Women in Pakistan Their Leadership Role and Contributions in the Health Sector

A Qualitative Research by Qudsia Mehmood and Samreen Ghauri

Abstract
Pakistani women have played an integral role in their families and communities since well before the beginning of modern day Pakistan. Health is one of the major fields where we can see women in leadership roles, such as managers, doctors, and nurses. This study focuses on the leadership role of women and their contribution in the health sector of Pakistan. In-depth interviews through a set of questionnaires were used to gather data. Most of the women leaders are confident and felt good about the contributions they have made in the health sector. However, they feel that males are still dominating the health sector and that the health sector should be a place for more women to gain leadership experience. Family support was cited as a major reason to empower women in their continuous struggle and successes. Social and gender stigmas were seen to inhibit women from rising through the ranks in their respective professions. Women leaders who have achieved some successes have done so against great personal and professional odds. Many women still need more opportunities to enhance their skills and are in search of resources to help them develop professionally.

Introduction
The importance of leadership is an emerging concept in Pakistans health sector. There are no statistics available that outline the percentage of men and women working in the health sector. The number of doctors registered in Pakistan at present is about 110,000 however not all of them are currently employed in Pakistan. Many are working abroad or often, female doctors do not practice after marriage. It is estimated that 25,000 Pakistani doctors work abroad, leaving about 85,000 for a population of over 150 million. This results in a ratio of one doctor for every 1,764 people. The ratio recommended for developing countries like Pakistan by the World Health Organization (WHO) is one doctor per 1,000 people. To meet the WHOs recommendation, Pakistan would need to almost double its number of doctors to 150,000. And this fails to take into consideration the scarcity of specialized doctors or the true impact of not having women physicians available. For example, there are hardly any female doctors available in many remote areas of Pakistan, making gynecological exams a rare occurrence. Within the health sector there is a big demarcation between public and private sectors. In the private sector women are often seen in managerial or leadership roles, but in the public sector the male to female gap is more visible. This study focuses on the leadership role of women in public and private sectors, their perceptions about personal and professional successes, their definition of leadership and their own bench marks of success.

Methodology
We conducted in-depth interviews of women working at different levels of the healthcare system, from a grassroots health worker to a country head of a health organization. Most of the women interviewed are either leading their own organizations or running a local or international healthcare organization. A simple individual interview technique was used in order to understand womens perceptions of their role as leaders in the health sector, leadership styles, role models and gender perspectives. The interviews were conducted in Urdu, audio taped and then transcribed into English. The total number of women interviewed was 16. These women belong to the provinces of Sindh and Punjab and are working in their regions. Women were not interviewed from Pakistans other two provinces, Baluchistan and Khyber-Pakhtunkhwa (formally known as the Northwest Frontier Province), due to the lack of security in those regions and funding constraints. A questionnaire was also distributed to learn more about womens leadership roles and how they have developed their own unique styles of leadership. The womens responses were categorized into three themes, each of which had their own sub-themes. The first theme encompassed the womens understanding of leadership in general, their definitions of the term and the qualities and characteristics they associated with a leader. The second theme consisted of the womens leadership experience and their personal challenges and achievements. It included their identification with past leaders and any role models in their life who may have been influential or supportive of their own development. Finally, the third theme consisted of the challenges and opportunities that women in the health sector face in general. It took into account the womens perceptions of opportunities that exist for professional growth and development and the general differences between male and female leaders in decision making and leadership style. 5

Findings and Analysis

The health sector is generally more women-friendly than other professional sectors in Pakistan. Women work in many jobs, from those working as cleaners to those working as administrators or still others who lead hospitals or health-related organisations. However, there are many more women in leadership positions in the private sector than in the public sector. The reasons for this difference are multi-fold. 1. Challenges In Pakistan we dont have a culture of promoting women in professional fields. Male dominance is still there. The only level where women are thought as a leader is mother. But professionally, if a woman [achieves] a superior role, she has to work really hard to prove her [self] as a leader. This is one of the very common responses from the women leaders who took part in this project. Most of them say that there is a glass ceiling effect in the workplace. If a woman does in fact reach a leadership position, she has to continually prove her worthiness of the position and she often receives minimal support from her male colleagues. Alternatively, women leaders are often very confident and most of them recognize themselves as successful career women. For these women, leadership is not a talent one is born with, but one that can be achieved by facing challenges and hardships. Essentially, there is a process in learning the skills of an effective leader. One woman discussed the rigors of working so much, explaining, Hard work really mattersespecially now I am working on 20 different things every day. And it demands a lot of discipline. You have to start work 7 in the morning, even when you get back from a social evening you still have to do your work for the night. Another woman said that

without better gender equity, society will continue to lack women leaders. She stated bluntly, The men to women ratio needs to be improved to have women leaders. In Pakistan we dont have a culture of promoting women in the professional field. Male dominance is still there. The only level where women are thought of as a leader is mother. But professionally, if a woman [achieves] a superior role, she has to work really hard to prove her [self] as a leader. (Director of a Health based NGO in Islamabad) This was a very common response from the women leaders who took part in this study. Most of them said that there is a glass ceiling effect in the workplace. If a woman does in fact reach a leadership position, she has to continually prove her worthiness of the position and she often receives minimal support from her male colleagues. Alternatively, women leaders are often very confident and most of them recognise themselves as successful career women. For these women, leadership is not a talent one is born with, but one that can be achieved by facing challenges and hardships. Essentially, there is a process in learning the skills of an effective leader. I genuinely think that if Jazba is not there you cant excel firstly. (Medical Doctor and Director of an NGO in Islamabad) The man to women ratio needs to be improved to have women leaders. (Director of an International Research based Organization in Islamabad) Pakistani women do retain top positions in parliament and the health sector, especially in non-governmental organisations (NGOs), however it is difficult to link their own personal success with any large institutional changes or tangible achievements insofar as womens access to leadership positions goes. It is clear that Pakistani women still have a long way to go before fundamental change is observed at the national level. Among the many barriers they face is rampant discrimination in and outside the workplace. Women are also held 7

responsible for duties within the household. Taken together, Pakistani women must continually prove themselves good mothers, caring wives and capable professionals. This often comes at the expense of their hobbies and social life. 2. Family Support During their personal and professional development many women shared that they received support from their family, but that when they were married it became difficult to balance everything in their lives. A grass root technical health expert working in Punjab Province explained, In Pakistan we have to face a lot of resistance to make a change. Sometimes when you are married, then the other family has some expectations. They dont [consider] if you are working or not. You have to meet those [expectations]. Many women realized the importance of the support they had received from their parents or husband and said that without family support in Pakistani context women cannot be successful. Similarly, some of them recognized their close family relatives as their role models. Others thought that their teachers were major influences on them, while others cited their colleagues or international experts in their field as role models. 3. Decision Making and Gender Differences Discrimination is a common element of all work relations in the Pakistani health sector. The women interviewed explained that men in leadership positions often assign tasks and make decisions based on the gender of their employees. A Director of a research based International organization explained; Their styles of leadership are definitely different, if you imagine two opposite gender (male and female) leaders in a company, a man would be given more preference than a lady. It might be possible that they give more relaxation to women on the basis of her gender with the 8

mindset that women dont know how to work or they are weak creatures, so, they will let you off from duty earlier or in time, even if there would have been a bulk of work left over to be done. Sometimes, women are over burdened for work because they work with accuracy This perspective represents the majority of interviewees in how gender-based discrimination manifests itself in the workplace. However, what is revealing is that many of these gendered views are normative. Many women recognize that gender discrimination is present in the system, but they say that when a woman is in a powerful position, her decisions are often the same as what a mans would be.

4. Meaning of Leadership Leadership has no definite meaning for all women leaders. For some its a learning process throughout life .While some link it with their personal drive and will to strive and achieve some goal. A woman working with an NGO in Islamabad said; You know there are certain attributes that a leader should have to be an effective leader. You have
to know your area really well. Whatever it is, if its running a shop, being in politics, being in a technical role, you have to know your area. There are times when you would be a failure and you have to accept that.

Some women see leadership in terms of gender (male to female difference). Like a senior health activist from Sindh shared:
Women are more courageous. Men cant sacrifice. Benazir Bhutto was a great leader. She

sacrificed her life, a man couldnt do that. A woman has courage and power A creative, hard working, woman who is an inspiration for all, a motivated individual is the definition of a leader for many women. Some perceive that a leader could be in the family and for many women who were involved in this research had early age inspirations from their parents and relatives. Few have said that their inspiration was a professional woman or man. 9

Some also shared that a woman has to prove that she is a leader regardless of whether its in a professional setting or in the home.

5. Institutional Change Women leaders are pleased that many changes are taking place at the individual and civil society level, but in the government very few women are given leading roles that affect policymaking and decision-making. The women interviewed in this research are already in top positions and have made some notable achievements in their fields. The women who are truly struggling, those with little leadership experience or opportunity, may feel different from their seniors.

6. Generational Differences Women who began their careers in the 1960s and 1970s have very different views than those who started their careers two and three decades later. The former group of women consider themselves as having lived through a more repressive time when they believe they had to face more discrimination from society, including their families. There were times when an ambitious woman was not encouraged and had to fight for every advancement in her career. During that time, males dominated the professional fields and very few women worked at all in healthcare. Similarly, some women saw this time as an opportunity because there were only a few women in the field, thus those that advanced became more prominent and faced less competition from other women. Women who started their careers over the past couple decades in general believe that the situation is improving, but that in the workplace men are still dominant and male leadership still is often characterized by discrimination against women. Sexist stereotypes are common. An assertive and aggressive male boss is liked by all, but a woman who leads in a 10

similar manner is considered strict or stubborn. Some women think that nature also plays a role in shaping leadership styles. For example, they think a female boss is naturally less assertive when it comes to making tough decisions such as the firing of staff. To offset these tendencies, the interviewees said women consciously show assertiveness, act rudely and in general, attempt to emulate their male bosses. Negative female stereotypes are linked to a culture and media establishment where woman are almost always portrayed as a submissive housewife, a symbol of glamour or the one tasked with serving the males in their lives. Such stereotypes influence peoples behaviour and expectations. Woman generally cannot reach a top position or become a leader without the support of their family. Many women leaders in our research shared that their families were very supportive, encouraging and caring and were a major cause of their various achievements. Women leaders are pleased that many changes are taking place at the individual and civil society level, but in the government very few women are given leading roles that affect policymaking and decision making. The women interviewed in this research are already in top positions and have made some notable achievements in their fields. The women who are truly struggling, those with little leadership experience or opportunities, may feel different from their seniors.

Conclusion and Recommendations

Women in Pakistan face tremendous challenges to their professional development in the health sector, yet are still contributing their skills, knowledge and leadership abilities in their attempt to make a more harmonious and just society. Women leaders sensed that they are perceived as soft and weak. In Pakistan misconceptions, feudal and patriarchal definitions 11

are more prominent. There is also a need to understand the concept of leadership. This will help to recognise and understand the role of women as leaders. It is also recommended that gender audits of public sector organisations will help to understand the reality of terms like glass ceiling affect and will develop a sense of control in women. Women make more progress when they have family support and in the absence of family support there must be such policies in which women feel cared for and their psychosocial needs are full filled. Facilities like career counselling, day care centres and working women hostels will also enhance the quality and quantity both in terms of female working at the public sector set ups and in far flung areas where women hesitate to go and work. Despite the advancement of a small cadre of women leaders in the healthcare arena, womens involvement at the policy level and in decision-making positions in the public sector is virtually non-existent. Women also face discrimination especially in the public sector and the policies at workplace must be gender sensitive and provide equal opportunities to both genders. This study aims to be a first step in exploring the leadership roles of Pakistani women in the health sector. It is the hope of this research team that future studies will take the next step and explore other elements of leadership in Pakistans public, private and non-governmental sectors. This research mainly focused on women who have already achieved leadership positions. It will be important to also document the perceptions on leadership of women who work at a lower professional level and have had less opportunity to advance.

Acknowledgements On behalf of our team we are thankful to all those women leaders who have contributed and shared their time and personal stories with us. We are also thankful to the

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LDM Pakistan office for their day and night support and guidance. Our special thanks to the Institute of International Education for supporting and providing funding for this research.

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Annexure 1:
Women in Pakistan Their Leadership Role & Contributions in Health Sector

1. Name: ------------------3. Age: ----------------

2.

Father/Husband Name: ------------

4. Marital Status: Single/Married/Widow/Divorced 5. Number of children: 0-1/ 1-2/more than 2 6. Job Nature: Doctor/LHW/Nurse/Activist/Politician/other: -------------------------------7. Number of years in Job:---------------------- Designation:---------------------------Key -Questions 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. What is your job in this sector? How do you perceive your Job? Is there any change in decision-making if the decision maker is woman? How woman bosses are different than males? How will you define your success? What is the bench mark or highlight of your life? What are the challenges in your area which can affect your decision making? What is the difference in Manager and a Leader? Do you see lots of leaders in Health Sector? Are you satisfied with your work or you feel any gaps to be filled? Do political situation and Policy decision can affect your work? What is the link between a women working at policy level and women working at grass root level? Who is your role model in this sector? What are the key facts about women working in the health sector? How do you see future of women in Health Sector? Any other comments?

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Annexure 2: Transcriptions of Interviews

Interview of Ms. Imtiaz Kamal

Interviewer: We are going to take the interview of Madam Imtiaz Kamal. Assalam-OAlaikum Madam! Ms. Imtiaz Kamal: Walaikum Assalam! Interviewer: Madam would you please tell me about you and your writings. Ms. Imtiaz Kamal: When Pakistan was founded, some people say there were only five or six Muslims trained nurses and some says only nurses, but at least someone was there. Then Madam Liaqat initiated a movement and appealed the families to lend their one to her daughter and will send them to England, got them educated and trained, the ladies will return back and we will open a school here, because we dont have trained girls. At that time, I was studying Law, in fact I was not studying rather looking in those books because of political unrest in the country. Hence, sometimes I was able to study them and sometimes not. I wish if there might be 10% of patriotism in people of today as compared to that time, we would not be experiences the worst situation of the country present today. In those days, Pakistan was everyones need and first priority. So as Madam Liaqat invited us to this mission, we put back our books of law in the cupboards and went to do nursing and there were 16 girls in our batch. We went to England, did nursing and midwifery and came back to Pakistan. The nursing of those days was not very interesting to me, because we not able to do anything without the permission of the doctor, like you were unable to prescribe or diagnose. The situation was like, you can not be able to make your boss happy, if you indulge in a work they use to say, What do you think you are, and if you have not taken any initiative his sight said How stupid can you be. Hence, we dont know what our personal identity was, this is the reason I have never liked nursing. Well! Despite of disliking it, I topped in the whole group and was awarded medals because the studies were very easy at that time but I did not enjoy it all. I knew my job what I had to do and after arriving Pakistan I started my work as a nurse to safe mothers life at the delivery of their child. Interviewer: Who was your ideal when you started your job? Ms. Imtiaz Kamal: Midwifery profession became ideal for me. This is a distinct profession and in those days, a person couldnt do Midwifery without having the training of nursing. I lived in England for six years and during this time I took the training of nursing and public health and worked their for a year. When I returned back to Pakistan, I turned the Jinnah hospital Midwifery ward as it should be. I noticed in the hospital that lady workers are not able to work properly, and asked Ms. Liaqat about providing them trainings, they shifted me 15

to Teaching of Public Health School Karachi. There, I felt teachers also dont know how to teach, since then I was the Secretary of Nursing Association, we struggled ahead and inaugurated the first College of Nursing in Pakistan. I went there to study and was from its 3 rd batch, I got the scholarship to study abroad and went to Columbia University to complete my bachelors and then Masters studies in nursing. Interviewer: What are the challenges you faced during your career? Ms. Imtiaz Kamal: The profession of nursing was highly humiliated and people use to turn their backs on hearing about this profession. I worked for 15 years and strengthened nursing association and brought it on international level. I remained out of country of 16 and 17 years I was working with WHO and Internal Plan Parenthood. The biggest challenge I faced was the lack of volunteers to work communities and it still persists. I have initiated Midwifery Association Pakistan, but only a couple of people are involved in it. The Midwifery profession is a complete one, a person can work on individual basis and in the nurses always have to work under the supervision of doctors. Midwife is legally authorized to prescribe, diagnose and has the right to open her own clinic and serve people while the nurse has not the specific rights. Our people and doctors dont know the difference between a Midwife and a nurse. They are also not aware of that the mortality rate has been decreased by midwives throughout the world and not the doctors. Midwife is a specialist in normal obstetric and 85% babies are born normally. Whenever, I tell that I am a Midwife, I am seen with a strange gaze, that Oh! Midwife, they think, these ladies are untrained and only works at grass root levels with no value and skills. In our country the number of Midwives is more than nurses, but unfortunately we dont have trained teachers for Midwifery, so its level is too low and needs a lot of improvement. The maternal mortality rate cannot be declined in our country unless we receive properly trained, equipped and skilled Midwives. TBA train is the complete waste of money, she is an illiterate lady who has not received any proper training and learns all the skills on the basis of observation. In a few countries TBA has worked out, where government has taken a solid step of their monitoring after their trainings as well. When TBA brings a mother to the hospital, she is appreciated by the doctors and hospital; on the other hand in our country they are humiliated on worsening a case. TBAs should be trained to take their patients to the nearby hospitals in case of emergency but in our country the hospitals which are situated 100 of miles away from the villages are not in proper working condition. Therefore, its becomes very difficult for TBAs to react in this situation. Interviewer: Madam! How do you analyze your success? Ms. Imtiaz Kamal: I regret to analyze that I have helped other countries to a greater extent than my own. I have worked in 50 countries through WHO, UNICEF and UNFPA, sometimes I have done consultancy and most the times in those foreign countries I planned with government for the betterment of community, if this much work I would have done in Pakistan, I thought I had brought a vast change for communities here. What I am able to do here is to only introduce the concept of Midwifery and now politicians have realized about us and during their speech they mention the name of midwife with doctor while they are not 16

aware of getting the midwives properly trained in the country. A midwife should be careful about herself and with the lives of two people she plays during the process. This profession has not been supported by anyone even the donors also has not supported it. Interviewer: Have you felt any improvement in womens decision making power as compared to men? Ms. Imtiaz Kamal: Muhatarma Benazir Bhutto set up a committee of three people, Dr. Sathna of Lady Difference Hospital, Dr. Sadiqa Jaffery and Prof. Imtiaz Kamal, she was a lady and had feelings for women but she only made a committee of three people and instructed them to rescue the women of Pakistan from dying. She has set up the committee but cannot meet the expenses as we receive only 6 or 7 lacs annually and it all goes in rent of the institution, we all are working voluntarily. I spend my 4 or 5 hours daily in the office. The name of the committee is National Committee for Maternal and Natal Health, but last year we did not receive any grant, there are many women in our committee but I have never seen that women are doing anything better for the other woman. Therefore, I dont think that woman or men can make better decision unless the issue is completely comprehended and worked on properly. We know our mothers are dying and in every hour three mothers die, nowadays, people say that two mothers die here in an hour, while in other countries two mothers might die in a year. This trend is going on in our country for last 60years and people say that there is a minor difference in it, but why this difference is occurring. Actually, the main thing is sensitivity if men and women would be sensitized and have passion to work for maternal mortality or any other issue, development would be gained in that section. Interviewer: Would you please explain why women are not able to reach the top positions in their
professions?

Ms. Imtiaz Kamal: Because the policies are not implemented by the persons who are authorized to implement it. Ms. Imtiaz Kamal: The educational standard of teaching and nursing has been lessened to an extent that doctors who pass MBBS are not able to work out. Interviewer: Is this a reason due to which women is not able to reach on the top most positions? Ms. Imtiaz Kamal: Yes, this problem still persists because majority of the women stay indoors and unable to do a job outside their homes because of their family set ups. On the other hand, most of the women who are working in health section do not perform their duties for complete hours, in the morning they reach office late and at evening go back earlier. They dont work with devotion. Hence, development cannot occur unless the policy makers and implementers would faithful to their work. The transport system in our country is very weak for women to easily move from one place to another. Some of the causes are genuine and on the basis of which women cannot grow in professional field, I have experienced in my life that a womans responsibilities for home can never be minimize even if she reaches to the top 17

most position in her career. So, she does dual jobs in her life, hence she divides herself into two persons and cannot completely focus on her job. Interviewer: What are different characteristics in women and men styles of leadership? Ms. Imtiaz Kamal: Their styles of leadership are definitely different, if you imagine two opposite gender (male and female) leaders in a company, a man would be given more preference than a lady. It might be possible that they give more relaxation to women on the basis of their gender with the mindset that women dont know to work or they are weak creatures, so, they will let you off from duty earlier or in time, even if there would have been a bulk of work left over to be done. Sometimes, women are over burdened for work because they work with accuracy. This type of lady has different types of problems and men do accept her as a boss. A man never bear a scold from a woman. This is our first generation of women working in banks and I have noticed many times when I go to bank that women dont know how to dress up for an office, they wear party dresses in the morning for duty what they had worn at night. Well! I think challenges are for both men and women only their nature is different. Interviewer: What are the factors affecting your decision making in your profession? As you have told me a couple of minutes ago that your committee is not receiving fund. Ms. Imtiaz Kamal: Yes! We do have problems as we are not getting professional people. Our profession needs highly motivated voluntary and missionary spirit because we safe lives of mothers and children and this voluntary mission spirit would never be generated in you if you aims to earn money only. So, the biggest challenge in our country is of not getting dedicated people to work for a mission. Interviewer: One factor is voluntarism, what are the other factors affecting your decision making? Ms. Imtiaz Kamal: Our Midwifery Association is running on the basis of voluntarism, and we dont have the venue or room as an office. We are getting projects because anyone can challenge the quality of work, we are the experts and perfectionists. I am the secretary of this association and in the same place we have arranged an office for Midwifery Association. Interviewer: Are you not writing to government and Ministers? Ms. Imtiaz Kamal: Government doesnt answer for a letter. Recently, they are writing a draft on nursing policy while Midwifery has no importance here. We are advising them to write two separate policies for nursing and Midwifery because they are different from one another. I am the president of this organization but dont have a desk and chair to sit, although we have four desks and four chairs there, but they are used by the accountant and the other staff. I sit in the meeting room outside of the main office, do some work there and the rest of the work, I do at home. 18

Interviewer: The government is not giving attention on these matters. Ms. Imtiaz Kamal: A USA funded project Takmeel which is now in its final stages, has put its best effort to promote the profession of Midwifery in Pakistan. They have given training of Midwifery to Midwifery teachers and women and millions of rupees have been spent on them, they have received the training but again the question arises of its implementation which I dont know whether be true or false. Interviewer: Who will monitor its implementation? Ms. Imtiaz Kamal: In our country most the times people request for the job of teaching because they consider it easy and whoever thinks teaching an easy job, I think he/she has gone mad. Actually, teaching the toughest job but our teachers copy from ten years old notes and the students rehearse it and pass in the examination, while in the profession of Midwifery practical work is essential, a person can never be a midwife until she has practiced it out. Surprisingly, in our country the diploma of Midwifery is given without its practical exercise. Interviewer: Have you observed leadership in the young generation? Ms. Imtiaz Kamal: It will arise gradually because it is also a necessity, wherever a group exists a leader emerge out from it, no matter how good or bad he/she is. But a group always contains a leader and he/she emerges out from the group automatically. Interviewer: Are you getting women leaders in the section of health, who will move the profession ahead? Ms. Imtiaz Kamal: There are five chapters of our Midwifery association and among these chapters a president does exist. There is a book as Roberts Rooms of Order, in this book instructions are given for president, a secretary and it is taught in the book that how to out resolutions and all these procedures are called parliamentary procedures. We have ordered for its latest addition and nowadays, I am working on it. I have planned to prepare lessons from it on leadership roles to teach the new emerging leaders. Interviewer: Are you satisfied with your work whatever you have done? Ms. Imtiaz Kamal: Because a person becomes stationary on satisfaction, therefore, I dont think rather than being satisfied by something a person should keep on struggling towards excellence. /The biggest hurdle in front of me is, I have established Midwifery Association, now who is going to move it forward with her voluntary work. The profession of Midwifery has some weaknesses and a person with weak education, like if a lady has completed her matriculation from a village with low standard of education, she could not represent this profession strongly. There are some people, but they will also work alone like me. Interviewer: What else you think about the deficiencies in this profession?

