Framing Women's Leadership: From Empowerment to Efficiency

Since the 1980s, notions of women's empowerment and leadership have been key themes in feminist (particularly third world feminist) development practice, emphasising women as active agents of social change and promoting women's empowerment through community organising and transformative action.Footnote ¹⁰ Wieringa recognises the fundamentally political nature of ‘empowerment’ in this context:

Promoting women's leadership was integral to the empowerment approach, and was understood as encouraging women to develop the necessary skills to be leaders in their communities, able to guide, inspire action and mobilise others, with the implicit assumption that good leaders actively promote progress and change.Footnote ¹² The empowerment approach has particularly been associated with participatory approaches to health and health education, and is therefore especially relevant to considering the leadership experiences of women health promoters.

However, despite the ‘feel-good’ nature of the notion of empowerment,Footnote ¹³ it is a concept for which there is no clearly agreed definition. How does someone become empowered? How do you know if someone is empowered? This leaves the concept open to being appropriated in the service of a wide range of agendas in which the idea of empowerment becomes detached from fundamental issues of power relations.Footnote ¹⁴ Reflecting a broader pattern of subsumation of alternative development concepts, potentially transformatory concepts such as leadership, empowerment and participation have been appropriated by multilateral organisations and the mainstream development paradigm as the gender and development agenda has become institutionalised, rendering originally radical and challenging concepts more conformist and mainstream.Footnote ¹⁵ Women's empowerment has come to be conflated with notions of efficiency and entrepreneurship, stressing ‘power to’ and ‘power with’, rather than more feminist and politicised conceptions of empowerment focusing on ‘power from within’.Footnote ¹⁶ The language of ‘empowerment’ is increasingly being employed in mainstream development discourses but de-coupled from its original emphasis on challenging social inequalities and encouraging wider structural change. As Batliwala notes, ‘the sharp political perspective from which it arose [has become] diffused and diluted’.Footnote ¹⁷

As Rowlands also observes, empowerment involves ‘more than participation in decision-making; it must also include the processes that lead people to perceive themselves as able and entitled to make decisions’.Footnote ¹⁸ However, empowerment within a neoliberal model of development re-casts poor people as ‘empowered active citizens capable of formulating their own needs and engaging in the setting of priorities and the implementation of projects’,Footnote ¹⁹ reducing empowerment to the shifting of responsibilities away from the state rather than promoting a collective process of active self-empowerment.

Within this context, Rao and Kelleher highlight a transition away from strategies promoting a leadership style focused on participation, social change and devolution of power that were espoused by feminist activists and popular organisations throughout the 1980s and early 1990s. Women's leadership has instead been reconstructed as an element of ‘best practice’ within the neoliberal paradigm, framed by the requirements of addressing new managerial exigencies such as accountability, efficiency, sound financial management and quantifiable policy results.Footnote ²⁰ Sweetman notes that, in extolling the virtues of women's leadership in achieving development goals, leadership training has become ‘an apolitical strategy favoured by development agencies who have adopted the language of power and politics, while doing little to challenge unequal relationships between women and men, the South and the North, and political elites and grassroots communities’.Footnote ²¹ Thus, while the importance of fomenting grassroots and women leaders is now being widely promoted, the style of leadership that is actually encouraged is much less empowering in its nature. This is reflected in Sweetman's conception of the recent focus on leadership training as an apolitical strategy, often creating a situation of ‘training women to train women to train women to train women’ rather than initiating a transformatory process whereby women leaders are capacitated to actively mobilise for and implement change.Footnote ²² Dolhinow highlights a similar scenario in the settlements along the US–Mexico border, asserting that, despite the physical improvements that are made through women's collective endeavours there, the activism of these women does not produce politicised leaders with an ‘awareness of their marginalisation’.Footnote ²³ Such observations resonate with wider concerns about the depoliticisation of feminism as it has been mainstreamed into development agendas,Footnote ²⁴ and can be directly contrasted with earlier aspirations that women's collective organising would provide a mechanism for enabling widespread social and political change.Footnote ²⁵

These shifting development discourses illustrate the extent to which notions of women's empowerment and leadership are becoming increasingly depoliticised. By ‘depoliticisation’, I refer to the process by which both development concepts and practices become delinked from an engagement with political agendas for social change, and become embedded in broader processes of professionalisation and bureaucratisation of development.Footnote ²⁶ While processes of depoliticisation have been noted in relation to a wide range of development concepts,Footnote ²⁷ this has been particularly prominent in the sphere of gender and development. In this paper I refer specifically to depoliticisation in relation to feminist agendas for gender equity.Footnote ²⁸ These changes provide the backdrop for considering women's leadership in the context of Peru, where it is apparent that a parallel process of broader social depoliticisation has taken place. The rest of this paper analyses how this depoliticisation of grassroots women's activism has shaped evolving leadership practices, emphasising that these changes can only be understood within the local social and political context.

