THE STRENGTH OF LINKS: BUILDING THE CANADIAN WOMEN'S HEALTH NETWORK


REPORT ON THE CANADIAN-WIDE CONSULTATION MEETING HELD IN WINNIPEG, MANITOBA MAY 21-24, 1993 AND INCLUDING A 1994 NETWORK UPDATE

December, 1994


Table of Contents

prepared by the Winnipeg Consultion Organizing Committee. Sari Tudiver, Consultation Coordinator

c/o Women's Health Clinic
3rd floor, 419 Graham Avenue
Winnipeg, Manitoba
R3C 0M3 Canada
Tel: 204-947-1517
Fax: 204-943-3844
TTY: 204-956-0385
A French version of this report is also available. Aussi disponsible en français.

ACKNOWLEDGEMENTS

Special appreciation goes to Health Canada, the major funders of the Canadian Women's Health Network Project. Many Health Canada staff have been helpful and supportive through a lengthy process and we acknowledge their help and trust with deep thanks.

A grant from the Department of Secretary of State and Multiculturalism and Citizenship towards the costs of French-English translation and sign interpretation helped to make the Consultation much more accessible and to bring together women from a variety of backgrounds. Thank you to Michelle Jego, Denise Laporte-Dawes, Michelle Fenez, the Independent Interpreter Referral Service and the other interpreters who worked hard and long and were very much part of building a Canada-wide women's health network.

We are also grateful for the significant in kind support we received from the Women's Health Branch, Province of Manitoba. As well, the former Manitoba Minister of Health, The Hon. Don Orchard, provided a hospitality grant towards the Consultation.

It was a pleasure to deal with Jan Dowling and the other staff of the Delta Hotel in Winnipeg and with the staff of Marlin Travel who cheerfully made and remade travel arrangements across this vast country. Thanks to Sarah Mintz and Kyla Bergthorson for help with childcare.

The Women's Health Clinic in Winnipeg served as an excellent organizational base for the Consultation. Thanks to all the staff who offered encouragement, hands-on help and enthusiasm, even when it added to their already heavy workload. A special thank you to Linda DeRiviere, financial officer, for her expertise.

Many volunteers helped with Consultation planning and logistics. We are grateful for their interest and dedication. In particular, thanks to Noella Wilson, Kate Manchur, and Suzanna Reza. Angie Balan, a social worker with strong statistical and evaluation skills reviewed our selection decisions for fairness and consistency, which helped strengthen our process. As well, The Popular Theatre Alliance of Manitoba helped facilitate the Consultation, and many women pitched in as needed to ensure things got done. We remain grateful for the support of our WHI sisters in Ottawa.

The Winnipeg Organizing Committee would also like to thank the Healthsharing staff in Toronto for the support they provided, particularly Hazelle Palmer and Amy Gottlieb. Hazelle, the former Managing Editor, provided key input in the early phases of the project, before going on to other creative pursuits on maternity leave. We are saddened by the passing of Healthsharing from the Canadian publishing scene this past year, but are committed to take forward the ground-breaking work Healthsharing laid.

A final thanks to all the women who came from far and wide and gave so freely of their insights and selves, and to those who wrote, phoned, and continue to build links as they work to ensure a healthy future. -The Winnipeg Organizing Committee Kim Bailey, Madeline Boscoe, Norma Buchan, Michelle Cenerini, Gio Guzzi, Paula Kierstead, Cheryl Osborne, Gabriela Rodrigues, Maureen McIntosh, Sari Tudiver


TABLE OF CONTENTS

Section A: Building A Network

Section B: The Consultation In Depth

APPENDICES


A GUIDE TO THIS REPORT

In an effort to make this report an easy-to-use reference tool for organizing and strengthening the network, we have divided it into two major sections with appendices at the end.

In Section A: Building a Network, you will find:
· Background information on the Canadian Women's Health Network Project so that those interested may become familiar with the "herstory" and goals. We hope this will encourage women to join the networking process if it meets your needs.
· The outcomes of the Consultation: decisions taken, principles and goals, who accepted responsibilities and what those reponsibilities are. An update is provided on happenings since the Consultation.
· Action strategies and "next steps" to link in so that anyone interested in becoming part of the networking process will know how to get in touch with others.

In Section B: The Consultation in Greater Depth, you will find:
· Some details about the Consultation planning, including information about the organizing committee, how participants were selected and the agenda of the meeting.
· Some of what the women said, debated and felt strongly about. At the Consultation, women laughed, sang and cried, communicating in several languages, including sign language. The report tries to capture some of the passion of the event through quotes from the women. Since only some of the women interested in attending the Consultation were able to be there, we felt it important to provide a ``feel'' for the meeting and the basis for the decisions made.
· Detailed proposals about the functions and possible structure of the network, membership and funding.

The Appendices include a list of participating organizations and Coordinating Committee members, as well as a brief evaluation by the Organizing Committee of what we learned in holding this event, through our own evaluation process and through the comments of participants who filled out formal evaluations or who wrote us afterwards.


SECTION A: BUILDING A NETWORK


CWHN UPDATE Sept. 1993 to Dec. 1994 In the months following the Consultation, the Winnipeg Committee was involved in preparing the English language draft of the Consultation report and other follow-up activities locally. Many Consultation participants returned home and held meeting to talk about the network and to involve others in their region.

