Ending Violence Against Women and Girls with Alice Han, Instructor, Harvard Medical School (transcribed by Sonix)

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Saul Marquez: And welcome back to the podcast, today have I special guest for you. Her name is Dr. Alice Han. She’s an Instructor of Obstetrics Gynecology and Reproductive Biology part time at Harvard Medical School. Dr. Alice Han is a Canadian physician with a global health research interest in humanitarian settings and gender based violence. She’s published and presented internationally on gender based violence in Latin America and the Caribbean. She’s very interested and currently working on contraceptive practices of Syrian child brides in Lebanon. Most recently she’s been very focused on the role of OBGYN on addressing violence against women worldwide. A very great endeavor as we hone in the discussion today and on public health and so it’s a true privilege to have Dr. Han on the podcast. Welcome.

Dr. Alice Han: Thank you. Thank you very much for this opportunity to speak.

Saul Marquez: Absolutely so did I miss anything in the intro that maybe you want to chat with the listeners about?

Dr. Alice Han: Well maybe just to give a bit more about my background. You mentioned my interest in violence against women. I would say it’s a public health problem I’d committed to address after my experiences training or working in a variety of settings from Kenya from Israel, Palestine, Rwanda, Brazil, as well as the USA, and my home country of Canada. So just to give a bit of context and where I’m coming from and perhaps to shed some light on why I’m doing what I’m doing.

Saul Marquez: Now I love that, that’s a really great call out Alice Han. You know one of the things that I always enjoy hearing and get and the listeners do too is what got you into the health sector to begin with/

Dr. Alice Han: Well back when I was completing my undergraduate studies at McGill University in Montreal Canada. I participated in a six week international development seminar in Vietnam. So it was an educational program to foster cross-cultural understanding and to learn about challenges that are faced by developing nations. I had a longstanding interest in women’s studies and so I chose to focus on examining Maternal Morbidity and Mortality. And what struck me from this experience was the challenges faced by women in achieving health due to all the barriers they had. And by the detrimental effects of this lack of health to the development and the flourishing of communities and economies. So I knew that I wanted to be able to develop the skills to help with this problem and to improve the status of women’s health. But I felt torn on what level I wanted to contribute whether it was through the individual level working one on one with patients as a healthcare provider or at a higher up level working in public health and help helping to shape policies and implementation of interventions to influence health at a larger scale. After I completed my undergraduate training I did an internship with the World Health Organization Collaborating Centre which looked at health equity in Brazil and I was looking at ways to close the health gap between the rich and the poor. During this time I had the opportunity to work with mentors who were physicians but also public health scientists working in the field of epidemiology. So I thought that the dilemma I felt in feeling torn between clinical patient care and public health science didn’t have to exist. I could exist in both worlds and so I went on to pursue a Master of Science and Epidemiology followed by my medical training and eventually my specialty training as an OBGYN. So in summary I went into the medical sector because I want to improve the health status of women as an academic physician.

Saul Marquez: Love that. And you did it in such a thoughtful way. You dove into you know the master’s program to understand epidemiology and then you got head first as a practitioner. So kudos to you for doing that Dr. Han and so today you know the topic of public health I think is on a lot of people’s minds. But I don’t know what would you say the hot topic that needs to be on every health leaders agenda today and how are you thinking about it?

Dr. Alice Han: In this era of me too. I see incredible strides being made on recognizing the magnitude of violence against women around the world. On a related front we’re seeing breakthroughs and milestones for gender equality around the world. For instance in India on New Year’s Day approximately 5 million women joined in and one of the largest mobilizations of women ever for gender equality and formed a wall of women. Three hundred and eighty five miles long. So one of the largest human chains in the world. In the US a record number of women, a hundred and two were recently sworn into Congress. And just last week on January 13th, Gillette contributed with its release of an ad challenging toxic masculinity encouraging mental hold each other accountable for harmful behaviors like sexual harassment. So in this in the midst of this climate and progress medical and health leaders should similarly have the topic of violence against women on their agendas. Your listeners may not immediately make a link between the role of health systems and violence against women as it’s in my experience I find it’s often considered a legal or a social problem and health providers may feel this is a problem therefore for the lawyers or the social workers to deal with. I myself have had experiences being told by authority figures and colleagues that this isn’t that this is a problem that it just doesn’t make sense for me as an OBGYN to be addressing. However if I can speak to other OBGYN’s and actually to all doctors and nurses, I can say that violence against women is absolutely our problem. Around the world it’s affecting one in every three of our female patients. It’s a public health problem on a massive scale and it causes serious health problems. It causes physical trauma, brain injury, depression, and it kills women. As an obstetrician it also harms women and pregnancy associated with low birth weight leading in pregnancy and fetal death. Medical and health systems have a critical role to play in addressing this problem and in helping to support women experiencing violence and in reducing the harmful impact of the violence. Women often turn to health providers as a trusted contact when experiencing violence and far too often, health providers are not responding adequately. So sometimes I like to draw this analogy. Would it be acceptable if a gynecologist saw a patient with cervical cancer and didn’t detect it or send the patient home with that treatment because she didn’t know how to respond to the cancer. Well absolutely not. Yet this is happening in healthcare settings around the world every day and it needs to change. Health systems need to do more and training providers on how to respond appropriately and how to offer appropriate medical care and support rather than highlighting my own work, I can highlight your work being done at the highest international level by the World Health Organization. So they’ve recently launched a global plan of action on health system response to violence against women. So they are addressing this precise problem and I look forward to seeing continued progress in the years to come.

