Like Water on a Stone - Women's Health Movement: Ways of Organizing and Prospects for the Future

Author(s): Lilián Abracinskas
Date Published: July 20, 2006
Source: Presentation at the 8th International Women and Health Meeting, Rio de Janeiro, March 1997


It is important for me to place where I'm coming from in this presentation, that is, as an activist for more than 15 years in the women's movement and in the feminist movement in Uruguay, Latin America and the Caribbean. It is my intention to try and enumerate what could be articulated as the accomplishments, difficulties, risks and prospects that, as politically engaged women working within the women's health movement, we have had, currently have, and must confront in the future as a movement.

If I had to articulate concisely how the feminist movement has affected me, I would say it is a way of life, a deep knowledge of one's self, and the deep conviction that this path in itself is an agent of change. What seduced me since the beginning was the very intense relationship and the challenge of living myself what I was proposing; to change myself, to parallel my experience with what I read, to articulate what was happening to me and to walk the talk. None of the other political parties, unions or social organizations with which I had been involved in Uruguay made this principle an almost indispensable part of putting theory into practice.

That was how I entered into the world of "women's issues" and I entered through what was, in my opinion, one of its most provocative and stirring doors: health and sexuality. In 1984, I participated as a representative of the group María Abella in "Women and Health", an inter-cultural exchange organized by Isis-Wicce. I had the invaluable opportunity to be trained in Alternative Sexual and Reproductive Health Care at the Dispensaire de Femmes in Geneva, later called Rosa Canina. Unfortunately, it closed its doors in 1995 . (Losses such as these we should contemplate and evaluate). This training gave fruit to various Casas de la Mujer (Women's Houses) or Colectivos de Salud (Health Collectives) that were created, for example, in Sao Paulo and Canelones (Uruguay).


Perhaps this is why I consider that one of the most valuable accomplishments that we have earned as a women's health movement is that of having reclaimed ourselves and having generated a body of knowledge about ourselves; to develop and disseminate knowledge through training and information. Our major successes have included educating women, generating spaces and developing our own practice. Only a few examples of this world-wide, years-long undertaking are the Health Centers, dispensaries and Women's Houses that have been created in many countries; the Boston Women's Health Book Collective and their invaluable book, Our Bodies, Our Selves; the regional, national and international networks; the research centers; the world gatherings; the national gatherings; the infinite meetings and seminars, the diversity of specialized publications and the victorious campaigns.

To attain the knowledge and to give it a political dimension and perspective. I would like to emphasize this aspect because as I understand it, it is one of the main axes for strengthening and developing prospects for the future. The acquired knowledge was not and is not "objective" knowledge in terms of traditional science. Rather, it is just the opposite: it has been and should continue to be a knowledge highly engaged in a political project aiming to reach one of the feminist utopias: to have power over our own bodies (the power of knowing them, of enjoying them, of protecting them and of deciding how to live them) and to grant and defend the right of all women to exercise that power.

Now, I do have some concerns that I would like to share with you when I think of all the existing ways of organizing, of the path traveled, of the successes, the accomplishments, the risks, the difficulties and the multiplicity of practices and political visions that coexist within the movement.


I want to cluster some of the problems we are confronting in two broad categories:

A) Those which concern our own ways of organizing internally.
B) Those which concern our connections with spaces "outside the movement."

A) With regards to our ways of organizing, I would like to start by addressing the provision of services.

1. A lot of the alternative services were set up, at least in Latin America, with the purpose of creating our own models of health care which would propel political actions in order to make demands and effect change. They confront various challenges. For example:

a) The increased demand for health services. In a neoliberal political juncture of structural adjustments the results have been: impoverishment of the general population and especially the female population, budget cuts in social services and privatization of services . The women's health centers have become, in many contexts, the only resort for obtaining health services. On the one hand, we could measure this as a success; on the other, the centers run the risk of becoming generic health centers, anxious to respond to the demands and urgent needs of women and, in some ways, becoming a substitute for the responsibility of the state, therefore losing their potential for political action.

b) In this practice of trying to meet the demand , these services can lose, in addition, something that is crucial to their existence: the link and relation that must exist between THEORY-PRACTICE and REALITY.

Let me offer an example: when I came back from the training at the Dispensaire de Femmes in Geneva, I returned excited to transmit to other women what I had learned because it had changed my life. We conducted a group training and began to offer services: we were putting into PRACTICE what we had learned in THEORY. Then we had to confront REALITY, and some of our good ideas and intentions that were shared with women couldn't be put into practice due to the limitations of reality. It was indispensable to relate our practice of providing services with the work of political and social change to generate the necessary conditions in which our ideas could take root.

To put into practice, then, the tenets and conceptions of feminist women's health care, to nourish the theory from the very concrete practice of the multiple realities of real women, involves respecting those diverse realities. We cannot afford to smother, to be self-righteous, omnipotent, the sole owners of the truth and the knowers of what is best for women because THESE WOMEN ALSO EXIST. We should take into account that we could easily fall into being "fundamentalist feminists". And we should keep in our services the potential for political transformation.

c) The stress due to budget cuts or, in other cases, the conditions imposed by sponsors can alter and put at risk the initial objectives of the centers, services or women's alternative health care houses. Yet it is worth noting that this is a problem that concerns many organizing arenas in the women's movement and it is a problem that, in my opinion, has not been discussed enough collectively.

2) In this sense I would like to point out the NETWORKS as another organizing principle inherent in our movement. When we talk about networking we express the need to exchange experiences, to know each other and not to act in isolation, a principle that I believe needs to prevail in our future strategies. But it is necessary that we engage today in a deep conversation to address how the different networks are functioning effectively, and whether they are accomplishing their objective of strengthening the women's movement. Let us recognize that today we have different models of networking, some that are economically strong, some that are not. Many times we are competing for funding, for the exclusiveness of the theme or emphasis, for making our political position prevail. Finally, [some networks have] different structures that at times facilitate a democratic discussion about their functioning and at times don't.

