International Women’s Day

Addressing social norms

Giza, Egypt, is home to the ancient world-renowned pyramids and a medical marvel of the modern age — the accredited Polio Regional Reference Laboratory (RRL) at the Egyptian Holding Company for Biological Products and Vaccines (VACSERA). Director of the polio regional reference laboratory,

Amira Zaghloul oversees five different departments, working closely with her 25-member team. They regularly conduct poliovirus diagnostic tests on stool samples obtained from children as well as sewage samples from Egypt. Additionally, they carry out sequencing of samples that have been identified as positive for polio in Egypt, Iran, Iraq, Jordan, Sudan, and Syria, which determines if the polioviruses confirmed are related to any other ones. Their goal is to meet tight deadlines, to swiftly respond to any detection of the poliovirus.

Like her counterparts across the Region, Ms Zaghloul and her colleagues rely on the latest laboratory and digital technology. With support from partners, they regularly upgrade their technology and skills to ensure the shortest possible time between sample collection and churning out results. Soon, for example, Ms Zaghloul and her team will acquire the next generation of sequencing technology – that will help test the entire genome of a virus, or genetic materials that make up a virus, and identify any mutations. This will also help to determine the origin of detected polioviruses, and track epidemiological patterns of spread.

Her work doesn’t come without challenges though. When she first took on this role, Ms Zaghloul faced negative social perceptions of being a female leader of a mixed team of men and women. To address this, Ms Zaghloul introduced rules and regulations that apply to all, regardless of age and gender.

People working in health should exemplify a spirit of perseverance, devotion, hope and ambition – regardless of their gender – she emphasizes.

Negotiating to receive samples for polio tests

When Dr Hanan Al Kindi finally settled on what to study − over virology, medicine or business — she had no idea she would need negotiation skills in her job. As the head of nine polio and measles laboratory departments that test samples from Bahrain, Qatar, United Arab Emirates and Yemen for polioviruses, Dr Al Kindi ensures everything runs like clockwork.

At times, this involves thinking out of the box. After noting huge time lags in the delivery of stool samples – used to test for polioviruses – from Yemen to Oman, Dr Al Kindi rolled up her sleeves and got to action. She learnt that after driving through mountains and deserts to reach Oman’s borders, the refrigerated trucks that transport stool samples were kept at the border for hours of inspection. Dr Al Kindi and her team got the contacts of officials at the border and invited them over for a chat.

Her determined negotiation skills and ability to read the room – to understand when peripheral stakeholders such as officials at the border and couriers needed more context about the laboratory’s role in saving children from polio — eventually helped reduce the red tape at the border. This means Dr Al Kindi and her team can test for polioviruses and turn over their results to the polio programme in Yemen in less time than before. This steers timely and appropriate outbreak response activities, including polio immunization campaigns to protect children from polio.

Working in an equitable environment

Dr Nayab Mahmood plays a vital role in ensuring samples are tested for poliovirus as swiftly as possible for timely interventions in Afghanistan and Pakistan – the only two countries left with naturally occurring poliovirus.

Dr Mahmood is a virologist serving the polio programme of the Regional Reference Polio Laboratory at Pakistan’s National Institutes of Health in Islamabad. Her role involves intricate technical procedures, including molecular diagnostics, and genetic sequencing of the poliovirus genome. This work helps to determine how wild polioviruses are spreading across both endemic countries.

Being part of an emergency programme means that Dr Mahmood and her colleagues need to be available 24 hours a day – a pace that is impossible to maintain without feeling an impact in one’s personal life. She feels that the best way to maintain a work-life balance is for each member of a team to communicate their needs with each other, which further helps the programme’s leaders like her to shape policies and programmes that enable a good work-life balance.

Grateful that she hasn’t had to challenge any stereotypes related to gender dynamics in her role,
Dr Mahmood credits this to directives in her workplace that support gender equality, and to the culture of her individual team. These attributes have blended to create an equitable environment where everyone can use their abilities.

Sharing rare, much-needed skills

Chief of the Laboratory of Clinical Virology in the Pasteur Institute of Tunis, Professor Henda Triki makes a concerted effort to share her knowledge with others. Her altruistic spirit goes beyond her laboratory, especially as her specialty of work is still rare in North Africa: She teaches virology at the Faculty of Medicine of Tunis, and constantly keeps an eye on how best to upgrade her team’s skills and technology at work.

Professor Henda Professor Triki has a collaborative leadership style at work, which results in her sharing her team-building skills with her colleagues – which has helped them address challenges many times before, including during the COVID-19 pandemic. Amidst the chaos and anxiety during the pandemic, Professor Triki and her team had strong moments of solidarity and collaborative work.

Professor Triki wants her fellow female colleagues to be proud of working for the polio eradication programme, as it offers great opportunities. It has allowed women to distinguish themselves from others by acquiring skills that other laboratories do not have. She is pleased to note now that there are many women who are the face of specialized laboratory work in the Eastern Mediterranean Region.

