On Overcoming Social Biases - A Conversation with Piera Marongiu

Episode Transcript

Claire  00:00

Hello and welcome to a new episode of Narratives of Purpose. My name is Claire Murigande. I am a scientist by training a TEDx speaker and your host on this show. This podcast is dedicated to amplifying social impact by bringing you inspiring individual stories of ordinary people who are making extraordinary impact within their communities and around the world. If you're looking for a programme that showcases unique stories of changemakers, stories of people who are contributing to make a difference in society, and at the same time, you want to be inspired to take action, then look no further, you are in the right place. So get comfortable, and listen into my conversations.

For this episode of the month of May we dive into a new theme, namely "inclusion". If you have been following us since the beginning, you will recall that this is not the first time we address inclusion on the podcast. In fact, we had a weekly series on season two, and our very first edition of the social impact virtual forum back in November 2021 was also focused on inclusion. As you can tell, there is still much to talk about. My guest today is Piera Marongiu. Piera is based in Switzerland. She is the founder of Integrate Include Engage a company that offers consultancy, support and training in the field of inclusion, mainly for healthcare organisations. In this discussion Piera talks to me about overcoming biases in society, and particularly in health care. Please take a moment to rate and review our show wherever you listen to your podcasts. And for now, listen to Piera's journey and her lifelong passion to build an inclusive society.

 

Claire  02:04

Piera a warm welcome to the podcast. How are you today?

 

Piera  02:07

I'm very good today. And thank you so much, Claire and to Narratives of Purpose, to give me space and especially to this topic of biases in the society in particular

 

Claire  02:21

So Piera, before we get into the conversation, please introduce yourself to our listeners, I just have to say full disclosure. So we know each other already from different families, as you like to call it. We are both volunteers with the Healthcare Business Women Association. And we also have a common connection with Capacity Zurich. So Capacity, which is a talent incubator for people with refugee and migrant backgrounds. That's what I can say for now. But I'll leave you the stage to present yourself and perhaps share a bit of your background with our listeners.

 

Piera  02:58

I'm Piera Marongiu, originally Italian, actually from Sardinia. 11 years that I live and I'm based in Switzerland. And my background, I started as experimental psychologist and neuropsychologist, I graduated in Italy. And then my life brought me into working for corporate companies and especially engaging myself personally and professionally in inclusion, diversity and belonging. And in the last few years I also founded Integrate Include Engage, which is a company that offers support and consultancy and training for inclusion in organisations, especially in health care.

 

Claire  03:47

I am curious to know where your interest or your passion so to speak come from in terms of, you know, diversity, inclusion, belonging? And if I'm not mistaken from your profile, you also have some experience in organisational development and so on. So tell me a bit about where that comes from?

 

Piera  04:06

I ask myself that, I had to go really back in time where my passion for inclusion comes. And I saw my very first signs when I was a kid. You know, I had a teacher in elementary school that used to place, let's say, people that had difficulties in integrating themselves very close to me. So she chose people that either came from difficult families, or they had issues integrating themselves close to me because she said, it will be easier for them. And so as I remember that I would fight whenever I would see people who were mocked in elementary school. So I think those were the first signs of myself that I could go back to where I see I've always had a passion to fight against injustice and against discrimination. And then more than 16 years ago, I found myself working, for example, for disability inclusion. And when still, I didn't know the words of diversity, inclusion, and so on. And now I can give a name to the work I was doing. So I think it goes very far back and is not a trending topic. For me, it is actually an attitude of engaging myself for what I believe is right, and for an inclusive society. And of course, the first place and platform to fight for it within myself, you know, whenever I see my biases, and my own prejudice and stereotypes, that is the first platform.

 

Claire  05:54

It's very interesting what you said there, you said, it starts with yourself, when you see your own biases. How do you notice that and what type of biases are you talking about?

 

