A Healer's Personal Journey in Women's Health
By Ester Rebeca Shapiro Rok
As a Cuban Jewish American woman of Polish and Russian descent, I continue to discover how profoundly politics weaves itself into our intimate psychic life, its compelling poetics entangled with whom we know ourselves to be. The ways that politics became interwoven with our family's fate and my own future, my life belonging to two worlds and therefore at the same time to both and to neither, have become my life's work. I became a clinical psychologist and college professor, a healer and a teacher, writing about how what appears in this society at this time as bounded individual selves are actually evolving conversations designed to help us shoulder--with our ancestors, intimate families, communities and cultures the hard work of living, growing, surviving, thriving, in eternal cycles of life and death.
My life as a woman between cultures has not been easy as I have sought, and failed, to find personally acceptable choices among my family's and society's prescriptions for a good daughter, wife, mother, teacher, psychologist, healer. I never stopped believing in my Cuban childhood's dream of a more just world in which health, education and economic justice are fundamental human rights. I have shifted my clinical practice to community-based health promotion that connects our personal struggles to the unjust distribution of resources necessary for health, and recognizes the value of joining others to transform our lives and communities. I have found that sharing the lessons gleaned from my own profoundly human struggle is itself one of my most powerful resources as a teacher and healer.
Most recently, I have had the privilege of working on the Spanish language translation and cultural adaptation of Our Bodies, Ourselves. The ground breaking women's health information resource book, first published in 1970 and currently in its 7th edition, has sold millions of copies in the United States and has been translated or adapted into 19 languages. A source of health information, Our Bodies, Ourselves (OBOS) also presents women's personal experiences of struggle and success as the foundation for a feminist critique of health system practices. Women have found the book both a valuable tool for personal transformation, and a catalyst mobilizing political action in critical areas such as reproductive health and rights, social and domestic violence, gender role and economic justice.
Typically, OBOS has been translated by groups of women's health activists working in their own countries. The approaches to translation have ranged from direct textual versions to those "inspired by" or "based on" OBOS that rewrite the text to better address women's experiences in diverse cultural and sociopolitical contexts. The Boston Women's Health Book Collective had translated the 1972 OBOS edition into Spanish, selling more than 50,000 copies at home and abroad. Yet many of us who appreciated the great value of the first Spanish translation saw a compelling need for a cultural adaptation addressing enormous differences at the interface of culture and gender where most of us live and love. I had been deeply influenced by the North American feminist movement during my desperate adolescent struggle to create a life outside the constraining values of my Cuban Jewish Miami upbringing. I also shared with many professional Latinas a tension between demands of our careers and enduring loyalty to our primary caretaking responsibilities within extended families. What might it take to go beyond words to the images and ideas capable of inspiring and sustaining personal transformation and social change? The work of cultural adaptation had been made even more of a challenge by the enormous growth in health information as the book expanded to 800 pages in the 1990s.
Although Latin American feminist groups collaborating with BWHBC believed in the dire necessity for an updated Spanish edition, none of the groups had the resources to do the work alone. They agreed to work with a Boston based editorial group of Latinas to adapt translated chapters. In 1993, they asked me to offer ideas for cultural adaptation; I suggested Paolo Freire's participatory education as an approach that could shift the book's emphasis toward participatory methodologiesand collaborative learning. Both as teacher and therapist, I was increasingly turning to Freire's work as a model of mutual learning linking personal reflection, consciousness of social injustice, and action for social change. I had been delighted to learn that Paolo's work, so necessary for a social democracy, had been banned by both the right and the left. Thanks to Donaldo Macedo, Paolo's translator/collaborator and my colleague at Umass Boston, I had the opportunity to learn from Paolo and cook him a dinner of his favorite Cuban roast pork and black beans before his death in May 1997.