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Ms. Imtiaz Kamal: There are a lot of draw backs in this profession and we have struggle hard to over come it but still there are a lot of improvement needed. To achieve leadership a person has work hard with perseverance. Interviewer: Is the present political situations in the country effecting your work? Ms. Imtiaz Kamal: Yes, it effects our work adversely, and there are a lot of problems to be solved. Interviewer: \Government has no awareness, how to protect mothers from dying on the delivery of their child? Ms. Imtiaz Kamal: Yes, it can be said to some extent. Interviewer: What is the difference between a lady working on grass root level and on policy level? Like, the difference between a TBA and a nurse. Ms. Imtiaz Kamal: Please dont talk about TBA, because she is a lady who has delivered a child just after watching a lady delivery a child or if she has delivered her own children. The average policy makers dont know about ground realities and lady working practically on grass root level knows her work very well. Interviewer: What is your vision regarding the field of health in Pakistan? Ms. Imtiaz Kamal: Every Pakistani person should be provided the basic needs of health, which is normally not available. This is my vision but I know that we will not achieve it in our country, till I am alive. Interviewer: Where do you see women leadership in future in Pakistan? Ms. Imtiaz Kamal: The major draw back in medical field is set up of merit in Medical Colleges, in which 70% of women hired and half of them only receive their degrees to be married in a rich family. Therefore, there should be a planning of human resource development and according to it people should be hired. There should be better and equal educational level for all the children. Interviewer: What is the most memorable moment of your life? Ms. Imtiaz Kamal: Fatima Jinnah Medal was awarded to Six people, among them 5 were doctors and one was me and doctors did not appreciated it that why some other doctor has not received it. Interviewer: Thank you Madam. (The interview ended)

Interview of Shahida Azfar

Q: your name 20

SA: Shahida Azfar Q: your age? SA: 64 Q: your marital status? SA: widow Q: any children? SA: 2 sons. Q: your education? SA: Masters in sociology from Punjab University and gold medal for securing first position. Q: is there any other profession? SA: board of many NGOs currently Q: how long have you been working in health sector? SA: see generally in development sector its been 35 years or so. From 1975 till now Q: your current designation is chief of party? SA: yes Q: first of all tell us from where you have started your journey? SA: from where I started my journey I got married when I was studying. I got my degree and went to America with my husband who was doing PhD at Harvard. I worked as research assistant at Harvard University at Massachusetts for two years and then one year. I am not counting that as my experience as that was a research assistant work for Pakistan research study, which I had worked with great names. At that time Harvard was full of them, had an opportunity to work with them. So it was a real path of growth. Then I came back and had two children. I didnt work. So my first professional job was with UNICEF where I worked for eight years. First as a planning officer and then as a program officer. I was responsible for provincial program and that covers health programs, a number of them education but I worked with most of health projects. And then I went to America when my husband died in 1983 to UNICEF New York and worked as program officer for 6 years for Africa. Then I worked as Rep designate for Namibia, a country that was going get freedom from South Africa in 1990 under the UN program of , UN sponsorship. I worked for Namibia for 3 years. I have a long career and I dont want you to listen to all detail Q: tell us that when you started working, was there any role model when you started work in health sector specially on Women and children as you were working with UNICEF for so long? SA: see I always wanted to work and inspiration was this that I wanted to work on women issues. 1975 was international year of women and UNICEF had got very eminent group of international consultant who have worked with them. And I had worked with one of them at my research in Harvard and she was principle consultant so it was a mere coincidence. So I 21

started working with UNICEF on women issues not necessarily on health issues but once we joined UNICEF, then its an agency that works for women and children and maternal child health care is one of the fundamental plans of UNICEF work . Later they shifted to other issues as well like child protection, child rights and so on but maternal health is a very important work of UNICEF so that brought me directly to the health field but mostly to the side of children and maternal health Q: during that period did you see anybody as a role model, any women? SA: mmm see there are two people I can say, one is Dr. Nafees Sadiq, who is a great name, we had personal relations with her, my husband worked with her in the planning commission. So there was professional association as well. And there were role models in family, and its women leaders. Because my Aunt (khala), I am talking about a very old thing, initially there were 2 women colleges in Karachi. She had represented Pakistan in UN and other forums etc Q: what was her name? SA: Zeenat Rasheed Ahmad. She was also the founder, what do we sayyeah foundation university for women. Opened two women colleges and she was the representative of Begum Rana Liaquat Ali khan, she did on her behalf. She was a very very talented woman who got to Cambridge England in those days, having got Queen Victoria fellowship but then off course she was not allowed to stay there for more than 3 years so she came back. In family I had women role models that have worked. So there was an issue professionally. Q: so when you started working in 1975, in Pakistan that was not a time for women to work, there was political instability in Pakistan and regionally, at that time you must have faced some challenges, in fact I should ask what the challenges were? SA: challenges were like as you said very rightly that at that time women were not development field. In job I had to travel a lot to remote areas like in Baluchistan, NWFP where the women visibility was minimum and went to Azad Kashmir etc, so that were the challenges, but UNICEF as an organization is very protective., so the whole office set and colleagues that worked together were very supportive and so was the family. So for me credit goes to my Husband. He was a senior government official, he worked in the planning commission and when he died he was chief economist and had a vision that was so great. So because of the support from my family and my mother helped me and my children were looked after by her and I had all the freedom in the world to workshop that was my main.. .. so the challenges that a normal woman faced was to travel in field and how would be they escorted. For that matter UNICEF had really good environment. So I really had not faced that much difficulty and hardship to be honest to say. Q: if I ask how you would measure your professional success or you think that you are successful. SA: see I feel professionally I am very successful with due respect because I have gone where seldom women go i went to America I was dealing with Africa and other countries which were in conflict, Sudan Somalia etc, there was a huge conflict in these areas and UN missions were working here and the mission went to places where instability was huge. There was no women working in the field, so that were the challenges. Then our executive 22

director wanted work done in rebel held areas. I had to do the programming and I knew a lot about them . there was no access , they were called countries on the frontline because south Africa being a leader in the southern Africa their confrontation and .., anyway leave it, I worked there and I was the first represent designate to work in Namibia a country who just got the independence and was kept being backward because of South Africas anti apartheid policy so the President of that country called me comrade and help build the nation. From there then I moved to UNFP, they took me with double promotion to set up their regional team in Nepal, covering 16 countries and 16-17 high level advisors and did that. Then UNICEF took me as Director for EASTERN Africa covering 22 countries and that again challenge with war, HIV & AIDS, famine, floods , nation building etc for those 22 countries. Then I asked my ED that I want to go back to my region and I came to Bangladesh . Again a country that was my own country sometime. It was very challenging. At that time arsenic poisoning happened and 70 million people were affected by drinking water. And UNICEF was accused for all this and it was not correct that was big challenge for me. Polio was a big issue there. From then, 2001, polio has been eradicated from Bangladesh and UNICEF was leading that, and I was coordinating that with WHO, World Bank, government of Japan and USAID, leading with those missions and prime ministers working for that with the ministries. And then I went to Egypt, it was more better country but it had also some issues like women genital issues, I took them with challenge and girls education etc. the last assignment as in US of child survival partnership, it was a global partnership with UNICEF, I was the director of secretariat of that partnership. Partnership included gays foundation USA, all the bilateral CIDA, etc NGOs etc. after that we developed a partnership on child health . again I was asked to be a director, but I refused because during my retirement I wanted to come back and I came back to Pakistan I was the CEPO for planning commission of Pakistan for a year and then I moved to Islamabad. So for me life was a challenge one after another and ALHAMDOLILLAH I enjoyed it a lot. Q: Yeah Masha ALLAH a long list of Success... if I ask you what was your benchmark and what was the highlight of your career? SA: it very difficult. People ask a lot about what country I liked the most what assignment I liked the most, for me every country and every assignment was absolutely exciting and I gave my best to it. Namibia was exciting because I had to set up UNICEFs office there for the first time. Its operations and a country which had no infrastructure, no system etc and for majority it was black so what best is than nation building? Who gets this opportunity of setting up institutions? W e got experts from abroad and consultants to train the Namibians in immunization and setting up the whole chain , we did trainings basically, trained nutritionist and collected data for planning so its really like building from scratch and when I left. The minister of health said that ok you can leave and I thought how easily they are saying goodbye, so she said we are on our feet now, so ok. That was very rewarding and then I was appointed back in Namibia as regional director and the president and prime minister welcomed me as if I was someone from their own community. That was very exciting. Regional director itself is an interesting job. You are responsible for 22 countries and you are helping them in policy and supervising them. Bangladesh was once Pakistan. It was very challenging to work with them. They treated me like one of them. Initially they thought how would a Pakistani work in Bangladesh but once I went there it was smooth, as 23

if I was one of them. I felt like that. Thats why every assignment has its own challenges and excitements. Q: okay. If I say you are one of the gifted people and you didnt have to go through challenges in personal life. Your husband was cooperative and your family was supportive, but many women in Pakistan are not this much luck they dont have support, so what do you have to say about that. Because you have so much exposure. In Pakistan women in the leadership positions specially in health sector .. what do you think about that? SA: see its very challenging working in our country we have a set up in which womens position is not really very of any equality, family tradition are very, it is particularly very difficult for women in Pakistan for women , that is why I left Pakistan when my husband died. Because to be single and working would have been very challenging without a husband who was very supportive and given a very respectable place. But the main issue is commitment and hard work. Woman who work with commitment and dedication will find ways for overcoming challenges. Q: you are right but there are many women at lower levels but there are very few women on top positions, why is that? SA:I also dont know why is that. Because they are equally competent and committed if not more than their counterparts. My be the system doesnt allow them or may be they dont I really cant tell you because I dont understand why is that Q: ok if at this level if there was a man , would there been any difference in decision making? SA: no I dont think gender makes a difference in decision making, in abilities, commitments etc etc. women might be even more successful because intuitively, to have a better feel for things that comes from intuitive and caring nature but I feel the style is different Q: that was my next question.. SA: my style of leadership is always different. I have been commended by and recognized by my organization, they have given me a certain mentoring role, for women professional in my organizations. Specially first time reps that come to me, why because one, I have total belief in team work and participatory management. That is my, I dont know if you have felt it or not, but that is belief I am practicing for the past 31 years and I have been recognized for that from my organizations and I have built teams that have gone to places now. The manger programs here of UNICEF was my number 2 and the HR officer here, so people I have worked are extremely talented and work in team and I strongly believe in team work, participatory management because I dont know everything, sometimes my drivers have contributed, because they knew better than me whats on ground. So my officers and others, I have taken their suggestions very positively. So participatory management is 2 and result oriented is number 3. I only drive result. I dont drive processes only for the sake of intellectual discourse and discussions, so on. I do that but major focus is on how are things going to be done and at the end of the day the proof of the pudding is in the eating. So for me these three principles have been very important. And lastly I am not shy of giving credit to the people. Give the devil its due and the credit comes back to you. Dont be shy in giving credit to others, they give you back more, so I have as a rep have always given credit for the 24

work my team did. All I did was to identify right people for the righjt job I was always telling people that what there shortfalls were , because its not what you say its how you say. Because I could be the harshest critic without feeling them against the wall. Whatever that takes to get the job done I would always do it first Q: ok one of part of your leadership style is to believe in people. Sometime it happens that when you give more confidence then you get hurt? SA: see it happens but that is more in personal relationships in professional relationships you have to oversee the work. Its not that you give full confidence and let them work on their own and you will dont monitor that cant happen. So when you delegate, first you have to select a right person. You cant delegate to a person who is not competent for that job. You have to believe in that person and then you should find what that person needs to do job. Because every person needs support. Then oversee what this person is doing. Dont just relax and you have seen I dont do it . I oversee the work that I delegate. My job is to relax when its done. I dont sit when its work and I dont sit that oh what a wonderful job done. I am on to the next and next and next. Q: Ok in Pakistan is in turmoils and conflicts etc. if i ask that you compare the work that you have done in so many countries , the challenges you have faced, the decision making powers, how have they changed after coming back here ? SA: see I was disappointed when I came back to Pakistan. The caliber of people dropped. 30 years ago there were people you looked up and really starts and I can name several. Then I have seen that quality of people has dropped down primarily in public/government sector. In private sector they might have but I dont have experienced. First thing is that people have low capability and have no commitment and thats the biggest thing. If there is no capability but there is commitment you can make it but if there is no commitment and no capability then there wont be any work. Thats one disappointment that one finds. And secondly the element of corruption in environment. Capability, commitment and possibilities of production so then that means that you have to be more vigilant i.e. the funds your are spending are used for the purpose. That people are not short circuiting things etc. and they will do what they have to do. So vigilance is important. So my leadership style is why different , I am much more hands on and I am more vigilant and at the same time respect. Q: I guess you have answered my question in a way. Do you see many women leaders or up coming in the health sector? SA: frankly speaking I dont see anybody standing out. There are a lot of people that one should admire but on the other hand they are few and far between. Yeah they are there and working with commitment. One like to see more and more coming in. Q: so does the political situation hampers your decisions in any way? SA: see the political pressure is everywhere, Pakistan is no exception. Wherever I have worked specially in developing countries they pressurize you mostly for job and contracts 25

but dont find it any more here than anywhere, beacsue I believe if you stick to your beliefs and follow your procedures then political pressures are not going to hamper. Q: what is your vision for health sector in Pakistan? Where do you see health sector in 10 years SA: Pakistans health sector could do a lot. See we have been concentrating on building hospitals and infrastructures and colleges, but thing we need is basic health care. And many times this has been experimented in the world. And specially regarding the maternal health care, there were articles of Lancep, when I was the part of child survival partnership, there are 3 great publications that have documented with evidence the simple things that have worked out and brought down the child and maternal mortality. And Pakistan can easily do that. But there is need of commitment to do it is not there fully. The problem is that the basic health care that we can do easily we dont do and we connect to referrals , and system dont work. There is no connectivity. Health system is segmented now because the decentralization was done that was good. Now you see that LHV is run by national, PPHI is a new system, EDOs have ther own programs but the resources are less, so there is fragmentation in the system. So health sector is very complex here and I think the basic health suytem needs to be worked on that will serve the majority of population. Then there are some structural issues. You dont find female health provider. The main issue s how are you going to deliver health care to women and children, because there are no health providers, why there is no health providers, because the girls are not educated. Then from there you start that proper investment is not made on girls education and our society doesnt give preference to girls education , female teachers are not available, society doesnt allow them to be on their own , so there are numerous challenges in health sector. Q: ok a few more questions, women working at grass root and at policy level, whats the linkage? SA; see everybody is working they dont have linkage as per say, but everybody is working in their own level. So the problems of the grass rot need to be addressed so that they work and efficiency increase. The policy makers should know the problems of grass root. But there are no linkages. The thing is the policy makers should address the problems of grass root. And for me it doesnt make a difference if they are male or female thing is issues need to be resolved and policies should be made to address that. And they should include women at grass root in policy making. Q: what is the future of women working in health sector? SA; future is very bright. The need is they should be there where the problems are. They are not in the rural areas where the problems are. The need is to make health providers work in these areas and facilitate them. Facilities should be given. So they can work in those areas. Q: any other comments? SA: no not really Q: thank you very much. Interview with Dr. Donya Aziz Q: First of all some basic question. Your name? DA: Donya Aziz. 26

Q: Age? DA: 33 years Q: marital status? DA: single Q: education? DA: MBBS Q: professionally you are a doctor? DA: doctor & politician Q; how long have you been in health sector? DA: almost 10 years. I completed my medicine in 1999 Q: ok, designation MNA? DA: MNA, previously I was parliamentary secretary. Q: tell us something about yourself? DA: I am a MBBS doctor; this is my second tenure in Assembly on reserved seat on PMLs ticket. In the last government I was parliamentary secretary for Ministry of Population & Welfare and I was representative for national Assembly from PMDC. And I was the representative for PMDC from Pakistan Nursing Council. And I was a member of health committee. This time I am National coordinator for the platform for HIV & AIDS and its chairperson is Ms. Yasmeen Aman. Again I am a member of health committee. Do you also want to know outside assembly? Q; yeah tell us more what else you do? DA: I am also member of South Asia task force on womens rights and reproductive health and recently I have become the chairperson of South Asian Parliamentary group on HIV & AIDS. There are 2, 3 more things regarding health, I have forgot right now Q: I would like to ask how you have come into politics being a doctor. DA: my interest was in public health since I was in medicine and I didnt have much interest in clinical health. My professor had a great role in this. He taught us. He developed the interest in us. And when you work in a government hospital and you have a privileged life style, and I dont belong to political family, I belong to a city and I dont have a village where you can see what you experience in government hospitals. So that I why I was interested in public health, it grew. When I graduated in 1999 I went to America and did research in intermediology and then when I came back I thought of working same domain and was looking for work. At that time reserved seats were announced. My parents and specially my brothers encouraged me a lot to join politics. They said if you want to do something for public health then the better way is join politics or you would work in an international organization. So then I applied and I was very lucky that after getting into assembly the portfolio I got was of my field and my interest. And I got an opportunity to be a member of health committee. I Alhamdolillah feel myself very lucky, the things people did not like politics they said to that that how pity is that you got population etc. but I loved it and even in college I loved this issue, reproductive health, population dynamics and what not. I have enjoyed it and I thought I had a good productive time in the ministry. I have learnt a lot but I dont know if I have really contributed. Q: ok Dr. Donya its been long that you have started your career, was there any role model when you started your career? DA: in health sector? Q; Yeah 27

DA: like I said Dr. Ali Mayer played a very important role in developing interest in community medicine. Then in politics there are many women despite having political affiliations have not taken Benazir as role model, her lady health worker program is an example in the world. It was her vision, being a woman she understood the requirement of resolving basic issues with the health of women. So when I met her and I met her once and it was 3 years back and I appreciated her for her Lady Health worker program and she said that I knew that women could be able to do this. Its a huge success that this was the only program in health sector that was appreciated all over the world. Its a very big thing for Pakistani women. Q; ok tell us politics is an uncertain profession, you must be facing many challenges and how are coping up with them? DA: challenges I must say situation has changed in the past years. The mind sets have changed. When we entered in assembly in 2002, the mind set was very different and male members and our female colleagues who were on general seats have always had differences. But I think you might have seen in past 6 years, you might have seen that the women on reserved seats are more active. They give callings, present bill; participate in every committee and most of the work 70 to 80 % parliamentary work is handled by women. So it was a big challenge and we had to work very hard and we could tell people that women do have an important share in assembly. And there have been changes in society. The presence of women in top bodies in politics generally has an effect on overall society by changing the mindsets in other fields. I still remember when I was in college, I was always told to when you would be a teacher or doctor... we were never told that we could be bank heads or etc... But now with the media and political women have excelled in every field and men have to give them space to them. Not that in every field there are reserved seats like assembly in every sector but the blockades have been removed. So I must say that these were very very big challenges and we have overcome that. Not that we have overcome that fully, there are many issues like sexual harassment and we have presented a bill in assembly. They will change but will take time. We should be realistic that it wont happen overnight. You will see these issues around the world that women face. But what we can do is we can tackle this together. Q: how would you define your professional success? DA: my professional success? Well one is that you are interviewing me (laughs). You have started your research and you thought of taking my interview. I think that is because I have done something right somewhere that you consider me leader in this filed. I think the happiest moment professionally is that the issues on which politicians would never thought of listening, because I was the doctor and I could talk on any issue if it was about adolescence or inclusion of reproductive health in curriculum at many platforms, I personally am satisfied that being a politician and being an MNA I was able to say all this. There were many barriers and people started listening so if things are brought into light so work could be done Q; so now what is the benchmark of your life? DA: I dont know. I have never had a benchmark. Every day you come up with new things. I have never had one. I have trusted ALLAH and ALLAH has always been kind to me. Q; ok, tell us that in health sector, women in grass root level are more than women on top levels. As you said that you were the first women to go in the population ministry, so why is this/ 28