Unfortunately, Healthsharing magazine, which had served as the anchor organization for CWHN, ceased publication at the end of 1993. This was a very difficult and sad decision, forced by rising costs and declining revenues. They kept hoping that it wouldn't be necessary, and hesitated to put out the word until they had decided definitely.

Since Healthsharing was responsible for the Network project, the remaining commitments had to be addressed. This included two regional issues of the magazine on Québec and on the North. As well, Healthsharing had also agreed to seek funding for translation and publication of the Consultation report. The Winnipeg Committee did not have the resources to cover all the expenses of the final report.

Early in 1994, Women's Health Clinic in Winnipeg, which had co-hosted the Consultation, after discussions with Health Canada and Healthsharing's board, agreed to take over responsibility for the remainder of the project. The Regroupement des Centres de Santé des Femmes in Québec took on the tasks to coordinate the Québec issue and to find an outlet for publication and distribution. Herizons magazine, a Canada-wide English language feminist publication based in Winnipeg, contracted to publish an issue on the North and an English version of the Québec report and distribute these widely. Women's Health Clinic will report to Health Canada and fulfill the remaining obligations of the contract held by Healthsharing.

The CWHN Coordinating Committee held a conference call June 26, 1994 to update everyone, share information and divide tasks. While some momentum has been lost over the past year, there was great enthusiasm and support for going forward. In addition, many Coordinating Committee members were able to meet in Ottawa in September, 1994 at the Symposium on Women's Health hosted by the Canadian Advisory Council on the Status of Women.

Thanks to translator Michelle Dehaies in Hull, Québec and Manuela Dias, a designer in Winnipeg, who are donating part of their labour, this Consultation Report was finally completed.

Since the Winnipeg Consultation meeting, women's health groups were involved in many major initiatives. One highlight was the National Breast Cancer Forum, held in October, 1993 in Montreal. Through the outstanding input of women survivors who demanded equal participation in discussions and decisions, approaches to treatment and research of breast cancer are being transformed. Networking among breast cancer groups across the country was strengthened.

Other groups have been coordinating responses to the Report of the Royal Commission on New Reproductive Technologies which was released November 30, 1993, and the DisAbled Women's Network/DAWN Canada organized a major conference in Vancouver on NRTs. Numerous women's health groups and individuals provide input to provincial governments on the strategies and effects of "health reform," and continue to deliver a range of services on ever-shrinking budgets.

The development of a database on women's health by the Vancouver Women's Health Collective is proceeding.

Another important initiative was the formation of ENSEMBLE! The Pan-Canadian Women's Centres Network, at a conference held in Winnipeg in September, 1994. Organizers approached members of CWHN to work together, since they were involved in a project to survey and enhance the health promotion activities of women's centres across Canada. In a workshop at the 1994 Winnipeg Conference, the women laid out some common goals and ways of communicating by e-mail.

As a result of this meeting and the discussions by Coordinating Committee members in Ottawa the next week at the Women's Health Symposium, some concrete ideas emerged for working together. Funds were secured from Health Canada's National Initiative on Women and Smoking for a three-month feasability study to survey women's health groups and women's centres about their current work and future interest in the area of women and smoking. Through this project, women's health groups and centres would be able to communicate electronically. The feasibility study will be completed between January and March 31, 1995.

Health Canada recently announced that it would put $12 million towards several Centres of Excellence to encourage research and policy in women's health. In seeking input, Abby Hoffman, Director General of the Women's Health Burueau of Health Canada has consulted with some of the women's groups involved in CWHN to discuss goals and possible structures.

As the "Action Strategies" suggest, there are many ways to become part of and help shape, a broad-based and important process linking women's groups across the country. Set-backs and regrouping are a natural part of going forward.


"I'd just like to say that for a couple months before I came here, I had been lobbying the government and feeling fairly isolated in my work. And feeling that I didn't have the energy to go on and do any more because it was just sapping it from me. . . But I have a whole network behind me now, so it makes it a lot better to go home and go on."
"When I first came here, I had two questions. And both questions have been answered. The first question was: Is it possible to even consider unifying so much diversity and so many differences? Can it be done? The answer is: Yes. The second question was: What can I personally get out of this? . . . And the answer there is to look after ourselves. And women have never learned to look after themselves. We look after everyone else. So there again, we received an answer and I can only tell you: Don't forget to look after yourself."

-Consultation Participants, May, 1993

INTRODUCTION: THE CANADIAN WOMEN'S HEALTH NETWORK IS BORN!

After a year of planning and over a decade of dreams, a Canadian Women's Health Network has been formed. Women representing more than 70 organizations involved in various aspects of women's health met May 21-24, 1993 in Winnipeg. They discussed ways to share resources, communicate more effectively, and advocate for better quality health care for women. The meeting was hosted by Women's Health Clinic, Women's Health Interaction Manitoba and Healthsharing magazine and was funded by Health Canada.

The diversity of participants was key to the successful process of building a network. Women came from all the provinces, the Northwest Territories and the Yukon, from small towns, large cities and rural communities. They represented national and provincial organizations, as well as local collectives. Among the participants were First Nations women, women of colour, immigrant women, women with disabilities, and lesbian women. Twenty women represented Francophone organizations from Qu¬bec and other provinces. The inclusiveness of the meeting and its comfortable atmosphere were strengths noted by the particpants. This was later reflected when the women addressed what they meant by solidarity within a network: "Unity with diversity and support without interference."

