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


SECTION B: THE CONSULTATION IN DEPTH


RETURN TO MAIN TABLE OF CONTENTS

"Did you look at other models, like a circle? When we think of national organizations, and alliances or networks, we don't always have to have one centre if we have a circle. There is another model that works that way. The work that needs to be done in any network can be shared and given to different groups and can be done in different areas. It costs a lot of money to travel across the country, we don't all have to be in one room at one time to make a decision and the work can be done by different groups who take on different things and use other networks.
"For example, if you are talking about political action, we have bodies that are political for political action in all our constituencies already and we can plug it in to the system through different ways. We don't need to have another organization to cover all of our needs; we have to be clear about which needs we want to address through a network or alliance. We are all so busy. We even noticed here we didn't have enough time - are we going to have more time when we get home? So we have to find a way to share the work where we work already and not to duplicate and to trust different tasks to other people and come together when we need to or use other means of communication and information-sharing systems."
-Consultation participant

PLANNING THE CONSULTATION

THE LOCAL ORGANIZING COMMITTEE

The local Consultation Organizing Committee was made up of a core of ten Winnipeg women. While some were members of Women's Health Interaction Manitoba (WHIM) - an informal network involved in education, action and advocacy on women's health issues in the province - others joined the committee because of a specific interest in building a Canada-wide network. Some committee members represented community health centres or other organizations (Women's Health Clinic, Klinic, Inc., Women's Health Research Foundation, Pluri-Elles) as staff or volunteers; others were there to share their skills and commitment as individuals.

We work or have worked in the past as nurses, social workers, health educators, disability rights advocate, artist, volunteer coordinator, researcher, hospital aide, students, and teachers. We are single or with partners, heterosexual and lesbian. Some of us have no children, others have sons, daughters and grandchildren. We are Francophone, Anglophone, Catholic, Protestant and Jewish by identity and come from a range of ethnic groups and immigrant experiences - Italian, Portuguese, Eastern European, Scottish, Irish and French. We have varying abilities and disabilities. We range in age from 27 to 59. (See list of committee in Appendix)

Early on in the project's history, WHIM and Women's Health Clinic had offered to host the Canada-wide consultation meeting. As the geographic centre of the country and a place with a strong and diverse women's community, Winnipeg seemed a logical choice for network launching. WHIM was one of the original groups involved in the network project and had overseen the writing of the final funding proposal to Health and Welfare Canada. The group had first formed to organize a successful provincial tour of the play Side Effects in 1984-85. Since then, the women involved in WHIM had made an effort to build province-wide links among women's health activists through sponsoring workshops, conferences and publishing several "Health Information Updates," a journal on women's health issues and initiatives from around the province. The decision to organize the Consultation was taken by the group after a "quiet" year of mutual support, discussions, and no major projects. We welcomed the renewed focus to our work and the opportunity to contribute to, and learn from, a larger process.

The strengths of the committee were tested over the ten months of intense planning and particularly in the last months leading up to the event when we had frequent meetings. Through it all, we were able to air opinions and suggestions, maintain an atmosphere of respect towards each other to listen and be heard, work to consensus, keep our sense of humour and emerge solid friends. After a break, we remain enthusiastic and committed to building the network. We have also begun to recruit "new blood."

GETTING STARTED

The Organizing Committee, in consultation with Healthsharing magazine, developed a job description for a Consultation Coordinator. She would work closely with the Organizing Committee, report regularly to them and to Healthsharing, carry out and coordinate the conference logistics, handle correspondence and develop promotional materials, liaise with community groups, government departments, health institutions, etc, as necessary, and write the final report. After an open hiring process, Sari Tudiver was hired to the position. As the workload increased several months prior to the Consultation, Michelle Cenerini was hired on a part-time basis to serve as Liaison Coordinator, handling many of the direct contacts with Francophone participants and other organizational tasks.

Women's Health Clinic served as the "home base" for the Consultation, providing office space, phone, fax, and some secretarial support. The Consultation budget was administered by the organizing committee, the coordinator, and the clinic's financial officer, and quarterly reports were submitted through Healthsharing to Health and Welfare. The organizational support provided by Women's Health Clinic proved crucial to the overall success of the Consultation process.

One of the first tasks was deciding where to hold the Consultation. We spent time talking with local disability groups and with women who had served as attendants at other conferences to know what to look for in choosing accessible facilities. When several sites outside of Winnipeg fell through, we targetted the local downtown hotels. We wanted a place that was friendly and comfortable, that provided some facilities for women to exercise and swim and where the kitchen staff would be flexible for vegetarians. We also wanted to deal with a unionized hotel. The Winnipeg Delta met these criteria and offered us a fair price. With the place booked, we could get on with other planning.

SELECTING THE PARTICIPANTS

Basic Principles of the Selection Criteria

  1. The process of choosing representatives for the Consultation will respect the diversity in women's experiences and backgrounds. Issues of access will be given particular importance. Every effort will be made to ensure that:

    · Representatives will include women of various ages, race, ethnic and socio-economic backgrounds, abilities/ disabilities, sexual orientation, and experiences.
    · The language needs of women attending are accommodated. The Consultation will offer translation in English, French and ASL. We encourage women to let us know of other language needs.
    · Through active outreach, women and organizations/groups working in the area of women's health who in the past may have been left out of other initiatives will be encouraged to participate.

  2. The Consultation will include women from all regions of Canada. Every effort will be made to ensure that:

    · Women's groups/organizations from all provinces and territories will be present at the Consultation (note: `groups' may be informal). · Within each province, northern, rural, small town and urban perspectives will be represented.
    · Women's health groups often left out because of location, will have access to the process. This will require good outreach.

