In between tweeting with teens, seeing patients at her Johannesburg clinic and carrying out her mandate as Special Rapporteur on the right to health as appointed by the United Nations (UN) Human Rights Office of the High Commissioner, Dr. Tlaleng Mofokeng wrote a book—Dr. T: A Guide to Sexual Health & Pleasure—that one grateful reader sums up this way: “I did not know how little I knew and how liberating it feels to have a better idea about sexual health, sexual pleasure, and sexual rights.”
The outspoken physician-author-activist-social influencer shrugs off the fact that her wide-ranging professional pursuits might be misconstrued as incongruous. Audacious, even. Dr. T won’t be pigeonholed. Won’t buckle to either-or. Equally at ease as both Special Rapporteur and “the sex doctor” (a vital role for which med school did not prepare her), she refuses to rein in her advocacy of pleasure and human rights on radio and Twitter, as well as the global stage of the UN.
Now, marshaling wide-ranging experience and boundless energy, she’s helping to steer AlignMNH: Collective Action for Maternal Newborn Health. In advance of participating in the opening forum taking place April 20 and 21, Dr. T took time to discuss global goals as well as personal aims—not least of which is aligning the serious, social and sensual sides of reproductive and sexual health and well-being for all, regardless of sexual and gender identities or economic status.
Where does AlignMNH fit in to your busy schedule?
Dr. T: As a clinician who takes care of women before and after birth, I think there is so much globally that we achieve by working together. If you look at maternal mortality and the very high rates of negative health outcomes, they are closely related to the failure to realize the right to the highest available standard of health. The important issues of maternal and newborn health resonate with all my work, especially my role as the UN Special Rapporteur on the right to health.
Please describe that role for us.
Dr. T: Basically, the mandate is to protect the right to health of all persons. Among the responsibilities is presenting annual reports to the Human Rights Council and the UN General Assembly, which involves monitoring the situation of the right to health throughout the world and, importantly, noting emerging trends and advising on best practices.
The synergy between my roles at the UN and on AlignMNH helps me to not only diagnose where things are not working, but also amplify what is working, and assist those in other parts of the world to replicate it. I refer to it as the “operationalization” of the right to health. Which means how we use the different types of interconnected rights to ensure that everyone realizes the full right to health, with a focus on those who are vulnerable and marginalized, which mothers and newborns tend to be in many countries.
Can you comment on an emerging trend?
Dr. T: The biggest is the use of digital interventions and innovation in health care; the use of telehealth and virtual consultations, which, pre-COVID-19, were not possible. This has benefited so many, especially people in rural areas, where maternal and newborn mortality rates are high because of delays in accessing care.
In Uganda, for instance, more people can access contraception now because of an app used by motorbike drivers who transport reproductive health commodities.
The issue of sexual and reproductive health rights, when addressed comprehensively, often determines health outcomes in the birthing period, in the antenatal period. . . . I really like where we are going with digital health.
What attracts you to social media as a caregiver?
Dr. T: It allows me the opportunity to reach further than I would if I just rely on one-on-one consultations. I see a desperate need for information that is credible and evidence-based. I use social media to help people learn without realizing that they’re learning. I try to be real because I think that’s where people can connect with me.
So you use Twitter to connect and teach?
Dr. T: The first step to advocating for yourself is to have information. That’s why I’m on Twitter—which is also riddled with so much disinformation and misinformation. If I’m not on it, that vacuum gets filled—and not always with the right things.
Social media helps demystify how I can be Dr. T, a clinician, and be serious when and where I need to be serious and be authentic about sex and sexual pleasure, but also be the UN Special Rapporteur. We don’t often get the chance for duality: It’s either you must be serious or no one will ever take you seriously, or you must be this young person on social media, and just know your place. If you took a screen grab of my Instagram and asked someone if they thought I represented the UN, they probably would say no, not a chance!
But yeah, I can be all of these things.
You work on dire issues—saving the lives of mothers and babies—and still have energy enough to concern yourself with sexual pleasure?
Dr. T: Yep! Pleasure is a primary reason that people are having sex, right? Even in the postpartum period, women have questions about sex. Yet they get shy to talk about it, so those issues never actually get addressed . . . they don’t know what to ask or they feel judged by their doctors for even being interested in pleasure. Those are some of my favorite things to talk about, the so-called less serious things.
And now, for a more serious thing: The virtual forum in April has the objective of setting a tone for a decade of continued learning and collective action to drive progress for maternal and newborn health and well-being. What kind of tone?
Dr. T: It’s really about accountability, and being honest about what hasn’t worked and why. The reason AlignMNH is needed in the first place is there are things that haven’t happened that should have. It’s also about global solidarity and coming together to commit ourselves—or recommit ourselves—to the goals, and realizing that we are now under pressure, and that COVID-19 has not made it any easier.
COVID is like this leaking bucket and no one knows when the leak is going to stop. It’s taking tremendous human resources . . . all the health workers we have lost . . . when will we get them back? So many countries have really terrible nurse- and doctor-to patient ratios.
How can health systems begin to recover from COVID, and global targets be achieved?
Dr. T: One way is realizing the importance of community health workers and investing in them.
I like to think about simple things we can do that can give us a lot of results; things that will have a ripple effect and touch as many lives as possible.
Access to safe water and sanitation are big health determinants, especially if you are thinking about mortality of newborns and diarrheal diseases and food safety. There’s so much we can do if we just focus on the basics and not forget that our goal to save mothers’ and babies’ lives is interconnected with the right to health.
Thanks so much, Dr. T!
Maryalice Yakutchik is the communications manager for Jhpiego.