The agenda for the meeting was a mix of plenary and small group sessions. A panel shared their "Agonies and Ecstasies of Working in Women's Health." In small groups, participants drafted a mission statement, discussed common values and principles, models of information exchange, solidarity and action, membership issues, accountability, tasks and responsibilities and possible sources of funding. The women also renewed old friendships and made new ones. There were energizing exercises, activities to help women get to know one another and have fun, and some wonderful songs.

By the final morning, the women had found much common ground, despite their diversities and an intense, sometimes difficult process. In the climate of harsh cutbacks to necessary services across Canada, the need for networking among women's health groups and organizations was clear, even if the specific ways were not entirely resolved.

Participants agreed to establish a Coordinating Committee that includes regional representatives and women committed to the interests of specific sectors - women with disabilities, immigrant women, women of colour, aboriginal women, lesbian women, older women and young women. The Committee includes Francophone and Anglophone women and will operate bilingually.

As part of a two year mandate, the tasks of the Coordinating Committee were identified: · to finalize the mission statement; · explore sources of funding; · develop an action plan and priorities to present back to interested groups and organizations; · work on a model for long term structure or networking; · link with other groups and regional contacts; · monitor health policies so that we know what issues might need to be put forward to the network participants for action.

As well, "focus or working groups" were established to develop specific strategies for communication (including computer linkages); membership; and funding. The participants expressed trust that the process begun in Winnipeg could be carried forward.

The Coordinating Committee and Working Groups will communicate by fax, mail and phone over the next while. Many participants made plans to hold regional/provincial meetings to tell other interested groups about the network, invite their participation and strengthen their regional networking.

The meeting ended on a high note. Women stood together in a circle, passed sweetgrass from one to the next and spoke about their experiences with appreciation.

"We might have a different colour of our bodies, we might have different shape of the eyes. But we are all the same. We grow in knowledge. We grow in skills and understanding. We grow in appreciation of each other, of this global community. Go back with the thought, 'I went, I walked, I talked, I touched, I started a process of healing.' We, the caregivers who have always been here have always walked behind the lines. I think yesterday and today said, 'women, we are together at last.' Let's work so that we generate other women and we can hug and hold hands and walk with other women of the globe."--Mary Burlie, Consultation participant


BACKGROUND INFORMATION

Some History Highlights (1982 - 1994)

1982-83
A group of women from different parts of Canada form a ``Committee for a Canadian Women's Health Network.'' There is interest, but no resources and group loses some momentum. The women involved stress the need for building local and regional ties.

1983-84
Idea for a play on the theme of women and pharmaceuticals is conceived and developed at a workshop attended by about 40 persons in Alymer, Qu¬bec, hosted by Inter Pares, the Ottawa-based development agency. Ideas for Canada-wide networking are discussed. The Great Canadian Theatre Company, with Inter Pares and local women's groups, develops the play Side Effects, based on women's stories.

1985
Side Effects tours across English Canada to rave reviews. It is translated into French and tours in Québec. Numerous groups across the country are involved, including Healthsharing magazine, Vancouver Women's Health Collective, DES Action . . . One recommendation that emerges is the need for a Canada-wide women's health network to share information and strategies for change. Some new networking groups are formed as a result. Side Effects organizers in Ottawa form Women's Health Interaction. Manitoba Side Effects Tour Committee becomes Women's Health Interaction Manitoba. A group forms in Kitchener-Waterloo.

May 1986
Informal meeting of women from various provinces takes place at Health and Welfare Conference on Women and Addictions. The women decide to draft funding proposals towards developing a Canadian Women's Health Network.

Fall 1986
Secretary of State approves funding for two cross-Canada Coordinating Committee meetings to plan a process for establishing a network.

February 1987
Proposal coordinated by WHI in Ottawa is submitted to Health and Welfare Canada. Co-sponsors include WHI and Inter Pares in Ottawa and WHIM in Manitoba. Nineteen groups make up the Coordinating Committee for the project. Coordinating Committee Meeting held in Toronto.

June 1987
Coordinating Committee Meeting held in Montreal. Participants included women from almost all the provinces and the Territories (approximately 25 women at each meeting). Network principles and goals are discussed and drafted.

Fall 1987
Proposal is rejected by Health and Welfare. Meetings with Health and Welfare follow; sponsors are encouraged to revise and submit again.

February 1988
Revised proposal coordinated by WHIM in Winnipeg is resubmitted; Co-sponsors are Inter Pares, WHI and WHIM.

August 1989
Three-year project ``Towards a Canadian Women's Health Network'' is finally approved by Health and Welfare Canada for $344,000. Due to delays, project has lost momentum. Serious cutbacks to funding affect many women's groups across Canada. Project sponsors decide to consult with original Coordinating Committee and others before deciding whether to proceed.

May to June 1990
Survey in French and English mailed to 26 groups across Canada with follow-up phone interviews. Eighteen groups respond. Overwhelming response to continue with the project. Respondents suggest that Healthsharing magazine be more directly involved.

Summer 1990
Original sponsors are unable to anchor the project but wish to remain involved. Healthsharing magazine agrees to serve as sponsor of the Project. Health and Welfare Canada approves.

Fall 1990 to Winter 1991
Goals remain the same, but project is revised to build on Healthsharing's capabilities and to address rising costs. The project now involves: Six regional issues of Healthsharing magazine, put together by Healthsharing staff and regional coordinators, latter hired on three-month contracts; Preliminary work to develop a database identifying groups and resources working on women's health issues; and A Canada-wide consultation for about 60 women from groups across Canada to develop strategies for building and sustaining the network.