  3. Representatives at the Consultation will be drawn from women working for change in a wide range of health issues in their community work. Rep- resentatives will include women working or involved in various aspects of women's physical, emotional and mental health.
  4. The process of choosing representatives for the Consultation will respect the different types of organizations and groups and the different experiences and skills of women working for changes to the health care system. Participants will represent different types of groups and organizations and will include paid workers, unpaid workers, consumers, organizers and activists in the area of women's health.
  5. Representatives should be committed to, and have some experience working towards an accessible, equitable and just health care system that sensitively addresses the broad range of women's needs. These goals are consistent with a feminist vision of health.
  6. Representatives should not include women or organizations who work against women's rights and equality or who in any way condone or encourage racism or other forms of discrimination.
  7. Representatives must be willing to sustain and continue the networking process.

Drafting Criteria, Consulting, Getting the Word Out

The Consultation was to be a working meeting to discuss strategies, rather than a conference on women's health issues. In earlier meetings with women across the country, it was suggested that the Consultation include women from about 60 groups, a workable number for this type of meeting. Groups - more than individuals - could be asked to provide ongoing support to their representative once she returned, and help get the word out about the network to others in their region. It was also suggested that all participants receive full funding so that everyone attended on an equal basis. Smaller groups with limited resources might be keen to apply if they knew there was a full subsidy. As the Committee reviewed the budget and discussed the diversity of women that we hoped would attend, we planned for 80 to 100 women.

In order to bring together women from all provinces and the Territories, and include women from many backgrounds, we agreed that there would have to be a selection process. We developed checklists of women's health issues, sectors and backgrounds which groups might represent, types of groups and organizations that women work in, as well as regional differences, such as urban, small town, and rural. These served as a guide to possible diversities. A great deal of discussion, consultation and thought went into developing a process that was as fair as possible and open to review.

First, the Organizing Committee drafted criteria that stated the values and principles we considered important to network-building and that had been discussed at earlier meetings in Montreal and Toronto. We then circulated these draft criteria to 25 Anglo- phone and Francophone groups, about half of whom responded with suggestions or points that needed to be clarified. In addition, Healthsharing invited a group of women in Toronto to review the criteria and they gave helpful feedback, as did many Winnipeg women.

We then incorporated the suggestions into the final draft (See Appendix). Women asked us to be clear about the roles and responsibilities of a participating organization and of a representative both before and after the Consultation. There were no major disagreements with our approach to draw women from all regions and reflecting the perspectives of many sectors. Respondants felt comfortable with a selection process in which a committee would review applications and choose participant groups, based on the criteria. They liked the proposal that it would be up to each group to select their representative. Many women said the criteria were respectful of women and their needs.

We developed information packages to be sent to groups across the country with the goals and history of the Project, the aims of the consultation, the criteria and application forms. From early September 1992 we put together mailing lists to try and reach a wide range of groups, organizations and institutions working on women's health issues throughout Canada. Some contacts came from the women who had worked on the regional issues of Healthsharing for B.C. and Alberta and for the Maritimes. Other lists were made available to us by the Fedération Nationale des Femmes Francophones, the Native Women's Association of Canada, the YWCA, and provincial Advisory Councils on Women's Issues. In all, we sent out over 500 English and about 225 French application packages. Healthsharing carried an ad and articles about the Consultation in its issues throughout the year. We set up meetings with women from the disability and immigrant communities in Winnipeg and encouraged others around the country to spread the word. All this took more time than we thought it would. It was well into January, 1993, when we began to send out the information packages and application forms. However, women were already contacting us from many different places about the Consultation. We began compiling a computerized database of contacts that would be useful to the future development of the network.

Choosing the Participants

One hundred thirty applications were received from across Canada. As applications came in, we monitored where they were from and the diversity of groups. When we found gaps, we made every effort to contact organizations in that region to encourage applications. We were flexible with deadlines and accepted applications until the final selection process began.

Everyone on the Organizing Committee and three members of Healthsharing read all the English language applications. Three committee members who were bilingual read all the French language applications. Every committee member was responsible for reviewing a number of applications in depth and presenting these to the others. We had a standard form that summarized information about the organization and its services/activities and had the reviewer rate applicants according to the stated criteria.

We set flexible quotas of numbers of participants from each province or territory, loosely based on population statistics. We also looked at current statistics on ethnic composition of the Canadian population. However, we did not apply these numbers rigidly, since we wanted to be as inclusive as possible of organizations and of women with different backgrounds, abilities and experiences.

Since all applicants would have been valuable participants, we had the difficult task of trying to balance regions and sectors. We tried to assess the capacity of groups to be involved in networking after the Consultation. We gave some preference to groups who had a capacity for networking and might not previously have had the opportunity to come to such a meeting, such as groups representing rural, immigrant and aboriginal women. We agonized for many days over the selection, drew charts and maps, drank lots of tea, squeezed more money out of the budget to include a few additional groups. All decisions were made by consensus.

Once the selection was made, we drafted letters to those who were not included that explained the process and encouraged them to remain involved. We stressed that the Consultation was only one stage of network building. They were asked to provide input and ideas by responding to questions that the Committee was circulating to participants as well. (See Appendix). They will receive copies of this report and follow-up information on how to become involved. Some groups called to discuss why they were rejected and we talked about the process.

As a way to evaluate the selection process, the Committee accepted the volunteer services of Angie Balan, a Masters of Social Work student at the University of Manitoba, and a good statistician. She reviewed our criteria and decisions, based on the forms the committee members had filled out for each organization. Overall, she found the process we used a fair one, that achieved the goals we set for inclusiveness.

By the first week in April 1993, we were able to send out letters to the participants. We were behind schedule and turned quickly from the selection process to finalize the Consultation agenda.

Developing the Agenda

Ideas about the agenda and `tone' of the Consultation had been discussed in depth with Hazelle Palmer and Amy Gottlieb from Healthsharing and with many other women over the previous year. We agreed it must be an accessible, working meeting with a comfortable atmosphere. Language services would be offered in English and French and ASL for which translation monies would be sought. We would try informally to accommodate other language needs.

