“We should start from the very beginning, with health literacy taught in schools, focusing also on equity and not measuring people by size, gender or anything else,” says Dr Liga Kuksa, Head of the WHO Collaborating Centre for Research and Training in Management of Multidrug-Resistant Tuberculosis, Riga, Latvia, talking about women making a career in public health in Latvia.
Despite advances for women and their health, disparities persist in research and treatment for conditions unique to women compared to those affecting men; they have fewer opportunities in science, technology, engineering and maths (STEM)-related fields; and their contributions in health-related professions and decision-making are not well recognized. When speaking about women and their health, it is important to hear their perspectives, as patients, doctors and researchers, but also as leaders of organizations in the field of public health.
One woman paving the way for women in public health and leading a partner organization of WHO/Europe is Dr Kuksa. She has worked with the collaborating centre since its inception over 20 years ago. Day to day in her role as the head of the centre, she leads training and research activities focusing on multidrug resistance in tuberculosis (TB). She and her team look at medical anomalies, shape guidelines and translate them into practical work, giving technical assistance in missions or field trainings abroad, while also conducting trainings in Latvia for health-care workers in various capacities. She spoke to us about her work and career.
WHO/Europe: Thank you for giving some of your time today. Can you share a little about your career journey?
Dr Kuksa: Thank you for this question because it brought me back to when I was 10 or 11. Since then, I wanted to become a doctor and never changed my mind. I followed that dream, but getting to where I am today was something of a series of coincidences. I never planned to focus on TB; I never thought that I would become a trainer or eventually lead others within a collaborating centre, but I am here.
WHO/Europe: Is there anything specific that inspired you at that young age to become a doctor?
Dr Kuksa: When I think back, my grandmother influenced me because she always told us that it is so good to be a doctor because it’s a very respected profession. She said that she would be very proud if any of her children or grandchildren were to become a doctor.
WHO/Europe: In your position as a leader of a WHO collaborating centre have you witnessed any disparities between men and women in the workplace?
Dr Kuksa: In general, in Latvia one could say on the surface that there are no huge disparities, but if we look deeper, of course there are disparities. For example, if we look at payment or salary differences for specific professions, those that are traditionally roles common for women, like nursing, will usually have lower pay than similar positions dominated by men, for example, technicians. So, salary is still a place where disparities exist. Similarly, in Latvia we have many women leading smaller regional hospitals, yet men are usually in charge at the state-level and university hospitals. Leadership isn’t equal at all levels within health care.
WHO/Europe: What can the European Region do differently, or how can it better support women?
Dr Kuksa: I think that we should start from the very beginning, with health literacy taught at schools, focusing also on equity and not measuring people by size, gender or anything else.
WHO/Europe: What challenges have you felt by being a woman leader in health care?
Dr Kuksa: In some situations, I feel that I don’t have the capacity to tackle a task because I have to do so much multitasking because I have children and am pulled in many directions. But this can also serve as a benefit for me because playing both roles, as a leader and as a mother, gives me a different level of empathy and the ability to step into others’ shoes, be it a patient or colleague. I do sometimes believe that women bring that unique kind of empathy to their roles.
WHO/Europe: In your field have there been times when you feel that bringing a woman’s perspective was particularly helpful?
Dr Kuksa: Yes, because we can speak woman to woman. This is especially important with vulnerable groups. We build trust, and a sense of collaboration, which helps with adherence to medical treatment. I remember one patient struggling with alcohol abuse who also experienced violence at home. We discussed this and she opened up to me, and felt like she could tell her story. Together we started to solve this situation. I think perhaps she may not have felt comfortable to do that with a male doctor.
WHO/Europe: What advice would you give a young woman or little girl interested in pursuing a career in health or medicine?
Dr Kuksa: I would say to follow your dreams and do not allow others to distract you from your way. Also, I would say, be confident enough to admit when you don’t know something. Work a lot and trust yourself a lot.
Advancing health for all, including all genders, in the Baltic region
Advancing health for all in the Baltic region and particularly primary health care was at the core of this year’s edition of the Baltic policy dialogue, organized by the European Observatory on Health Systems and Policies and WHO/Europe for the 18th time on 7–8 March 2024 in Riga, Latvia. Senior policy-makers from Estonia, Latvia and Lithuania came together in Riga to share experiences around a range of health and health policy issues.