A public and Community Health Champion and the 2022 Nobel Peace Prize Nominee

The 2022 Nobel Peace Prize Nominee Prof. Miriam Khamadi is a kindhearted and vastly intelligent woman who has dedicated her entire life to advocating for Public and Community Health in Africa. At 80, Prof. Khamadi has won numerous awards, the latest one being the Lifetime Achievement Award at the recently held Quality Healthcare Kenyan Awards 2022. Her achievements notwithstanding, she still feels she has a lot to do to impact the health sector before she retires.

The first thing you notice when you engage her is her promptness and efficiency in communication and decision-making. She categorically picked the midmorning for this interview, quoting that this is the time she is most spirited, prolific, and has her memory in check. As we sat under the mid-morning East African sun, we listened raptly as she took us through the journey to becoming one of the most respected medical doctors in Africa and beyond.

Medicine; a delayed dream

Prof Were is among the few girls who had the privilege of attending school during colonial times. Inspiration from her elder siblings who were progressing well in school and sound advice from her mum to avoid boys, however, saw her complete her high school education at Butere Girls and later pursue A-Levels at the Royal Technical College, the current University of Nairobi.

Prof. Were had always harbored a dream of becoming a doctor one day. Her high school struck a heavy blow to this dream, as it was not offering chemistry and physics at the time. Without these necessary prerequisites, she resigned herself to studying literature, history, and scripture on her A-levels.

An opportunity to study Bachelor’s Degree in Sciences at the Liberal Arts College in the United States in 1961 revived her long-held dream. Upon graduation in 1964, she got admission to a medical school in the US to start immediately. A homesick Khamadi, however, opted to come back home.

She tried registering for the Medicine school at the Makerere University in Uganda

 but was not successful. With her dream paused for the second time, she took up an offer from Kenya’s Ministry of Education to teach Chemistry and Biology. She took another Diploma in Teaching High School Sciences and later on enjoyed teaching Chemistry and Physics for another 2 years (1966–1968), teaching at Lugulu Girls, Kaimosi Girls, and Eastleigh Secondary School.

Her stint at Eastleigh Secondary School brought to the fore the enormous gap in the health of the African child, stirring up once again the desire for medicine. “I could take some to the hospital in my car in the afternoons but even the care they were given was not enough,” she recalls.  Jolted with a burning desire to help, she left the teaching profession in 1968 and enrolled at the Medical School of the University of Nairobi (UON), choosing to specialize in Community Health rather than surgery. For 5 years, she juggled between raising a family and school. In 1973, she graduated, finally realizing a long-held dream.

Steering Kenya’s community health program

After graduating as a Medical Doctor from the UON, Prof. Were was posted to the Division of Communicable Disease Control at the Ministry of Health, Kenya, where she developed the framework for the Integrated TB-Leprosy Control Program in Kenya.

The only way to practice Community Health was through Public Health, so after her internship as the Medical Officer, Ministry of Health in 1973-1974, Prof. Were grabbed yet another chance to study Public Health at the Johns Hopkins University, Department of International Health where she graduated with a Master of Public Health in 1976.

A master of public health, Prof. Were pursued a research project in community health at the Ministry of Health Kenya (MOH).

Her research was adopted by MOH as the National Health Pilot Programme on Community Health. Evidence from this project premiered at the 1978 International Conference on Primary Health Care (PHC). It was also honored with the 1978 Global UNICEF MAURICE PATE AWARD, the first time the award came to Africa. During this time, she was also doubling as a Senior lecturer at the Department of Community Health, Faculty of Medicine, University of Nairobi.

Her project inspired the training of community health workers (CHWs) in the country for the first time with the sole agenda of introducing modern healthcare to communities still stuck in traditional healthcare. CHWs became critical drivers of health in Kenya, promoting community cohesion, preventing diseases at the community level, and eventually reducing the mortality rates. This model will, later on, be introduced in Ethiopia in 1985 while she was working with the United Nations.

She continued working at the UON, where she went on to become the Chair of the Department of Community Health, Faculty of Medicine. During her tenure, she developed the Curriculum for classroom and fieldwork on the Basic principles of Public Health.

When you focus on curative services, it’s like wiping the floor where the taps are leaking, instead of turning off.

Prof. Miriam Khamadi- 2022 Nobel Peace Prize Nominee

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Building Ethiopia’s health systems

Prof. Were moved to Ethiopia in September 1985 and stayed for 15 years working with UNICEF as the Chief Health and Nutrition/Senior PHC Adviser. While in Ethiopia, she made various impactful changes to the health systems, most notably the Accelerated Child Health Development (ACHD) Programme that raised child immunization from 3% in 1985 to over 60% by the end of 1990.