The overall goal of the meeting was to emerge with an action plan for the next few years to strengthen network-building. We also wanted to develop a sense of trust, respect and solidarity among the women attending as a basis for the network. We saw all the participants as "experts," knowledgeable about networking in their region and on specific issues. A format that combined plenary sessions with informal working groups and allowed women to participate actively suited this approach. We wanted the women to share their experiences and expertise throughout the weekend. We tried to leave free time for women to socialize, exchange information and resources.

In designing the agenda, we tried to weave the personal and the political: women would tell their personal stories and experiences working in women's health, discuss the mandate, goals and ways of organizing a network, and develop an action plan for the next few years. While working nationally, we tried to build in some time to plan regional strategies. We didn't have one particular model to put forward for network building and felt that was to be determined by the group. We agreed that facilitation would be important in this meeting to keep participants on track and steered towards the goal of an action plan.

As the time drew closer, we felt overburdened with details and limited staff. Volunteer time was stretched to the limit. We decided to hire the Popular Theatre Alliance of Manitoba to help us finalize the agenda and provide us with skilled facilitators. PTAM uses theatre in community development, facilitates conferences and meetings and have worked with ethnic and core area communities in Winnipeg. Two members of our planning committee were among the six facilitators hired by PTAM. In addition, we assigned "support facilitators" to each group. We ensured that at least three of the six working groups had bilingual facilitators or support facilitators.

We developed a draft agenda for the meeting, recognizing that we needed to be flexible and sensitive to what was happening throughout the weekend and make changes if necessary. We sent the draft agenda, the list of participants, and some other background information to participants about two weeks before the consultation. We then geared up for the final logistics of the meeting - airport schedules, room assignments, special diet needs, supplies, pre-Consultation media interviews and numerous other details. Women's Health Clinic organized a panel discussion for the public, with some of the participants as speakers, on the evening before the Consultation. The excitement mounted as we prepared for everyone to arrive.

PANEL HIGHLIGHTS, FRIDAY, MAY 21, 1993
THE AGONIES AND ECSTASIES OF WORKING ON WOMEN'S HEALTH

"I think this is an important place for us to begin our work this weekend because the women's health movement haas been founded upon taking our personal experiences and churning them into political action. That is, our experience as consumers, patients, victims, paid and unpaid workers and as the health care coordinators of our families and friends has stimulated our passion, our critiques, our wisdom and our vision. I'm hoping that as we listen today to Justine, Sunera, Lucie and Carla, they will call to mind our personal stories and help us recall our vision as we go forward today in this process."
--MadelineBoscoe, Winnipeg

The panelists were asked to speak very briefly about their personal struggles and commitments to working for women's health and what empowers them in their work.

Justine Kiwanuku (from Disabled Persons International), Sunera Thobani (National Action Committee on the Status of Women), Lucie Thibodeau (Centre des femmes, Inter-femmes), and Carla Marcelis (Women's Health Interaction), were "catalysts" for the exchanges that took place afterwards in small groups. Madeline Boscoe from Women's Health Clinic in Winnipeg chaired the session.


SUNERA THOBANI

. . .From childhood we are taught so little about our bodies, about our health. We are taught respect for authority, unquestioning respect for doctors - believe in them, they know what is best. We learn about the authority of science and technology at a very early age and what that does is make us doubt our own knowledge of our bodies, of ourselves and of our feelings. Knowing about your body and your health is connected deeply with how you feel about your body and your health; and I think having that knowledge kept away breaks that relationship that women have. That's what I have grown up with, that's what I have seen a lot of women around me grow up with. When I became active in the field of women's health, not only was I learning things about organizing, getting access to resources, but I was also developing a different kind of relationship with my own body, with my own emotions and relating to myself in a different manner. When I think about the barriers women face, certainly I think this is a very big barrier.

For women of colour, for immigrant women, the other barrier we face is not having the language to be able to understand the emotions, what is happening to our bodies, what is done to our bodies, and not having the language to be able to share that with other women. I think I became most aware of this when I was working in the area of new reproductive technologies. Because the technologies themselves are shrouded in so much scientific jargon that even to get to the bottom of what these technologies do and what their consequences are is a real struggle and none of this information is available in the languages we speak in our communities. We cannot access information about the technologies. So for me that's a big barrier that women face as well.

The attitudes of health service providers are a further barrier to women's health and wellbeing . . . A friend of mine discovered she was pregnant, she was a student at that time, didn't have a job and didn't have much choice except to go and get an abortion. And she came to that position after a very long and agonizing process. When she went to have the abortion, she was told at the clinic she had made a wonderful decision because there were too many East Indian kids anyway. And so that is the kind of reality that women live with.

When I think about the politics and culture of Western medicine, I think it's based on the dis-empowerment of women. It's based on controlling women, and so I don't see women getting much out of that. I think we have to look at alternatives, we have to dismantle what is put out to us as "rational, cost-effective, scientific, medical care."

. . . Empowering. Now what empowers? I think learning about other women's experiences, learning what we can change and how we can change that and learning to work together, for me that's the most empowering thing.


CARLA MARCELIS

I was quite happy to be asked to speak here as a lesbian about women's health issues and about our barriers to health care because lesbians have often felt quite invisible at women's gatherings. I think one of the "ecstasies" I see at the moment is that we are becoming more and more visible and the word `lesbians' are being used in papers and conferences.

I also have some apprehension about coming out, as I have everywhere where I come out, and which I am doing more now since I have a daughter. I have to explain that I don't have a husband, a male partner, and that she has two mothers and that the other mother plays an important role - is a mother - not a co-parent. Usually, I get positive feedback but there is always the possibility that I can get negative feedback: that can be on the emotional level of being regarded as different, being disregarded because I am a lesbian, so people won't listen to me any more about what I have to say. It can also go much further and become more serious because lesbians have lost their children in custody battles, lesbians have lost contact with their partners when they became ill, and families of the partners didn't allow access to the lesbian partner.

