Resilience as a double-edged health promotion goal : examples from Lao PDR

Individual and community resilience are undoubtedly important targets for health enhancement and invaluable aspirational outcomes in the health promotion endeavour especially in disaster contexts. However, overreliance on resilience as a proxy for positive well-being has serious personal and political implications in many contexts, as illustrated in research findings on women's quality of life in southern Lao PDR. Case studies derived from focus group interviews with ethnic minority Lao women about their quality of life are used to exemplify how overt signs of resilience may mask, rather than mirror, covert existential reality leaving women without a voice. The political implications of this silencing are profound. Private troubles remain hidden rather than being identified as public issues subject to public policy. This conundrum is not confined to third world countries. Structural limitations to achieving profound fulfilment abound in affluent countries also, yet neo-liberal governments rely heavily on the resilience of populations to minimize public spending. The challenge for health promotion researchers, policy makers and practitioners is to explore the nexus between individual agency and structural change in each specific context to ensure that health promotion initiatives do not inadvertently perpetuate disparities in access to power and resources.