Hesperian Health Guides

Hesperian Health Guides

Working for Change

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HealthWiki > Where Women Have No Doctor > Chapter 3: The Medical System > Working for Change


Millions of people throughout the world suffer and die from illnesses that could have been prevented or treated if they had access to good medical care. And even where health services do exist, there are many barriers that keep women, especially poor women, from using them.

But together, health workers and groups of women can change the medical system. They can make it a resource— rather than a barrier—for women as they try to solve their health problems. The medical system will not change on its own, though. It will change only when people demand it, and when they offer creative ways to bring the health care that people need within the reach of all.

A good place to begin changing the medical system is by discussing the health care problems that affect people in your community—including lack of access to good care—with other women and men.


a group of women with small children, sitting on a bench and talking
I live very far away. If there were a health worker close by, it would save my family the 2 weeks' wages I spend every time I have to come.
I wish they didn't run out of family planning supplies. I got pregnant last year because the clinic ran out, and I can't afford to buy a lot all at once when they do have them.
These city doctors look down on us. I would feel better if people from the village helped run the clinic.
I wish they could give us Pap tests here. I've heard they are important, but I can't afford to go to the city.
I want there to be separate rooms where we could be examined without everyone listening.
I don't like having a man examine me. I wish there were women health workers.
I would like the clinic to be open in the evenings, after I have finished my work.
I wish they explained what was wrong. This is the 4th time this year I've had pain when I passed urine. Why does this keep happening?
There is always such a long wait. If someone asked right away what each person needed then the really sick people could be treated sooner.



Women can also work together to:

  • help every member of the community to learn about women’s health problems. For example, you can organize a campaign to explain how important it is that women get good prenatal care. If women and their families know about women’s health needs, women will be more likely to use the health services that already exist. They will also be more likely to demand that new ones—such as better treatment and screening for cervical and breast cancer—be made available.
three women putting up a sign that invites women to get prenatal care
  • see how existing health resources can be improved. For example, if there is already a community midwife, how can she get training in new skills?
  • find new ways to make health care available. It is important to think about what health services you want to have, and not just what you have now. So, if there is no health worker now, how can one be trained and supported? If there is already a clinic, could it offer new services like workshops or counseling?
  • share the knowledge each woman has about health care. Women already do much of the ‘health work’ in the community. For example, it is usually women who care for the sick, teach children to stay healthy, prepare food, keep the home and community clean and safe, and help other women have babies. Through this work, they have learned many skills that they can use to care for each other and every member of the community.


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