Woman's Hour - Endometriosis, NI Abortion, Portraits

Episode Date: March 24, 2021

Endometriosis is a condition where cells similar to the ones in the lining of the womb are found elsewhere in the body, often around reproductive organs, bowel and bladder. This can cause inflammation, pain and scar tissue. We hear about a new study which uses Dichloroacetate as a treatment. Jessica Rafferty talks to use about her experience which includes more than 200 visits to the hospital. And we also hear from Andrew Horne, Professor of Gynaecology and Reproductive Sciences at the University of Edinburgh.Litter! Get annoyed when it’s all over the place? Find yourself picking up other people's rubbish? What about all those covid masks? Is it mostly women leading the charge on litter? We hear from you. Theoretically women can now get an abortion in Northern Ireland. The new law came into force last year but in reality it's a very different story. It's hard to access services and some women are still travelling to England and Ireland. The Northern Ireland Secretary, Brandon Lewis, has stepped in and said the Northern Ireland Executive must do something about it. We get the latest from Jayne McCormack, political reporter at BBC Northern Ireland, and Les Allamby, Chief Commissioner from the Northern Ireland Human Rights Commission.And we talk about the portraits on display at the National Portrait Gallery. Why are most of them of men, and why are they created by mostly male painters? How do experts plan to change things?

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2, and of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme, peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. Hello, I'm Emma Barnett and welcome to Woman's Hour from BBC Radio 4. Good morning. There are a few things we are permitted to do in these restricted times. Going outside and litter picking is one of them. You could also argue that this could be a time when people actually learn to pick up their own rubbish. And leaving that very valid debate just to one side for a moment the great british spring clean

the annual litter picking event has just been launched by keep britain tidy very much with the thought of us unlocking as lockdown comes to an end that being a reality and us wanting to be more in our green spaces and for them to be beautiful women are are leading the charge. The Environment Minister, Rebecca Poe, who helped launch the Spring Clean campaign yesterday, said she hopes all 650 MPs will offer their support this year and the Spring Clean would set the tone as Britain emerges from lockdown. And the Chief Executive of Keep Britain Tidy, Alison Ogden-Newton, who says, we know without a shadow of a doubt

that the country is about to be covered in rubbish and our absolute front line will be our litter pickups. In fact, Keep Britain Tidy has seen that lockdown has led to a rise in the number of families asking for their litter picking kits to help keep their communities clean. So are you a lockdown litter picker or perhaps you've been at it for a bit longer? I have to say personally, I invested in my own litter claw a few years ago. I've never looked back. I've picked up everything from burger boxes to chicken bones to thongs. In fact, yes, more than one thong, no questions asked. And while it is infuriating, I have to say it is also gratifying to tidy up your area or near where you live or the park that you go to. Make your patch a little more pleasant.

Plus, my own experience is all sorts of people come up to you and talk to you while you're doing it. You sort of end up guilting them into doing it as well, and they get involved. Why do you do it, though, if you do it? What has it led to for you? What motivates you? What drives you?

We've already had lots of messages coming in on this. 84844 is the number you need to text on social media. We're at BBC Women's Hour Hour or email us through our website. Stephanie says, by coincidence, I've just started litter picking in earnest today. Littering has always infuriated me. And this morning I did the walk to school and back armed with gloves, claw and bag. Depressingly, got quite a haul, but it felt positive and I was enthused after. I actually found it quite relaxing.

I know what you mean. I mean, the claw after a while sort of hurts your hand, but if you can get the stuff up, it's quite satisfying. And then you look back at where you've cleared. So tell us your stories of that. Perhaps you've also made some friends by doing it. Also on today's programme, why women in Northern Ireland should be able to access abortion services,

but cannot. We'll get behind that story. And painting women into the picture. Why the National Portrait Gallery is going to look quite different when it reopens. More details on that. But as spring has most definitely sprung and the days are getting longer, the Great British Spring Clean 2021 has been officially launched by Keep Britain Tidy. It's been described as the country's biggest ever mass action environmental campaign,

which last year attracted more than half a million to sign up. It hopes to marshal an army of litter pickers. Perhaps you'll be tempted to do it for the first time. Well, in the meantime, I'm joined by, before you get your stories to us, the writer and broadcaster, of course, formerly of this parish of Radio 4, Alice Arnold, who hit the headlines a few years ago and was hailed a hero for taking on a little out. Alice, good morning. Good morning, Emma. Do you remember this? You became a sensation, didn't you? You became the news.