Developing Grassroots Leaders in Lima: Leadership for Change?

Early experiences of grassroots women's community organising in Peru in the 1960s, 1970s and 1980s have become emblematic if slightly well-worn examples, for scholars of both gender and development and social movement studies, of urban Latin American grassroots women's capacity for organising and self-reliance.Footnote ²⁹ These experiences are central to the trajectory of contemporary Peruvian women's organisations, and therefore merit re-examination specifically in relation to the development and experiences of grassroots women leaders, which have received little attention either in the context of Peru or elsewhere.

Women's organising has characterised barriada communities since their earliest days, as the massive growth of low-income urban settlements brought together large concentrations of workers for the first time.Footnote ³⁰ It is from the emergence of clubes de madres (Mothers’ Clubs) in these communities in the late 1960s that a definitive strand of women's grassroots leadership can be traced.Footnote ³¹ The clubes de madres were primarily initiated by political parties as a means of securing the votes and allegiance of neighbourhood women. Their organisation tended to be hierarchical and autocratic, with dirigentas (women leaders) relishing their relative power and influence over women members, granting favours and overseeing the distribution of goods to those they considered allies.Footnote ³² The dirigentas were usually women from the community who were in an economically more secure situation and did not need to work, allowing them to devote their time to organising the club and securing patronage from wealthy individuals and organisations. There was a precarious sense of solidarity in these early experiences, with individualism and collectivism existing side-by-side. Both the dirigentas and their members endeavoured to extract as much personal benefit as possible, in the form of donated goods, food and favours, in the absence of more universal mechanisms of state provisioning.Footnote ³³ As Blondet notes, ‘Precariousness and insecurity reinforce individualism and generate problems and conflicts. Envy grows in the midst of poverty and solidarities are maintained to the extent that they are necessary for survival.’Footnote ³⁴

Despite the clientelistic and top-down nature of the clubes de madres, they played a crucial role in establishing and sustaining barriada communities, and for the first time provided women with a collective space in which to relate to each other outside the confines of their own homes (yet still broadly within the domestic sphere). The emergence of these women from their homes was groundbreaking, challenging a status quo that constructed public space as the preserve of men and laying important groundwork for more transformative women's organising in the future. Towards the end of the 1970s, the comedores populares developed out of the structures of the clubes de madres.Footnote ³⁵ The comedores were variously instigated and supported by the clubes de madres, the government, the Catholic Church (CEAS and Cáritas), the Evangelical Church (SEPAS), the Adventist Church (OFASA) and the international lay organisation CARE.Footnote ³⁶ Barrig notes a lack of coordination by the government of these various programmes, however, resulting in duplication of provision and ‘segmented organizations with different modes of operation’, with the state reproducing practices of asistencialismo (welfarism) through selective support for social organisations on the basis of political allegiances.Footnote ³⁷ Blondet and Montero suggest that in later years this lack of coordination also hampered the development of an articulated political agenda among popular women's organisations.Footnote ³⁸ Nevertheless, the comedores burgeoned throughout the various economic crises of the 1980s and 1990s. By 1996, ‘the transfer of resources between poor women and other poor people [had] virtually replaced the withering social function of the state’, with the participation of an estimated 250,000 women across Lima.Footnote ³⁹ Less autocratic than the clubes de madres, the comedores were bolstered by the involvement of a younger generation of women who brought with them more radical ideas developed through their involvement in popular education centres and parish organisations, and who challenged the autocratic tendencies of the neighbourhood organisations.Footnote ⁴⁰

The women leaders of the comedores emerged as a driving force in their communities, learning skills such as basic accounting, organising meetings, and negotiating with government and donor organisations.Footnote ⁴¹ Barrig asserts that the ‘massive presence’ of the comedores populares ‘has converted the leaders of the comedores into visible public figures whose projection transcends the community setting’.Footnote ⁴² This has had important implications over the years, as will be seen in the next section. However, the success of these popular women leaders began to create a divide between themselves and the women involved with the day-to-day running of the comedores, as the leaders began to engage with a wider network of actors. As Barrig states:

Although they gained certain skills and experience, it appears there was no deliberate knowledge transfer by the dirigentas to other members of the comedores, somewhat undermining the collective nature of the organisations and giving the dirigentas a relative degree of power. Leadership at the grassroots level thus provided possibilities for progress and upward mobility for a few charismatic women, but although such organisations were clearly a leap forward in terms of women's collective emancipation and engagement in a wider sphere beyond their own homes, the leadership paradigm that emerges from examining these formative experiences of community organising still appears to be based on vertical power relationships and clientelism rather than on horizontal, participatory practices. Importantly, in terms of fomenting empowerment and social change through collective organising, towards the end of the 1980s Blondet concluded that:

