Berkley Center

Background: Sister Teresa Kiragu, ASN, teaches theology at the Catholic University of East Africa (CUEA) and does research focused on medical ethics. As a religious sister in the order of the Assumption Sisters of Nairobi, she is involved in work on ongoing formation. She is a volunteer in the hospital ethics committee where she serves, and is also part of several international theological networks. Her doctoral thesis was entitled “Holistic Healthcare Ethics and a Culture of Life: Towards a New Approach to Healing in Catholic Hospitals in Africa.” She spoke with Katherine Marshall on April 17, 2025, in advance of participating in a certificate program at Georgetown University in April and May; she will also do a post-doctoral fellowship at Boston College later in 2025. In the discussion, Sr. Kiragu traced her career both as a theologian and a Catholic sister, reflecting especially on the ethical challenges that confront contemporary health care in Kenya and beyond. She noted the particular challenges that women face in a patriarchal society, in having their voice heard and their needs met. She reflected on pervasive issues arising from the erosion of trust in many institutions, highlighting the need for real accountability in leadership at many levels and in many sectors.

Bio: Sister Teresa Kiragu is a theologian and she belongs to the Assumption Sisters of the Blessed Virgin Mary of Nairobi. She is a member of the Georgetown University Women Faith Leaders Fellowship 2024–2025 cohort. She holds bachelor's degrees in both philosophy and sacred theology from the Catholic University of Eastern Africa (CUEA), where she also earned a master's degree and a Ph.D. in moral theology. She is a lecturer at CUEA, in the Faculty of Theology, and a visiting lecturer of ethics at the Centre for Social Justice and Ethics, as well as a visiting lecturer at the Institute of Catechetical and Pastoral Ministry AOSK – Chemi Chemi Ya Uzima. She is a research fellow at the Centre for World Catholicism and Intercultural Theology (CWCIT) at DePaul University and a member of Globethics, an international network promoting ethical reflection and practice. She is a leader in two professional organizations: Catholic Theological Ethics in the World Church (CTEWC) and the Pan-African Catholic Theology and Pastoral Network (Pactpan), where she heads the Health and Healing Research Unit. One of her areas of focus is empowerment of girls to seek formal education and health education.

Can you, to start, please tell me something about yourself? Where do you come from? How did you come to your interest in theology? And in becoming a religious sister?

I am one of eight children, and I happen to be the last born. We have five girls and three boys. Our second born sister is also a religious sister, but in a different congregation. When I was growing up, I admired her, and I felt that one day I would like to be like her. But when I was young, my ambitions were not so clear, and I wanted to become a priest. I thought then that women could become priests, and I used to admire them as they celebrated mass. But then, later, when I became older, that is when I realized that I could only become a religious sister.

I had that inspiration from a young age because my parents were staunch Catholics. We were raised up going to church, following the faith. I got a lot of inspiration and encouragement from my sister. I looked up to her and saw how nice she was to all of us. I felt that I would want to do the same, basically to serve people and to commit myself to a life of prayer.

Where were you born?

I was born in the central part of Kenya, in Nyeri, in a place known as Othaya.

What about your studies? How did you make your choices on what to do?

I finished high school when I was barely 18, just turning 18. At the time I wanted to become a nurse, which even today is in my heart. And in high school, I had a grade that would have taken me to campus, but I felt I wanted to join the life of service. So right after high school, I made a decision to join the religious life. I started aspiring with different congregations, and I ended up joining one of them, the Assumption Sisters of Nairobi [Note: The Sisters of the Assumption of the Blessed Virgin Mary of Nairobi were founded in 1955 in Nairobi, Kenya, by Archbishop John Joseph McCarthy as an African women's religious congregation dedicated to serving the local church and people]. Joining the congregation basically took me into my life as a religious sister.

After the formation, I was given the chance to study education. As you know, as a religious, we go with what the congregation needs at that time, and the opportunity I was given was to do education. I applied to CUEA and I was admitted. But then, when I was to join in August, the decision changed, and they asked me to do theology. I would admit that that was a moment of crisis for me. Nursing, that I wanted to do, was not there, and I was getting to feel at home with the prospect of studying education. And then I finally entered with theology! The first year of philosophy was very hard, because it was something I didn't like. It wasn't my choice. But after my first year I saw that I was doing well. I decided to appreciate it and to embrace it, and I embraced it fully. Thus, by the time I was graduating with my first degree, I got first class honors, and I immediately got a scholarship to continue. I had not yet done my final vow, but the congregation and the university were impressed, and they supported me for a Missio scholarship. Thus, Missio sponsored my study in CUEA for my master’s. I continued immediately. After that, Missio were again impressed, because I passed my master's well, and they paid for my doctorate in theology and I graduated in 2021.