Spring 1991
Year 2 of the Canadian Women's Health Project begins.

Summer 1991
Project Coordinator/Managing Editor hired by Healthsharing.

Fall 1991
B.C./Alberta Coordinator hired and initial work on database begun.

Winter 1992
Atlantic Regional Coordinator hired.

Spring 1992
Year 3 of project begins. B.C./Alberta issue of Healthsharing completed. Atlantic issue in progress.

June 1992
Consultation Coordinator hired in Winnipeg. WHIM and Women's Health Clinic to co-host Canada-wide Consultation in May, 1993.

Fall 1992
Manitoba/Saskatchewan Regional Coordinators hired. Consultation Advisory Committee formed in Manitoba and planning underway. Because of start-up delays, one-year extension of project time frame granted by Health and Welfare Canada (no additional money!).

Winter 1993 Atlantic Region issue of Healthsharing published.

May 21-24 1993 Canada-wide Consultation in Winnipeg. CWHN Coordinating Committee and Working Groups established.

May 1993 Manitoba/Saskatchewan issue of Healthsharing.

Fall 1993 Ontario issue of Healthsharing.

THE NEED FOR A CANADIAN WOMEN'S HEALTH NETWORK

Recognizing Those Who Came Before Us . . .

Women in Canada have a long history as providers of health care for their families and communities, whether as mothers, wives, sisters, daughters, traditional midwives and healers or as paid health workers. Long neglected and disparaged, the rich and complex contributions that women from different backgrounds have made to the health of their communities is finally being documented and acknowledged.

The social movements to achieve greater equality for women have been closely tied to women's struggles to gain greater control over their bodies and improve their health. In the early 20th century, thousands of women demanded basic information about reproduction and birth control, better housing and public health measures for poor and immigrant communities, and for greater numbers of women to be trained as doctors. Many individual women as well as long-established women's organizations in English-speaking and French-speaking Canada played a role in these efforts.

While economic circumstances and attitudes of paternalism and racism divided wealthy, middle class and poor women, both in cities and in rural areas, the need for better health care also led many women of different social classes, ethnic backgrounds and religions to join together and advocate for changes, despite their differences. Gains were hard won. For example, only in 1969 did women in Canada achieve legal rights to birth control and abortion, and access to such services continues to vary throughout the country.

Over the past three decades, more women have begun to speak openly about their bodies, sexuality and experiences with the medical system. They identified experiences long ignored by health professionals - such as abuse and incest. They told about poor treatment during birthing, not knowing where to turn for help with addictions, abuse, or for information about sexuality, about being prescribed tranquillizers when they needed advice and support. The women's movement gave many women the courage to begin to voice these concerns and demand that the health care system be more responsive to their needs.

Throughout the 1970s and 1980s, women in Canada organized many local, provincial and national groups to fill critical gaps in health services for women or to lobby for such services. They have developed creative models of health service delivery in women's health centres, community health and resource centres, immigrant women's centres, transition houses and in some hospital settings. Some are part of strong regional networks, such as the Regroupement des Centres de Santé des Femmes du Québec.

Self-help groups have supported women with mental health problems, breast cancer, PMS, endometriosis, exposure to the drug DES, and other conditions to explore a range of alternative approaches to their care. Health professionals are beginning to recognize the importance of such woman-centred approaches to more effective healing, as with breast cancer.

Coalitions are mobilizing to share information and strategies about the new reproductive, contraceptive and genetic technologies. Despite limited resources, such groups serve an important role as watchdogs over the pharmaceutical industry and government on issues that affect women's health. Health and publishing collectives, such as the Montreal Health Press, the Vancouver Women's Health Collective, and until very recently, Healthsharing magazine, provide critical information, encourage action on specific issues and work for better quality health care for women.

In particular, Aboriginal women, women of colour, immigrant women, women with disabilities and lesbian women have demonstrated how poverty, discrimination, violence against women and poor treatment by the medical system determine ill health. They have challenged mainstream society and predominantly white women's organizations to confront their attitudes of racism, homophobia, and fears of disability, and have also helped sensitize others to holistic approaches to health and healing.

Increasingly, there is a need for women's health groups to communicate effectively across the country, to share information, resources, and insights in various languages, and to mobilize for action when necessary on issues of concern to the health of all women. As well, individual women need to know about resources in their area to seek information, services and support.

Why a Network Now?

The 1990s are a time of severe cutbacks in government spending on health and social services and far-reaching attacks on Medicare and medical care as a right in Canada. The cutbacks are targetted to the poor and the poorest of the poor - women on welfare, persons with disabilities requiring home care services, shelters and other services for abused women and children. Rather than being nurtured and expanded, crucial and creative programs on shoestring budgets that make a real difference in people's everyday lives have closed or are in jeopardy.

Governments present a scenario of inevitable belt-tightening; consumers are told that the only way to control deficits is through these types of cutbacks. At the same time, an intense consolidation of wealth is taking place in Canada through changes in taxation and in the policies of international financial institutions. There is a widening gap between rich and poor and deepening poverty. A future of very high unemployment and vastly reduced social programs has profound implications, not only for our health and wellbeing, but for who we are and wish to be.