Blondet recognises that women's participation in collective organising at this time was an attempt to improve their living standards and ensure the survival of their families rather than a militant struggle for social change.Footnote ⁴⁵ However, alongside these instances of women's organising in the barriadas, there also emerged an idealistic generation of middle-class university students and newly qualified young professionals who were committed to working towards progressive social change. Many of these groups of activists began to initiate and get involved in popular education projects in Lima's barriadas in the 1980s, using the radical notions of empowerment and participatory approaches discussed above.Footnote ⁴⁶ They used the clubes de madres and comedores populares to access ready-made groups of women with whom to collaborate, bringing a more politicised agenda into these spaces. The development of women's leadership formed a key element of this emancipatory activism and popular education, reflecting Wieringa's conceptualisation of empowerment.Footnote ⁴⁷ Blondet also notes that by the mid-1980s the comedores were beginning to coordinate with other organisations such as trade unions, neighbourhood organisations and political parties.Footnote ⁴⁸

This politicised context is evident in the creation of the Esperanza NGO by a group of middle-class feminists in 1980. These women began by analysing their own experiences of gendered subordination, but quickly found commonalities with the lives of women from other backgrounds. They developed a proposal to work with popular women's organisations, holding workshops designed to facilitate women's reflection on the gendered oppression that shaped their lives. An agenda for far-reaching social and political change, with an emphasis on gender equity, was at the heart of all Esperanza's interventions, and this was exemplified by their early work with a group of women in Barrio Alegre, some of whom would later become health promoters. When the women from Esperanza first started working in the barriada their methodology was, by their own admission, vague and largely improvised, but they had endless enthusiasm for sharing their ideas with grassroots women:

This quote from Marisol highlights the ‘hands-on’ nature of Esperanza's approach, while also alluding to the subsequent professionalisation and NGO-isation of Esperanza, which frames the shifts outlined below.Footnote ⁴⁹ Esperanza's early workshops emphasised participatory learning in a non-hierarchical environment, focusing on strengthening women's grassroots organisations and promoting change through consciousness-raising workshops that dealt with issues of identity, sexuality, self-esteem, work and community organising.Footnote ⁵⁰ Esperanza recognised the significance of the women who were emerging as community leaders in the 1980s and prioritised the development of their skills as grassroots leaders as a key element for furthering its own feminist agenda.Footnote ⁵¹ Esperanza also recognised that prior involvement in community organising would probably make women more likely to be interested in becoming a health promoter and more suitably skilled to take on the role. Correspondingly, in my interviews with the health promoters, it transpired that the majority of them had previously held a community leadership role.

When Esperanza first started working in Barrio Alegre in 1982, what it was doing was radical and challenging to the status quo. Feminists were viewed with suspicion as sexually liberated women who wanted to dominate men and who encouraged women to leave their husbands:

Health issues provided an entry point for Esperanza's work in Barrio Alegre, as this was seen to be more acceptable and less threatening than an overtly feminist agenda. The NGO took a practical, hands-on approach to its work in Barrio Alegre, forming close and affectionate relationships with the women of the community, who remember these early experiences with great fondness. Over time, the NGO developed a close working relationship with a group of these women, and together they identified reproductive health issues as a particular problem in the community.

Echoing the broader feminist development discourses discussed above, issues of women's empowerment were conceived as having transformative potential and were central to Esperanza's philosophy during the 1970s and 1980s, forming a key part of its politicised agenda. Esperanza explicitly linked its work in Barrio Alegre around sexual and reproductive health to a process of empowerment. One of its basic premises was the use of ‘self-consciousness and information about healthcare as a tool for autonomy and empowerment’.Footnote ⁵² Teaching women about their bodies and basic sexual and reproductive health in a participatory environment formed part of an ongoing process of empowerment, reflecting Hlupekile's notion of empowerment as control – in this case, women gaining control over their own bodies and fertility.Footnote ⁵³ Importantly, this feminist empowerment approach included an emphasis on encouraging grassroots women leaders’ progression and personal development, in contrast with the current, more hegemonic usage of ‘empowerment’ by multilateral organisations, which tends to be more focused on efficiency, entrepreneurship and attaining specific project targets.Footnote ⁵⁴