DA; the major reason is that we have almost recently came to assembly in this number. 6 years is a very small time fragment. Women were less on policy level before. I mean in national assemblies there were only 4 women and others were male. Out of that four, women were on leadership positions, one was Mohtarma Benazir herself and the other one was Shenaz Wazir Ali. Shenaz Wazir was always placed on top level by Mohtarma. Then before that when women were less, Dr. Atiya was population minister. Abida Husain has been population minister. So there have been women but they were very few at that leadership tier. Now those women are coming up to that leadership tier you will find more and more women taking up leadership positions. And you women feel apprehensive in going to civil sector because you see; you tag a woman to certain topics that these are only womens area so they should be quiet and do this only. Like women development and women uplift topics etc. Defense is not considered as womens topic and up recently economic affairs was not considered as womens topic and information etc. but in last assembly and this you see women taking up these roles. But women have natural sympathy and empathy for development sectors. I feel also good that they have not limited to social sectors and have gone to others areas too. Q: yeah not only in political scenario, but like EDO health, you wont find many women in these positions? DA: then you have to look how many women are in DMG group and is the environment conducive to women to be Edo Sukker or Layya? Would it be safe? She will have living facilities etc. Its unfortunate that women like in my class they were 75 % and men were 25 %. All those men are working but out of 75 % women only 20 % would be working. And this is something that when we talk about women in leadership and womens role in leadership we must be honest with ourselves. It a big lacuna. If we want to fix it then we must be honest that yes its because that 80 % women in health sector have health education but are not working and sitting at homes. They are housewives or raising children. That is an important thing but when you have got education on government subsidy and you dont give back then you are, you yourself are not bettering the cause of women. And women should feel comfortable in their own roles to be able to be honest because thats the first thing. Because if you are not able to fix a problem. In our heath committees we always come across this problem and we are looking for some solution either those girls serve their country or after giving services she develop interest in becoming EDO health. So she might give CSS exam. But there is a need of push so we are trying to do it. Q; ok, Dr. Donya what do you think decision making power of women differs from men? Like a man in position of women. Will there be any difference? DA: yes, there is. I dont know men always try to show that they know everything and they dont need any ones help. Whereas my experience is that if woman is in mans role show would try to get best input from everyone and make decision based on that input. I guess there is some natural thing. Men feel shame in asking whereas women dont Q; so leadership styles are different? DA: Yeah leadership styles are different. Women are more inclusive. But it depends. What I have experienced is that its an issue that woman is womans enemy. But by and large I have 29

seen that if women is in a leadership position and she is inclusive she is also open to taking input from them and basing her decisions on them. Which is very good because its a leadership style that is not imposing from the top but collective wisdom, bringing collective wisdom forward, naturally women are more towards collective wisdom rather than imposing from the top. Q: you yourself practice same? DA: yeah it depends on case to case. Sometimes it is important to impose from the top and to exert you. Initially i had exerted a lot. When I joined I was very young at the age of 21 and people were very older to me. So it took time and they realized that she wouldnt be adverse, so then collective wisdom started. Q: If I ask in current scenario, like there is political instability, does it affect your decisions? DA; being a woman or generally? Q; being a woman/? DA: being a woman No. political instability doesnt differentiate between men and women. That generally affects your decisions. See in leadership its always easy to put weight on the shoulders of politician. But you have to see exactly the relationship between bureaucracy and politics. And I think that with the condition of degree this dynamic is changing. I can tell you from my experience that for so many years that are not used to being asked so many questions by their elective representatives. But I tell there women who are doing most of it, especially at committee level, women are more active. Asking the bureaucracy why, when, where. It should cultivate leadership. Q: do you see many women leaders. DA: yeah. In our civil society you see women in health sector and it very good in health a population. In Parliament there are so many doctors who are in parliament and they are coming up. The most dangerous indicators in our health sector are women related and why the indicators are to be fixed because the decision makers are men. I mean even health ministry never had a female health secretary. There was once a woman DG. She was from army. This is because men are the decision makers. As a nation we should realize that these are the worst indicators and we have to fix them. Q; do you see any link in the women at grass root level and at policy level in health sector? DA: yeah there is difference. I think at policy level; unless you take input from grass root you cant make good decision. You see it sometimes become difficult. You see government is political machinery. People at grass root demand different from policy makers and they rightfully do so because they interact people at grass root level, but at policy level it becomes almost very difficult to implement all. Q; are you satisfies with your work? Any gaps? DA: no there is a lot to do. We have a lot to do. We are nowhere near to success. Regarding gaps its implementation. Who doesnt want to make its constituency to be healthy but the gap is because at implementation level they are not taken on board. And frankly speaking there is no accountability at every level. It very difficult to actually get a definite answer. For example its been 6 years I am in committee; I have always asked if you have told the MNA 30

or MPA of that constituency about Polio Campaign. But they have never told. These are major implementation gaps. Q: ok what is your vision of health sector in Pakistan? DA: see my vision of health sector in Pakistan is that we at least provide the basic services that are required. The mapping that we have done, and the work in files if that is implemented I think problems will be minimized. Q: and what is the future of women in health sector? DA: I see very bright future in health sector. I think as society changes and more and more room is made for women in policy making and in grass root working, you know there is something that my mother always told me that if you can do work being a woman you can do everything. The only thing that stops a woman is the wrong thinking of the society. The results in the last week have shown that girls are definitely smarter than the boys there is nothing to stop. See if you work in the limits of your society you can do everything. Q: Any other comments? DA: I think I have said so much Q; Thank you Dr Donya

Interview of Fatima

Interviewer: How are you Ms. Fatima? Would you please tell me about your job in this sector? Ms. Fatima: I am Fatima and my job is a sort of managing this organization called Ahang. My day to day responsibilities include work plan with different departments and our a lot of work is revolving around advocacy and making sure that these policies are being implemented, working with government, trying to share their working with different organizations and expanding the scope and an axis of sexual reproduction and health. So, there might be an education all and all in Pakistan. So, I am actually involved in this kind of work. Interviewer: What is your age? Ms. Fatima: I am 29. Interviewer: Are you married? 31

Ms. Fatima: Yah! Interviewer: What is your spouses name? Ms. Fatima: Mr. Ayaz Abdullah. Interviewer: Alright! Do you have kids? Ms. Fatima: Yes, I have one daughter. She is one year old. Interviewer: Ok! For how long have you been working here? Ms. Fatima: I am working in this organization for the last 6 years and before it I was working in Agha Khan University, Institute for Educational Development and did my duties there for six to eight months and before that I was studying. Thus, my total number of experience is six and half or round about seven years. Interviewer: How do you perceive your job? Ms. Fatima: Majority of my job is related to managerial position, like if my job is counted as 100% than I will say that it is 60% related to management which basically insuring smooth running of the organization and HR related issues and program management. Then, I would say that 30% of it is advocacy and growing the organization and expanding our work for health and rights related activism and 10% would be providing some kind of services. Interviewer: Did you have any ideal personality when you started your work in this sector? Why did you join health? Ms. Fatima: My initial studies are all in medical, I did my intermediate in Pre-Medical and then my Bachelors education also included medical subjects. I want to become a doctor but my councilor in college advised and made me aware that I would be more suitable, if I work for public health because I had the desire to work for community and poor people. I took his advice and went to public health. I didnt really know about sexual and reproductive health when I started off, it was by chance that I joined this organization. I heard about it and was quite fascinated about that how can an organization work for sexual health in Pakistan. So, it was the curiosity which led me towards Ahung and some predetermined thoughts and passions. Well! I developed a passion for reproductive health after joining Ahung and since I was in my high school, I was very passionate about womens rights issues and gender disparity really bothered and frustrated me. Interviewer: Did any one give you inspiration about this field? Ms. Fatima: Well! I have been inspired by different people in different phases of time. I have been inspired by Ms. Zeba Sattar from Population Council, the way she carries herself and the way that she speaks, her commitment to the field. Recently, I have been very inspired by Mr. Sher Shah, he has been so determined and active in the field, so different people have inspired me along the way. I have also taken inspirations from people in other organizations 32

in foreign countries, when some people, I come across in the field and she is one of my colleagues actually and I am very inspired by her. She has come from Norway and from High Income background, although she is not very educated but on a senior position in Ahung. She is one of our leap training and supporting her family. Hence, these kind of people become a source of my inspirations, especially the women who beat the odd ends and beat the circumstances they are put in. Interviewer: What are the challenges you faced during your work? Ms. Fatima: The biggest challenge is that I am young, a woman and not a doctor. I thought that if I would have been a male, older doctor, I have received a lot respect that I literally have to face resistance from participants in trainings and sometimes when I attend the meetings and give my suggestions people dont take it seriously. Even, sometimes when people start me calling as a Dr. Fatima, then I correct them and sometimes I dont correct them because I thought to let them think as I am doctor, only in order to take me seriously. The minute I tell them I am not a doctor, automatically, their respect level goes down. Once a male doctor was warmly appreciated for suggestion but when I said the same thing, I was completely disregarded. So, I think the biggest challenge for me has been this, which I think I couldnt control. Interviewer: But at the same time, it is also your strength that you are young, a woman and not a doctor. Ms. Fatima: I personally, dont think that I have this limit and sometimes women are more better in doing things than men. Mainly, you dont have to be a doctor to do all these things but it is only the respect you get from your friends, other colleagues and sectors and this thing sometimes becomes more challenging. Interviewer: Despite of all these things, you are very good in your field, so how do you think about your success? What is the secrete of your success? Ms. Fatima: I think, I am very hard working, consciousness and whenever I made a commitment, I dont want to disappoint people around me. Even when I was pregnant for the entire nine months I came and fulfill my duties and never shrugged off my responsibilities and take my professional responsibilities extremely seriously. I think this is probably, the reason of my success. I have a very supportive family, my husband and colleagues are very supportive. The work environment in Ahung is very conducive for being able to succeed and to continue your work, as you can hear my childs voice at the back, Ahung facilitates a woman to continue her work and bring along her baby and every organization is not supportive in this sense. Interviewer: Working women have great responsibilities and they have to balance it by all means? Ok! Fatima, now, please tell me that what is a difference between a manager and a leader?

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Ms. Fatima: I think the fundamental difference between a leader and manager is that the people who work with a leader are inspired by him while a manager gives directions and vision for the work and he makes it sure that the job get done in time, I dont want to undermine a manager as sometimes a manager has to become a leader too. A leader can also be a manager, there is not any hard and tough qualities, sometimes a leader also contains the qualities of manager as well. There are very few people who are both leaders and managers, even at Ahung we had different types of people, in my experience I have noticed that there some people who make it sure that the work gets done and make sure to achieve the target. But they dont know how to define the target and a lot of times it happens to me that we decide to write the proposal in a certain way but then we think that it would be great idea if we do it in this way and try different kinds of approaches. There are some people who only concentrate on completing a task, I think they are only managers because they dont beyond. Interviewer: Do you think women are able to work as a leader and manager? Ms. Fatima: Yes, of course. Women have every capacity. There are many women who are talented and changed themselves successfully. My biggest weakness is that I can not delegate, as managers have the quality delegation. I think that asking someone else to do a particular thing is not worth and they will take a long time, this is not good quality because in this way you dont develop other people. Although, over the years I have changed a lot and try to delegate more to people but still this habit exists in me and I still feels that it is the area of my weakness. Interviewer: What difference do you think there would be decision making of a woman and a man? Ms. Fatima: I think women decide on the basis of emotions as well but men without it keeping view the financial and other aspects in minds. It is probably, due to our socialization that women are more sociable then men. Men are raised with a thinking of supporting family financially, therefore they keep in mind all the thinks relating to costs, while a woman thinks about cost effectiveness as well in how people might be made happy through it. Interviewer: What is the reason behind that women could not reach the decision making positions even in the area of health? Ms. Fatima: Perhaps, women have to give up their ambitions after getting married and having children, because then their primary responsibility is to take care of their children and family, no matter how supporting is her husband and officer but over all she has to take the responsibility of all house hold tasks and family. So, most of the women quit their jobs and stays at home. Dr. Ms. Shamshad Akhtar, the banker and Ms. Mushraf Hai and many more women who reached to the top most positions are unmarried ladies, and there are a few women who gained this much success taking their family along, Ms. Benzir Bhutto is an example, but she had a hierarchy in politics and a different case.

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Interviewer: Hence, you stated that family and kids can be a hindrance in the way of progress. Ms. Fatima: Yes, unless the mindset of people with rigid social taboos is changed. Even, if you take my own example, if my husbands comes late at home at night, it doesnt make a difference but if I reach home late for a single day, it will make a big difference for my kids and family. Similarly, if my husband stays out of home for a week on a business trip, it will not make a difference for my kids but it will, if I do it. So, there is a difference between men and women and I dont when it is going to change. Interviewer: Please, explain some factors which effects your decision making as a woman leader. Ms. Fatima: I dont remember any example when it would has been a problem for me to make decision as a woman leader. I dont know. Yah! Interviewer: Have you found emerging leadership in the sector of health? Ms. Fatima: Yes, definitely, it is. I think more women are entering in health and reproductive section of health. You will find more women if you be the part of a network on health and attend their meetings or seminars and there would be more women in leadership roles. Interviewer: Do you see it on grass level as well? Ms. Fatima: Yes, there are at grass root level as well. Interviewer: How do you perceive roles of the groups LHV and LHW as they are also leaders at grass root and community levels? Ms. Fatima: Personally, I dont know about lady health workers and lady health visitors, therefore, I cannot really comment on that, they might be the service providers like nurses, doctors, Midwives and female welfare workers who are associated with Population Welfare Association. The councilors appointed by government are working efficiently and they are the strong role in a community and the community looks up to them for the solution of their problems. Interviewer: Ok! Fatima would you please tell me that, do political policies or chaos in the country effects your work? Ms. Fatima: Yes, it definitely does, because our main task in Ahung is to work with government and other organization to include sexual health context in their work and if a fair and good leader emerge in a ministry then our work goes on smoothly, like the current Secretary of Population Department Mr. Sadiq Memon is a brilliant man and strongly committed to his work. During his tenure a lot of NGOs got connected to ministry and a lot of projects have been gone through and when the ministers change every thing goes back to 35

zero. Same happens in education department our work is done in a more better way if a cooperative EDO comes on seats and EDOs change very abruptly. Interviewer: Policies also affect a lot on the working of organizations. Ms. Fatima: I think policies dont have that much effect. Interviewer: Because they are related with budget that how much is going to be spent on certain project. Ms. Fatima: Yes, as this year our health policy is fine and all the policies on paper are very good but problem arises in their implementation and the implementers can make difference if they are honest, dedicated, hard workers and practical whether the policy is good or bad. I might have contradicted my self in this sense, first I used to say that policies really make a difference but now I have changed to what I have said initially that policies do make a difference but more than policies is the people at the grass root level and people at the provincial and district level leadership who makes difference. Interviewer: Fatima! As you work in the government sector, have you noticed that women in this section can implement policies on the due to the presence of emotional quality in her? Can women work more effectively due to their passion? Ms. Fatima: You can see Ms. Nasreen Jalil who is a Naib Nazima (councilor) of Karachi and in a high leadership role. Her contribution in Karachi is great as you can see the progression in the city for the last two years. She understands well educational and social welfare projects and promote them. I think women in ministry and leadership really thinks about for the betterment of communities rather than just about economics. Interviewer: What is the difference between a lady working at grass root level and at high level in the health sector? The woman who works at upper level has power and the one working at grass root level dont have it. Ms. Fatima: I think the lady who work for communities at grass root level have more honour and authority than the ones on policy level as most of them are elected on the basis of quota and act as dummies and prove to be weaker. So, this is my feelings and I dont have any evidence to prove them but this all from what I have observed so far. Interviewer: What is your vision in health sector? Ms. Fatima: I wish none of the woman should die from pregnancy or from any form of violence like domestic or sexual violence, this is the thing which touches from my inner. My vision for this country is that there should be provided justice to the victims of sexual and domestic violence which includes children as well. Yesterday, I was reading from the newspaper that somebody who was sent to jail in a case of rape, he was quitted by the Shariat Court. So, the criminal was once again free.

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My other hope for the health sector is, every woman and man may have access to health care, especially if you look into the rural areas of our country the access to health sector is devastating and most of the times their suffering is not very serious but due to lack of treatment they die and this is a big injustice with them and also a human rights violations that they dont have access to their rights. We have one of the best policies in our country but they are not implemented, if they should be implemented, monitored and accounted then would also have facilities here. Interviewer: Again, the point arises that political do effects on all the fields. Ms. Fatima: I have seen in the NGOs sector as well that they get projects to make money. I dont know when it is going to change because this corruption exists at every level, people are trying to cut corners. Hence, law making and enforcement have to monitored and these kinds of things will be diminished. Interviewer: How do you see women in the sector of health in future? Ms. Fatima: Definitely, I want them to join this profession.

Interviewer: Do you think there would be change if we move them forward as a leader in this sector? Ms. Fatima: I have seen numerous women becoming corrupt on getting leadership and power, I dont think it is a matter of man or women rather a matter of responsible and honest individual. I think if such kinds of people are pushed forward to make a difference, they can do so. The change can be about by sensitizing youth regarding gender sensitivity, equity, honesty and commitment and the media can play an important role to change their minds. On the other hand, family and peers and the surrounding environment play an important role in developing and shaping your personality. Our religion can play an important role for better mindset rather than focusing more on rituals. Interviewer: What else you want to do in life? Ms. Fatima: My dream is to provide shelter to the needy and poor people and stop the domestic violence. There are very few organizations who are doing do. Interviewer: Ok! Fatima, thank you very much. Ms. Fatima: Thank you.

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Interview from Dr.Sania Nishter

Qudsia: First OF all tell us something about yourself? : In urdu or English? Anything, u r comfortable with. : I am basically from NWFP, I belong to a Urdu speaking family. I got all basic education from Peshawar. There was a lot emphasis on extra curricular activities. I always participated in extra curricular activities. My parents always supported me. So I participated in every activity. Then I entered in medical field. Did my medicine from Peshawar I graduated in 1986.For 7 years I did not do anything. I had 2 children. If u look at my cv u wont find anything for 7 years after graduation. Outside Pakistan I have to tell people that I was married and had children thats why didnt do anything. Then I went on vacation to England and gave exam of MRCP and got through in first attempt. Then I came did some training and got membership. Then I did cardiology training and then worked in UK. Then I setup this thing and yeah before that I worked as consultant with PIMS. Then I go t interested in Public health and prevention. And I set up this NGO. It was a very small set up initially. The building u r sitting in was our she. I took a single room and bought a computer out of pocket money and set up this NGO. The purpose was to create awareness amongst people about heart diseases as I was a heart specialist. Then it grew and I learnt on job as I did not know anything about organizations working. I was trained as a cardiologist, I as trained how to save peoples live but I didnt know anything about governance, management and running of an organization. Then I kept expanding the organization and meanwhile I went to UK for a Ph.D. That was a very busy time in my life as I was doing PhD , managing my NGO and I was working as consultant. Three jobs I was at the same time and then a time came when I completed my PhD and came back resigned from PIMs job as the work had grown here and I could not do justice to all. After that its a long story. I worked with government and made a plan of action for non communable diseases. Then I got interested in system because I learnt that problem is not with sectoral planning but its with system I wrote my second book then. Then I made a coalition of partners called the health forum. And after that off course there has been series of things in the organization. Heartfile is 5% f my total work. Most of my work is international. Ii sit on different task forces and committees , board of governors, directors and expert with different organizations most notably with WHO. I have worked in the Geneva office on honorary capacity. Q: I have a question here. Obviously reaching this level of expertise being a woman is not an easy task in Pakistan. Tell us about the difficulties u have faced? SN: u have to be very committed to work, for many people work is just work but for me work is not work its the main interest in my life. I cant recall a single day even when I was on holidays, I always had a book and a file in my handbag and I work round the clock. So for me work is not only work u have to be passionately involved in what you do. And I genuinely think that if Jazba is not there you cant excel firstly. Secondly hard work really matters because, passionately work is different, very

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disciplined hard work really matters, specially now I am working on 20 different things everyday. And it demands a lot of discipline, you have to start work 7 in the morning, even when you get back from a social evening you still have to do your work for the night. When people go and have holidays I cant. When people relax I cant I dont have the time. I am not complaining, this is what I have chosen and I love to work. So you have to have a lot of passion and discipline required to excel. These are important. Q: when you started work what were different opportunities & challenges you faced? SN: there were a lot of different challenges at different levels. When I was working as a cardiologist and there is patients you come across. Some of them couldnt afford and the hospital dont have resources to accommodate them I was frustrated at that time, that was a challenge and when I worked in UK that was a whole new world very different from here. And when I started organizational building, by the way when I was working in hospital I never faced discrimination between men and women which is a lot people complain about, when I was starting my organization I had no guidance. Because when you start an organization in developed countries they have mentoring programs which you go into and educate yourself, and mentor yourself I started with nothing, I had to learn while starting my organization what articles of association and memorandum , when chartered accountant comes into play , whats strategic planning, what really audit means all I had to learn myself through trial and errors and a lot of mistakes. I didnt know what HR management is. I took it positively and I have developed a skill. And with respect international work I find really frustrating is limited mobility because I have Pakistani citizenship which I greatly cherish. I have international work and I am based in Islamabad I have to travel all the time , so the flight connections I have had, there is always an element of suspicion where ever you go. People I work with are very welcoming but at airports they have suspicions. So thats the nity gritty challenges I have faced. Q: so have you face many problem due to gender? Was there any challenge related to being women? Like if you were a man you wouldnt have faced that? SN: its a very difficult question to answer. The standard answer would be yeas there is a glass ceiling. Women have been discriminated. I have never experienced it in a very glaring way, off course there had been different forms of discrimination. If a person is coming from civil society you are a very different person. I wouldnt that I have significantly felt discriminated against on the ground of gender . you know honestly I cant recall any such incident Q: Has your family been supportive? SN: yes my has always been fully supportive of my work, its an important consideration, you know where ever I look women working seriously, they are working on the cost of time, on their own well being, they have to work as mothers, have to fulfill social responsibility and then you pursue a very aggressive career so people like me dont have time for themselves. I always tell people that I have two stacks of wardrobes, one has stitched clothes and the other has unstitched ones. The one full of unstitched looks for stitching. You have to do lot of sacrifices. I cant exercise, dont have time. So its life that I have chosen my self

