Women and Health at the UN Conferences in the 90's

The broad agenda of the feminist health movement, addressing all aspects of the political economy of ill health and disempowerment of women, narrowed in the Cairo process to an agenda on reproductive health and rights. Whatever the women's health movement had hitherto formulated in terms of ideals and demands related to reproductive health and rights was rephrased and polished to make a crucial intervention in the population agenda, without addressing the overall development agenda with its built-in neo-malthusian frame. It worked, that is to say the official negotiations ended up with a reformulated population control approach with a woman's face. I would call this a remarkable structural adjustment, however within the overall framework of "business as usual". This is all the more dangerous in the economic context of SAP, privatization and the social context of rising woman hatred.

To redirect the earlier demographic orientation of the population control framework, the focus of the movement's advocates on reproductive health and rights was positive. However, a less noted but crucial negative effect was that the attention of policy makers could focus on an anti-natalist scenario in the South, letting them off the hook for the "dis-abling" and deteriorating conditions undermining the regular day to day broad health concerns of women. This contextualization of women's health in terms of poverty and quality of life was, and remains, crucial. As the women's health movement, we may turn again to the excellent Women's Agenda 21, which may be advocated for and implemented locally, bottom up, by broad critical and constructive people's alliances.

In retrospect we may say that the UN, and especially the Cairo process in terms of internal women's movement dynamics, shifted attention from broad horizontal work toward a more vertical summit and lobby orientation. While advocacy per se is needed, it is not all there is to the feminist health "project" of the movement. In the building up of lobby momentum, many learned from the exposure to UN level negotiation, but many could not or did not want to be involved, and were not involved. The challenge is to establish and maintain accountability and transparency and to cherish the rich diversity in the movement, especially where and when funding and status goes to (professional) feminists in positions of "experts" in the UN process, official dialoguers and advisors. In this respect tensions and conflicts have risen in the movement: complaints abound about feminist elitism and the growing gap between "ground work" and institutional/lobby work. Differences in view about objectives, strategies and sites of feminist politics easily lead to unilateral or top down decision making and agenda setting by those with power and resources. This results in vicious circles of distrust and silencing of critical or less well groomed voices.

All women's voices should be heard, including those who are marginalized or ridiculed in more mainstream policy making. After all, a feminist transformation project should be broad based, and implemented at local, national and global levels. A movement cannot fly with clipped wings. Therefore we need to face the uncomfortable questions arising from reflecting on the dangers and costs of engagement in the UN process. Is the international women's health movement, which has so strongly and proudly managed to introduce feminist language in the UN Plan of Action, in fact de-radicalizing, that is, literally becoming up-rooted from its erstwhile broad base and domesticated in the house of the World Order? What can we learn from the costs and setbacks in order to invigorate the critical and constructive feminist quest for women's health and well-being in an overall sustainable, democratic, humane and equitable development framework?

Loes Keysers
Reproductive Rights activist, member of Women's Global Network for Reproductive Rights. Actively involved in the internal women's health and right's movements' debates and strategies towards, in and beyond Cairo. Lecturer at the Institute of Social Studies, The Hague, the Netherlands in Programs on Women, Population and Development. Research on the shaping of action field of fertility control in the decade 1984-1994 from the perspective of women organizing for reproductive rights.