Traditional forms of organising have been transplanted into and adapted in an urban context through contemporary processes of migration and settlement.Footnote ⁵⁵ The election of community leaders has been a prominent feature of urban settlement, introduced by migrants whose precarious situation implied a need to organise, and who elected dirigentes to represent their local neighbourhood in negotiations at higher-level community assemblies and with governmental officials.Footnote ⁵⁶ While the role of the health promoters is not one of being a dirigenta (although some of them are dirigentas as well), the importance placed by Esperanza on fomenting grassroots leadership in these early days is evidenced in the extent to which the identity and status of all the health promoters is rooted in their community's perception and recognition of them as dynamic and respected líderes (leaders),Footnote ⁵⁷ in the broad social sense of the word:

The concept of a líder is particularly Andean in its origins and is rooted in traditional forms of community organising. To be a community leader traditionally bestows a certain social status on an individual but also carries particular obligations, especially in relation to organising (and funding) community events and fiestas.Footnote ⁵⁸ Building on the struggles and experiences of the clubes de madres and the comedores populares, the Integra project is the latest in a series of women's community organisations that have incrementally challenged how the notion of a líder is constructed. As the women have become accepted and respected in the community for the work they do, they have come to be considered as líderes. To achieve this position of high regard in the community has involved investing a great deal of time and energy, as the health promoters were certainly not viewed in this way when the project first began:Footnote ⁵⁹

Susi's comments remind us of the struggle that grassroots women faced in becoming involved in activism,Footnote ⁶⁰ and illustrate the opposition that the health promoters faced in the community and in their families at this time, when feminism was viewed with suspicion and a culture of machismo was the norm.Footnote ⁶¹ This again emphasises the politicised nature of experiences of women's activism in the barriadas in the 1980s and early 1990s, as grassroots women collaborated closely with feminist activists.

However, the politicisation of women's organising and these early experiences of building solidarity during the 1980s were brutally disrupted by widespread political violence and the activities of the left-wing Maoist guerrilla organisation Sendero Luminoso (Shining Path, SL) and state counterinsurgency forces in Lima's barriadas, precluding the development of a more coherent or politicised popular women's movement.

Grassroots Women Leaders in the Line of Fire

The internal war between SL and the state's counterinsurgency forces had a profound effect on the course of development in Peru in the 1980s and 1990s, destroying much of the country's social, economic and political fabric.Footnote ⁶² An estimated 69,000 people died during the 20 years of guerrilla and state violence that began in 1980.Footnote ⁶³ Having initially been active in highland areas, SL began its assault on Lima towards the end of the 1980s. With such a concentration of poor, working-class people, the barriadas were a key staging ground for SL. It aimed to eliminate all possible opposition, and thus not only the state but also community organisations such as popular education centres, church activities and neighbourhood associations were perceived as a threat. Left-leaning organisations and community activists were a particular problem for SL as they provided a viable and well-organised alternative to it, and they thus bore the brunt of the assassinations and violence. High-profile activists, NGO workers, progressive members of the clergy and community leaders were all targeted for intimidation and violence, and in many cases were assassinated.Footnote ⁶⁴ As a crucial part of the social fabric of the barriadas, and often one of the few things holding communities together and enabling their survival, the popular women's organisations represented a real threat to SL's ambitions.Footnote ⁶⁵

Neighbourhood dirigentas were central in shaping local opinion and were at the height of their prestige at this time, and for this reason they became prime targets for SL.Footnote ⁶⁶ Both the Truth and Reconciliation Commission and Human Rights Watch highlight that leaders of women's organisations received no protection from the government and were thus highly vulnerable to attack.Footnote ⁶⁷ Women's organisations in Lima provided one of the few organised opposition forces to SL, but violence and intimidation gradually eroded these organisations and their alliances in the community.Footnote ⁶⁸ Few women leaders risked publicly opposing SL, and those who did were often murdered, as in the high-profile case of Maria Elena Moyano, a grassroots feminist activist assassinated by SL shortly after making a speech denouncing its activities in 1992.Footnote ⁶⁹ Through its targeting of prominent grassroots leaders, SL managed to paralyse Lima's popular organisations, accelerating their decline in an atmosphere of terror and suspicion. The women who participated in this research lived through these brutal and chaotic events. The violence of this time was seldom openly discussed during my interviews with health promoters, but as prominent individuals involved in grassroots activism, members of Integra and Esperanza received death threats from SL. The Integra clinic was also targeted, with two promoters being forced to leave the community temporarily.