I can say today that I love what I do in theology. I have embraced it fully, and today when I look at my path, I say that some decisions can be made for you. But later you realize, I think, that this was the will of God for me. But still, it could not kill my dream of becoming a nurse. Therefore, I did my Ph.D. in health care ethics, and I still try to bring in that aspect of health care, even in my work as a theologian. So, in everything I do I bring in a lot of medical ethics and bioethics.

What is your professional life now, as well as your spiritual life? Are you teaching mostly, or doing research? And how are you using the medical ethics?

I began teaching back in 2019, while I was doing my Ph.D. They hired me as a part-time lecturer in the university when I was studying, in the Center for Social Justice and |Ethics (CSJE). I was interacting with many students, teaching ethics courses, medical ethics, social practice, among other disciplines. But last year in September, I was hired as a permanent lecturer in the faculty of theology, and so currently I teach in that faculty. I lecture, with about four or six units each semester, including medical ethics and bioethics. I am also supervising the work of students in undergraduate and master’s programs.

So, I would say that currently I'm in academia. I do research, but basically I'm still settling in theology, trying to settle down, preparing my classes. I have now finished one academic semester, and I would say, I'm getting back to my research so that I can also be able to publish.

What is your research focus now? And what would you like to do? How does it link to what you're interested in?

I have done my research in medical ethics and I want to pursue more research there. This time, I want to do more on artificial intelligence (AI) and health care ethics. I can share with you that I got a postdoctoral fellowship with Boston College, and so from August this year until January 2026, I'll be in Boston. I hope to be able to publish a book on health care ethics and on health care and AI and how it impacts the health care sector. So currently, I'm trying to organize things so that when I go there in August—September is when the program officially begins—I will be prepared.

What are the main themes that interest you in AI? And how are you approaching the topic?

I am still at scratch. We have had webinars on the topic, but what interests me is basically to look at the ethics of AI, to see what are the positive things that the health care sector can still embrace, and also where in the health care sector there are ethical issues that really are going too far, especially in regards to care of the human person, and especially care of sick people in the hospital. Sometimes I feel that AI might be going too far, even to eliminate the care that a nurse should be able to give. So those are some of the things that I want to explore. We must not forget the benefits that this AI is bringing in the health care sector, but then also trying to learn more what are unethical things that also happen with AI, and especially as far as a human person and human dignity is concerned.

And you want to do a book on it. I think it's too early to ask you when the book will come out!

Yes! Before I go, by August, I hope to have a plan that is clear, for each chapter. I intend when I go there to try to bring things together, so that by January I will have at least the draft already out, and then I can be looking for the book’s publication.

But what do you find are the issues that your students are interested in, among the topics you're teaching? Obviously, they are fundamental sorts of issues of principle. But what is on people's minds and on your mind, including, of course, our basic topic of the impact on women and girls?

One of my students is also doing his master's thesis on AI, its impact on higher education. Others are focusing on looking at the issue of governance, especially, environmental issues and gender justice. Those are some of the things that the students are interested in.

What about you?

Of course, I'm also interested in issues to do with women, and especially women and health care. That of course has many connected aspects. So empowering women, especially in regard to health care, poses many issues. That includes equality, making sure that there's a voice for them that is heard, and respecting their rights, and empowering women, so that they can be able to have a voice in the society. That’s something that’s really missing, especially in Africa.

That’s even true in the education sector. I now teach in the faculty of theology and I'm the only sister. So empowering women there is important. I would like to see even more women in theology. It's something that I look forward to, that I hope to be able to do. Why not also empower other women, especially religious, or even lay women, to be able to also embrace this work? That's something that I hope for: that in ten years, I will be able to look back and say and think that I've also been able to encourage other women to venture into theological studies and especially theological studies for and about women. So, among many others, those are some of my interests.

How do you see those issues in Kenya? Do you see much change within the Church in Kenya? How much is happening and how might you describe it? And among the different orders of sisters? Do they approach matters in similar ways, or are there big differences? Are there active debates?

