Better Health For All

It’s World TB Day on 24 March 2019.  Tuberculosis (TB) is preventable and curable, and World TB Day falls on 24 March each year, commemorating the day in 1882 when Dr. Robert Koch first announced he had discovered the bacterium causing TB.  Global efforts to tackle TB make a difference and are estimated to have saved 54 million lives from TB since 2000. 

However, World TB Day is an annual reminder that TB remains a huge threat to public health worldwide.  The World Health Organisation still describe it as the world’s ‘deadliest infectious killer’, as every day nearly 4,500 people lose their lives to TB, that’s about 1 every 20 seconds.  In England, a Collaborative Strategy introduced in 2015 has resulted in a fall in TB rates and numbers, but there are concerns that without the continued collaborative efforts and funding to continue addressing this as a public health priority we’ll regress back to previous rising trends when this strategy comes to an end in 2020. 

The World Health Organisation has launched a joint initiative ‘Find. Treat. All. #EndTB’ with the Global Fund and Stop TB Partnership with the aim of scaling up the TB response and ensuring universal access to TB prevention and care.  This World TB Day, the WHO calls for partners around the world to unite forces under the banner ‘Find. Treat. All. #EndTB’ to ensure no-one is left behind.  The theme this year is ‘it’s time’, emphasising the urgency to act on commitments made by global leaders to: 

• scale up access to prevention and treatment
• build accountability
• ensure sufficient and sustainable financing including for research
• promote an end to stigma and discrimination
• promote an equitable, rights-based and people-centered TB response

Across Yorkshire and Humber, there are a wide range of World TB activities to raise awareness of the continuing threat of this disease spanning across multiple organisations such as:

• Lighting up buildings across the region as part of ‘Light up the World for TB’  
• Digital and rolling posters at Leeds City Council and at bus shelters  
• A health bus to promote TB awareness, provide clinical support from TB nurses and translator services in Dewsbury and Huddersfield, and another health bus in Sheffield 
• Social media promotion across the region. 
• Letters sent to all community pharmacists across Kirklees, with an article in their bulletin, asking to support the LTBI programme by displaying posters sent to each pharmacy 
• Clinical Commissioning Group and practice staff bulletins in Bradford 
• Stalls at Girlington Community Centre and other sites throughout Bradford
• Practice protected time outs about TB, the latent TB programme and World TB Day 
• A TB nurse interview on Sangham Community radio, which drew an audience of almost 185,000 listeners 

Leeds Town Hall on ‘Light up the World for TB’ on World TB Day 2018

Colleagues and I from Public Health England and local authorities will be running a symposium at our annual regional Association of Directors of Public Health Sector-Led Improvement conference on what local authorities can do to tackle TB and what support can Public Health England offer. We will be focusing on people with TB who have nowhere to live and no recourse to public funds as this poses a particular challenge.  There is no nationally agreed pathway for providing accommodation for these people, yet without the basics like somewhere to live there is no way we can effectively and humanely treat these vulnerable people and prevent spread to others. We hope to pull together a resource of information for local commissioners trying to develop pathways to address this issue. 

It’s time to find, treat and end TB for all! 

Written by Claire Gilbert, Public Health Specialty Registrar.

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“Deafness separates people from people”  Helen Keller  

Hearing loss is highly prevalent and can have profound effects not only on communication, but also on health, wellbeing and quality of life for individuals, families and communities. On Thursday 6 December 2018, at the Curzon Cinema in Oxford, the Public Health Film Society in conjunction with the Faculty of Public Health (FPH) Special Interest Groups (SIGs), Public Health England  and Oxfordshire County Council kicked off the start of the 3rd Public Health Film Festival with a screening of the Oscar winning film “The Silent Child”. The aim was to raise awareness of hearing loss in children and its potential for significant personal, social and economic impact.  

The short film was introduced by the film’s writer and producer Rachel Shenton. It explores the tensions and differences in expectations between the hearing family of a young deaf girl and her specialist teacher who attempts to nurture and improve the child’s communication skills and ability to interact and connect with others.  The family however remained resistant to learning sign language and did not have high expectations for their daughter.   

