Meet The product engineer encouraging the education and awareness of women's healthcare.
BY ALEX CLEATOR
Zubaida Bai has a mission to educate women about safer practices and encourage them to be self-aware throughout their reproductive life cycles. Bai founded Ayzh (pronounced “eyes”) in 2010, a social enterprise which originated with her birth kit, JANMA, designed to prevent infection during childbirth for women in developing countries. JANMA, meaning ‘Birth,’ is a purse containing the “basic, clean tools” needed for safer childbirth. As a mother herself, she understands how important it is to have the safest possible medical care.
Bai was initially responding to maternal mortality rates in the developing world where poor hygiene practices meant that mothers and newborn babies died from infection. According to UNICEF, 800 women die of preventable causes during pregnancy or childbirth every day, 20 percent of whom are from India. By selling JANMA for only three U.S. dollars, Bai and her team have been able to reach mothers in 20 developing countries. Not only are the people at Ayzh saving lives, they also crafted something beautiful––the desirable packaging, a purse––in the process.
For Bai, the purse packaging design was of the highest importance, as it is intended to be kept by the new mother. Bai believes that the birth kit will create a behaviour change, and that this change in turn will encourage more women to use this product. This will undoubtedly mean that more lives will be saved. Bai has said that the purse often becomes “a symbol of prosperity” for mothers. When talking about her encounters with the mothers who have given birth using JANMA, Bai spoke of one woman, who asked, “Will you give me a different colour when I have my next baby?”
With the benefit of hindsight, she understands that we need to be educated and prepared for all eventualities in life as much as possible. Bai makes the valid point that “when we in the western world don’t think about such things, we are made to think about such things.” Bai wants to see young women who are aware of the risks, and who can then take preventive measures to make sure they can live happy and healthy lives. With this goal in focus, Ayzh has started to develop products which, Bai hopes, will improve women’s health from the menstrual cycle through to menopause.
Are there universal misconceptions about women’s health?
ZB: Many people believe they don’t know what they need and what are the right products for them. The biggest problem with that is you don’t engage the stakeholder group you are developing for and that definitely needs to change–– it’s a big issue.
If the majority of women are comfortable discussing sexual health with other women, why is it still such a taboo, and why are there still these misconceptions?
ZB: The majority of women are willing to discuss with other women, and I think a lot of people designing products are still men … [Men are] amazing designers [but] there are not many women out there who are actually taking action on what they’re hearing. There is a lot of the community talking around health but is that translating to a service, product or even policy to help them get what they need? I think that’s the larger problem.
Historically, has childbirth been a dangerous procedure for women across the world? And is this still an issue today?
ZB: It has always been an issue. Maternal mortality is not a known issue, even for the developing world. I think a lot of people come to the realisation and wake up to the fact when they have an issue during childbirth. I see a lot of women raise their voices after they experience an issue, but then do these women also know that there are … thousands of women on the other side of the world that have no access to what we have, and that’s the gap. As much as we talk about maternal health as a topical issue, I don’t think it has been treated as one because of the kind of services available in different parts of the world. Even today, when I go to investors, you get a blank stare because not many of them have even thought of this as an existing issue.
For a lot of people it’s like, ‘Ok, women have been giving birth for …forever! What’s so complicated about it?’ I feel like that awareness is missing and in my mind I have come to the realisation that it’s such a spiritual process, not only for the mother, but also for the baby that is born; and that spirituality is lost as the baby grows up. Engagement doesn’t stay alongside [the child’s growth] and that’s probably why the disconnect is happening. We don’t speak about the process unless you want to go to a medical school and want to do that as a specialty.
Why has it taken so long for attitudes and procedures to change?
ZB: It’s how much priority you lay on it, right? People are trying to add the economic or dollar value to the life-cost of a mother. When you add a dollar value to the impact of the next generation [such as] the health of the child as the child grows up, [this] starts affecting the future workforce and economy of people. Those numbers are now being calculated and that’s bringing a much larger-scale awakening of the issue.
Also, involving men in [the] maternal health movement is pretty recent. I was listening to the story that someone told me about African men, that it’s not considered a male characteristic to go with the woman for childbirth. How do you change that equation? Make it more about, not male culture, but engage them and bring them to the clinic. Somebody was telling me that men would come to the [clinic] if they could play soccer games in the waiting room! It’s deeply embedded in the cultures of different countries, so a woman becomes [excluded] from the emotional support she needs, and I don’t think men are aware of the issue. The man, even in the developed world, only knows the importance of this when he is intentionally involved through the process, and that is what is missing.
The whole missing link is many women speaking about the issue. Not many women speak about maternal health.
What is it about childbirth that makes it so dangerous?
ZB: Childbirth itself is not a dangerous thing. It’s not something to be scared about as long as you know what you’re going through. The problem is the lack of education and awareness of getting into the process. Me, being an educated women with my first, I hardly knew anything about being pregnant. I read a lot about it through my pregnancy, [and that] was good, but also like shooting an arrow at the dark. When you plan your business, when you can plan your life, you also have to plan childbirth. You have to understand what you’re getting into and what are the potential things that could go wrong. … It’s about what you know about it, and how you plan for it.
What was the initial response from local communities, doctors and nurses when you started your research?
ZB: The more and more I spoke to women, the more I got to know how ignorant they were about the basic things. If I had gone into it without being a mother, I probably wouldn’t have known what they [were] going through. It was when a lot of women looked at each other and said, ‘So, what is infection?’ [and] ‘What is she talking about?’
It’s the lack of awareness of your own [body]–– nobody teaches you about your reproductive health lifecycle. A lot of women, when they hit menopause, they have no clue what’s happening. It’s something they should have known because it’s going to come and it has to come, but how many of us know about it earlier on and how many of us are prepared for it?
