Fifth-year medical student, Ashna Biju, is not afraid to talk about the topics that other people would rather avoid. She’s passionate about public health and getting out into the community to get to the very heart of an issue.

At school I enjoyed most subjects, especially psychology, and so medicine – with its mixture of science and communication skills – felt like a good fit. And maybe, there was another reason: as someone who is deaf, I wanted to ‘prove’ that I could be a doctor – whether this was proving to myself, others, or society, I’m not quite sure, but it certainly played a role in my choice.

My parents and teachers were incredibly supportive of me applying to study medicine. But I was still aware that I’d never seen a doctor with disability – at least not one that was visible. I was shocked to learn in a recent survey by the National Deaf Children’s Society that almost half of the public don’t think you can be deaf and be a doctor or nurse.

I often face a ‘hair-up’ or ‘hair-down’ dilemma – but not for the reason you might think. If my hair is up and my hearing aids are on show, people are surprised that I understood and followed the conversation, often with a comment of “you don’t look deaf!” It reminds me that there are still so many assumptions made about what people can and can’t do.

Being a woman of colour also comes with implicit biases. People may say “your name doesn’t sound British”. They’re not trying to be hurtful, but it does have an impact. Some assume I’m a nurse. Why could I not be seen as a doctor? Why don’t we see women of colour in the top positions?

My parents moved to the UK from Kerala in India when I was about five years old. I’ve grown up here and feel British, but people may not perceive me as being British. Equally when I visit my family in Kerala, I’m not seen as truly Indian as I carry myself differently or don’t pronounce my mother tongue quite so ‘correctly’.

I’m passionate about understanding how racial, cultural and gender differences play out in everyday life, especially when it comes to health care. I’m also interested in understanding how communities can influence people’s health – for good or bad. I’ve realised I’m drawn to topics that are considered a bit ‘out there’ like mental health or woman’s health.

I’ve always been interested in menstrual health – it’s something that affects half the world’s population and yet there is still stigma surrounding periods. It’s not fair that in some countries girls can’t go to school because they are on their period or can’t talk about their period just because a senior male figure has told them not to.

When something is seen as taboo it’s often underfunded and under resourced. In India – as in many other parts of the world – cultural factors come into play. Doing things differently can be seen as being too modern or Westernised – it can be difficult to break thousands of years of tradition.

In India there isn’t a centralised system for disposing of sanitary waste – people just do whatever they can. Pads may be flushed down the toilet, burnt in backyards or thrown into wells or fields. This has knock-on effects for people’s health and the environment.

Disposable pads are very absorbent, which means they can block sewage systems. This can lead to a backflow of waste and the spread of disease. Often water systems are cleared by people who do not have access to protective clothing, putting them at risk of coming into contact with toxins or infected blood.

It’s been estimated that commercial pads could take up to 800 years to break down into microplastics. We know that microplastics build up in organisms and affect ecosystems. Burning pads can lead to the release of harmful chemicals.

I put forward a model for how we might tackle the disposal of period products in India. The paper was published in the journal The Lancet! I suggested that there could be community education to tackle the stigma around periods, encouragement to use reusable period products and the development of national infrastructure to safely dispose of sanitary waste.

Here in Cambridge, I'm part of The Cambridge Period Project. We’ve successfully campaigned to have free period products in toilets across the University and we also hold fundraising initiatives to provide toiletries to local charities that support vulnerable individuals in the community.

In the future I hope I'll get the chance to work alongside communities. I think it’s important to get out of the consulting room and lecture halls to talk to people – that's how you get to the heart of how someone feels and what they choose to do.

One of the best parts of being a doctor is working with the patients – finding out about their lives, listening to what they’re struggling with and hopefully helping them. To be with patients at one of their most vulnerable times in their life is such a privilege. I feel so honoured as a medical student, to be able to listen to their stories and know that I can help, even if just to provide comfort.

To be joining the NHS – the organisation that has provided so much support to me over the years feels like I’ve come full circle. I am so grateful for all the lovely doctors, nurses, and teachers of the deaf who have looked after me. The people really make the NHS, and I am thrilled that in just a year’s time I will hopefully qualify and join them.

I very much believe in the ripple effect – you just never know how doing one little thing for someone might help them and ultimately have a big impact on their lives. That’s certainly been the case for me when I think about all the people who have helped me over the years to get me to where I am today, and I just feel so grateful.

Ashna Biju attends Caius College.

Published 3 July 2023
With thanks to:

_{Ashna Biju}

_{Words:
Charis Goodyear}

_{Photography:
Lloyd Mann}

_{The text in this work is licensed under a Creative Commons Attribution 4.0 International License}