All these issues put an amazing stress on lesbians. Therefore, it is not surprising that there are about two to four times more lesbians in counselling than heterosexual women. Among young lesbians there are about two to three times more suicides than among other young women of the same age.

I myself am in counselling because another challenge in my life is that I am an incest survivor. And I wanted to talk about that too. We don't know whether there are more lesbian incest survivors than heterosexual women incest survivors because when research gets done, lesbians are not a category in the research. This applies also to other health issues and I think this is something we should ask for. We don't know whether lesbians have more breast cancer than heterosexual women. We know the issues about women who have not given birth, but it would be good for us to know and to have that named. We also may have some positive surprises. Lesbians may have less of a chance of contracting AIDS; lesbians may have less risk of cervical cancer - we think but we don't know for sure because the research has not been done.

Lesbians are also not a homogenous category. I'm sitting here as a lesbian, an immigrant, I'm white, but there are lesbians of colour, young lesbians, older lesbians, lesbians with disabilities.

At the moment, the ecstasies are around working together with all the women here - and the fact that it is ok to be out, although I am slightly nervous about that.


JUSTINE KIWANUKA

It's one thing to be a woman, it's another to be a disabled and a coloured woman. It gives me two or three hats to wear. That's not a very easy thing to move around with, when you have your head with three hats!

. . . Sometimes I wonder how disabled black women manage to survive, but we do. Because I find myself or my fellow black disabled women don't fit quite well or comfortably in one way or another in the society, even to the extent that we are excluded in our fellow women's movements.

My personal strength as a person with an acquired disability was to accept what I acquired; to come to my understanding that the disability I have is part of me. The society didn't make it easier for me either.

. . . There is discrimination against disability or disabled people, but when it comes to disabled women it is even worse. You look for a position . . . for an identity, as a disabled person and you have to struggle to find that identify. It is very hard to live without identity. . . . even our fellow women within their own movement have declined to include us. We always have to go and knock on the door. We are existing, we are here, we have a big contribution to make as disabled people.

My strong hope was to make you abled people understand that the fact I am a disabled woman, the fact that I am `different,' does not really mean that I contribute less; it simply means that I have a limited ability to do what you can do, to a certain degree. But when or if I am given the chance, the time, if you can slow down and catch up with me, I can live within my limits and abled life.

When it comes to health and disability, disabled women live without the right to make decisions over what is to happen to their lives. Disabled women are often denied the right to say what should be for them. They have been faced with sterilization without consent; with learning about new technology and coping with it in their lives. What is going to happen? New technologies are practiced on us.

I think simply because we are disabled we need a voice of our own. We need to be contributors to development. I work with Disabled Peoples International. DPI began as a voice for all disabled people worldwide. I see DPI as a `born again' for the disabled. DPI is trying to reach out to help disabled persons realize that despite the fact there is a disability, we still have a chance and we still can live an independent life, if we are given that chance.

My position in DPI is to work with disabled women's issues. It is a challenge to teach the public and to teach and to empower disabled women. Sometimes the abled think they know it all as far as disabled issues are concerned. I sometimes think that is a disabled behaviour towards disabled people. We must start to realize that you really don't know it all, and neither do we. We all still have to learn, there's a step to go in our lives for both parties and the learning doesn't end.

I would encourage each and every one of you here when you go back to your areas to realize that the disabled women you have left behind have a position, a contribution in life, in development, in community organization and in the society. Unless we join hands we shall always have to fight it by ourselves.


LUCIE THIBODEAU

I work for Inter-femmes, the women's centre in Repentigny, a suburb of Montréal and would like to tell you about our initiative to set up a regional women's health committee for the Lanaudi...re region, where Repentigny is located.

Inter-femmes offers a variety of resources and supports for women and has a holistic and feminist approach. It offers drop-in services, information and referral; popular education and training; and is involved in collective action. We try to respond to women's needs and requests, and address issues of poverty, workplace health, being a single parent, isolation and violence. The goals of the centre are to help women come together and gain greater control over their lives, develop friendships and support networks, become actively involved in issues of importance to them.

Recently, a law was passed in Québec that began the regionalization of health and social services. Lanaudi...re became a new independent administrative region through this reform process. I am a member of the Board of Directors of this regional government body, whose tasks are to manage, plan and organize health and social services.

Of the four persons representing community organizations on the Board of Directors, I am the only one from a woman's organization. However, in order to truly represent such groups, the four of us needed a structure that would let us know what sort of agenda the groups want us to press for. We could easily be told by the others on the Board, "you are the only four with expertise, there are many other groups that differ from yours." So, we set up an association of community organizations - something entirely new.

I then asked myself: "How will I truly represent women? How will I bring forward and defend an agenda on women's health when there is no structure in place to develop and support the agenda?" I needed a solid base of support in order to serve as a representative of women's issues.

We decided to set up a women's health committee and put out an appeal through our newsletter to any interested women. The mandate of the committee would be determined by the members. I was anxious to include consumers, not only women who were involved in health care, such as nurses or social workers. We sought women of all ages, occupations and backgrounds.

Thirteen women came to the first meeting, and another six said they were interested in attending future meetings. We set out four basic principles as a framework for the committee:

  1. Mental and physical health are linked and each influences the other.
  2. Health is linked to the environment, to the socio-economic conditions under which a person lives, to a person's social and emotional networks, to the nature of male-female relations, to work, nutrition, and physical activity.
  3. The health of women is a specific aspect of health.
  4. In addition to being individuals, women are often mothers and so merit attention that extends beyond the individual to the family and society.

