The name Curaçao, which incorporates the word ‘cura’ (healing), could create a vision of True Healing for the people of this Caribbean island. The Caribbean Association for Feminist Research and Action is seeking true health for Caribbean women by providing the basis for a comprehensive framework for the advancement of women’s health and the realizing of the basic rights to gender equity.

 

Although the results of a Curaçao Health study in the begin of the 21th century pointed to the necessity of a health policy, that should translate the target of ‘equity in health’ into concrete, tangible objectives, aiming at reducing the disadvantages of women and people with low income, still little was done.

Finally CAFRA Curaçao and LACWHN decided together to invite health care professionals to the Itinerant University (UI) Curaçao on Health Sector Reforms. This post-graduate course took place from June 11th up till 17^th 2006 at the University of the Antillies.

 

The aims of the Itinerant University covered three basic needs:

 

I)            Technical and political knowledge of the causes and phenomena that determine gender inequity and women’s greater vulnerability in health-illness processes, as well as their difficulties in accessing health care services.

 

II)                 The need to incorporate new theoretical- methodological gender frameworks, currently vital to the promotion of equity and human and civic development in both public health policy planning and service management in the health sector.

 

III)              The need to promote feminist leadership to consistently occupying decision-making positions in both government and non-governmental health institutions.

 

The Island Government of Curaçao had agreed to be a partner of the UI, but most of the local professionals, occupying decision-making positions in governmental health institutions, didn’t show much interest. The teachers of the UI were professionals of the institutes Betesda, GGD, Wit Gele Kruis, Former Minister of Health, Department of Youth Health, Council of Public health, UNA, St.Thuiszorg Banda Abou, Skuchami and Sonrisa Foundation. They presented their thesis on the aims of the UI.

The partners of the UI were the Office of Women’s Affairs, Naskho, UNA, Foundation Banda Bou and the Deputy of Health Care. These partners had agreed to jointly and or separately take action for the implementation of the recommendations and resolutions as outcome of The Curaçao IU 2006. But the Government still has not fully complied with the agreement of the UI.

So CAFRA Curacao decided, in spite of the lack of sustain from the government, to start with the follow-up of the UI. The strategy was chosen to take only the mental health sector as focus point.

 

 

The Teacher of the governmental institute for Mental Health Therapeutic Service SKUCHAMI was the only one who dared to recommend feministic therapy during the UI course. Skuchami gives consultation, therapies and training in the mental health area. Her clients are individuals, families, groups, organizations and ngo’s. They have local branches in every district. The therapeutic service was asked to look into their mental health organization for possibilities to implement the recommendations and resolutions of The Curaçao IU 2006.

 

A CAFRA-member, who works for the non-governmental recreational and educational Mental Health Activity Centre Foundation SONRISA, was also asked to give sustain. Sonrisa is a partner of Skuchami, because she has the clients of Skuchami. They visit the Centre with the intention to enable their resocialization through participating in a variety of activities. Sonrisa offers support based on a methodic agogical approach.

 

Skuchami and Cafra/Sonrisa met during 15 meetings to discuss the possibilities of implementation of the gender perspective in governmental and non-governmental mental health organizations. Later they were joined by the former Minister of Health and Social Development of the Netherlands Antilles.

The three had the consensus of opinion that until the UI 2006 theoretical discussions on the difference in female and male socialization were essentially non-existent in mental health. They were convinced that it would be possible and necessary to implement the gender perspective in mental health work. Doing so would disclose publicly the inequity of distribution of power in family and society between men and woman on Curaçao.

 

 

While analyzing the mental health issues of Curaçao women, it was found that gender implementations in Mental Health organizations are hindered by the following issues:

 

·        The Government of Curaçao has still no mental health policy and thus there is not a real notion of creating a gender-related mental health policy based on research.

 

·        The governmental Office for Women’s Affairs have made a leap to develop a gender policy for 2007 but has no base of gender researches or gender information about gender perspectives on Curaçao.

 

·        One archaeological anthropologist of Curacao informs her students theoretically about gender issues in her reader Cultural and Anthropology. She examined once the gender roles on Curaçao between 1917 and 1921, when 50 percent males worked in the cane-fields of Cuba. There is no sufficient base of gender researches in health on Curaçao to sustain her work with students, by which she can put (mental) health in a psychosocial context. She states that academic discussions on gender roles tend to borrow frames of analysis conceived in other cultures and fail to provide visions from our own historical experience. Standard analyses of Curacao have relied on written documents, which portrayed women as helpless, irrelevant and with little effect on society. The female self-awareness has been influenced by conventional history and socialization.