Piera  06:03

Here I would also go back to my background. I've always been passionate about the brain. I've always been passionate about science, about neuropsychology, which is what I first studied. So I think the very first obstacle that we have when we face biases is that we feel guilty and that we feel  ashamed. So the very first step is really understanding how our brain works. So our brain works in an "energy saving mode", we wouldn't be able to live without this "energy saving mode" of our brain. The point is, when is this mode functional and when is it no longer functional? Okay. So, to me the importance with myself and with others is recognising "Okay, am I now what I feel there is a bias, it is functional or not functional?" because that is actually the automatic pilot that we all have. And we should recognise it without the burden of feeling ashamed and feeling guilty about it. Now, the second step is, "what can tell me that I am experiencing things in this moment, are biassed, is actually my emotions" okay? When the intensity of my emotions are either middle or high, there is something happening to me towards a person I grew up with or a situation that tells me that I'm not neutral anymore. So being aware, it's about being aware that something is happening, either that I feel rejection, or I feel attraction towards this person. And therefore, if I need to make decisions, or if I want to be inclusive, I need to be aware of these emotions, because either way, I wouldn't be objective towards the situation or the person. So it really starts from myself and starts with recognising what is happening to me. Because sometimes, and this is again, another bias, people feel this emotion and their reaction is to shut it up, push it away, because I don't want to feel that my world is racist, is not welcoming, sexist, and so on. But we are all in cultures that do have these signs and we need to separate you know, our actions from our full being. And I think this is also another obstacle that prevents us from being more inclusive in our society.

 

Claire  08:50

Is this awareness directly linked to the organisation that you founded?

 

Piera  08:56

It is very much connected. First of all, as I told you, I need to start from personal awareness and from my personal awareness, raising that awareness, first of all, as a person and then if I am in an organisation, raising this awareness as an organisation, so that inclusion becomes part of the culture. Yeah. And also, inclusion, I have a very holistic view about what inclusion is. And first of all, if I look at a personal level, to me, inclusion means that every person just belongs to a group that belongs to a culture. No matter who you are, what language you speak, you can contribute and you are led to contribute with the best of yourself. To me, inclusion is the freedom and the peace also to be the person that you are and that you can really live your potential. That they took him to leave your vocation. So, that is what inclusion is to me from a personal level. Now, if I translate it into a bigger context like on an organisational level into a culture and up to a society, to me inclusion, I see it holistically. So in a company it is not just the demographics that a company has, it's the attitude that it has towards the employees, towards the suppliers, towards the patients when we look at the life science, towards the marketing as well. So, it impacts each and every thing, that is my view and with Integrate Include Engage, I want to support individual teams and organisations to raise this awareness, so that our services and products reflect these inclusion in the society.

 

Claire  10:59

So if I understand correctly, Integrate, Include Engage is your consultancy, so to speak, because you help organisations relive that inclusion and ensure that every employee are the people who are part of the organisation they belong, right,

 

Piera  11:15

Exactly. But also to see it in a broader view, not just on the employees. So inclusion is not, let's say, a programme that you implement, inclusion is not something you do. Inclusion is, first of all, personally a lifestyle. And second in an organisation is really the attitude that as I mentioned, you have towards your supply chain, for example, or towards the marketing. And to me, if I raise the level of awareness, something that right now is a blind spot can become a strategy when seeing. So for example, if right now, a company doesn't realise that they are excluding a group, because they just don't see it, because it's on their blind spot, you can show them that there is a group that is not included in that sense. And they can decide, do we want to serve this group consciously? Or because of our strategy, we want to direct our strategy somewhere else? So to me, awareness is also very linked to in strategy, actually,

 

Claire  12:30

And you're specifically focusing so with Integrate Include Engage on life science, healthcare, gender medicine, among other things. Why is that?

 

Piera  12:42

Yes, I think that I partially already replied to you. So as I told you, I have two souls, the humanistic and the scientific one which brought me first of all the passion for the brain and for neuropsychology. And here, I bring together the experience that I had as a researcher, and in this field at the beginning of my career, all the experience that I had in organisational development and working in big companies, working in NGOs, like also you and women or a Capacity as we said, and I'm basically bringing this together in inclusion in the life science, because here, it is especially important to look at inclusion because the consequences of this unconscious bias in health care have serious impact for the lives of people that are less represented or not represented - like women, like other ethnicities, the consequences are also debts. Late diagnoses, misdiagnosed, so the consequences are so important that we must do something about it.

 

Claire  13:58

And I just want to refer to something, so you were part of the Women in Healthcare Innovation 2021. So this is a list of 16 women that was put together by Femtrepreneur. And before I ask you my question, because I have a question about that. Let me just quote what they posted when they released that list. So they said, "We believe that women's contribution to innovation in Switzerland needs to be more visible, be it in digital, academia, politics or business. With this edition of FEM showcase, we proudly present a select list of women in healthcare innovation 2021 that highlights the significant contribution by women in the healthcare industry in Switzerland. Women represent over 50% of the world's population, and significantly more than that, in both health and care roles. Yet, innovations in healthcare are largely influenced and funded by men. We therefore see it as essential to our own health that we encourage and support all the amazing women working in innovation in healthcare today, and highlight role models for our future generations." How did that feel for you to be part of this list?