Following the film, a panel of experts engaged in discussion with the audience and the film proved most effective in galvanizing debate on this important public health priority. The ensuing debate covered issues including: 

1. Policy: at national level there is PHE’s screening and prevention programme offering hearing tests to newborn babies and children to identify any problems early on in their development along with PHE’s wider work around speech and language.  NHS England and others produced an “Action Plan on Hearing Loss” to support services for deaf people and others recommending ways that services can be improved. 
2. Partnerships: further integrated and holistic approaches should be developed with more joined up approaches across services to reduce, for example, developmental and educational gaps and to increase personalised care planning.   
3. Awareness and understanding: work to strengthen understanding amongst the public and professionals including dispel the myth that deafness is a learning disability given deaf children have the potential to achieve the same as any other child with the right support.  
4. Data and intelligence: enhance the quality of data collection and monitor this more effectively to better understand social, financial and personal health implications. 
5. Resources: the direct cost to the NHS of managing hearing loss is estimated to cost up to £450 million a year. The Minister of State for Children and Families reported councils were given £223m extra funding to pay for the biggest reforms to special needs education in a generation, with new education, health and care plans tailored to the needs of every child; however the “Consortium for Research into Deaf Education” reported the number of teachers of the deaf had been cut by 14% in the past seven years, at the same time as a 31% increase in the number of children requiring support.  

The panel was chaired by Uy Hoang, President, Public Health Film Society. The experts on the panel were: 

• Richard Kuziara, Health Improvement Practitioner, Oxford County Council 
• Karen Saunders, Health and Wellbeing Programme Lead/Public Health Specialist, Public Health England (West Midlands)  
• Alison Kahn, research and tutorial fellow in material culture and film at Stanford University in Oxford and Director of the Oxford Documentary Film Institute 

This briefing will be shared widely and feedback is welcomed. If you’d like to read the briefing, please contact Uy via email: publichealthfilmsociety@gmail.com. 

Written by Karen Saunders, Health and Wellbeing Programme Lead/Public Health Specialist, Public Health England (West Midlands) and Co-Chair of FPH’s Children and Young People Special Interest Group. 

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The second Wessex Public Health Conference, to be held on March 15th at St Mary’s Football Ground in Southampton, poses the question ‘Are we getting serious about prevention?’, as per the Five Year Forward View and the NHS Long-Term Plan.

Our annual conference draws colleagues from across the breadth of the public health
community in Hampshire, Dorset, Isle of Wight and Channel Islands, including staff in local authorities, NHS services and academics from our local universities. The conference is organised by a Wessex-wise public health collaboration and is led by Health Education England (HEE) and this year we have been greatly
oversubscribed with 250 delegates confirmed to attend.

The conference themes pose critical questions to our professional community. Are we doing enough to act on basic needs, mitigating the effects of poverty and ensuring access to basic requirements of food, clean air and housing? What are the threats and opportunities in public mental health and what more should we be doing? Given our skills in system leadership how can we use these to influence the direction of policy and service reconfiguration towards prevention? We are delighted that three eminent and influential keynote speakers have agreed to introduce the debates around
these issues:

1. Professor Richard Wilkinson, co-author of ‘The Inner Level: how more equal societies
   reduce stress, restore sanity and improve everyone’s well-being’;
2. David Buck, Senior Fellow of Public Health and Inequalities at the Kings Fund;
3. Dr Julie Rugg from the Centre for Housing Policy, University of York.

We will have four streams of workshops and oral paper sessions running throughout the day, including in addition to the three above, a fourth open stream on local public health action. There was an enthusiastic response to the call for abstracts so we have a full programme of four workshops on System Leadership, Air Quality, Mental Health in Teenagers, and Housing and Homelessness; and over 30 oral presentations in other sessions. There will also be 40 posters which will be judged to award the Best Poster Prize of the day, as well as a full range of Exhibition stands.