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Q: ok, so when you started your career did un have any role model in front of you ? especially when u started your organization? SN: No, I had no role model at all. There are two things, when we were kids my mother was very keen that we, we were three sisters, that we should have professional life. We were really irritated but you when somebody keeps saying something that you have in back of your mind. my mother was very very very keen that we should have professional lives. Thats number one. Although I lost my father at a very early stage but I remember his personality and demure . His interpersonal relationships and I emulate them, he was never loud, even when he has to pass through door, if there was a servant he would let him go first. So when I was a child I used to emulate his style. But in terms of professional, specially when I started my foundation. This is I always tell people, people intern with us, I always tell them , feel in an open sea, dont set boundaries. And you can go anywhere. drowning can be a risk. Q; how would u define your professional success? SN: I have set very high benchmarks for myself so I wouldnt say that I have succeeded. Q: ok, u havent reached a level of success? SN: no you really have to reach a level where you can have an impact ,m you can change peoples lives. I think there is a lot more to be done here. Although I have achieved many milestones in my international work but I think unless I deliver to my own people I can never attain success that I hope someday I will Q: what are your benchmark? Any one that you have said yeah I have achieved? SN: no I am very away from that , I havent reached Q: dr sania you are one of those women who are on the top. But there are many women in health sector that couldnt reach that top level / why is that so? Whats the reason behind it? SN: see, you have to define top, for me if I were only the cardiologist then i would be a professor that is a tope for me. And you can see many women professors. They have reached the height of their careers there are other some other in different departments those face leadership glass ceiling, so there is leadership ceiling. You cant generalize my example as I entered into an open sea and went from one thing to another. And I experimented with different things, that are a risky thing. The higher the risk the higher the stakes. There are many women achieving. So I think there are many women. Q: do u see many women in health sector? SN: in policy arena? Q: Both SN: I mean leaders in the policy arena could be politics and civil services. But the denomination is not significant. If you want to have leaders than you should have more denominations. The men to

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women ratio needs to be improved to have women leaders. Literacy is improving. A lot of women are coming in the field I hope situation would be much better. Q: what are the present challenges? SN: I dont call them challenges or they may be in a way, I now work in the area of policy a analysis its like looking through a window and looking into the room seeing whats need to be done and knowing how to do it but your not the one in the room at the realm of things. Thats a bit, its not frustrating because I chose to be on the other side of the window but its disappointing to see things the way they are and its very disappointing to see the petty behavior of people who can make a change. So that bit is very saddening and disappointing I see government have lots of resources and lots of money at hands, they have lots of lots , access to ample resources but they cant use because they are not interested to do it. Thats sad. I am not frustrated right now; I am networked with many initiatives around the world. I dont have any major frustration at this point except for the fact that the . Q: why is that a constraint? You are member board of many organizations so why couldnt you get resources? SN: you see problem is that I dont run an implementation organization I run a think tank and I have to do most of the work myself. Think tanks usually, one, are centered on individuals or they are very high budget initiatives, very high budget because you have to attract best minds. And i dont want to take responsibility of mobilizing money and end up working myself, that has happened for the past many years, work started but I couldnt find the right people so ended up doing all my work. I dont have resources to make some impact. Q: if I ask that women at grass root and women working at top levels. Whats the linkages and gaps? SN: at the grass root , you implement tings, experiences from grass root should be given in evidence that should be placed in policy and planning. There is a direct relationship. if you brought that from field, you will see that there is no access to plain water . But different agencies have done nothing for it. So there is always a gap between the people who plan and people who live at grass root level and people who paln need to plan on evidence , and they need to see, to have the means in getting information from the field. When they have to use it for planning. There is a very direct link but not operational. Q: what are the barriers and hindrances? SN: its a long discussion because the decision making in our environment is on adhocism and people in ministries really not interested in what would be delivered to people, they are interested in short term gains, how to please superiors, how to get benefits. There is a lot of corruption in their environment and somewhere in between all this there is no welfare thought for people. Q: whats your vision of health for Pakistan? SN: for health progress in Pakistan, Pakistan is a large country, population is increasing. The ministries and departments are inactive to a certain extent. They lack capacity. Government

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infrastructure is crumbling, private sector is un regularized. There are a lot of challenges but opportunities are there because the infrastructure is there. I always say that its a jigsaw puzzle. So with the right policy and planning tools and with capable leadership with the right strategic thinking things can change and my vision, you might know that my book is going to be published this November on health reforms, and I basically outlined a roadmap for health reforms on different health dimensions and really see some one implementing that in the years to come. Q: ok and do political decisions and policy change affect your decision at some level? SN: my decisions? No not in the least, I , you will see in my writings, I am apolitical and neutral because I mostly write about governance issues and I write them on purely impartial stance, so change in the political landscape and government dont make change in my writings and my views. Q: some questions about leadership. What is your leadership style? SN: well there are a lot of theories and statistics about women leadership styles being different from men. Women have differently but if you ask about my style, u know there are certain attributes that a leader should have to be an effective leader. You have to know your area really well. Whatever it is, if its running a shop, being in politics, being in a technical role, you have to know your area. there are times when you would be a failure and you have to accept that. Number three on ehas to be very innovative so you cant just keep the status quo. And I think that over tNumber two, I think its risk taking because one thing that is leaders should be prepared for everything. Thhe years I have done , I have been very risky and did a lot of mistakes and learnt from them and off course there are some leadership attributes that really help you so if you can communicate well and an other thing that personally I feel is important is to be, to have empathy. I feel that a lot of leaders are very very arrogant and I think arrogance doesnt work and if will not reach people and people will not be happy then things dont work. And people will not have sense of ownership, so kind of being inclusive, and participatory, being open to criticism towards yourself, so very inclusive style of governance amongst your own peers is one certain personal attribute, certain attributes are other and what else.

Q: in your professional life, you have to take many decisions, what do you think , instead of you being there if a male has to take all those decisions, would it had been a different thing? SN: I dont know Qudsia, I really dont know. Its a very different thing to say. It doesnt have to do being , really doesnt have to being a man or a woman. Its just a personal attribute . people who have leadership capabilities will not shy away from venturing into something new or taking risks or bringing change , fundamental change. Q: so you think that gender dimension doesnt matter whether its a male or a female , decision would be the same? SN: I dont think. I think leadership is a more personal attribute. I dont think that women have more leadership tendency than men or vice versa. I dont think thats the case. But off course leadership

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styles are different according to the statistics. But it would be unfair to say women are more natural leaders. Q: how do you see the role of Pakistan women in health.? SN: the enrollment in medical schools has substantially increased , so clearly over the coming years you will see a lot more women representation in health sector. Q: and that is a positive sign for health sector? SN: well as I said when denominators changes then you talk about women participation, so yes it will be positive. Q: any other comments? SN: No I think you have covered all aspects. Thank you Qudsia. Q: thank you Dr. Sania

Interview Dr. Zeba. A. Sathar

QM: first of all tell us about yourself? ZS: About how I end up here?, I think I am surprised when I think about myself in this role because I always imagined that I would be a researcher and academic. And in my heart thoughts I still feel that what I really want to be, but what I have become is very different from what I imagined. and the surprise element is that its not planned, none of this I planned, to me it seems very accidental and outcome of circumstances, I joined population council which is a research organization but also has a lot of policy work and now moving more into interventions, life has changed has changed quite a bit, and management of such a large office, it was never such a large office, its growing all the time, so I am surprised that I am managing such a large office without any real training for that. So that where I, I do a lot of thinking about this, its not that I planned this and got a training. To some extent I think life shapes you and profession in particular it is planned to be a manager or a researcher. QM: How many people are you managing right now in this organizatio? ZS: directly I am probably managing 15 people and this office is large and currently we are around 100 people as its a large organization, those 15 are managing other people and ultimately its a large organization. as you know qudsia its a difficult to be and work in Pakistan, u are worrying about not managing people but also ensuring security and ensuring that you are making decisions that dont jeopardize human beings involved and at the same time your concern about your organization and vulnerabilities of the organization and its a national organization with a base here it not just like heading an ngo, Pakistani ngo where one can make more autonomous decisions. QM:if I look at your years in health and population sector, its around 32 years which is like you are the one of senior women member population and health sector in Pakistan, when u 43

started your work u said you wanted to be a researcher and wanted to be academia, so who was your role model at that time? Have you ever thought that this lady, especially m asking about women, I mean women? ZS: because many men come to my mind, Dr sattar hasmi was my mentor and I really looked up to him, in Pakistan I would say there were no such researchers so most of my role models have always been women abroad. people I had read not met but whose work I liked, I wanted to be able to write in that way and to think and do research that was so outstanding that really open up new horizons that was my ambition and I have found that I have not been able to do that way in last 3 years, as I have told you that life has changed. Name wont mean much to you but people I ended up becoming friends with and working with, shireen ggboy, Karen mason, Susan greenhaal, there are many women in this field of demography and health that write well and done outstanding research that shift thinking in this field and that were some names. In Pakistan there were not many established researchers, women, men were there. QM: what is the scenario now? Do you see many women or still the men are there? ZS: I see a lot of women on key positions and in population and health as u said m one of the senior but there are many other heading institutions and so on but if the reference point is research then you see research is such a, u think health is given less importance in this society and research is even given less importance. One person I do admire her is dr sadiqa Jafri, I always admired her, her research her personality, I admire the fact she brings younger people with her. She would be closest to my role model. In positions of heading organizations I wont say she is my role model but somebody I admire very much there are two people I admire one is Mohsina bilgrami shes heading the Mari Stopes society and the other I am very impressed by is Begum Shenaz Wazir Ali. I admire the way she assists issues and how effective she is addressing issues. These are three ladies that I admire most. They are all off course on high positions.

QM: ok when you started your career what were the challenges that you faced being a women in population field? ZS: not been taken seriously. You know you come back and you, basically you are seen as young and on top of that you are a young women, I think it is a disadvantage. So you say something and it is often. I have attended many government meetings when I was in Pakistan institute of Development Economics even in internal meetings, internally it was not so bad, they respected women I must say but attending government meetings where you would say something, you raise your hand, youd make a point and people were so senior and so fixed in their ways, they disregarded you. And now I look back 30 years later and when I raise my hand and say something they do listen. So I think that is a result of age and they probably realized that they were wrong for so long she must know something and in this society they show a lot of respect as you grow older, you see an old lady they never insult you, partially it that, but may be it partially, on a more serious note, you have to earn your credibility. When you come back and you are a young leader you feel you have a lot to say, you feel more confident about what you have to say but people dont know they have no interest in you. So leadership doesnt happen automatically and born leader because I am intelligent or I am so smart or my personality is charismatic or I am so presentable or something, these characteristics are all important but I think the thing is that you have to work hard to make 44

sure what you said was important so you have to repeat it . You know I found that attending meetings and then I go there again with the same point of view and I felt somewhere in my heart that Zeba havent you said this in that meeting? These people are not listening? But it is part of that full growth thing. And when you see oh my God they have listened you when you have told it tenth time, may be they realize that you have something to say. Its part of your growth. May be you are learning how to communicate better, its growth, your own maturity is growing and you must have something to give you know, you should have something strong to say. Just because you have articulated and have PhD. PhD was a help to research, help to be a leader. PhD doesnt give you a training to be a leader. That is learnt from learning life. Leadership is something in you. Something was driving me, it was one thing that I must do something for Pakistan; I must make some difference in the country. But I dint know in which field. So the field was ill defined but I had to try to make a difference and do well to this country. That has been the driving force. That is why I am here, I came back. Thats the only thing that keeps me going. I mean moving me forward. Q; how would you define your professional success? ZS: see, my success would be when I am recognized Masha ALLAH I am. Recognized by my peers and research circles internationally. When this is Zeba sattar and one of the Pakistans best, she has done some of the best researches in Pakistan. That would be my professional success because that is what I have changed for. But you see we have got a lot of award at Population council. Population has got a lot of success. Off course that is satisfying because I think I am not responsible for the success but I am part of success and I am fortunate enough to be surrounded by people who do excellent work like yourself and others. If you are successful I feel very proud. So there are two dimensions, personal, what you see from insight and Zeba sattar being recognized because of a contribution to something. Then there is people surrounding you and you are a part of something that is another sort of happiness. There is very very different sort of happiness. And my growth was when I grew from putting aside one and learn how to appreciate others. That was a transition in the last 10 years and it was a huge transition from institution and you are recognized for your efforts, researches and publications for population council. The best thing about Population council is that we really think collectively. I would say first it was 90 percent now its 75 percent, but now its fragmented between people that we do think in terms of joint success. You are a part of Falah project. Yesterday we were praised by our donors. All of us felt happy. Q; what would you say what was landmark of your life? Highlight of your life? ZS; I think it was receiving the award from government of Pakistan because it was a, you know, conference and culmination of man things. I know that I was not politically good choice to be nominated for the Tamgha-e-Imtiaz because I dont have any political affiliations and I am not apolitical person. And I know that there was a lot of opposition because there were other two people that were nominated. The fact that it happened was recognition of my work not as a researcher but also as Population council worker but when they read the citation, the cabinet secretary did all his homework and he cited many of the 45

things. It was also a year after I became a member; I was elected as a member of International Union of scientific study of Population. For me that was, or maybe I should say this came second that came first, that was the recognition because a Pakistani was never recognized on this level, due to the demographics, few professionals. Then you know how difficult it there were many lobbyists that dont favor Pakistan. I was selected despite all that and I am really proud and happy because there was no campaigning for me. Other countries had lobbies like Latin America and Africa. Thos e was the two high points that happened in 2005. I got help from ALLAH Q: ok those were the great achievements and highlights of your life. Lets talk about some other points. What do you think if there was a male at your place would his leadership style and decision making? ZS: I have learnt a lot about teamwork from my previous country rep Peter Miller who is an American national and is eleven years older than me, I came from individual culture where every individual was competing with the other no one was friend of any other it was like a competition a healthy one He also said that when u include someone you make a team. I dont think that Peter Miller should have continued but he laid the foundations and in previous it was George Fernandez, both are American and I am a Pakistani woman. So I dont think that it make any difference to population council, they have a culture. We were talking about a very named organization and we were interviewing the head of that that there are many organization that are driven by.the organization culture is about money and about being on top and that sort of thing .. Getting contracts for profit, dont forget that Population council is not for profit it has very very strong values that we stand for, about capacity building, about improving the lives of women and children. So the person who works for population council and the one who heads it, they probably should not do headings of such organization if he does not have these values and qualities. So ummnnn in near future I will be thinking about moving and there will be another head that whoever will be the head must carry the values otherwise it wont be a good gesture, so I dont doubt, I do not think that gender has to do something to values Q: Do you think that they have the same values and they will have the same kind of leadership style and same decision making? ZS: I think may be women are more...obvious. I dont know aa... women are more emotional so I think that at times that acts against you sometimes you become more soft towards someone and almost .. I think at times I make myself a bit more softer to hide and to not..now we have hundred people working here and monthly with at least ten to fifteen people have savior problems financially , family you know .. what I am saying that professionally I try not to get involved in these problems and if I am involved then I think there is no objectivity as compare to men that this is an office work or so,, women are softhearted, this is natural difference in women but I think that it would not really that management side should change, I dont think that the outcomes would change .. 46

Q: Our society is also a bit like this that if u have a boss and he is very strict and assertive, people say wow he is a good head with great control but if your boss is a female she is strict then people say that she is very annoying (daddi aurat) boss means that they point out negativity in a female and strict boss? ZS: yea this is a big problem; you raised a good point that there was an impression that all good bosses are men . This impression I think has now changed , I am not talking personally , if look around you will find women like MNA Shenaz Wazir Ali , Dr Sadiqa .very soft person I think that that was an old style of heading any organization strictly now its not that much important I think. You almost find it at times I must be looking very hard, I am sure! You tell me you have seen me a lot working Q: (Laughs) ZS: (Laughs). So may be you should interview people around me and I am sure that will give u set back . Q: yea this happens ummnnn... ZS: she is strict and I am sure they will think that but I... you should interview. I dont know what the perception is uuhhh Q: ok tell me. You have said that when you started your career you faced a lot of challenges what do you think that now a days female who want to come to this profession, what are their challenges and what are your challenges as being the boss of this organization? ZS: they are two different questions the first one is ..In way life is easier now because when the proportion increases of. Many women are working and in your age we have numerous female in this field in media in health, professionals I mean... so I think that life is easier, in ways uuunn... for young women entering now... in terms of competition, if there is top there will be more competition and dont forget numbers will increase so not everyone will make it so.. I have great consciousness that this is not what I am successful because .like giving a name in a committee is only because we dont have any other female candidate this is the starting of opposition and you are the only one, so you doubt that my progress and recognition is due to my gender and they want a token woman in this position, but you will be competing more and equal to men that will be an advantage you dont have to feel apologetic being a woman and.. but doubt that your generation will have more competition about heading an organization because there will not be more jobs in future at higher level but competition will differ its a double edge thing , the way will be easier if you really have the ability , I honestly think that it will be easier for young women to go the top . Because there is more glass experience, there is no feeling that Oh! I dont want to be the head of organization, how can I manage so many men, because you will have more women working with you... Secondly you asked that what were the challenges for at the start of my career .ummnnn... 47

Actually the biggest challenge for me in my job is to keep everyone happy... a very big challenge ,keep your colleagues happy , keep outsiders happy , keep the donors happy , keep New York office happy and maintain the equilibrium between all these forces so dealing with many different prospective thats my challenge forces and all of them are very important to me and I dont want that within the organization who is the more important if I am heading it as you said that my impression is very strict like riding rough shots on people, hiring and firing and not respecting them that would upset me tremendously the most , then comes the order that what are the relations with the government and with the foreign colleagues and the sitting circle . that I keep on trying my best and sometimes it becomes very difficult that someone saying that you are not participating in rent, and why are you not having partnership, why are you working with them or government follows its priorities those sanctions are number two and the number three I would say the donors and the last of all I am dealing with the New York. Because ultimately my bosses are in N.Y although there is too autonomy on this position but... have to take care of them now you will meet our president he is coming the day after tomorrow but he will be going . But it will be no problem Q: Do political situations make your decision easier or difficult at times or not??? ZS: I said it makes it very difficult because we... every time political situation changes it takes time because mainly we are working with and for the Government of Pakistan for changing policies and programmes they are out counterparts so it makes difficult when players change and the understandings and they asses you , they place you , they evaluate you ,because how and will you work for them and told you before that you cannot get prestige again and again and it is not overnight it is not that you are the country director of Population council ,they will invite you on tea but not compulsory that they will regard you and for me thats most important that a person will not hear you attentively until he respects you he wont come to events as you see that people come to our events , they dont come , even if they come in the Population council in what sense because each one has evenly earn the respect so if the peer is changed , new people come in political scenario and it changes so this is an instability that now you have to work again for six months but luckily so far we have worked hard to maintain an equal political stance and that you have to work hard and I mention to you that it was a surprise coming out that I have been nominated for medal as dont have any friends or political relationship so e-political stand helps and no one is mean and it is a neutral organization and it works Q ok if we look at the grass root level women are working and we can see them in politics as well. So what do you see, the links between the grass root level women and the policy level women? Any linking or gaps? ZS: I think there is a big gap ., women are working extraordinary at grass root level and you know that many time this question arises when you interact that where you work you dont what is going on and that is correct I dont know that what is happening and people challenge you that the work is actually done at the grass root level and on the position your are working you just have to shuffle a file or give some wording on the policy but what I thought is that 48

really I could never have been a grass root worker and a good grass root worker will never be me , so everyone has part to play in this game and what may be I can contribute sitting here , it will do well for me to interact , interaction is good but mind makes the difference and may be my specialization to be the voice of some research findings about women and through the research and policies I can utilize the women and want to be a grass root worker and want to do something for then but I will never be that why should I try if whatever I can do for them is research and presentation of evidence and I guess a policy change and earn that so I can do that I think if it impacts policies and programmes then surely it will have impact on grass root level , so , you are right there is a gap , one is a natural gap , just like between a male grass root worker and policy male worker , but in female sympathy would be more because you know that some female related problem in Pakistans society you will share and I will share female , men have less problems . Q: if I ask you what is your vision for health for Pakistan? What will you say? ZS: I would say that the priorities should be for the womens health and childrens health but its women health that has to improve. when we say for health we lose the prospective and I dont think a poor man can have good health but women should given priority because they are so disadvantaged that you will have to try harder to bring them at least at the level of this advantage of men and then we raise the overall levels of health and for this I think to functions efforts and address. The biggest gap right now is the lack of female workforce for health, like paramedics let say if we have a large number of women in workforce and let say there are many women in BHUs, those are very few in numbers, then to me the whole issue would be resolved. Then women would be able to argue at home that they have to go to hospital. It will just become more acceptable. But right now majority of women dont have access to any health care, so the biggest challenge is that. I think the solution, one of the solutions is this and off course there is education. If a woman is educated, she can work herself and help herself to have better health. I dont know which comes first. I guess health care should be second and then again womens education should be first. Because Pakistan can ill afford these gender differentials. Whatever work a research I do, the disadvantage of girls whether its in health or education, and particularly in poor families, there is just a finding that its pathetic. It comes up, its like run the table and I know that I am going to find it and I am going to find. But this touches your heart that how we are allowing this to happen. Q: Do you see many women leaders in health sector right now? ZS: I think I mentioned that earlier that I do, I really do think that many, I think women are really doing outstanding stuff in Pakistan. I dont feel shortage. There are so many and I think that they are playing usual role and no shortage of women. Q; and how do you see the future of women in health sector? ZS: very good. I think that as I said that there is an endless amount of work to be done and we need champions. Perhaps my answer would be that women leaders are many but we have a 49

few champions out of them. You earlier mentioned about MNAs etc. I think political leadership also needs some champions. See Fehmida Raza went in and she adopted a child, the IDP. It symbolic value was huge. Her small gesture proved to be huge. So we need such leadership. Respected women MNas, parliamentarians, senators etc. and they do work in reality than I think it would make a huge difference. Q: I think I have covered most of my questions and if you feel you want to add anything to this or any comments if left? ZS: no I have given honest answers to your question. I said everything that came to my mind. I think we have covered everything. Q: yeah for me , if some talks to a person like you there are so many questions that arise in mind and but I know that time is limited. Thank you so much Dr. Zeba. ZS: Thank you Qudsia Interview Dr. Fauzia
Q: First of all dr fauzia tell us something about yourself? Dr. fauzia: a very good question indeed. Its very difficult to tell something about your own self..but being a career women I think that may be being a working lady a woman has to fight at both fronts of office ^ & home. I have always tried to develop that kind of personality. So I could balance both fronts. And definitely that credit is given initially to parents and then after getting the huge credit goes to husband. Without his support I couldnt have reached where I am today. if you look at my qualification MBBS and LLB thats initially what I did but after that I did mba and different diplomas that I have taken and all the jobs I did u can see on my cv and the level I have achieved today and all the opportunities I have gained is due to support of my husband. I think woman has to keep balance and I think I have managed my life and still m managing it properly. For that matter I regard myself successful. Being a mother I am a dedicated and being a working lady I am dedicated too. Being a daughter and daughter I law , all the roles that I carry according to our society I try to carry them well. This what you have been imposed duties by the society and ALLAH. But there is an inside thats has needs and desires. I have always had two major wishes one is that I want to build a mosque its a dream that I have always dreamt. And the other is that whenever I find opportunity I try to serve the community hat I not just because I am a doctor or anything, thats something very in with me. I get satisfaction. Thats why since my student life I have been working with different organizations. All my basic education was from Karachi. i have volunteered in many programs. Till now I run 365 free medical camps. These camps are established in far flung areas and northern areas and include those areas where communication is nil almost. I have been to all these places. I am saying all this because that inner satisfaction and peace I am talking about come from these activities, when I help people. This is not like sitting in office and working in clinics. I give time to this inner satisfaction. Q: ok you were talking about your working with different organizations and I see that you have focused on reproductive health, an d you have been working as Technical advisor, how did it happen?