We also acknowledged that women are diverse and do not all have the same concerns. The committee's mandate would be to share information and educate its members, research women's issues, and work to create alternative services that are not available in the Lanaudi...re region. Currently, there are two shelters for women who are victims of violence and a women's centre, but there is no women's health centre, no abortion services, no resources for women who are victims of sexual assault.

The women want to influence the decision-making process by developing policies and making recommendations to the regional government health committee about services. The major issues identified for collective action were menopause, services for elderly women, and women and addictions, among others. Future meetings are set.

The regional women's committee is very enthused at the idea of connecting with a women's health network across Canada. The women support my participation here and expect much when I return. We are highly motivated to try and influence the decision-making process in our region, to ensure that the specific needs of women are considered.


IDEAS, FRUSTRATIONS, VISIONS AND STRATEGIES BASED ON THE SMALL GROUP DISCUSSIONS AND PLENARIES ON MAY 22 & MAY 23, 1993

"There is no network that already exists. We're creating it today. There is no committee that's going to take it all, put it all together and hand it to you at the end of the weekend. You are the committee. And there are lots of questions. It's not going to be easy, wrestling with them. And we'll get as far as we can."

Saturday's discussions in small groups ranged broadly and generated excellent and creative ideas - captured on over 100 flip chart pages! Among many topics, the women explored:

By late Saturday afternoon, it was clear that three main areas needed more work:

  1. 1) models for information and exchange

  2. 2) solidarity and action

  3. 3) operations - values of the network, who will belong, accountability, process

    and funding

Sunday's tasks were to address these areas in greater depth. Participants were encouraged to raise whatever questions seemed pressing. We recognized that some people had been thinking about this for a long time and others were just coming to it now, but that everyone could have a voice in shaping the networking process.

Working groups were formed and everyone reconvened later that afternoon to report back in plenary. A summary of the reports along with a sample of quotes from participants are included here. This work and the discussions formed the basis for the decisions about network structure agreed to in the final session on Monday morning.

As the reports were presented, participants asked questions, raised concerns or added fresh points. Presenters wanted to know whether "we are on track or not? Do you approve of the direction?" There was usually consensus about the direction, but in most cases, questions and issues were identified that needed further discussion and clarification.

SOLIDARITY/ACTION GROUP

Finding Common Ground

The groups identified some common ground - issues they felt had to be dealt with by a women's health network if we were really going to be speaking as women concerned about quality health care. These are:

· Support for universality of health care. This includes: accessibility to services, respecting women's choices in accessing services, and understanding women's health needs.

· The detrimental impacts of poverty on the health of women, our families and future generations.

· The oppression of women - reflected in family violence, harrassment in the workplace, in stressful jobs with low pay, etc.- which intimately affects the poor physical, emotional and mental health of women.

They thought network members should:

· Focus on prevention, by addressing the root causes of health problems and applying what we know about prevention and health promotion.
· Be proactive and ahead of the issues to educate and sensitize policy makers, and government agents to our concerns and issues.
· Educate network members about each others' differences and similarities by using community resources on anti-racism, sexual orientation, disability perspectives, etc. to learn about one anothers' issues and strengths, to better understand each other, gather information and support.
· Use the knowledge, resources and skills available within the network and beyond it, locally, nationally and internationally. Identify expertise and support on issues, through databases and catalogues. Serve as resources to one another.
· Support and empower each other through joint actions. Rotate the leadership, using everyone's expertise.


The Meaning of Solidarity

"When we combined our thoughts we found we were talking about: `Unity with diversity; and support without interference' as the key essences that came out of the discussions. "There were times when the network as a national body may want to have one voice representing all members; for example, if universality of health care was challenged, or if women's right to choose what health care they wished to access were challenged, or if accessibility to services was limited for women. "We recognized the need to speak up on how poverty and violence impede women's health and that addressing the root causes of ill health and prevention must be the thrust of programs, not just treating symptoms. So, a Canadian network might speak out with one voice on these broad concerns. "To lobby on specific health care issues, you'd seek support among the members and those who wish to work together on it. If you don't agree with it, you wouldn't work against it. That is what we meant by `support without interference.' "


Funding

The Solidarity/Action group also discussed funding and identified possible sources and means to raise money:

· Government - federal, provincial and municipal. Examples of specific depart- ments: Health Canada, Secretary of State, Multiculturalism and Citizenship.
· Our own organizations. What resources can be shared or used to benefit others in the network? This requires commitment among members to share our expertise or resources, such as printing facilities and newsletters. Current publications might develop a catalogue to list member organizations and what they are doing. Groups might join together in a "buddy" system for their mutual benefit to provide each other with specific resources.
· Membership fees (possibly an initial fee and then a smaller fee yearly; gear it to ability to pay, since many groups can't afford fees).
· Private funding sources: identify corporations sensitive to women's issues.
· Organizations that sell products to women; solicit funding for special projects, posters, materials, etc;
· Look for services in kind.
· Join with other women to form a business and identify creative ways of getting money. For example, most women wear pantyhose! Sell each other good quality products at lower rates and turn the profits towards the network.
· Garage sales; auctions; raffles within our respective organizations or if there will be a central network point.
· Secure a charity number to accept donations or work with another organization that has a charity number.
· Create a women's health investment fund (like an RRSP).

Comments

"I am prepared to sell pantyhose; perhaps not door to door, but I really appreciate the idea behind it. We are women with a certain amount of power and we need to find ways to utilize the power we do have. We don't just have to have bake sales."

"Regarding membership fees, in our case, most of our immigrant women can't afford this. They are concerned with bread and butter, and have no jobs. Bear this in mind."

"I'm the pantyhose suggester. The idea behind it is to start in business instead of just being fund-raisers and waiting for grants, but us taking the responsibility and being creative. So who wears panty-hose here? Being in business and working with women can lead to financial autonomy, one of the basic things to help women. If you can buy panty-hose and help a woman get money for herself, and help your group and a national netwrok survive on an ongoing basis -it's a new, creative way."