It was extraordinary. It was some years ago. And I think Twitter was in its kind of infancy then and I remember tweeting that I'd done it and then seeing that I had literally hundreds of replies to this which in those days when as I say Twitter was in its infancy was extraordinary and I thought gosh this seems to have hit a mark and then I had dozens and dozens of requests to go on various shows I was actually reading the news on Radio 4 that day. I remember Radio 2 wanted me on and I said, no, I can't. They said, no, no, no, you can.

I said, no, I can't because I'm actually reading the news at one o'clock on Radio 4. So I can't be on your programme. But it was an extraordinary reaction that I certainly wasn't expecting because I thought everybody did what I did. Remind us what you did. Well, I was behind a car in a traffic jam, broad daylight, Bank Holiday Monday, actually, over Hampton Court Bridge. I can remember it vividly. And somebody in front of me threw a plastic bottle out of their window.

And we were in a traffic jam that clearly wasn't going anywhere. And I just got out of my car, picked up a plastic bottle and threw it back in their car and um they looked absolutely stunned it was a couple actually they they looked completely stunned at what I'd done and uh and then as I drove on a bit I did feel a little bit shaky and thought oh maybe that was a bit daring but um did they say anything did they say anything they didn't say anything they looked absolutely horrified and shocked, I was lucky because I think I could have got, you know, perhaps a very angry reaction or something worse. I was in a very public space.

It was very busy and there were a lot of people around. I wouldn't recommend anybody doing that quietly. I've been tempted to and been stopped by Claire, my partner, who said, Alice, calm down. Don't do that now. That's not safe. So you've not done it since? No, I've asked people to pick up their litter since. I've asked young children to and received some very fruity replies from them. Well, I was going to say, that's actually part of this, isn't it? While it's one thing to to get on that front line and pick up the litter and we can talk about that as well.

But actually saying to people, can you do something about this? It's not something a lot of people perhaps they think it, but they don't go and do it. They find it quite hard to do or perhaps they, you know, they go for it. Well, you see, I it makes me angry and people say, well, why did I do what I did? Because I was furious. Because why would you do that? Why wouldn't you just take your bottle home? And I just don't understand a culture of not caring about the environment. And as you were saying, we need our parks more than ever. I've been every day walking on the streets, walking in the park. And as Pete and Taji have said, you know, this is going to get worse because we're only allowed to mix in outside spaces.

Parks will be very common. People will have picnics. And a lot of them will just simply not take their rubbish home with them. And that's going to be a disaster. But you see that every day. And I simply don't understand the culture of people not picking up their litter. I don't understand it. Well, there's apparently something called the bystander effect that, you know, if you see it happening, that rubbish is on the floor, you just add to it almost like a child.

You know, that's sort of not setting by example, that you do the worst possible thing. And I should say, in my list of things that I've been picking up, and it's not just me, you know, I've seen it in reports, masks, disposable masks, are now the new sort of chicken box almost as well. Absolutely, they are, and you see them everywhere. And because they're an extra thing that we have to carry around

and, you know, they seem like a piece of paper. Sometimes I think they probably just fall out of people's pockets. But other times, obviously, there is deliberate littering. But the culture of it, as you said, the bystander effect, you know, I think it's in Japan, there is just no litter. And if people don't see any litter, their one piece of litter looks a lot more obvious. Whereas if you see generally messy streets with litter all over them and parks with the litter, you add to it and you don't feel that bad about it because you think, well, there it is. Other people haven't done it, so I'm not going to do it. Yes, I think that's the other thing which I was seeing that people have written messages to their council about which is making sure that the bins get emptied because if you're in a park I think

that one of the worst things is you see it all build up next to the bin absolutely which I presume makes it easier for the collectors to to collect it when when they do come but it is really annoying when you are trying you may be quite a long way to get to the bin and then find the bin is overflowing um and that tends to happen on bank bin and then find the bin is overflowing. And that tends to happen on bank holidays and times when it's when it's really busy. But we do need to make sure there are plenty of bins and plenty of places for people to put their rubbish. Yes. And I should say at this point, you know, there are some clear rules when you are doing this, especially with children, you know, about being safe, about what you actually pick up. You know, you don't want to harm yourself.

