Immigrant Women's Health Centre

December 06, 2011 18:34 ET

Sexual Health Services for Toronto's Immigrant Women Under Dire Threat from Ford Administration

TORONTO, ONTARIO--(Marketwire - Dec. 6, 2011) - In a unparalleled attack on sexual health services for Toronto's immigrant women, the Ford administration's Core Services Review is considering a massive cut of $200,000 to the Immigrant Women's Health Centre. The 22.5% cut to its already modest budget will hobble one of Canada's leading lights in the delivery of critical health care services and impair access for thousands of immigrant women.

Bypassing any semblance of democratic process, Mayor Ford's review has precipitated a crisis by silencing those who deliver services and the communities that depend on them. No impact statements have been solicited. Instead, the centre has been given only two minutes to make its case.

The IWHC is not only a pioneer in the delivery of sexual health, it is held in high esteem by hospitals, community centres, the medical profession and clients for the practices and protocols it has developed over more than three decades. "IWHC's expertise in dealing with diverse cultural practices and overcoming the many, many barriers encountered by immigrant populations have resulted in the trust and confidence of women who have accessed our services," said IWHC Board Member Mary di Felice.

"Mayor Ford must not follow in Harper's footsteps, targeting immigrant communities and the service providers they depend on. With Toronto's immigrant population at more than 50%, this is sheer folly. There is a compelling need for more, not less, funding," she said.

By the end of the year, the IWHC will have served almost 5000 women in nine languages in hard-to-reach and marginalized communities. Its celebrated Mobile Health Clinic Program delivered on a 31-ft Winnebago is a traveling medical clinic offering services such as STI screening, emergency contraceptive pills, birth control, pregnancy tests, Pap tests and breast exams, and is staffed entirely by women.

"Imagine having a case of genital warts and not knowing how to communicate your health complaint because English isn't your first language. Or hiding it untreated because of shame and fear. Or suffering in silence because every trip out of the house needs your husband's permission. This is the reality for thousands of immigrant women in this city who rely on our medical staff and service providers," said Ayesha Adhami, Administrative Coordinator.

The IWHC will depute to the City's Budget Committee during its public hearings tomorrow, Wed., Dec. 7th.

MEDIA: See backgrounder attached to this release.


Who we are:

  • Immigrant Women's Health Centre was created in 1975 to address barriers to sexual healthcare specific to immigrant and refugee women. We serve women in 9 different languages, in a culturally sensitive environment, and with an all-female staff at our site clinic at 489 College St. location and through our pioneering Mobile Health Clinic Program. The Mobile, a 31-ft Winnabego, redesigned in a clinic format - delivers sexual health services to women all across Toronto.

  • 85% of our funding dollars come from the City of Toronto's Public Health Department.

What's at stake:

  • As a part of the Core Service Review, recommendations for cuts were made to the Board of Health in September, in-camera

  • IWHC was not advised that a $200,000 cost-cutting recommendation was being made for the Centre and we were not given an opportunity to depute as in previous years

Downloading cuts to immigrant communities:

  • In-camera and package cuts with no impact statements from those who stand to be affected, amount to cost-cutting by stealth; a non-democratic way of doing government business that we have already seen at the federal level and are now experiencing at the municipal level.

  • Also similar to the federal government, the Ford administration's service cuts appear to be targeting immigrant services - particularly distressing given Toronto has a 50%+ immigrant population, including Ford's own constituents

  • Despite there being three contracted clinics, cuts were downloaded ONLY to the sexual health service provider that specializes in immigrant populations

  • Only $50k of city money is being saved; under the 20/80 funding agreement for the Public Health Department with the province, the MOH is saving more money than the city by cutting IWHC funding

  • There are other ways that the city can save money than by creating further inequities for vulnerable and marginalized women

