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Archive for the ‘women’ Category

Celebrating women in public health

Posted in women on March 8, 2018| Leave a Comment »

By Sue Lloyd, Fellow and Board member of Faculty of Public Health

During the past year the Faculty of Public Health (FPH) has been celebrating the contribution of women to medicine and health alongside the Royal College of Physicians. As a woman working in this field it’s been a joy to hear the stories of women’s lives and their work to improve the lives of others, despite the challenges, or maybe because of the challenges, that they faced.

It’s not an accident that woman have been active throughout human history in improving the lot of us all; it’s part of our DNA. Women have always been active as carers whether in an official capacity or not, this being subject to the whims of the cultural orthodoxy of the time. We’re fortunate to have seen great contributions from the likes of Kitty Wilkinson, the Liverpool ‘Saint of the Slums’ who in the 1832 Cholera epidemic offered her boiler to slum families so that they could wash clothes (this killed the bacteria); Josephine Butler who campaigned to end child prostitution; and Anne Bieznak, who opened the first Catholic contraceptive clinic, after she had personal experience of eleven pregnancies by the age of 34 years. These are just a few examples, of many.

Public health historian Virginia Berridge of the London School Hygiene and Tropical Medicine, said: “Women have played a significant role in public health in the past – just think of the work of the Ladies Sanitary Associations in the nineteenth century which were one of the first ways in which women were visible in public life. We must use knowledge of that past history in planning for the future of public health.”

Today, we are joyfully celebrating International Women’s Day. FPH is proud that from its establishment in 1972 women and men have always been equally active partners.
Many of the institutional challenges that FPH’s founders overcame have been removed. Rosemary Rue (President 1986-1989) was expelled from her medical degree when she married and was later sacked from her first job when it was discovered that she had a husband and child. Rosemary pushed against the cultural norms of her time as a woman to improve housing, water supplies and immunisation in Oxfordshire, where she was Chief Medical Officer.

It’s fortunate that these barriers are now somewhat diminished, but as public health professionals we are always vigilant that these barriers don’t transform into something else, something with a different name. We see echos of this in the #MeToo campaign.

As we move forward into a new era where women and men are contributing equally to health and social care we want to celebrate what has gone before and to hope for a truly integrated future.

We look forward to seeing health in all policies and the radical prevention approach integrated into new ways of working.

Dr Catherine Calderwood, Chief Medical Officer, Scotland, celebrates this future with the following words: “Despite the social and cultural obstacles facing women, evidence from across the centuries clearly shows them at the forefront of delivering practical solutions to past public health issues. Although attitudes to women providing healthcare have changed, I am sure that we will continue to make the same positive contribution to drive forward improvements in public health in the future.”

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AHPs excelling in public health

Posted in AHPs, Ambulance, dietitian, Obesity, physiotherapists, women on November 22, 2017| Leave a Comment »

By Linda Hindle, Deputy Chief AHP Officer, Public Health England, and James Gore, Director of Education & Standards, Faculty of Public Health

Three years ago the Allied Health Professions (AHPs) agreed a collective ambition to be recognised as an integral part of the public health workforce. Since then AHPs have developed their public health contribution and profile, and there have been some excellent examples of AHP public health initiatives.

We want to support AHPs to share and celebrate some of the fantastic work happening already, which is why Public Health England (PHE) and the Faculty of Public Health (FPH) are delighted to be co-sponsoring the public health award at next year’s Advancing Healthcare Awards.

Previous winners have commented on the opportunities applying for this award has created in terms of profile and recognition.

In this blog we want to showcase winners from the past four years and encourage AHPs to consider applying for this prestigious award.

Previous winners have so far included occupational therapists, dietitians, physiotherapists and paramedics, but we have had applications from members of most of the AHPs.

In 2014 Mary Jardine and Allison Black from NHS Ayrshire and Arran won the award for their ‘whole system approach for women’ which was developed to divert women from the criminal justice and court systems with the aim of reducing offending behaviour and targeting the reasons for offending. This project showed clear outcomes in terms of health and re-offending and involved partnership-working between statutory and voluntary organisations across health, criminal justice, social and community organisations

Winners in 2015 were Lisa De’Ath and her team from the Family Food First Programme in Luton. This programme aims to encourage families with young children to adopt healthy lifestyles in order to reduce the burden of disease such as obesity and tooth decay. The team work in early years settings, such as nurseries, pre-schools and children centres, to promote and adopt healthy-eating messages. This is an example of AHPs using their unique skills and working through other partners to support population-level outcomes.

In 2016 Emma Holmes and Katie Palmer lifted the trophy. Emma and Katie are dietitians from Cardiff whose innovative project used food facilities during the school holidays to provide meals and educational play for children in need. The project involved working with more than 20 partners from the public, private and third sector. As well as addressing health problems, they provided affordable childcare to support families during school holidays.