You know, some people getting in touch around that. Do you yourself do litter picking or are you our great enforcer, Alice Arnold? Are you out there telling people not to drop it in the first place? Are you on the preventer side of this? I'm probably more on the preventer side. But having, you know, until recently been a dog owner, I did do a fair amount of picking up other people's dog mess. Putting that in bags and putting that away. But safety is really important.

And gosh, you must wear gloves. You know, you could so easily get cut on cans, which are often discarded or whatever, and things that are dirty and unclean. And, you know, gloves are absolutely essential. Yes, I think it's also it's interesting, you know, keeping streets safe, which we've talked about, especially from the point of view of women last week, you know, making sure our streets are a good place to be, making sure that we feel like they aren't just trash cans as well. You know, that they were living now, especially as we unlock, we're living just outside.

It's just about all of us being in that space together. Absolutely. And, you know, I live in a residential road and and quite often it's filthy. It's absolutely filthy. People, you know, people just leave bottles lying around. Well, they get smashed. That's then dangerous. Some people will cut themselves on that glass. Yeah, I do believe it's a cultural thing and we have to take some more pride in where we live. But I guess there are people who don't care about that

and those are the ones I speak to. Unsurprisingly, they are not the ones texting in right now, Alice Arnold. So I'm going to have a look at who is getting in touch. And I think they might be more along the lines of what you're trying to say here and taking pride. But it would be very interesting if you have thrown litter and you would get in touch with me this morning. 84844. Why did you do it?

Would Alice telling you off stop it? What's changed your mind? Would somebody else talking to you, maybe that did change your mind. Alice Arnold, good to have you on the programme. Nice to hear your voice again on Radio 4. We'll talk again, I'm sure. More messages coming in around this. Natalie says, I live in a lovely part of Suffolk. I walk my dogs twice

a day. I always bring home litter, which is getting worse suddenly. I hate it. It feels like vandalism. I clear rubbish to thank nature for giving me such a lovely place to walk. Another one here, I pick up a carrier bag full every day, mostly from verges and hedgerows. Why are more drivers chucking litter out of their cars?

These are the questions and also your experiences. Please keep them coming in. I'll come back to those very shortly. But we did say we'd explain what's going on in Northern Ireland because theoretically women can now get an abortion in Northern Ireland after a new law came into force last year when MPs at Westminster voted to decriminalise abortion in 2019. But the reality for women needing terminations tells a very different story. The further you are into a pregnancy, the harder it is to access services in Northern Ireland.

And some women are still travelling to England and the Republic of Ireland to get services and to get access. Yesterday afternoon, the Northern Ireland Secretary, Brandon Lewis, stepped in and said the Northern Ireland executive must do something about it. So what is really going on? Jane McCormack is political reporter at BBC Northern Ireland and Les Allenby is chief commissioner at the Northern Ireland Human Rights Commission. Jane, I'll begin with you. Tell us about the barriers women in Northern Ireland are experiencing at the moment if they choose an abortion.

So, Emma, at the moment, women who are seeking an abortion here, they can get one, but it's not regulated across the board because the politicians at Stormont can't agree on a properly centralised structure. Now, we know that since the laws changed last March, more than 1,000 abortions have been carried out. So obviously there is some provision, but some of the doctors and nurses involved in it, they have had to work without direction, resources. They've had no funding from Stormont about it.

And that's why then you've seen some women who are in those later stages of a pregnancy having to travel outside of Northern Ireland to get the specialist services that have been in place much longer elsewhere. And that is why we've now seen the government having to step in because it says that delay in commissioning really cannot be sustained any longer. What is the reason for the delay? Is it political intransigence? I would imagine if you speak to most political parties here, they would say that that is the reason. I mean, to explain for listeners, we have five parties who make up the Stormont Power Sharing Executive.