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DF: its a very interesting question, my husband works for army so for this reason I was able to visit different areas of Pakistan, we lived for 3 years in northern Areas. In Skardu I was working in DHQ Hospital. There were 2 gynaecholgysts that were local and I was the other outsider. Because there was no CMH at that time we also dealt with army. It was a very busy time. It was a center of Different areas like Astore etc. day and night we were busy. There came green star team at one day, we offered some panning services to our clients so they thought I can work on RH issues, I can be a trainer. They asked me if I would be interested in this area I should work. Then I spent 3 years at Skardu then my husband was posted at Lahore. When I went there I thought of working with green star. There I started working there as trainer. I worked for 2 years there. There were different areas under my training. Green start worked as a nursery for me and its of international repute so had a different working experience. Got different opportunities for grooming. I was so groomed there that different organization showed interest in me to work with them. I got a chance in JAPIAGer to work as independent consultant. In which I worked for 3 three years with them and then I was appointed here in Falah project as Technical advisor. Q; tell us when you started working, you became a doctor was there any role model ? DF: if I call role model someone in my life that would be mu Aunt (khala). She is normal woman, she has recently retired as a school teacher. She groomed me a lot. She was a teacher so that is might be the reason she is my role model. The way she managed everything her home and profession, and she is an artist as well, her aesthetic sense and medium of delivery everything inspired me. And one thing very interesting is that I did calligraphy a lot. In my childhood I have exhibited my work. I saw her engaged in so many different roles at a same time and doing them properly, managing everything, so in general terms she was my only role model. Q: so when you started professional work was there any other role model, in professional area? DF: yeah there has been a role model. I really look at my colleague Nabeel as role model. He is so young and energetic and we are in same age group and he has also worked in green star, but the thing is that the dedication and style of work he had , he is working in America for our organization , the sincerity to his work and dedication was the most inspiring thing. He was very clear in his ideas. He handled things beautiful. He was a leader of our team, he was very motivative. All these things made us idealize him. I know so many people, but he has been my professional ideal.

Q: its been 13 years that you are working in the field. But when you started your work what were the different challenges that you faced? DF: Initially the biggest challenge is to make a change. When you have to make change for a community or area that is very challenging. I know change is very slow and then its acceptable to people. But in Pakistan we have to face a lot of resistance to make a change. And people dont accept it initially and process implementation comes after that. So I think that was the main challenges and it happen sometimes now that I have to face that. Secondly my family has always been supportive but my father, he is an advocate but when he sees my hectic schedule he says that whats the need of doing all this. Somehow at initial level that was also very challenging. A fe w

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disagreements. But now when sees things are smooth so he is ok with that. I dont know what kind of challenges you are talking about personal? Q: yeah personal , professional or emotional? Sometimes when you are married, then the other family has some expectations they dont see if you are working or not you have to meet those . but personally I think it was very challenging when I got married and that was a challenge while professional there is a challenge, if something is very distracting and against the standards, I think that should not happen , against norms or against medical ethics, I acnt bear it all , but that is present in our present health care system, that sometimes act as obstacles and one has to deal them tactfully. Q: how do u define your professional success? DF: I have always liked challenging jobs. Simple jobs any one can do. They are frustrating at times but then you can some opportunity to handle challenges. It grooms ones personality. I am professionally successful. The main thing is where ever I have worked I have always been recognized for my efforts. And ALLAH has always helped me and acknowledged me. I have worked at different places and I wan never worried about my job. I think I cant get any others bread. I have always got a good opportunity everywhere I have stayed. I have never been jobless for even a month. So I think ALLAH has always been kind to me and blessed. There was help from ALLAHs side. Secondly wherever I have worked I got credits and rewards and appreciations. I have got US Presidential award for community in 1999. It is also a long story. I found a girl in a camp, we usually do work in camps. The girl fell into the well and got injured. She was paralyzed. I helped her and remained with her until she got recovered. Many other people might have done the same thing. But my case was given and it got shortlisted and they selected 2 cases from all over the world. She did some work on mosquitoes ect but I was given award for doing so much in a young age. I have been given a chief minister gold medal , women of the millennium award etc, this type of appreciation I have got can be included in my success. Q: what is the benchmark of your success? DF: can you define it a little bit more? Q; you have you have so many things that you regard as your success , there might be some remarkable or noticeable, milestone type of thing in your career so far? DF: the most remarkable thing if I start from beginning, at 13 years I completed a Quran Shareef, that was my first achievement. That is the thing I inculcating in my daughters. Then I got good marks in Fsc, and got admission in medicine and I worked very hard, I studied for 22 hours a day. And then when I became a mother, that was a complete transformation. Professionally, working with GIPIBAL, then the presidential award that I got from US. And there are many others

Q: you are technical advisor and you take different decisions, what do u think if there was a man in your place and he was decision would it be a different story ?

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DF: I dont know but I think women are good decision makers, men are hasty. Women always think before deciding. May be women are good decision maker. They always have contingencies, men also have but their pace might be slow. Q: if we talk about leader ship styles, these days it also refers to decision making? Whats your? is it different from men ? DF: to tell you the truth, in our society it is believed that if woman is given power, she would be authoritative, aggressive and bossy but man wouldnt be like but that is not the case. Women are equally competitive. A leader cant be a good leader unless he/she manages team well. The role of leader is of facilitator. Boosting moral and overcoming their weaknesses and increasing your strengths then you become a good leader. Leader is not authoritative, but to be at equal footing and work on the level of team members. All these things are important and teams success is leaders success. A good leader is that who believes in team work and building team. You cant make a building with just a truck of bricks, if you have to build a palace you have to bind them. Q: tell us whatever decision making you do nowadays is there anything that hampers your decisions? DF: Many time I decide myself, as I am a technical advisor I take many decisions myself, but there are some times and decisions that ones decisions are dependent on other s than its a difficult thing but one should have the power to alter others decisions. I dont know I should say it or not, its difficult to work with public sector, people come with rigid ideas and they have high level of resistances. This is a difficult area; otherwise decision making is not that difficult. Q: if I ask it with a different angle, do political decisions or political scenarios affect your decision making? DF: yes they do, because the organization I am working with is of High repute and is international so whenever there is uncertainty, orders come from home department and instructions from our office here. Because when we work with community all our meetings and work stand still because of the uncertainty. And change of government causes uncertainty and policy changes causes issues and decisions hampered. Q: dr fauzia there are many women working in health sector, but when we talk about the leaders at top levels we dont see many? Y is that so? DF: there is lack of opportunities. Some are born leaders and some are acquired. The born leaders can always find their places but the acquired leaders need opportunities. If they found it and there parents can give the right direction then they can come to front. Plus confidence and self reliance is very important. If I tell you about myself I was a very shy kid in my childhood. I was the only child of my parents that was also a factor, I was afraid of gatherings etc, I started talking when I was 5, very over protected and over sensitive. When i entered in profession I indulged in different activities. I am not a born leader, I am an acquired leader, I have polished myself.

Q; I am talking about general scenario here why women in Pakistan couldnt come up?

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DF: thing is they dont get opportunity. In Pakistan we dont have a culture of promoting women in professional field. Male dominance is still there. The only level where women are thought as a leader is mother. But professionally if there comes a women in a superior role , she has to work really hard to prove her as a leader. For me unless we change our mind we cant find good women leader. And we never give space to new leaders. We follow one person one leader. We never focus lay man. We dont have a leadership definition. The one who is in media is our leader Q: you find lots of leader in health sector? DF: yeah there are many. There are many leaders in different organization. In green star my boss was a good leader, she was very sincere, she always worked in development and community. Dr Rehana was a leader, she is in Kenya now. She was very sincere with her work. She has always been a source of leadership. If you go towards gynae area you will find Dr Rizwana. Everyone is leading at every front. Q: Are you satisfied with your work that you have done till now? Do you see any gaps? DF: till now whatever I have done I am satisfied but there is always a room for improvement. Satisfaction is there regarding my work. But thinking of improvement is also there. Q: ok, what do you think woman at the grass root level and a woman working on policy level, do u see any links? DF: Unfortunately not. If you talk about health sector, in the present scenario there is difference between field people and people at policy level. They know the harsh realities, they know psychological areas, they know what is the requirement of a community whats need to be done, what are issues of field, and these are those things that policy makers dont know unless they go in field. There is a huge gap between policy making and implantation. Policy is made from their own ideas and mind set. They dont know whats the requirement. There is no need assessment by policy maker. Q: how do u see the future of women in health sector? DF: very bright, I think more women are actively participating in health sector, drs are addressing very proactively on different forum be it gender issues, HIV , ay other health issue, at every level in advocacy and at community level, I think in field the women are working more actively in fields. They are contributing more in health sector. Q: whats your vision of Health sector in Pakistan? DF; my vision is quality health services to every Pakistani. And achieving Mdgs. Everything is possible; we just need to do it. Q: any other thing? DF: thank you so much Q; thank you so much Dr. Fauzia

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Interview Kamyla Marvi

KM: The female emerges from there , she has to fight on a much broader spectrum, so in a way its more difficult for them, in NGO sector its very easy for us because we talk about gender we talk about non discrimination, these all things are acceptable for us S: I think we are equal in terms of gender KM: Yes yes, more, comparatively, whereas in other sector its much more difficult for women. I think it would be much more difficult. S: ok, how do you think decision making process , does it count that women can do this and men do that, decision making power of women KM: see in the current scenario, I think , again its an ideal situation that there shouldnt be any difference, our values, our, once those gender equalities achieved, I would like to see a world where men and women decisions are based on similar reasoning and thinking, but currently I think male culture I mean there are differences, stereotypical types. I think men are aggressive by nature and ambitious by nature, right, because they have been the people who have been required to produce. In economics men produce and women , men have productive role and women have reproductive role. If we look at this perspective then men have to be aggressive, they had to go out of the house , they had to .., they are the ones who are responsible for earning an income. I mean to this day the primary bread earner in our home is still my husband, you know. Its all his responsibility. I mean I run the house hold , there are times when you know I am taking the load of it, its the S: the prime responsibility. KM: Prime responsibility is his. And my prime responsibility is still the kids. Even though we are more in the centre of spectrum but we still have this divison of labour, so . S; so thats why man has the authority.. KM: so men therefore have to be more ambitious. Because they have , its like I will fight more for what is right for my children , may be my husband will because its my primary role. Whereas I find that men perhaps have more ambitious and more aggressive on the work front than the women and then therefore seek leadership position. Because leadership is often , positional leadership is often associated with economical benefits that if you have a higher position you have high perks, so therefore men are more aspiring towards those positions whereas women will think that if I get promotion I will have to work more , my responsibilities will increase , I wont be able to take time out for my sick child, so these things will bother her. Right, they will be concerned, so even she is ambitious she will hold herself back , she will think twice about that. Right S; hmmm KM: so it leads in to a difference on how aggressive you are in attaining leadership, but having said that I think women have very strong analytical skills , sometimes. Because they have a very strong ability to empathize, they make very good leaders. S: and analyse.. KM: analyse and empathise , so they can understand their followers well than males who are not yet ..men havent I think have developed the sense of empathy as well the women have. Because of the same productive and reproductive role. So men are leaders of different they dont have to get this empathy thing going on, which women need to do, you know. So there are different things happening with men and women in leadership. I am not trying to say that one is better than the

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other . I think sometimes women can be too soft, sometimes men can be too harsh. You know, so it depends . S: do you think that leadership has some characteristics? Can just because some one is a woman can fail because of gender? Like Benazir, being a woman was not a hurdle in her success. She had a family and relationships though, but she was ambitious and she was a leader. So do you think that being a women there is a hurdle? KM: For some people yes offcourse. If I am born into a home where there are no facilities like this , dont have any support, then my being a women might be a hurdle, right ,like I said somebody who doesnt have a economic support, who has to use public transport, to go in public spaces, to be harrased by people, that is the hurdle, social acceptance is nil. If I stand in a group, I try to speak, I will get a lot less people listening to me than if its a man. Right, in our society at some places people listen. They want to hear from the men, if I want to say something in religious sector, I will be shut up, you know. So there are spaces where women are still not welcomed , forget religious sector thats too far.go in medicine or engineering , try and break into those environement, go in a factory setting try and break into those environements its not easy. We are in a very different environment, NGO sector is very easy. There are huge hurdles. S; women in health sector are less in top leadership position why is that so ? do you think these are the reasons or there might be some other reasons KM: I think its the same. Same productive and reproductive role. So the common complaint that women study medicine but dont practice. S: exactly, as compared to other sectors in health sector there are many women KM: yea relatively speaking they are morein health, you will find women leadership. S: as such at top positions or decision making level there are less women? Whats the reason? KM: I think it one they dont push themselves much , 2 society doesnt accept them to come in to leadership roles. Infact who wa I talking to recently.. yeah in population welfare, they were talking about, FWW are this an d that , their supervisrors work, he said that there was supervisor that looked after them. He was calling him deputy district officer. They look after them and supervise. I asked him why you dont have female in filed, he said they just have male supervisors they supervise females , we just hire males. See there was no reason no logic , why it was all men. But for them this was all men position, no female could apply, neither they will hire females. Like 20-30 years ago no body could think a woman could become a pilot, no woman could become. S: constable.. KM: a constable, a councilor, any of those things. They are happening today. There are role models that are bringing changes. So in those ways there are so many places where we still dont think woman can enter or take that place. Mentally we have a blank, a wall that doesnt allow, woman cant enter this place/area. Why not? Nobody has ever thought. S: what are the challenges and problems that may hinder or hindering your decision making process? KM: ummm.nothing related to gender..infact nothing related to that I am a female. One thing I miss in this office is that our team is quite vast, distributed in 5 country, so the fun to work in a team in Ahung, where we used to brainstorm before taking a decision, then ran programs. Now I kind of sometimes feel alone to make my decisions, I dont have a team to work with. Kashif and sabiha, they are great but I still miss that team work. I miss a team work.

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S: do LDM have gender sensitivity? Is there afemale domination or male domination? KM: like I said in NGO sector things are simpler. I mean if you look at the basics, the women are equal in number if not a little bit more. We have more women as our fellows. In terms of opportunities I think that the women and women availing equal if not more for women, because women are tending to be more active. I found that women are more active, so they take up the opportunity more. Its not like that men dont take, they do. In terms of leadership, I think we have more senior women leaders who remain active. I think women tend to be better collaborators. Its easier for women because they are less competitive. Now these are all stereotypes and sweeping statements but I think women tend to be less competitive and therefore be more cooperative and this makes them say they can work with anybody. So for them the network concept is easier to work with. We have some great collaborators in men also you know. We have some very good people in male group as well. So yeah I dont think there is an issue but may be right that I have never looked it through gender lens. I have never done gender analysis for this and the numbers are equal if not more for women. So its okay with the numbers but who is getting the opportunity, are we supporting women or not , that able to stand and take then lead may be we havent done that analysis. S: right. As we have talked about challenges, when we are advocating issues, does government decisions or policy maker affect your decision making power? KM: As a woman? S: As a woman and as a LDM representative? KM: our work is less with advocacy; its more of capacity building. So we work less in advocacy. The advocacy that I am part of is more of a collaborative thing. So we work in networks and groups. So as individual I am advocating less. So when I work with, for me its very easy to work with teams, its second to nature to work in team, I dont feel there is any challenge in working team. When we have these teams, like we have post abortion alliance , LDM group, network alliance, these all are very big big alliances. its really easy to work with each other. Its not a problem to work. When its about advocacy , the challenges are that one wonders when you are going to achieve something. When is the change going to come. When is the basics, you know sometimes we are caught up in such complex issues. Things should be like this or that. Things are so simple. The basics are to provide basic health, to run BHUs. I think the majority of problems will be solved. The gender issue will also be solved, because nobody minds going to a good doctor. Its when you that doctor is corrupt then you say that my wife wont go there. But when there is a very good doctor, many women will come, even the issue of mobility which is the most difficult challenge in our society for women, they cant access for these services. I think part of not accessing those services is that the BHU is in such a condition that why would one go there. Her husband says you dont need to go there. S: BHUs are far flung.. KM: Yeah they are quite far away. But if your local doctor is giving service of good quality then those women will also go who dont have access, they will also try to visit that doctor. Because there would be some comfort level with that doctor. When I have to go to doctor, why do I call up dr. Sikandar, because he is a friend of mine I trust him, I know he will look after me properly. I dont want to go to some big hospital or some place where I dont know any doctor. I would go where Id trust. So I dont blame those women for being nervous to go a BHU and dealing of that doctor might be nasty. S: you have worked on community level, in early years then on higher level at policy level , so how do u think, whats your vision regarding health sector for Pakistan, like you said you want a vibrant

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BHU system, improving the quality of health service that will resolve major problems, is there anything more you want to say there should be some more? KM: I am really with the improving primary health care. I believe in primary health care, I really, I think, you should improve facility and institutions and everything else will be solved. That can only come through good management and leadership. You dont have technical problems and they can be resolved. I am a strong believer in integrity, good management, if you have a strong institution you can learn, you can hire consultants for technical aspect, but you need a very strong leadership who can guide the projects and programs and maintain the integrity and whatever you are doing you are doing for right reasons, not for personal gains or names. You are doing it because you have achieving your goals that you have set. So be it BHU, if the doctor who is heading the BHU has integrity then that BHU will run well and he/she will deliver best in all the given resources. But if there is no integrity then there are many excuses. There were no injections etc.. I mean look at Dr. Shershah he work with minimal conditions, minimum of conditions. You must have watched his film in which he asks for a light bulb and there is no bulb, so bring it from somewhere I will give the money, he operates in those minimum of conditions. S: or if somebody wants to do something no body can stop him. KM: yeah, it takes integrity that whatever is your work you will do it like it should be done than nobody can break you down. S: okay, do you think that health sector which is very related to gender, so there might not be any health issue for a man as such but there is always a connection of health with women. You may find many women in health sector comparatively more than other sectors.. KM: you know why is that right. If you look at productive and reproductive roles, the reproductive role for women is to teach and take care of her children, the health. If you extend it then women are in nursing, teaching, then into professions that are extension of reproductive role, so thats why you will find women coming into health sector more than other fields. Those sector like teaching you will find women more because that is more acceptable. S: so women in health sector, if there is a good leadership that emerges out, so dont you think that will have a positive effect on health sector, like management will improve. Like BHUs KM: I am not in an illusion that brings women and all problems will be solved. S: yeah but if there is a women who is sitting on high level, wont it be a different thing? It would be closed to her heart? Why women are dying, there should be some hospital? KM: I have seen really bad people in positions, many women. I mean in government sectors and in other sectors as well, I mean I t might be true to some extent. Yeah to some extent if we have equal men to women ratio in all levels, it would change the environment but its not the solution. I think its got to do a lot with the other values, other skills of the leader, beyond gender. S: so it really doesnt matter if its a woman or man? KM: no it does matter but to some extent. I think if you do this that you make it 50% women in every field S: especially in health sector? KM: yeah may be in health sector, thats not going to solve our problems of health sector. Yeah it might to some extent. That females may be more sympathetic to some issues, but ultimately its many other things as well, professionalism, integrity, skills, ability and many other things. Its not just being a woman. So may be. I am not excited about that being a solution. S: okay, you have said you see many senior leaders in health sector, what about new leaders?