There are quite a number of congregations in Kenya, especially for religious women. And I would say that the sisters are making a lot of impact in the society. I would emphasize, of course, that the sisters are involved due to different charisms, and we are therefore involved in different ministries: education, health care, pastoral work, etc. And I would say that the Church is able to embrace or to appreciate the roles that the women are playing. I would say, even so, that there is still a challenge which I would term the issue of clericalism. Even if the impact of women is there, still the Church in Africa has yet to really give women, even those women religious, a voice. Sometimes it is not easy to be heard, especially where the religious have to work, especially in diocese projects or in others. So sometimes it's not easy to move forward. But I would say the sisters are able to do their ministry, and they have created a lot of impacts. And the entire country is able to really appreciate the work that the sisters are doing. It's not easy, of course, and there are a few constraints, with the government sometimes, even with the Church leadership. But all in all, I think the sisters are really impacting a lot.

What kinds of constraints might you meet?

Apart from those I mentioned, sometimes the hierarchy can represent a constraint. And there are also financial constraints. Some challenges can arise to do with leadership. You find that many of the congregations, maybe local congregation, meaning they are not pontifical, may face issues of leadership, which can complicate the decisions that must also come from that kind of leadership. So that can be constraining.

The sustainability of the missions that the sisters are doing is, I think, one of the major challenges. I've talked about it in terms of financial constraints. That’s number one. And sometimes also, we say nowadays, we find it difficult to have enough manpower to do the activities that the sisters want to do. Sometimes it's also getting to us here in Africa that sometimes you find congregations where they don't have enough members who can do the mission they would want to do.

Do you find that the congregations work a lot with lay women as well?

Yes, we partner with the lay women in many of our missions, and even with the lay men, especially if we are working in the hospital. For example, I stay in a hospital compound where we have a level four hospital. Of course we are working with them, like we have hired them. Some of them even hold positions in our schools, in our hospitals, in any mission that we are doing. So, we really collaborate with them.

How many Catholic hospitals are there in Kenya? Are they a large part of the health care system today?

It is the largest part of the health care system. Basically, when the missionaries came to Kenya in particular, they began especially the health care sector and the education. I would say that in every locality you'd find a Catholic hospital.

Do you, as a theologian, work with the hospitals, and how?

I volunteer in two hospitals in their health care committee. This also entails giving the nurses, the doctors, workshops on health care ethics, and currently we are working on a manual of health care ethics for Catholic hospitals.

I was part of what was called an ethics consult at a hospital in Chicago, where one person would present a problem or a challenge to colleagues in a safe space. Is there anything equivalent? If someone is troubled by how to deal with a patient or a family, where can they get some advice?

The hospital’s ethics committee deals with ethical dilemmas. Sometimes it may be management issues, sometimes it may be also disciplinary issues. And sometimes it can take a form where someone can share, something where they are not sure what would be the best thing, the best way to handle an issue. So, it deals with quite different matters. But mostly it helps the management of the hospital to look at challenges that might arise, so that one is not left alone to think about the way forward.

Musimbi Kanyoro, whom we met in October, works with the Circle of Concerned Women Theologians in Africa. Have you been part of that, or are you interested in the approach?

I'd be interested and I hope to get in touch with her, although I'm also working with other organizations. There's one network for African theologians, mixed with women and men theologians, known as the Pan-African Catholic Theology and Pastoral Network. We have our website and hold meetings. We have nine units in that network and I'm the head of the health and healing unit. We organize a lot of webinars, and we have posted them already on YouTube. We have organized workshops on critical dilemmas that occur in the clinical setting. So, we're dealing with the different dilemmas, and we invite doctors to come and share, and people can ask questions. I'm in another one known as Catholic Theological Ethics in the World Church. This one is basically for moral theologians, and I'm the regional coordinator for Africa. So basically, I have been trying to catch up with the networks I am part of before I enter into new ones.

At Georgetown, we are launching the Commission on Faith, Trust, and Health. Is this issue of trust one that you're focused on or are concerned about from where you're sitting? Trust means many things, of course, but among them is the lack of trust in vaccines. It also links to AI, or to the fact that so many people get information now from Google rather than their doctor. Trust in government is another issue, and in the Church and religious communities more broadly. Issues of failing trust seems to permeate societies.

