venture into leadership positions faced significant societal backlash, often labelled as neglectful of their ‘traditional roles’ and ‘overambitious’. Early women leaders had little to no support networks and role models, further making their leadership journeys immensely difficult. Women could barely access the fundamental prerequisites for decision making, such as voting rights, property rights, and access to education et cetera.  Furthermore, navigating societal expectations and traditional roles that de-prioritized career ambitions provided a challenge of balancing professional aspirations with personal responsibilities such as motherhood.

It is no doubt that women leaders are pivotal in driving social change through their unique strengths, values, perspectives and leadership styles that embody empathy and resilience. Despite significant progress in women's leadership, numerous challenges persist, one of which is visibility and representation. There is an obvious visibility gap for women in leadership positions. The impact of patriarchal socialization on how women show up in careers as well as leadership is quite present. Women have been known to sideline themselves in leadership roles, and hesitate to take up leadership positions, an effect of the deep moral injury caused by social conditioning. Internal barriers faced such as impostor syndrome, self-doubt, indecision, lack of confidence, second guessing et cetera dampen enhancing of female accomplishments, authority, and discourages autonomy in decision making.

Changing Tides…

With the changing times, there is an undeniable trend of emerging women powerhouses ascending into leadership echelons, women who are constantly breaking barriers and reshaping the future. I have had the immense privilege of sharing platforms with a few, and their inspiration has been more than profound.

With Professor Laura Viani, RCSI: Irelands first female Consultant Otolaryngologist and Neuro-Otologist, RCSI president 2022-2024.

Dr. Agneta Odera, Paediatric General and Cardio-Thoraxic surgeon at Tenwek Hospital, Bomet Kenya, and past President WiSA-COSECSA.. A Personal mentor, Academic giant, and

stellar surgeon.

Her academic accolades include: FCS General Surgery, FCS Paediatric surgery subspecialty, FCS Cardiothoraxic surgery and currently pursuing FCS Paediatric Cardiothoraxic Surgery.

Dr Miriam Mutebi, Consultant Breast Surgical Oncologist, Assistant Professor Department of Surgery AKUH. President AORTIC. First African oncologist to sit on Board of Director of the Union for International Cancer Control (UICC). Co-Founder Pan African Women’s association of surgeons (PAWAS).

Professor Julie Gralow at a C/CAN (City Cancer Challenge/ASCO collaboration event in Nairobi. Prof. Julie serves as the Chief Medical Officer and Executive Vice President of the American Society of Clinical Oncology. She is a Professor of Breast Medical Oncology and Global Health.

Dr Mumba Chalwe is a Consultant Urological-Surgeon with a clinical practice that spans over the last 15 years.

She is currently The Chairperson for the Women in Surgery Africa (WiSA) board under The College of Surgeons of East, Central and Southern Africa. Dr Chalwe is also a member of the Editorial board for The Annals of African Surgery as an Associate Editor and has a keen interest in clinical and translational research.

Dr Chalwe boasts of several awards and recognition from various organizations worldwide. In 2018 she was awarded the PUSH women's award in recognition of her status as Zambia's first Female Urologist. She is a fellow of the College of Surgeons of Eastern, Central and Southern Africa, and was awarded the Gold medalist status by the same college for academic excellence in 2018. Additionally, she is an Associate Fellow of the American College of Surgeons and was the inaugural William Crain Global Surgical Fellow at Stanford University in the Stanford Urology Department for 2019.

Dr. Jane Fualal Odubu is a Senior Consultant Surgeon and Head of the Breast and Endocrine Unit at Mulago National Referral Hospital, Uganda, with 26 years of experience and over 20,000 surgeries. She is the first female president-elect of COSECSA, a distinguished member of the Foundation Fellowship, and Patron of Women in Surgery Africa (WiSA), where she champions gender equity in surgical training.Dr. Fualal has made significant contributions to health policy, academic discourse, and surgical education, including serving as an examiner for COSECSA, WACS, and CMSA. She has held leadership roles such as COSECSA Treasurer ,Vice President and most recently President , playing a key part in strategic planning and regional collaborations. Recognized with numerous awards, including Uganda’s Independence Medal, she remains dedicated to expanding COSECSA’s influence, strengthening its financial stability, and mentoring the next generation of surgeons.

