Episode 017: Gender Equity, Social Science & Public Health with Puleng Letsie
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Puleng is a public health education and gender specialist with more than 20 years of experience managing programs within the HIV, gender, sexual and reproductive health and human rights spaces. She is passionate about Sexual, Reproductive, Maternal, Newborn, Child and Adolescent Health and also cares deeply about social change communications and community capacity development. She has worked with the United Nations and many government ministries as well as national and regional NGOs in various capacities. At present, she is a member of the WHO SocialNet: a team of 23 social scientists trained to integrate social science-based interventions into health emergency work.
In this episode, Puleng shares what drives her as a fierce advocate of gender equity, what it means to be a social scientist working in the public health sector and why social/cultural elements must be factored into emergency health interventions. She also unpacks the importance of ‘community capacity enhancement’ – and why lasting change must always start from the inside out.
“That has been my mantra: that the answer lies within us. It lies within the person that wants to make a change, it lies within the person that is affected by inequality, it lies within the person that really aspires to see change – either change from getting out of patriarchy, change from getting out of inequality, change from getting out of poverty, from out of stigma and discrimination, and so on. So that that is my passion.”
- How Puleng’s feminist spirit and upbringing inspired her prolific career as a gender equity advocate
- Her personal trauma with gender discrimination in the workplace, and how it deepened her resolve to fight for the rights of all women and girls
- All about WHO SocialNet’s efforts to integrate social science interventions into emergency health work
- Why identifying the social/cultural norms, values, dynamics and capital that exist within communities can help improve outcomes in any public health crisis
- How taking a social scientist approach to issues like vaccine hesitancy can improve COVID-19 outcomes around the world
- The importance of community engagement and risk communication in health emergencies – and what happens when the health sector fails to prioritize these
- Community capacity enhancement: why meaningful change is only possible when challenges are contextualized and those most affected are at the center of solutions
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Puleng is a public health, education, and gender specialist with more than 20 years of experience in HIV, public health, gender and development communications; managing programs on HIV, gender, sexual and reproductive health; human rights programming and Civil Society Organisations (CSO); and strengthening and organizational development. She has provided technical, advisory and policy support to government ministries and departments, national institutions and parliamentary committees on HIV, SDGs and social development. She is a Global Fund Technical Review Panel member as a Human Rights and Gender Expert, and a member of the WHO SocialNet: a team of 23 social scientists trained to integrate social science-based interventions into health emergency work.
Puleng’s passion for Sexual, Reproductive, Maternal, Newborn, Child and Adolescent Health (SRMNCAH), social and behavior change communications, capacity development, community mobilization, program development, risk communication and community engagement (RCCE), and knowledge management among others, has led her work for the United Nations (UNDP and UNAIDS in Lesotho), government ministries (in Health and Education), as well as with national and regional NGOs in various capacities within Lesotho and South Africa. Her last assignment before re-joining UNAIDS was with UNFPA East and Southern Africa Regional Office (ESARO) where she was the Regional Coordinator for Menstrual Health Management, the African Coalition for Menstrual Health Management (ACMHM), and Youth Participation and Leadership.
Puleng holds a Bachelor of Education degree; a Master of Education degree (Psychology); a Post-Graduate Diploma in Public Health; a PhD in Psychology of Education (Gender, Culture, School Health, HIV & Sexuality Education); and is pursuing an MPhil in Sexual and Reproductive Rights in Africa with the University of Pretoria.
Jessica Wiliams 0:02
Welcome to the Days for Girls Podcast, a show about breaking barriers for women and girls around the world. I'm your host, Jessica Wiliams Chief Communications Officer at Days for Girls International. At Days for Girls, we believe in a world where periods are never a problem. We are on a mission to shatter the stigma and limitations associated with menstruation by increasing access to sustainable period products and menstrual health education for all people with periods.
Today's episode is with Puleng Letsie. Puleng is a public health education and gender specialist with more than 20 years of experience in HIV, public health, gender and development, and managing programs on HIV, gender, sexual and reproductive health, human rights programming and civil society organizations. She is passionate about Sexual, Reproductive, Maternal, Newborn, Child and Adolescent Health and she also cares deeply about social change communications and capacity development. She has worked with the United Nations and many government ministries as well as national and regional NGOs in various capacities. Her last assignment before joining us was with UNFPA East and Southern Africa's regional office, where she was the Regional Coordinator for Menstrual Health Management with the African Coalition for Menstrual Health Management and Youth Participation and Leadership. She is currently pursuing a Master's in Philosophy and Sexual and Reproductive Rights in Africa. She has a Master's of Education, and a PhD in Psychology of Education. This conversation is so interesting, and I hope you enjoy it as much as I did. Now, let's go on to the show. Welcome to the show Puleng. How are you today?
