From global achievement to national impact

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Her name appears in the frontline of the global battle against HIV/AIDS largely because of her fruitful advocacy for affordable and later free ART medicines for Asia and Africa. Dr. Teguest Guerma is one of the few black women that have achieved high leadership positions in the United Nations and now is a founder and CEO of Le-Deg Midwifery College. The baby girl who once said “let her die” when she was an infant has now invested every penny she makes in her 42 year expat career to build the Non-Profit Excellence Center which she discussed in this exclusive interview with Capital’s Haimanot Ashenafi.

Capital: You once said “let her die” in your infancy. Take us to that moment.

Teguest: When I was born I was a huge baby and it was very difficult for my mom to deliver easily which meant the doctors had to work hard just to save her life. After many hours of labor the medical team decided to get me out into the world any way possible; alive or dead. The doctors tried their best and finally exclaimed: “Let her die and let’s save the life of the mother”. Even if I was able to be born via C section, I was going to be exposed to complications because of the methods they used trying to get me out. I was lucky to have survived. I was born in Addis Ababa which gave me the chance to get good medical treatment but how many children died in rural areas that same day? That’s one of my reasons for establishing this public enterprise without worrying about profits. Also, achieving the dream of my mother was another reason. She always wanted to be a nurse in her childhood, before her father gives her for marriage. She pushed us to be doctors which she brainwashed us to think of the profession as a divine help for the weak. Out of four girls in the house three of us became doctors because of her good influence. So the two reasons convince me to establish this school.

Capital: How do you see the understanding of the community to the field of Midwifery?

Teguest: I was on one radio show which was open for the audience participation recently. A mother called and told us that she was angry at her daughter for choosing the field of midwifery and she called to thank me because I was elaborating about how important job it is. She told me that she will send her to our college. The term “Awalaj” in Amharic is also inappropriate and narrow to represent this precious job. Midwifes are the lifetime partners of women as they assist them starting from teenage years through menopause. The prejudice is one factor for the lack professionals in the country. There are courses up to PhD and midwifes in the developed world have their own practice. Midwifes are the ones who do the entire job and only on some exceptional complications the physicians intervene. To change this thinking of the society am also planning to travel all over the nation in collaboration with the Midwife Association to raise the awareness of the community about the field.

Capital: It is obvious to see Diasporas invest in some business areas. But you invested your fortune in a nonprofit and the building is also being built at a higher quality. How did you decide to contribute this way?

Teguest: When I came back and told people my plan everyone told me I couldn’t do it, but I had a dream which no one could stop. I choose long lasting happiness which can be obtained by impacting other people’s lives. I faced many challenges in my life and this was also one which I think I complete the first phase of the infrastructure within three years. People always asked me if I was building a hotel looking the building. But we have to be thinking that schools should look comfortable.

Capital: How many students can Ledeg accommodate per year and how do you choose your students?

Teguest: We are accredited to accept 80 degree students per year with excellent skills. Our students are going to be made up of students from the rural area and those who sign up by themselves. We are going to provide dormitory, food and education for the students from the rural area which costs USD 3,000 per year for a student. The establish Ledeg foundation is on its way which is going to administer any incomes of the collage, as no profit runs to our pocket. Recruitments are underway for out first batch from the Afar and Somali Regions where the maternal death is relatively high. The regional health bureaus will select the compliant students from poor families and we will also screen them if they are the right person to avoid any inappropriate selections. The trained females will have a commitment to serve their community for two years when they finish their degree. We are also registering students who want to learn by themselves. We will have two and half year training for those who have a diploma and four year training for those who have the national minimum score to join higher education. We are planning to make our composition equal from the rural and the urban where our profits will somehow cover the expenses from the rural. We want a compliant, ethical and compassionate midwifes and that is what is missing in our country.

Capital: As there is no actual delivery here in the campus where are you going to teach the practical skills for the students to meet your excellence goals?

photo: Anteneh Aklilu

Teguest: We signed the agreement with two hospitals one is Heman which is near our campus around Arat-killo. Also Mariestops Adama also has a high flow of delivery which is going to be a good experience for the students to go out of the town. We want to engage with government hospitals but it is very difficult as it is already crowded with students.

Capital: What do you think about the performance of the Ethiopian health sector compared with the African countries you know in terms of maternal death?

Teguest: Maternal death in Ethiopia is avoidable. Many die because of high blood pressure, loss of blood or abortion. Ethiopia has achieved a lot in the battle to minimize the maternal death, but still we are among the list lines in the continent. Most of females in the rural area still call for their neighbors for delivery. Even if they go to the Health Centers they found heath extension workers and sometime midwifes. When a simple complication appears the life of the mother and the baby will be at risk. So we have to increase the number of midwifes with the compressive skills. The government also has to strengthen the health system. If there is no enough equipment, medicine, blood and other equipment are not available the effort will be without a fruit. So we as a country have to strive together, and I am just throwing a little stone for that fight.

Capital: Let us go back to how did you leave your country and what was your work experience like over 42 years?

