Full transcript of Fire and Wire: Oxford women making a global impact

Professor Irene Tracey
Welcome to the latest edition of Fire and Wire. You are joining me today on International Women's Day. So, congratulations to all those fabulous women out there, both in the University of Oxford and all our listeners out there in the wider world.

As it's International Women's Day, we have decided to go with an international theme today. And I've got three fabulous women from my university here, at Oxford, who are going to talk about their work in different areas. So with me today, I have from the Department of Surgical Sciences, Professor Kokila Lakhoo. From the Department of Social Policy and Intervention, I have the Head of Advocacy, Dr Isang Awah. And from the School of Geography and Environment, I have Professor Katrina Charles.

Welcome to you all, and happy International Women’s Day.

All guests
Thank you.

Irene Tracey
Well, let's start by just hearing a little bit about what you do and what your areas of research are and how they touch on that sort of international space. So maybe Katrina, I might turn to you first. Tell us a little bit about your amazing work.

Professor Katrina Charles
I work on water security, in particular improving water security for the poor. So, I work across Bangladesh, Ethiopia and Kenya with the REACH programme and we've been doing that since 2015. So, it's been quite a long-term research programme and it captures quite a few different aspects of water security. Some of the key areas are: improving drinking water in schools and healthcare facilities and for communities; we do work improving access to climate information for water security; and work around improving water quality in hospitals.

Irene Tracey
Fantastic, extraordinary work. And I really enjoyed being at the celebration you had just recently where all the different colleagues from around the world came back.
But maybe I could turn to you now Kokila. Tell us a little bit about your work in paediatric surgery.

Professor Kokila Lakhoo
Basically what I do is capacity building and exchange of skills from a clinical and research perspective in Africa and Southeast Asia. And I've honed into Tanzania, that work is almost 22 years old, and work with research capacity building in Bangladesh.

Irene Tracey
Fantastic. Well, it's extraordinary the impactful work that you're doing and I'm keen to get into a little bit more detail.

Isang, tell us a little bit about what you're doing in the Department of Social Policy and Intervention.

Dr Isang Awah
I work on advocacy in the Global Parenting Initiative. That is, the GPI. And in this role, I work with national governments, UN agencies, NGOs and faith-based organisations to support the uptake and scale up of evidence-based playful parenting programmes.

I also support the national research teams. So, we have research teams in six countries. We have nine research teams. So, I support them. I work with advocacy colleagues to support them in developing and implementing an advocacy strategy for the uptake of evidence-based permitting programmes in their different contexts.

Irene Tracey
Fantastic, extraordinary. Well, hopefully already you are as impressed as I am by just what we have around the table from three examples of our wonderful academic women here in the University and what impact they're making globally.

I'm very keen to explore what playful parenting is. I'm sure my children will not consider me a playful parent back in the day.

Some of the challenges that I think, you know, one will assume you face working on an international stage is the fact that you're sort of – you're Oxford based, and you’ve obviously got research teams here and this is where your academic home is. And yet you need to, again, work in many different countries, as we've just heard. And each country will present different challenges and different abilities for you to probably, you know, conduct your research there, spend time there just on a practical level.

Can I just understand a little bit from you how well that works and how you've learned to juggle those two, sort of, demands on your time? So maybe Isang, you could kick off.

Isang Awah
So, what we've done at the Global Parenting Initiative is that we work collaboratively with different teams. We have teams in different universities and we have partner organisations. So, we work with them collaboratively in researching the different aspects of our work and even in working with the governments in those countries. So, they lead. We provide the support, and they lead the work there.

Irene Tracey
And in terms of the, sort of, time split, is that something that just varies as projects evolve? How do you, at the outset of a project, decide how much time you're going to invest having to be overseas to facilitate that collaboration and to give your contribution to it in an effective way – not by Zoom.

Isang Awah
Sure, sometimes it's challenging, but we make the effort to go there to meet with the teams. And we also attend conferences together and so, we actually create the time to be there to meet with them. And where there's an opportunity, we get the teams to also come over here and work with us.

Irene Tracey
Right, okay. In terms of the surgical side of things, there’s a very practical element to that. And there's obviously a huge amount of skill and training that's needed. So, can you maybe just talk us through how that works in your world?

Kokila Lakhoo
Yes, I I think I can give a example of how it started for me. In Oxford in 2002, the Vice-Chancellor from a university in Tanzania came over to look for people that could help them develop specialism, because most basic surgery can be done in country, but anything specialised meant travelling to India or South Africa. At that time, I have a full-time job in Oxford. I'm a female and a surgeon. I have two kids under five. And I went home and I said to my husband: I need to go down there to see how it can be done.