 

·        Family therapists work with the method of R. Kanter, which has several weak

points, when we have a gender perspective in mind. First it does not create 

circular power contribution within the family, because it is neutral and

complementary. A complementary systemic concept does not take the permanent disadvantaged position of women, caused by their socialization, in account. A neutral position of the therapist suggests that family members are equal to blame. But who remains silent about the disempowerment of women within the family consolidates the unequal distribution of power in the family.

 

·        Skuchami experience concludes that people in management and in their families suffer from attention disorders.

 

·        Poor intellectual ability of a people causes motivation problems within their society and thus little desire for broad research. For the wellbeing of the people it is necessary to unite intellectual abilities and emotional experience. Only in this way there can be an insight into illness and moral sense.

 

·        Therapists do not know much about gender and even have reluctance towards integrating a gender perspective within their work. They often base themselves on a hierarchical christian ideology, that resembles pastoral assistance.

 

·        If the constant instinct of a people has become an imposed hierarchical christian ideology, it is difficult to stimulate cultural roots into the future. In Curacao there is no blending of afro/christian cultures, which could form pubic standards, as is the case in other Latin American societies. The cultural roots are buried so deep, that they can not become standards, nor they can be made functional in the community of the present day.

 

·        Further most adults often deny their own reality (and especially the gender reality), which results in an apathetic nation that seems to have an inability to ask for more education and self-development.

 

·        An Antillean psychologist wrote a book about the envy of Dutch Antillean people (Curaçao is part of the Dutch Antilles). Our people suffer of a pathological jealousy, which is based on a distorted Self image. This has its roots in a not equivalent communicational behavior like disqualifying others by gossip. Such behavior results in fear to review, a disability to give constructive critique, egoistic attitude, and pathological greed. These behaviors also influence the cooperation between different organizations for women’s issues. They seldom can agree on working together and give their support to act in concert to help create a gender policy.

 

To confront these obstacles mental health therapists and assistances will need to be educated towards the possibilities of a gender approach within their work. This will mean that we need to start introducing gender sensitive diagnostic and treatment instrument, interventions and activities within mental health services. We think here of Feminist Family Therapy as Carter, Silverstein, Papp and Walters have promoted. It is recommendable, with sustain of LACHWN, to join hands with the Family Institute of Westchester in the USA, where they interweave gender sensitivity into all aspects of training. Feminist interventions are intended to reduce the power differential between the counselor and the therapist and to build egalitarian therapeutic relationships.

 

Trainings for therapist of Curacao could involve interventions like: 

-bibliotherapy: reading and processing literature that help the client understand the societal influences that impact her personal experiences;

-consciousness-raising therapy groups: a group that discusses their female personal gender-role experiences, which offers them a supportive forum in which they may process the commonalities in women’s lives and see the association between their experiences and socio-political structure;

-reframing techniques: considering the socio-political and cultural contributions to clients’ presenting issues, the therapist shifts the etiologic of the problem from the individual to the external environment. This reduces the possibility of blaming the victim;

-relabeling techniques: in these interventions a client’s response to sexism is relabelled as a positive coping strategy. And ‘feminine’ characteristics are revalued through a feminist lens instead of devalued through an androcentric lens. Valuing the client’s perspective as a woman, many of their perceived weaknesses are relabelled as strengths and their “symptoms” as normal coping reactions to an oppressive society;

-therapy-demystifying strategies: the therapist attempt to demystify the therapeutic process by educating clients about the counseling interventions to be used, by collaboratively evaluating the therapeutic relationship and progress in therapy;

-assertive communications skills in counseling: the therapist teaches the client relevant skills for use in therapy and other relationships. The counseling interventions seek to empower the women and try to mobilize the client’s personal and collective resources to effect individual, interpersonal and socio-political change.*

Our next LACHWN course could be especially focusing on adapting the gender perspective within our ‘intake’ instruments, while basing them on the three core principles of feminist therapy: a) the personal is political; b)belief in egalitarian relationships; c) understanding and appreciating female perspectives, values and skills.

 

Also we need to learn how to bring the gender perspective into daily life of our people with the help of services working in the districts, culture centers and families. Our Institute for Women’s Affairs, Department for Culture and Human Development and our House of Culture could become research partners and help Cafra and LACHWN to form a gender policy and to get it on the political agenda. These research projects should not only gather information about the socialization of women, men and the impact of hierarchal christian ideologies for a community and gender related mental illnesses. But they also should research the effects of the implementations of gender sensitive programs and the effects of gender sensitivity on power distribution and sexual behavior within our families.

 

But before we will start further LACHWN courses, researches and reforms it is planned to present the UI conclusions of all Health Services in the form of a presentation for the Government and the National Board for Public Health. This way we want to motivate them to collaborate mutually so we can fulfill the objectives of our IU Collaboration Agreement and create True Curaçao Health.

 

 

Mrs.Velma R.A. Solomons

Secretary UI Curaçao