SL's activities had a widespread and wholly negative impact on the organising capacity of women in Lima's barriadas. SL's specific targeting of grassroots leaders made being a ‘leader’ a risky undertaking with enduring negative connotations, and left a largely disarticulated grassroots women's movement with few leaders. In this context we also see the beginnings of a process of distancing between grassroots women and feminist organisations, as NGOs such as Esperanza were temporarily forced to suspend work in the barriadas.Footnote ⁷⁰ Those women who continued to be involved in community organisations during the time of SL mostly concentrated on maintaining a low profile and emphasising the service provision aspect of their work, and avoided engaging with wider political agendas.Footnote ⁷¹ This pattern has continued into the present day, albeit to a lesser extent, with a general lack of coordination between community women's organisations, something also manifested in this case study.Footnote ⁷²

By 1990, when President Alberto Fujimori was elected, Peru was in turmoil – state power had been almost completed eroded and ceded to the military.Footnote ⁷³ This situation facilitated Fujimori's imposition of an increasingly authoritarian regime; by 1991, Fujimori had extended emergency zones to cover 40 per cent of Peru's territory and half its population.Footnote ⁷⁴ Soon after coming to power Fujimori began the implementation of a heterodox set of neoliberal reforms, with the infamous ‘Fujishock’ leading to a renewed emphasis on women's organisations as providers of social welfare in times of crisis.Footnote ⁷⁵ These extreme conditions allowed Fujimori to initiate a self-coup in April 1992, initially widely supported by the population.Footnote ⁷⁶ With the justification of fighting SL, Fujimori's self-coup suspended the Constitution, dissolved Congress and reorganised the judiciary.Footnote ⁷⁷

Grassroots organisations became increasingly fragmented during the Fujimori dictatorship, which saw a continuation of the authoritarianism, human rights abuses and military impunity that had dominated much of the 1980s.Footnote ⁷⁸ This situation was exacerbated and largely orchestrated by the shadowy figure of Vladimiro Montesinos, an ex-spy and drug trafficker who infiltrated the highest echelons of Fujimori's government and clandestinely headed the notorious Servicio de Inteligencia Nacional (National Intelligence Service, SIN).Footnote ⁷⁹ Over the course of a decade, Montesinos and Fujimori effectively dismantled the mechanisms of the state and manipulated them to serve their own interests.Footnote ⁸⁰ It was only in 2000 that Peru was able to begin the process of rebuilding its fragile social fabric, after Fujimori resigned and both he and Montesinos fled the country.Footnote ⁸¹ An understanding of this destruction and fragmentation wrought by both SL and the Peruvian government (principally via the military), at every level of Peruvian society over a 20-year period, is crucial to an analysis of the current position of grassroots women and community organisations in the country. Not only have conceptions of leadership among grassroots women been informed by generalised neoliberal constructions of women's leadership and empowerment, but this particular political backdrop has also been a key factor in shaping the depoliticisation of grassroots women's leadership practices in Peru. The grassroots organisations and activists that endured these years of violence and instability were put under immense strain, compounded by a general sense of fatigue after having been involved in community organising for so long.Footnote ⁸² Now, almost 30 years on from the heyday of urban women's organising, much of this popular women's movement appears to have lost its momentum, a direct consequence of the violent history outlined above and of the manipulation of women's organisations by the Fujimori regime, ‘convert[ing] temporary poverty relief into a structural practice that depended entirely on the voluntary work of women’.Footnote ⁸³

At the time of this research, Peru was in a post-Sendero, post-Fujimori era under President Toledo, with both the state and mainstream development institutions emphasising a neoliberal approach to development. Bury notes that Peru has become ‘one of the most open and liberal economies … in the world’ following the rapid neoliberalisation of the economy during the 1990s, with an emphasis on privatisation and market-led reforms, and Arce suggests that this economic liberalisation has led to a re-politicisation of collective action in Peru.Footnote ⁸⁴ Arce focuses on protests, however – he does not consider other forms of collective action, and in particular does not examine gendered spaces of collective organising with their long historical trajectory. The remainder of this paper therefore explores narratives of women's grassroots leadership, arguing that it is essential to situate understandings of gendered leadership and collective organising within a community's political and historical trajectory rather than simply in terms of the universalised, neoliberal ‘best practice’ discussed above. This discussion contributes to a more nuanced analysis of processes of de/politicisation under neoliberalism in Peru.

Depoliticisation and Changing Leadership Practices in the Integra Health Promotion Project

As outlined above, the leadership style that developed at Integra during the 1980s was framed by an overarching ethos of collective empowerment and a desire to challenge existing gendered social structures. This approach emphasised horizontal structures and rotating leadership, and encouraged participation and the health promoters’ relative autonomy, albeit guided and supervised by Esperanza. However, the wider scenario in which the Integra clinic and the health promoters now operate is very different. While women's organisations in Peru have enabled the survival of communities over many years, it appears that they have not facilitated ordinary women members’ politicisation through reflection on the causes of their marginalised position, nor generated a sustained political agenda.Footnote ⁸⁵ Additionally, as barriada communities have become more established, collective organising has become less widespread.Footnote ⁸⁶ Younger generations of women are also less inclined to get involved in collective organising, often preferring paid employment to voluntary work in community organisations and employing different survival mechanisms as a result of having grown up in the city.Footnote ⁸⁷

