Background to the Research

• Despite a wealth of academic, policy and practice-based material addressing the conflict in and about NI, there is a paucity of literature and documented evidence that directly considers the narratives, experiences and perceptions of women who have lived in the border regions of Ireland. By addressing a gap in the current literature on women in border areas, this study contributes to debate concerned with the legacy of the past.
• The research had two distinct aims: to improve understanding of the impact of the border and of the conflict on both sides of the border on women's health and to improve understanding of women's roles, particularly as they impact on mental health, in post conflict society.
  

Research Approach

• The findings are based on a series of 31 in-depth interviews and one focus group with women both north and south of the border and on one focus group and six interviews with women who were specifically consulted as service providers. The findings and themes from the primary research are discussed within the context of a wide-ranging literature review that explored material from Ireland, UK and internationally.
  

Main Findings

Six principal themes emerged from the interviews:

• Women's role in the family and in local communities. ThThe role of women in their families and in local communities developed and strengthened as a result of the conflict. However, increased responsibilities were not necessarily accompanied by increased support systems. As a result, women's general health and wellbeing was often considered secondary to those of other family members. The coping mechanisms they called on sometimes compounded underlying and undetected ill health.
• Poverty and disruption. For many women, the disruption to day to day life caused by poverty was exacerbated by the conflict. It impacted tangibly on the life choices they made about where, with whom and how to engage in wider society. Being forced reluctantly into the labour market because of adverse family circumstances, including the loss of the family's breadwinner through death, injury and incarceration, enabled some women to achieve a degree of independence, but for most it came as an unwelcome necessity in an already busy life.
• The value placed on health issues. The peace process has brought with it the potential for advancements in the general and mental health of women of all ages in Ireland. While women may continue to face some structural barriers in being able to access services, mental health and wellbeing is now more readily recognised as being crucial to healthy communities and societies. Women reported that they and health practitioners are now placing more value on gender specific health care and that an increase in cross border cooperation for health care provision was a tangible benefit of the peace process.
• Perceptions and meaning of the border and the conflict. At the height of the conflict, the significance of the impact of the border on women's lives was in part dependant on their cultural identity, place of residence and degree of their involvement with the conflict. Attitudes to crossing the border were changing rapidly and significantly with a reported increased willingness to do so. Women now consider the border in one of three ways: an unimportant concept, in name only, which has little or no real impact on their lives; an unacceptable barrier dividing the country; or an acceptable demarcation of their country's boundaries.
• Support networks. The value and significance of support networks and the core role that could be played by the family was recognised. It was suggested that during the conflict, women living in urban Catholic communities and those with family members imprisoned were able to access practical and emotional community support networks more easily than women from rural and border Protestant communities and those with connections to the security services. The churches were recognised as offering some assistance to women but were not considered to be well connected to wider networks of support.
• Women's contribution to community peace building. Since the ceasefires and the Good Friday Agreement (1998), women reported being increasingly willing to become involved in cross-community and cross-border community development initiatives on shared issues such as health and education. They consider that they are actively contributing to a 'post conflict' society by sharing resources, personal experiences and history with women from other traditions.
• Within these themes a number of cross-cutting issues were found. These include: the impact of the peace process; different manifestations of trauma; positive and negative coping strategies; processes of normalisation; the medicalisation and pathologisation of mental health issues; and social capital and networks of support.

Conclusions

• The important role that women have played in building civil society and contributing to peace has often been underplayed and merits greater acknowledgement. Based on this research study, the researchers made the following recommendations:
• Community development and skill development for women needs to be supported and resourced to enable them to engage in civil society, take up public appointments and contribute to political parties. This particularly applies to women from a Protestant background.
• The North West Women's Health Network is central to maintaining focus and momentum in the North West on the wider determinants of women's health. Derry Well Women should continue to be resourced to drive the Network so that it can achieve important health outcomes.
• Action is needed to strengthen gender mainstreaming and the promotion of women's health and wellbeing throughout the public health sector North and South.
• The statutory sector should identify and ensure the provision of appropriate services for women experiencing hidden mental health problems and domestic violence resulting from the conflict and undertake work to address the stigma associated with these conditions.
• The statutory sector should support interventions for young children who have no direct experience of the conflict but whose parents may still be suffering the consequences.
• Further research is required into the challenges faced by women living in border areas during the conflict. There should be a particular emphasis on vulnerable groups such as women with disabilities, women who are carers, families of ex-combatants and other armed groups who live or lived in border areas, and mobile groups who cross the border frequently such as Travellers and migrant workers. Research into the trans-generational nature of trauma should also be considered. The emphasis of research should be on developing the evidence base for interventions that reduce inequalities in health for women.
• An investigation of the current and potential use of cross-border services for women should be undertaken. A new focus on all-island policy development and EU health strategy is driving the need for public services such as health and social care to serve an increasingly mobile population.