Episode Transcript

Lama Alsafi (00:00): Hello, and welcome to 15 minutes to change the world. We're in 15 minutes or less, you can learn a bit more about the world and how you can help change it.

Lama Alsafi (00:40): My name is Lama Alsafi and I'm the host of this podcast. This month, we'll be bringing you four special episodes to celebrate international women's day. As part of our March for women podcast series throughout the month of March, we'll be talking to four incredible women working in different sectors and with different areas of expertise to learn more about women's leadership here in Canada and around the world. As always you'll hear about how you can get involved by learning, from advocating for, and supporting women to lead today. We're talking about how women are leading in healthcare, the complexities of the global health system in a post COVID 19 world and health equity. Our guest today is Dr. Sameera Hussain. The newly appointed adjunct professor at the university of Ottawa's School of Epidemiology and Public Health. Welcome Dr. Hussain. We're so happy to have you on the podcast. Thanks so much for taking the time to speak with us today.

Dr. Sameera Hussain (01:33): Thank you for having me.

Lama Alsafi (01:36): Thank you. Dr. Hussain, I wonder please, if you can tell us a bit about your background and the work you're currently doing.

Dr. Sameera Hussain (01:42): So my specialization is in public health, focused in global health policy and how that plays out in health systems across the world. It's anchored in health policy and systems research, which is an area I've worked in in numerous countries. I've done ground level work in Afghanistan in Kabul province. I've done work with marginalized communities in the Southern areas of the Philippines and Indigenous groups in Bangladesh, as well as working in multi-country collaboration, with other Asian and South American countries where we collaborate on community understandings of health and the barriers to good health and wellbeing for marginalized communities specifically, but also the dominant groups in those countries. I've done work funded by UNICEF and the Rockefeller Foundation, and what I'm really proud to say is that some of my work has also contributed to the development of the sustainable development goals, which I think many of your listeners will be familiar with. So I'm an adjunct professor, as you said. My passion is bringing the evidence that I worked on building from my research work and bringing that to the policy table. And that's part of the work I'm doing right now and doing some COVID response with the Government of Canada and it's an honor and a privilege to be doing that kind of work, bringing evidence to the table for policy consideration.

Lama Alsafi (03:22): Dr. Hussain, I understand your work is rooted in the principles of health equity. Can you please explain what health equity means to our audience and why it's such an important part of the healthcare conversation?

Dr. Sameera Hussain (03:33): Yes. Health equity is simply put, it's making sure everyone everywhere has a fair opportunity to reach their fullest potential for physical and mental health, regardless of where they live. Many causes of health inequities relate to social issues. There are differences in health that are unnecessary and unavoidable and more importantly, unfair and unjust. They relate to social and environmental factors such as income and social status, race, gender someone's occupation. And it's important for two reasons because the research says we need to solve the problem of inequity in society in order for people to enjoy the highest attainable standard of health in their communities. And secondly, because it's very important in terms of the connectedness we have as human beings with each other, whether we're at local level or a global level, as we're seeing playing out in the pandemic at the moment. We're all tied to each other and the worst health outcomes will hit us back. So it's in everybody's interest to make an effort, concertedly to, ensure that health equity is achieved in their community.

Lama Alsafi (04:49): How has COVID-19 transformed healthcare systems and leadership in Canada? And I wondered Dr. Hussain, if you can tell us what trends you are seeing and do you think these will continue post-pandemic?

Dr. Sameera Hussain (05:01): Oh, that's a very good question. Certainly there have been some, if not changes, some things we're noticing more. Early findings from a study done at the University of Toronto suggest that women who are health care workers have an increased risk of stress and burnout and depression during COVID-19. Interestingly in Canada, we've had leadership from chief medical officers of health and public health officials. And that's something I think we as Canadians notice. Others across the world have noticed that the leadership among women. And I think it is, certainly in the workforce, there will be hopefully changes to support women and sort of the setbacks we experience to delivering on the mandates that we hold of health care workers and public health officials and so forth.

Lama Alsafi (05:58): When women are involved in leadership and the decision-making process in public health, what kind of difference does that make for society?

Dr. Sameera Hussain (06:06): It does make a very big difference in society. The research certainly indicates that when you have, at all levels of health care and public health, when you have women and women who reflect the diversity of the population that they serve, they bring to that decision-making role a different kind of perspective that does affect their decision-making, which in turn plays out at the population and public health level.

Lama Alsafi (06:33): We know that that women make up about 70% of the global health care workforce. And we also know that in many parts of the world, women aren't consulted or involved in decision-making or properly represented in leadership positions. So we've discussed a bit about the caregiving responsibilities that some women have in the global health care workforce, but what are some of the other barriers and challenges that women face, who are working in health care and what needs to change critically for them to be properly supported, represented and included?