Such fragmentation of grassroots interests also reflects an increasing distance between the predominantly middle-class feminist movement and popular women's organisations.Footnote ⁸⁸ While the latter were very active in the 1980s and 1990s, the middle-class feminist movement tended to be the catalyst for mobilising these women for political ends. As alliances between these groups have become more tenuous, it has become less possible to identify any sort of cohesive ‘women's movement’ in the barriadas. Eckstein recognises this process in relation to Latin America more generally, noting that women's concerns have become less focused on political protest and more rooted in their particular class-based and ethnic context.Footnote ⁸⁹

While feminist organisations such as Esperanza have become more professionalised (with the associated challenges that this brings), focusing on strategic issues such as democracy and women's representation in the political sphere, women in the barriadas continue, out of necessity, to focus on subsistence and daily survival.Footnote ⁹⁰ Below, I therefore consider how grassroots leadership is being re-worked in this new scenario, exploring the Integra health promoters’ practices within an increasingly depoliticised context.

Leadership without the politics?

As discussed above, feminist conceptions of empowerment emphasised women's leadership as a key aspect of a long-term process of promoting social change in grassroots communities, providing an explicitly politicised agenda for popular women's organisations in the 1980s. However, as feminist organisations have become NGO-isedFootnote ⁹¹ and women's organising has become more fragmented, this politicised context has become less prominent. How then might we understand the current position of this unique generation of Peruvian women who have dedicated much of their lives to community activism?

Ideas around leadership roles and responsibilities emerged as central to the promoters’ experiences, and their interviews provide an insight into the increasingly depoliticised nature of grassroots leadership and activism. There are various roles that can be identified as ‘leadership’ positions within the Integra clinic: a coordinator for the group delivering health promotion workshops (Sandra), and two coordinators for the team that runs the clinic (Elena and Fatima). Additionally, Julia is the coordinator responsible for overseeing the whole of the health project. These four coordinators are paid more than the basic health promoters, but their positions are full-time ones, officially 40 hours a week but in reality often much more, with the boundary between work and home life often becoming blurred. I do not want to suggest that only the health promoters who occupy formal leadership positions within the Integra hierarchy should be seen as leaders; the leadership model that has developed over the years draws as much on informal leadership mechanisms as on formally assigned positions of authority, with the longest-serving health promoters such as Anita and Susi being respected for their knowledge and experience.

However, my research highlights an apparent shift towards new managerial practices in the way in which Integra is organised, with management skills being concentrated in a few key people in order to promote greater efficiency and accountability. These skills are increasingly perceived to be essential by Esperanza, as Integra begins to be incorporated into a professionalised style of development practice based around meeting targets and producing statistics and quantifiable results. For example, while previously there had apparently been little in the way of systematic efforts by Esperanza to evaluate and monitor Integra's impact, donors increasingly require Esperanza, and thus the Integra promoters, to produce reports (both qualitative and quantitative) summarising their monthly activities, such as recording the number of women who have attended workshops and the number of smear tests carried out. This provides insight into the ways in which the everyday work of the health promoters has been depoliticised, with the long-term objectives of women's empowerment and education being reduced to a series of indicators, and the health promoters’ activities becoming focused on service delivery. Madhok's discussion of an Indian programme around empowerment in which ‘the radical empowerment component of the programme has been effectively silenced and … exists only as a caricature of the original programme’ as the grassroots women have become embroiled in ‘administrative procedures, reports and inspections and the collection of statistics and setting of tangible development targets’ resonates strongly here.Footnote ⁹²

This depoliticisation and shift to a service delivery focus is also evident in the scope of the promoters’ everyday activities. Notably, the emphasis on gender relations, feminism and empowerment, which was central to the work of Esperanza and its training of the health promoters, was largely lost when the health promoters taught others. This was evident in workshops for community women being trained to act as first points of contact in the community: after a 12-week course, very few of them understood the concept of gender that was supposed to underpin all of the workshops.Footnote ⁹³ There was no sense of challenging women to evaluate their own lives and relationships, but rather a much narrower focus on health issues – such as sexually transmitted diseases and contraception – without any explicit discussion of the gendered nature of reproductive health, and of health and health care more generally.