They all take quite different views on it. But the DUP are the largest party at Stormont and they are an anti-abortion party. And essentially, the way things work is you need to have the consensus of all the parties on board in order to get something passed and they so far have refused to let this issue progress because they don't agree with how the initial laws were passed back in 2019 when Westminster wasn't sitting. So it has been held up there and Brandon Lewis in putting down those regulations yesterday and saying that he is now acting has said that even with the pandemic problems over the past year ultimately Stormont

has had more than enough time to get its act together on this and he's stepping in now and hoping that that will focus minds around the executive table here in Northern Ireland. And in the meantime women are just trying to get through this? Yeah well as I say, obviously, you know, it's an incredibly difficult issue for many women, but wider afield, the debate here around this is still quite raw as well. I think given the kind of shake-up there was a couple of years ago when Westminster acted, and obviously there are those here

who feel that what Brandon Lewis is doing is right because ultimately the British government has human rights obligations to follow through on this. So I think the difficulty is, at the moment, it's the wider political debate that is taking precedence on this. We know that there are still women who need to access these services. Ultimately, I think from speaking to politicians here, there's also a sense that even if they do get back around the table and start talking about this, it's such a sticky, wicked issue. It's been going on for so many years here and often it's fallen to the courts to resolve this. And this is where it could end up again. Well, let's talk, as I was saying, to Les Allenby, Chief Commissioner at the Northern Ireland Human Rights Commission.

You are taking legal action about this. What do you make of the Secretary of State for Northern Ireland stepping in? Well, we welcome it. We'd like this to be resolved locally rather than through Westminster. But the reality is the legal responsibility is with the Secretary of State. It's worth going back to the genesis of this, which was that an investigation by the committee that monitors the UN Convention on the Elimination of Discrimination Against Women found that our old laws, which criminalised women and clinicians and others,

amounted to grave and severe violation of human rights. We had three years without a Northern Ireland executive in devolved institutions, and it was during that time that through Stella Creasy and across party support brought forward an amendment to a bill in Westminster to implement the recommendations of the UN Treaty Committee's report, and that included that women should have access to abortion services safely and locally, and no longer effectively export this problem across

the Irish Sea to Britain. So the responsibility was vested in the Secretary of State. We eventually got the Assembly and the Executive back, but the tools to deliver this are with the Northern Ireland Government Departments, but the tools to deliver this are with the Northern Ireland Government Departments, but the issue has got stuck at the Northern Ireland Executive. So we are looking to take both the Northern Ireland Executive and the Department of Health to court on human rights grounds, and also to enforce the Secretary of State to do what the legislation says, which is ensure that the CEDAW report is implemented in full. And I suspect the regulations are a response to the absence of the Northern Ireland

government department, which has brought a paper to the executive asking to commission and fund a service. And that, as as I say has got stuck there politically so this is about trying to break that log jam. If though the events overtake you because of what Brandon Lewis has stepped in and said will you drop the court case? We'd love to drop the court case I think the basis on which we would drop our court case would be if a service was commissioned and funded in line with the regulations that have been passed. So that's the threshold, that's the test you're waiting for. Have you had any response from any of the players that you're

planning to do this, you're taking this action? Yes, the Secretary of State has said, his lawyers have said, the government is taking all reasonable steps. We're trying to persuade the Department of Health and the Northern Ireland Executive to deal with this. The Department of Health has said, well, we've brought a paper to the Northern Ireland Executive, but it's got stuck at the Executive. And then the Northern Ireland Executive is saying, it's not a matter for us. It's a matter for the Department for Health. Wow. So it's being kicked around you in the sense between departments? I've described it as a kind of Kafkaesque pass the parcel where the music never stops.

And that's clearly in human rights terms. And I think in terms of the statutory requirements of the legislation. But I suppose just because we don't have anybody here from those parties to talk for themselves, wouldn't one of the arguments certainly be that this was never the place for Westminster to do in the first place? You know, this is not the role of those Westminster MPs. What would you say from that? Because obviously it was put through and you're coming at this from a human rights perspective. Well, yeah, our position is clear. Human rights are a Westminster driven. The Human Rights Act is a UK wide act. So Northern Ireland government departments are required and Northern Ireland political parties are required to adhere to human rights, domestic and international standards. You can't opt out of those standards.