A network can help us all sharpen our understandings about how the current health care system works and be critical in constructive ways. For example, many provincial governments are promoting "community-based services," but not providing the crucial, accessible resources and supports needed within the community, such as translation services or home-care. Despite the talk about community care and demedicalization, there are contradictory trends going on towards over-medicalization. For example, while some provinces are introducing midwifery, new reproductive, contraceptive and genetic technologies are major expanding industries that have enormous implications for how birthing, health and diseases will be treated.

The language of the women's movement has been taken on by governments and media, but without the deep commitment to empowering women and their organizations and real voice in health care policy and planning. Many women spend long hours "consulting" with governments - usually for no pay - to try and sensitize them to our models and approaches. A strong network can help reclaim this language and share strategies for advocacy.

From their experiences, women know what is lacking in mainstream institutions and policies. Through networking, we can build a clearer understanding of alternative policies and choices, such as progressive tax reforms and the cost-effective, creative, person-centred, service models developed by community and women's health groups around the country. One of the challenges of a network is to ensure these alternative, women-centred approaches are lobbied for strongly and become ``mainstream'' public policies, rather than "marginal" projects.

A Canadian Women's Health Network is about overcoming isolation in the midst of cutbacks and layoffs, when women and their families feel isolated and fearful and, all too often, sick. But many women also feel angry and we hope to transform that anger into creative action. Networking is a challenging task in Canada, with its vast geographic distances, linguistic, cultural and regional diversities. But given the level of poverty and human need and the politics of conservatism in Canada and globally, the time for a Canadian Women's Health Network has come.

THE CANADIAN WOMEN'S HEALTH NETWORK PROJECT

Origins of the Project

One of the first group activities at the Consultation involved each woman noting on huge rolls of paper something meaningful to her in relation to women's health. Women could fill in memories or significant moments of any relevant year. Some comments were very personal ``1980 - I have my hysterectomy,'' while others remembered an important meeting. The end product reflected how a rich history of the Canadian women's health movement can be written by any group.

Since the 1970s, groups of women across the country have talked about forming a Canadian Women's Health Network. A Committee for a Canadian Women's Health Network came together in 1982, but saw the need to emphasize regional over national work. While they lost some momentum and didn't have the resources to work on a Canada-wide scale, the idea for a network remained alive. Women from different parts of the country, including women involved in the newly founded Healthsharing magazine, would meet at national conferences and talk informally about the idea.

The play Side Effects, on women and pharmaceuticals was an important catalyst to help link groups across the country. At a meeting sponsored by the Ottawa-based development agency, Inter Pares, in Québec in 1983, about 40 people talked about creative ways to develop and share health resources and strategies for education and advocacy on women's health issues. The idea for a play that might go on national tour was suggested and embraced with enthusiasm. Women in Ottawa worked with the Great Canadian Theatre Company to develop a play based on the personal stories of women who had serious problems with prescription drugs. Side Effects was born and toured to national acclaim from Newfoundland to B.C., in northern and rural as well as urban centres. A French version toured in Qu¬bec. Audiences stayed after the shows to talk with the actors and local sponsors; women came forward with their own stories about misuse of drugs and asked about support groups and resources. A number of local women's health groups were started as a result of the tour, including Women's Health Interaction in Ottawa and Women's Health Interaction Manitoba WHIM. Other groups, such as DES Action and Vancouver Women's Health Collective, participated in the process.

Over the next several years, women across the country continued to meet at conferences, and exchanged ideas about getting a network started. Two planning meetings in Toronto and Montreal (1987) were funded by Secretary of State and provided the opportunity for groups to explore goals and common principles. A detailed proposal was developed - and reworked after it was rejected. It described a process of building up the regional ties among groups working in women's health as well as cross-Canada links. It took several more years to secure funding from Health and Welfare Canada towards developing the network. During that time, many of the original sponsoring groups had lost their funding and were unable to put much effort to the initiative, as they struggled to survive.

In 1989, three years of funding for the project was approved by Health and Welfare Canada. Members of the original coordinating committee, WHI in Ottawa and WHIM, surveyed women's health groups across Canada to ask their advice on how to proceed. The message was clear: use the money to build a network, which was needed now more than ever. The suggestion was made that Healthsharing magazine be the anchor organization for the project, given its central role in providing English language information about women's health in Canada for over a decade.

Healthsharing agreed and the project was revised to include:
· Six regional issues of the magazine to involve women within each region and to inform others across the country about what was happening in women's health.
· Development of a database identifying groups across Canada working in the areas of women's health.
· A Consultation meeting with representatives from women's health groups to help establish the network. WHIM and Women's Health Clinic in Winnipeg agreed to serve as host organizations with Healthsharing of this meeting.

Throughout the changes, the Canadian Women's Health Network project remained part of a process to strengthen ties among women working in women's health across Canada, and to encourage women in each region to define their needs for sharing information and strategies. The project was rooted in the view that grass roots organizations involved in women's health must be the ones to clarify the vision and determine what a Canada-wide women's health network could be.

