Reach for the moon, and you will catch a star Interview with Marleen Temmerman

REACH FOR WHAT YOU WANT TO CHANGE OR IMPROVE, AND AT LEAST YOU WILL ACHIEVE PART OF IT. EVENTUALLY IT ALL COMES DOWN TO THINK GLOBALLY, BUT ACT LOCALLY

Marleen Temmerman, gynaecologist and fighter for human rights, just celebrated her 64th birthday but she is not thinking about retirement just yet. She works as head of the Obstetrics and Gynaecology department of the Aga Khan University in Nairobi. She desires to achieve ‘more of the same’ in the battle to further lower maternal mortality and to improve women’s rights. We very much enjoyed discussing with her the challenges and achievements of the past years and her ideas for the near future.

How to act locally

In 1986, Marleen started to work in Nairobi in the Pumani Maternity Hospital (PMH), quite a challenging setting.

I wanted to combine clinical work with training and research and got the opportunity to work as lecturer/researcher at the University of Nairobi. After some fundraising, I bought the first ultrasound machine and started a training program. I was involved in a research program, which was carried out in PMH. There were around 100 deliveries per day and there was a shortage of everything, including doctors and midwives. This resulted in a combination of clinical work, teaching and research. Later, I got involved in project management.

After five years, I moved back to Belgium but stayed in touch with the hospital and the project management. Nowadays, the hospital has foetal monitoring, incubators, ultrasound, ambulances and a working communication system with referral clinics. Maternal and perinatal mortality has decreased significantly. In the 1980s we had 2 stillbirths a day, compared with 2 per week these days. Maternal deaths were weekly events; now very few women are dying, and many of these are unavoidable deaths.

These days, I work for Aga Khan University, a private not for profit university in Nairobi, where I am the head of Obstetrics and Gynaecology. I hope to establish a public private partnership with PMH, since it has become a teaching hospital and a centre of excellence with a huge impact on quality of care combined with opportunities for training doctors and midwives. The hospital is also an excellent place for research. My dream is to create a bridge between people working in clinical care and those who are involved in public health. Interventions to reduce maternal mortality include: 1) encouraging women to deliver in health facilities, but also investing in quality of care during childbirth and 2) investing in women’s rights and access to reproductive health services for girls and women.

How to think globally

Safe motherhood should continue to be sky-high on the international agenda. In 2010, the United Nations Secretary General (UNSG) office assessed the MDGs and found that number 4 (reduction of child mortality) and especially number 5 (reducing maternal mortality) were lagging. It took seven years before universal access to reproductive and sexual health and family planning was incorporated in MDG 5. Hence, the UNSG Mr. Ban Ki-moon initiated EWEC (i.e. Every Woman, Every Child), a partnership between UN, governments, private sector, public sector, civil society, champions, mission organizations, and all constituencies to support MDG 4 & 5, resulting in an acceleration of implementation. In 2015, the world did not meet the millennium goals but still had a lot to celebrate. Never before had the world achieved such an improvement in health as at that moment. Maternal mortality actually decreased globally from 1600 to 800 mothers dying per day because of pregnancy related issues.

Key factors in safe motherhood

We learned a lot about the local dif-ferences in low-resource countries. What stands out in countries that met MDG 5 (for example Rwanda) is strong governmental leadership as well as strong collaboration with the donor community. In Kenya, we do have a strong champion. First Lady Margaret Kenyatta started an important program, ‘Beyond Zero (maternal mortality)’, bringing all constituencies together to engage in women’s and child health. The percentage of women giving birth in a health centre increased from 32% in 2010 to 88% nowadays. The government is now increasing invest-ment in structural improvements of quality of healthcare in the facilities.

Marleen’s passion and ideas

My biggest passion is improving health and taking women’s rights on a higher level. In 2007, I was asked to join politics. After refusing initially, I took the step into politics to have the chance to bridge the healthcare sector and politics. I enjoyed my 6 years as a senator in the Belgian Parliament and working globally with the European Parliamentary Forum as well as in the IPU (Inter-Parliamentary Union). I left my senate seat in 2012 to join WHO as Director of Reproductive Health and Research. Working with the UN was interesting and I loved it very much. Having retired from the UN, I am happy to be back in Kenya.

5 highlights CV
2007 – 2012 Senator sp.a, Belgium
2012 – 2015 Head of Department of Reproductive Health and Research (RHR), WHO
Marleen Temmerman
1986 – 1992 Lecturer and researcher University of Nairobi and Pumani Maternity Hospital
1994 Founding of the International Centre for Reproductive Health (ICRH)
2015 – Head of Obstetrics and Gynaecology department, Aga Khan University, Nairobi

More of the same in the future

I hope to continue my work for the com-ing five to six years. I want to achieve ‘more of the same’. Besides that, I want to be a role model for young doctors. I would like to show them that there is not just one magic bullet, but that a lot of little magic bullets together will enable us to improve the world. As an indi-vidual, you can make the difference, and it gives me energy to see improvement.

I am an optimist who enjoys life and work as well as connecting with people, especially young people and health care providers. I always use my three keys: astonishment, indignation and responsibility. As a little girl and more in my teenage years, I often thought “How is this possible?” (mainly related to inequities), followed by “What can we do about it?” Instead of complaining, one should take responsibility in one’s own way. Know that you can’t improve everything, but try to contribute just a little. That’s my motivation. My mother always used to say “Reach for the moon, and you’ll catch a star”. I translated it as “Reach for what you want to change or improve, and at least you will achieve part of it”. Eventually it all comes down to “Think globally, but act locally”.