I believe that the movement, in general terms, must be discussed and our practice must be revised in depth, because it is not to be taken lightly that we have internalized the millenniums of patriarchal culture in our history. It is only recently that we have attempted to construct new ways of relating to one another and with society as a whole.

B) In regards to the difficulties with the exterior world, I would like to focus on our relationship to the worldwide conferences and the action plans that have been derived from them. First I would like to thank and recognize Roxana Vazquez' point in her presentation that the action plans are political agreements signed by governments that are not legally binding like the agreements resulting from the conventions. Second, these agreements are JUST ANOTHER TOOL, an important one, no doubt, which we use within the movement, yet they are not our agenda. Further,

1) The agreements and action plans resulting from summits, worldwide conferences and the different programs that gestate from international organizations, recognize women's organizations (NGOs, mainly) as representatives of civil society with which to converse . This is not a gift or a concession, it is the fruit of the wrestling and pressure exerted by different women's organizations worldwide. Without reviewing the different points of view regarding our participation in the United Nation's agenda, I would like to introduce the following in the debate:

a) The role or place we should have -as members of the health and feminist movement and women's movement in general- in terms of the implementation of the mentioned action plans and programs.

Should women's organizations be tools for the application of those programs, becoming the "implementing hands" and therefore should they be the main recipients of resources to make them happen?

Should women's organizations also be the supervisors, the ones making sure that agreements are honored in women's best interest, denouncing abuses and unfulfilled agreements due to other interests?

Can they be both the implementing force and the supervisors?

b) The effort with regards to the fulfillment of agreements.

Should the efforts be aimed towards the improvement of women's life conditions in any possible way? In addition, should the efforts entail the guaranteeing and strengthening of the health movement, its connection to other arenas of the women's movement and its relation to other movements and social sectors?
If this is the choice, have we found the mechanisms to be able to effectively strengthen our movement?

Some experiences seem to have indicated that it is indeed possible to come to certain agreements and to work jointly with certain sectors. However, we should be realistic that even in the best cases, many of our struggles (abortion, lesbianism, family structure) fall outside the margins of those agreements, and we can count solely on our own strength to defend them. That is why it is crucial to have a strong movement holding up our demands.

c) With regards to our human resources:
How can we include the accumulated knowledge and the women who have been trained for years (and who want to participate) in the sharing of experiences and the drafting of national or regional policies? How can groups and organizations participate in the implementation of better services? How can we make the possibility of participation in international organizations an option?
How can we do all of the above without falling into traps of other logics, without losing touch with the movement, without inducing fractures, isolation or weakening? How do we do it without losing the trust? And most importantly, how do we do it so that each choice that we make reinforces and strengthens the movement?

"The transferring of information to the movement or group, (would be) the minimum measure of accountability; it would allow women's groups to fortify their position and to understand the ideas and actions of the agency or institution in question. " Posed by some women at the Women's Global Network for Reproductive Rights members meeting, this could be a viable option. Yet one of our major dilemmas within the movement is that of reestablishing trust again, to have a transparent practice, to be explicit about our objectives and to discuss our differences, because it is important to admit that the whole process of participating in summits and worldwide conferences has fractured, divided and made us confront one another. We owe to each other a candid and frank discussion about our relation to power and power dynamics.

Of course, I do not have the answers to all of the above questions. I still want to continue to try, I still believe in the need to fortify our movement and I have wishes, many intentions and even a few convictions.

I believe we have advanced, we have grown (from this stems one of our dilemmas), we have had an impact on the evidence, in making visible the different problems that constitute the deeply unjust life conditions of women. We have cut into the macro spheres and we now confront the power expressed in the several fundamentalisms.

But I think that it is most important that we have found spaces to penetrate. Like water on a stone, we find holes and fissures where we penetrate and undermine cultural stereotypes. We cannot quantify nor measure exactly the changes that will happen, but patterns of behavior have changed, there has been a destabilization of a patriarchal and hegemonic vision of society. Things have been altered.

Perhaps because of that, our greatest power resides in the searching for the fissures and holes to continue to penetrate and undermine patriarchal power in its different facets. To find our allies in our struggle and to multiply our spaces of impact. But in an action better articulated, we should always remember that one of our primary objectives is that we have a movement of resistance and of strong pressure that will back up the different activities developed within the movement.

A movement that will use in its favor the intentional and well-intentioned knowledge that we learned to generate throughout this time. The political and politicized knowledge that we developed so intelligently should give us the tools to discuss issues from the vantage point of our political differences, to ease our difficulties, to resist the trampling and to give us the power of joint and coordinated action reinforcing our strengths. Thank you.

Lilián Abracinskas is a member and founder of the collective responsible for Cotidiano Mujer (Woman Daily) a feminist communication group from Uruguay; of the editing group Lolapress (International Feminist Magazine) and co-responsible for the Health Center Alternativas (Alternatives) in Montevideo, Uruguay. She was a co-founder of the first center of Women's Alternative Sexual and Reproductive Health Care, La Casa de la Mujer María Abella (the House of the Woman María Abella). Her formal profession is technician in anatomical pathology with a degree in biological sciences. Regarding her alternative feminist training, she is a sexuality counselor, trained in sexuality, contraceptive use and diaphragm measure.

Address: Rondeau 1578, ap. 202, 11100/ Montevideo Uruguay.

Translated from Spanish by Mariángeles Soto-Díaz