 

Piera  15:13

Of course, very, very much honoured to be part of this list with 15 other amazing women to do a great job for innovation in health care. And I was also very proud to be included in this race, especially for my efforts in inclusion in health care, and in gender medicine. And also in projects. Like, for example, the projects that I did, together with the Women's Brain Project, the Women's Brain Project is an NGO that engage itself for the gender differences in medicine, and for precision medicine. So I was nominated for all my effort in this field, and also with projects, for example, in attention disorder and differences for women and girls.

 

Claire  16:06

And going back to the examples you just shared, you spoke about the Women's Brain Project. Can you tell me a bit more about that? And how did you contribute? In that sense, with working on that project.

 

Piera  16:16

I had the pleasure a bit more than one year ago to get you know, women's brain projects. And we must bring a project as I said, it's an organisation, an NGO based here in Switzerland. That brings together experts of different disciplines in order to have sex and gender representation in precision medicine. And in healthcare, there was a hackathon one year ago, and I proposed myself to be a mentor in this hackathon. And also I propose different projects to my group, and one which I was also very passionate about, was about gender differences in ADHD, so called the attention disorder. And also in this area, there are big differences between girls and boys and men and women. And these differences make it much harder for a woman to be detected, diagnosed and treated for ADHD. So we started this adventure. This project was successful, it's continuing to go on, I still contribute to the Women's Brain Project, and I'm very happy about it. And also to see that something like ADHD is being looked at, specifically for women and girls, and to improve their quality of life of course.

 

Claire  17:51

Coming back to this Women in Healthcare Innovation 2021. So first of all, I asked what it meant for you personally, but now for your work, did this list bring all of these 16 women together, did it bring more leverage, more visibility, what is the impact? 

 

Piera  18:06

Yes, I think the innovation office of the University of Basel is doing a huge job in order to have more representation of women in startups to have more women startups funded, because right now, it's less than the 10% that are getting funded. Therefore, it was important to have visibility for all these great women here are women that are really doing a wonderful job. Some have visibility, some do not. And it's important to share and to see these role models and also for society to see how women, also as entrepreneurs, contribute to society. So every step in this direction is important.

 

Claire  18:56

And there's something that's coming to mind as well. I think we had a recent conversation, where we were speaking about women's health, and you told me something, or at least in that conversation, you said something that really stuck into my mind. And I was like, "that is true, I never thought about it". It's that women's health should not be reduced or at least not centred around reproductive health. Why do you think that this is not really talked about?

 

Piera  19:21

It's really good that we now have much more attention to the health of women. So we saw so many femtechs popping up, which I think is wonderful. The point is, I always go a few steps ahead. And it is the fact that all of these femtech Focus themselves on reproductive health, maternity, now they are also looking at menopause which is great because menopause is also linked to a stigma and we need to de stigmatise also menopause but all only focusing on these parts is just replicating the full stereotype that we are living in medicine, which women are just women for our reproductive system. So the full medicine is based actually on a standard persona, which happens to be white men, young, able, possibly hetrosexual, and so on. And all that is far from this persona, either for being a woman, either for being not hetrosexual, either for being not so able, or a black person, an Asian person. So all that goes farther from that, it means that it's much, much less or not represented, and the women were just represented. Also, this is also in the handbooks. Okay, if you take any of the anatomy handbooks, it is always drawn as a male, and the only part with a female is the reproductive system. So in femtech, we are sort of reproducing, making a stab at reproducing a bit of the stereotype. But I have to say there are also some very interesting femtechs that really look at, for example, the agnostic system, and really look at the full health of the women.

 

Claire  21:28

Let me shift gears a bit here because I know that you're also a lecturer at the Fachhochschule Nordwestschweiz (FHNW), how does that fit into your holistic approach? 

 

Piera  21:40

Yeah so here it is about sharing. Normally these are students that have already graduated, these are advanced studies. And therefore it's people that are already professional. And maybe for some, it is the first time that they come into contact with what it means in real terms, to be inclusive, for example, what it means to be inclusive towards people considered disabled or with some sort of different ability. First of all, to get to know this phenomenon - so really, what are we talking about? It is actually a huge number of people, especially as 80% of disabilities are invisible. And it's also a condition that can happen to each and every of us at any point in time. And it is important, again, to know the phenomenon, to know what we can do to bridge the start. Because at the end, it is not so much of what type of ability a person has, but it is about the environment. Let's say if you break your arm, or you break your leg, and you don't have a lift, you will feel more disabled than if you have a lift. The point is whatever step you take towards more inclusion of disability, you are facilitating the life of each and every one. Okay, so all the "Alexa", for example, all the voice recognition systems that we are using Alexa and so on, they started to be a support for people with disabilities. And they made life easier for many more people. Right? So any accommodation, but again, to me, is the environment that makes a person more or less able.

