Fighting the System from Within

When I was a first-year resident, I won the SOS ‘Best Research Award’. The opening ceremony was to be held in Jeddah, a city far from Riyadh, where I lived at the time. I was invited to receive my certificate with recognition. I remember sitting in the elegant conference hall, waiting for my name to be called per the ceremony announcement card – but it never was. At the intermission, I asked the person in charge what happened, why was my award not announced? I was informed the agenda had been made before they realized the recipient was a woman. Rather than presenting the recognition and award during the opening ceremony with all the officials, they would present it in the scientific meeting the following day instead. I asked why. He said: “There are cameras and we don’t think it’s appropriate for a woman to be broadcasted on stage.” I asked to speak to whoever was next in charge, and he pointed me to the head of the Ophthalmic Society, a royal. I introduced myself and explained that I had come all the way from Riyadh per the society’s invitation to receive recognition during opening ceremony. I had a family member with me who would be reporting to my parents, parents who had paved the way for me be there. I said I deserved to get my award. He asked what he was supposed to do with the TV broadcasting. I replied: “There is no need for my part to be televised.” So it wasn’t. I got on stage and collected my award. There were no lights, no cameras, no photos – no one would even shake my hand.

I attended the same ceremony 15 years later as a leader in the ophthalmic field, and was seated in the front row. I watched as a female colleague won the best research award, just as I had 15 years ago. The cameras were on as she shook hands with the minister, royalty, and other officials. It thrilled me to see how my persistence and courage had eased the path for the next generation.

In the spotlight

Today, I am Chairman of Ophthalmology at King Faisal Specialist Hospital and Research Centre – the first female to be department head in the hospital’s history. I have had the privilege of being the late King Fahad’s personal ophthalmologist, able to go into a palace where no woman of any nationality had been allowed before, and was a senior advisor to the previous Minister of Health. Like any successful woman, I have had to struggle to get where I am today. Nothing was given to me, I forged my own path. Of course, I experienced obstacles along the way, but if I hadn't faced those obstacles, I wouldn’t be as strong as I am now. It was those challenges that made me so resilient. As a woman, I have had to work ten times harder than my male colleagues – but when I do succeed, I get ten times the credit, so it balances out in the end.

When I was chosen as department head in 1997, my superiors considered my skills and credentials over my gender – and I share that philosophy. I believe we are all colleagues, regardless of gender, ethnic background, or religion. I preach to my students: there are no short cuts to being a leader. You have to have a strong foundation. Build yourselves up, and if you fall, fall forwards as it is easier to get back up. One recently said to me, “You are so lucky, you have no more challenges.” But she was mistaken. Every morning is a challenge because I don’t know what I’m up against. When I’m in the hospital, I’m protected because I have proven myself there. When I leave that environment, I am no longer a physician in a protected environment. But I believe in the saying ‘when in Rome, do as the Romans do,’ so I try to fit in. I have never fought the system from the outside. I learn the system inside out, and fight it from within. Colleagues may despise me, but they can never hate me or hurt me because I am part of them. It is only by getting to know the system that I have been able to challenge it and help my fellow colleagues.

Poking holes through the mud ceiling

We have to remind ourselves that as some of the first women in ophthalmology, we are pioneers and like all pioneers, we are faced with challenges. I remember being appointed to an all-male committee and sitting quietly for the first two meetings, despite having answers to the subjects being discussed. I wanted my male colleagues to feel comfortable with the fact I was the only female there. That’s important because most men, no matter who they are – Saudi, American, European – have an ego. That’s just the way they are made. It took a while but once they realized my skills, they became accustomed to my presence. Only then did I start to progress and flourish.

In Saudi, we don’t have a glass ceiling, we have a mud ceiling. We are told to our faces, “This is your boundary, you cannot cross it.” But the good thing about mud is that you can always make a hole in it, and I have done that repeatedly. You just need to be patient and resilient. When things get hard, remember there is a light at the end of the tunnel. Even if you progress three steps forward and get pushed back two steps, you are still one step ahead. I got this positive mentality from my father. He came from a wealthy family who thought you did not need to read and write when you have money. But my father wanted to go to school. After a hard day’s work, he would pretend to be blind and go the nearest mosque to practice reading and writing while his family slept. During his home schooling days, he got married to my mother and had five daughters, studying all the while. Upon graduation, my father was accepted for a scholarship to study in the United States. When he informed his family of his desire to continue his education, they refused. They gave him an ultimatum: “If you want to go, you have to leave your five girls behind.” Although my father preliminarily agreed to keep the family content, he had other plans in mind. He ensured that we were with him in the States, defying his family's desires. I was 16 before I saw Riyadh again.

A turning point

The journey from King Khalid International Airport was a turning point in my life. I remember sitting with my sisters in the car, talking to each other in English, our mother tongue. The relative who came to pick us up was the most educated family member and he listened to us in amazement. He turned to my father and said, “Uncle Abdullah, can you imagine if these girls were boys? What they would do to this country with their education and their language?” The doors closed before they even opened. I decided right then that I was going to make a difference in changing this stereotype and prove that a female can make a difference for her country.

I am proud of what I have achieved in making positive changes for my country, my institute and my gender. Even today, female physician candidates are asked in interviews, “What happens if you get married and have children?” It is humbling to hear them reply, “Dr Al-Hazzaa got married and had children, and she is our role model.” I know I have made a difference. Some will say the prejudices I have faced stem from the fact I am a Saudi woman, but that is not the case. I have friends in Europe, Asia and United States who have experienced similar prejudices because of their gender. Regardless of what part of the world we are from, as women, we are the minority. It is only when we acknowledge that, can we truly succeed.

Selwa Al-Hazzaa is Chairman of Ophthalmology at King Faisal Specialist Hospital and Research Center, Professor in the College of Medicine at Alfaisal University and Former Shura Parliamentary member.