Professor Mahmoud F Fathalla: “unarguably the greatest women’s health rights champion of the last century” at 80-something

Mahmoud F Fathalla of Egypt earned his medical degree in obstetrics and gynaecology from the University of Cairo in 1962 and his PhD from Edinburgh University in 1967. He has had a long and distinguished career, which has continued many years into his retirement.

He served as the Dean of the Medical School, Assiut University, Egypt. He was the former Director of the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, based at WHO. He was a Senior Advisor, Biomedical and Reproductive Health and Research, for the Rockefeller Foundation, former President of the International Federation of Gynaecology and Obstetrics, and former Chairman of the International Medical Advisory Panel of the International Planned Parenthood Federation. He has also served as the Chairman of the WHO Global Advisory Committee on Health Research.

He is an Honorary Fellow of the American College of Obstetricians and Gynaecologists (1985) and the Faculty of Family Planning and Reproductive Health Care of the Royal College of Obstetricians and Gynaecologists (1996) and Honorary Fellow ad eund. of the Royal College of Obstetricians and Gynaecologists (1990). He holds Dr Honoris Causa from Helsinki University, Uppsala University and Toronto University.

In 1995 Professor Fathalla was awarded the Mastroianni-Segal Award by the World Academy of Art and Science. In 2001, he received the Ihsan Dogramaci Family Health Foundation Prize awarded by the World Health Organization.

He is the author of more than 150 scientific publications. He has campaigned internationally for safe motherhood and was a founder of the Safer Motherhood Initiative. His scientific interests include women’s health, safe motherhood, reproductive health, ethics and human rights, contraceptive research and development, and ovarian tumours. He has also been a stalwart supporter of safe abortion and women’s rights.

Prof Sir Sabaratnam Arulkumaran, President of FIGO, in a Foreword on the FIGO website page introducing Mahmoud Fathalla’s lectures, speeches and statements on women’s health and rights, writes:

“Professor Mahmoud Fathalla, [is] unarguably the greatest Women’s Health Rights champion in the last century. Fondly known as ‘Prof’ to juniors and as ‘Mahmoud’ to his peers, he has dedicated his life to Women’s Health and Rights. His lectures, full of emotion, inspire people to follow his path. His teaching – looking at women’s health in a holistic and person-centred way – is fully reflected in his myriad lectures and statements. He is therefore well known for his capacity to mobilise global organisations to take forward effective ‘Safe Motherhood’ action plans.

“The landmark film ‘Why did Mrs X die?’ (the updated version of which was premiered at the FIGO World Congress in Rome, 2012) has prompted food for thought from politicians, policymakers and healthcare providers, encouraging them to take appropriate actions to save women’s lives. His penetrating observation: ‘Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving’, is used by many speakers and has been a powerful tool in arguing for funding to provide women’s health services. One of the key questions raised to policymakers is: ‘How much is a woman’s life worth?’

“FIGO and the World Health Organization (WHO) have been inextricably linked to his life. He has served FIGO in many areas, including as Vice President and then President. From my observations over the last three decades, he has shifted the focus of this prestigious organisation to do even greater work through advocacy and also through projects and programmes with Member Societies, so that women benefit both ‘on the ground’ and at grassroots levels.

Mahmoud has published 201 papers, books, book chapters and conference papers. They can all be found at ResearchGate. Some are papers on abortion and one is a chapter in the book Issues in Women’s Health and Rights, entitled “Women and the abortion dilemma”, which was published by IPPF.

Lectures and speeches Mahmoud Fathalla covers women’s health, maternal mortality, family planning, abortion, human rights, autonomy, and many other issues. Two of these lectures are about safe abortion, though the subject arises in almost all of his lectures. In a lecture at WHO in 2010 entitled Safe Abortion: Women, the Health Profession and WHO, a wonderful speech, he tells this story of how he came to recognise the importance of safe abortion and how he views it now:

“‘Whenever the topic of abortion is raised, the face of one woman pops up in front of my eyes and her words ring in my ears as she said: “.Do you doctors understand what it means for a woman to have an unwanted pregnancy”. I can never forget my encounter with her. It happened in my early professional practice, more than 40 years ago. I was on clinical duty in the emergency room, when a young woman was admitted in extreme  distress and agony. On pelvic examination, it was with a sense of shock and horror that I found her intestines in the vagina. It turned out that she had a botched abortion, during which the uterus was perforated and the intestines were mistaken for the products of conception and pulled down into the vagina. Her life was saved by emergency surgery but her damaged uterus had to be removed, together with part of her intestines When she recovered, I ventured very gently to ask her why she did that to herself. I still recall her pale face, her shrivelled hair and her weak voice answering with another question: Do you doctors understand what it means to a woman to have an unwanted pregnancy? From that time, I tried to understand… 

“‘A woman can claim as her own – her head, her hair, her hands, her arms, her upper body, her legs and her feet. She cannot claim the same right to the remaining area of her body, which appears to belong more to certain males of the species, moralists, politicians, lawyers, and others, all of whom claim to decide how this area is best utilized. Within this disputed territory the fetus happens to lie.

Basically, the opposition to abortion was part of the wider spectrum of reproductive subordination of women. Men in the patriarchal societies have always reasoned that if women had control over their reproduction, they would also have the unthinkable: control over their own sexuality…'”

He goes on to remind us: In the heated abortion debate, many people are unaware that Mother Nature performs by far the vast majority of abortions. Nature is very selective in allowing a pregnancy to continue.”

And he pinpoints an important truth when he says: “From a health professional perspective, I can confirm that women may not want abortion, but they need it. They have needed it throughout human history.”

In a speech to Ipas in 2005, entitled Reflections on Abortion and Moral Values, he talked about one of his dreams as a scientist as regards the development of new methods for safe abortion:

“Another reflection about science is a sad regret. Science could have provided a way out of the abortion dilemma, but it was not allowed to do it. One of my dreams as a scientist was to see a pill developed which a woman can use in the privacy of her home if she has made the moral decision to terminate an unwanted pregnancy. We came quite near to that with the development of Mifepristone and the discovery of the action of Misoprostol, two drugs that are currently being used in regimens for medication abortion. But that stops short of de-medicalizing abortion, to have abortion without the need for medical services. If ideology did not interfere, if public and private sector investment continued, then I am sure we would have had second and third generations of these drugs which would have brought us closer to that objective. In fact, I know for sure that in the chemical libraries of major international pharmaceutical companies there are already a number of compounds which, if circumstances allow, could be tested and further developed.”

In closing his biography, Prof Sir Sabaratnam Arulkumaran said: “At a personal level, Professor Fathalla has been a mentor, teacher, friend and guide – I am sure many others who know him would also express this sentiment.”

Indeed, we do.

SOURCES: FIGO ; World Health Organization