And he was very, very supportive, which he always is. And he said: well, why are you wasting time? Go and join them and see how you can support and help. So I came down to Tanzania and realised that, okay, there's no paediatric surgery here. But they are very well-trained adult surgeons who are doing some of the children's work. And they’re paediatricians who know how to look after children. And there was an empty ward, which was used for mothers to sleep in. So, we converted that ward into a paediatric surgical ward with adult surgeons getting some training and paediatricians working together to look after children.

So, I took ten days off my annual leave. I used my own funds to travel, and I did that twice a year. And over 22 years, we have a fully established paediatric surgery department in seven centres. We're aiming for ten. We have almost 18 paediatric surgeons there. We’ve had a training programme for the past five years, where we're training our own paediatric surgeons.

Irene Tracey
It's extraordinary. I mean, what an amazing legacy. You know, 22 years and to have built up seven centres aiming for ten. But what a sacrifice, you know. Ad without the support of your husband and your desire to do this and sacrifice a lot with family holidays, with a young family, and financially.

Kokila Lakhoo
Yeah. And I didn't want to compromise my children, so I did a lot of the work from midnight to four in the morning, or would get up at four in the morning to put in some work before the children got up. I feel very comfortable now that my children are young adults, that they have not regretted having me as a mother.

Irene Tracey
I'm sure they're hugely proud of you, hugely proud of such an amazing legacy. And did you say, the research then followed on once the clinical practise was there?

Kokila Lakhoo
Yes.

Irene Tracey
And Katrina, if I could turn to you and the REACH programme. Could you just tell us a little bit more about what the sort of origins of that were? How did that come about, and then how did you build that consensus and collaborative cohort and consortium to deliver what you're doing? And maybe just explain a little about how it works on the ground in terms of what you’re doing.

Katrina Charles
Yeah. So, the REACH programme came about from, well, a group of us who were already working at Oxford around issues on water security. So, a couple years before I joined the University as well, there’d been a water security risk conference where they really tried to bring these ideas together. And so when the call came out from, what's now Foreign Commonwealth Development Office, FCDO, the team was in a good place. We already had these collaborations with partners in countries in some cases – although, some were new. We had collaborations across the University from different disciplines of people working together on these issues around water security.

And we developed that over the years, and I think these issues of what you do in Oxford versus what you do in countries are quite relevant in that. So, a lot of it has been about supporting the country teams to develop their capacity to take a leading role in water security in their countries, and in that, you know, we fly in, but to help facilitate what they need.

For those of us who are more senior, that's a very political role now. What we do and how we travel is based around those needs. Whereas, as you were saying, it's early in the career when your children are young, but also, there are demands to go out and do the field work and spend a lot of time in the lab. We have postdocs who we’re supporting to manage those teams because they're the ones who spend a lot of time in the field working on the methodologies with local partners and developing things on the ground.

Irene Tracey
How did you go about identifying where to start with where the need was? Obviously, there's a lot of need everywhere, so how do you go about selecting where you can add value, as you say. And not just swoop in, but really use the knowledge and skill sets that you have and then bring in that benefit and then do that empowering and then walk away.

Katrina Charles
I think for water security, it's an issue everywhere. So there's no geographic boundary for that. There are political areas that were better to work with, but I think one of the ways it works is to identify water security observatories where we could focus our interdisciplinary research on dedicated areas and get people working together effectively. Because that was one of the challenges to overcome: how get people from different disciplines to communicate?

We chose areas where we thought there were interesting questions about what was going to change over the course of the programme that we could start to engage in. But we also started right from the very beginning by working with partners in UNICEF, working with partners in government to work out what was relevant to them and that was part of that delicate process of working out ‘and where can we add things to this?’ because we don't have every expertise. And what do you actually need over a relevant timescale for academics to?

Irene Tracey
Maybe historically, there's been a temptation to go in and assume we know what it was that we should be fixing and not doing enough listening. And having and creating the forum to learn what is actually needed, and then to know whether you actually have got something to offer. So, it sounds like you got that process working well.

Katrina Charles
And that's one of the things we've been trying to share back with funders as well, that one of the reasons to be able to do this is because of the long-term funding. We've been a ten year research programme, which is quite unusual. So we've had time to do that preliminary research to work out where we want to work together with government, work out what their needs are, do the baseline work and develop models.
In Bangladesh, we've been able to develop our safe planning model for drinking water services in schools and healthcare clinics. We're at the stage now where the Government is investing in that. And because of the longevity of the funding and the flexibility of it, we've been able to work with them on the development of the policy and continuing to work with them as advisors as they take this to scale.