Dr. Sameera Hussain (07:06): Interestingly in Canada, it's actually 80% of women who make up, 80% of the health workforce is made up of women. And I don't think that this is just a global experience where it's something that is experienced by other women in other countries. When you mentioned the issue of women not being consulted or involved in their decision-making, that is not the experience of all women in Canada. Many women and girls experience in Canada structural issues that prevent their ability to make decisions or access appropriate health care services. And there are many examples that come to mind, for myself as a woman of colour and an immigrant. But also I would say foremost for me, the example of Indigenous and First Nations and Métis background women whose experience of health systems across Canada—we have seen in the news, it's so unfortunate—it's been riddled with racism and a number of other structural issues that prevent them from having any kind of agency or very little agency for their own health decision-making. There are still adolescent girls who don't have agency in making decisions about their sexual and reproductive health. So I wouldn't say it's an issue of the other, it's an issue that we have as well, and it's something that I really like to draw attention to in Canada, because we often think many of the problems that we see in global health are other people's problems. They're not. They're in our homes, they're in our backyards, they're with our neighbours. And I would urge your listeners to really bring Canada into that global conversation about women and girls and, you know, those issues of sex and gender and intersectionality.

And as for women making decisions, there are nuanced experiences that women have. We have setbacks due to gender, due to race, due to socioeconomic status. And organizational culture will have to change in order to accommodate that. And ways that they can do that are not just directing women to websites, evidence suggests that financial support, care for basic physical needs for women, giving them manageable workloads and access to leisure activities create a positive impact on how they're able to perform in their health care and public health leadership roles.

Lama Alsafi (09:44): Thank you so much, Dr. Hussain. That is a very insightful response and you're right. You know, that often we look at other parts of the world, but these same issues are happening at a systemic level here in Canada. So I'm very glad that you pointed out. Dr. Hussain, what does the future of health care look like in a post COVID-19 world? Do you see women's rules changing? And if so, how?

Dr. Sameera Hussain (10:10): I think the future of health care in a post-COVID world is riddled with complexity. We had pre-existing issues going into COVID and some of those have been exacerbated, particularly the issues that come to light because of inequity, as well as infectious disease and anti-microbial resistance. And what we're seeing now is there's a focus on the long-term effects after COVID infection, which I think will impact our health system negatively. And we will have to be better prepared for the next pandemic, as well as prepared to deal with the onslaught of health care issues we will be seeing that are not limited to long COVID, but also mental health impacts. And the people who have been set back on their cancer treatments and other kinds of non-urgent surgeries.

In terms of women's roles changing, boy I hope so. I hope there is a greater understanding how important women are to the workforce at large, but specifically in health care roles where all of us are in a situation where we're working long hours, we have other responsibilities outside our professional life. I do see a shift in societal understanding for some of the experiences that women have balancing work and home life, and some of the insecurities that they face due to job losses and furloughing of their livelihoods. Finally, I would say that women's roles will be changing terms of leadership. We've seen many studies on women's leadership during COVID and a recent study that analyzed the speeches that women leaders are making in comparison to male leaders, males were using a lot more languaging around war, and, you know, we're waging a war against COVID, we're not in peace time. Whereas women have been communicating their public health messages with empathy and social cohesion. And I think that has a major impact on women's roles, as well as whether women will be pushed more into visible roles that have a lot of visibility in terms of achieving social cohesion and behavior change in terms of crisis.

Lama Alsafi (12:41): This is an interesting point that you bring up. I wonder, do you have any idea about the impact that this type of rhetoric—just in terms of the language that men are using, men leaders, such as fighting and war versus a more inclusive language—does that have an impact on the public trust and perception related to COVID-19 response and things like this?

Dr. Sameera Hussain (13:06): I would certainly that so. I haven't seen any concrete research around this, but certainly, at Ottawa Public Health, —which I follow on Twitter and on Facebook, I adore that communication—and I think Dr. Vera Etches is a remarkable leader in her messaging and acknowledgement that we're in the same storm, but we're not all on the same boat in this. We all have different experiences and that empathy is really important. It does have an impact on the psyche, on the collective wellbeing of a community to know that um, our leaders are there for us.

Lama Alsafi (13:50): What can our listeners do to help support and advocate for health equity, both at home and around the world?

Dr. Sameera Hussain (13:56): Thank you for that question. I'm very passionate about this issue. So I will just leave you with this: the health inequities reflect power and privilege imbalances along historical, geographic and gender lines. So that said, I would say that I would hope your listeners will support and advocate social justice, first by modeling that in their own behavior, but also to indicate their allyship with others who are doing so. Really at the root of health equity is social justice. So do what you can be a good role model for your coworkers and for your families, and show your solidarity with others who are doing the same.

Lama Alsafi (14:49): Dr. Hussain, thank you so much for joining us today. It's been a sincere pleasure to speak with you, and thank you for all of your efforts to help improve health equity within Canada's healthcare system.

Dr. Sameera Hussain (15:00): Thank you so much for having me.

Lama Alsafi (15:01): Thank you. And thank you to all of our listeners for tuning in today. Please stay tuned for the rest of our March4Women series as we listen, learn from and amplify the voices of women leaders in Canada and around the world, such as Dr. Hussain. As always, you can stay up to date on the latest episode of 15 Minutes to Change the World on Spotify iTunes, and by visiting care.ca/podcast.