Puleng Letsie 1:45
I am good. Thanks. How are you, Jessica?
Jessica Wiliams 1:48
I'm good. I'm good. So where are you calling us from today? Where do you live today?
Puleng Letsie 1:53
I'm calling you from winter in Namibia, called the land of the brave. So this is where I am today. And this is where I live as of two months ago. Today, exactly from the 15th of February, I moved to Windhoek in Namibia.
Jessica Wiliams 2:13
Is that where you're originally from?
Puleng Letsie 2:15
No, I'm originally from the kingdom of Lesotho but have been working in the region in South Africa. South Africa was my last duty station before coming to Namibia two months ago.
Jessica Wiliams 2:27
Great. Well, let's talk about your time in South Africa. Prior to working at UNAIDS you were on assignment with UNFPA, supporting various mental health efforts in eastern Southern Africa. So I'd love to start there for the conversation. Can you talk about your passion for empowering women and children and where that comes from?
Puleng Letsie 2:48
That passion really comes from… I think from my upbringing. At home, I come from a very women influenced family – I should say, women led family. And that I think has entrenched in me the spirit and values of equality and equity. We know that women's vulnerability and inequalities are some factors that continuously sort of influence the way we survive, the way we live, especially in some of our countries in the region and in my country. So the patriarchy is a key issue. So that spirit of always fighting for equality and equity has been in me since forever – well, as far as I can remember. And looking back even at my career, at my schooling, from when I started, I always feel like now upon reflection, I realized that I have sort of fought my way through life, even at work, you know. I could not stand being discriminated against or feeling marginalized, either because of contractual status… by the way, most of my career I have worked on projects and project-based assignments. And in some instances, you know, there will be like core staff of the organization and then there'll be like project stuff. So those divisions for me have never really [inaudbile]. And I continued to fight for equality and I continued to fight for equity, I continued to fight for for harmonization…. I continue to fight for all of us being humane in the same space and to be treated equally. So that that has been me for for as long as I can remember.
So for me, one's background, either social or economic status or background, do not determine the person – they do not determine their destiny, they do not determine how they should be treated. And that has been me. And that is how I have been living my life. So fortunately, my career has always also been along those lines where advocacy and activism have been part of what I do. And I think it's not by default, it seems so smoothly as initially I thought, I've just been here. But I think upon hindsight, I realized that it's it wasn't by default, when I look at a job description or terms of reference, that whole advocacy, the activism, the fighting for equality, and equity, are some of the things that really excites me – the representation to say, everyone should be around the table. So those are some of the things that really excited me when I look at even opportunities or spaces that I should be. So that's just me.
Jessica Wiliams 6:02
I'm curious, you said that you've had to overcome some challenges to get to where you are today. And in your career. Do you mind talking about some of those challenges?
Puleng Letsie 6:16
Okay, I think I can talk about some of the bits without being so emotional. My first main major challenge in the workplace happened when, like I said, I'd been working in projects. And so I joined this really exciting project. Yes, of course, usually projects are time bound, and you know, the contracts will be shorter, and so on. So that was for a one year assignment. And I think, in my mind, it was a “this is a human rights organization.” You know, I never even really thought twice about what was happening at that point, when I applied for the position, when I went for the interview and got the job. But a few months into the job, I had to go for maternity leave. And the first response from the leader was “okay, how do you go for maternity leave on a one year contract.” So that was my first major hurdle. And it became a fight. Well, not physically, but emotionally and technically, organizationally, where eventually, I just had to then leave, because I had to go for maternity leave. I mean, it's not negotiable. You know, it happens when it has to happen. And then it was it was not approved. So I left, I went to my doctor one Friday afternoon and said, “okay, I need to,” and he was aware that I needed now to go in and have the baby. And it was a struggle. So I think I was given like two months, two weeks sick leave, just to maybe sort out the issues. And then so, you know, I just, I had to leave and I left. So a lot of things happened, then. I don't want to say because of that, but for whatever reason, and things that unfolded, I lost the baby. And after that, then the organization came back within a week later during the same week, to say, we're sorry about what happened, when are you ready to come back to work?