Teguest: I went to France for a scholarship of medicine. At the moment from the students who took the exam he fist 150 high scorers will join medicine and the rest will be obliged to study Dental medicine. So I rolled the exam 160 and I joined the dental medicine school without my passion. I study the filed for three years and I couldn’t proceed because that was not my dream. I proceed my fourth year in Senegal in Medicine, but not with scholarship. I have to clean the hospital corridors to cover my school fees. I was from the upper class here in Ethiopia and I haven’t clean before that. I remember I clean while crying and people in the hospital feel for me and help me clean. But the generous Senegal government gave me a scholarship later, which I am still grateful for their welcoming nation. I also specialized in epidemiology at John Hopkins, Medical Center in the US state of Maryland. I started my work life in Burundi and I worked in the World Health Organization for 21 years starting from Medical Officer to a special envoy of WHO Africa in the United Nations in New York. I also served as a director of the HIV global program in the WHO before I took my early retirement to come back to Africa. My last experience was to serve AMREF as a global director which marked me as the first female and black person in the positions.

Capital: You are among those witnessed the outbreak of HIV/AIDS. Also, you were able to lead the global fight against the virus. How did you describe the moment and do you think the world has won the battle against HIV/AIDS?

Teguest: I was in Burundi as a head of the hospital, when the virus broke out. As I was an epidemiologist I was the one who tell people the bad news and also do the counseling. HIV was a death sentence at the moment which makes it difficult for us to tell the patient. Some may shout, cry and few might try to hit you. But as we have to protect the spouse the telling the victim the truth was without a choice. Meanwhile governments didn’t want the world to know the existence of the virus in their country. The Burundi government keeps denying the fact rather than trying to solve the crises, which I was against. In the meantime a data leaked to the Newsweek Newspaper which led my colleague from Belgium to be deported within 24 hours. At the moment I applied to the WHO global program for AIDS and they accept me.

photo: Anteneh Aklilu

HIV created a revolution to shape our world in social, economic or political ways. It changes how we see sex work, homosexuality and many more other social interactions in our community. It changes our understanding of poverty and trans gender issues. But now it is just a chronic disease and the understanding of the people is also I proved. People used be stigmatized and beaten to death in the early days. The high number of activists in the advocacy to raise funds for the disease bore fruit. Also after the discovery of the Anti Retro Viral Treatment the biggest challenge was that companies demanded thousands of dollars for treating the patent and research costs. Even after the arrival of the ART the third world was dining like a fly. We advocated minimizing the cost to hundreds and later for the free access of the medicine. HIV changed how their world reacts to epidemics. I also met the late Prime Minister Meles Zenawi for free ART in the country.

Capital: Why did you retire early from WHO?

Teguest: The environment in the global intuitions is not how it looks from the outside. The recent World Bank director, Dr. John Kim was then assigned in the HIV program in the WHO. He called me and asked me to be his deputy and advocated for the free medicine for Africa and Asia. I asked him if he wants a black associate just to be a flower for his office or if he is indeed believe in me. He said that he didn’t know me personally and that people he trusts recommended him. So we were successful on free ART. This is one thing I will mark as my contribution for the continent. HIV is now like any other chronic diseases. When Kim resigned they didn’t give me the post and gave it to other white male. I accept it because of my responsibilities as a single mom. He also resigned within two years. I act for a year and also they open another competition which I win. But they cancelled and hire someone which I opt to accept. They pay me damages accepting their mess. On the day of my resignation I was called from AMREF which I chair for five year. I was the first female to lead the Amref Health Africa.

Capital: How do people react when they see a female in such a high position?

Teguest: let me tell you a funny story. I was assigned to Asia as a special envoy of the WHO for the country. The attitude of the community against women in power is very difficult from Africa. You can find no female in the government offices. When they see that I am an African female they asked me what I brought from my continent to lead them. I strive to demonstrate my skills, and within a week they asked me if I have any roots from Asia. Also, when I moved to Nepal the racism even pushed them to ignore my hand shakes for six months. But I strive not only to improve my work but also to advance my relationships with the people. Some Nepali women even visited my office to see a women sitting in the managerial chair. But when I left Nepal they made a song using my father’s name which has a meaning of “a teaching mother”. I left Nepal with tears. So the challenges I faced as a single mom of two with a dynamic working environment was many but I believe I defeated all with the help of the Almighty.

Capital: Do you feel that your mission is accomplished now?

Teguest: No I will feel that when I see the first batch going back to their place of residence and serve their community. Also I want this center to be a global excellence center which s also my dream to make our collage the best for the excellence.

Capital: What are you doing now as you finish constructing the college?

Teguest: Now we are lobbying people in Ethiopia and also organizations to raise funds to cover the expenses of the trainee from the rural area. We need 3000 dollars for the trainee from the countryside area per year. So I am now engaged in the fund raising. Also, I am writing my biography expecting it to be finalizing within three months. I am writing in Amharic so that I can inspire Ethiopian females who are struggling with life to tell them that winning is possible. I entitled it “Timut Gid Yelem”, let her die, to narrate how high we can fly from people’s expectation.