Bernadette Theodore-Gandi Pan American Health Organisation (PAHO)

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Women leaders of the United Nations in T&T

By By Cedriann Martin

Development work is never done. The balancing acts involved are particularly delicate. And the bottom-line is that most complex and vital of factors—people. This year Trinidad and Tobago celebrates 50 years of United Nations (UN) membership. Ahead of UN Day on Wednesday, Express Woman takes a glimpse into the work and lives of those women who head UN agencies serving T&T.

Bernadette Theodore-Gandi Pan American Health Organisation (PAHO) PAHO's Representative to Trinidad and Tobago, Bernadette Theodore-Gandi, grasped the need to tackle the big picture early. The spark came during her long wait at the Port of Spain General Hospital after suffering a dog bite as a girl. She immediately tapped into a motivation to change the system. "In clinical medicine you see the people who are drowning at the bottom of the river and try to pull them out," she says. "We in public health go to the source of the river to prevent people being thrown into the water in the first place." And so, after working as a medical doctor for three years she transitioned to public health training and work in England. Her expertise and interest in international health brought her back to our region when she joined PAHO 22 years ago. "Vision is absolutely critical. We're looking at the long term impact. We have to persuade governments and people but first we have to listen... to understand their agendas, their contexts and the challenges they face," she notes. Theodore-Gandi points to several T&T public health successes, starting with improved sanitation, access to clean water, education and income. Excellent immunisation coverage has made illnesses like rubella, polio, mumps and measles, constructs of the past. (She considers the move to offer Human Papillomavirus vaccines to girls a marker of just how far we have come, assuring that "there are no significant risks".) Also important are the development of the primary health care system, access to free healthcare and improved diagnostic facilities. They are the kind of strides that are most striking when viewed with a long lens. Theodore-Gandi accepts that while the successes invariably become taken-for-granted, the gaps get all the press. She insists that T&T's public health service offers good clinical care. Many of the shortcomings do not necessarily require more resources but can be addressed through improved management. There are several issues on PAHO's agenda including non-communicable diseases (NCD), HIV, maternal and child health and strengthening health systems and primary care. Theodore-Gandi stresses that in order to maximise both bang for the health buck and impact on people's lives, it is essential that the health sector integrate services. "Whether you have heart disease, HIV or both, you need good quality lab support and training, empathy and confidentiality," she says.

Khin-Sandi Lwin United Nations Children's Fund (UNICEF) On Christmas Day in 1978, Vietnam launched a full-scale invasion of Cambodia. A stream of terrified people rushed into Thailand. Recent university graduate, Khin-Sandi Lwin, volunteered for UNICEF during that border crisis but spent just a couple days distributing bags of rice. Her expertise in writing donor reports was more needed. Lwin hadn't planned on this professional path but her instinctive reaction to this refugee emergency kicked off a more than three-decade-long career at UNICEF that has taken her from Bangladesh to Sudan, India to Indonesia, Namibia to Botswana. "The level of development in the Caribbean is fairly high," she notes. "We are working in middle- and upper-middle income countries so the usual issues like child survival are generally no longer valid but child development and child protection issues are critical." It's shocking, then, to learn of a recent UNICEF study which highlighted that T&T's rate of reduction in the deaths of children under age five isn't commensurate with our level of development. "We are trying to work with the Ministry of Health to understand why the child mortality rates are not improving," Lwin says. Social data of this kind tells crucial stories and defines the path to solutions. Unfortunately, there isn't enough emphasis on research about children. Filling the information gap with respect to child abuse and child protection issues is a pressing priority. "What we do know is that the reported cases are increasingly horrendous. Infants and very small children are being sexually abused. We are working with the Ministry of Gender Youth and Child Development to understand whether this has been there all along or whether it is a new phenomenon," she says. Addressing issues that go to the heart of family life and social mores can be a tricky business but Lwin stresses that UNICEF's mandate is not to change positive traditions in culture, but rather to change behaviours, attitudes and social norms that impede on child development over time. "It is about valuing the care, nurturing and love that we all agree children need and channelling that into polices that protect children's fundamental right to life, to protection and to full development of their potential," she says.

