In conversation with Dr. Mumta Hargovan

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Hello, I’m Domhnall MacAuley, and welcome to this BMJ Leader conversation where we talk to the key opinion leaders in Health and Medicine around the world. Today we’re in Cape Town and I’m talking to one of the most exciting new voices in medical leadership. Mumta Hargovan is a doctor, a researcher, and I suppose you could call her a key medical influencer. Tell me about your career.

Mumta Hargovan: I started off in medical school, along with many of my colleagues, wanting to something good in the world, wanting to help people, and then getting out into the working world and being completely overwhelmed with the magnitude of the problems that end up inevitably in the health system. I’ve worked in various settings in South Africa across urban, rural, at different levels of the health system from primary to tertiary care, and it left me feeling quite despondent, because you feel quite helpless seeing similar problems again and again, dealing with them on an individual level in a clinical setting, in a hospital setting, but really feeling powerless against the real root causes behind a lot of these very preventable health conditions. That’s what led me to public health and doing a Master’s in Public Health, which was a breath of fresh air. It allowed me to step back, to see the bigger picture, see that change was happening at a national level, the health system infrastructure being improved, the types of public health policies coming in, and really get a sense of momentum and hope.

I thought public health was as big as you could go, but I came across the concept of ‘Planetary Health’ and this was my next big leap into an area that I knew nothing about but that just made so much sense to me. Now that I know about planetary health I can’t go back. Being a doctor, and being in public health, I felt like there was more than enough on my plate and that I couldn’t possibly even think about the environment as well. That felt like it should be someone else’s job. It’s just too much for one person to have to think about. I lived in that kind of blissful wilful ignorance for most of my life but the rose tinted lenses have been taken off and the planetary health field has really helped me to see how these things are so interconnected. We need to break down those silos and think about more than one issue at a time so that’s where I am now in the field of Planetary Health.

DMacA: You have a most unusual job description – Knowledge Partner. What’s a Knowledge Partner and where do you work. What is Douglas Knowledge Partners?

MH: Currently I have two jobs. The first is as a Knowledge Partner at Douglas Knowledge Partners, which is a strategic consultancy based in Cape Town, and what we do is that we work with clients across all sectors to try and help them to consolidate or communicate their ideas. We really believe that ideas matter and amplifying those ideas can have a profound impact on the world. In my role there, I try to bring my public health and planetary health thinking and the frameworks I’ve learned to incorporate that across different topic areas. The second job that I have is as leader of the South African Hub of Women Leaders for Planetary Health. This is an organization I’m particularly proud of. We only launched last year but we’ve grown in numbers and we’ve got a network of amazing women who are looking to be leaders across different spaces and apply the Planetary Health framework in their spaces.

DMacA: When you describe these women leaders, are these women who are in health care or outside health care. Give us a flavour of what the movement is like.

MH: The movement started with a series of workshops to introduce the concept of Planetary Health, which isn’t that well known in South Africa and is only just starting to gain ground in academic spaces but not so much outside of that. As I began learning about Planetary Health, I developed a series of workshops to capture my learnings but also to share them, and the women that have been attracted to this program are from all kinds of disciplines. We’ve had teachers, engineers, writers as well as doctors and public health experts, and also Planetary Health experts. So, it’s really a space of co-learning and discussion where there’s no kind of power hierarchy as I am certainly not proclaiming to be the expert. It’s more of a facilitated space to engage with these ideas in a way that’s not overwhelming and in a way that, most importantly, is hopeful and acts as a more supportive ‘ bubble’ than some of the very overwhelming literature out there, and the news which can be very discouraging.

DMacA: Let me bring you back to your other role as a Knowledge Partner because in medicine we don’t really hear a lot about the communication industry. Tell us what you do there.

MH: I wear many hats in that job. It’s a bit of project management, it’s a bit of writing, a bit of editing, and developing relationships with clients to help them bring forward their ideas. I agree that it is a most unusual path for a doctor to end up in communications consultancy, but what I’ve realized on my journey is that so many of the skills that doctors build along the way, that sometimes we don’t even recognize that we have, are incredibly useful to other industries. One of those is our ability to connect with people. As a doctor it doesn’t matter who walks in the door, whether they’re someone who is homeless, a prisoner, a president. It doesn’t matter. You see the humanity and you’re able to have a conversation with them. Also, as a junior doctor have to phone a high profile professor at the tertiary hospital and be able to express yourself clearly and calmly while there could be a critical patient in front of you. That type of communication is what makes us quite adaptable to very different working environments.