Saul Marquez: Well Alice I think this is a really great point that you’re making because if these women are showing up to the doctor’s office and you see it, it’s gonna be a way for you to report it and I think a lot of of times it doesn’t happen it doesn’t get reported because people don’t know how to or they don’t know that or even understand that maybe that’s part of their regimen of responsibility. Like what advice or what tips or what resource would you share with folks wanting to make a difference here that don’t know how?

Dr. Alice Han: Well I would say if I could speak to say medical professionals and medical administrators, I would say that the way we see this problem and think about this problem needs to change. There needs to be the investment of more resources into this public health problem. For instance it needs to be accorded the same devotion of resources as any public health crisis or epidemic would receive. And to give a concrete example I saw this past summer what such an investment could produce and how it could be helpful for medical providers. So this past summer I was invited by the World Health Organization to Geneva and Switzerland to participate and help facilitate some sessions and a training of the training workshop on health response to violence against women. So along with over 60 health professionals from around the world including countries as varied as Kenya, and Canada, the US, Jordan, Jamaica, and India, and many more countries. We were immersed in the World Health Organization recommendations on how to provide clinical care and first line support for women experiencing violence, how to offer appropriate referrals, and support services, how to complete appropriate medical documentation, and how to engage in communities as advocates along with many more topics. So each participant thereby returned to his or her community and can start to affect change. So I would say to individual health practitioners know that there are such resources that exist that they can refer to such as those produced by the World Health Organization and for those higher up in administrative and leadership positions, this is an example of the type of investment into training skilled health providers that needs to be replicated in more and more settings around the world.

Saul Marquez: I love it. What a great great example there Alice Han. So would you give us an example of how maybe a project you’ve been on or or a group that you’ve been a part of has shown results by doing things differently.

Dr. Alice Han: Well I would say that’s what I was able to do to effect change was highlight the problem that I saw through my experiences working in different countries. And once I saw the magnitude and the effects of the violence but also once I saw that this problem was not recognized as a health problem I wanted to advocate for change and so I did so by giving a TED X talk in Boston. It was an incredible experience and opportunity to speak to an international audience. In my talk I wanted make to make people see the old problem of violence against women in a new way. So I used a tool of persuasion called framing which is to present information in a context that helps audiences to understand and process it. For example doctors understand disease as problems with the cause that they can make better. So I framed the violence against women as a disease to make them see it as a problem. They need to provide support for and it succeeded. Many doctors told me they had previously thought violence against women was too complicated and they couldn’t do anything about it but that this changed after they hear her talk. A high ranking politician told me that this was the first time he thought of violence against women as a health problem. So this was incredibly satisfying to be able to change perspectives on this problem.

Saul Marquez: That’s awesome. Dr. Hahn and you know folks invitation to you to listen and watch the TED talk. We’ll include a link to that in the show notes just as a reminder if you go to outcomesrocket.health there’s a search bar there. And in this particular instance type in Alice Han and you’ll find the entire podcast of the show notes and a link to the TED talk. We’ll definitely be referencing it for you to enjoy. I had had the opportunity to watch it and it definitely will challenge what you believe today in a good way to effect positive change here and violence against women so really really phenomenal work. Dr. Hahn love that you just shared that. And how about on the other side of the coin here. Can you share a time when you had a setback and what you learned from it?

Dr. Alice Han: Well I would say that the entire process of preparing that TED talk was a major challenge. What surprised me when I started to talk about this topic was the hostility that I received from audience members who would listen while I was practicing the talk. I think what I’d learned was that violence against women is a very sensitive topic and it’s very important to keep this in mind at all times when speaking to audiences one might never know what audience members themselves have experienced their own beliefs whether there are survivors or perpetrators that they’re speaking to. So I learned to tread very with always some sensitivity at the back of my mind. I had one person and another TED speaker from last year who spoke on gender equality. Tell me when I actually turned to her because I felt so discouraged from the negative reactions to my talk she said you’re speaking about gender equality. You’re going to have negative feedback. She actually told me she had experienced death threats after she gave her talk as well as a lot of hostility and she said to me if you’re not prepared for this negative feedback and criticism you’re not the right one to give this talk. I would say it built in my awareness about how sensitive the topic is but also showed to me that there’s still so much work to be done.

