Comments in reply to Barbara's "big" questions.

Having been around and around and around this stuff in my own head to the
point of dizziness many times - let me begin by (rather boldly) saying that
I've decided I'm going to try not to use the phrase "health promotion" any
more.  As your questions suggest - this phrase is now being defined and made
operational in so many different ways, for so many different purposes, that
it has begun to mean less and less to me.  Also, in international work with
at least 2 different cultures, I've found it to be an impossible phrase to
translate and achieve any depth of meaning.


I think - the questions you are raising reflect more the question of "can
hierarchical organizations support empowering practice among paid workers?"

(Hope - you weren't expecting an answer.)

Seriously, at my office we've "played around with" concepts of self managed
teams and the like - but with lots of problems.  Let me highlight two
thoughts on this, and I'd enjoy hearing experience of others in this respect:

1. The entire organization has to make the shift - not just one small unit
within.  If the entire climate doesn't change - then there is just added
pressures on the unit that is self managed - and ALL their energy goes to
dealing with that new stress and less energy goes to doing "the work" that
the self-managed in order to better.    Does that mean it might actually be
better (in terms of the community work being done) to have a "powerful"
manager hold back the waters of bureaucracy so to permit staff to get on
with it??   Maybe a hierarchy actually supports empowering practice more?

(I think it would be different if the entire organization changed  but....)


2. We (as paid health professionals) talk often about our own lack of power
in our organizations.  But I think we need to frame this a little better -
what types of power do we think we need that we don't have.  If we work
within  - what I would call - a feminist approach - then power is a
collective ability to accomplish something.  We have that now, and don't use
it.  (Sometimes I think we are too busy navel gazing (can you say collective
cyber navel gazing) about how we need more power, that we don't even "test"
the power we have.



Thanks for the postings Barbara.  I've enjoyed your questions.
Theresa Schumilas
Director
Family and Community Resources
Community Health Department
Region of Waterloo

phone:  (519) 883 2254
fax:    (519) 883 2254
email:  [log in to unmask]