Dr. Aparna Hegde is a force of nature. She is #15 on Fortune’s list of World’s Greatest Leaders 2021 making India and women all across the world proud. She is the Founder, Chairperson and Managing Trustee of Armman. Dr. Hegde is an internationally renowned Urogynecologist. She is Associate Professor (Hon) of Urogynecology and is setting up the upcoming Department of Urogynecology at Cama Hospital, Grant Medical College, Mumbai; India’s first comprehensive Center of Excellence in the field. She is also the Founder and Director of the Center for Urogynecology and Pelvic Health, Delhi and Consultant Urogynecologist at Global Hospital, Surya Hospital and Women’s Hospital, Mumbai.
In addition to MD (ObGyn), DNB, FCPS (Gold Medal) and DGO, Dr Hegde holds a master’s degree from Stanford University, and she was awarded the IUGA International Fellowship in Urogynecology and Pelvic Reconstructive Surgery which she completed in the prestigious Department of Urogynecology at Cleveland Clinic Florida, before returning to India. She is a member of the Editorial Board of International Urogynecology Journal. She is also a member of the International Urogynecology Committee on Prolapse and the 7th International Consultation on Continence, international committees of experts constituted to develop evidence-based guidelines in the field. She is the Vice-Chair of FIUGA (the Foundation for International Urogynecological Assistance).
She is also an avid researcher with multiple research awards, the best paper award at the American Urogynecological Society Annual Meeting in 2013 and more than 75 publications and abstracts in peer-reviewed journals. She is an internationally recognized pioneer in the field of 3D and 2D sonographic assessment of the pelvic floor and is invited as an expert to conduct workshops and round tables on her research work at the IUGA (International Urogynecology Association) and AUGS (American Urogynecology Society) annual meetings and last year’s FIGO conference. She was recently awarded the highly prestigious NIH (National Institute of Health, US) grant for her field study on bladder health in adolescent girls. She was also awarded the Sri Lankan Menopause Society Fellowship in 2019, the 2nd international dignitary to be awarded the same, for contributions made to develop Urogynecology in Sri Lanka.
She is a TED Fellow 2020 and received the Skoll Award for Social Entrepreneurship 2020. Dr Hegde was awarded USAID ‘Social Entrepreneur’ award (2018), ‘Woman ChangeMaker’ award (Womanity Foundation, Geneva, 2017), Woman Icon Award in Asia by Nanyung University, Singapore (2016), ‘the Mother Teresa Social Leadership Fellowship in 2016, Digital Woman Entrepreneur Award in 2015, Top Social Innovator Award in 2014 and 2017, the ‘People’s Choice Award’ at Saving Lives at a Birth event in Washington DC in 2011, among other awards. She has been featured as one of the five global women leaders in the Voice of America documentary, ‘A Single Step: Journeys of Women Leaders (2015).
She is filled with contagious energy and positive vibes. Hearing her speak about her work and passion is enough to make one feel motivated and start working towards their goal. Her kind and polite nature make it easy to communicate with her. Let us get to know more about Dr Aparna Hegde.
- Armman is this wonderful organization you found in 2008. It leverages technology and provides information to pregnant women, mothers and health workers on their cell phones. What inspired you to start this NGO?
The idea of Armman germinated from my experiences during residency. I did my medical residency at Sion hospital, in Mumbai, which is one of the largest tertiary Government hospitals in the country. I saw firsthand how pervasive systemic problems led to preventable maternal and child mortality. Often, we would save these mothers and children, but the sequelae would be so severe and they would go back to the slums or communities in such a horrible state, that death seemed a better eventuality. Most of the deaths and severe morbidity could have been easily avoided if only the women had access to the right information at the right time and/or the health workers were trained to pick up and treat the risk factors early in the antenatal period or infancy before it was too late. I saw this happening over and over again. I realized early on, that only hospital-based solutions are not enough; we need to go into the community and solve these issues at scale. And then the mobile phone came to India and spread through the country in a few years. I realized that technology, especially mobile technology would be a great tool to reach out to women directly with information as often as needed through pregnancy and infancy, to train health workers and for better delivery of health services.