I was aware of the enormous sacrifices in personal prestige and sources of self-regard required by true collaborative learning you give up the expert's power to silence the more vulnerable partner, expose the vulnerability of your own learning. As often happens to me, the clarity of ideas came first and the profound, destabilizing personal learning necessary to make the work possible inevitably followed. Let me give you one example: I speak fluent home-cooked Cuban-inflected Spanish, but read little in Spanish and write even less. When I first started to read our translated chapters and the resource materials in the BWHBC library, I felt confused and deeply ashamed. Arriving in Miami in 1960, I was placed in a classroom for the mentally retarded so I could learn English efficiently. At the same time, I was diagnosed with hypothyroid disease: for at least a year I had become depressed, slow and sluggish. My family failed to recognize my illness until my physically vain Abuela Adela noticed my goiter and insisted I see a doctor upon arriving in Miami. I was placed on thyroid medication, but my parents were told to closely observe me for signs of retardation. Over the years I found, beneath my quick mind and capacious intellect, a deep terror of not knowing. With my commitment to Nuestros Cuerpos, I was forced to endure my panic and shame as I struggled to understand Latin American and Caribbean women's health movement texts, to express myself in written Spanish, to face that I could not write a single grammatically correct sentence in Spanish. My Spanish literacy has vastly improved, and paved the way for a far deeper knowledge of counterpoint and convergence between my public, adult, professional life in English and my private, intimate family life in Spanish. But these were excruciating if ultimately exhilirating lessons, and I can sympathize with my desire to avoid them at all costs.
Beginning in 1994, translated chapters were sent to 20 women's health organizations in the region for revisions. Veronica Nielsen Vilars, an experienced medical translator, edited each chapter word by word so as to give the book an inviting, accessible voice (to see more about the book, our editorial team and Latin American collaborators, and ordering information, please visit http://www.ourbodiesourselves.org ). We worked closely with Taller Salud in Puerto Rico, and consulted with Isis International in Chile, who runs the Latin American Women's Health Information Center and makes their data base and documents available; CIDHAL in Cuernavaca, Mexico; Red de Salud in Chile, who publishes a quarterly women's health magazine and maintains a data base of regional organizations; and CIDEM in Bolivia, the coordinators of the Latin American abortion legalization campaign.
Nuestros Cuerpos Nuestras Vidas (New York: Seven Stories Press and Madrid: Debate 2000) re-organized the book at multiple levels, changing about half the text. The changes begin with the very different implications of the title, as Nuestros Cuerpos, Nuestras Vidas/Our Bodies, Our Lives communicates the importance of our relationships of mutuality and interdependence in promoting good health. Throughout the book, the word self-help has been translated as "mutual help"; no one takes care of themselves by themselves. We carefully crafted new introductions to create an inviting space and supportive voice introducing the reader to the major themes in each section. We wanted women to hear the message in as inspiring and evocative a way as possible that our good health begins with us, with our wisdom, our relationships and our communities. Social support and adequate resources are essential to taking individual initiative in our lives. Under conditions of social injustice, action for social change is necessary for our health. Consistent with the strong ethics of mutual care in our communities, we emphasized that we cannot take good care of others without also caring for ourselves.
We also changed the order and conceptual organization of key chapters. The book now begins with the chapters in Saber es Poder/Knowledge is Power (located in the English version at the end of the book). We begin with an international, women's health and human rights approach using the WHO definition of health as well-being connected to our human rights. We described the problems that the world's women face as we become increasingly responsible for paid employment outside the home while being a primary caretaker. Education, sanitation, work conditions, social support, adequate food and shelter, exercise, and other quality of life experiences determine a far larger part of our health and well-being than any contact with the health system. The section on organizing for change includes a statement by Catholics for Free Choice, and we use the language of women's sacred responsibility for life to affirm our need for sovereignty in reproductive choice. The Traditional Medicine chapter now introduces the second section of the book, "Cuidandonos/Taking care of ourselves", recognizing the importance of religion and spirituality as sources of healing, community bonding, and political change.
Latin American feminism has its own culturally informed political strategies, and we learned a great deal from their characteristic emphasis on women's health and citizenship rights, their organized resource networks and collaborative campaigns, and the participatory practice methodologies. The final product is a dynamic, three way trialogue/trialogo between U.S. English speaking women, U.S. Latinas and Latin American women which encourages the readers to participate in completing a personally meaningful and culturally appropriate text. Initial responses from our Latin American and Caribbean collaborators, a growing network of readers, and media reviewers, suggest that we indeed succeeded in producing a text which truly speaks to some profound cultural differences in the lives of Latin American women, wherever in the world we find ourselves living, while preserving the health information, political inspiration, and stories of women's struggles and strengths which inspired a revolution. As I've traveled with Nuestros Cuerpos Nuestras Vidas and have spoken to groups all over the U.S. and the Caribbean, I've joked that my internalized gringa will never be the same.