FROM BETSY, WHO WAS IN RIO DE JANEIRO
Lessons from the Professional Fellowship on Women’s Health and Leadership
Betsy Garson Neisner
Professional Fellowship on Women’s Health and Leadership
Brazil, 2012 to 2013
The vast majority of women leading small, non-governmental, nonprofit, progressive social service and health care programs come to their roles from the grass roots of social change. They are largely self-taught and self-motivated. They are generally poorly paid and overworked--and gladly choose to accept their economic lot and overburdened workload because they believe in their cause and know that if they do not do it, no other segment of society will. As a result, they rarely have the time (or money) to engage in national or international collaboration or training.
This fellowship brought the intellectual growth and inspiration of academia’s sabbatical programs to a group of women who would never otherwise have sought out or been given the opportunity. I did not know that it was an exchange program when I was asked if Cancer Connection would host several Brazilian women from NGOs devoted to improved breast cancer treatment and advocacy. When offered the chance to travel to Brazil, I was reluctant. Cancer Connection has only three employees, two of whom are part-time. Could I justify spending two weeks away? And what would I learn that could improve my own work?
I have learned that women in Brazil think of universal health care as a gift which they accept passively without question. They need to understand it as an entitlement, a right, and to find new ways within Brazilian culture to demand the best of care, including annual mammograms, breast reconstruction, fully trained professionals, and more equipment so that the time between diagnosis and treatment doesn’t mean the difference between curing Stage I and dying from Stage IV.
I was surprised to find a similar issue for breast cancer patients in this country. Although the American health care system offers far more advanced and timely treatment, patients here are prone to accept the medical opinions they are offered without question, afraid to request second opinions or to challenge their doctors to work with them as a team, rather than as enlightened dictators. Like the Brazilian fellows who shadowed me at Cancer Connection and those who hosted me in Sao Paulo and Rio de Janeiro, we are fundamentally concerned with empowering women both to ask for better resources from their doctors and to demand that the system, governmental or private, respond to the needs of women with breast cancer and save lives.
In both our countries, change requires the concerted energy of the group, and individual groups need to coalesce to provide a groundswell for change. To have influence on the larger system, you need to create an army of individuals who can influence the centers of power and money, because both are needed for change.
I learned from my Brazilian colleagues new ways to celebrate the power of the group. One of the most powerful learning experiences of my stay was a rally organized by the Pink Ribbon Foundation in a “pacified community” (slum neighborhood) to educated women about breast cancer. This small gathering took on the gaiety of a block party with “people’s music” – samba - spreading the word outward from the core of the neighborhood, educating and countering misinformation, fostering discussion, welcoming questions. To have influence on the larger system, you need to create an army of individuals who can influence the centers of power and money, because both are needed for change. Through this one pink-balloon rally, samba dancing and social interaction, I saw survivors, families, neighborhoods and political communities merging to maximize the opportunities for education and political change.
I will continue to work with the women I met in Brazil as they bring to fruition the projects they are creating. The lessons I was able to share included ways to lobby legislators for systemic change and to develop and nurture relationships with people in the business community who can provide money, goods and skills to solidify the work of a new program. In addition, I have found a community of women across Massachusetts willing to collaborate with each other to accomplish more than each could do alone.
My recommendation to ITD is to provide the American fellows with a brief overview of the history and economic environment of the new culture they will experience, or at least a reference to a good book on that country. Americans need to avoid the easy trap of comparing a static present in the new country to a static present in the USA. The trajectory of Brazil’s social, cultural, political and economic development is far more important to our learning experience than a cursory comparison of achievements. How steep was the curve of progress? What were the goals for the future? What were considered the important standards to meet and to exceed?
The fellowship was a tremendous learning experience--about Brazil, about women’s health, about leadership strategies, and about transforming our own nonprofits in this country. ITD created a superb program with unlimited potential for future collaboration between Brazil and America and within each country.
