Adrienne Germain, a women's health and human rights activist, was once on a small plane returning from a visit to a family planning clinic in a remote part of Brazil. A thunderstorm and loss of air-to-ground communication resulted in an emergency crash landing in the Amazon. Unfazed, Germain, already bruised from a head-on car collision a few days before in Rio de Janeiro, walked 17 hours out of the forest and got a ride back to her temporary headquarters in the city of Manaus, where she continued her work supporting women's health projects.

Germain was one of five female pioneers in the world of global health and women's rights who died this year. Though you might not recognize their names, each left a legacy. They helped countless women, lifting them out of poverty, finding better ways to treat their diseases and paving the way for them to become scientists and public health leaders.

Adrienne Germain: 'A rare combination of passion, total devotion, intelligence and integrity'

Head-on collisions and plane crashes in the jungle couldn't stop Germain, nor could endless meetings or narrow-minded notions of what poor women need to thrive.

After earning a master's degree in sociology and demography from the University of California at Berkeley, Germain signed on to the Ford Foundation. Ford sent Germain to Bangladesh as its first female country representative. She quickly saw that when it came to helping women, it would take much more than a singular focus on contraception, which was a guiding principle at the time.

She built up programs that enabled women to establish independence — from improving education to obtaining loans to establish their own businesses. In the 1980s, she co-founded the International Women's Health Coalition, which supported women and pro-women policies around the world.

She focused on the big picture — playing a key role in drafting a mission statement about women's rights at the landmark 1994 international conference on population and development. But she had an eye for details that made a difference. At that conference, Germain noticed the Iranian delegation, thought at the time to be sympathetic to women's health issues, was uncharacteristically resistant to statements supporting access to reproductive health care. Germain worked with her network of women to figure out the problem – translators were using the word for pornography rather than the term for sexual health. Gentle suggestions to the translators righted the discussions and the Iranians returned to their more positive stance, joining the international consensus supporting empowerment of women and access to sexual and reproductive health.

Germain died by suicide on May 19 at age 75. In a note she prepared, she wrote: "My life was deeply rewarding and largely self-determined, reflecting my conviction that, as Eleanor Roosevelt wrote, 'There is no more liberating, no more exhilarating experience than to determine one's position, state it bravely and then act boldly.' As aging reduced my autonomy and freedom to live fully as I wished, I decided to end my life."

Editor's note: If you or someone you know may be considering suicide or is in crisis, call or text 988 to reach the Suicide & Crisis Lifeline.

Mwele Ntuli Malecela: 'She made it her mission to empower ... African women scientists'

Mwele Ntuli Malecela was a world leader in public health but she never lost sight of the need to connect with ordinary folks. Her focus was on neglected tropical diseases that afflict the poor and disadvantaged.

She was steeped in the concept of public service from her childhood – her father, a politician, eventually became prime minister of Tanzania. After earning an undergraduate degree in zoology and moving to London to pursue a master's degree and Ph.D. in parasitology, she returned to Tanzania and joined the National Institute for Medical Research in 1987.

At NIMR, Malecela became the first female director-general. One priority was addressing lymphatic filariasis, a painful and highly stigmatized disease, spread by parasites, that causes limbs to swell. Visiting rural villages, "Mwele was able to talk to people with LF and get them to come out," says Joan Fahy of the University of Liverpool, who worked with Malecela. Instead of hiding at home, these people could then have their symptoms treated.

Malecela died Feb. 10 in Geneva at the age of 58.

At the time of her death, she was director of the World Health Organization's Department of Control of Neglected Tropical Diseases. Diagnosed with cancer, she did not let the disease stop her from creating a landmark 10-year road map to stop diseases such as malaria, lymphatic filariasis and tuberculosis that was adopted by WHO in 2021.

Efforts to end these diseases, she wrote, are "rooted in the best of our values as public health workers and as people – namely a commitment to community and our shared humanity."

Indeed, the importance of community was her mantra. After joining WHO in 2017, she did her best to see that clinics were staffed by locals and that villages were involved in research planning. And on an international level, "she was really keen that countries themselves actually led their own programs," says Thoko Elphick-Pooley, a close friend and director of Uniting to Combat NTDs. Malecela mentored everyone she could. Says Elphick-Pooley: "She made it her mission to empower and really raise the profile of African women scientists."

Ela Bhatt: 'She has given them dignity and visibility, and a voice'

"Every success has the seed of some failure," Ela Bhatt once wrote. "But it doesn't matter. It is how you go about it. That is the real challenge."

Bhatt, who died Nov. 2 at the age of 89, took failure in her stride as she fought against the poverty and powerlessness of women in India. She believed that women, no matter how poor, could succeed if given a chance. And she was able to give millions of women that chance.