Goals of the Consultation

The goals of the Consultation meeting were laid out in the information package sent to potential applicants:

``The Consultation hopes to build on the strengths of diversity, drawing together women from different parts of the country, with differing backgrounds, abilities/disabilities and interests. Participants will share their experiences working for change to the health care system. In planning for the Consultation, we are building on the valuable discussions held at Coordinating Committee meetings in 1987 to plan for the Canadian Women's Health Network. At these Toronto and Montreal meetings, participants wanted to work for an accessible, equitable and just health care system that addresses the broad range of women's needs and against racism or other forms of discrimination. Women discussed a network which would empower and support women to make informed, critical choices about our health. The network would encourage exchange, dialogue and discussion about strategies and policies. As many women have noted, women's health and well-being are deeply affected by poverty and social class, by experiences of abuse and racism. Health policies must address these broader issues. Approaches to health and healing must be rooted in an understanding of women's diverse cultural traditions and meanings. These goals are consistent with a feminist vision of health. ``The process of building the network must be open, include broad consultation and be sensitive to the fact that groups around the country do not need more work or bureaucracy, but support to advance their work and goals. The Consultation will be accessible in English, French, and ASL and attempt to ensure that women whose first language is different from those and women with particular disabilities feel welcome and are comfortable with the process.

"The Consultation will address such issues as:

  1. How to have effective exchange of resources and information among groups;

  2. Strategies for advocacy and action on women's health issues;

  3. Use of computers (databases, on-line communication), fax, etc, in communication;

  4. Network models: Who could do what, when, where? How could tasks be done? How will decisions be made?;

  5. Funding: how might a network be sustained?;

  6. How to feel empowered, have fun and maintain a sense of humour through networking."


OUTCOMES OF THE CONSULTATION

WHAT WE HAVE BEGUN . . .

The Consultation meeting took place from Friday afternoon until Monday noon, May 21 to 24, 1993. Saturday and Sunday were spent mostly in small groups, with a plenary meeting at the end of each day. Groups drafted a mission statement and principles of network solidarity, discussed possible structures for networking, and explored communication strategies and possible sources of funding. They began to address issues concerning membership in the network.

By Sunday evening, everyone was tired, but knew there was still a lot to do if we wanted to emerge with an action plan. Twenty-eight women met for over three hours on Sunday evening to summarize the issues brought forward by the various groups. They identified proposals for all the participants to consider on Monday morning.

On Monday morning, the proposals developed the night before were discussed. Participants then approved a number of proposals in principle, recognizing that further work needed to be done on all.

The following summarizes this important work that will now continue.

DRAFT MISSION STATEMENT

Included here is the beginning statement drafted by the working groups and the issues that everyone agreed should be clarified, strengthened or altered. Based on the suggestions at the Consultation, draft wording is provided for these additions. These revisions are now one of the tasks of the Coordinating Committee appointed at the Consultation. (see below). This is not a final version and women are encouraged to send in comments to the committee member in their region.

``The Canadian Women's Health Network is a national, feminist lobbying and information-sharing network which works toward, and promotes, a holistic view of women's health. A holistic vision of women's health includes an understanding that many different factors influence women's health, such as income, safety, the environment, employment, attitudes towards women. Such a vision recognizes that health involves physical, emotional and spiritual well-being. ``A feminist analysis of women's health assumes a woman's right and ability to make informed choices and her right to speak out directly and be heard in matters concerning her own health. It also means having control over decisions affecting her health. ``The network is open to women from all cultural and socio-economic back- grounds, religions, ages, sexual orientations, abilities, etc. Discrimination in the form of racism, homophobia, sexism, ageism or discriminatory practices against persons with disabilities or others will not be tolerated and will be opposed. ``The operations of the network are bilingual in English and French. Efforts will be made to access and produce materials in other languages and in alternate media and to respect the first language needs of members. ``The network will be pro-active as well as respond to issues and share information. It is through social change that we enable women to maximize their health on their own terms. ``The Canadian Women's Health Network emerges from the work, wisdom and knowledge of women in previous generations and in diverse communities who cared for their own health and the health of their families and others. ``The network will build solidarity links with other women's health networks internationally, for mutual learning and support.''

The following suggestions from participants were noted and incorporated into this statement:

· Inclusiveness of the network must be stressed. · Specify strong opposition to racism, homophobia and other forms of discrimination. · A statement on social change and transformation needs to be added. · Point out that the network has a herstory. · Note that the network will operate in English and French and will pay attention to first language needs of others. · Clarify the definition of `health' to include broad areas of physical, emotional, spiritual health.

The following comments were made and are to be followed up by the coordinating committee through consultation. Comments about inclusion of specific network functions in the mission statement need to be reviewed. They may be more appropriately included in network objectives and description of structure.
· Given the historical primacy of First Nations women, we will consult with our aboriginal sisters about the use of one or more aboriginal languages for the network.
· The use of the word ``feminist'' needs to be discussed further. Some women felt that the term might discourage the involvement of many women of colour because of the history of the Canadian feminist movement as one involving mostly white, middle class women. Others felt it might discourage some rural, farm and working class women in agreement with the goals but uncomfortable with the term. Many women do not want to see the word removed, but feel it needs to be clarified through consultation with a variety of groups. The Coordinating Committee members who take on the responsibility for reworking and circulating the mission statement will work with organizations of women of colour, immigrant and refugee women to take into account their concerns around use of the term. The goal is to be as inclusive as possible in the language used and in the meanings of words. This must be consistent with what we have already built into the mission statement as a very strong anti-racist, inclusive and representative network. One of our first ways of doing that is in how we write the mission statement and the principles of the network.
· Identify the mutual accountability among those assuming roles, for example, Coordinating Committee and members.
· Identify the network functions clearly. On advocacy:
``On particular issues, members would seek others within the network to help them lobby or speak out on certain issues. The network would speak as one on issues of concern to all members, such as the fundamental principles of universality of health care, women choosing or creating their own health services, accessibility and adaptability of services; and on how poverty, unemployment and violence impede women's health and wellbeing. It would not take the place of other coalitions working specifically on issues such as unemployment, but focus on women's health.''