DMacA: I saw on your Twitter account that you describe yourself as a ‘raging feminist’. Tell us about that.

MH: I’m so glad you picked that up because I love talking about that. I have been a feminist for most of my life but I was a very quiet feminist. I observed what was going on around me, injustices within my own family, within my community and, of course you know, South Africa has one of the highest rates of gender-based violence in the world. But I found that when you talk about these things there’s often such a backlash and that caused me to shut down about it for a while, until I read a book called “Rage Becomes Her- The Power of Women’s Anger” by Soraya Chemaly.

This book is really a love letter to anger which, as a woman, you are taught is a negative emotion, it’s unattractive, it’s inappropriate for women to express anger, but the point made in this book is that anger is what is behind every big social movement to date, because anger is what sparks action. In that sense it’s not a negative thing, it’s valid and we should be feeling angry about injustices in the world, whether it’s poverty, whether it’s gender inequality, racial inequality, homophobia. These are things that should make us angry and that’s why I proudly proclaim to be a raging feminist. I’m angry about the issues in the world but also, it gives me joy to be a feminist and to connect with other women to try and tackle these issues.

DMacA: What do you think about the role of women in medicine? The proportion of women is increasing. Are there still problems in medicine?

MH: Definitely. I would definitely say medicine can be a tricky space for women to navigate. I feel like we, my generation, has grown up in a time where we were taught in school that we were equal but increasingly, as we face the real world, we see that we are still treated differently. I remember being in a class in medical school and being told by a professor that the women in the class are a waste of time because they’re all going to drop out and get pregnant and so they shouldn’t even be there. And this is current, this is in our generation. Another example is that we had a lecturer who was a little ‘handsy’ in doing clinical demonstrations with students volunteering to demonstrate certain clinical skills. At that time you’re just not empowered to speak up, you’re not empowered, you don’t know who to go to, you don’t know what the backlash is going to be, and that’s just getting through medical school. When you enter the health system sexism is rampant, whether it’s the security guard cat-calling you as a doctor on your way into the hospital, or treatment by patients, treatment by colleagues. It’s something that isn’t spoken about enough and women feel like they just have to deal with it and it’s part of life, it’s part of the job, but it really doesn’t have to be so.

DMacA: There are two components to what you say. One is the overt sexism but then there is the covert sexism in terms of promotion in medicine and equality at the highest level. How can we encourage that, how can we promote women in medicine?

MH: Often the answer that comes is in supporting women and developing women and that, of course, is one side of it. But it also places the onus and the burden on women as though they’re the problem when they’re not. They are fully capable of leadership and they should be in those positions and that is what this organization, Women Leaders for Planetary Health, is saying. It’s saying that women should be there because we can’t be making decisions for the whole planet with only men at the decision-making table. But that’s where the other component is. These higher level decision-making spaces need to start transforming in terms of gender, in terms of race, in terms of inclusivity of all of all types, and it’s only when there’s that higher level buy-in and people start shifting these perceptions of who should and who shouldn’t be in a decision-making space, that we can move forward.

DMacA: One of the things that we hear talked about in politics is having quotas. Should there be quotas in medicine in terms of consultants or professors or in terms of research grants?

MH: I think this is quite a tricky issue especially coming from South Africa where quotas are in place and have been in place for some time. I do think that in our setting, especially coming out of apartheid, it is a necessary thing to recognize that there are injustices that have been generational and have excluded people from certain types of spaces. It’s more difficult to comment on a global context, just recognizing that the situation is different in every country, but certainly in South Africa I do think it’s making an impact that women of colour are being prioritized for certain positions. But, you know, the challenge is to ensure that it’s not simply a tick box exercise but rather, a meaningful engagement and involves a mentorship or some kind of process to make sure you’re not putting people in positions that they aren’t ready for just for the sake of ticking a box, and that’s something in the South African healthcare system we are definitely working on.

DMacA: Your name came up associated with the Youth Innovation Award. Tell me about it.