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Do u see? KM: you know especially in reproductive health, there is a strong awareness that there is a lot to do with youth issues. You know we need a lot to be done. And we have lot awareness as compared to other. That youth leadership should be increased, we have youth parliaments, etc. so there is young leadership. I know in Ahung we always had very young leaders, we have always had young team and young leaders and our senior management our director level and executive levels have always been over 20s and 30s. Always 20s & 30s. Shina is in 20s, I guess 28 not more than that. So they are always young and I see that in some other organizations but not in all. S: and what about other youth groups, leadership qualities? KM: look at media there are young people. So creative so confident. I mean off course you can criticize media; there are so many channels, beautiful people. Music industry, fashion industry, lot of potential for growth. They are all young in those industries. S: in health sector? KM: in health sector we are unfortunately losing all our good doctors, the younger ones, they still go abroad probably for studies and get better posts abroad, so .. S: so can you see that dedication or commitment, like there are seniors working without any earnings. KM: to be honest that senior people let younger people grow. So we dont let younger people come forward that much. I think youth not youth but young people have just as much capacity. But I think the older people feel threatened by youth that what can they do. We feel threatened that they will take our positions. Not everybody. I know many great people who grow people around them. Like Kauser Awan, many people regard their mentor. Now she ahs grown a lot of people around her .like shama , Ayesha Aziz, etc . She is growing new leadership. Its not that she is running a youth program but she has always had people around her who are learning with her and emerging, she brings them out and send them forward and that very subtle, its not like that its a huge program of UNFPA, its a small program but shes bringing out very strong leaders. S: yeah its a great contribution. KM: yeah it is. She is giving leaders to the whole sector. Shes growing some very solid people. S: does political situation or condition affect the health sector. KM: yeah off course. Your budgets come from there. They allocate budgets for health etc. and also politics in the formal sense and politics like internal politics like organizational etc. S: we will talk about the governance first. KM: yeah, see if we look at different governments, although we had fairly consistent health budget its always been low, its never gone up. S: in health and education. KM: in education they have increased but in health it was low. See the people who need health and education are not those who are particularly powerful, not people who are well off, because they can afford private, they dont need to go there, who will go? The poor who are not relevant for my political career, so it doesnt make sense. Yeah its in Pakistani politics, you know what sad thing is there is no institution building in Pakistani politics, your politician that everybody like would be a politician that will favor for you. Like I give a chit to somebody who has asked me to give a reference for a doctor for operation. To do favors. S: its a mindset.

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KM: its a mind set. They are not making an institution. They are not making a hospital that whenever a woman comes to that hospital will get good service. That would be useful for me, because people will go to the hospital directly without coming to me, then there wont be any use of me, so its useful for me that you come to me to go to that doctor. S: its a culture KM: yeah its a culture, what our politicians do; they do favors for others for their own sake. That person has given m e votes etc. Somebody was telling me that when you go to some politicians they give you their mobile numbers that whenever you need my service call me, because they are happy with this... S: yeah it happens. KM: yeah, they dont say you go I will fix it from there, no, they want you; they dont want to strengthen institutions. Because then there wont be any favors and they would not be able to get votes. Unfortunately our political system doesnt work the way it should have. S: yeah an if we look at the long run, it would be beneficial for them if the institutions are built. KM: okay and if they will build institutions what kind they will build? S: yeah on their own name. S: yeah a very big name tag will be there on the building. A marble one, they wont see what would be the maintenance, service, what would be the quality, is the staff trained etc? they are just happy with that the huge building is seen by people. So people would say he is a good man he built hospitals. So give him votes. Now if the hospitals works or not or kill people, nobody sees that. S: and you have talked about budget allocation, I would like to quote Dr. Shershah here he said that government does not want women to live, they want to kill them , we know what we can do to save women but we dont want to. KM: you like I said I am studying for my masters, there is a new concept in health that is health security. You must have heard about this concept. Health security concept is very common in global health. That means you protect your country and human beings in ur country from ill health. Thats is protection like at the borders army protects a nations boundary used, it is to safe your own people from ill health. S: its a right? KM: no its protection not a right. Its protection. When you are talking about protection it is from external. Right, I will save myself from outside right. What then which diseases become dangerous from outside. All the infectious diseases, sars, bird flu, these all diseases become dangerous for us. So that is where all the money is going in. into those diseases from which I am endangered from outside. Okay. Thats a concept of health security. HIV & AIDS is one of those diseases. So then what happens is, if your focus is on health security then issues which are from internal like your reproductive health doesnt bother. If ten moms die today in Pakistan, America would not have any problem but if 10 people die of bird flu then there is danger. Pakistani go America so there is danger, so they will fund bird flu and sars. But why would they bother for women. They died and are buried there. If there son come he wont bring an infectious disease, maternal mortality is not an infectious disease. They dont care. And if you look at media what does it report on bird flu, sars. What are interntonal health issues, these are.

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S: yeah, I was closely monitoring media lately and I was wondering that I have heard very less about women health, primary health or reproductive health, they dont focus on it, HIV & AIDS KM: HIV & AIDS is a classic example. In our country HIV & AIDS is not a problem as such. Right, we have a little bit of problem and we have to deal with it , I am not doubting it. If you see HIV & AIDS is mall issue as compared to RH, but the amount of money used for HIV & AIDS is much more than RH. Its not balanced. Everybody is worried about HIV & AIDS . S: yeah different programs are running, tv programs are running, KM: these are all infectious diseases.. S: yeah.. pinpoint.. KM: these are all infectious diseases, and the other diseases which are of concern in world is life style rich country diseases, cancer in the west.. S: hepatitis? KM: no hepatitis has never been an issue, it was never in west. Now we are gradually pushiong it because its a concern for our country, so it has now pushed a little bit plus because it has been associated with HIV & AIDS now, people said that you are doing so much about HIV & AIDS but people are dying of hepatitis. Because they are not using clean syringes or condoms, so if you are working On HIV & AIDS then why dont you also focus on Hepatitis. That is why hepatitis has been given a little importance now. And yeah the other lifestyle diseases are cancer, heart, diabetes, these are all the diseases that the west is suffering from. Obesity . the amount of money utilized for the research on these diseases is huge. Its nothing to be compared tro what we are spending on RH issues and in our countries we do suffer from these diseases , eventually as our lifestyle changes and we will move to their life style then we will face problems. But cancer is still an issue. These thongs are bothering us now. But the main issues of RH they dongt concern them. It doesnt affect them. It doesnt affect the opulations, its international politics. S: alright, lets talk about ypur professional success,how do you see it? Have you succeeded in binging out the change? KM: as I said my belief is in institution building. I think I have worked with several organizations, I feel like, I hope I have supported them with strengthening them institutionally. Ahung obviously, I would like to see PHRN grow through LDM thats my current area of work. I am working currently with WAR. On their strategic thinking and planning. I used to work quite close to PPAF; I have worked quite closely with them. Thats where my focus is. I really enjoy working on a level where you change peoples way of working organizationally they become stronger. I am not interested in staying anywhere for too long. I get bored after a while. Somebody else can.. I am not a person who does that on daily basis prefers others to take over. S: so you also contributed in leadership KM: yeah I guess so, through leaving. S: what is your most memorable moment of life? KM: its a difficult question. A lot, tons and tons and tons. Its really difficult. I love travelling by the way. I have travelled a lot. When I was a student I travelled a lot. For 6 six weeks, very basic travels with backpacks. I have list of memories of those travels and then obviously with family, with Kauser when we were in AKU, with Ahung, there are hundreds and hundreds of memories.. S: any achievement that you feel yehs thats the moment of my life.

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KM: no I couldnt say that there was one such moment. All of it, I have no regrets, I have only one regret in my life, ok , when my husband and I were married. We saw an ad in a paper which was from WWF that they were searching for people how can count brown bear in Deosai. It was a three month program that you come and camp in Deosai plains. These are very rare bears and they wanted somebody to count them with binoculars. And both my husband and I are nature lovers, sea, mountain etc, we do a lot of camping, so we both applied and they selected us immediately because we would have a company, w are young and we could do it. And then we thought we have careers etc and we didnt do that. To date I really say that I have missed that opportunity and that time wont come again. Thats my only regret otherwise no other regrets. Everything has been great. S: hmm any other thing you want to say?? KM: umm in terms of leadership, what was your question, research question? S: leadership of women in health sector KM: no what is your research question about women leadership..? S: No okay, at grass root level and at policy level, women are working, what is the difference or similarity? KM: you know the sad thing is women are not connected. It would have been great if women were connected. Grass root know who are our parliamentarians. It should have been great if there is a health movement. S: yeah like begum liaqat ali khan had a great contribution in health sector, in the time when Pakistan came into being and there were no women like us. There was a movement and it was successful, so I also have this wish that there should be a grand movement on a platform on which we address the issues of health KM: I would like to see phrn do that role because phrn has potential to come in his role. That al the people are connected in health sector, they know who is in Islamabad or Quetta. I mean we try to do that through ldm, to get them all connected but its a temporary thing, long term phrn can do it, get everybody together. S: and there can be a public private partnership like LHV program, malaria control HIV etc, all these merged and government and private both work closely. KM: yeah that would be great, you know there is some information sharing, connections, networking, they are bonafide professionals, like you are a member of phrn, I am also, I will help you out. S: but that is for those who have computer KM: it has to go beyond that. Thats why I think phrn has the ability because it has connections on the grass root level. They have leadership at that level. If once a year they have a grand meeting, they meet, yeah S: they form a source KM: yeah, that kind of leadership is missing that pull this force together. That why I think the work Dr. Yasmeen does is really amazing. Really amazing. S: okay

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Interview Kausar Zamani SG: tell us about yourself and your professional career KZ: I always wanted to help people; I always felt pain for them. They could not go to hospital and pay huge bills. I started off with low fee so people started coming to me and liked me for my service. There were mainly normal case but there were some cases which were serious, I thought I couldnt do that, I took them as challenge. My experience is about 32 years. SG: tell us something about your qualification KZ: MA sociology, I did BUMS- bachelors of unani medicine and surgery in 1993. Unani medicine is modern so we use all modern medicine. I have also done correspondence courses to increase my knowledge. SG: In the past 30 years you have been involved in maternity health, do you remember how many people have got benefited from your services? KZ: Numerous, I started this work back in 1980 SG: YOU were telling me that you have handled almost 60, 000 cases? KZ: yeah, I have, some are written. Have done many, 3 were daily SG: Who was your ideal? And how did you start your career? KZ: my father was my ideal. He was a graduate of Unani medicine. College Delhi. He had quite a research in unani medicine. Many people got benefited from him. Then I also started studying. Brothers also knew, so we make medicines on our own. My father used to say that I have to take this forward and have to help people. SG: does you have any other in your family in unani medicine? Yeah I have brothers in my family SG: Until now in your professional career have you ever faced any challenges? KZ: the main challenge was that specialists women rejected normal cases to c-sections. I have taken those cases as challenge, most of them were normal, Some of them were difficult but they were not operation case, they were told that they would be operated, they came to me then, they were happy and said I dont lie, yeah there were some operation cases, and I always referred these cases to specialist for operation, because I had so much experience. SG: tell us more challenges KZ: yeah more challenges are like cancer and hepatitis C is increasing, so we are researching on that, and have helped a lot of people. We have medicine. 1st & 2nd stage cancer can be cured but last stage cant. And we dont treat people who have been electrocuted for cancer. In case of Hepatitis we just cover disorders. SG: Are you doing anything to expand your research as it is a very significant research? KZ: I want to expand but I couldnt find way. SG: What are the difficulties/issues? KZ: Difficulty is that, m trying hard , I am writing to government as well , have written to everyone , to donor agencies , but you know what have they said, they say that they will grant 63

funds through government, if I get funds I can work on it. Cancer medicines are expensive if I get donation I can treat more people. SG: Whom you have contacted? KZ: I have contacted donors, and have talked to minister of social welfare as well. I havent talked to health welfare. But of no use. I have talked to Australian agency but they say that this should be done through government. I dont understand this thing. I am writing a letter to chief minister, now thing is nobody cares SG: Do you want to spread your research? KZ: yeah I want to, thing is that medicine is way too expensive. Sometimes we help but we cant always help people. SG: YOU want support from government? Yeah I do, with government's support I can help people more if I have funds. I have successfully treated 16-17 hepatitis patients. There is a lady from tando hafiz shah bulari she came for treatment for hepatitis, she is good now, and she doesnt have hepatitis. SG: How do you look to your career so far? KZ: yeah I am very satisfies and I want to introduce my medicine in market for cancer, hepatitis etc. SG: You were telling us about different cases, how do you feels about that? KZ: Yeah it has been by grace of ALLAH; every time I did a case people hug me. I want to educate people about this. I want to do seminars but I dont have much resources SG: do you have any students or have given lectures? KZ: yeah I have, but its not systematic. SG: have you contacted any government health personnel? KZ: I was in TB sanatorium in 75; I worked there for 9 years. I have worked quite a long for them. SG: has any educational institute contacted you to teach their students? KZ: no not anyone. SG: have you talked to people /institutions that you have medicines for these diseases? KZ: yeah I tell everyone at every function but nobody takes me seriously. SG: tell us the most memorable moment of your life? KZ: I have done a case that was very difficult case in which the baby's position was very strange. When I did that I was very happy. People said that there is a price on that delivery. And when my son was born that was the most memorable moment of my life. These 2 were very memorable moments.

SG: YOU have some spiritual side? KZ: yeah I just believe in ALLAH. 64

SG: What do you think what is the difference between decision making of men and women? KZ: yeah they have different. Women think before making decision and men just impose their decisions. Women are successful in every field. Women understand everything. Women are very intelligent SG: Many women are working in health sector but they still couldnt make to higher level, what do you think why that is? KZ: there are several issues, family doesnt allow, they couldnt come to field work due to societal pressures, and our society dont allow women in field. Men dont support women to work in field SG: What is leadership style of women and men? KZ: womens decision goes wrong due to men's pressure. Women sacrifice a lot than men. Women are more courageous. Men cant sacrifice. Benazir Bhutto was a great leader. She sacrificed her life, a man couldnt do that. Woman has courage and power. She was a great leader even a normal woman can be courageous, she also has got power. SG: yah you mean that woman has to sacrifice if she wants to be a leader. KZ: Yeah, and women sacrifices more than man. In fact man cant sacrifice. SG: What are the hindrances in your profession? KZ: I dont have resources. I want to have nurses and trained staff. I never wanted to close my maternity, I dint have resources, I couldnt wake up for late hours, people want services at low rates I cant offer them as I dont have resources I dont have young doctors I cant pay salaries m running OPD but I cant run maternity so these are the issues. SG: is there any societal barrier to decision making? KZ: no there hasnt been any problems. SG: do you see commitment and leaders in society? KZ: yeah youngster are, but people have become careless, I have left because I cant stay up all night, I cant leave all matter with nurses, I cant be careless but people have turned out be careless. SG: Do you think women are good leaders? KZ: they dont sacrifice either shes a nurse or LHV but some are. I had a nurse from tando Mohammad she was very committed when even I wasnt around she took care of all maternity matters and did everything smoothly. There are some women who can be leaders of tomorrow. : do u think todays student have any spark of leader of tomorrow? KZ: they just want degrees they dont have commitment, they dont want to work. SG: Do you think women have extraordinarily qualities of leadership? KZ: some have, I trained a girl she was Matric. In a week she turned out to be very skillful, she learned very quickly. : Are you satisfied with your work? KZ: yeah I am. The normal work I do this delivery thing, 100 % work that I do I am satisfied. 65

I have never worried. : do political decisions hamper your work? KZ: yeah they do. Ministers dont listen they dont listen to what we say. Government doesnt care for patients SG: you have been working for almost 30 years in this sector; do you think there has been some era in which government has seriously worked on health sector? KZ: when I was in Bhittai there was MS Shahid Ali, he was murdered but he managed hospital very well. SG: what do you think the concept behind all the health projects is welfare or political? Like in our society the basic health care is important, so do you think its played politically? KZ: No I dont feel this. Anybody who is coming in power is doing what he has to. Its been for years, if there is political or not, there is no care from government. : What do see a grass root level women and a policy maker, what is the difference between them? KZ: both work, thing is that who gives them regard. I have been working so long; you are the first one to interview me. Women should be given proper health care SG: Do you think there is a link between grass root women and women at policy making level? KZ: yeah theres a link but the thing is policy maker gets funding and resources and trainings but nobody asks us. We cant do this; if we have to do this we need funds. SG: but both working for welfare of health? KZ: yeah both are working for welfare; they are at different levels but working or same thing. SG: what is the vision that you have for health sector? KZ: health I snot good anywhere. Hepatitis is so much everywhere in village. I have worked in villages for almost 25 years. I have seen so many diseases in them. They say they are working in villages but I cant see any work done in reality. SG: you mean that all the big projects of HIV & AIDS, Polio, and Hepatitis KZ: they all are on papers, people are so ill. SG: there are no proper health facilities in villages? KZ: they have BHUs and health centers but they dont have doctors, no nurses no doctors go there. They just have LHVs SG: this was the rural picture, what do you see now in cities? KZ: in cities situation is much better but everything is so privatized and monetized. I was popular because I dont have high fees. SG: tell us the overall situation is bad in Pakistan of Health sector, what do you have an overall view of sector? KZ; there are no doctors, no medicine, no facilities, give facilities to help patients. 66

SG: do you think Pakistan should invest in health sector? KZ: yes they should and they should have accountability system as well. SG: where do you think women in health sector? KZ: women are in a very poor situation. SG: where do you see women working in health sector? KZ: yeah women are working more than men and they are working well than man SG: do you think if women are given more space and opportunity the health sector will grow more? KZ: yeah it will develop more SG: any other thing you want to share? KZ: yeah, people should know about medicine, they divide medicine between small doctor and specialists, and capsules will work only. SG: Thank you very much. Will be in contact, the work you have done and are doing is really good. Thanks

Interview of Ms. Kausar

Interviewer: Assalam-O-Alikum! Madam, how should I address you? Ms. Kausar: As Kausar! Interviewer: Ok! Kausar, would you please tell me, how did you start your work in the field of health? Ms. Kausar: I have not entered directly in the profession of Community Health Department before it, we were working in three slum areas of Karachi, on a project of family planning Association of Pakistan which aimed to have economically strong women in order to get their better health. Women can never be healthy unless they are financially strong and would be able to make decisions. At the outset, we used to consider sector of health merely limited to a clinic with a doctor in it, our views broadened and altered in this field after working in it. When this pilot project of three years duration ended, we came across that Agha Kahn University is hiring the people having experience of working in slum areas, because it was a trend in Agha Khan University to take the medical students in the slum areas and teach them about the people there, this is called Community Based Teachings. The medical students in medical colleges are taught about the whole cycle of a disease which also includes the factors and roots causes of the ailment, hence it is an entire learning cycle. A learning cycle consists of a population of a community and you analyze the health of a population and know how to identify and classify the causes of a disease. A medical college is linked to a hospital and obliged to teach its 67

students, therefore to know the causes of certain epidemics it is necessary to study the root causes of it, so, we were hired with the experience of working in slum areas. A question arises here that what is the difference between an environment and health, according to WHO, it is the social determinacy of health? It means to find out the economical conditions effecting health. In those years every year one or two slum areas were selected and every new class was assigned a slum areas community and to accomplish this task they used to hire the experts working in slums. Interviewer: You are talking about which year? Ms. Kausar: I think it was in late 80s. It was newly inaugurated university, and we were hired in the third year of its deployment. The university decided in the first year to take the students to the slum areas and in the first year they were taken to the Aurangi area, the second badge was taken to Karimabad and we joined with the third badge and we took them to the Chaneysargot and Garaks. We also studied about community dynamics with the concepts of origin of slum areas, the life has had been different if these slums have not been existed. The declaration of 1978 is very important in the manuals of WHO of primary Health Care and it was the largest conference held in the world in 1978 and it is called PHC declaration, which explains about primary health care. The slogan for it was Health for All by the year 2000 and the meaning of health is described in the first paragraph of the article that the meaning of health is physical, mental and social well being and not merely the absence of disease and infirmity, it says that health is prosperity rather than absence of disease. This declaration of 1978 gives a significant turn to the concept of health to focus on health rather than disease but still medical fields in most the countries focus on disease only. In our country we never ponder upon for the change in environment but only on giving medicines to patients. Once the most apparent disease in America was TB, they overcame it with environment change, so social determinants play a vital role in health. We have worked with the chairmen who were involved in 1978 declaration and they helped a lot for implementation of policy. As you have mentioned about Dr. Rahila Magsi, she might be able to work more effectively if would have worked for community health sciences and if you monitored that area, I dont think there would be any difference in the deaths of people in the area. To open a clinic resembles to a story in which some people sit beside the river and suddenly watch a dead body sinking in the river, they rushed near it, check it and after a while another dead body appears and they did the same thing. Ultimately, people decided to climb up the hill to analyze the causes of these deaths. Hence, primary health is not only related to the diagnosis of a disease but of its root causes. This is called a social health module and not only the clinical module in health. When we were working in Thatta, we asked women the meaning of health, they said it means to feel happy and relaxed every time, so this definition of WHO is all, what people really think about health. It is also included in the declaration of Primary Health that health is a basic necessity and people are involved to build the system of health. We should know how the society will progress and all the factors relating to health are their right and health is a political process. The subject of community health sciences is not as powerful in the colleges of Pakistan as it is all over the world. 68