We are also very pleased to welcome FPH President, Professor John Middleton, and FPH CEO, James Gore, who will be running a lunch time meeting for all delegates to have
the opportunity to discuss professional issues with them. Also this year we have teamed up with the Saints Foundation, the charitable arm of the football club, who will be offering lunchtime fitness activities.

The conference is seen as a key development opportunity for our Specialist Registrars, some of whom have helped in planning and ensuring that we have a clear sustainability policy to minimise the environmental effects of the conference. The planning committee has been a collaboration across our public health teams, academics and PHE colleagues and we are grateful for their involvement and all the contributions to make a success of the day.

Written by Dr Viv Speller on behalf of the Wessex Public Health Conference 2019 Planning Committee. The agenda for this year’s conference is available here. 

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At FPH’s Annual Conference 2017 in Telford, I learned about recent medical evidence and forthcoming research that widely acknowledges the value of Animal Assisted Intervention (AAI) –  including Animal Assisted Therapy (AAT). 

Animal-assisted therapy is an alternative therapy that involves animals as a form of treatment to improve a patient’s social, emotional, or cognitive functioning. According to Nagasawa et al, social interaction with dogs can increase the level of oxytocin – the happy hormone – in humans. This is known as amazing gaze, or oxytocin gaze. 

Dr Sigmund Freud, a pioneer in the field of psychology, often had his pet dog, Jofi at his side during psychotherapy sessions with patients. According to several reports on the topic, Freud himself was more relaxed when the dog was with him but he noticed that the presence of the dog had a positive impact on his patients too.  

However, the concept of pet therapy was conceptualised by child psychologist, Dr Boris Levinson. According to several reports on the topic, he noticed by chance that sessions with one of his patients were more productive when his dog Jingles was in the room.  

While there are more than 50,000 Therapy Dogs in the United States and Canada, the role of Therapy Dogs in the UK is slowly but surely gaining popularity; namely in airports, schools and even hospitals. 

Here are some examples of our furry friends helping humans in their role as therapy dogs across the UK: 

1. Harley was the first therapy dog to be introduced at Aberdeen Airport to calm passengers before their flights 
2. Bella the Staffordshire bull terrier is a former stray dog who spends four days per week at  Shirebrook Academy in Derbyshire. The dog – who has her own tie and timetable – helps children with mental health issues and those on the autism spectrum.  
3. In Eastbourne, another dog called Bella won the ‘Inspiration’ Award at the More Radio Eastbourne Awards 2017, by the brother of a patient who had suffered a stroke. On her ward round the hospital, Bella visits patients across all the departments but is particularly appreciated on the stroke and dementia wards. Donna Bloodworth, Stroke Unit Matron said: “Research has suggested that introducing a companion animal into therapy session can result in patients feeling more at ease, enhancing communicative tendency and motivating to engage in therapy. Bella and [her owner] Barry have touched many people’s lives by coming into the ward.” 

All of these stories show that pet therapy or pet ownership can have significantly positive effects on a person’s mental health and well-being. I can see how a dog could also play an important role in helping people struggling to find a sense of community – particularly in cities like London where demanding lifestyles, unjustifiably high rents and a lack of social housing make it hard to find a place to call home.  

Sharon Hall of Noah’s Art  has been extremely helpful in enlightening me about the unique approach in AAT for a variety of needs: empathy, stress, emotional comfort and mindfulness. Moose, a spaniel and the centre’s resident dog therapist was absolutely captivating. Personally, I had an amazing experience with a brilliant Dalmatian called Mr Bond who I photographed as part of a photo competition. I was introduced to Mr Bond by David Allen, formed CEO of FPH, who commissioned me to photograph former FPH President, Professor John Ashton, for his President’s Portrait. 

Written by Ray of Light, London Photographer and a friend of FPH. Click here to read more about Ray and how you can commission him.  If you’d like to learn more about the positive impact that dogs can have on the public’s health, click here. 
 

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