Be exceptional at what you do, and your gender will not matter….
Barbara Burmen:邁向頂尖卓越 衝破性別天花板
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          Dr. Barbara Burmen receives the 2018 Gro Brundtland Week of Women in Sustainable Development from Dr. Gro Harlem Brundtland, Tang Prize Foundation and NCUK President Huey-Jen Jenny Su at NCKU, April 3rd.

          Endorsed by Dr. Gro Harlem Brundtland, granted by Tang Prize Foundation and organized by NCKU, the Gro Brundtland Week of Women in Sustainable Development commits to engage outstanding female researchers working in the field public health and sustainable development. It facilitates the creation of an international platform for collaboration and partnership between female researchers from Taiwan and female researchers from developing countries.

          Dr. Burmen’s recognition is attributed to her accomplishments as a medical doctor and a public health specialist in the field of HIV and TB implementation Science at the Kenya Medical Research Institute Center for Global Health Research. The 2018 Gro Brundtland award is an important impetus for for Dr. Burmen to continue her research into enhancing population health and promoting sustainable health systems through operations research.

          Dr Burmen’s current research focuses on the utility of Tuberculosis (TB) household contact investigation as a means to control childhood TB in a high TB burden densely populated region. Her research showed that nearly 80% of TB index cases had at least one household contact, and 23% of them were child contacts. The TB index child contact ratio was 1: 0.62. Latent TB infection (LTBI) as evidenced by a positive Tuberculin skin test was diagnosed in 43% of children and TB disease in 2% of children. The results fully support the recommended guidelines of providing TB prevention using isoniazid chemoprophylaxis to all child contacts who do not have TB.

          This research also highlighted the issues that would need to be considered by TB programs when transitioning from a setting with routine TB household contact invitation to standardized TB household contact investigation and proposed sustainable methods to aide in this transition; a topic she would address symposium speaker.

          Her prior research has focused on screening for TB in HIV, the use of cough monitors to increase TB detection within a health facility and screening for HIV in hospital and non-hospital settings.

          Annual TB mortality in a PLWHA is ten times that in HIV negative individuals in their lifetime. Newly diagnosed PLHIV would benefit from TB screening and timely TB diagnosis. The initiation of Tuberculosis prevention therapy with Isoniazid will also reduce their risk for developing TB. We implemented an evidence-based approach to TB screening in 15 HIV care and treatment clinics in the Nyanza Province of Kenya, that led to the timely identification of 11% (81/779) of PLHIV with TB who were initiated on TB treatment and had favorable treatment outcomes. The use of lay persons (cough monitors) to improve TB case finding in community settings contributed to 33% of annual TB case burden.

          Furthermore, access to voluntary counseling and testing services for HIV provided through research and programmatic settings run by our unit led to the timely identification of PLHIV who can receive ART to either decrease their risk of TB infection if they do not have concurrent TB infection or improve their TB treatment outcomes if they have TB coinfection respectively.

          In 2013, Dr. Burmen facilitated the launch of an “Express Nursing Desk” in at a busy HIV clinic that facilitated the delivery of a monthly ART prescription after a nurse’s review if deemed “clinically stable”, and successfully reduced patient waiting time. This supported clinic operations as it had only 60% of its staffing requirements. This was incepted approximately 5 years’ before the inception of “Differentiated care model” (DCM) by the WHO that recommended different levels of services for different patients to alleviate the burden on the health system.

          Dr. Burmen believes that women bring their unique perspective to science, which differs from that of males, and this leads to an increase in the range of inventions and breakthroughs. “Whatever problem is prioritized and solutions generated to address, it will depend on the gender of the scientists at that time.”

          When women are involved in science, research is more likely to address problems related to women’s health and welfare and solutions generated are more likely to be gender inclusive. Subsequently, women are likely to receive better quality health care. Similar results have been observed where there are women in leadership positions. Women are also more socially aware than men and foster more "communal" qualities (good communal relations and inclusive environments), which can yield "immensely positive" results in scientific research.