People [going] through childbirth is nothing new… we in the western world don’t think about such things. We are made to think about such things. It’s similar in childbirth and in different cultures: we have to educate them from a perspective that they will understand.
Your products are safe to use, desirable, sustainable, and cost-effective. With design constraints pertaining to production, sanitation, sustainability and waste, how did you know which elements to prioritise?
ZB: From the beginning, the key thing that came out was the packaging. That’s something that would lighten up every woman’s eye. They really want to see something beautiful, something that was useful. … The biodegradability was something we had to bring in because 70 percent of the waste in [the] Indian medical industry is because of packaging. There [are] a lot more aspects that are still design constraints in terms of making every component in the kit environmentally friendly, but then the larger medical manufacturing sector [did] not allow us to do that. We had to pick our battles. We had to prioritise the top three things which, for us, were the ethics of the product, the price, [and] the impact and usefulness of the product.
Could you share a story about a new mother who benefited from a birth kit?
ZB: A woman was talking about having a birth–– usually in these remote areas, when the birth happens, the placenta and all the blood is collected in a plastic bucket which looks more like a trash bin. She was like, ‘It kind of makes me feel dirty when that happens,’ but, when the kit came in, she [said], ‘This was giving me a more dignified birth. I knew everything was clean around me, and the baby was well taken care of.’
We’ve realised that no woman on whom the birth kit is used perceives it as a medical product. She perceives it as a respectful childbirth or a “dignified” childbirth. We can sell the product to the hospitals and healthcare workers with the medical benefits, but, for the mother, it comes down to a dignified birth, which is what she wants.
As a product developer and engineer by trade, have you faced any personal difficulties in your field, as a woman?
ZB: I remember when I used to go for a field trip, we were designing the product, and I had my second child. He would travel with me all the time because he was being breastfed. I would always face this comment from men saying, ‘You’re not being fair to your child.’ I started travelling when my child was probably less than a month old. [I said] ‘I’m being absolutely fair to him because I’m breastfeeding him, and he’s travelling with me, and that’s all he needs, right? He’s with me.’
The person I’m not being fair to is myself, not the child. I’m taking a lot of pain and effort to give the child what the child deserves. I think it’s a very Indian, African issue and not necessarily a western world issue. I am not advocating that women should go into this world when they have little babies–– they definitely should take a rest! I just feel like the world is not fair to women who are out there trying to do their thing, and [doesn’t] respect them for what they’re doing.
Besides life-threatening childbirth procedures, what are the next big challenges you're looking to take on?
ZB: There is a lot. We said ‘Ok, we’re not going into dangerous procedures, we are going to the root cause of why maternal mortality is happening.’ The biggest issue is that women are not talking about the beginning of the lifecycle, and if [women are] not given the appropriate tools and education, then… we have maternal and neonatal health issues. As of this year we decided to enter the menstrual hygiene space. We want to be able to provide the product along with the education of basic hygiene. The adolescent girls today are going to be mothers in the next decade, and that’s where you’ll really see the impact. From a long-term impact perspective, we decided that, instead of going into menopause or family planning, we should start in the beginning and that’s what we’re doing right now.
How have mainstream medical manufacturers responded to your projects?
ZB: We still considered medical supplies and medical equipment. We do work with the industry. The manufacturers who manufacture this project like that they are engaging with a product that is creating impact because usually they supply to hospitals. I see that they liked being engaged with us and they check in on us. It’s a good relationship overall; we aren’t competing with them. In fact, we are using their expertise in terms of manufacturing. It’s more a collaborative process than anything. If we had decided to manufacture every component of the kit ourselves, we wouldn’t be where we are today. We had to explore and work with the ecosystem that already existed in a way that benefits them and us. That was also a part of the design process.
Have there been developments in women’s healthcare since you started your work that interest you?
ZB: There is a lot happening in women’s health. The one thing that interests me very dearly in terms of the investment landscape is a new device that has come out––the gynaecological speculum––which has been designed by women. So, instead of the metal speculum that’s been used, there is this new speculum [that] is less painful.
What do you hope to achieve with your range of products, now that they have been successful in advancing medical procedures in women's health?
ZB: We are moving on from just the maternal health issue to looking at women’s health as one reproductive health lifecycle. We are starting with menstrual hygiene, going on, all the way up to postpartum hygiene. Over the next few years, we hope to include products in family planning and menopause as well. We aspire to be a company that focuses on women’s health overall by providing products, services and education at different points of intervention throughout life. [Women] can associate with the brand, trust the brand and come to us with any need that they have. At least at this point, that’s where we aspire to go.
As equality in the workplace and various disciplines slowly becomes more of a reality, do you think designing feminine hygiene products and services should only fall to women, who understand women’s needs and bodies?
ZB: I’m not averse to men being involved in the process, but we are here and talking about this issue because it has been primarily men [in the industry]. Even the wings [on] sanitary pads [were] designed by a man. The concept came from a woman.
I am not averse to men designing the products, but I am averse to women not being involved in the physical creation process. There are certain issues that women need to take the lead and talk about. For example, the metal speculum: it has been in existence and we all never spoke about it until a group of women came and said, ‘Let’s do this!’
That’s what I’m talking about–– this is women taking the lead in the process. It’s ok to partner with a male colleague, but it needs to be vetted by a woman because it’s her on whom the product is going to be used.
NOTE: This interview has been edited for clarity and brevity.
Author portraits by Amber Phillips. Amber is originally from Bristol, UK but currently living in Melbourne, Australia. She is a digital illustrator. Inspired by people, animals and the world around, her illustration draws from the concepts of culture, family and friends.