A Surgeon in…the UAE

THE COUNTRY’S FIRST FEMALE SURGEON, MS HOURIYA KAZIM FOUNDED THE UAE’S WELL WOMAN CLINIC, A ONE STEP HEALTHCARE SERVICE FOR WOMEN orn in Dubai in 1959, Ms Houriya Kazim (Dr Kazim in the UAE) grew up in London, where her late father, Dr Ahmad Kazim, did his surgical training, and in the Caribbean, where he worked as an orthopaedic surgeon. She attended boarding school in Canada.

Ms Houriya Kazim, BSc, MPH, MB BCh, LRCP&SI, BAO, FRCSI, FRCS(Eng) RCSI Fellow (1993) and Alumna (Class of 1988) is a Consultant Breast Surgeon, Medical Director of the Well Woman Clinic, Adjunct Clinical Assistant Professor MBRU and Founder and President of Brest Friends.

“I have only realised as an adult how lucky I was to have the parents I had,” she says via Zoom from her home in Dubai. “ ey had a traditional arranged marriage but my mother Sultana trained as a radiographer and later had her own fashion business, now she is an artist. I grew up with both parents working and did not see that as anything odd. ey were both very much into education, it didn’t matter if you were a boy or a girl. I remember telling my grandmother once that I was going to be a nun because I didn’t want to get married and have kids and she freaked out. ose things never bothered my parents, but if I got up one day and said, ‘I didn’t feel like going to school’, it was as if the world had stopped revolving on its axis. Other women in this country didn’t have the same kind of parents.”

Ms Kazim’s grandfather was a hakeem or faith healer, and her father’s siblings, and now their children and grandchildren, are all involved in medicine.

“ ere are now more than 70 doctors in the family,” she says. “And it was expected of me to study medicine. I don’t remember my parents ever saying, ‘You have to be a doctor’, but I also don’t remember them saying, ‘You have options’!”

A er boarding school, Ms Kazim completed a bachelor’s degree in Canada and a master’s in public health in Texas before enrolling in RCSI in 1982.

“My dentist and GP in Dubai were Irish,” she recalls, “and between them they decided that I was going to RCSI. ey turned out to be the best years of my life. I’m not sure how I ended up thinking about surgery, because there were no female surgeons that I knew, but I knew I liked cutting and sewing - I de nitely didn’t consider the work life balance questions that young doctors do now! I remember mentioning I was considering a career in surgery to one of the scary surgeons on a ward round in Dublin. He said, ‘You’re very aggressive’. When I was re ecting on it a erwards, I thought, if I was a guy, he’d have used the word ambitious.”

A er graduating, Ms Kazim returned to the UAE to commence her internship.

“On my surgical rotation, I saw really advanced cases of breast cancer. I’d seen breast cancer in Ireland, but never anything like this. I remember pulling out my father’s general surgery textbooks from the 1940s and seeing the same things I was seeing in the 1980s. Arab women are modest, and we had no female surgeons. ey didn’t want to show their breasts to a male surgeon. And because women were presenting late, they would end up succumbing to breast cancer. So in everybody’s mind, breast cancer equalled death. And here we are superstitious, we don’t even use the word ‘cancer’. We say ‘that disease’, or we mouth it without actually vocalising it, because if you say it, you’ll get it. I saw what happens to a tumour when you don’t do anything about it. It just keeps growing until it grows out of your body. And so this thing is right under your nose, you can smell it, you can see it, you can feel it. Obviously their deaths made me think, ‘ is is what I want to do’. But this was the late 1980s and there was no such thing as a breast surgeon.”

Ms Kazim moved to the UK to study for her Fellowship exams and obtained her Fellowship in General Surgery. She then sub-specialised in surgical oncology and, in particular, breast surgery and reconstruction at the Royal Marsden Hospital in London and the MD Anderson Cancer Centre in Houston, Texas.

“For me, the appeal of breast surgery is that as well as the actual surgery, a lot of the work is general practice because you get to know the patients and their families and you see them again and again. And if you’re like me, and you’ve been working long enough, you start taking care of their children too. ere’s a lot of psychiatry because, of course, everybody who comes to see you thinks they have cancer. And then there’s plastics as well, because we do breast reconstruction, so you are using a lot of your creative genes.”