MH: The Youth Innovation Essay Competition is run by my current employer Douglas Knowledge Partners and I came across it last year. I thought it looked fascinating and I decided to enter. I wrote an essay about gender-based violence in South Africa and the need to have a more cohesive health system response. As it currently stands, the health system is the first point of contact for women who are facing in domestic violence and other types of abuse. But the health system is very poorly connected with the legal system, with the social services, and all the other financial services etc that a woman in that position needs. So, the care we are able to provide is extremely limited and it’s up to the woman to know how to navigate across these very different services. My essay proposed a way to bring a more cohesive approach to this issue. It was through the competition that I met my new employer and I’m really fortunate that this year, as an alumnus, I am running this year’s competition. And I got to choose the theme so, of course, I chose Planetary Health. The idea behind the competition is that there are quite a lot of fellowships and prizes out there for start-ups and for people who’ve got great business ideas, and grant funding competitions, and that sort of thing, but the gap that we wanted to fill, as a communications company, was encouraging young people to take an idea that they have, take the time to write it down in a powerful way, and develop those types of skills in young people. As part of the competition you go through a mentorship phase where you’re linked with someone who is either a content expert in the type of work that you’ve done or has expertise in in writing and in communication and, through that support, you then get to improve upon your essay and submit it for a final round. So, for me, this was a really valuable experience because of the power the written word and how it can shape hearts and minds. That’s what it’s all about. It’s really a development opportunity specifically to help people communicate for impact.

DMacA: Overall, in terms of your various roles, are you optimistic for the future of women in healthcare, and women in Planetary Health?

MH: Definitely. I would definitely say that there is momentum building. It gives me great pride to see women stepping into leadership roles throughout Africa and they are often at the forefront of climate change activism wherever you look, advocating for better infrastructure for their communities in terms of agriculture, in terms of food security, they’re really at the front line of leading change. And that gives me a lot of hope. The barrier that still needs to be broken is at the high level positions that are still very male dominated but overall I think working with this organization and of seeing what women are doing in their spaces definitely makes me hopeful.

DMacA: And a final question, which is probably an impossible question to answer, is how do you see the future of the North-South divide?

MH: I think there is a new wave of Africans doing it for Africans. Africans taking ownership of our challenges and working towards the solutions and trying to cut off the toxic postcolonial reliance that we often have in terms of western aid. Where I’ve seen that is at the recent Africa Impact Summit which was really all about – how do we unlock the potential of our own people, of our own businesses. And we have the solutions, we’ve got the creativity, we’ve got the innovations and, the more those sort of conversations start to happen, I think the harder it will be for traditionally exploitative and extractive types of input from the north being such a big influence, such a barrier to development in Africa.

DMacA: Mumta, it’s been such a pleasure talking to you. We’ve covered some pretty serious and major issues. We’ve only scratched the surface but all I can say is, I would like to share your optimism and with refreshing new leaders like you, I think the future is bright. Thank you very much. It’s been a pleasure talking to you.


Photo of Dr Mumta Hargovan

Dr Mumta Hargovan

Mumta is a South African medical doctor, currently completing a masters in Public Health (specialisation in health systems and policy) at the University of Cape Town. She is a Knowledge Partner at Douglas Knowledge Partners, a strategic knowledge consultancy focused on magnifying the impact of ideas on the world.

“I am passionate about working at the intersection of social justice, public health and communications to amplify evidence-based social impact. I have a decade of experience in healthcare, research, and consulting. 

My background has given me a combination of academic and practical skills in working in interdisciplinary, international teams to develop solutions to social and public health challenges. I trained and worked as a medical doctor in South Africa and gained a master’s in public health, focusing on health systems and policy at the University of Cape Town. I furthered my project management and writing skills working at a strategic knowledge consultancy, which partners with organizations to communicate ideas for impact. Additionally, I have gained skills in advocacy, training and community building in the NGO sector, focusing on advancing women’s leadership in the planetary health movement.

 I am a systems thinker and enjoy connecting the dots across different sectors and disciplines. I bring an open mindset, creativity, and empathy to the teams I work with, and aim to cultivate environments that support connection, learning and growth.”

Declaration of interests

I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none.

Professor Domhnall MacAuley

Domhnall MacAuley currently serves on the International Editorial Board for BMJ Leader.

Declaration of interests

I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none.

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