Q and A with PCI’s new Chair: Dorcas Gwata

Dorcas joined PCI as Chair of the Board at the end of last year.  A Clinical Mental Health Nurse Specialist, originally from Zimbabwe, she is a passionate and experienced global health practitioner. Now she has had a little time to get settled we sat down with her to hear more about her vision for PCI in the coming years.

What do you see as the main priorities and challenges for PCI in the year ahead?

I am very honoured to have joined PCI. This is an interesting time to join. But whilst it is an exciting time I am also very much aware of the challenges ahead of us, and many others working in global health. Not least the challenge of covid, not least the challenge of financial stability in an uncertain world. The funding landscape has drastically changed and local economies around the world are under threat.

Primary healthcare itself has actually become threatened in many ways. There is a threat to the health workforce – a strong workforce being the greatest asset to health systems worldwide. The pandemic has put a strain on the workforce, our staff are fatigued and traumatised, this poses a threat to the mental health wellbeing of the workforce, we need to be attentive to this at policy and implementation level.

The design and delivery of primary healthcare globally has also become more difficult. This is in many ways aligned to challenges around climate change. As livelihoods are increasingly threatened by climate change, so accessing healthcare becomes more difficult.  And too many people are left in poverty because of the devastating costs of accessing healthcare.

PCI will have to stand to, and rise to, those challenges – and others. But I am in no doubt that we have the right people on board to do this and the right strategy to deliver our goals. I have seen how this is an organisation that can survive a long pandemic, a very difficult pandemic such as this and still stand tall. And remain innovative and responsive and relevant.

You already touched on the challenges of climate change. PCI’s focus is on strengthening primary care. But what about the links between global health and climate change? What does this mean for PCI?

We need to think more widely than health.  Having attended the COP26 conference myself, I heard increasing talk of the intersections between climate change and health. The role of primary healthcare services in delivering and supporting some of those climate actions and solutions is really critical.

We need to work within this intersection – both downstream – to ensure we have strong and resilient health systems and a health workforce to respond to the changes we will be seeing – and upstream – at policy level, to speak out on the causes and effects on people. Are we pooling our expertise – and that of the wider health community – enough to engage in the climate change agenda? I think those two haven’t really linked in and linked up together enough yet. So beyond just responding to climate emergencies, I think there is a lot of work to be done upstream. Those who make decisions around health are often not themselves healthcare professionals and we need to make sure our voices are heard.

How are the discussions on ‘localisation’ of the humanitarian and development sectors relevant to PCI?

There is a challenge around real and meaningful ‘localisation’ within global health. This is all tied up to issues around racism and inequality. These are very big issues which have now come to the surface though they are not new issues. And I am confident PCI can address these issues, is bold enough to take them on. I am delighted to have seen thinking around that already at PCI, some very strong thinking around that. This is not an easy subject, and there is not an easy overnight solution.

But there are things that we can do as an organisation to shift power and increase the sustainability of our work, that I already see we are doing: working with existing and emerging leaders within project settings, co-designing programmes and aligning with cultures where we work.  These are efforts that go a very long way and we need to do more. We also need to leave space for people to be very honest and feedback how they feel about different power dynamics. The risk of NOT unpacking them puts any organisation at huge risk.

And finally, what are you most excited about, as PCI Chair

I am very excited to be working with the dynamic and passionate team at PCI. I feel I have arrived at an organisation that understands what we need to do, and I very much feel I fit into the vision and values. I very much feel at home. Above all I look forward to driving forward existing and new initiatives and watch the organisation grow.

You can read more about Dorcas and the rest of our Board here.