So that, for me, was the beginning. I think one of the struggles now in a professional setting is to say, okay, if as women, these are some of the struggles that we face every day, you know, you face them at home socially, in other non formal and informal spaces in the community. But even in the professional sphere, where you'd think based on the kind of organization that you would be joining, would believe that. No, no, no, even this organization, you know, people understand that the human rights focused organization, it's an equality focused organization. But what I learned then, was that it's not that at the end of the day, it's about the people in them. It's about the systems, it's about the entrenched socio cultural norms, the inequality and the basic lack of respect for me, if women and girls or any other people who need time off for specific sexual and reproductive health needs. So yeah, I learned a lot of lessons from from that experience. And I think these are some of the struggles that I was talking about, and it's not just one of them, but I think that happened very, very early in my career. And it's sort of then cemented that spirit of always looking out for myself, looking out for my rights, but at the same time also looking out for colleagues rights and survival you know, to ensure that no one is mistreated…so the inequalities that we have grown up with, that we were left with, do not continue and are not perpetuated. Even in professional spaces, especially within organizations that are perceived to be more understanding and should be better and leading by example. Yeah.
Jessica Wiliams 10:34
I'm sorry, that happened to you. But it sounds like you've turned it around into something, an experience where you can go out and advocate for others. So that it doesn't happen to them. And I love that.
Puleng Letsie 10:51
Thank you. Thank you. Yeah, I always tell them that, you know, I was fired for being pregnant. It was just so… I don't know, I wouldn't want to say it was by luck. But it may be destiny or whatever happened that I had to go back to that same position. And as I had been re-energized, that particular project became the flagship project for the organization globally, and this is a multi country organization, which I will not name, but it became the flagship program. And within about two months of me being back from that very traumatic experience, I was invited to a global meeting within the organization where I was to share with colleagues as far as in Slovakia, and I traveled there. And we shared how I did it, and unfortunately, or maybe, fortunately, was that it was sort of a one person project. Because it was a pilot where the organization was saying, “how can we entrench mainstream stuff with health and wellness into programming?” So it became the organization's flagship project. And it's one of my career highlights, which had started off on a very sour note. Yeah.
Jessica Wiliams 12:19
So I want to pivot to your experience as a human rights and gender expert. So you're currently working with a team of social scientists to integrate social science based interventions into health emergency work. And I'm really interested in what that entails, for you.
Puleng Letsie 12:37
That work is part of an initiative by WHO, the World Health Organization. It's, we're part of 23 in number, and this is people from all regions of the world, the 23 that were accepted into the program. While I'm working for UNAIDS, and now in being the first track advisor for Namibia. But that is part of the work that I do, we are in a pool. And this is a pool that is managed by WHO. So what this means is that as social scientists, our space and our mandates, I think in the work that we do generally, is that we work with communities, we work on social science based interventions. On a daily basis, I have HIV work or in sexual and reproductive health or in gender, any work that we do, I think, as social scientists, that's our strength, so that we agree to realize that when there are health emergencies or outbreaks, including COVID. Now, the response is always – and it should be, it's not that it's wrong, it's a health response which is ideal – but there is a gap when the health response does not make sense, or is not aligned to the social aspirations, to the social norms to the social settings, because at the end of the day, whatever health emergency or outbreak that happens, happens within a social space. It happens at community level, we are people, we are social beings. So that gap was realized that there's something missing for instance, if we take an example of vaccination, there are some people who don't believe in vaccination even for their children and so on. But the issue is why? And that why is a social, it has a social response, because people don't believe it because they believe that okay, in my culture, we don't do this, or socially or in the past when people were vaccinated, this is what happens. So these are social issues. So WHO recognized that gap and realized that in order for us to get to respond to these health emergencies or outbreaks or pandemics, right, the social aspects should be integrated or entrenched in whatever the health sector is doing. And this basically means that whatever is happening should make sense to the community, it should resonate with them, it should, you know, they should see themselves as part of that. It shouldn't, they shouldn't see that something [inaudible], it should resonate with their social norms and the way they do business. So the social and cultural data in should inform the health response to say these people here, this is how they live. This is what they believe in. This is how they usually do their business. This is how they treat health issues. This is how they have been dealing with whatever kind of challenges that they've been faced with: to solve the social and cultural data is very important to inform health responses to all these emergencies, outbreaks and pandemics.