Interviewer: Did you start your career in this field after being inspired by someone? Or, was there an ideal personality due to which you adopted this profession? Ms. Kausar: No, as such there wasnt, but due to womens action forum linked to human rights. People did not have much awareness about rights when I started by career in this field, but when General Zia constituted some laws which were somehow contrary to us, we protested and discussed and as a result many facts were disclosed to us. Naturally, women live longer than men, hence according to the statistics in various countries if there are 100 men then there would be 102 women, contrarily the sex ratio in Pakistan is opposite as compared to the world wide ratio and there are more men than women. Similarly, maternal mortality is high in India as also and number of men is more than women. Despite of poverty, womens lives can be saved but here we dont consider women as precious beings, therefore they are not saved. Thus, womens health is connected to the status given by the society. Interviewer: All these things are interrelated to our political and social system, now would please explain that do the political chaos in the country affects health of people? Ms. Kausar: sense of public good public policy Initially, I would say that any ruler who reigns in Pakistan should have a good sense for public and public policies but unfortunately whoever gets supremacy in our country do not have a good sense for public and consequently, womens status cannot be raised here. Iran has very rigid rules for women and the tradition of stoning to death is applicable there and if any critique raises his voice the police capture him. But they are better than us because their state know and give the basic rights to their public, defiantly our leaders never think of providing basic rights their public. We who also work as human rights activists support democracy and states that solution of problems is obtained from the public and we have also created awareness in the local bodies of government which includes women but still their mindsets have not been changed. An individual in a society cannot bring change in it but it is the effort of an institution containing individuals in it, therefore, role of institution is significant in a society for a positive revolution. We all are related to certain organizations and there are a few consultants who work individually and the status of public health can only be improved if the society changes. We talked to a human rights lawyer and came to know that the indicators of malnutrition have not been modified at all, the malnutrition should be regarded as unlawful. Pakistan has signed CRC of child malnutrition and a child brain doesnt completely develop if he doesnt get proper nutrition in the first two years of his birth and this affects his whole life. Even if the child goes to school she/he would not be able to learn affectively. Therefore, it is needed to form constitutions against all these malpractices in the society and on the basis of those laws people would be able to ask for their rights. Hence, health is a primary right and has to be linked with laws of a country. Interviewer: Right now, you mentioned that leadership shouldnt arise from an individual but from an institution. Ms. Kausar: It should be from both, there is an individual and then an institution and it is worthless if a right individual is inhibited to perform certain tasks, on the other hand if an 69

individual is least interested in his job but the institution encourages and motivates him to achieve specific tasks then the work is more slower than the individual who wants to do it himself. People join and leave organizations but the point is of having a true and dedicated worker, like in olden times people use to be very happy with a generous leader, after his death his son takes over the throne, but he proved out to be cruel leader and people became melancholic with him. The purpose of institutions is to exist and let the people join, perform their duties for a specific period of time and then they leave and in their places the other comes. So, leaderships are evaluated in order to know whether it is strengthening the institutions or not. Mr. Edhi was an individual and established an institution but after his existence his institution will run because his son and wife are in position to continue it. People used to talk about Aurangi Pilot Project that will this institution run after Akhtar Hameed Khan, but he also set up a small institution to take forward his mission. Therefore, institutions are needed to make leaders and we cannot rely on a single or individual leader without an institution. Interviewer: What is the linkage between the tasks of a woman working at policy level and the other at the grass root level who also works with great enthusiasm for her mission? Ms. Kausar: Policies are formed and analyzed on the basis of the criteria that to what extent that have had been fruitful to women. Most of the times policies are formed but do not implemented, therefore, it is needed to monitor the organization of a society. Once, I met a government personnel, he shared one of his experience with us of a village, where he wanted to provide electricity to the villagers but the feudalist of that area prohibited him to do so. So, sometimes the leaders are willing to implement certain policies but some powers stop them to achieve their goals and this draw back has to be overcome. Tasneem Saddiqui is one of the policy makers who worked on housing schemes in the interior Sindh despite of facing hurdles, so we need this kind of policy makers as in our country we have fight to bring a positive change and it is the duty of all of us to support the leadership at micro level. We always talk about (Ms.) Mai Bakhtawar who was the member of Harri movement, she stopped the landlords who came to get the harvested crop and in turn they killed her, but still her name is alive. She was an ordinary lady but rose up courageously for her right and she deserves an award on her bravery and this award should be given to the rural women. It should also be given to a lady in urban areas who defies a law which violates human rights and this kind of person is a leader. WHO formed a commission on Social Determinants of Health and it was assigned to explain, how peoples health could be made better and they took this report after pervasive research and effort and named it as Closing a gap in a Generation, it tells to bring change in one generation. Today, we were on a paper which depicts that in one generation of Pakistan destruction seems to be increasing and this our generation if we examine the last 5 to 10 years, conditions have become worst during since that period of time. The first recommendation in that report is improving daily living conditions. So, wherever you work, you should know the daily life of a lady and make it better. 70

Interviewer: Kausar! Would you please tell me, what is the difference between the leadership of a man and woman? Ms. Kausar: Leadership depends upon its definition, often there is normative definition for leadership we say what should be done and according to it a man and woman should be a leader. If you want to know this question, you have to do a study on leadership and conduct a research on men and women leadership and you will get the results. Interviewer: What do you mean by leadership? Ms. Kausar: According to us leadership, is to bring people in the position of leadership. Interviewer: Is there a difference between the decisions of men and women? Ms. Kausar: The qualities of human beings are both in men and women same but men seems to be more authoritative and ordering because these qualities are imposed on them by the society. Similarly, women are also conditioned by the society, and they become more emotional than men. If a woman exhibits some qualities, these should be expressed and used by her, she should be given a chance to do what she wants either it is dancing or singing. Interviewer: Why women are unable to reach the top most positions in their profession? Although, they are visible in educational institutes and hospitals but not on policy making levels in the government. Ms. Kausar: You might have noticed what type of policies are being constructed in Pakistan. If a woman is aspired to attempt certain task but being stopped by someone, she should protest and we from womens rights group will support her. Interviewer: I think a woman can work more effectively for women, because she can feel the other ladys pain. Ms. Kausar: Well! It is an assumption, but it doesnt exist in reality. According to us health is different and even the councilor you mentioned couldnt understand our perspective of health. Interviewer: Do women have opportunities to move ahead in the sector of health? Ms. Kausar: Yes! There are lots of opportunities for women and men both but the question is of utilizing them by the right persons who really wants to work. Although, the system of our country is not right but still if women and men struggle to achieve a goal, they can. Interviewer: Are you satisfied your work or do you feel to do something else as well? Ms. Kausar: I think work and tasks are like natural trees who keep on growing. Interviewer: What is your vision or dream for the country?

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Ms. Kausar: I wish to have an organization on Social Science in Sindh which might focus on women rights. Interviewer: This is your vision for health. Ms. Kausar: This vision is not only limited to health but relates to the entire life of a woman. The concept of Social Sciences is extremely weak in Pakistan. This debate has to be in the mainstream, therefore I wish for an institute on Social Sciences where women should be educated and efforts should be made there to achieve womens rights. A woman can come and stay to research on an issue and this institute might become a centre for education and research. Interviewer: And where do you see women in this sector in the future? Ms. Kausar: I dont distinguish women from men, but want progress and prosperity for both of the gender, as women dont have their own world. I think women are aware of the violation of their rights but men even dont know what are they lacking and where their rights have been violated. Interviewer: Have you ever faced challenges in your career? Ms. Kausar: The biggest problem for me is of traffic and I feel very difficult to reach to places in time, I think our lives should be easy but in our country it is becoming more complicated than before. Interviewer: The security risks have also increased nowadays. Ms. Kausar: Challenge is the part of our lives, when my father and my maternal grandmother died, I felt grieved and was gradually able to cope with the situation. Interviewer: and in your career, have you come across any challenge? Ms. Kausar: I always, did what I liked to do, hence I did not faced any major challenges in my career. Leadership is always interactive skill, a person cannot be alone and lead, and being with others mean that the person will have supporters as well enemies because some people will cooperate in your thoughts and some not. But it is important to be in a team despite of having conflicts. Interviewer: Do you remember a moment in your life when you felt that you have conquered a situation or won? Ms. Kausar: When I was working in the slum area, suddenly I used to feel happy by the womens comments or smiles and realized that yes! It should be in this way. Interviewer: Do you want to say anything else? Ms. Kausar: Yes! I would like to research on this field when you will be having any other task relating to this field. As we all know, the standard of research is very low in Pakistan. 72

There are two types of people, one who reads books and others who think, those who dont think and only read books are very boring and the ones who dont read books but think are very dangerous, so we people become very hazardous when we assume and dont study. Thus, study and thinking both are important to research and work. The trend of studying in profession is decreasing in Pakistan and this habit has to be developed. Interviewer: It is a very impressive message, thank you. Ms. Kausar: Thank you.

Interview Ms Saddiqa Muzzafar SG: Assalamoalikum we are interviewing Siddiqa Muzzafar, lets start the interview SG: Assalamoalikum Saddiqa SM: walaikumasslama SG: how are you? SM: i am fine SG: tell us something about yourself? SM: my name is Saddiqa Muzzafar, and i am related to health, i am working in National program as assistant district cordinatinator national program on family planning and primary health care. I am working on this post since 94. I also work for NGOs. There is an NGO Naari welfare association in Tando ALLAH Yar, i have done BA, it s been 14 years that i am working in health sector. SG: from where you have started your work. SM: i lived in Karachi, there is started work in health sector with different people and NGOs. In city national international NGOs were working. Whenever i came back to my village the conditions were bad. Then i thought whatever i have learned i can use that to help the people of my village. Then i came to my village its a small village Sanjarchaan, UC Sanjarchaanj, the name is Chaudry Sultan Ahmad Goth. i started my work there. There i established my own NGO so that i have a plat form to work. There i a talked to my people. SG: who was your ideal when u started working, from where you got the inspiration? SM: at that time the prime minister was Benazir Bhutto, i was impressed by her, if a prime minister can be a woman then why should we lag behind we can also be leaders. We can work like her. I was very much impressed with her. SG: tell me when u started your work what kind of challenges you have faced? SM: i havent faced any difficulty as it was a good cause and people helped me.
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Whenever you start a new thing or work you have to face some difficulties, but we overcame those difficulties because the people of the village helped us a lot. They praised it a lot. SG: what were the challenges anyway? SM: challenge was that the environment was different as i came from city so to adjust to village life was a bit difficult. As women in village have a different social setup, they dont go out in the field etc but when we talked to people, involved them they knew what we are doing and praised and helped us. So now its quite easy for us. SG: do u think that u r successful in your sector? And how do u rate your successfulness? SM: i have been very successful in whatever i am doing and I thank ALLAH. The way i am working, people love that. I want each woman to work like this. SG: what is the most memorable moment of your life? SM: the day Benazir was shot dead, i was in Hyderabad, i had to come back to my home, the situation was not good, people asked me not to leave Hyderabad but i had to rush back home, and i took it as challenge and went back home in this gory situation and i still remember that i came back home unharmed. Though the situation was quite critical. SG: do u have any memorable moment in your professional life like you have been successful or unsuccessful in any manner, and one always remembers that whole life, do u have any such moment in your professional career? Like you started your organization so there might be nay instance SM: yeah like when i started my work and here and i worked for one year being a woman and i was the only woman working i was given award for my work i felt so proud that being a woman my efforts have been acknowledged, that was a really good moment plus i felt leader in my own capacity. Women are less in every field here and men are many, every time there is an event at district level i am being called and that makes me really happy. SG: the decision making style of men and women are different if they have to decide over same thing what do u think they will do? SM: in my opinion if the decision is related to some good work and it all depends on the nature of work. SG: do u think that decision making style of men and women are different? SM: women should be confident that they can do everything and anything like women.
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SG: in health sector, as u have 14 years experience and you have been working both for public and private sector, women working at executive level are less why is this so? SM: it is because the education level is low, they are not allowed to get out of homes and there are no opportunities for them to get out and work in this sector that is why you dont see women in this sector as a majority or in good numbers. SG: societal pressures? SM: yeah social barriers and pressures wont let them excel. Especially this can be seen in villages SG: you said you were impressed with Benazir; she also had to face these problems. How did she rise to such a position? SM: she had a will to overcome all these problems she was dedicated. She worked hard and sacrificed for nation. SG: leadership styles are different? Of men and women? SM: its recent in politics that 33 % female should be given representation in assembly it wasnt a few years back. When woman is given leadership that means she will work hard with more dedication and commitment. SG: why is male leadership style different? SM: its not different, but the more dedication and commitment comes from women. SG: you mean that leadership is same? They have different qualities. SM: yeah as i said women have more dedication and commitment so they work more dedicatedly SG: you have been working for long in this sector, public and privately, what are the obstacles they hamper your decisions? SM: whatever work we do we do for the welfare of people, any decision that we take is supported by people as every decision is for their betterment. SG: dont you have ever faced any problem? SM: yeah i have been settled now in my work and whatever decision i take people facilitate me and help me, so there is as such no issue. SG: you have working from grass root level to national level; do u think there are women leaders in this field?
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SM: yeah , in this district where i am working , our district nazim is a woman, She is Dr. raheela gulmagsi, she is so committed and determined and she works without taking into consideration that she is a woman. She has so many leadership qualities and she is so determined. She wants to make her district a role model. We get inspiration from her that if she can do all this why cant i be a leader like. SG: in health sector do u see anyone? SM: in tando ALLAH yar. SG: all over [Pakistan do u think there are good women leaders in health sector? you know there are many problems that a woman has to face in health, so this sector is very much related to women. SM: we have link with different NGOs, most of them are working for mother and child issues. SG: what are the different health projects that you have done so far? SM: first of all when i registered CCB in 2006 and started work in 2007 , my aim was to work in health area and focus on women. When i surveyed the village the maternity deaths rate was very high, and there was no system in place to save mothers from dying. Then i started a project to save women. Then i thought of conducting a training of TBS, for that i trained 40 TBS in my district and they belonged to 250 different villages. It was 15 days training; they were given certificates and midwife kit, in which there were instruments for normal delivery so they can manage a safe delivery. They were told where they have to refer women etc; in this way we were able to reduce IMR. SG: how do u monitor that? SM: there were other people, we trained district trainers and we get feedback with different personnel we have. They update on everything. SG; this was the project that u did with CCB, and it was a 2 lac project? SM: yeah, we gave them certificates, kits and stipend. SG: what was the other project? SM: that was my first project of TBS that I did with tts people, it was a model project, it went there, and people came from Islamabad and interviewed me, and they published in a newspaper. They i did a project on mother child health, in that we were focusing on reduced TBRs, IN THAT we also trained the TBS and mothers in almost 300 villages SG: who funded this project? SM: it was funded by district government. 20 % is shared by ngo and 80 % is
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given by district government, SG: what are you doing under your organization's banner? SM: we have established a maternity home under its banner and its open 24 hours. Women from all over district come there for checkup. We have a gynecologist dr; we see free patients and charge very little. SG: how many people get benefit from this clinic? SM: the total population of this district is almost 500,000. So people from all over district come and get themselves checked SG: is it successful? SM: yeah it is and women are happy SG: are you satisfied with your work? do u think there is some thing left? SM: yeah i am very satisfied with the work. I am very happy because so many women get benefit from it. I want to expand my work in every village. I dont have much resources but my future plan is to expand my work SG: do the political decisions affect your work SM: yeah definitely there is a political influence but the work we are doing is for the welfare of people, and this is not against government we are working for everyone, we dont discriminate between people that they belong to such and such group or political party. We work for welfare of people. SG: Political people have ever interfered into your work? SM: no they have never SG: tell me that you are working on grass root level, what is the difference between the grassroots women and high up women? SM: both want to work, the difference is the level, resources and influences. A woman on minister level and a grass root woman have same objective of working. SG: both have same powers or? SM: both have different powers , one is at ministerial level and other working at UC level both will definitely have different levels of power and resources. SG: what is your vision about health sector in Pakistan? SM: the situation is bit better from past , but there is a lot more effort needed , different groups have collaborated and joined like NGOs , political groups or Agha khan etc, everyone is working for health sector so its improving day by
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day SG: you see a good future of health sector SM yeah if the work continues the way it is the INSHALLAH we will be able to meet our goals and objectives of having a healthy Pakistan. SG: are you satisfied with the work of government? SM: yeah but government is unable to reach villages, the ngos and social welfare departments have a huge role in this regard SG: as a woman where do u see women in health sector? SM: the way we are working, we are working hard and i think and i pray that every where we find women those work at grass root level, at villages and they should be awarded about the health issues. They should be given proper programs

SG: you started this work yourself, what do u think for women to work on their own in this sector? SM: when women see me working like this, they are really are impressed and they want to work like me, and they want to work with me. SG: are you doing for this? SM: yeah we have quite a large number of members and they organize different events. Any kind of activity, camps, workshops etc they go with s and arrange everything. They go in camps and train people. SG: anything you want to say? Any wishes? SM: i wish that at every level women should come out and they should fight for their rights they should be awarded and they should work whatever they want to. SG: thank you so much that you gave us your precious time

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Interview of Dr. Rahila Magsi

Interviewer: Assalam-O-Alaikum! Dr. Rahila Magsi. Would you please tell me about your self that who is Rahila Magsi? Dr. Rahila Magsi: Dr. Rahila Magsi is a doctor by profession. I belong to Magsi family and my father Mr. Allah Buksh Magsi is a land owner and also allied to politics. My younger brother Dr. Irfan Gul Maqsi was the revenue Minister in the former government and MPA from Tando Allahyar District. I have selected as the first district counsellor of this Tando Allahyar District. We have the honour for selection of four women counselors from Sindh and there is no one from the province Punjab, NWFP and Balochistan. Out of these four counselors one was Ms. Faryal Talpur, the sister in law of Ms. Benazir Bhutto. She belongs to Nawabshah. The mother of ex-chairman senator Muhammad Mian Soomro, she belongs to Jacobabad and the third district counselors is Ms. Sugra Junego the daughter of ex-prime minister Muhammad Khan Jonejo from Mir Pur Khas and I am the fourth district counselor of Pakistan who doesnt belong to any political party. I won this election on my self credibility. People trusted on me and brought me on this position and it was a newly created district where I started from zero and proceeded ahead, currently this district is assumed as a model district among all the districts of Pakistan. Interviewer: Ok! Madam, Please tell me the extent of difficulties you faced to reach at this level. Dr. Rahila Magsi: The main thing is that Tando Allahyar is an interior district and in the interior Sindh there is a male dominating society where men are more influential and powerful than women. These people are called Waderay (land owners) who exhibits huge vehicles for transport. It is not easy to effectuate among them and I did due to my hard work, dedication and perseverance achieved this goal. I created a spirit of team work and all the district people supported me and we carried on our work and for all this efforts and associations , I am thankful to all our team members, councils, the honourable people and poor ones. Interviewer: Ok! Maam when you started your work, did you realized something or was there a source of inspiration for you? Dr. Rahila Magsi: My parents are source of inspiration for me and my ideal personalities are Quad-e-Azam Muhammad Ali Jinnah, Muhatarma Benazir Bhutto and her allegiance for political commandeering boosted me to arise. My mother belonged to Punjab, was a doctor and used to recite Quran, she was herself an institution. My father was a Baloch. These were the relations from whom I learnt a lot and they inspired me enormously. I kept those personalities in mind and except these challenges as a service. Interviewer: How do cope up with the challenges in this male dominating society? 79

Dr. Rahila Magsi: I have already replied you about it, that in the male dominating society, I teamed up people and brought them on board and by the grace of God, I have never been disappointed by the people of Tando Allahyar, in 2006 I started my work as a district counselor, in 2007 the process of elections started and at the end of 2007, Ms. Benazir Bhutto was martyred. I have never encountered any problem by the side of Prime Minister or President. But I have been given a lot of trouble from the local politicians of this area and FIR has been lodged against me, my brother and father who is eighty years old. Many of my members and councilors were victimized and FIRs were lodged against me by them. The funds being given to me were blocked and every person stood against me in order to paralyze me. But, I instigated myself to work for people and never to leave them alone. I believe that defeat and victory is in the hand of God and decided to be with people in every condition. Interviewer: Well done! Would you please define leadership in your context? Dr. Rahila Magsi: A leader should be bold, dedicated and arise as the voice of public who voted him/her and should serve them and bring revolutionary changes in their lives. Secondly, leader should be able to provide employment to people because they are the ones who makes a person leader and ordain them with honour. Leaders should be non-corrupt acting for development of the country and its citizens. Interviewer: What are factors affecting your decision making in your profession? Dr. Rahila Magsi: District Counselor is the financial and administrative head and a system can run successfully only if the whole team is on board. At present, I am having problem with Mr. Tariq Maimoon who has been specifically brought here to distress me. The DCO and district counselor has a close relationship like a Chief Minister and Chief Secretary and a District Counselor is the head of a district and his position is equal to a governor while the position of a DCO is equivalent to a secretary. If the DCO will not obey what ever I told him to do, I would not be able to give the positive deliverance in the as I used to give in the initial stages. Interviewer: What are your attempts in the section of health? Dr. Rahila Magsi: I have worked tremendously on health section in district Tando Allahyar, like the formation of Mother-Child Health Centre, established hundred bedded hospital which was built at the cost of 55 million (550 cror) in which there were separate wards for men and women and wards of paediatrics, medicine, surgery, orthopaedics, gynaecology and obstetrician had been established in the facility with two advanced theatres. Moreover, there was the facility of ventilator and life saving machines, I was running 30 BHU and dispensaries but when I analzed that government is not able to run it properly, doctors are transferring to other districts and medical sector is adversely suffering, then I thought to sign an MOU with BPHI and confer every budget of these dispensaries and BHU to BPHI, so as they might be able to provide in it the facility of lady doctors and BPHI is working efficiently in district Tando Allahyar. Approximately, there are 12 lady doctors and 15 male doctors who provide the medical facilities in BHUs and dispensaries. Budget is ours and 80

services are of BPHI, moreover , the a biggest achievement is that in district Tando Allahyar a large hospital is going to be built for which the government has donated 12-acre land for 300 hospitals, I declared its name as Shahid Bhutto Memorial Hospital. Many people told me to name the 100-bedded hospital after my mother or my own name as it is all my effort to establish but I named it after Shahid Muhatarma Benazir Bhutto and declared its name as Muhatarma Benazir Bhutto Memorial Hospital as a credit to her tremendous sacrifice. I boosted the Hepatitis program in my district Tano Allahyar and the district government donated hepatitis medicine of worth 8-cror, for one person the cost of these medicines is Rs. 50,000. I purchased the medicine and from my own fund distributed medicines among the people. District government also worked in the test of hepatitis, lady health workers, polio campaigns. We also made people aware by CCBs. Interviewer: Like, we heard about Ms. Saddiqa that she recorded her CCB and held the trainings of TB where women were benefitted at a great extent. Dr. Rahila Magsi: The lady health workers (Dayee) was given trainings for child delivery, so that they can work in areas where doctors couldnt reach in time. I facilitated 218 villages with electricity, sui gas facility to 103 villages. I spent the fund of 64 cror on sui gas and electrification. I constructed a network of 716Km roads in this district and brought the drainage of 26 cror rupees and provided clean water to people. I donated my own 6 acre land for the grid station in Chabar and gave scheme of 2cror for pure drinking water. In this district Support Complex is being built and I have established DCO house here with worth more than 1cror. I built rest house and temporarily declared it as DPO house, as he did not have house. All the work which I have accomplished is on my finger tips and they are obvious on the grounds. I also built a new Eid Gah, rehabilitation centers for disables and social economic centers for ladies, a new Jim in Tando Allahyar. I will show you all these things. Interviewer: Yes, a spirit of leadership is being seen in you. Do you see women leaders in the field of health like you?