BASIC PRINICIPLES OF NETWORK BUILDING

The women identified basic principles and characteristics that any short term and long term strategy for the network must uphold. The coordinating body, whatever form it would take, would also reflect these principles in its composition.

The following principles were presented and approved by the participants:
· representation from across Canada
· being inclusive of women's diversity
· building on existing expertise and skills
· maintaining continuity with what has been started in network building
· bringing in new energy and ``new blood''

MANDATE OF THE COORDINATING BODY

The coordinating body was given the following responsibilities and tasks:
· a two-year mandate
· finalize the mission statement, incorporating the work of the groups at the Consultation, feedback from participants, and input from consultations with other organizations and individuals, as suggested
· explore funding options for the network
· finalize an action plan that would clarify the network's role in advocacy and any priorities for action
· work on models for long-term structure
· link with working groups on particular areas of relevance to the network (see below) and to regional contacts, explore other links with national and international groups, as relevant
· monitor health policy issues in Canada that have implications for network participants and put out a call to action, when necessary
· consult with other national networks to see how we could work together, and limit the need for costly new structures

This mandate was agreed to in principle.

THE COORDINATING COMMITTEE: HOW WILL THINGS GET DONE?

Drawing from these principles and mandate, the women identified some options for a structure that would last for a two year period to help establish the network on a solid footing. They felt a ``Coordinating Committtee'' or steering committee accountable to the participants was necessary for tasks to get done. Seven ways to make up a ``coordinating committee'' were suggested. In the first six, representatives could be from:

  1. the different regions of Canada and from different sectors

  2. the regions only, at least in the short term the current consultation organizing committee; (note: this was not suggested by any of the organizing committee members and in fact rejected by them!)

  3. the current consultation organizing committee and the regions

  4. existing groups who have particular interests or expertise that relate to the network and who are willing to take on various responsibilities;

  5. the regions plus groups with specific interests and expertise who are willing to take on responsibilties.

The seventh option was thought to be the one most faithful to the principles and to provide a clear way to fulfill the mandate. It attempted to combine:
· representatives from all regions,
· representatives from different sectors, and
· expertise and commitment.

In this option, the Coordinating Committee would be made up of representatives ready to take on work in the regions. Each province and Territory would identify a representative willing to be responsible for certain tasks. Inclusiveness and diversity would be recognized by adding positions on the Committee, if necessary.

In addition to the Coordinating Committee, regional groups would identify contact persons or organizations, as a contact point between the Coordinating Committee and the regions for communication. The contacts would be able to reach others in their area interested in the network and help get the word out to sister organizations if there is a call to action or other information to exchange.

Women with skills to share concerning membership issues, communications and funding, are encouraged to join Working Groups. These groups will develop ideas and strategies in these areas and liaise with the Coordinating Committee, to help in development of the network. Working Groups would link women around the country interested in these issues and tap into the creative energy of women working in women's health in Canada.

SOLIDARITY

Two principles were stressed by the groups working on network solidarity. These were:

  1. Unity with diversity.

  2. Support without interference.

Many women spoke about a sense of commitment, of working together, and drawing support from each other. We would "honour the diversity of the members, embrace it, welcome it." Members would share some common visions and principles. At the same time, support could be there without necessarily agreeing on every point. If we did not agree, we would not interfere with each other's actions.

"Network solidarity" addresses how we speak as one voice, and how regional groups connect and find support. This would be clarified in the mission statement and in the network's goals and objectives.

WORKING GROUPS

Participants agreed to establish three Working Groups to address issues and strategies: Funding, Communication, and Membership. Individual women and organizations could join the groups to develop creative ideas about the network. They would be in contact with members of the Coordinating Committee who would ensure that ideas and proposals were circulated to interested participants in their regions for feedback and discussion.

Funding Working Group

Many of the groups meeting Saturday and Sunday identified specific funding strategies. These included starting our own business, investments, a sliding scale of membership fees, and donations. Some suggested we should be self-sustaining, free of government funding, as well as seek services and resources in kind. The Working Group would build on all these ideas. (See Section B for specific suggestions.)

Communication Working Group

The Communication Working Group would assess the communication needs of network participants, and develop longer term plans for different types of communication among network members, appropriate to their needs (see Section B).

Participants identified the following issues for immediate attention: · We need a short term and fairly simple strategy to keep in touch. The regional groups would identify what modes of communication are available to them, for example access to fax, e-mail, a budget for long distance calls. It is important to be able to reach all groups and not exclude any groups interested (e.g. if they don't have a fax machine). Identify the options to keep in touch and start the flow.
· When there is a need for a call to action - to reach groups who may want to lobby together on an issue - regional or provincial contacts and national organizations would develop a chain or tree to pass the information. Use the ways we have available to us. Regional contacts are essential.
· We need to use the print media we already have. Healthsharing is a key English language resource and needs to find ways to keep going. We must make sure we have bilingual options. We do not necessarily need to create our own newsletter but build on those already there. Articles can be exchanged and reprinted. A variety of newsletters might be used to share information from the Coordinating Committee and each in turn send it to the network mailing list on a rotating basis. We may decide to work towards a more permanent bilingual newsletter as a long term goal, but it is equally important to build on what's there.
· The Communications Working Group could help identify ways of accessing and using alternate media to reach more women dependent on media such as tapes, braille, and large print. Devices for the Deaf, such as TTY machines can be used. A variety of women's groups have access to these.
· Community access TV, radio and community newspapers also help get the word out to the wider community and can sometimes be accessed free.
· The Working Group would explore long term strategies for network communication through electronic mail, access to computerized databases, bulletin boards, conferencing and information systems (e.g. Internet, etc). They would identify what existing databases might be particularly relevant to the network and how they can be accessed and ensure that there is no duplication. They would help look for funding for computerization and training.