So because it's only through that known social and cultural data, that we will be able to identify what would be some of the risky behaviors that might be perpetuating whatever issue that we're trying to deal with. For instance, let me make an example with COVID. It will inform us that what are the usual practices that might be perpetuating or increasing the infection rate, what are some of the strong points, what is the social capital that exists within this community that we can work with to mitigate the impact of the epidemic that we are dealing with? So, that is that. And if I can make a small example, if you will allow me, when there was the Ebola outbreak, part of the response was said when the person who died from Ebola was picked by the state or by the Ministry of Health or the the response team, they would not be buried by family. But in some cultures, the requirement or the practice is that six months after somebody has died or passed on, we go back as a family, we dress the corpse or the person again, in new clothes, you know, like a visit, but the person is is more or less [inaudible] and redressed, and so on. And so these are some of the practices. And what then happened in some countries or in some communities, when people realize that if somebody in a family dies from Ebola, the state or the response team comes to pick the corpse, and we're unable to do our social and cultural rituals. And so then people did not report cases, and therefore the epidemic spread the disease spread. And it was unclear why is it spreading, when we think we're containing it. And then afterwards, the social and cultural data, then came in to say, no, no, no, we're not on top of things. Because now people are not reporting cases, they're going underground, because they know that they will not be able to have access to their dead or deceased relatives for their cultural practices, six months down the line. So it's some of those things that we cannot just jump in without understanding some of those dynamics and then working with communities to say, okay, we are aware this, this is how we do things. So how do we then mitigate one if there's a danger or a risk of that practice spreading the disease or the danger that we are dealing with? How do we mitigate that together with the community or together with the people that are affected? So that is the exciting bit about that, okay, and I can go on and on. That's what excites us as social scientists, to say, nothing you can just go into your community without understanding them, and acknowledging the power that they have to be able to sort out or to unblock challenges, and to find solutions to issues that they face.
Jessica Wiliams 19:20
Have you in your experience with COVID-19 had any interesting work in regards to COVID-19 and the pandemic, related to integrating the social aspect and the cultural aspect of the communities that you're serving?
Puleng Letsie 19:37
Most definitely. My colleagues are out in different parts of the world, unfortunately, I'm not on the team now. But what I do in the space that I'm in, which is now more or less working on public health, HIV, menstrual health, sexual and reproductive health and rights, I continue to implement or provide that advice. For instance, in the risk communication and community engagement working groups of the COVID responses in the different countries. These are some of our inputs to say, yes, here is the health sector response, or here's the national response plan. Here is the national vaccination rollout plan. So let's go back…how are we communicating with the communities? What are some of the issues, for instance? Now, we cannot deny the the issue of vaccine denialism and the, what we call fake news, you know, discrediting the vaccine. Yeah, fake news that's going around by social media or the web. So our role here is to get to the bottom of this to say, why is this happening? And it seems to be happening, we can say it happens maybe across countries or across regions, but it is different per setting, the kind of messaging that goes out should resonate with the community, the kind of messaging that we also hear from the community should also inform our response plans, even for COVID. So that is the work that is ongoing right now to say, yes, vaccination programs are going out in some areas of communities, people are saying, no, we don't want it. And we don't just leave them. Our role is now to go and find out the why. And always the response to the why is a social answer – social responsibility, why. Yeah.
So then we use those to turn around the strategy and say, okay, if there are fears around – because some of these things are historical, something bad may have happened with one, you know, it might be one is an isolated case, or a cluster of cases where they've been, for instance, reactions to a particular vaccine by a group of children reported here and there. And then that community for them, you know, vaccines are bad, or they take it that vaccines are bad. So it's to understand that “why,” provide the right information, and then work with them to identify their strengths as they know, we can turn this around. And this is what will work. So a lot of misinformation that goes unchecked, and is unresponded to, is the one that perpetuates the negative information and the challenges that we find ourselves in. So that is the work that is ongoing today. And I think we realized this even the early days of COVID. Even now, unfortunately, in some of the countries that risk communication and community engagement were not part of the health sector response. And that created the, I'll just be nonchalant and say the mess that we found ourselves in, in some countries, because communities were never engaged. The miscommunication, the myths, the misconceptions were rife, and they were going unchecked. The low no responses, no information, no communication will see people going into a shop and borrow and lending each other one mask to say, okay, can I use your mask so that I go into the shop? Because they're not allowing me? And that's because people did not understand why should I wear a mask. What is the risk, and then for what is the risk of me using the mask that was worn by my brother just a minute ago. So those were some of the things that we saying: that if we do not prioritize socials, the social aspect or the social factors, or integrate them into our responses to whatever health emergency or issue or outbreak, whether it's a pandemic or not, we shall not make any progress. Because at the end of the day, it's about the human being understanding the benefits of the change that we are advocating for as health professionals, and being part of the change, embracing the change and seeing the benefits of them embracing it. And therefore they're able to then influence each other at the community, at the family level and with interpersonal opportunities.