          “We also live in a society where there are are now some female role models to not only look up to, but to also approach for mentorship,”, commented Dr. Burmen. “Each application you make is an opportunity to reflect on your career path and sharpen your skills to make the next (and maybe successful) application.

          “My advices for the other female scientists are: to develop a supportive network both at work and at home; to be willing to ask for and accept help both at home and in the workplace; to find time to mentor others and always know in the back of your mind that you are an inspiration to other women (and men alike) who are known or unknown to you. Above all, be exceptional at what you do, and your gender will not matter!”

          來自肯亞的Barbara Burmen,目前正攻讀公共衛生博士學位,是肯亞醫學研究院的資深研究員,帶領團隊從事愛滋病毒與肺結核病毒研究。獲得2018 Gro Brundtland Award,Dr. Burmen說,Gro Brundtland博士是響譽國際的公共衛生專家,台灣又是致力於永續發展的國家,能在眾多提名者中獲獎,是極大的榮幸。這個獎不僅提高專業上的認可,也強化了個人聲譽,期待這個獎帶來更多的研究能量,也成為她繼續投入健康照護系統、公共衛生研究的重大動力。

          Dr. Burmen目前的研究集中於結核病(TB)家庭接觸者調查,希望能夠用來控制結核病高負擔人口密集地區童年結核病,研究發現近80%的結核病指數病例至少有一次家庭接觸,其中23%是兒童接觸。

          Dr. Burmen表示,肯亞結核病新病例,大多是病患出現症狀求診才發現,而最新的結核病流行率調查,約40%的結核病患者未被診斷出。為此,她曾小規模在社區調查與研究,結核病患者的家戶日常生活情形,並設計多種篩檢與預防治療模式,在結核病病例密集區針對兒童進行,降低兒童羅患潛伏型結核病轉為確定病例的比例。

          2010年起,肯亞透過愛滋篩檢、社區咳嗽監測、結核指數病例來找尋新結核病例,Dr. Burmen也加入愛滋與結核病的研究,她與團隊在肯亞Nyanza省的15個愛滋病診所進行結核病篩檢,及時讓11%的結核病感染者接受治療。另外,她在愛滋病診所也觀察到,病人花了很多時間等待,於是引入快速「護理台」服務,針對病情穩定者提供快速複查、領取處方藥服務,以減少等待時間。

          Dr. Burmen認為,女性科學家不論身處哪個國家,都面臨很多挑戰,原因之一是性別定型觀念及性別規範,同時升遷經常被忽略。在肯亞,大家仍常發現,工作場所中因性別帶來的壓力與困擾,與上一代沒有差太多。「本身有家庭子女的女科學家更是辛苦,等於有兩份全職工作,一是8到12小時的上班時間,另一個是24小時的母親角色,加起來科學家媽媽的工作等於約42小時。」

          Dr. Burmen說,目前女性在科學、技術、工程、數學這些領域仍屬少數,但仍不乏優秀女性學者專家為榜樣,鼓勵年輕女性學子勇敢跟進與跨入。Dr. Burmen強調,女性投入科學研究對社會是正面的,女性特有的觀察力與細密心思與男性大不相同,有女性參與研究能夠帶來更多的突破並擴大研究的範圍。此外,女性的社會意識與包容性也較男性強,女性的許多特質能夠產出積極正面的科學研究成果,也更能解決與婦女健康和福祉有關的問題,帶來更好的優質醫療保健。

          Dr. Burmen鼓勵有心投入科學領域的年輕女性學子,在生活、職場、科學領域上有許多挑戰,女性要在工作和家庭之間取得平衡,一定要建立一個支持性的網絡,遇到挑戰要積極尋求並接受幫助,也盡可能去指導他人,「我們的所做所為都可能對他人產生啟發或鼓勵,更要記住,我們所做的事,無關乎性別。」