Ruth De Souza: Shifting and shaping the narrative of healthcare

Ruth De Souza wears many hats and those who know her, know this very well. With the research she does, the communities she uplifts and the awareness she spreads through her work, Ruth has cracked the code to caring for community and culturally safe healthcare for all in many ways.

It’s a mighty challenge to encompass in a short space, an experience and practice that span 35 years this year. A career that has seen Ruth as a nurse, community health worker, an educator, a researcher, writer, and most recently a podcaster working in fields as diverse as nursing, maternal mental health, community health, tertiary education, migrant health, media, creative industries, data systems and more.

So in my attempt to highlight the amazing, affirming and valuable work Ruth does, as part of SAARI Collective’s IWD profile series I used 2023 theme of Cracking the Code: Innovation for a gender equal future as a guiding lens to dig deep and learn more about her work, current projects and what’s on the horizon for her.

It all starts with care for and with community

I have known Ruth and followed her work for many years but I can’t recall how I first met her; it might have been through common friends or at a seminar where she might have been delivering a speech or was part of a panel. But the thing I remember is always coming away inspired and moved each time I heard her speak. Of late, I have been enjoying her foray into podcasts with her Birthing & Justice podcast, which is now in its 4th series.

Ruth was born in Tanzania and is of Catholic Goan heritage from both her parents’ sides, was raised in Kenya and Aotearoa (some call it New Zealand) where she started her career in nursing and moved here a decade ago for work. She has just wrapped up her role as the Vice-Chancellor’s Fellow at RMIT University, based in the School of Art and Design and Creative Practice Enabling Capability Platform where her work centres on research in gender, race, health and digital technologies.

In her engagement with technology and the role digital technologies can play in healthcare, she said three aspects come to the fore. The first was leadership; the second was participation and the third, literacies.

“I've been interested in, and involved in those aspects of technology for a really long time.”

Ruth’s pioneering approach and leadership started early; she has always been interested in the interaction of community health and digital technologies, and started doing research, in the mid 90s in Aotearoa, about how community organizations were using the Internet and communication technologies (ICT). In the early 2000s, she along with her then partner set up an email list and network and online journal for people who were interested in the interface between migrant settler and indigenous experiences. This won her two awards for outstanding contribution to race relations because it opened up conversations around digital literacies and the migrant and Indigenous healthcare experience like never before.  

She tells me she is excited about the potential that communities can do really interesting things, when it comes to understanding the role of participation of everyone in a community in shared decision-making. During lockdown she did research around the electronic health records and sharing data privacy with migrant and refugee background women and was also involved with work being done about the COVID Safe app.

“So, in terms of community participation, my interest is in thinking how can people participate in systems that are dominant but are not very transparent?”

Widening the lens of healthcare education

At the moment she is involved as a mentor for the women in digital health leadership program. It started last year and Ruth was asked to be one of the mentors by the Australasian Institute of Digital Health, where 25 women take part over a six-month period. Ruth’s observation is that often the environments the women are working in are very heteronormative and so the work of the mentors is to help strengthen the capacity of the mentees to work and lead in such environments, but also to understand how to navigate them.  

“This is why I moved from practice to education, as I wanted to change the pedagogy, the learning for future generations, and to really widen the lens from being about a particular kind of person who's white and middle class, able bodied, cis and straight and to really expand the capacity of health professionals to respond to difference.”

One of the ways Ruth has been widening this lens has been through her podcast, Birthing & Justice, where she hosts conversations about birth, racism and cultural safety with change makers working within the maternal health-care sector to break down the structures built on colonisation. This is a series that intends to give birthing people hope and power when they’re at their most vulnerable. Ruth shares that her PhD was about people who have a baby in a new country.

“I was really interested in the history of birthing you know, so everything about the present comes from the past, right? So I'm inspired by the term reproductive justice.”

Ruth shares she is interested in histories of antinatalism and pronatalism: who has historically been encouraged to birth – white middle class women in the colony were the ones that were the ideal birthers – and who has not, Indigenous people and migrants, for example, the Chinese or Indians or South Asians who have long histories in settler colonies were not encouraged to birth. There were all kinds of regulations and restrictions on migration, including those on who could birth.

And here we have the reproductive justice paradigm as opposed to the paradigm of choice, which comes from white feminism and really limits and ignores the intersectional forces that constraint access, Ruth elaborates.

“I think reproductive justice highlights the roles of institutions, governments and communities in ensuring justice.”

 

Reproductive justice is a term and theoretical framework that comes from Black women’s advocacy. She also has a deep interest in cultural safety in healthcare - a term and approach developed by Maori nurses. For Ruth, the best theorising comes from the margins, and she extends a debt of gratitude to these practitioners for these terms and the work around them that are the foundation of her podcast.

Through her podcast, Ruth centers the voices of people who identify as women or birthing people who may not often feature on or be the ideal consumer of yummy mummy podcasts, which often tend to be white middle class people.

“I'm interested in talking to people on the margins as a way to highlight the forces of race, class, ability, environment, and sexuality on reproduction and also demanding change at the same time.”

A change that’s already happened is that the podcast has been assigned as part of curriculum for students of midwifery and nursing programs and, and that’s both powerful and exciting.

“I've been talking about racism and birth for years, and it's like, I’ve only maybe made a dent in it, but with the podcast, maybe I can make a kind of ripple. The more people that listen, the more people will try and do things differently. You know, will feel resourced or empowered, that’s my hope.”

 

In our conversation the word polyvocality comes up, and to me it really sums up the work that Ruth does and endeavours others to do as well – the power of many voices, many narratives and plurality to sustain change and shift the current, often inadequate systems that support people in their need for better healthcare.

Ruth is a staunch believer in bringing the many voices and strengths of community together to find solutions to issues concerning them. She has long been a practitioner and believer of polyvocality and this is very obvious throughout her 35-year strong career and practice. There was heaps more we talked about, but I’ll leave it for people to know more through her work.


You can follow Ruth on Twitter or Instagram, and listen to her amazing podcast here.


Jasmeet Kaur Sahi is a member of SAARI Collective's editorial team and a Melbourne-based writer and editor.


Credits

Images sourced via Ruth De Souza and her website