BOSCOE, Madeline



Veuillez noter que les discours sont publiés dans la langue dans laquelle ils ont été présentés.

Members of the University of Ottawa’s academic community-- fellow graduates, family members, and invited guests.  I am privileged to be here with you today.

I have many people to thank: my mom and dad, who were willing to love and support a daughter who angrily rebelled without necessarily knowing against what; my children, Cary and Kay, who grew up thinking that “going to meetings” was a job description; and my life’s companion, Victor, who has always supported me and my work – including its late nights and chaotic schedule.
I offer a 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 do this work with a nurturing environment, and to the funders of these organizations who saw the importance of this work.

I have had wonderful teachers – early mentors in my training as a nurse at the Vancouver General Hospital, members of the Vancouver Women’s Health Collective, public health nurses, and, of course, women who were not prepared to silently accept that with which they were not satisfied.

J’ai eu de la chance. J’ai pu travailler à l’amélioration de la santé et de la condition des femmes avec une communauté étendue et diverse – le mouvement pour la santé des femmes.
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 this award being given to me as an award for our collective work.

The women’s health movement arose out of, and with, the broader women’s movement of the 1960s, and shared many of its critiques and dissatisfactions. It was a growing rejection of the narrow and unequal social roles forced on women, roles that undermined our health status, as well as a response to a health care system that did not take women into account.   The women’s health movement brought together women who were dissatisfied with the care they received, researchers wanting to learn more about the risks to women’s health, support networks, health providers, and many others.  Like most social movements, it has given voice to those who are often marginalized by society and given limited, if any, decision making power in setting health policies. 
 We -- and we used the word “we” intentionally to ensure we maintained a commitment to equality and 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, helped get each other off mood-altering drugs, and “caught” babies.

We shared stories about our interactions with the medical system. We started asking questions. We understood that knowledge was power and sought information we could understand and use – and to get our experiences counted as knowledge. We realized how medical information needed to be accessible to all, and began the necessary “translations.”  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, debate and sharing, we developed new approaches to health services and health care, 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 about the absence of policies to reconcile our paid work and our home lives.  Angry because our health issues counted mostly because we were “containers” for developing fetuses or because we were seen as  (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 our normal experiences, such as birth and menopause, were reduced to abnormalities requiring interventions. We recognized the impact of violence and racism on our health and wanted others to do so, too. 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 “No Longer Patient.”

Depuis que j’ai appris que je recevrais cet hommage, je me demande quelles pourraient être les réflexions et les leçons que je pourrais partager avec vous qui seraient pertinentes pour cette occasion spéciale. 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 that could be useful to you as you go forward as health care providers, educators, researchers and citizens, lessons that I am confident will contribute to better health for women … and also, better health for men.

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, communicating the environmental issues related to safety of contraceptive and other hormonal patches, advocating for access to midwifery and community hospitals or birth centres, drawing on the work of colleagues in Quebec to implement 
“anti poverty legislation,”  a couple of themes emerge that have broad relevance. One is about the relationships between health care providers and their clients/patients and the other is related to the role health professionals can play within our democracy regarding healthy public policy.

On the wall of my office is a quote from a woman who participated in a support group for endometriosis 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 did not blindly trust or accept the information or health services she was directed to; that she was not provided with services she felt would have been helpful; and that, by asking questions and questioning the status quo, created tensions between her and her health care providers -- to the point that, at times, providers began to see her, and patients like her, as “bad patients” to whom they did not want to provide care.

Learning from this woman’s words suggests we all need to rethink how we structure care.  New relationships are called for, ones that:
•     engage our patients/clients/service users in the design and control of health care delivery systems;
•     encourage innovative services models;
•     create new relationships between provider and patient;
•     engage citizens in the development  and synthesis of research.

De plus, nous devons repenser nos rôles en tant qu’éducatrices sanitaires – même à l’extérieur du travail.  As well, we need to rethink our roles as health educators --- even when we are not at work.  Health Care providers have contributed to advancing public health in areas such as safe water and waste management, nutrition, good hand washing and tobacco control to name but a few examples. We have always contributed to advancing healthy public policy.

I believe there is a critical leadership role for all of us to promote the understanding that health is, in many ways, a product of public policy and not just of personal behavior.

Health care providers have always known intuitively that poverty is hazardous to health --- not only for those living in poverty but to the health of everyone in society -- and research increasingly shows how right we were. We urgently need to help the rest of society – especially our politicians -- understand the relationship between social exclusion, inequities in income and the health of all.  It will take time, but is no less challenging than explaining the germ theory or the relationship between smoking, depression and heart disease.

We should all promote healthy public policy.  And so I urge you to get involved in minimum wage reviews, hearings on pension benefits for unpaid care giving, education programs for, or coalitions working for, supportive housing programs. If we fail to reduce poverty and social inequality in our society, we will never fully promote women’s – or men’s – health.

All of us can learn – and learn richly and deeply, as I have -- from the critical voices working on the margins of society.  Hear them, and remember to “first do no harm” and that compassion and empathy are critical skills for the work that awaits you.  Have the courage to challenge assumptions and to make a real difference.
Merci une fois de plus pour ce magnifique hommage. À nous toutes, je nous dis : félicitations et bonne chance pour les prochains chapitres de notre vie. 
Thank you once again for this great honour. Congratulations and good luck to us all as we begin the next chapters in our lives.

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