STRUCTURE AND MEMBERSHIP

Values and Needs

This group identified and agreed to values that they considered basic for a Canadian Women's Health Network structure. These included:

Then the group brainstormed organizational approaches that might be consistent with these principles. They talked about a network:

The group posed the questions: How would decisions be taken? How would we ensure fair and equal representation from regions?

A second group addressed what might happen immediately after the Consultation. One suggestion was to add regional or national representation to the current organizing committee. They asked that the role of the Organizing Committee and of Healthsharing magazine in the period after the Consultation be clarified. They identified some immediate needs for information:

Comments

"There is one assurance that I would like to hear . . . please give us the assurance that the following women will be represented: 1) women with disabilities; 2) Aboriginal women; and 3) immigrant women/women of colour. In other national organizations, these people are not represented."

"Among this committee, I hope that there will not be just university academics, feminists, but also women who work daily in a feminine way, not just those who intellectualize women's needs."

"I want to comment about the suggestion to expand the planning committee into another form of committee to continue the work. I think I would be very concerned about doing something like that. A planning committee usually has a very specific role, but their mandate finishes as soon as the event is completed and from this group some other type of committee must be formed to continue the job from now on. I hope that other suggestions will come later on to allow us to look at the future. No doubt the planning committee has done an excellent job to take us from wherever to now. And you don't need to applaud, I'm ok! (laughter)."

Membership

Questions were also raised about who would be a member of the network, whether members would be groups or individuals. As one participant noted, we want representativeness, "but you can have a woman who is anglophone, francophone, or from a particular cultural minority who is not necessarily working to empower her sisters.

The women explored the idea of different categories of membership for individuals and for community organizations or institutions. They considered whether the ability to make decisions should be based on agreement with certain basic principles. They raised questions about what types of input groups might have, and how they would join together, without necessarily agreeing on all issues. There was not enough time to discuss voting and decision-making in depth.

It was decided that a working group would explore different options and consult with other organizations about how they handle membership. It was emphasized that the framework for membership within the Canadian Women's Health Network must be a broad one to reflect the commitment to being inclusive and diverse.

Comments

"You wouldn't be excluding individual women from using the network for sure. But what this proposal is saying at this stage is that organizations would be the voting members and that women who aren't in organizations could be helped by others to form one, or invited to join a regional group. The point is we are trying to get some level of accountability and consistency here."

"I just want to reflect that we are building an organization, not a network and the structure and the objective are political. That's what I'm hearing. And we have a national political body already. We have a lot of things already as women. What we don't have is a network that allows every woman access to resources that otherwise are organized in particular uses. So with this, this is not my organization. I just want a network."

"Just to clarify. We are not saying that women as individuals could not access the network. That's not what has been said at all. Using the network, its resources, is there for any woman to access. What we are saying is when it comes to defining and clarifying the role of the network, how it will function, we need to know that people who are doing that are committed to the mission statement. And there needs to be a way of ascertaining that. And that's why the concept of membership voting could be linked to organizations so we can actually see what the mission statements of organizations are. Are they honouring who we are? This point is purely how we make sure the network's structure and mission stay sound by the membership we have. But that is a different point from who can use the network."

"I like the idea of categories of membership. Maybe each individual organization, based on the amount of membership they have, could outline certain categories of membership fees. Because of all the work that still has to get done, and the limited resources of the planning committee after the Consultation, perhaps our membership could fund a part-time coordinator."

"I am concerned if you only say organizations can be members. There are women who don't belong in any organizations or who would like to come individually. Wouldn't we be excluding them, leaving them out?"

"I think it would be useful to hear advantages to having it organized on the basis of organizations and advantages to having it with individual memberships so more direction goes to the Working Group on this and to the Coordinating Committee. It has been advanced that individual memberships allow for more inclusivity.. . . "Last night was the first time I entertained the idea of having it be based on organizational memberships. And the reason that idea appealed to me is that organizational memberships mean there is a group of people working together on something and they are doing something on a local, provincial, regional or territorial way. And that work then links with work in other places. Now I know people also work individually, but it seems to me in forming a network a lot of what we are doing is wanting to build organization and communication between us in new ways and so I think that there is some possibility that going for an organizational basis would allow for greater accountability on a local level than an individual basis."

"I guess I'm hearing that there's something somehow more honorable about an organization which may have 15 or 20 members or 5000 adhering to our mission statement than an individual woman who might do an incredible amount of work in her community but just doesn't happen to have an organization or for whatever reason she hasn't gotten involved with it. I'm hearing that there is a real distinction between the two and I don't think there is or should be. I would like to see more weight given to the idea of individual membership. I guess I'm not convinced by the arguments so far about group membership."

"I just want to again remind us that we've got a lot of history and there are lots of networks out there. The BC Coalition for Abortion Clinics struggled with this point at its inaugural meeting and agreed to have a combination of individuals and representatives of groups with the majority going to groups. We chose that organizations should have the power because we could make organizational representatives more accountable than individuals. The lesson that we need to learn is that accountability is critical. That we need this steering committee and the decision-makers within the network to be accountable not only to themselves but to the communities they live in and to the communities they represent."

"I'm just concerned about the membership that individual women cannot be members. Because we are excluding women - if they are paying a membership fee - why can't they have a say on who is on a coordinating committee or in the voting. I think this is exclusionary and I don't think it's a good way to go."

"Sometimes, an individual woman may be excluded from organizations in her regions for whatever reasons, otheres might not talk to her, or draw her in, but the network and the ideas we are working on might talk to her, draw her in."