This year, the UN’s theme for International Women’s Day is ‘DigitALL: Innovation and technology for gender equality’.

Originally published here.

A moderator speaks in a workshop for the female frontline workers initiative. © BMGF/Sang-hee Min

ISLAMABAD – Poultry farming, EPI technicians, creative writing, midwifery, embroidery, online businesses: it’s a room filled with possibilities and dreams when women health workers come together to imagine their lives in a polio-free Pakistan.

These ambitions surface during the workshops the Pakistan Polio Programme initiated last year, as part of a unique project to actively listen to female frontline workers in the areas at highest risk for poliovirus transmission across the country.

The initiative used a bottom-up, data-informed approach to better understand the experiences of women on the frontlines and hear their ideas for how the programme can better support them to do their jobs safely and effectively. And came with a prior promise: leadership from all partners at the Emergency Operations Centres were to review – and implement – workable solutions.

This systematic listening process, which began in July 2022 and concluded last week, was done in two parts: First, an independent research company was brought on to conduct more than 2,600 randomized, anonymous surveys with polio frontline workers across Pakistan to understand their unique challenges and experiences in the field. After this, based on the results of these surveys, 14 workshops were designed to hear from women frontline workers themselves on what they think are the solutions to the challenges they face.

Female health workers from the polio endemic districts of Bannu, DI Khan, Lakki Marwat and Tank in southern Khyber Pakhtunkhwa to the geographically challenging terrains of Chaman, Quetta and Killa Abdullah in Balochistan to Punjab in central Pakistan to Sindh in the south of the country to the capital city of Islamabad were brought together in this series of workshops.

Participants during the workshops. © BMGF/Sang-hee Min

The workshops were also moderated by a third party to allow for open and honest discussions, and carefully curated to create spaces where, for the first time, the women were the chief guests, they were the people who mattered most, while everyone else had one job: to listen.

“When you get respect, you get everything. It’s the first time that we have talked, and other people have listened,” says Fauzia Naseem, an Area-In-Charge from Chaman.

As each of the two-day workshops finished, there was excitement, energy and almost a sense of disbelief that hours had been dedicated to listening to them. “I’ve been here since 2017 and no one has ever really asked us what we think. Otherwise we are only told where to go and what to do. Today I feel like what we say matters,” says Samreen, a polio worker, from Tank.

“This is a very special project – and a very insightful one too. It offers us the opportunity to gain from the wealth of knowledge of the polio programme’s frontline staff. For the very first time, the people who actually do the work of delivering the vaccine to a child have been systematically asked how they think it should be done. We are currently looking into their suggested solutions and seeing which are implementable and can be taken forward,” said Dr Shahzad Baig, the Coordinator of the National Emergency Operations Centre in Islamabad.

“For many women, this is the first time they are together to just talk to each other, hear from each other, take a selfie and be in a space where they have the right to simple joys that they otherwise may not have access to. The workshops for women from southern Khyber Pakhtunkhwa were particularly special. These were held in Islamabad and for many women, this was the first time they had visited the country’s capital city. Their excitement and sheer joy was infectious. It lit up the room,” said Dr Atiya Abro, Deputy Director Ministry of National Health Services.

Moderators guide the participants during a workshop for the female frontline workers initiative. © BMGF/Sang-hee Min

The last session in all workshops was dedicated to listening and understanding the women’s diverse interests in other career pathways after polio, and what skills or support the workers felt would be needed for them to transition into these jobs in the future.

This initiative was coordinated by the Pakistan Polio Programme’s National Gender Group, comprised of representatives from the government and partner agencies including WHO, UNICEF, BMGF and N-STOP.

“Having the opportunity to listen and give center stage to these women has been a true privilege. It’s encouraging to see such strong commitment from Pakistan programme leadership to support these female health workers – not only in their work toward our collective goal of eradicating polio, but also to facilitate transitions into other potential livelihood opportunities in the future. We look forward to the next phases of this exciting initiative as well,” said Sang-Hee Min, Senior Programme Officer, Bill & Melinda Gates Foundation and member of the National Gender Group.

“Polio teams are a valuable asset to our country,” said Dr Baig. “It is very important to me that when we finish polio from Pakistan, we don’t just pack up and leave but utilize this incredible workforce. We build systems and create opportunities to serve the workforce, a majority of them women, and find some way, however small, in giving back to the people who have worked tirelessly to protect the children of our country.”

By Zehra Abid,
Communications Officer, WHO Pakistan

This International Women’s Day, we get to meet some of the women leading the polio eradication efforts in Pakistan.

On International Women’s Day, Spanish Minister for Foreign Affairs, European Union and Cooperation and Gender Champion for Polio Eradication, José Manuel Albares pays tribute to all the women in polio eradication across the world and reminds us that women are still underrepresented in senior leadership and decision making roles in global health and that these gaps in leadership are driven by stereotypes, discrimination and power imbalances that we are all responsible to tackle.