This lack of critical perspective was evident in many of the workshops that the promoters carried out with community women. In one exercise, groups of women were given pictures of different tasks – driving a lorry, cooking, building a house, feeding a baby and so forth – to sort into categories of ‘tasks women do’, ‘tasks men do’ and ‘tasks both women and men do’. After 20 years of feminist activism in their community, the women had clearly got the message that women can do anything men do, and that men should contribute to traditionally female household chores. So, in almost every workshop I attended, every task except breastfeeding was sorted into the category of ‘tasks both women and men do’. The women had a clear idea of what was expected of them and performed accordingly, but with no reference to the reality of their own households, and the tasks that men and women actually carried out. The health promoters did not pick up on this or push the women to analyse the situation more closely, and thus the critical stance on gendered household relations, which had presumably originally characterised this task, was entirely diluted.

I also witnessed this lack of critical engagement in the preparations for a protest march organised for International Women's Health Day on 8 March 2003. All the health promoters and women involved in Integra workshops were encouraged by Esperanza staff to attend and to bring their female friends, but there seemed to be little political engagement on the part of any of the women in terms of understanding what they would be protesting about. Esperanza staff told me that the march was to protest the decline of reproductive health services – lack of access to contraception, the government's attempted banning of the morning-after pill, and the generally conservative stance of the Ministry of Health – but this was not made explicit to the community women who were encouraged to attend.Footnote ⁹⁴

The promoters’ everyday leadership practices in their community therefore appear to retain little of the explicitly politicised agenda for change that previously characterised them, although some elements of a more radical agenda for social change are still evident in their organising structures. Weekly meetings of the health promoters and coordinators form the main organisational mechanism at Integra, and these reflect traditional organising strategies of collective decision-making by assembly, and suggest the continued influence of feminist participatory mechanisms based on horizontal power relations and an ‘alternative’ development approach. We therefore see a weaving together of the originally collective, participatory ethos of Integra, elements of professionalised neoliberal development practices, and the particular socio-political circumstances outlined above. This creates tensions and a certain degree of confusion among individual actors at the grassroots level and between the health promoters and Esperanza, undermining the potential for transformatory and empowering practices to be enacted in an increasingly depoliticised and fragmented context.

Knowledge transfer and leadership development

Such tensions are particularly evident in the concentration of leadership responsibilities in a few key people at Integra. These women are elected to the post of coordinator by the whole group of promoters, and it is a position that is meant to last for two years. However, despite this rotating model, Julia has apparently held the position of overall health services coordinator almost constantly. As well as being the overall coordinator for the health section, Julia is in charge of the wider community project of which the health promotion project is a part. This suggests that there is excessive concentration of power in the hands of one individual, albeit one highly competent and motivated individual, and the promoters themselves recognised this as a problem:

Julia recognised that she shouldered a disproportionate share of responsibilities and was trying to avoid this happening too much in the future. However, despite her good intentions, the situation is perpetuated by a lack of skills transfer to other members of the group to enable them to take on a coordinating role, something the health promoters highlighted to me in the interviews:

This is not a problem caused particularly by Julia, and certainly not in any malicious way, but more a case of the project not having the formal mechanisms in place, and the promoters not necessarily having the enthusiasm or spare time, to ensure that this knowledge transfer can occur. In theory, rotating leadership should facilitate this sort of knowledge and skills transfer between members, but in this case it appears not to be happening. Rowlands discusses a similar situation among a group of health promoters in Honduras, resonating with the experiences of the Integra promoters:

This could suggest that the experiences of the Integra promoters are not unusual but rather reflect much broader changes within grassroots organising, as neoliberal development paradigms of efficiency and specialisation impact across Latin America (and beyond). However, I argue that what may initially appear to be simply the dominance of neoliberal efficiency through the rationalisation of leadership responsibilities is actually part of a more particular process of depoliticisation in Peru, manifested in a general reluctance on the part of the health promoters to assume leadership roles. Relatively little of this shift can be attributed to the direct imposition of a neoliberal development model; rather, it results from the interweaving of changing development practices with the specific socio-political and historical scenario in which Integra has evolved, where women's activism has become a mechanistic and depoliticised response to the continued lack of adequate provision of health care and other key services, increasingly distant from explicit feminist consciousness-raising and transformatory processes of empowerment and knowledge transfer.

Reluctant leaders?

