Since 1909 International Women’s Day has focussed attention on women’s work. When hundreds of young working class immigrant women were killed in the Triangle Shirtwaist Factory Fire in New York City in 1911, IWD became truly international. March 8 provides a time to both reflect and act on what has happened in the lives of women during the past year. For many of us IWD was an important introduction to the women’s movement and issues. The marches, demonstrations, dances and celebrations in early March are often the focus of debates and struggles within the movement itself. The first time we marched with women through the streets of Vancouver in the 1970s we were overcome by the energy and commitment of groups whose banners proclaimed the Vancouver Women’s Health Collective or rape crisis centre, lesbian mothers, anarchafeminists, anti-poverty or arts collectives. In the later 1990s our enthusiasm tends to fluctuate. Despite gains made by grassroots and academic women in Canada, hundreds of thousands of women remain isolated through poverty, ill-health, violence, race, geography, lack of access to education, little economic decision-making power, poor wages and double or triple workdays. Why then, should we continue to celebrate what appears to be a paradox? Perhaps because the victories feel so precious.

One small victory has occurred. Over the last few years the voices of women speaking about their own health and the health of their various communities have grown strong across the country, and the world. What women have known for years — that health is inseparable from our status — is increasingly being heard, and is reflected in the Beijing Platform for Action (1995) which says that the "major barrier for women to the achievement of the highest attainable standard of health is inequality, both between women and men, and among women." Certainly Canadian women have contributed to an analysis of health and an ongoing critique of the health system. This year for example the Vancouver Women’s Health Collective celebrated 25 years of action and service to women; a Canadian Women’s Health Network is underway, and last summer Health Canada announced funding for five Centres of Excellence for Women’s Health. One of those centres, the BC Consortium (community groups in northern & southern areas of the province, BC Women’s Hospital, UNBC, UBC, and University of Victoria) will focus its work on the health needs of women, the patterns of health provision, health reform and other determinants of health. As researchers and teachers at UNBC, our work with community partners and academic colleagues will hopefully begin to address the effects on health of a northern and remote environment.

While we know that women’s health has received disparate attention from researchers, much of the information we do have is the result of research conducted in southern urban centres. Barriers to equitable access to health care are exacerbated by geographical isolation, lack of qualified health practitioners, and the need to travel south at great cost for many services that are taken for granted in metropolitan areas. Such disparity is magnified by race/ethnicity, poverty, sexual orientation, and environmental factors (air quality, the effect of clear-cut logging on water supplies and wild foods, etc.). Communities in northern BC for example, have been shown to have air pollution measurements at a level well above that which has been determined to have adverse health effects (Provincial Health Officer’s Report, 1995). Similarly, northern areas rank worst on a list of three socio-economic variables: percentage of people on income assistance (a large number of whom are single parent mothers), lowest percentage of high school graduates, and the highest percentage of people over 15 who are unemployed. These statistics have been shown to correlate with higher death rates; northern areas also rank highest in age-standardized mortality with concomitant high rates of drug and alcohol abuse.

Through a Northern Secretariat of the BC Centre of Excellence, community women from across the north, and academic women at UNBC will examine ways to improve the health status of women who live in remote, rural and northern areas, and whose health concerns may be complicated by geographic isolation, lack of access to women-centred care, and other issues mentioned above which are only recently seen as affecting health. Women of aboriginal ancestry for example, comprise about five per cent of BC women and 30 per cent of women in the North; and their life expectancy is nearly 12 years less than the provincial average. Violence, the suicide rate, poverty, the need for culturally sensitive health services coupled with experiences of racism and the effects of ongoing stereotypes magnifies the health issues immeasurably.

In our joint meetings with women from across the North, regardless of affiliation, women consistently identify family violence, mental health, addictions and reproductive health as their key health issues. For Northern women a related social and emotional cost is being separated from intimate support if they or their loved ones must receive health services away from home. Prince George has the only contraceptive planning clinic in the upper two-thirds of the province. The highest rates of teen pregnancy are reported in this area, as are hysterectomy rates. (Provincial Health Officer’s Report). Additionally, in northern communities women earn less than the oft-quoted figures of 65 per cent of men’s wages (a recent survey showed that women in Quesnel earn less than 50 per cent of men’s wages).

Through our sporadic planning meetings with community women we have talked about how our lives in northern communities vary from near-urban conditions to near-third world. Despite these differences, each woman talked about her experience of health barriers: aboriginal women, lesbians, the elderly had faced health crises in their communities related to marginalization and isolation. Those of us working with the Northern Secretariat will ensure that the centre’s work effectively encompasses and integrates the unique cultural, geographic and economic dynamics faced by women living in this part of the province. It will also provide a concrete mechanism by which northern women are able to truly participate in the development of women’s health policy which accurately reflects our needs. Together community and academic women are attempting to uncover the work that women do to stay well in isolated environments, and to create ways to provide health care that women say we need.

In our theorizing we tend to separate the community from the academic — forgetting perhaps that we are connected to communities of choice or location. Our hope is that the Northern Secretariat will serve as a model for establishing productive partnerships among community and academic women, as well as among women in geographically isolated areas and larger urban centres for action research and policy development regarding our health.

This year International Women’s Day will be a time to celebrate our health "work" and to gather energy to discover creative solutions.

Barbara Isaac has coordinated the work of the research and management group of the Northern Secretariat. Barbara Herringer is a member of CAUT’s Status of Women Committee. Both teach in the Faculty of Health & Human Sciences/Social Work at UNBC.