Ms Kazim returned to the UAE in 1998 to be appointed the country’s rst female surgeon, soon a er having married her ancé of nine years, American war journalist, Ron Bagnulo.

“I came back as a 39-year-old newlywed wanting to start a family,” she recalls. “And I wanted to nd part-time work, which was di cult. And nobody knew what a breast surgeon was, because it was not and is still not actually recognised as a standalone speciality. So I was making it up as I went along. It was interesting trying to get a licence.”

A er working at a hospital two hours away from her home for a few years, Ms Kazim established the UAE’s rst Well Woman Clinic. Her motivation was a desire to nd a way through the long waiting times women had to endure waiting for mammograms and biopsies.

“I didn’t want it to be scary,” she explains, “so it looks like a living room. It’s sta ed solely by women, we have radiology in the building and the lab is across the street. So I can have a diagnosis within 24 hours.”

In addition, Ms Kazim and her colleagues started an outreach programme to raise the national consciousness of breast cancer and to encourage women to be more proactive about their health, travelling to ladies clubs’, schools and colleges to give talks about breast cancer and teach women how to examine themselves.

She also started a charity to raise money to help people without medical insurance pay for their cancer treatment, and a support group for breast cancer patients. is evolved into the rst cancer drop-in centre in the Middle East, Majlis Al Amal – Lounge of Hope.

Ms Kazim has operating privileges at three hospitals in the UAE, and now her colleagues include other female surgeons, both local and foreign. ere are trained breast surgeons in all the major hospitals.

“Breast surgery is an emotive subject,” she says. “It’s not a hernia, it’s not a lump or bump. I nd it very hard to take time o or to go on holiday. ere are so many emotions involved. And even though I have another breast surgeon in the clinic who covers for me when I’m away and vice versa, I still work every single day even when I am away.”

As well as her clinical work, Ms Kazim is an adjunct professor at Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU) and enjoys mentoring young female medical students, encouraging them to see surgery as a viable career option.

“Sadly things have again become di cult for women here in the UAE. In my time there were no universities here, so pretty much everybody went away to school. Now, because we have universities and branches of major universities here, parents, the same parents who themselves went away to university, will choose to keep their children, especially their daughters, home. I think it’s important for a career in surgery to travel. I had that opportunity when I worked in the Caribbean before returning to the UAE and it was a great experience. Now the girls are kept home and there is a lot of pressure still to get married and have kids. I don’t think I could have combined my training with having small children, I am glad I waited until I was nished.”

Currently, Ms Kazim is engaged in research on the pattern of breast cancer in the UAE, Middle East, and North Africa region, where the median age for breast cancer diagnosis is 45, compared to 62 in Ireland, the UK, Western Europe and North America.

“I get women in their 20s and 30s with breast cancer,” she says. “ ey may have young families and be working hard at their careers. We have been auditing our patients along the way and now we are putting together a large study looking at genomic pro ling, to see if there is something genetic going on.”

Dubai is a notoriously expensive place to live; Ms Kazim lives in a small bungalow on the beach where she tries to get in a 5km walk each day.

“I work seven days a week, but two of those are from home. I do three days in the clinic, have one day for surgery, and then one day is for over ow, either clinic or surgery. My commute is an 18 minute drive if I’m early enough; the tra c is a big deal here.”

Ms Kazim knits and crochets to de-stress – a habit that got her through some tough modules in RCSI. “I found it just took my mind o things, especially if I had to do some kind of intricate pattern. I still have big u y mohair jumpers that I made in Ireland; my daughters pull them out sometimes.”

In her Dublin days Ms Kazim was voted queen of the cocktail party circuit but now prefers a quieter life.

“I socialised too much when I was young and now prefer to stay home with a cup of tea and a good book. My daughters, Tara and Gina, are at university in New York and Dublin, studying science and politics, respectively, and I visit as o en as I can. I love what I do. When I go on holiday, people ask, ‘Do you miss being in surgery?’ I say I don’t miss the actual cutting, but I do miss the people. I miss their stories.” ■