Irene Tracey
Right. That is such a good point. And it's obvious now you mention it, but you've got a particular funding model.

Isang, is that similar for you in terms of the funding? Because obviously parenting is a long journey, as we know.

Isang Awah
Definitely, and I think the one area that we've really had challenges in is in the humanitarian work that we've been doing. For the past few years, we've done what we call parenting in crisis. Typically when there's a crisis, people think of immediate needs like clothing, shelter and they don't think of parenting support as an urgent need. But when you think about it, parents are so stressed in that moment and they take out their frustration and their stress on children. So, we find out that when we have humanitarian crisis, children are usually the victims of most humanitarian crisis. So that's part of the work we've done.

Let me start by talking about what we did during COVID. That was in 2020. We did this in collaboration with UN agencies, WHO, UNICEF, UNODC and other partners. The parenting for lifelong health team quickly developed parenting tip sheets with simple but very clear tips on what to do when you are stressed. And we had different teams disseminating the resources all over the world globally. So far, the COVID-19 parenting tips have reached over 210 million people.

We were collaborating with local partners who would reach out to NGO's, fed-based organisations and civil society organisations. 34 Governments actually partnered with us and included the tip sheets, the resources, in their palliatives, in the things that they were sharing for their citizens. We had it on radio and television in Pakistan and so on.

And moving on from that, when we have the conflict in Ukraine two years ago, there were some needs that these tip sheets did not address. For instance, child trafficking was a risk. And then child sexual abuse. So we went back, developed new set of tip sheets, and we even added in QR codes. So what the UNODC did was, as people were leaving Ukraine, they would share the QR codes to enable them to download it.

Irene Tracey
Kokila, if I could turn to you. Obviously, you must develop lots of sheets for parents, cause you're a paediatric surgeon. So, is a lot of what Isang is saying chiming with you.

Kokila Lakhoo
Yes, it resonates with me a lot. I think the most important thing is to engage people and empower them, because they will say to you: this is our need. And then you build on that need. Language is important and social media is important. Not a lot of people have televisions in the rural community. So most importantly, they all have mobile phones. What we've done for trauma prevention is to use a mobile phone app and it gives you information on what to do when the child is injured, where to take them and which is the best facility close by.

Irene Tracey
You know, if I could maybe turn to a slightly different topic. And that is, as I mentioned at the start, it’s International Women's Day today, but because there's just so many fabulous things to celebrate about women, we've actually been hosting events pretty much all week.

One of the things that's really struck me this week that's come out in all these different panel events, is the issue of retention. Why are women, having been highly trained, with all that skill set and all that investment, leaving the workplace or leaving academia. Because of a toxic culture or a recognition that when things are being flagged and raised, it's not being dealt with effectively? So, I'd love to hear from you all about the challenges you've seen and some of the ways that, again going forwards, we can help in terms of the local academics that you're working with.

Katrina Charles
My experience across the partners we work with and the countries we work with are that there are some very common challenges that academics face. So, you know, common challenges around publications, getting money for research, dealing with the University administration. But also common challenges that women face, and the expectations and how they clash with academia.

One of the things that's been really important in building partnerships with countries is to understand those different challenges in different places. Because, while there are similarities at that top level, they're quite different when you get down to the drivers for individual academics, individual women at the local level, and how they're managing those local cultural demands.

And one of the things we've had to deal with while running an international research programme is how do you support women who are working in a what's already a very patriarchal sector, the water sector, but then also working in very patriarchal cultures. How do you support them to develop? And unfortunately, sometimes that means leaving the programme. But we've had women who have gone on to brilliant further careers. And that's sometimes a great option, of going on to international organisations which are better placed to support women, but it does mean you're still left with that issue more broadly.

Irene Tracey
Yea, you’ve not dealt with the causal problem. Yeah, no, really important.

Kokila Lakhoo
So what the Tanzanians have done is they've formed a women's medical society, just from the medical perspective, and they talk about these issues. Here we are, you know, we are looked upon as mothers and wives, rather than colleagues in the workplace. How do we change that paradigm?

And I think the problem is not just in the low-income countries, it's even in Oxford. Come to a certain level and it feels like a glass ceiling. They just can't get ahead because there's no support for that. And I think flexible working hours is one of the best solutions where you can put your best in if you're allowed to work flexibly around your needs. And that applies across the board internationally.

Irene Tracey
Now Isang, you were nodding your head about the part time flexibility. I could see that.

Isang Awah
Absolutely. First of all, I just want to say I agree with everything that has been said so far and I really love the idea of women coming together. But you know, for me, I think the first thing is for us to recognise that there is a problem here because sometimes people don't even recognise that there is a problem.