And in this case, the UK government has passed legislation to implement a human rights treaty monitoring body recommendations. So for us, this is not an overreach by the Secretary of State. He has got legal requirements to implement this report. And we know because we've been monitoring what's happening on the ground, there is a service at the moment, but it's not a service in accordance with the law. There have been heroic efforts by clinicians to get a service off the ground, but it's not being funded. And as more than one clinician has said to me, we're used to operating in an environment where we

manage risk and we do it under a framework that's commissioned and we do it with guidance. And we have none of that at the moment. To provide those services to women at the moment. That's the reality. So the chasm between what's meant to be happening and what is actually happening. Thank you for coming to talk to us, Les Allenby, the Chief Commissioner at the Northern Ireland Human Rights Commission, will of course stay with that story. And across the BBC, we have been reflecting on the past year and the circumstances of how we've been living. If you did miss yesterday, we had a particular recollection from the actor Sheila Hancock, who joined us here on Woman's Hour. You can catch back up on her thoughts on a year of doing nothing

what she's been thinking about. She's telling us she's achieved nothing, staring at the walls, going upstairs and forgetting why she went and why she thinks she needs and we need a revolution. She also confessed to loving being a bit slutty. Her words not mine and I think you should catch up on that if you missed it. It's over at BBC Sounds

so do check that out. Thank you so much for all these messages coming in. Many of you have been litter picking for years. Kate's been doing it for 20 years. Getting back to our discussion around that. She says, I'm nearly 70 now

and I just don't like mess on our streets. Nappies, bags of dog poop amongst the fines. Yes, I had a few nappies the other day. I tackle people if I see them as well.

And CJ in Reddit, good morning, says, have you seen the state of verges along our motorways and A roads? I've never seen it so bad. It's depressing. Why do people do it? Why are they so selfish? That is a question that is coming in again and again and again. And some of you also getting in touch to say you've made some friends through doing this. Come back to those in just a moment. Now, one in 10 women have it. It takes an average of seven years to diagnose and its hallmark is crippling bone grinding pain. Endometriosis is a condition where cells similar

to the ones in the lining of the womb are found elsewhere in the body, often around reproductive organs, bowel and bladder, which can cause inflammation, severe pain and the formation of scar tissue. It is a chronic and often debilitating condition that can lead to infertility. There's no known cure. Doctors don't know what causes it. And treatment options include surgery, hormonal drugs or painkillers. And yet and yet, as we speak during Endometriosis Awareness Month, there has been a tiny shaft of hope with a medical breakthrough, albeit at the very early stages, led by Andrew Horne, professor of Gynaecology and Reproductive Sciences

at the University of Edinburgh. 24-year-old Jessica Rafferty has been on Professor Horne's trial with positive results. She's suffered with endometriosis for more than seven years before receiving a diagnosis and has been to hospital more than 200 times. Jessica's had two surgeries and tried several types of hormonal treatments,

including a medically induced menopause. She told me about her experience. It took me seven and a half years to be diagnosed to begin with. You were living with pain that you didn't know why. I was hospitalised over 220 times. I had an appendectomy, as they thought, because where my endometriosis was my pains were always there so they thought that's what it was they removed that and then the month after surgery I was still getting persistent pain it wasn't until I went to a different doctor and she was like oh no all these symptoms seem to lead to endometriosis and I was was like, what is this? And they were hired with it. And then, yeah. So from her, it then got me to get a laparoscopy and I got diagnosed in 2018. A laparoscopy is a keyhole procedure, keyhole surgery. That's what you have to have.

And that is the only way to know for sure that you have endometriosis. I speak from painful experience, I should also declare at this point, and it took me actually over two decades to be diagnosed. As we're talking towards the end of Endometriosis Awareness Month, which March is, we're actually going to talk about some good news, which I have to say is a lovely thing to be able to say. And I'm going to pass back over to Andrew for this, because you've had a bit of a breakthrough. And I'll say with all the usual cautiousness around this and with a drug. Tell us more, Andrew. Yes, it is nice to have good news about endometriosis, because I think so often it's not good news.