- Armman’s quick response to Covid-19 has been highly talked about. When the pandemic started, Armman launched four interventions to support pregnant women, children, and healthcare workers within a week. Can you share some details about the work that went into forming these interventions in such a short time?
Our programs, mMitra, Kilkari and Mobile Academy, work through partnerships with hospitals, NGO partners on the ground and of course, the Government in 18 states. We leverage the existing health infrastructure on the ground and Government partnership to implement our programs. We also have a large technology platform in place. Hence when covid struck, we already had a system in place. And we could repurpose our platform and networks overnight to create solutions to bridge the sudden gaps in health care during covid.
For example, we have a call centre manned by trained counsellors. During covid, hospitals closed down or became covid centres and so women were calling in with medical queries, for example, someone had vaginal bleeding during pregnancy, or the baby was not moving. We needed doctors to answer these queries. And so, in a matter of days, we created a virtual antenatal and pediatric clinic manned by Obstetricians and Pediatricians. I put out a call for doctors and virtually overnight, 60 doctors volunteered. Over 17,700 women have availed of the services of the virtual clinic. We created a two-tier support system. When a woman calls, our staff take the call and handle any logistic issues, for example helping women find an ambulance or understand which hospital offers a particular service and how to reach there. And if there is a medical query, then the call is routed to the doctor on call. We have helped our 60,000 women with logistic support.
Pregnancy and infancy are vulnerable periods with respect to covid. Hence, we added covid specific content to our weekly voice calls (providing preventive care information) that go out to women through pregnancy and infancy. We revised the content every 6 weeks based on any new information that needed to be sent out.
Also, our Mobile Academy platform is a health training platform for ASHA workers. We repurposed the platform to send covid specific information that the Government needed to send to over 800,000 health workers ( ASHAs, ANMs and rural doctors) throughout the country.
Additionally, we have added modules on the management of covid in pregnancy to the statewide program we are doing in Telangana on integrated high-risk pregnancy management in which we are training 9500 Auxiliary nurse midwives, 1500 medical officers and 330 specialists in covid management in pregnancy. We are also in the process of modifying Mobile Academy content to add covid specific content.
- You have changed and inspired so many lives as a Doctor and as a social entrepreneur. Who is your greatest inspiration or role model?
(Laughing) I think the freedom fighters of India. Currently, I am reading India after Gandhi by Ramachandra Guha and I am again struck with melancholy (that I felt like a kid) that I will never ever meet Nehru and Gandhi. That time was so inspirational. India’s existence itself is a miracle, I mean India is so diverse, it’s like many countries together and the fact that our forefathers gave up so much and sacrificed so much for India. They had a dream of a secular India. Their dream was their priority, and they went to jail in service of a larger story for all of us. My maternal grandfather too dropped out of college and went to jail for 9 months during the Quit India Movement, in response to Gandhi’s call. He was a small-time freedom fighter and our family has been witness to the travails of those who responded to the clarion call of the leaders and fought for India’s freedom but never ever tried to benefit from it later when India became independent.
- Did you always want to pursue a career in medicine and be a doctor?
Frankly, as a kid, I loved maths and physics. So I wanted to be an Engineer or a Scientist, become a Professor doing pioneering research.
Even now, one of the reasons I love Urogynecology is that it deals with a lot of physiology of the bladder and bowel and diagnostics like Urodynamics and anorectal manometry that draw on mechanics and biophysics of the human body.
But as I grew up, my privilege became obvious to me. I was born into a lower-middle-class family and grew up in a typical Mumbai chawl. But we come from Kannadiga Havyaka Brahmin stock (mentioning this here to let you know my privilege, but I think caste is the biggest scourge in the country and I am ashamed of the privilege it has accorded me) and just this fact meant that I had access to education and other privileges. And I also became conscious of how lucky I am to be born in Mumbai where my gender never stopped me. In a country like India, our status in life has so much to do with where we are born, ‘the accident of birth’. While I have always felt grateful for what I have been given, it was disturbing that other women and children did not have access to the same privileges because of so many equity barriers, including caste, religion, gender etc. So, I have always been an activist, having volunteered with education NGOs and animal welfare organizations. When I entered the 11th standard, medicine seemed like a perfect amalgamation of all my aspirations in life: to me, medicine is science, service, and research, all that I wanted to do in my life. And that is what I do now. In addition to being a Urogynecologist and social entrepreneur, I am also a researcher and an Associate Professor (Hon). I have done a lot of research in 2D and 3D USG imaging of the pelvic floor (that started during my fellowship in the US) that I teach internationally. Armman also does a lot of research, and all our programs are evidence-based. I feel really blessed. Lastly, as a Urogynecologist, I treat one of the things Armman tries to prevent: pelvic floor problems resulting from childbirth gone wrong. Secondly, I am a ‘tech’ social entrepreneur now as Armman’s programs leverage technology. So I guess, it has all come together.