So I just want to talk about me. I was a stay-at-home mom for a long time and I think – well, I like to think that – if I had the option of working part time or I was able to work flexibly, that that may have been a choice I may have taken up instead of just resigning from work and looking after my children. So if women, especially in African countries where the culture is really patriarchal, have these options, I think it's a way that we can support them to stay on.

Irene Tracey
No, you're absolutely right. I've often said, you know, why would you not have a fantastic woman for half a day, one day a week, rather than no days a week? Have that talent for whatever amount of time you can have that talent. Having developed that talent. And that will absolutely help facilitate, also, if they wish to return in an increasing volume to the workplace. But we've just got to get better, and I say that as Vice Chancellor here, in thinking about how can we be more open, more flexible, about how we think about career structures and that part time flexibility.

If I take the local Oxford context, there is actually a lot more than I think people realise there is in that capacity. So we need to work harder at making sure that that is communicated. But then to really make sure where maybe it's not happening or it's been prevented, that we come down heavy and ensure that people are able to combine, you know, what is always going to be difficult patches and pinch points in their careers, combining everything all at once.

Sadly, we're coming to the end of our time but maybe just to finish off let's discuss some of the more difficult sides of working internationally. Maybe I could start Isang with you, in terms of how you think about good examples of collaborating so that there really is net benefit.

Isang Awah
Basically what we do when we're working with different partners, especially when we're developing resources, we allow them to live. So, it's not like we take, it's not a top-down process.
Let me speak about our parenting in crisis resources. We have the evidence base. Obviously, we have the content, but we allow them to lead, especially in cultural adaptations. And just like we've discussed earlier, we listen to them. Not just in terms of the phrases and the language that we use, but even in designing illustrations or images.

I remember when we did the Pakistan parenting resources and we shared them with our colleagues, they came back and they said: Oh, this doesn't quite work. Tweak the moustache of the man a little bit, change this, change that. So, we just allowed them this respect and collaboration. We allowed them to lead. They know what is right for their context. Just working with them in a flexible way is what has led to so much rich content. We listen to them and then we take in terms of what works with their context, we allow them to lead that.

Irene Tracey
Yeah. No, it sounds good. And in a nutshell, playful parenting in one sentence?

Isang Awah
Yeah, playful parenting. It's spending time with your child. Deliberately playing with them. Yeah, and I think it's something that we often don't think of as something important. Allow them to lead in playing. It's not always what we want to do. If you want to read and maybe you want to read a story, book to them and they'll rather play football or something in the garden, allow them to do that. Just creating that time to be playful.

Irene Tracey
Yeah, to be led by what the child wants. The same way as the collaboration.

Isang Awah
Yes, exactly, yes.

Irene Tracey
And Katrina, how about yourself in in the REACH work? This sort of issue around these ethical tightropes that I think you recognise.

Katrina Charles
One of the things we're really proud of in the programme is when we have our partners tell us that, you know, the Minister now listens to them. That their research, their science, is being recognised and informing policy locally. And that for us is such a such a big gain for that country. That they now have a scientist who's trusted in informing policy.

And so for us, you know, working with partners in country and helping them to build in a way that's useful for them, understanding the pressures they're under to, and when this works for them and what doesn't. It's been really successful for us. And I think it would have been a very different issue if we'd come in and just set up a research centre separately and taken people away from those established institutions.
And we see this, we see donors coming in. We see other examples where they haven't realised the impact that it's having. That they're actually, perhaps, undermining the capacity they're trying to build because they haven't realised the system they're working in and are not supporting those systems.

Irene Tracey
Yeah. That's a really important point and Kokila, you must have seen this yourself. Goodwill, but not necessarily applied the right way.

Kokila Lakhoo
Yes, yeah. I think the most important thing is your research questions will come from the ground to empower local people. To mentor them in situations where you need to mentor. To collaborate, but always they are in charge. And that's when it becomes successful.

Irene Tracey
Yeah, no, fantastic. Well, sadly, we've come to the end of our time here. But can I just finish by thanking you, Katrina and Kokila and Isang for joining me today and just sharing a little bit about your work. I hope that that's inspired every everybody, not just by feeling very proud of what our wonderful academics here are doing on a global level, but to go and find out a little bit more about them. And if you feel that there are areas that you'd like to collaborate with them on, then I'm sure you'll be very open for people to reach out to you.
So best of luck going forward with everything that you're doing. Very proud of all the work that you are contributing and thank you again for joining us on Fire and Wire. I look forward to joining colleagues and friends at the next episode next term.