 

Claire  23:45

So is it fair to say that your role as well as a lecturer is also adding to your contribution in terms of this awareness discussion, and conversation?

 

Piera  23:55

Yes, it is. But I also support in seeing what each and every one can do to improve also the systems. Okay. So if, in a company they feel they don't have people with disabilities, there is something really happening in the recruitment system, first of all, and second in their organisational culture, because it means that the people they do have some issues with a colleague, they don't feel comfortable in sharing it. There are several points they they need to look at. And normally after they go, they realise first of all, how big the blind spot was, and also what they can do in order to be more inclusive.

 

Claire  24:40

You spoke earlier about startups and how things are evolving in technology. You mentioned Alexa and things like that. So my question to you is, if we're not doing it yet, maybe we are, what will it take to make sure that this whole digitization and digital transformation will really include everyone?

 

Piera  25:00

First of all, the digital transformation, is part of a bigger change that we all are living that is called the Fourth Industrial Revolution. And the Fourth Industrial Revolution, that implies also the heavy use of the digital technologies, it means that we are in an environment, which is where the speed is not comparable to what we were used to the complexity is very high, the level of uncertainty and the big changes, it's also with no precedent, and a massive and pervasive use of digital technologies. So, what do we need? First of all, I mean, the digital technologies, they make use of artificial intelligence, that is the first thing you know, in a broader sense. And if we talk about bias, actually, the artificial intelligence is not just replicating, but also amplifying the biases that people, groups and organisations have. And we can give so many examples of it. Like, we mentioned about the voice recognition or the facial recognition they make, they are very accurate when they need to recognise a white male, they are not so reliable when they need to recognise a woman. First of all, a woman that is with makeup, a black woman, a black person, or maybe people who are gender fluid. And this is because the systems are biassed too and they amplify this. So the first step, in order to be more inclusive in this step is about looking at our artificial intelligence system looking at the data, we fed it to the data that was collected, how did we feed it? Who were the groups involved? So where are the blind spots in this data, because the system might be making wrong decisions and they are. So one of the steps to be more inclusive is by looking at these technologies, and de-bias them. On the other hand, what I mentioned about the high complexity and the uncertainty that we are living with these needs, really a mix of perspectives. So we cannot solve just the issues that we face, just with people that think alike, we need multidisciplinary teams, but they are really including different perspectives, really including different personalities, we cannot manage it anymore. And also the uncertainty, you also need people that can be very flexible. And look what the neurodiverse people were always excluded by this criteria. And they are those that actually are key to success in this moment. We don't need to have war for talent, there is enough talent and there is enough good talent. If an organisation has issues in finding talent, it means that it has issues with bias, because we do have people and we do have this talent, you just need to remove the barriers for you to see it.

 

Claire  28:36

And the other question I had for looking into the future is how do you see health equity evolving? What role do you think that if we go very much into this digital health, precision medicine, will that remove this bias that we see? Or what influence will it have in terms of health equity?

 

Piera  28:56

Yes. So the future is going to be more precise and going to be based on those characteristics more than, let's say, the idea that you have more people, but also to know "who am I representing right now, who am I not representing?" if you want to bridge that gap. And if not just to know that you are not representing everyone, because one of the issues right now in healthcare is that everything was built on that standard persona, but still said that it was valid for everyone. And that is the problem. The point is, we need to be more precise, and we need to state who this product represents and who is not represented so that each and every one can, let's say, choose the option that best represents you.

 

Claire  29:52

Just before we move to the last part of the conversation, I'd like to just leave you the stage and if there's something you want our listeners to know, what would be in a nutshell, their takeaway from our conversation so far?

 

Piera  30:07

The takeaway for me is, first of all, recognising that we do have bias because this is the way that our brain functions. And it's our automatic pilot. And we do need this automatic pilot. And second is there are ways to raise your awareness, and to bring what is unconscious bias to bring it to a conscious level and still do something about it. So in order to make good decisions. It's important to see our blind spot to increase our human awareness. And this can be applied in all the fields, again, in healthcare in each part of the process, from the clinical studies, until the very end of the healthcare delivery, it can be implemented in the organisation. But first of all, it is also a good way to discover who you are, discover your identity, and to finally also make you a better person.