Bhatt was born into a prominent family in the state of Gujarat, India, and was first in her law school class in 1954. She ignored society's limits on women from the start — she found and married her husband by choice, not by family directive.

In 1972, Bhatt founded the Self-Employed Women's Association (SEWA), a trade union that now has more than 2 million members. The association provides training, education and support for poor women throughout India and is associated with a bank co-operative that Bhatt also founded. Through SEWA, Bhatt helped the poorest of the poor become self-reliant.

"Her many organizations that feed into the original SEWA give women — and especially marginalized women — skills and facilities that help them surmount the many inequalities they face," says her longtime friend and fellow activist Mallika Sarabhai says. "She has given them dignity and visibility, and a voice."

Yet Bhatt herself lived an austere life. She lived humbly, says Sarabhai, and used a simple rickshaw to get around when she could have afforded a car and driver.

Joyce Cohen Lashof: 'Courage, kindness, no nonsense ... curiosity about the world, and that endearing smile'

At first, Joyce Cohen Lashof wanted to be a nurse.

But her mother had a suggestion: "If you're going to be a nurse and do all that work, you might as well be a doctor and be in charge." That's a memory that Lashof shared with her son, Dan.

It wasn't an easy path. After graduating with honors from Duke in 1946, Lashof found that men returning from the war were given priority for acceptance at medical schools. But she didn't give up, earning a place at the Medical Women's College of Pennsylvania.

"She was deeply committed to shattering the glass ceiling that held so many women back from achieving their full potential," said Meredith Minkler, a UC Berkeley School of Public Health professor.

In 1967, Lashof established a community health center in a low-income area of Chicago and was eventually appointed director of the Illinois Department of Public Health. "She was one of the key people in helping get community health centers federally funded and viable in this country," said Nancy Krieger, who worked on AIDS policy with Lashof in the 1980s.

Lashof become the first female dean of UC Berkeley's School of Public Health in 1981, where she continued to focus on underserved communities and helped build programs for developing public health schools in other countries. She helped found the Berkeley Wellness Letter, an internationally distributed publication that covers public health and offers research-based advice about healthy lifestyles.

In 1986, Lashof led a coordinated effort among public health schools — the first of its kind — to protest California's Proposition 64, which would have required all HIV-positive people to report their status to the state Department of Health and face the loss of their jobs and quarantine.

Her colleague at UC Berkeley, Kathleen Roe, said Lashof embodied "everything a student could want in their academic leader — a model of courage, kindness, no nonsense, scholarship and practical application of knowledge, humility, interest in others, curiosity about the world, and that endearing smile."

Up until her death on June 4 at age 96, Lashof kept fighting for social justice. At age 91, she carried a sign at a California protest that said, "End the Muslim Ban Now."

Having helped create protocols for women to get safe access to abortion, she was dismayed that the U.S. Supreme Court overturned Roe v. Wade. "She was absolutely baffled," said her daughter Carol Lashof. "She just looked at me and said, 'How could that have happened?'"

Leslie Bernstein: 'She was so competent and joyous and happy about it'

In 1950, in Long Beach, Calif., eighth-grader Leslie Bernstein wrote a term paper on what she wanted to be when she grew up. The job? A statistician. The reason? Baseball.

Bernstein loved listening to baseball games on the radio. "The announcers would refer to the people crunching all those numbers as 'the statisticians' and I thought, 'I want to be one of those,'" she told a City of Hope publication a few years ago.

A nationally ranked swimmer in her youth, Bernstein became a statistician and epidemiologist.

She began her studies at UCLA at age 16, married at 18, finished most of her undergraduate work at 19, and took a 17-year hiatus to raise a family. At 36 she started graduate work at the University of Southern California and got her Ph.D at the age of 41. Then it was 25 years of research and teaching at USC and 15 years at City of Hope, a cancer research and treatment center, all the while mentoring women scientists. She died July 28 at the age of 82.

Bernstein ran several painstakingly careful studies that showed, among other things, that the longer a woman is exposed to hormones because of early menarche or delayed childbearing, the greater her risk of breast cancer. Her research also showed women that they can reduce their risk of breast cancer through moderate exercise.

"Her impact on the understanding of breast cancer was profound," says friend and colleague Mary-Claire King of the University of Washington, who discovered several genes that increase a woman's risk of breast cancer.

Throughout her career, Bernstein mentored up-and-coming women scientists, inspired most likely by her own struggles to pursue her career at a time when opportunities were limited for women. "It's remarkable she pulled it off," says King. "And she was so competent and joyous and happy about it."

Joanne Silberner, a former health policy correspondent for NPR, is an independent journalist living on Bainbridge Island in Washington state.

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