Meet Gloria Maimela, a medical doctor with business savvy, who’s leading an inspiring group of researchers to implement HIGH Horizons’ work in South Africa.
Can you tell me a bit about your background and how you came to be involved in HIGH Horizons?
I’m a medical doctor and I’ve also got an MBA. I’m based at Wits RHI, which is affiliated with Wits University in Johannesburg. I joined Wits RHI in 2013 to manage HIV health programmes. Last year, I pivoted to climate change and health. And now I’m the Director of the ‘Climate and Health’ portfolio at Wits RHI. One of the projects within this Directorate is HIGH Horizons. We’re very pleased to be implementing this project.
Why did you pivot into climate change?
That’s a very good question. In my leadership journey, I’ve been managing large teams. With the HIV health programme, I got to a point where I had imparted knowledge and skills to my team and they knew what they were doing. So I felt that I needed to go do something else in a new area. Ultimately, because I’m a doctor, I’m motivated by public health so it had to be health-related. Climate change is vastly different from HIV, but it’s also all about improving the lives of people. It’s a fresh challenge, and I’m always looking for new challenges.
HIGH Horizons is certainly a challenge, but an exciting one! Can you describe why HIGH Horizons is so important?
HIGH Horizons aims to develop interventions to mitigate the impact of heat on vulnerable populations – pregnant women, infants and health care workers. A rise in heat is happening right now, the world is getting warmer and warmer by the day. Somebody has to stand up, somebody has to act to protect the most vulnerable in our society from the impact of climate change, particularly heat. This is why the work of HIGH Horizons is so important.
And why is this needed now?
Current projections from the Intergovernmental Panel on Climate Change (IPCC) say we’re 1.2oC warmer than pre-industrial levels, and we’re getting to 1.5oC
If we don’t halt this, we’re going to reach 2oC. By the time we get to 4oC, we would have passed the point of liveability. Action has to be taken now, we don’t have more time.
From your experience, can you describe what it’s like for women, newborns and healthcare workers during heatwaves?
My work in HIV means I’ve had experience working with women ‘on the ground’ as well as looking at health systems.
Women in many African regions come from poor backgrounds and have difficulty accessing healthcare, and this is worsened by extreme heat. Firstly, they have to walk to facilities, and when they get to facilities they have to stand in long queues, and even when they get inside, the facilities are poorly ventilated. Literature has shown that exposure to high heat has a direct impact on the health of the mother and on the health of her unborn baby. Many women choose to stay at home rather than access healthcare which comes with its own risks.
What about health systems? There are already problems, and the heatwaves are compounding those problems. From the healthcare worker perspective, they’re working in an environment where it’s extremely hot. Data is showing that high temperatures are linked to poor performance. We have to look into the root cause of that, and we believe that heat is a contributing factor.
And speaking of that, in Johannesburg, where you’re based, are there any existing mitigation strategies or local adaptions that are helping to protect women, infants, and healthcare workers?
I guess that’s the whole aim of HIGH Horizons – to generate a body of evidence on mitigation and adaptation interventions. So this is still early – we’re hoping to have a full list of evidence-based interventions by the end of this study.
But there are other groups that are looking into the built environment and we hope to learn from them. For example, the South African Medical Research Council are using cool-roofing technology which uses reflective materials to reduce heat and it’s been shown to reduce indoor temperature by 30%. We’ve also been in discussions with The World Bank – they’re working with city planners to address urban heat islands by increasing vegetation and planting trees.
We are focusing on adaptation interventions and many of these are intuitive. For example, people often take access to water for granted, but it’s vital for communities with scarcity. We need to make sure women have access to water during heatwaves. For our interventions to have success we also need to raise awareness. We need to increase knowledge about the impact of heat on women’s health and on the health of their unborn babies, so that women can start protecting themselves.
What role will you be playing in the research project? And are there any particularly interesting methods or techniques that you’d like to share that may be of interest?
We are participating in several of the work packages but primarily we’re preparing ourselves to be the implementation site.
One of the research interventions I’m really excited about is photo voice. We will be giving women cameras to go home and capture the impact of heat in their space. We want to obtain their reflections and perspectives: I.e. what do they think about the impact of heat on their health? And what could be done to address that?
The voices of the women we work with will also help to develop Early Warning Systems (EWS) messaging. We’re developing these with our partners to warn women about the risks of exposure to heat and how they can protect themselves. For example, ‘make sure that you’re in a cool area’ or ‘make sure that you’re drinking water to protect yourself’.
It’s great that you’re working so closely with the women involved and getting the voices of the community to co-design interventions! Say everything goes to plan and you get the results you’re hoping for, what would you hope to achieve?
First, we want to share the lessons learned broadly, so we hope to create evidence and then scale it up. Second, we hope this evidence will be used to inform policy and we’re working closely with policymakers for that. Finally, we want to see that heat-health indicators become a regular part of reporting.
For anyone who may not be familiar, what do you mean by heat-health indicators?
These are monitoring and evaluation indicators that will be used at national level or district level. It will be based for example on the number of women who have been exposed to heat and the number of women who have certain outcomes as a result of heat. For example, how many women had a premature birth that can be directly attributed to heat. We’ll use the indicators to determine whether the mitigation and adaptation interventions we’ve put in place are working or not.
Looking at climate change news and predictions can be quite a bleak exercise. It sometimes it feels like we’re facing an impossible challenge. What motivates you to keep going?
The knowledge that it can be done. The IPCC didn’t say we were beyond hope, their message was that if we take action now we can halt global warming, and even reverse it!
And that’s what we cling on to – it’s not a hopeless situation. There are solutions and we’re part of that.
And is there anything else you wanted to add?
I’m very privileged to work with a brilliant team, and a consortium of different experts. Working together with lots of different teams is absolutely amazing. I’m confident that our results will be great, but more importantly it’s about the beneficiaries on the ground and we are making a difference to protect them.