And what we have been doing over the last few years is, of all trying to better understand the condition itself and in doing so we discovered that women with endometriosis have cells that line the pelvis that produce different amounts of something called lactate and in finding this what we then went on to do is in the laboratory look at ways that we could try and reduce the levels of lactate and potentially reduce the endometriosis and the symptoms associated with it. And in doing so, we turned to look at drugs that had been used in cancer trials, and in particular, a drug that's also been used to treat rare metabolic disorders in children called dichloracetate. And we showed in our laboratory models that we could reduce levels of lactate. And then we just moved it into a clinical trial,

which Jessica's taking part in. It's an open clinical trial. So the participants know that they're on the treatment. So as you say, we have to be cautious about the excitement that we have about the results. But certainly we're feeling very positive about it. And I'd be interested to hear Jessica's views. Yes, well, so would we. And I should also stress at this point for people who don't know very much about the condition, which affects millions of women all over the world, there is no cure for it at the moment. There are treatments that one can try, but they don't necessarily work and they vary between different women. So with that in mind, Jessica, you went on to this trial. How was it

for you? The trial was the best thing I have tried for endometriosis, hands down. So I've done all like hormone treatments, the pills, injection, I've done the medically induced menopause. I've tried nearly everything so I get pain every day with my endo and I also get Braxton Hicks on the trial it was like night and day I was in no pain daily it was just amazing really yeah I mean that's incredible yeah you must have felt a lightness you haven't felt for years I mean I know you're only 24 but you've been struggling with this ever since you started menstruating yeah it was a new lease of life I could take the dog out a walk I wasn't having to turn back early

I was able to actually go and do things that I haven't been able to do or I've had to cut short it was just brilliant you you obviously only did this for a reduced, a sort of set time period, I should say. And what was it like coming off it? Did the symptoms immediately return? For the first two weeks, it was still like I was on it. But now the pain's back and I'm getting Braxton Hicks again daily.

Those sort of contractions that, how would you describe that pain? It's just like two minute intervals of like little short stabbing pains, it's horrible. Andrew what's that like to hear how much it changed Jessica's life? I see patients within the NHS setting all the time with endometriosis. And it's always so disheartening to hear the impact, the symptoms that they have and the impact that it's having on their quality of life. So I think if we can find something that changes that, it would just be a fantastic breakthrough. So it's very exciting. It's really nice hearing that from Jessica. So this particular drug, it's non-hormonal. Are there side effects that we know

of? Yes. So the commonest side effect can be this, it can make you feel sick. So we start it at quite a low dose and then give the option to increase that dose. And then at very high doses, it can cause things like tingling in your hands and your legs. We're not starting it at those high doses. Our vision with the treatment, assuming that we can demonstrate that it is of benefit, is potentially to put in something called a vaginal ring so that patients wouldn't have to take a tablet every day. And it could just be changed maybe on a weekly or a monthly basis. And that may also reduce any side effects that are associated with it. So that's our kind of long-term plan. And do you think that there, or are you concerned at this

stage about any dangers or long-term side effects to being on this? Because I presume with the way endometriosis is a chronic condition for any sort of treatment like this, it would be for the rest of your life? Yes, I think as Jessica's demonstrated, it's not going to be a cure, something that you take for two weeks and then the endometriosis disappears, which would be lovely. But as you say, with anything that you have to take

on a daily basis, we have to be really cautious. So we have to look at safety. And in particular in this trial, we've been very careful, you know, looking at liver function, kidney function, et cetera. But we will need to look at it in the longer term because it's a non-hormonal treatment which ideally we'd like people to be able to take without contraception we'll also have to do some studies to make sure it doesn't have any impact on the developing pregnancy so yes there's still if you say we have to be cautious there's still, as you say, we have to be cautious. There's still

a bit of work to do here. But it's been a long time since I can remember any form of, I don't know, hope or breakthrough in this area. Jessica, I don't know if you feel the same. Yeah, definitely. So I know a few girls who the medically induced menopause worked for them, and you kind of, when you then get to that stage, you a bit like oh yes it's going to work for me and then when it doesn't you're a bit like oh another that's me again back to square one so to find something that was a bit like oh you know what it's not your body's not pumped of hormones it's actually something that isn't going to like affect your moods because at one point I was on three different birth controls to try and not get a period. So as you can imagine, I was like, oh, all over the place.