Dr. Rahila Magsi: The women of Tando Allahyar and Sindh are very dedicated and devoted to work for a task. Women are supported if female are on some position to solve their problems because they can explain well to the same gender as compared to the opposite one. I promised the women before being a counselor to facilitate with sui gas and electricity and I fulfilled my promise and put an ease in women lives. Sui gas is very cheap in cost and if the public will use another thing to as fuel their bill will be raised three times and there would be a lot difference in poverty elevation. Interviewer: What is the link between the women working at grass root level and leadership level like you?

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Dr. Rahila Magsi: We have councils on grass root levels and there are members of these councils. The women working grass root level bring up the problems of women facing number of problems in the village. A person who is hired on a post is for a certain period of time, now it depends on him/her whether he fill his pockets with money or work for the communities. There are two things in politics either earn money or fame. But, I thought to get fame by my good works because Prophet (PBUH) had given me everything. My father always advice me serve the communities because the people who love and serve the creature of Lord are blessed by him either in the form of health, good children or wealth. If God will be chance to serve the community, I will definitely do so. Interviewer: Are you satisfied with whatever work you have done or there is still some deficiencies. Dr. Rahila Magsi: Human beings are never satisfied, but if I would have thought that I have only four years and one year I can use as my leisure then I could not get the opportunity of serving people. I have brought a major developmental revolution in lives of poor, middle classed and rich people of this area in one and a half year duration. This district is an example and you can go and see it. I will never say that I am satisfied, I have to do much more for people in future as well. This is an agriculture based district and I have to provide employment to people here. It was my desire to bring in foreign funds and turn this area into an industrial zone. Interviewer: What is the difference in the decision of a man and a woman? Dr. Rahila Magsi: I have not seen any difference in this, as I have mentioned earlier that a district councilor is the head of a districts and both the genders have the same powers. I also have the same power as the district counselors in Karachi or Tharparker. I have not lied with people in any case or condition and trying my best to provide them their rights and it is my duty to do my job perfectly. It is the duty of everyone either citizens, presidency or senate to bring a better change in their lives. Interviewer: What is your about health section in Pakistan, how it should be like? Dr. Rahila Magsi: Well! You know, although a building of infrastructure is needed but the main thing is to operate a system, paramedics staff, doctors, competent surgeons, gynecologists who are very short in number and for gynecologists, I have funded 1cror and 20 lacs (12 million) in my district. Government should hired the most competent gynecologists, surgeons and opticians to run a hospital even if they have to pay them salary about Rs. 1,000,000. I have precious ideas but no one has let me work, and I am very much annoyed with this DCO who is working for me. He should work beyond discriminating on the basis of religion, race, cast or political. The secret of my success is that I have always kept equality as my first virtue and you can reach my witnesses in the areas through print or electronic media and they will explain you definitely that how have I dealt with them and I request you to do so. It is also a research to ask people about their opinion for me in order to analyze how much true I am saying here. 82

Interviewer: Madam! You have any other dream? Dr. Rahila Magsi: I pray to God to give me enough courage, wisdom and strength in my hands to serve people with an intense motivation, enthusiasm and dedication, and I know he will do it and this is also my dream. Interviewer: What is the memorable moment of your life? Dr. Rahila Magsi: I got married in an early age of sixteen and when I was going to give the last exam of my academic education, my child was going to school on his first day. At that time, I realized that what a chance, that I am going to give my last exam and my child is starting his education. Hence, there are numerous moments which we remember with the passage of time. Interviewer: Right! Madam, how many children do you have? Dr. Rahila Magsi: I have four children, my son is Civil Engineer and nowadays, he is studying in America and doing his Masters from there. I have three daughters, the eldest one is also a civil engineer, she did her Masters from UET, and the second daughter has F.Sc and the third daughter is an American citizen she has done her Matriculation. My sons name is Muhasson and then the daughter Ana, Malika and Marriam. I am very happy and satisfied with my family life as well. Interviewer: Great! You have kept a balance between your professional and personal lives. Dr. Rahila Magsi: Yes, this is all because of God and my mother and the prayers of my parents. Interviewer: Thank you! Madam, it has really been a great conversation. Dr. Rahila Magsi: Thank you so much and God bless you. Interview Dr. Yasmeen Sabhi Qazi

Dr. Yasmeen Sabhi: My name is Dr. Yasmeen Sabhi Qazi, by profession, Im a doctor and I completed my medicine from Karachi and specialized in public health. I have history to join this field although my plan was to be a General Surgeon and at that time women used not to be General Surgeon in Karachi. While I was working after the birth of my eldest son, I entered in public health field, I got an opportunity to work in villages and it changed my whole life because I realized that women spend their whole life due to the biological cause of being pregnant and as being a woman, so

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when I went to the field, it was a wake up call for me and after that everything changed around my life, my child was very small and I was breast feeding him, I thought found it difficult to be a surgeon, because its duty requires night shifts as well and I did not wanted to leave my son alone at night, but I do wanted to work beside sitting at home. Hence, I shifted to community work because I felt womens misery from deepest and decided to do some thing to change their lives. Interviewer: How long have you been working in public health? Dr. Yasmeen Sabhi: For public health, I have been working for the last 22 years. I entered this field as a fresh graduate about 22 years ago and I stick to this field, although people at time used to think that I am taking a wrong step as it was very prestigious to be a general surgeon and only top class students had the chance to enter this field. My friends used to ask me, Are you crazy or are you out of your mind, people will consider you as flop and third class, so this was the public image about this profession. Nobody, cared for public health, and they though that there is no intelligence involve in public health. I am thankful to God that my husband was supportive and he always motivated me to do what I want to do. Interviewer: Yasmeen! You one of the ladies, who faced the taboos and obstacles and reached to this position, but you are case of, one of the few, as in our country there are numerous women working on the grass root level, but why they couldnt reach to the top level jobs or positions , what are the reasons behind? Dr. Yasmeen Sabhi: In our sector you can see women on top most positions, but if you point at public sector, corporate sector or any other sector where there is hierarchy and bureaucracy, this kind of system always restricts women to reach at the top most positions. Some people think that the job of a human right activists is to burn tyres and fight, but actually it is a skill to get your supporter also to make you able to lead, may be I am lucky in case of my family and team to get their support. When I entered in this group as a fresh medical candidate, the number of non-medical group was more here, like Khawar and Shirkat Gah, all were women activists like Apva, Behbood. When I joined this group some people were dismissive and used to say, What is this junior small, doctor is doing here? Tell her to mind her business and try to instruct us, because I used to tell them to change their strategic vision, in such cases I didnt become hopeless and kept on doing my internal advocacy and people supported me , I always got the attention what I wanted to. Some people say, you have an enchanting personality. May be this is the cause, but I think that one shouldnt wave off their field and should keep on working in the mainstream then they could reach to the top most position. Nowadays, the people who only speaks and are not credible in their work cannot succeed because it is only the work which speaks and take you up, perhaps in olden times when women had not much courage to speak in front of many people, got appreciation, but at present beside saying you also have to do. We should

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always be updated what is happening around us, as if Ministry of Health or Population calls me in task forces, they know that I would always be updated and I know what is happening around me and they respect it. Interviewer: What is the bench mark of your life? Dr. Yasmeen Sabhi: The bench mark of my life was when I went to British Parliament, it isnt in a sense that I went to British Parliament, but in a way that I represented Pakistan there. When I got the invitation, I thought it would be like other conference, although it was written in the letter that we would really like to invite you as an expert from Pakistan to talk in British Parliament,well it was very prestigious from all angles. I went there and the I read about myself that A lead representative health form Pakistan is going to speak, after a while, I came to know that I was the only speaker who is invited, at that moment the enormity of the occasion who were looking at me, I said, Oh! My God. Ofcourse! I was astonished because the British Parliamentarians are highly educated and know everything, there were also some pregnant women, who brought along them some banners relating to health. So, I think it was the bench mark of my life, but I dont say that it was the only bench mark in my life, but I felt being honoured at that place to represent Pakistan. I would like to make connections with British NGOs and all the NGOs working on health were present there, I had a warm interaction with them and many of them did work. I have a very close networking with the government and they know that we choose very strategic leaders to work, we are not very big donors as compared to DFID, but we are taking very modest sip, I would also mention here that it is also a bench mark because recognition for donor, for being very strategic player in country, for making all the right kind of interventions, by the government itself is a huge landmark for the Packer it was huge land because it has never received any appreciation as such highest level from any other country, I felt good because I want them to remain committed to Pakistan, I also did internal advocacy there that they should remain committed to Pakistan and fund our NGO and due to this quality of internal advocacy I got a lot of boost, because if Government of Pakistan recognize them a lot and return they fund nothing to Government of Pakistan. We fund only NGOs, we work with them and give them technical support, we let our granites to use their projects money to help the government if they need something, thats what we do and we never fund them directly, we are not mandated to fund them directly, beside it if they are recognizing you as they give billions of dollars to other bilaterals, so it was big land mark and I think it got a lot of positive outcome for Pakistan itself, because as the Pakard had a commitment and Prime Minister will award you for it, then how would you talk about to leave your country. All is a bench mark for me to get donors for your country and be as a mobilize here, I introduced gates and rolled out buffet here. Most of the times, foreigners used to ask me why are you interested in money, I said, because I want that money to go to Pakistan and I want to invest the money for our womens health. So, for me this goes on, Gates and Buffet has funded a lot and their project are on run, but I am

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more delighted as when we went to Marvi in Ummer kot, when I see the leaders in Marvi as a symbol of women empowerment that is my real professional satisfaction that I am able to be a part of something which could bring a larger change. The women who used to not come out of their once now are leaders in our project of NRSP and over the life of your project when you see the changes coming over there through the work of your grantee partner, these are the most satisfying pieces for me. The reason to sit with ministries is to bring change on a larger scale. Interviewer: Ok! Yasmeen, I just want to ask you that do you feel any difference in the women working on grass root level and on policy making level? Do you feel there are any linkages or gaps in their work? Dr. Yasmeen Sabhi: I think there are not very strong linkages and there should be very strong linkages because you do advocacy by evidence and you can get evidence on grass root level only. So, I am always interested to see whats happening in the field and you have to develop the mechanism regarding it and there is a difference of capacity there. When I was Pawna, we got 3 billion pound project in 1999-2000 from DFID, we selected 14 NGO partner and all of them were CBOs and we developed their capacities to a large extent. Some organizations do not have the capacity to write strong proposals and cannot document well, so they work on grass root level. When joined Packard, we were linked with 80% of international NGOs and 20% Pakistani, now 80% are Pakistani and 20% International which means a lot of work as to be done. I and partner do a lot of work, we build trust with NGOs, the ones who are hardworking, committed and honest. Therefore, I totally believe in to build up local organizations and local capacities. Now, Lumps and AQ are our leader shop

organizations, in the last four years I have phased out all international organizations and all are doing leadership trainings through local organizations, why do we have to work through San Francisco based or any other country based organization. Why dont we strengthen our organizations and work through them, as Lumps has worked with University Washington and now, they are doing all the work themselves. Lead already had a module and we add another in it also. ILDA is only to strengthen local institutions. Interviewer: Is there any difference in decision making on the basis of gender? Dr. Yasmeen Sabhi: Mostly woman do not reach to the position of decision making and the sector of health who reach to this position are much passionate. Women are Ministers in women development and population but in other fields, they are less. Interviewer: Do you think the women at decision making positions really have the authority to take decisions?

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Dr. Yasmeen Sabhi: Yes, a woman minister do have the power, in fact some of the women are so strong that they are not liked by the bureaucrats. Ms. Sherry Rehman is one the example, but she also resigned because she was astonished that there is too much corruption and ultimately resigned. Anyway, things are changed and media has brought great revolution, things are being accountable. Interviewer: What you think the role of a family to make a lady a good leader? Dr. Yasmeen Sabhi: It has a great role, (She laughs) either the marriage will remain or her profession, because these situations do emerge in their lives. Obviously, your children and husband need time and when you are out for whole day and sometimes more than one day or a month it creates a lot of complexities, so in such kind of circumstances women sacrifices their professions. Hence, the family support is extremely necessary. Interviewer: How do you see the future of Pakistani women in the health sector? Dr. Yasmeen Sabhi: I think it is going to be very good, because we need to have more and more women coming to the health sector as leaders, if all the development sectors either on education, or woman activists, if linked together then we would have a larger force. Interviewer: Whats the definition of leadership for you? Dr. Yasmeen Sabhi: I think leaders are ones who can stand with his/her team, most of the people think leaders as above the group, but contrarily I think he is the one who can work with the people and take them ahead along him. Leader is something, who think far ahead and always look up for a change in a positive way. So, for me those are the leaders who have the vision and want to bring a change and they are beyond personal things. I have got the support of many people and have never thought only about myself because when you are lost in yourself then you become a selfish leader. So, as simple as that. Interviewer: Thank you so much.

Interview Zahra Kamal Q: what were the challenges when you started working? Specially working on child sexual abuse is not an easy task, its a taboo. ZK: when we started working on Child Sexual Abuse (CSA), the challenges we faced were internal & external. Internal were that the issue is sensitive. I still remember when I took my first crisis case, we used to do blend of works. We worked on emotional health, awareness etc. it wasnt like just dealing with clients & crisis. And that crisis case was mild not a serious one but I was overwhelmed. And when you see a child like this one you naturally become 87

overwhelmed. It was internal challenge. Another challenge was how to keep ourselves positive and check others constantly and talking and discussing with each other. Then comes the external challenges. They were before I started working and I was not really involved. I was an intern only. People said that this issue doesnt exist and you are talking about west. But gradually, people were very open. Communities were open. They understood that we were talking about the betterment of their children and believe me everywhere people said that it happens. But we had to be really careful at that time. We didnt want others to think that its something unislamic or anything. We had to carefully design our strategy. Media was a bit apprehensive, governments were apprehensive on this issue. No was working on this issue. From then till now in 10.5 years, there has been a lot of change. But initially when we used to go to communities we were never forced to go back because we had a very careful approach without accusing anyone. But at the same time we had to be careful in larger environment. Secondly when you ttalk about sexual abuse, people thought igf tehse girls can talk about sexual abuse, we can talk to them about anything. So we had to be careful. People started cracking non snese jokes, and stuff. But as I was from an organization that also works on gender and violence against women were also core issues. Gender and violence against women were much more resisted . people ask about the donations and etc but in CSA case ther has been less resistance as compared to VAW. This is what I have experienced. Q: how have you coped up with all these things? When you face challenges, you sometimes feel bad and hurt. At any point your motivation level was dropped?

ZK: motivation level remained intact just because we were doing variety of work. Secondly there was an emphasis on self development at Rozan. Every psychologist sat in supervision and there were weekly sessions, and then it was mandatory for every psychologist to go in workshops etc for self development. If we have any concern , any problems, discomforts, so we can easily talk about them. And then we had opportunity of working creatively and there was a lot of appreciation and acknowledgement. So I think I got help from that secondly there were a lot of people around us that we started a community helpline at Rozan for youth on reproductive health and I remember my female colleagues said that they have not told their families about the issue they work. So I feel very lucky because my parents and my husband , they were very supportive and I could share everything with them. We could debate , that environment helped. I think professional environment was excellent and my family was very supportive. Initially it was overwhelming. Every third person said that it happened to them. Then you realize how common it is and I have to work on it. That was a source of support. I was frustrated at times and Q: how would you explain your professional success? ZK: ha-ha success?? How would i? can you explain the question? 88

Q: I mean you have done a lot of work and at a point one feels professional success. Do you feel that professional success? Any benchmark you have achieved? ZK: I am not so sure but I think when I look back to my work, the years I have worked for Rozan is the age of Rozan. When Angan and Bedari collapsed I started work with Rozan, there people knew u and liked our work. The fact that lies in my success is that I started from grass root level. The benefit of that what I have felt now is that my thinking is not superficial. Its based on facts. Its not like that you have done things by just reading a book. In clinical psychology you get a chance of meeting different people and that really helps. So I think that if I look at success, I will call it a success that I can understand things well and I am not superficial. Q: any benchmark? Or highlight of your work or life? ZK: there were so many good things. In fact now I have gain maturity I look back at things and I say I could have done this, that way. At that time I was very young and took responsibility and things were more excitement and passion driven. Now I think I could have done them a lot better if I had known this thing, looking back and saying Wow I have done this but I say I could have done it better or this way. But there is an element of satisfaction that I have worked. Q: how many cases of Child sexual abuse or sexual abuse, have you handled? ZK: Its very difficult to tell because we received letters and calls. Q: any idea or estimate? Hundreds or thousands? ZK: no it shouldnt be thousands, but may be 150-200 or may be 250 not more. Q: we see many women working in health sector. But when we talk about top level, you have also worked on executive level and director level at a very young age, but there are a few women that can be seen on such positions. Why is this so? ZK: you will see it everywhere. Except for some human rights and women rights organizations and that also local. You see all big organizations heads are male, and when we were at Rozan, it was women dominated organization but more I started going out in different cities and organizations, I saw No there is not many women, men are many. There are a few things that I see, what I have noticed that women get married and especially when they start having their children. For them its the priority. You can be a leader without being a good manager. Women are at good positions like I have my colleagues that have children and they are still working at director level but the thing is responsibility differs and grows causing a pressure on some of them, like you have noticed, running many organizations but some of dont do, run their own business because they have to see finance, management etc. how much time they can give, how much support they get from family and how much she is giving time to children. I have seen many women working here couldnt continue just because they couldnt get permission after marriage or if they join back then after having children it was difficult to manage I think their valuable role of being a mother has come in their way. I would say challenges have increased. Secondly there is politics behind all this, mind set behind this, the thinking that women cant be good leaders and managers and they dont know anything. But that environment has not 89

been exposed. I came from a very different environment. It would be hard for me to say but yes you keep hearing from people. But it is interesting that most of top managers might not have experience of health sector. Q: tell me when it comes to decision making, if some male was here at your position to take decisions, so would it be a different thing? ZK: it doesnt. It simply depends on the nature. Nothing to do with them being a man and being a woman. It depends upon nature. If a woman is indecisive and doubts man has same traits then both have same fate. Q: so leadership styles are different or not? ZK: dont know Qudsia. I would say it varies from person to person. Leadership in power position, woman boss can be different and same goes for man. It varies. Q: What is your style? ZK: mine, if you ask, is dominating. I have a varied role. It depends on my tasks. I am authoritative in deadlines but I am motivating and supportive in technical area. Q: there are women working in Pakistan on grass root level and at policy level, do you think that there are linkages or gaps? ZK: I am not so sure. I am not mainstream. But there is gap. We do strategic planning and we talk with people, but there is mix. Most of our policies are donor driven. We do what donor requires. In other countries like India women at grass root level is getting what she is demanding, that is not here in Pakistan. These are my feelings and statements. All the planning organizations have disconnect. I dont think if anyone has background of grass root. If you dont have how could you work. They are planning after seeing the economic indicators but how these are implemented, that link is missing. We know that maternal mortality is high and we know abortion related complication is high. We know violence against women is high but how these are translated at grass root level, how people will take it as their need, which is missing. That I think is missing in our programming because we are unable to articulate that. Q: Ok do you see many women coming in health sector? ZK: Now one can see many coming. Like you see Dr. Firdous Ashiq Awan population minister and many others and the secretaries. You can see many in NGO sector but at government level you dont see many, sorry I will take back what I said. They are like puppets. There are many good women but they dont come forward and they dont have a say. Q: ok, are you satisfied or do you feel some gaps to be filled? ZK: I am pretty satisfied and feel gaps left. But I think there is so much more to be done. We need strong interventions. I still have a lot to learn. Like research is an area that I dont know. I guess there are many areas. Yeah there are gaps Q: what is your vision for health sector in Pakistan? 90

ZK: health is a very broad concept. But I feel that if a rich person can afford treatment from a private hospital, a poor man can also have. It is my vision. People should be told about prevention and we need to improve health care and health messaging. Q: Does political decisions affect your work? ZK: yes this affects our work. See we are linked together. Q: what are different challenges in your current position? ZK: this one is new. I am working with a male boss, so that would be an issue. I am settling down. Q: how do you see future of women in health sector? ZK: You see, opportunity has arisen due to the emphasis on reproductive health. I see a good future but there are some challenges. There are some political, social and cultural challenges. Women cant have permissions and etc, there are challenges. Q: any other comments? ZK: if a woman is not a good manager, all women would be blamed, but one man does something wrong or is not a good boss, it will not be generalized.

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