She later took up a role as the Representative and Chief of Mission for the World Health Organization to Ethiopia in 1990. In this capacity, she provided support to government planning and management of national health programs for improved delivery of medical/health services. While serving as Director, United Nations Population Fund Country Support Team Addis Ababa (UNFPA/CSTAA) between 1993 and 2000, she steered a multidisciplinary team of over 20 international and regional advisors, to provide a timely, appropriate and effective response to country requests for technical support in population and development programs.

In her work both in Kenya and Ethiopia, Prof. Were came to one conclusion: community health care is much better in improving public health outcomes as it focuses on preventing disease and promoting health. Hospitals to her are an expression of failure, not an expression of success. “When you focus on curative services, it’s like wiping the floor where the taps are leaking, instead of turning off,” She says

Empowering the Youth through Uzima Foundation

Apart from being an ardent champion of public health, Prof. Were also happens to be an ardent supporter of the youth. “I like seeing young people like you do great things, “she says. Her love for youth mentorship saw Prof. Were and her husband start the Uzima Foundation in 1995 to catalyze youth empowerment. According to Prof. Were, the foundation aims to stimulate young men and women to define, plan for, and act to experience improved quality of life.

About KES 2 million (about US$17,000) was spent to get the foundation up and running. The initial focus was on Nairobi, Nyanza, and the Western regions, but soon afterward, activities spread to other regions where interest had picked up. With the support of donors and other NGOs, the Uzima Foundation has been able to spread its tentacles across the country. 27 years after its establishment, the foundation has grown its membership to over 20,000 across 100 Uzima youth groups.

Prof. Were has also employed her prolific literature talents to help nurture the youth. Her books The Boy in Between (1969), The High School Gent (1972), The Eighth Wife (1972), and Your Heart is My Alter (1980) not only epitomize literary prowess but also highlight other issues that affect the community other than health.

Steering Kenya’s HIV/ AIDs response

In 2003, Prof. Were again found herself in public service, this time as the Chair of the National AIDS Control Council (NACC). With her leadership, NACC coordinated the work and inputs of National and International Stakeholders in Kenya’s National Response to HIV/AIDS. Under her watch, the HIV prevalence rate reduced from 14% in 2000 to 6.8% in 2003 and 5.1% in 2006. New infections also dropped from 120,000 to 55,000 by 2006.

As the Chair of the International Board of Directors of the African Medical and Research Foundation (AMREF) from February 2003, Prof. Were also championed the foundation’s mission to improve the health of disadvantaged people in Africa. During her tenure, AMREF expanded its medical services. As a result, the foundation’s annual budget increased from US$19 million in 2003 to US$60 million in 2007.

An astute health administrator, Dr. Had also sat on several medical organization boards. From September 2002, she sat on the Board of Directors of MAP International, a Christian NGO with the theme of health and hope for a hurting world for over 50 years. She also sat on the Action Africa Help–International (AAH-I) Board, an international NGO focused on improving the quality of life of people through their community involvement in health care, food production, and good governance. To crown her boardroom prowess, Dr. Were currently sits on the COVID-19 Commission Board, an international board that has people from all over the world monitoring the development and the approaches to be used by nations on how to tame the pandemic.

An award-winning health professional

Dr. Were has won outstanding International Awards for her role in health and other sectors. In 1978, she received the UNICEF Maurice Pate Award. This was followed by the George P. Tolbert Health Award of the National Council of International Health of the USA in 1980, the International Order of Merit (IOM) in 2000, and Elder of the Order of the Burning Spear (EBS) of the Republic of Kenya in 2005. In 2006, she received the Medal of the Italian Cabinet and The Eve Woman of Year Award in the Academia Category.

Her work spanning decades also saw her receive the Queen Elizabeth II Gold Medal for Public Health in the Commonwealth in 2007, and the HIDEYO Noguchi Africa Prize in 2008 in Japan, where she was honored in the Medical Services category. In her tray of awards also sits the Order of the Rising Sun with Gold Rays and Neck Ribbon by the Emperor of Japan, which she received in 2020. Adding to the impressive list is the 2022 Lifetime Achievement Award presented to her in April 2022 during the Quality Healthcare Kenyan Awards (QHKA). 

To crown it all, Prof. Were was recently nominated for the 2022 Nobel Peace Prize. The professor has the opportunity to become the second woman to be the laureate after the late Prof. Wangari Maathai. She talks about it with a smile and wonders how she made it to the nomination list. The nomination is in recognition of her tireless work over the years in promoting trust between governments, health authorities, and the citizens through culturally sensitive program

As she retires, she is still a firm believer in the community approach to healthcare. She reckons that embracing community health care is good not only for health but also for economic growth and business management. Her one wish is that the leaders of today embraced this approach and implemented programs aimed at involving the people in health management through the community approach.

This feature appeared in the June 2022 issue of Healthcare Middle East & Africa. You can read this and the entire magazine HERE