"This is not resolved and nor was it intended to be this morning. We are not all convinced of one option over another at this point. We want to strike a focus group that could work with the Coordinating Committee to seek out women's organizations or women could volunteer here, to flesh out other options. This is as far as we got last night. The discussion here will serve as the beginning points." (applause)

Network Functions

The question was posed: "What specifically do we want the network to do? This affects the structure." It was decided some of the functions might be: · Linking and communication - to share information, resources, ideas about women's health issues. · To seek like-minded groups for solidarity and lobbying on an issue - "solidarity without interference." · To develop a capacity to research/respond to new issues or look at old issues in a new way. · To speak as one voice on behalf of its members about some key issues agreed to by all as basic to women's health and wellbeing.

Comments

"We talked a bit about the function of the network being not to overshadow or to take on work that is already existing in Canada - so much is already being done in pockets around the country - but to link that work and that would be a new function not currently done."

"I think that is one of the functions, but I don't see that as the only function. I think that there are issues that will arise that are very important for a Canadian Women's Health Network to address and we need to figure out how they would be addressed. But they will be new issues, they won't necessarily be issues on which we have already developed positions, and even some of the positions we have, may need to be redeveloped, as we have acknowledged this weekend. So I think there are two things: the linking of our resources and information of the already existing organizations, beyond the groups already in this room; and to initiate responses to, and advocate on behalf of, women's health and that means doing some new work at a regional level and also within a central coordinating body."

"In the first presentation we were talking about two kinds of things the network could do: the network as a process of communication, that would allow people to develop contacts and come together. The second was the network as a thing that would speak on behalf of its member groups. And it seemed to me that the first presentation posed that it do a little of both. And so I'm having trouble thinking about structure since what we decide influences very much what we do mean by structure. Is anyone else confused?"

"I agree with linking that function. The other function that I think we are developing is solidarity. And so for me who speaks for whom becomes a question of who stands with whom and if I have an issue of health or whatever, my group or people or community should be the one to initiate the call for action and to get support from the network in whatever ways people can plug in at that time, so the leadership on any issue would come from the people whose issue it is."

INFORMATION/COMMUNICATION GROUP

This group looked at several areas: the overall communication needs of a network, including the need for rapid mobilization and for research information; the use of print resources; and communication through computer and new technologies. They also analyzed the pros and cons of the existing systems and what else might be needed for better communication and exchange.

Communication Needs

When assessing the needs of the users of the women's health network, the women emphasized that it was essential to consider rural, urban, north, south, national, regional, provincial, local needs. As well, individuals and groups have specific needs such as first language considerations, accessible language (no jargon!), braille, signing, large print. Class, level of education, race, age, ethnicity, sexual orientation, ability or disability all have to be considered in anything we develop to ensure it is appropriate, sensitive and accessible.

The group identified some costs, such as securing access to computers and faxes within our organizations (many groups have these already); office space; personnel; time and energy; travel for meetings; newsletter; communicating costs from our individual organizations. Groups must be prepared to take these on and/or seek added funding.

The women identified "guidelines for network communication:" · always a woman spokesperson · adopt a wide definition of health, to include body, mind and spirit as well as the environment · consider socio-economic and political conditions in areas of women's health · be inclusive of groups · consider the power inequalities in decisions as they are made · ensure accessibility · consider a decentralised base for the network, rather than focusing activity in central Canada

For immediate action: · inform and consult with the groups and individuals in our own regions regarding the Canadian Women's Health Network
· Healthsharing should provide information about the network
· survey all the reps here and their contributions and services
· consider forming an "information centre" with a 1-800 number

Positive features to a communication network:
· provides rapid access to up-to-date information
· creates solidarity among groups across the country
· inclusiveness would promote tolerance and acceptance of one another's differences
· there is power and influence through numbers

Some drawbacks to a communication network:
· the distances in Canada. Communication is costly.
· regional imbalances can occur as systems develop since urban groups may have better access to resources than rural or northern ones
· as groups communicate more, there may be more conflict because of the diversity among members and conflicts would need to be addressed

Print Resources

The group suggested that Healthsharing magazine be the major English language print medium for the network. For example, instead of starting a separate network newsletter, a section inside the magazine could serve this function. Newsletters from other organizations could carry news of the network, for example, excerpted from a report done every three months. These print mediums would be a way of promoting the network and getting the information out on a regular basis.

With regards to French language materials, the group suggested making contacts with Femmes D'Action, a national women's magazine. Perhaps they too would carry a regular update on the network. We could promote subscriptions to Healthsharing and Femmes D'Action as well.

Other print sources in other languages will need to be explored.

It was suggested that the network should have a logo.

Computers and New Technologies

This group drew from the experiences and expertise of women involved in developing Nativenet, a bulletin board for use in the Aboriginal community, and from the Vancouver Women's Health Collective, which is developing a health information database and bulletin board for British Columbia. This session helped explain some of the potential of computerized communication systems and laid the basis for further work after the Consultation in the Communication Working Group. It also contributed to the discussion on network structure.

The women started by identifying the pros and cons of computer communication.

The group identified some "guidelines for developing a computerized communication system and database." These included:

Positives of computer communication:

Problems of computer communication:

Databases and Bulletin Boards

The database is where the bulk of the information is entered and stored to be accessed. The bulletin board is where individuals actually do the talking by computer and exchange information. As the group pointed out, "It's cheaper in the long run if you have a database because a bulletin board is just a window into databases."

Information would have to be entered regularly to the database from across the country. We would have to make sure that what came in from one region would actually be passed on to other regions so everyone could access all the available information.

The group proposed a regional plan. Regional databases - five were suggested - would talk directly to each other and maintain up-to-date information. Designated groups in a region or province would access their information directly from one of these five to ensure it was current information. Then local community groups would access information from those designated groups. Since it costs money to download information through long distance phone lines, it saves money to do it regionally. Modems cost much less per minute of service than phone or fax.