Why the rationale behind the cuts is flawed

  • Since our inception in 1975, the City of Toronto's Public Health Department understood that dealing with immigrant women took approximately 1 1/2 times longer than dealing with English-speaking women; facilitating interpretation between the medical service provider and the client is especially time-consuming

  • Women who utilize our services have higher instances of language/literacy barriers, domestic abuse, mental health issues, and poverty. Navigating sexual health medical assessments through the effects of these social determinants of health is both difficult and time-consuming

  • No other clinic runs the Mobile Health Clinic Program - which targets hard-to-reach women in marginalized communities; through agency partnerships and workshops we access pockets of women isolated from mainstream sexual health services. In 2010, IWHC reached 1964 women through sexual health workshops, displays and other forms of outreach

  • It is time-consuming and costly to build trust of service and frequency of usage in insular communities, particularly in matters of sexual health; other clinics do not get 1/4 of the clientele through this much resource investment

  • The cost of running and maintaining the Mobile Health Clinic vehicle has risen greatly with the price of gas and repairs, as well as operational expenses; it costs approximately 17% of our overall budget

Sexual Healthcare Services are not accessed simply because they are offered:

  • Stigma and lack of education play a huge part in immigrant communities accessing sexual healthcare. The feeling that Canadian service providers don't understand client needs or cultural concerns may also impact use

  • Sexual health knowledge and literacy is not high among women, no matter if you are from another country, how long you have been in this country, or even if you are Canadian-born

  • In some immigrant communities, we must be sensitive to how sexual health discussions take place; for example, HIV and other STI related workshops may be met with denial of possible partner infidelity, denial of risk, homophobia, fear of guilt by association and may prevent immigrant women from attending

  • For sexual health outreach to translate into accessing service, the approach must be culturally sensitive and build trust of confidentiality

  • IWHC will typically arrange workshops on birth control or Cervical Cancer Screening and create trust and a comfort level before offering screening services

  • Meaningful sexual healthcare is more than handing someone a box of condoms

  • Quality of care suffers because the language barrier can inhibit the communication of medical history and symptoms, physical examination, delivery of prescriptions and self-care advisory from the physician.

  • Language barriers also play a huge role in medication non-compliance for non-English speaking patients, which is very dangerous when dealing with public health concerns such as Gonorrhea, Syphilis and Chlamydia

  • IWHC provides a space where these issues are comprehensively and respectfully addressed with clients

  • We have a reputation among immigrant communities to the extent that we have had women call us from their countries of origin even before they have arrived in Canada to find out about our services and book appointments

Don't just sit there, find us some clients!

  • Our Mobile Health Clinic Program is a pioneering concept in sexual healthcare delivery

  • Our barely 5ft tall Mobile Health Clinic coordinator drives a mammoth 31-ft Winnebago, taking a doctor and a sexual health counselor to areas like Agincourt, Malvern, Jane/Finch, and Weston Road, where sexual healthcare resources are scarce; to community agencies and newcomer settlement services; to education bridging programs in community colleges and ESL classes all across the city

  • Women can access sexual healthcare services two steps from where they study, work and raise their kids

  • Mobile Program started as a pilot project with Health and Welfare Canada in 1981; after its success, funding was taken up by Toronto Public Health and integrated into IWHC's operational budget

  • MHC program has been around for over 30 years

  • IWHC fundraised for a new Mobile in 2003

  • Launched at City Hall in 2005; hailed by the Late Dr. Sheela Basrur, then Ontario's Chief Medical Officer of Health, as an innovative system of delivering sexual healthcare

  • 1/4 of our clientele comes from the Mobile

  • Constantly increasing demand; we are already booked into April of 2012

  • No advertising - it is all word of mouth


  • Public Health Policies need to reflect the reality of the clients

  • The over-burdened healthcare system cannot meet the service demands of the growing population, especially the inequities of access faced by immigrant women

Contact Information

  • Ayesha Adhami
    Administrative Coordinator, IWHC

    Dr. Sheila Wijayasinghe
    Medical Director, IWHC