- You are juggling and acing different roles throughout the day. We would love to know how you do it all because most of us are very bad at time management.
I don’t know if I have cracked how to manage my time and sometimes it does get overwhelming (laughing). But yes, I get up very early. I have fixed time for research and a bit of Armman work and then I am trying, nowadays, to get in an hour of exercise before I leave for work at around 8.30. I am an Honorary Associate Professor of Urogynecology at Cama Hospital and I work there until the afternoon seeing patients or performing surgeries and then in the afternoon, I have my private practice. In between patients and while driving to hospitals, I do Armman meetings and then I get back home in the late evening to more meetings and Armman work. I work very long hours actually and work through the weekend. I love what I do, and the passion drives me. I have found a rhythm and balance that works best for me. I read a lot and I love watching movies as well.
- What is that one experience you can share with us that changed your life?
It isn’t just one experience. I would say, it is a series of experiences during my medical residency when I saw closely how tragic life can get for women and children who are underprivileged. Our antenatal clinics were so overcrowded (with over 200-300 patients waiting to access care), that we never had time to counsel them. There are many stories and some of these stories are too gory. But I will speak of this one patient who came in a dying state during labour when I was doing a residency at Sion hospital. When I opened her antenatal papers, I saw my own handwriting. I had seen her in the third month of pregnancy and then she never came back for antenatal care. I was wracked with guilt: was the antenatal OPD so overcrowded that I did not get time to counsel her on the danger signs, the complications, why she needed to access antenatal care? I kept wondering whether she could have been saved only if she had access to a little information at the right time.
These experiences solidified my resolve to do something and formed the genesis of my NGO, Armman.
- In the light of the recent events, our health care system has been praised but at the same time has also been on receiving end of a lot of brutalities and backlash. What would you like to say to our readers, so that we as a community can help the healthcare system in whichever way possible?
Has the healthcare system been praised? Frankly, our health care system has been suffering from years of disinvestment. Our primary health care system and referral system are very poor leading to overcrowded tertiary health facilities. What you saw during covid namely, patients not getting beds, not getting oxygen or a doctor for treatment etc., is something that women and children face in rural India daily. The middle class does not face this during non-pandemic times and hence is not aware of how tough things are for most of our population. We have a vibrant private health sector in urban India, but one thing you must realize is that when push comes to shove when there is an epidemic, pandemic, or a calamity, it is the government healthcare system that comes to the forefront. And we must all do our utmost to advocate to increase spending on health infrastructure and solving systemic problems so that we are better prepared to face calamities in the future. When this is all over, we must not forget this time. Because if there is no health then there is nothing, right? Health is a foundation for everything and among all fields, maternal and child health is a barometer for a country’s socio-economic development. If you invest in maternal-child health, it leads to horizontal development of the health systems. If a village can look after its women and children well, it can look after all other conditions through the ripple effect.
- Do you think women and girls in India are more aware of their bodies, their health and hygiene, and about pregnancies and care?
No, not at all. There is a long way to go. It is improving obviously but still, there is a very long way to go. Women and girls are bound in the shackles of patriarchy and even what constitutes ‘choice’ and ‘free will is limited by the paucity of exposure due to gender.
- One piece of advice or tip you would like to share with us?
Persevere. Never lose sight of your dreams. We tend to get lost in our day to day problems, but we must never lose sight of the larger story that our life can become.
On behalf of the SheSight Team, we are extremely grateful to her for taking out the time and effort from her busy schedule. We wish her the very best on both a personal and professional front.