The bulletin board would be designed to exchange information. It could have different categories in it, such as urgent messages. The individual goes in (logs on), clicks on what sections they want information about and it opens up into a bigger database or into a smaller information exchange.

Through the bulletin board groups can make announcements, share information, have a directory of resources. Computer conferences can be set up, including ones that no one but members have access to. The database itself can contain health information on various topics, larger resource bases, bibliographies, symptoms, all sorts of things.

In response to a question about the availability of computerized information to visually impaired persons, it was noted that scanners are now available that scan documents and read them through voice. While the technology is costly at present, it is changing so fast that in several years it will be really accessible. This is an important access issue to be noted.

Comments

"If your do it region by region, and each of the regions update each other, it doesn't limit a group from calling PEI and getting information directly from them, but it makes it more cost efficient if I can be sure that every week the system in Victoria has all the information from across Canada in it."

"For example, the Vancouver Women's Health Collective is developing a `symptoms list' for doctors. When women come in with hard-to-diagnose symptoms, doctors can actually look at the database and get additional information they might not have considered before. It's an educational tool for doctors. It's a source of revenue for the organization."

Action Plan

The group then laid out the beginnings of an Action Plan. This will be further developed by the Communication Working Group.

They estimated that this process would take at minimum one year and that it would require about $20,000 to develop the database. Detailed budgets would be developed by the Communication Working Group.

Others in the Communications group added some general comments about communication and mobilizing for action.

"The main idea about mobilizing a communication system is "a connection." We are trying to make connections. And whether or not you use the system on an ongoing basis is immaterial, it's what you contribute that's important. Every little piece counts, every little piece of the puzzle. We're hoping to get a very rich and diverse base by having this database and that over time, we'll be able to mobilize forces when needed, but it's not necessary that you contribute all the time, you may only find you need to use it once a month or once a year, but the point is it's there and accessible."

"We thought it important to identify some of the key issues that the network could look at and to develop some type of a standardized approach. For example, if you are going to mobilize on birth control, then we could have a standardized letter that everyone could use as a basis for advocacy to send out . . . that's one kind of action, taking a national point of view. It's something we can discuss as we progress."

"We want to identify the expertise. We have a lot of expertise in this particular group, and at this point we need to identify it, develop it and find a way to tap into it. That includes the multi-lingual aspects since we are dealing with women from different cultures and languages."

"We need to identify the resources of those organizations not here now but who want to contribute and be part of the network."

"As far as existing resources, many groups already possess computer, fax and e-mail. But there are others that don't and we need to take them into account."

"A 1-800 number has been suggested, but it will take some time to figure out how to implement this cost-effectively."

THE "BIG PICTURE" GROUP

This group formed after lunch on Sunday, composed of about twenty women from some of the other groups. They wanted to try and develop an overview of a possible interim struc- ture for the network. They worked for an hour to tie together various ideas that had surfaced.

They started the process by identifying some of the common values, and starting to draft a mission statement. They suggested that:
· Those who adhere to the vision and values, individuals and groups, can be members of the network. · That there be an interim steering or coordinating committtee, that it be representative and inclusive and have as its mandate:

  1. Seeking funds.
  2. Reworking and developing further the mission statement started here.
  3. Developing a plan of action.
  4. Taking a coordinating/leadership role.
  5. The structure of representation would be provincial and territorial which There would need to be sectoral representation as well to ensure inclusiveness.

WEAVING IT TOGETHER

After the groups reported, the women recognized the need to draw together the ideas and proposals to form an action plan that hopefully, could be agreed to the next morning. Yet women were tired. In particular, many Francophone women were exhausted from trying to follow the largely English discussions in the plenary through simultaneous translation.

The suggestion was made that those who still had the energy, and the organizing committee members, meet to develop models, based on what had been discussed so far. These would be presented in the morning, with timelines. Others would go off to informal meetings or just recoup their strength. About two dozen women, including some of the facilitators, volunteered to return that evening. The results of this process have been presented in Section A of this report.

THE CLOSING CIRCLE: PASSION AND HOPE

The morning's work was done. The women gathered in a circle. The translators and interpreters were invited to join the circle and thanked for their hard work. The women were asked to think about one commitment each might make to move the network forward as soon as they returned home and something they might give to the network. They turned, faced homeward and shouted their particular actions and thoughts in unison.

Aboriginal and M&eacupte;tis women passed sweetgrass around the circle, offering it to everyone before leaving for home, "as cleansing, as thanksgiving, as unifying yourself and being in regulation with each other, as we do our final words and closing . . . In the circle, you say what you need to say before you go. So now is the time."

This is what some of the women said:

"I want to thank the organizers; it has been well carried out. There was a great effort to bring us from all places. It has been the long weekend - and a good experience for me and I really enjoyed it and appreciated you all."

"Thanks to the organizing committee for having excluded the press."

"I have gone to several workshops and conferences, not only in Canada but around the world. Here most especially, I feel the aura of each and every one, your acceptance of us immigrants. It's wonderful. This is the banner that I shall carry home and carry all over Canada. Yes, in the health network, we are accepted."

"I want to make a very personal appreciation to the women that I had personal close communion with this weekend. I find myself empowered by being here. I also want to appreciate everyone for making a very determined, forceful commitment to resolve the very difficult issues that we faced and I think we overcame a lot of personal fears, we broke a lot of barriers and I think we are well on our way."

"I have a sense of appreciation for the amount of effort and energy that many people put into making this go well. I would particularly like to recognize the women who have worked all weekend in a language that is not their first language."

"It took a lot for some women to get here and for some women to carry one and this should be acknowledged. Some women had traumas before they came, and came anyway. There were losses here - one woman had a miscarriage and we feel deeply sad about that. There were women who felt very tired, but still continued on. That's what we are very good at doing, carrying on."

"I want to thank all the women who were not here today but who are thinking about us and sent their energy here to us so we could work together."

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