This is the final blog post of our FemInEM Forward series, featuring blog submissions from the The FIX19 International Attendee Scholarship. The post below is written by Dr. Prisca Mary Kizito (@prisca_kizito), an emergency medicine physician in Uganda.
Dr. Kizito is one of the five pioneer residents of Emergency Medicine at Mbarara University of Science and Technology. She is involved in teaching undergraduate students about emergency care and facilitating the locally accredited ACLS course. She doubles as an emergency care provider for patients at Mbarara Regional Referral Hospital and Trainer of Trainers in the Basic Emergency Care (BEC) course under AFEM. She serves as the Treasurer of DELTA, an association that unites all African Emergency Medicine Residents affiliated to the African Federation of Emergency Medicine (AFEM). She graduated with a Bachelor of Medicine and Bachelor of Surgery at Makerere University College of Health Sciences (MUCHS) and acquired a Post Graduate Diploma (DTM&H) at the London School of Tropical Medicine and Hygiene. She has previously worked at the Infectious Diseases Institute (IDI) MUCHS as a medical officer caring for HIV positive individuals with other co-infections. She has special interests in global health, tropical medicine, bedside ultrasound and medical education.
Gender Equity refers to fairness and justice in the distribution of benefits, power, resources and responsibilities between women and men. Despite women having clearly defined authority, gender is still one of the strongest factors governing work relations. (1) Gutek and Morasch’s concept of “sex-role spillover” argues that gender-based norms (woman as maid/mother) that seep into the workplace leads to gender inequity. (2) Sexual harassment reflects the inferiority of women in society, mostly in the form of gender harassment (insulting remarks, vulgar gestures/jokes). These inequities are worse in poorly structured systems in low-resource settings without structures in place for reporting.
Sexual harassment is unwelcomed behavior of a sexual nature that may occur subtly: subtle sexual harassment. Though not a legal term, subtle sexual harassment if uncontrolled can create a spiteful workplace for the victim through unwelcomed sexual comments, jokes and innuendos. While busy being BAFERDS (Bad-Ass-***ing-ER-Doctors) and saving the world, many female emergency physicians are very prone to “excessive gratitude” from patients and colleagues.
One day, while interacting with ED male interns, I was told “you are the interns most crushed on resident.” My mind raced with questions: are they crushing on my clinical skills? Or am I only as good as what they see-the skirts/dresses/ looks? Comments like “because you’re on call, I’m happy to work” initially seems benign and makes one feel appreciated. But are these supporting the skills of female physicians or “excessive gratitude” and examples of subtle sexual harassment?
These same questions arose when I worked with colleagues from other departments. For example, while helping a research colleague with a biostatistics challenge, I experienced “excessive gratitude”. Nearly every time we interacted, he complimented me while leering at me. One day while walking ahead of him, he saw something stuck on my trousers, and wanted to remove a piece of colorless cello tape from my trousers (actually…my butt)!!! I felt uncomfortable and walked away angrily. Later, he approached me with more lewd compliments asking me to be his soul-mate and take care of him. I felt like a sex object, at least to my male colleagues. Eventually I confronted him. But this is just one of the many belittling experiences with gender inequities that I have experienced.
From such experiences, I often wonder if women will ever be seen for their substance and not their sex roles. Ironically, being a female doctor in Uganda is still considered over-achievement, yet their treatment is questionable with so many inappropriate comments disguised as compliments/gratitude, awkward stares, and unnecessary hugs. We often walk the line to keep peace at work, brush it off or lash out hoping for a change. Some men believe we should be grateful for the attention, but the rationale for attention is misplaced. If female doctors behaved similarly with male colleagues, workplaces would be intolerable.
Power differences between institutional leaders/senior leaders and those undergoing career growth contribute to harassment and gender inequity, which is undoubtedly worse for women in low-resource settings. When a female achieves a position of power, it’s thought of as baseless. Men continue to hold most positions of power. For example, at my hospital all senior hospital administrators and Departmental Heads are male except one. Thus, men are the predominant perpetrators. The victims, mostly women, feel ashamed, and often mitigate harm by changing their behavior, opting for silence over confrontation.
Sexual harassment is not unique to me in emergency medicine. It undermines the abiding principle of medicine: do not harm. It affects the mental and physical health of many front-line health-workers. While in developed countries all health-workers are fighting gender inequity in the healthcare industry, this is not yet a priority in Uganda. As females in emergency medicine, we have to foster safety, equity, and dignity in our workplaces because only we can ensure that we enjoy what we do in the best way possible.
- Grauerholz, E. (1989). Sexual harassment of women professors by students: Exploring the dynamics of power, authority, and gender in a university setting. Sex Roles: A Journal of Research, 21(11-12), 789–801. https://doi.org/10.1007/BF00289809
- Gutek, B.A. and Morasch, B. (1982), Sex‐Ratios, Sex‐Role Spillover, and Sexual Harassment of Women at Work. Journal of Social Issues, 38: 55-74. doi:10.1111/j.1540-4560.1982.tb01910.x