CHAPTER 3

ADULT HEALTH LEARNING

For Women, with Women

A key area of work for feminists, both inside and outside of organizations, is to build broad-based support for women’s health, often with the help of multiple partners and with a vision of health that transcends clinics and doctors. And, at times, this support has to be built in visible and provocative ways. When Theresa Spence, chief of the Attawapiskat First Nation in Canada, could see what the poor housing and infrastructure crisis was doing to her people, she knew drastic action was called for (Wotherspoon & Hansen, 2013). As a leader, she did not feel heard by the various levels of government, so she took matters into her own hands in 2012, staging a hunger strike near the national House of Parliament in to show that her people needed help. This drastic act served as a visceral lesson in ’ angst, anger, and action. Spence’s hunger strike was widely televised and tracked through Facebook and Twitter—it is a prime example of how one woman with race written on her body, could be a symbol and a living embodiment of protest for other Aboriginal women in Canada. Theresa Spence and the other indigenous women who have played major roles in these movements in the early 21st century that are collectively called , were asking for respect and healing for their people. In the words of Wanda Nanibush (2013): Women who have worked at the ground level healing their communities from historical trauma, who deal with large socio-economic disparities and have counteracted cultural discontinuity—all brought on by colonialism and racism—bring a considerable knowledge base to the movement. (p. 504) Deep within these words are a notion and a belief that a holistic way of looking at issues is important, and that it is not enough to focus specifically on First Nations’ education or housing; healing, which encompasses all the issues that affect the community must also be a focus. This broad notion of what will make the First Nations strong again is reflective of the social determinants of health (SDOH), which the World Health Organization (2011) defines as: the circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics. (n.p.) So, in addition to lifestyle factors and behaviours, adult educators working with First Nations’ populations need to look more broadly at our full context, something the Idle

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No More leaders have tried to do. This movement in support of First Nations’ rights was criticized by some for lacking focus, but they have reflected the complexity of the multiple causes of the injustices First Nations face. No matter how many individual programs have been implemented to respond to individual crises, the root causes are not being fully acknowledged and addressed in the way that Idle No More activists call for. For adult educators, one of the key ways to support people’s analysis of the complexities is to foster learning and education, both formally in schools and institutions, and informally in homes, communities, and groups (Coady, 2013).

CONNECTING HEALTH AND LEARNING

In the global sphere, adult health learning (AHL) has become increasingly important, both as a practice and as a lens for viewing social complexities and issues; however, the term itself is not widely used or understood. Simply put, AHL is a broad-based concern for learning and acting on the social determinants of health (English, 2012), and it pays particular attention to the ways that women are affected. AHL connects many other pieces to education, to the larger social context, and to the ways in which women live and learn about life. Indeed, the United Nations Decade for Women (1976–1985) tried to address many of these issues on a global scale, but most are still with us. When the MDGs were drafted, a deliberate effort was made to focus on select and measurable issues, which resulted in the decontextualizing of interlocking causes and decreased the potential for multisectoral approaches. Further, these MDGs are enacted primarily in the formal political sphere, where women’s representation is marginalized (Cornwall & Edwards, 2014). Adult health learning goes much deeper to analysing the system and critiquing it, and finding alternate pathways for pressing for change. Such a holistic approach to health learning is responding to growing critiques of the medical model. Mainstream health education following the medical model tends to assume the expert knower as lecturer, imparting expertise to the citizen as client of a system, and health as located in specialized medical facilities. For a long time, certainly for much of the second half of the 20th century, health was increasingly centred in the expertise of medical doctors, hospitals, and in the pharmaceutical industry. Women’s reproductive health, for instance, was medicalized and child bearing was treated as an illness rather than a natural event. With increasing professionalization in many aspects of health care, it was common to see health as resting in the purview of experts, with citizens becoming more and more dependent on the knowledge and skills of a select few (Coady, 2013). With the growing attention to the social determinants of health, however, citizens have slowly taken back ownership of their health and their right to address and assess their broader interests in it. We see this in women`s reproductive health initiatives, lobbying to legalize midwives and home births, and growing attention to the safety of the food supply. While most of us know that the better our education and income the better our health, we do not often think about the fact that health is more than the absence of disease or the presence of adequate medical supports, in that it concerns itself

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