Andrew, how long do you reckon this could be? If you've got to go through all these hoops, I know. But how long do you think it could be until it gets to market, if it was to? It's a good question. So we need to get some funding to do the next trial. And the next trial we would we would try and do in say 300 400 participants that would probably take a couple of years so i i mean to get to

market maybe four to five years at a push that's that sounds like a long time but actually because we're using a drug that's been used for other conditions which is what we call repurposing a drug, it actually shortens the time to take an idea, a concept from the bench into clinical practice as we were trying to do. Professor Andrew Horne there and Jessica Rafferty. Now I mentioned when the National Portrait Gallery, which is obviously closed like all museums at the moment, but when it is reopening, and it's also, I should say, closed for renovation, but when it reopens in 2023, it promises to be a different place. The last commission before it closed involved two women, a portrait of the author Zadie Smith by the artist Toyin Oji Adutala,

who I shall speak to shortly. But these are relatively rare within the context of the rest of the permanent collection, with 88% of the artists and 75% of the sitters being men. Curator and art historian Dr Flavia Frigeri is now trying to put women in the picture, literally, with a project called Reframing Narratives, Women in Portraiture. The plan is to rebalance what's on show, learn the histories of forgotten women and make sure women are properly represented. I'm also going to be joined by the artist Roxana Halls,

who focuses on images of women and has just had a portrait of the singer Horst MacDonald unveiled at the Scottish National Portrait Gallery. A warm welcome to all of you. But Flavia, if I could start with you, why so few women? I think it goes back to tradition, the tradition of portraiture. I mean, you must think traditionally, portraits were very much mostly focusing on men, because men were the ones that had prominence in cultural, social, political spheres. Women were very much traditionally relegated to the household, the domestic realm. So they weren't so much the subjects of portraits, unless obviously they were

from a certain class. So that's why, in a way, it's important now that we reclaim a place for them because women made history throughout times and that we know and we should celebrate. Yes, but I suppose if you've got a gap in what's available or what was actually created, what do you do? Is it about commissioning new work? It's a mix of things in the sense, yes, you can commission new work by contemporary artists and asking them to do what one could say a historic intervention. But also we have material. We may not have portraits necessarily of women in gilded frames, but we have photographs, we have prints showing them often, you know, in different contexts. But what's important is also to reclaim this material and say, this is equally important.

This tells us a story that we should be knowing about a woman who's made strides in whatever field that might be. And when women are painted, have they been painted differently to men or are they painted for men? I mean, that varies really really. It depends on the painting. But in terms of portraiture, and this I think is true both of male and female portraits, very often it's very posed, it's very choreographed. And one thing that I'm trying to do as part of the project is really show you women at work. So show you women who are active agents in society and not just very pretty and wearing lovely bonnets. So, yeah, it's really about thinking how we represent women. Because you also think photography is very important in this.

And is there a specific example of women you're trying to bring back into the frame? Tons of examples, but I won't keep you here for hours. So I'll give you one that I think is a very good one. So the frame is she is the woman who invented the plaster cast so if today our bones heal properly it's thanks to Anne Aikson that during the war was volunteering and thanks to her anatomy skills and experience was able to develop and invent that as a system the plaster cast that's an example of someone we don't represent in the collection. Sorry, so is there a painting of her that you're bringing back? No, there's not.

Okay. There's not even a photograph of her. So she's an example of someone that I'm actively researching the photograph of for the collection. And you're trying to include that within the collection. Yeah. Fascinating to hear her story. Toyin, good morning to you.

What were you trying to do with Zadie Smith's portrait? Tell us about, you know, creating now and painting a woman. And may I say, I've been lucky enough to have a good look at it. You can look it up online. And it is it is wonderful. Yes, thank you so much for having me. The portrait really was just a dream come true, because I got to work with someone who I really admire. And I knew that there was very few portraiture in the National Portrait Gallery of women of color, particularly Black women. So I was very conscious of the choices I was going to make in the picture. And so what I wanted to do was to have an inclusive picture. It's not simply just an image or a capturing of Zadie. It's more of a portrait of Black Britain and all the people that

can look at that portrait and feel like they belong to that narrative. And that was key for me. And the ease that she has in the portrait was also intentioned. I didn't want her to feel like she was subject to the gaze, which is often an issue when you're creating any sort of image of a figure. There's, especially a woman, you always have this concern that they're going to look at her in a very particular way. And I wanted her to look like she didn't care how you looked at her or if you looked at her she was going to be fine and she had agency and she could do whatever she wanted making it about as opposed to how others would look at her just how she is and and getting away from the idea of that gaze on women or just the performativity of that you know the gaze makes it like women it how do I put it it