Jessica Wiliams 24:25
So I want to pivot a little bit before I let you go, and have you talk a little bit more about your passion for empowering women and girls. And I'm wondering what it is that you're most passionate about when it comes to breaking down those barriers for women around the world?
Puleng Letsie 24:44
Well, my passion is really about community empowerment. But most importantly, community capacity enhancement, and this is basically to say….when I talk about communities, I'm not talking about communities and villages or countries or towns, but I'm talking about communities, which will include a community of people with a common purpose. And this can either be women, as a community, girls, as a community, transgender people, as a community. Women who are, who sell at the market, as a community, or wherever. So I'm talking about community in that broader aspect. And for me, it's that communities are people who already have the resources, they have the skills, they have the expertise, and they have the social capital. And if we do not recognize and acknowledge all these, whatever kind of solution or program or initiative that we bring to people, they will not necessarily succeed. Because the resources may not necessarily be money, they can be resources that are already available in that community. So for me, the community capacity enhancement aspect is: let's utilize what is already there, and enhance what is, instead of us coming as the like, I bring solutions to a particular community and coming from outside of that particular community. So the solutions lie within specific people. And there's this, through this program that was done by UNDP, a long time ago, which was exactly that the community capacity management. This slogan, or the tagline used was, the answer lies within. And that has been my mantra, the answer lies within us, it lies within the person that wants to make a change, it lies within the person that is affected by inequality, it lies within the person that really aspires to see change – either change from getting out of patriarchy, change from getting out of inequality, change from getting out of poverty, from out of stigma and discrimination, and so on. So that is my passion. And I always say why lessons sharing is very important, because it helps us to, you know, if we go to a particular place to see what they're doing, it opens up our outlook, it opens up our view, we're able to share, and learn from other people what they're doing. But the direct importation of solutions from other places or communities, it doesn't necessarily work as is. So it needs to be contextualized, it needs to resonate with the people, because they already have the capacity to change their lives. So that is that is my passion in all this to say, we cannot do anything, if we don't involve the people that are affected, they should be at the center. If we're talking about empowerment of young people, we cannot do that without them being at the center of whatever it is that we're doing. So it is that for me, the answer lies within you.
Jessica Wiliams 28:11
Yes. Well, I am so inspired by you and the work that you're doing and the stories that you've shared today. If people want to connect with you, how can they do that if they want to reach out and say hello or or talk to you about more about your work?
Puleng Letsie 28:30
I'm active on Twitter. A colleague yesterday was saying, but I haven't seen you so active on Twitter, well, no but there are differences. There are certain things that are you know, when I want to be formal a bit. I'm active on Twitter and my Twitter handle is @PulengL. I'm also active on Facebook as willingly. Yeah. And on LinkedIn as well. My email is open as my name and sending email@example.com. But I really love social media. So I try to, even whenever I'm having busy days, like this is a hectic week. But before I sleep at least I am able to just see what's happening, what are people saying? So I try as much as possible to be responsive to colleagues or friends. So yeah, out there and always willing to engage.
Jessica Wiliams 29:29
I love it. Well, we will put all of those links in the show notes for everyone to get. Thank you so much for coming on the show today. I really appreciate your time.
Puleng Letsie 29:39
Thank you very much, Jessica, and thanks a lot to the work that you're doing to Days for Girls and partners, for really continuing to highlight some of these critical lessons. I mean, these are very, very helpful. They really excite me and I always look forward to listening to the next one. So I'm really honored that today, I am also on this site. So thank you very, very much.
Jessica Wiliams 30:06
You're very welcome. It's my pleasure. The Days for Girls Podcast is produced by Days for Girls International. For show notes and resources mentioned in this episode, visit daysforgirls.org/podcast. If you'd like to support the work we do on the show, leave a rating or a review wherever you listen, subscribe to the show, and share our episodes on social media with your friends. To learn more about Days for Girls and to join our global movement, please visit daysforgirls.org Thank you for listening. See you next time.