 

Claire  31:14

So towards the end of my podcasts, what I like to do, I asked my guests the exact same set of questions, because I want to get a bit of a sneak preview on who is Piera? What music she listens to or what books that she reads, because you never know, perhaps you can have some good recommendations for our listeners. Number one, do you have specific music that you're listening to very often at this time, or if you're not very much of a music person, what is the book that you're reading right now?

 

Piera  31:42

So in the last maybe a couple of months, I've been listening quite obsessively to a group, an Italian group called Morning Skin, and they are having huge success across the globe. And they finally brought Italian music in his rock version, really across the globe. And I love them. I mean, I used to hear something about them in the past, but really recently they are becoming very well known. And this is one part of the music which I really like. And also because Italian music is not just this cheesy type of music. But also can be rock, which is great. And the other part is that they do represent having 20 years more or less the gender roles. So they are showing how comfortable they are in being who they want to be without compromise. And you know, a man can still be a men and can be still heterosexual even if you know they dress with dresses or they have makeup on. So it is about showing this, again, normalising what should be normal, but it wasn't. I very much like that because they are showing an example that I couldn't leave. And then I mean about the book, the last one that really impressed me it's about Italian author Nadeesha Uyangoda. The title is "The Only Black Person In The Room." And she describes her experience as an Italian and also the experience of many black Italians, which is not exactly the same way that for example, in America, they consider black basically an Italian, black is anything that is not completely white. So with all different origins, and she describes this experience, it really touched me very deeply. Also, because of course I'm Italian, it's been more than 20 years that I've lived abroad, but still I am, and so feeling and reading the experience of this person and also how black person is considered you know, with micro aggressions, big aggressions, discrimination and everything. This really helped to give me a vision which is closer to me.

 

Claire  31:53

Second question, do you have a song or a book that was special for you at a specific time in your life and why?

 

Piera  34:25

Probably I'm telling you because I discussed this with a friend recently. I'd say a film, "Sliding Doors." This film "Sliding Doors" is not probably the best feeling in terms of cinematography. But to me that film really represents an idea that I've had. Sometimes a few seconds or just one second will completely change the path of your life either because you meet or don't meet certain people and it seems that sometimes life. When you look back, that exact second really changed your life completely. And in this film, they show you the life of a person. If she would have taken the subway in London, she'd have managed to take that Subway, or she wouldn't have managed. And they show you finally, what is the life of this person, if only that second changes? So I would say that one.

 

Claire  35:28

And last question, do you have a band or a piece of music, perhaps even a book that you would absolutely recommend, and you say, you know, everybody needs to read that or to listen to that?

 

Piera  35:39

So probably a song that I would absolutely recommend. It's a Sardinian song. I'm Sardinia, Mediterranean, and the song is "Non Riesco a Riposare" That means I cannot rest, I cannot sleep. And actually it was a poem written which became a song, which is also very touching. And to me, besides the poetry and the depth of this song, it reminds me of my father. And it reminds me of my island, which is my roots, and I'm very proud of my roots. 

 

Claire  36:19

So Piera, it's been a really great pleasure to share your experience on the show, and to learn more about, you know, more specifically what you do and how you approach things. And I am truly happy that our paths have crossed, and that I was able to share what you do on the show. So thank you so much for joining me today. 

 

Piera  36:39

Claire, thank you so much. First of all, I also want to thank all of my teachers and inspirations that made it so that I'm here today with you. I'm very thankful to you and also that our paths crossed and they would have crossed in many different families. We realise that I'm really happy about that. Thank you so much for the work you do in order to increase social inclusion. And it's really been a pleasure to get to know you and also the people that you invited and I'm really honoured to be here. I thank you, I thank my teachers, my inspiration, and my family for being here, thank you.

 

Claire  37:25

"Recognise and be aware that we all have biases, because that is how our brain functions, then do something about it." What a powerful approach to inclusion, an approach that is meaningful at both the personal level and the organisational level. Thank you so much for tuning in today. I appreciate you taking the time. That was episode 32 "A Conversation with Piera Marongiu". Make sure you leave us a review everywhere you listen to podcasts. And if you like what you're hearing, remember to share our show within your network. And you can also connect with us through our social handles or our website at narratives-of-purpose.podcastpage.io Until the next episode, take care of yourself, stay well and stay inspired.