Madame Chancellor, Members of the University of Ottawa 's academic community,
and invited guests. I am privileged to be here with you today. Especially to
be in a university that has identified research on women's health as a priority.
Since learning I would receive this honor, I have been trying to figure out
what insights or lessons I could share with you that might have some meaning
on this special occasion.
There are some which, I believe, could be useful to you as you go forward
as health care providers, researchers, and citizens.Lessons that I am confident
will contribute to better health for women . and also, better health for men.
I have been lucky. I've been able to spend my time working to advance the
health and status of women with an extended and diverse community: the women's
health movement.
I can visualize my colleagues standing here with me this evening. And I see
th is award being given to me as really an award for our collective work.
Like most social movements, the women's health movement has given voice to
those who are often marginalized by society and given limited, if any, decision
making power in setting health policies and priorities.
It rose out of, and with, the broader women's movement-- with shared critiques
and dissatisfactions. It was a growing rejection of the narrow and unequal
social roles forced on women, roles that undermined our social as well as health
status. We were very concerned about a health care system that did not ---
and still, often, does not --- take women into account. We were frustrated
as recipients of care and as those who worked providing care.
We -- and we used the word "we" intentionally to ensure we maintained a commitment
to equity, and to resist thinking that some of us were more "expert" than others,
-- we came together to share experiences and knowledge. We looked at our cervixes,
fitted diaphragms, fought for home care and "caught" babies.
We shared stories about our interactions with the medical system. And we started
asking questions.
We came to understand that knowledge was power -- and sought to get our experiences
counted as knowledge. We realized that those who formulated the research questions
controlled the answers. And so, initiated our own research. about the problems
that concerned us most.
Through discussion and debate, we developed new approaches to health care
services, approaches that would not over-medicalize our health and well-being.
For example, we looked at the high use of tranquilizers and mood elevators
and realized that we were not "mad," but we were angry; angry that the impact
of poverty, violence and racism on our health was ignored. Angry because much
of the focus on our health was because we were seen as "containers" for developing
fetuses or because we were seen as the (unpaid) agents to provide health information
and care within our families and communities.
We understood that access to reproductive health care was critical to the
equality and human rights of women.
We were frustrated that normal events in our lives, like birth and menopause,
were reduced to abnormalities requiring interventions.
In short, we understood that women's health is a political, social and economic
matter and, to quote Sharon Batt, a longtime breast cancer activist, we would
be "Patient No More."
When I think of some of the projects with which I am currently involved ---
preserving and enhancing medicare, organizing public involvement in decisions
about the safety of breast implants, advocating for access to midwifery or
birth centres, and drawing on the work of colleagues in Quebec to implement
anti poverty legislation; a couple of themes emerge.
One is about the need for changes in the relationships between health care
providers and their clients/patients and the other is related to the role that
we as health professionals can play within our democracy.
On the wall of my office is a quote from a woman who participated in an endometriosis
support group I facilitated years ago. "The more I know, the fewer doctors
I can talk to", she said.
What did she mean by this?
Several things, I think.
- That she had had to become an expert in her own health issues;
- that she was not prepared to blindly accept the information or
treatments suggested to her; and
- that , by asking questions and questioning
the status quo , she created tensions between her and her
health care providers -- to the point that, at times, her
providers began to see her, . and patients like her, as "bad
patients" to whom they did not want to provide care.
She already knew that we need to rethink how we structure care. That new approaches
are called for, ones that:
- engage our patients/clients much more directly in the design
of, and control of, health care delivery services;
- that encourage innovative services models;
- that are based on multidisciplinary teams of providers with professionals
and para-professionals working together
- that engage citizens in the development and synthesis of research
and last but not least,
- that provide for new collaborative and equal relationships between
health care providers and the citizens we serve.
Health Care providers have a long history of contributing to advancing healthy
public policy -- safe water and waste management, nutrition programs, the value
of good hand washing and tobacco control, to name but a few examples.
We have always been advocates for public health.
I believe there is now, a critical leadership role for all of us to promote
the understanding that health is, in many ways, a
product of or one could say a "side effect" of, public policy, and not just
of personal behavior.
Health care providers have always understood intuitively that poverty is hazardous
to health --- not only for those living in poverty but to the health of everyone.
We urgently need to help the rest of society understand this relationship
-- that social exclusion and inequities in income affects the health of all.
It will take time, but is no less challenging I think, than explaining the
germ theory or the relationship between smoking, depression and heart disease.
And so, I urge you to get involved, get involved in minimum wage reviews, demands
for supportive housing programs, reviews of the tax structure and other public
policy debates that affect health. If we fail to reduce poverty and social
inequality in our society, we will never fully be able to protect or improve
the health of women - or men.
In closing, I would like to take a moment to say thank you.to
my mom and dad, who were willing to love and support a daughter who angrily
rebelled without necessarily knowing against what; to my children, Cary and
Kay, who grew up thinking that "going to meetings" was
a job description; and, to my life's companion, Victor, who has always supported
me and my work - including its late nights and chaotic schedule over the past
thirty years.
I offer a very special thank you to the boards and staff of the Women's Health
Clinic in Winnipeg and of the Canadian Women's Health Network who have given
me the opportunity to work with an nurturing creative environment, and to the
funders of these organizations who saw the importance of our work.
I have had wonderful teachers - early mentors in my training as a nurse at
the Vancouver General Hospital, and, of course, the women, women who were
prepared to take action and speak up.
All of us can learn - and learn richly and deeply, -- from the critical voices
working on the margins of society. Remember. "First do no harm" and that compassion
and empathy are critical skills for the work that awaits you. Seek joy. And,
have the courage to challenge assumptions and to make a real difference.
Thank you once again for
this great honour. Congratulations and good luck to us all as we begin the
next chapters in our lives.
Posted: July 2005