Membership Working Group

"What's the big deal about being a member of the network? Besides the honour of it of course!"

The discussion pertaining to membership was only begun at the Consultation, as the exerpts from that discussion show. A number of key questions emerged: · What benefits, responsibilities, duties would membership in the network bring?
· Who might be members? Organizations? Individual women? Both?
· Should there be different categories of membership?
· Might there be a difference between being a network member and having access to the network resources and information?
· What about organizations that employ/serve women and men and subscribe to the mission statement? Can they be members?
· Should there be membership fees or other levees to support network activities? If so, how could those fees or levees be applied in a fair and sensitive way, recognizing the limited resources of many groups?
· How can we ensure access to anyone committed to the network goals?

In the discussions on Sunday evening, the women suggested that being a member could be different from accessing the network. Individual women could access the network. Organizations would be members and would be able to make decisions as to how the network would function and what its agenda would be.

This option was put forward for discussion and sparked debates about organizational and individual memberships. Discussion also showed how network structure was closely linked to network functions. The option proposed:

"Women's organizations and mixed organizations (those serving or employing men and women) who aspire to our mission statement in every aspect, can be a member of the Canadian Women's Health Network; but their representative must be a woman. Recognizing that individual women may be working actively in the area of women's health in regions and parts of Canada that might not have a group organized yet, they would be encouraged and assisted to form a group so that they could become a member. Organizational members would vote and be involved in determining network directions and policy. Individual women would be able to access the network's resources."

There was no consensus on membership criteria. The Working Group on Membership was to explore the issues raised in more detail and put forward proposals.

THE REGIONS ORGANIZE

After these discussions, regional groups met to identify their representative to the Coordinating Committee and the network contacts in their region. Women were also asked to note whether they or their organization wanted to participate in any of the three working groups and whether there were any other tasks and responsibilities their group might want to take on.

The women named as the regional representatives to the Coordinating Committee, were then asked to come into the middle of the room. Based on the structure of the Coordinating Committee agreed to by all the participants earlier, and the important discussions throughout the weekend about the desire to be inclusive, the participants then identified which sectors were already represented and which were not.

The regional representatives included women with disabilities, immigrant women, women of colour, and youth. A mature woman was sought to represent the older, mature woman's point of view. Everyone was delighted when Mary Burlie volunteered her wisdom. Valerie Brooks came onto the Coordinating Committee bringing her perspective as an Aboriginal woman; Margo Fauchon, as a minority Francophone woman outside Qu¬bec; and Carla Marcelis, as a lesbian woman.

It was agreed that the Coordinating Committee would ensure further representatives from the Yukon and the NWT since participants from these regions had already left for home.

The interim Coordinating Committee was ratified by the participants with applause and cheers!


ACTION STRATEGIES: GETTING INVOLVED

"There's not going to be this big great communication system just appearing; we're going to have to create it."

We hope you are interested and keen to become involved. There are many ways to do so.

Contact Someone Involved

Groups and individuals interested in being involved in the network should identify the Coordinating Committee members or contacts in their region (see Appendix) and get in touch with them for further information about what's happening near them.

Women's Health Interaction Manitoba and Women's Health Clinic are serving as the central contact point for the Canadian Women's Health Network until early 1995.

Hold Local Or Regional Meetings To Talk About Networking

Use this process as a way to organize on women's health locally.

Regional ties are the the basis of a Canada-wide network. Discuss some of the questions listed in this report and other topics of importance to you and your group on women's health. Contact some of the groups listed here if you need resources.

Use The Networking Process Already Started

If you have a call to action that others should know about, contact groups through the network list. If you are asking for help, be specific about what you need.

Consider Joining A Working Group

Share your ideas and skills. We are anxious to hear from women interested in joining groups on Communications, Funding, and Membership and will help put people in touch with each other around the country. If someone in your region is already involved, contact them. If not, call the Manitoba contacts.

Give Us Feedback

If you have comments to share about the mission statement, possible network structures, who might be a helpful resource person - creative, random thoughts, jot them down or put them on tape, and send them along. The expertise of women around the country is vast and sharing makes us strong!

Look For Funding

"Personally I don't think we have a choice . . . We are here, we already decided we are interested in this movement . . . We decide that we are going to be included so organizations donate $200, $100 whatever they can. It's empowerment and we have to go with what we have."

"How many groups here began with lots of money? Need I say more? I know we have to be realistic and I know money is harder but how many of us had a huge pot to get our work going?"

Many women at the Consultation noted that if we wanted things to happen, we are the only sources of money right now. Groups should think about putting aside even small amounts for mail; phone; fax; e-mail if they have it, and seek in-kind resources.

There are no plans for a national meeting in the near future, but conference calls, informal meetings when women are travelling for other purposes, and computer conferencing are ways of keeping in touch. Be creative in finding a few dollars here and there to get it functioning!

Send us your name, address and other information about your group for the database! Remember, there has never been a more crucial time for women to mobilize to ensure a healthy future.


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