Power is Ripe for Reinvention

by Karl Hofmann, President and CEO, PSI @KarlHofmannPSI

Power, its abuses and its character are all around us in 2019. We see it in our politics, in our struggles over economic systems and business models. We see it playing out in the dispossession of millions of people of their homes and safe places to live, as the world grapples with more refugees and displaced people than ever. And, as always, we see it playing out in the bedroom.

“No one gives you power; you just have to take it,” is attributed recently to Speaker Nancy Pelosi, but also to comedian Roseanne Barr. It doesn’t matter where you stand on the US political spectrum: the truth of this statement transcends politics.

A more apt quote might be the 18th century wisdom of author and pioneer of Western women’s rights, Mary Wollstonecraft, “I do not wish women to have power over men; but over themselves.”

© PSI/Olivier Girard

What about power in healthcare? Our moment is ripe for reinvention.

New diagnostic tools and self-administered therapies are creating the possibility for radically reducing the middle man, so to speak. The barriers of old—too few doctors and trained medical personnel in the Global South; inefficient or overwhelmed health facilities; and a mismatch between where the people are and where the healthcare is—are now potentially surmountable, with the help of digital healthcare tools, connectivity and referral networks that allow for a system leapfrog. Primary healthcare, more in the hands of health consumers and patients themselves, can unlock faster progress toward universal health coverage.

Where our healthcare moment of today connects with Wollstonecraft’s 225-year-old wish is in the most prized and most contested realm of control of them all: fertility.

First radical, then seemingly banal to the 21st century audience, but now considered radical again, is the idea that women need to be able to exercise control over their own fertility. The benefits accruing to women, to their families and communities, and to the planet as a whole are now clearer than ever. And yet, today we see ever more indications of just how threatening this control must be to men around the world, as leaders in the North and South disparage and undermine family planning, contraception, women’s agency and, ultimately, control of fertility.

Power isn’t mine to give, though as a white American male in his 50s leading an international NGO, I am perceived to have lots of it. But there is power to seize, and it is hers to take. My job is to ensure that my role and my organization help remove the barriers to women’s ability to take their power and use it for themselves. Our job is to make it easier for Sara, PSI’s archetypical health consumer, to lead a healthier life and plan the family she desires.

I wouldn’t condescend to “empower” Sara. I can, however, get out of her way.


Hear more from Karl at “The Power of Stories: Making sexual and reproductive health and rights come to life” Plenary Session on Wednesday, June 5 from 1:30-2:30pm and at “Transforming Health Care through Self Care: Agency and Power in Sexual and Reproductive Health” a Women Deliver side event on self-care, on Wednesday, June 5 from 6:30-8:00 a.m. in VCC West, Room 211

This article appears in PSI’s Impact magazine, released in tandem with Women Deliver 2019, as part of an ongoing conversation about putting #PowerInHerHands.

Banner Image: © PSI

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