Q&A with Dr Nighat Arif

Dr Nighat Arif, who has just released her book ‘The Knowledge’, has kindly collaborated with us on a Q&A blog regarding her career and recently published work! She is a Muslim GP who specialises in women’s health and family planning, with over 15 years of experience working in the NHS.

Alongside her NHS clinical role, she is also a resident doctor on BBC Breakfast and ITV’s ‘This Morning’, as well as an Ambassador for Wellbeing of Women (WoW)! She is passionate about using her knowledge and platforms to address health inequalities and has worked to raise awareness of menopause and women’s healthcare in Black and Asian women.

Our Q&A blog with Dr Nighat below gives further insight into the journey and motivation behind creating her book, The Knowledge!

What motivated you to write the book and how long did it take for you to put the book together?

The book compiles 10 years of my clinical knowledge as a practicing GP with a specialist interest in women’s health. I deal with so many myths, lack of information and the lack of basic understanding of the female hormonal life journey in my clinics. Underpinning that, it is marginalised communities that are left out of mainstream conversations when it comes to women’s health and hence these communities don’t come forward for research and have worse outcomes. This book took me 2 years to write, painstakingly put into lay form the biological journey that women go through for all to understand. Women’s health is not a “woman’s problem” but a societal issue because fundamentally if a woman is well the household is well and the economy of a nation thrives.

Were the images and illustrations used intentional? Tell us about the process of selecting images and illustrations.

Yes. From the beginning I wanted women from all ethnicities, colour, faith groups, and people from the LGBTQ community represented. If you see it, you can be it. I wanted my book to be the most accurate representation of my work and also illustrate how we are all affected. Respect, compassion and humanity thrives if we breed familiarity.

Does the book highlight particular reproductive health issues that are specific to minority ethnic women?

There are no health issues that affect an ethnicity more, just lack of understanding and research that means particular communities do not receive equitable healthcare. Historically we have medically gaslighted communities due to medical misogyny and institutional racism. We do know that uterine fibroids is more common in Black women, however the clinical pathway management in the NHS is still white centric. South Asian women are more likely not to attend breast screening or self-check their breasts because of lack of proper education and therefore more likely to present with late diagnosis and poor outcome than their white counterpart. This is why The KNOWLEDGE of our body is vital to help save lives

What did you enjoy about the process of writing this book?

I am dyslexic so the writing process was daunting and I was scared that it wouldn’t read well. I am blessed to have a great editor, Pauline. I wanted someone who could question me and say “this is complex medicine”, and that was essential as I wanted the book to be accessible for anyone from age 13 to 100 years old. The other aspect was having my contemporaries read my work. The book is a wide door open to my consultation room. Normally how we practice is behind closed doors bound by patient:doctor confidentiality. I was putting myself up to be judged by the medical, academic fraternity - this was my biggest fear. However, the kindest feedback has been from my contemporaries who wish they had abook like The Knowledge growing up or they had written it first! :-) which is the biggest compliment I could get in my career.

Do you have examples of feedback from Muslim / minority ethnic women who have purchased your book?

The biggest feedback has been from women from all communities, but Muslim women have been particularly sending me messages about how they loved the myth busting around periods and fasting as well HRT and fasting. Currently as it stands there is not guidance for HRT medication and Ramadan from the RCOG. We have guidance for diabetes or Hypertension medication and Ramadan but nothing for women’s health. So, I am proud to be the first clinician globally to have my father Imam Arif Hussain MBE write up the guidance with me for Muslim women and transdermal systemic HRT in The Knowledge

Have you highlighted anything about teen female health? If so, what was the most challenging topic to explain?

For teen female health, the biggest issue is to explain that period pain affecting their activity of daily living is NOT normal. To understand that heavy periods is not normal. These issues should be fully investigated. If you don’t want a period then Long Acting Reversible contraceptives (LARCS) are safe and will in the long run not affect fertility but allow you to not have a period and thrive in your life.

Do you think this book will / should be available in schools, colleges, universities, and workplaces?

YES!

What would you like others to take away from this book?

I want men to read to my book. There are many sections related to fathers, sons, partners - because they love the women in their lives and they also need to understand the biological journey of women and girls.

What is next for you?

More clinical work. I love practicing as a GP. It’s the best work in the world. Raising the flag for equitable women’s health. I don’t want fame or money- that’s not my driver. Nine-year-old Nighat when she came to the UK, didn’t speak English and began translating issues like periods, miscarriage, fibroids, endometriosis, so that a tiny bit of change can happen so we are not still translating women’s health in the future due to lack of understanding. Lack of The Knowledge.

Are there any other aspects of women’s health you would like to cover in the future?

Perhaps another book? InshAllah I hope so. For now I want to learn. I am thirsty and hungry to become a better clinician!

Order: The Knowledge here. Your guide to female health from Menstruation to the Menopause!