The all-Male panel (‘Manel’) in Decision making Summits.

In 2023, Global chief executive officer of Amref Health Africa, Dr Githinji Gitahi, was applauded for abruptly walking out of the World Health Assembly stage due to absence of women representatives in the panel, where member states had gathered to discuss on Climate resilience, a topic that disproportionately harms women. He went on to advocate for women-led and women-responsive policies (https://mg.co.za/world/2024-05-31-i-walked-out-of-the-world-health-assembly-due-to-womens-absence-and-would-do-it-again/).

The all-male panel fails to platform women in pivotal decision making. In extreme situations, we have seen events with a ‘Manel’ discussing topics on issues directly and exclusively affecting females. The question to ask however, is that, is there a role that women play to perpetuate this lack of visibility, vis a vis, is society structured with deep rooted biases that prevent visibility by minimizing female accomplishments? The biases do exist. It is important to note here that according to the WHO, while women make up 70% of the global health workforce, they hold only 25% of senior jobs. In LMICs, that average falls to 5%. As Dr. Githinji Gitahi points out accurately, ‘panels seem to be curated to give a voice to the most senior person, and many of these are still male, which makes for all male panels. Getting a non-director female, who is just as informed, will bring insight from a woman’s lived experience’.

When you read Megan Dalla Caminas Amazon bestseller book ‘Women Rising: The Forces that hold us back, The tools to help us rise’, she introduces a fresh and interesting concept by stating that maybe we have been asking the wrong question. ‘It is not just about how workplaces change for women, it is about how women become so empowered , clear, and connected that workplaces have no choice but to rise to the new consciousness we create’.

Women on the Wall, Royal College of Surgeons Ireland (RCSI)

In January of 2023, I had the privilege of being hosted by the RCSI College, in Dublin Ireland.  The head porter Mr Frank Donegan led me on an informative tour around the historic building at St Stephens Green. Not only did I get to see the RCSI Heritage collections of the founding fathers of surgery like William Dease and Abraham Colles, but I also had the immense pleasure of viewing the iconic Women on the Wall portraits. We ventured into this 19th century boardroom located at the first floor of RCSI original building. In 1885, a meeting took place at this same room, where under the second supplemental charter, it was agreed to open the medical school to women.

These portraits recognized the pioneering achievements of eight extraordinary women and enhanced their visibility as historic female leaders who forged careers in health care at a time when women were supposed to stay at home. Among a lot of things, I picked out a lot of interesting facts about these women. One common factor was that their histories were a tapestry woven with stories of resilience, perseverance, and academic achievements. For example, aside from being a health care worker, Dr. Mary Josephine Hanna (1859-1936) refused to pay taxes which applied to unmarried women but not unmarried men. Most of the women on the wall enjoyed and carried accolades for their distinguished academic performances.

Think ‘Greys Anatomy’ on Female empowerment and The Impact of improving visibility

Oh, the iconic female surgeons of Greys anatomy!

Any time I envision the enactment of powerful female surgeons and gender representation in surgery, I think of the women in the hit TV show Greys anatomy, a personal favorite.  I think of Dr. Miranda Bailey, Dr. Callie Torres, Dr. Christina Yang, Dr. Meredith Grey and all the iconic female characters who were represented as formidable, knowledgeable, excellent and accomplished go getters. Well, however fictional as it is, the producer Shonda Rhimes definitely did an amazing job at gender inclusion and empowerment, amplifying their accomplishments, accolades, research, and compelling the women of the show to be highly competitive and excellent in a male dominated workforce.  The female gender is given a bit more representation in Greys anatomy. The show, however hilarious, is quite inspiring.

In conclusion, we need to create spaces for women to thrive, elevate their voices, uplift them to be formidable leaders capable of equitable decision making, and promote accomplished women to visible leadership positions.

Books to read: Megan Dalla Caminas ‘Women Rising: The Forces That Hold Us Back. The Tools to Help Us Rise.