Saul Marquez: Now for sure and kudos to you for being able to stand up and deliver and continue delivering the message. Despite that and folks I hope that you can take this learning that Dr. Alice Han is sharing with us today and and ask yourself are you doing what you were called to do in this particular instance, Dr. Han is and she’s not allowing this pressure this this negative feedback to hold her back because the problem is there and it needs solving and so love the inspiration you’ve given us with this story Alice and I definitely am taking a little note for myself to stay strong in the in the discussions and things that we do here on the outcomes rocket. So what would you say is one of your proudest leadership moments in healthcare that you’ve experienced to date?

Dr. Alice Han: I would say the most satisfying thing or moments have always revolved around being able to change perspectives on this problem. I spoke a bit about the experiences from the Tedx talk but this also led to other endeavors including a piece I published in CNN and recently I was invited to speak in Rio de Janeiro at the World Congress of OBGYN on the role of advocacy by OBGYN’s and health providers on addressing violence against women worldwide. And I can tell you it was a thrilling experience perhaps one of the proudest moments was after my talk hearing back feedback from audience members that they felt inspired and they also wanted to join in its advocates to address this problem. It was just it was immensely satisfying to be able to change how people see this problem and help shape a solution oriented mindset towards the problem.

Saul Marquez: Well I think it’s it’s a wonderful thing and kudos to you Alice. I think today you know sort of being Martin Luther King Day you know there’s nothing better than than just a message from a leader that stood up against all just injustice, inequality, and said I’m not going to put up with that ominous keep speaking from my heart, from my mind. And the difference has been made and Silas you’re making a difference for this movement as well. I encourage you to to keep doing what you’re doing. So with that, I want to give an opportunity for you to go through the lightning round we’re about to do. This is going to be the short syllabus of Dr. Alice Han on resolving this problem. So I’ve got five questions for you actually four questions for you lightning round style followed by a book that you recommend to the listeners. You ready?

Dr. Alice Han: Okay shoot.

Saul Marquez: All right. What’s the best way to improve healthcare outcomes?

Dr. Alice Han: If I focus on violence against women I would say that health care providers we all need to have it on our radar. The World Health Organization does not recommend routine screening but we need to see it as a potential problem being faced by all of our female patients. We need to be comfortable in detecting and encouraging disclosure other problem and when when it is disclosed feel comfortable to provide support and help connect women to support services.

Saul Marquez: What is the biggest mistake or pitfall to avoid?

Dr. Alice Han: We have to stop thinking that this is someone else’s problem, that it’s for the lawyers or the social workers to work at. As medical professionals, violence against women is our problem.

Saul Marquez: Love it. What’s one area of focus that drives everything for you?

Dr. Alice Han: The belief in the human right of women’s health.

Saul Marquez: And this last one. Alice is a two part question. What is your number one success habit? What is your number one health habit?

Dr. Alice Han: What keeps me on the road to success is that I need to keep feeling inspired. I need to pursue what invigorates me and I need to feel that I’m leveraging the privilege I’ve had for social change. Terms of my health habit, I like to stay active. One of my greatest new addictions is surfing.

Saul Marquez: Oh nice. That’s awesome. I’ve never tried I tried I did like paddle boarding once and I just never got into it because I don’t live by the ocean.

Dr. Alice Han: The problem for me as well but I find ways get up there.

Saul Marquez: That’s good. That’s good. Well you know you’re you’re a globe trotter so you’re always finding it with you. I love that, Alice thanks for sharing that. And what book would you recommend with the listeners?

Dr. Alice Han: My favorite author of All Time Is Paolo Coelho. I love all of his books. His writing is poetic, emotive, and his lyrical paragraphs, to me they flow like music. However, a book that I enjoyed immensely which may resonate more with your listeners is the Originals by Adam Grant on how nonconformists knew the world. What appealed to me about this book was the inspiration I derived on challenging the status quo and taking a new idea and bringing it to the attention of the world. The book celebrated creativity, initiative, and entrepreneurship. So I do highly recommend it.

Saul Marquez: Love that. Great recommendation Alice and folks again go to outcomesrocket.health in the search bar type in Dr. Alice Han you’ll find a link to that book, a link to her TED Talk, Tedx Talk and you’ll also be able to find the entire transcript of our conversation and some brief show notes. This has been really a fascinating conversation with you Alice. I love if you could just leave us with a closing thought and then the best place for the listeners could get in touch with or follow you.

Dr. Alice Han: Sure. Well first of all listeners can reach me through LinkedIn. They can find me and follow me or message me at twitter @alicehan262 or on Instagram I’m at alice.han. In terms of my closing thought, I would say to any health professionals that are listening I say let’s be agents of change. I’d say that the problem is now in your hands. We have the capacity to empower patients, to support women’s health and make a profound impact in our lives. I say let’s do it.

Saul Marquez: I love it. Let’s do it folks take this as a call to action. It is, now’s the time. You know and this is the day to do it. So really appreciate your time Dr. Han and looking forward to staying in touch.

Dr. Alice Han: It’s been my pleasure. Thank you.

Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration, and so much more.

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