For sure, lack of trust is something that is very common here, especially, I would say, with the health care sector, and here in Kenya and in Africa in general, since the time of COVID-19 especially, and all that surrounded COVID-19. There were so many theories, for example that COVID-19 or COVID-19 vaccines were made to finish Africa. Sometimes there are tests that are done and people are not even allowed to give their consent. They don't know what impact it will have. Recently, there was to be mass vaccination for malaria, and people did not turn up for it, because of that lack of trust with the health care sector, and not to say anything about the government. Because, as in Kenya, there is no trust with the government, because they keep promising things that they never do. So even if maybe they say they will do something, citizens no longer trust. In fact, there’s hardly anything on which literally anyone in Kenya would trust someone quickly, especially because of being cheated in the past.

With regard to religion, of course there is a little bit of trust, although sometimes it fades when maybe one of the leaders in the Church doesn't conform or adapt to what people expected. But there is still that trust in the religious sector. But in the governance and the health care sector, and even in business, that trust, I think, is something that is rare. Even for health care, it's something that we look at. With the vaccination difficulties and the controversies that surround them, that is something that we have also been exploring, especially this semester with my students, in a course on special medical moral issues.

So, an issue is to explore why there's an erosion in trust. What if you were asked for advice on helping to solve the problems? What would you advise?

I would say that accountability is very important, because if there is a lack of that trust, especially in governance and in the health care sector, poor accountability and transparency are a central reason. I think it will be something that leaders can help to solve if they recognize the root cause. And then, they also must come up with the right policies to respond. I think this is a big challenge in Africa in general: to come up with the policies, and then to ensure that we fulfill the policies, because even when the government has policies, they don't fulfill them as they are supposed to do. They need to focus on what citizens need to ensure that there is development. But sadly, too often they do not. They will promise, but they will not end up doing that they said. Thus, good policies, real implementation, and also ensuring that the rule of law is observed, so that whenever someone is going contrary to what is expected, the rule of law can be applied. This is a big challenge in Africa. And again, because of the issue of corruption, especially in our country here in Kenya, trust must be rebuilt.

I will say that having ethical leadership is essential. Ethical leadership can be another way that we could be able to bring back that trust: ethical leadership and servant leadership.

What would that look like if you had ethical leadership? Are you thinking of the politicians living by their principles? What do you have in mind?

Yes, ethical leadership. I would summarize again what I've said: a politician or anyone who has any leadership role should be accountable, transparent, and also ensure that they live to that. That's what I mean by ethical kinds of leadership. That is a leader who is also doing what is expected of them and also respecting the rights of the people that they are leading.

We face many similar challenges in the United States right now. What you're referring to is the gap between what people say and what they do or what they promise and what they deliver. There are also complex questions about how people's personal and public lives relate. We need real, decent, humane morality. People are complicated, with good and bad sides, good and bad angels.

When you look at your career and your life (of course, you're really just at the beginning: you have so much ahead of you), do you have specific areas where you're dreaming of change? You said you wanted to be a nurse; connecting ethics and health care challenges may be on your list. But what would you say are the things you think are most important to pursue?

One thing, also related to what this fellowship has been able to offer me, is to be an effective advocate for women and girls. I have always done this, but I think now that I have been strengthened and am more empowered, having gained a lot of skills, I feel that this is a thing that I need to do as I move forward. And it is something that I want to be able to put as one of my key future agendas. Another thing is building my career. I have a dream of not remaining at the same state, just as a lecturer, thus constantly improving my career. So, I plan to be involved in a lot of research. Once I'm settled in my career, I think I could do a lot of publication and research, especially again with advocacy about women and also advocacy about issues of health care. Those are some of the things that I'll be looking forward to. After every quarter, I’ll hope to share something through my publications. I also will want to do different kinds of outreach. Now that I've been empowered, I have gotten the skills, I think I'll become an influencer to other women.

Yesterday, there was a powerful talk. As religious, we have some who follow us, and people have trust in us. Being able to influence other people that I interact with and to do so deliberately can, I think, bring about change. And working on the capstone that I've been working on, I dream of making it still better.

Those are things I dream of exploring. I want to continue dreaming as each new day comes along.

Health care is such a wide field now, and it is so important to everyone. I think it's a universal that everyone is concerned with their health and so much change happening around the dynamics of health with AI and with so many other things. I'm delighted that you're dreaming of its transformation! Thank you.