A lack of dynamic leadership was evident throughout my time at Integra, creating a general sense of stagnation and loss of momentum on the part of the promoters. In particular, there seemed to be a deep ambiguity in the promoters’ construction of leadership, manifesting itself in their widespread reluctance to adopt leadership roles and responsibilities. Much of this reluctance must surely stem from the women's experiences during the 1980s and 1990s, when SL's targeting of grassroots women leaders meant that assuming a prominent leadership position was a risky undertaking, with widespread violent repression in women's communities. Despite the cessation of SL violence and the end of the Fujimori regime, this has clearly left grassroots women with enduring negative connotations of leadership, and this is accompanied by the wider process of the fragmentation of women's organising and the ensuing lack of wider political context.Footnote ⁹⁶

The health promoters themselves, however, frame their reluctance to take on coordinator roles around issues of the triple burden, highlighting the difficulties they face in juggling quite demanding voluntary work with domestic responsibilities and often other paid work:

This ‘triple burden’ is clearly nothing new when considering the situation of poor urban women involved in community organising.Footnote ⁹⁷ In this particular scenario, however, the specific association of the triple burden with the assumption of leadership duties serves to illustrate another negative association that the health promoters make with leadership responsibilities. Importantly, in terms of the overlaying of different neoliberal development practices over time, Isabela's comment above particularly suggests that the triple burden is exacerbated by an increasingly target-driven approach.

Several coordinators past and present commented on the strain put on them and their family by their commitments as coordinators,Footnote ⁹⁸ and stressed the incompatibility of the role of coordinator with bringing up young children:

Julia, as the individual promoter with most responsibility, particularly emphasised the problems her job caused in relation to her family responsibilities, asserting that she did not want to continue as coordinator beyond the end of her current tenure. As a feminist NGO whose work has historically focused on consciousness-raising and empowerment, one would have hoped that Esperanza would have been equipped to recognise and address these sorts of issues, but despite their apparent empowerment and emancipation at a community level, the health promoters still have overwhelming responsibility for childcare: empowerment in the community sphere does not automatically translate to empowerment in the domestic sphere.

This persistence of the triple burden suggests that little has changed since Moser's examination of the issue in a low-income neighbourhood of Guayaquil: when women are attempting to juggle competing roles and multiple obligations, it is reproductive tasks in the domestic sphere that are frequently neglected.Footnote ⁹⁹ One particular afternoon, Isabela told me that she had had to leave her very young child at home alone so that she could come to work. Despite some of the promoters’ husbands apparently sharing the household chores, this was still perceived by the promoters (and presumably their husbands) as their husbands ‘helping’ them, rather than as something which was legitimately a shared responsibility. This underlines the extent to which grassroots women's organising activities have again become delinked from feminist concerns of women's emancipation and equality and have instead focused on service delivery, emphasising the continued contradiction between practical and strategic gender interests in relation to the roles adopted by women in community organising.Footnote ¹⁰⁰

These accounts of the triple burden were evident in the experiences of all the health promoters but were particularly prominent in the experiences of those who were, or had been, coordinators. Although undoubtedly a problem for the women, I have no way of knowing to what extent their representation of the triple burden that they faced disguised a more fundamental reluctance to adopt more prominent leadership roles, rooted in their experiences of political violence outlined above. These issues of the triple burden are also undoubtedly augmented by an understandable fatigue, and almost a sense of resignation, on the part of the health promoters after dedicating up to 20 years of their lives to struggling to improve the health and living conditions of their community, leaving them feeling undervalued and largely apolitical rather than emancipated and politicised. Overall, this situation means that the principle of rotating leadership is not actually implemented in practice as few of the promoters are prepared to take on leadership roles. Leadership in this context is not an empowering experience. Thus we see a narrowing of leadership responsibilities, on the one hand reflecting the mainstream shift to an efficiency-led development paradigm, but more specifically reflecting the historical trajectory and depoliticised context in which the health promoters’ activism now takes place.

This stagnation of transformatory leadership practices is exacerbated by the health promoters’ changing relationship with Esperanza, which no longer provides the inspirational leadership that it once did. A perceived lack of support aimed at helping the health promoters to progress causes a sense of frustration and stagnation whereby the health promoters feel ‘stuck’ and unable to fulfil their potential. Esperanza's focus has shifted to higher-profile, larger-scale projects with correspondingly larger budgets. Integra has itself become an increasingly marginal element of Esperanza's agenda, ‘left behind’ as the NGO has engaged with a more donor-led policy agenda beyond the local level.Footnote ¹⁰¹ While Esperanza maintains a commitment to the Integra project, particularly as an exemplar of the organisation's progressive feminist ideology, there is no longer the same substantive ongoing politicised involvement with the promoters on the part of the institution.Footnote ¹⁰² Although the health promoters are still ostensibly working within a collective and relatively horizontal structure on a day-to-day level, this is no longer backed up by a radical, empowerment model on the part of Esperanza. We thus see a process of depoliticisation on two levels. Firstly, Esperanza's NGO-isation and engagement in processes of negotiating with international donors and the state requires a less overtly politicised stance.Footnote ¹⁰³ Secondly, the depoliticisation of Integra is mired in the more everyday practical challenges of providing health care in a poor neighbourhood, without the support of the politicised context at one time offered by the hands-on involvement of Esperanza.