Catherine Mackenzie UN Department of Safety and Security (UNDSS) With her larger-than-life personality, Catherine Mackenzie isn't the type that comes to mind when one thinks "security". In fact, she isn't the gender that comes to mind either. "Only nine per cent of the staff members in the UNDSS are women," Mackenzie notes. "It's not a line that's easy for females to take. You're away from home, family and children. It's not glamorous and it's thankless. Security measures might keep people safe but they're not popular." She quietly commiserates with the guards at her apartment building who get snide comments and cutting looks when they request ID. She often suspects that people expect her to be less firm and more flexible by dint of being a woman. For her own part she tries to ensure buy-in at every stage of the decision-making process. And she also takes a collaborative approach when things go wrong. "I always make the point that what has happened is a systems failure,"—and here she smiles—"exploited by yourself… but it's something that we all have to work together to address." Mackenzie's career path was entirely uncharted. Her parents were doctors who were eventually posted to the British Virgin Islands. She fell in love with the sun and the lifestyle and (notwithstanding a degree in adult education) for a while considered becoming a scuba diving instructor. Her meandering professional life would take her from Borneo to Singapore to New Zealand (where she started her family) to Malaysia, to an MBA, to developing programmes for senior managers in high level security. She went on to earn another advanced degree in civil aviation management and switched industries. She worked as an assistant chief of security at the UN Headquarters in New York for seven years before a four year stint as Chief of the Mobile Training Team at the UNDSS. Mackenzie has been here for just over two years and leads a team responsible for the safety of staff and family members in T&T, Barbados and the Eastern Caribbean. She notes of this country's evolving security culture: "People are becoming empowered and responsible about their own safety. They're saying 'we the people of Trinidad can do something too'."

Izola Garcia Joint United Nations Programme on HIV/AIDS (UNAIDS) Izola Garcia didn't know it at first, but the seeds for her commitment to social development were planted in a thousand different ways. Her Arima mother and grandmother had grasped the difference that education could make in the lives of girls. They'd come from the era of cocoa and coffee when opportunities—particularly for women—were few. Her first job at a bank in the late 1980s brought her into contact with a gamut of people. Some were homeless. One was rumoured to be living with HIV. When she pursued an economics degree at the University of the West Indies, she was invariably drawn to courses on poverty. When she began work on population issues, none of the subject matter was abstract. Now the UNAIDS Country Coordinator for Trinidad and Tobago, Garcia has had stints everywhere from the United Nations Economic Commission for Latin America and the Caribbean to Habitat for Humanity, the Transparency Institute to the National AIDS Coordinating Committee. She's seen the national HIV response evolve. Garcia maintains that the contributions of stakeholders from different sectors (including civil society, government, development agencies and people living with HIV themselves) are bearing fruit. "We're doing well in many respects and we have many of the essential elements, programmes and policies in place for an effective HIV response. For example T&T is doing a good job at ensuring that fewer babies are being born with HIV. What needs to be done now is to ensure that when these children become adolescents they remain HIV negative" she stresses. She notes that the high HIV rate among people in the 15-24 age group means that many young people are sexually active or victims of sexual abuse. Garcia says that work must continue to ensure that "young people access consistent and comprehensive sexuality education so that they can delay sex, make informed choices and access important services and commodities when sexually active." While applauding the state's provision of free antiretroviral treatment to all citizens, she stresses that in order for our treatment programme to be sustainable in the long term there must be renewed emphasis on prevention. "Sustainability of the response is essential lest we lose the gains on the investment of the past decades," she says.

Diane Quarless — United Nations Economic Commission for Latin America and the Caribbean (ECLAC) Last week Diane Quarless, Director of the ECLAC Subregional Headquarters for the Caribbean, surprised residents of Arima during a lecture on poverty eradication. "The United Nations Development Programme (UNDP) led the production of a Human Development Atlas of Trinidad and Tobago which has disaggregated analysis of the development challenges faced by specific regions. Arima was high on the gender inequality index which means there are significant challenges with respect to development opportunities for women in the area," she explains. She shares the anecdote to illustrate the difference statistics make. Good data ensures that governments are able to make targeted and well-informed decisions to address specific issues. The research and analysis work of her office—whether supporting the Central Statistical Office or conducting an assessment of the economic impact of climate change—is never about numbers for their own sake. In fact, moving forward her office will renew its focus on performing a policy think tank role. Energetic and passionate, Quarless' optimism sharply contrasts the economic picture painted of the Caribbean. She levels about the region's potential: "With the exception of Barbados, our region has not pursued as aggressively as it might the development of renewable alternative energy sources. This is where ECLAC can play an important role because we need to look thoughtfully at the policy mix that promotes incentives and facilitates development". Also on the region's to-do list: promoting trade among Caricom and Central American countries and addressing the lack of air routes. Is that a huge mandate? Yes. Does Quarless think it can be managed? Absolutely! Describing herself as "a Caribbean woman", Quarless was born and raised in Jamaica. She balanced the disciplined study her parents insisted upon with music, even becoming the choir mistress at her church at 16. And she recalls with a laugh that she met her Trinidadian husband in a pan yard at UWI. She studied international relations before beginning a career that would span more than two decades in Jamaica's Foreign Service. From there she was recruited by the UN to be Chief of the Small Island Developing States Unit. She's ecstatic to now call this small island state her home. *Geeta Sethi who was featured on our April 1st 2012 cover is Director of the United Nations Population Fund (UNFPA) Sub-regional Office for the Caribbean and Jewel Ali is Head of Office at the International Organisation for Migration (IOM).

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