it reduces women to their function and I wasn't trying to do that I wanted to show her humanity and also show that I mean I don't know if I can curse but she's a badass and I I just thought that was so great that I had the opportunity to do that and yeah because we do we do show we do think of portraits don't we it's quite stiff uh things that that have as we were just hearing in history signified power or royalty or robes and a lot of formality with that and i suppose you're you know we're taking that on now let me bring roxana into this do you think women paint women differently to an extent that's inevitable isn't it and by the way thank you for having me on the programme. I mean I wouldn't want to make any kind of gross generalisations about the

differences between male artists and female artists. Much has been said about that but I think it's inevitable that we bring to bear everything that we know and everything that we bring to bear, everything that we know and everything that we experience into our work. So I think there will be key differences, yes. And how do you feel hearing about this change at the Portrait Gallery? You know, the idea that we're trying now to correct this. And where do you come into that working as a female artist today? Well, I think working as a female artist, well I think I think you you working as a female artist I think that's just um something that you do I don't think that when you are making things you

are always conscious of the fact that you are a female artist you're thinking about the pictures that you make you're thinking about the endeavor itself and in particular when you're working with an individual you are thinking in terms of how best to depict them how best to speak of them of their lives of their agency just echoing Toya there I'm really excited I'm absolutely thrilled that the National Portrait Gallery is doing this it's not before time and it's vital this is vital that we see ourselves reflected, that we see diverse voices and that we get a fuller picture of who is working today, who is achieving today. I think without having female voices, it is like having only half an orchestra playing. It's like keeping half of the instruments in the orchestra in their cases.

I think we need the full sound. Yes. Well, we hope to have that when the National Portrait Gallery reopens and to continue seeing that as a trend. Thank you to all of you. Very quickly, I can squeeze in Alison Ogden-Newton, who is the Chief Executive of Keep Britain Tidy,

because we have been talking about your campaign and litter picking this morning. Alison, I did say women seem to be leading the charge in this area. It's not to say there's not male litter pickers out there, but tell us your view on that, first of all, Alison. Well, I mean, it stands to reason we were founded by the Women's Institute in 1955. So right from the get go, it was women showing leadership in local environment quality that set up Keep Britain Tidy. And of our 300 Litter Hero ambassadors, the majority of them are women. So, you know, why do you think that is, Alison? I'm seeing obviously loads of messages this morning. But why do you think that is?

I think we all notice the rubbish that's around us. But I think women in particular have a tendency to take responsibility for the world around them and particularly the world on their doorstep. So I think that has really responded. I think particularly girls at school, of all our school age ambassadors, the vast majority are girls. And I think environmentalism really resonates with women sorry i was just going to say because we are slightly short of time but i wanted to make sure we spoke to you dare i say are you saying women are better at cleaning up i do you know i'm really trying not to say that um really trying not to say that because it's not our responsibility and we are not there to do it are we but on the other hand it does seem to be

something that we we roll up our sleeves and get stuck into. So whilst we, you know, this is very much a group sport, litter picking and the support of local environment quality does seem to be something that women really respond to. And we're very grateful for that. The irony is people seem to be getting a lot out of picking up litter whilst being very angry about it yeah well doesn't it make you angry makes me angry i mean who put it there in the first place it shouldn't be there we shouldn't have to live with it and the environment certainly shouldn't have to weather it and it it is and the impact of that is very serious so it is a serious business

it does make people cross but there's a difference between being cross and doing something about it so i'll make the key well i was going to say something about there you go on that alison ogden newton chief executive of keep britain tidy we managed to talk thank you that's all for today's woman's hour thank you so much for your time join us again for the next one hi russell kane here i just want to tell you about Evil Genius. It's the show where we take legends and icons from history. Everyone from Henry VIII to Gandhi, Richard Pryor, Mary Stokes, Dr Seuss. And I have a panel of funny people who are gathered around my desk and are subjected to horrific fact bombs which reveal things about their heroes they don't want to hear. At the end of the lively mind tennis, they must vote evil

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