Last year’s winner was Gillian Rawlinson, a physiotherapist from Salford Royal Hospitals NHS Trust, whose project embedded health promotion within musculoskeletal physiotherapy services. This collaborative service redesign incorporated opportunistic health assessments, NHS Health Check and diabetes checks within routine physiotherapy assessments. This resulted in a holistic service for patients, improved assessment and an income generating a financial model. Gillian has blogged about her experience of winning this award.

Ruth Crabtree and Tom Hayward from Yorkshire Ambulance Service were highly commended for their pathway to support ambulance service staff to identify, support and signpost people who would benefit from support to reduce their alcohol intake. This example demonstrated how a making-every-contact-count approach can be adopted in a systematic way across a full service.

We know there are many other excellent projects like these.

Applying for an award can take time, but this is generally time well spent regardless of whether the project wins. The process of making an application helps to raise the profile of the work internally and externally. It is also a useful in supporting reflection on what has been successful with the project and where it can go next.

This year we hope to profile all of the shortlisted applicants because we know it is not just the winners who have undertaken excellent pieces of work, and we want to use this as an opportunity to share good practice as much as possible.

So what are the judges looking for and how do you apply?

We will particularly be looking for examples of AHPs which have shown leadership and partnership in working to deliver effective health improvement interventions across a population or with the potential to be broadened to a population level – with evidence of impact, value for money and sustainability.

You have until 19 January 2018 to apply, so don’t put it off; start thinking about your application today.

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Human trafficking – what should our public health response be?

Posted in Asia, Children and young people, Global Health, HIV, human trafficking, India, poverty, prostitution, slavery, women on October 3, 2017| Leave a Comment »

By Dr Tina Maddison, CCDC PHE West Midlands Team

Human trafficking is the acquisition of people by improper means such as force, fraud or deception, with the aim of exploiting them (1). Sexual exploitation is by far the most commonly identified form of human trafficking (2), with women and girls disproportionately affected (3). This is a problem that is not diminishing.

Indian brothel

Inside an Indian brothel

My husband and I are currently volunteering in South East Asia for an NGO that rescues and rehabilitates children from human trafficking and sexual exploitation. My husband has recently returned from India where he witnessed first-hand the prolific nature of this trade. Many of the women and children are subjected to sexual exploitation either by the families into which they are sold or in the public brothels that line the backstreets of countless cities.

 

In New Delhi, home to a myriad of brothels and massage parlours, children as young as 12 are sold to men up to 40 times a day. This abuse is beyond comprehension. The damage to the individual, both physically and emotionally, is catastrophic. Babies born to these girls are also used for the gratification of perverted minds.

Abha was just 12 when she was trafficked into a brothel in Delhi (4). “I was kept day and night in that place. They made me go with men all day and all through the night. If I resisted the owners would cut my arms, burn my face with cigarettes and scald my body. They would open up my wounds the next day to remind me not to disobey. They would inject me with drugs and force me to drink alcohol to make sure I did what I was told.
Whilst I was there I caught TB from the other girls. Seven men escorted me to hospital; they did not let me out of their sight. I was a prisoner, and I lost all hope of ever escaping. Eventually I tried to kill myself by cutting my wrists. They stitched me up so I could carry on making money for them.”

Across South East Asia, in the poorest of towns and villages, families are forced to make agonising decisions just to survive. Fathers will sell their oldest daughters to feed their younger siblings. The fundamental human rights of a child have no meaning in a world of extreme poverty.

Cultural issues in some countries contribute to the problem. Women and girls are viewed, by many, to be of little significance or worth. This diminished social standing is exploited by organised criminal gangs who view young girls as objects to be bought, auctioned and sold. To them women have a high value but for all the wrong reasons.
The crisis in India, where woman and girls routinely face sexual exploitation, harassment and lack of human worth has, in recent years, been amplified by the availability of pornography on the internet. One exasperated Indian social worker put it like this: “Pornography has intensified the lack of respect for women here. The problem has become much worse in a short space of time.”

Where does our public health duty lie in response to the appalling reality faced daily by girls such as Abha? Poverty, disregard of a woman’s worth and the prevalence of pornography are all underlying factors in this human tragedy. Should our response be to attempt to deal with these fundamental problems?

If these root causes are just too enormous a challenge, then should our public health response be to deal with the aftercare of individuals directly affected? Children rescued from the brothels have been broken mentally, physically and spiritually. Many suffer with rejection, they cannot reconcile the fact that their own families could have sold them. For others, the shame they burden for the abuse they have suffered is a barrier to ever being reunited with loved ones. They become outcasts.

Those still trapped within this insidious industry suffer with even greater self-degrading effects. A sense of hopelessness inevitably leads to depression. Many try to take their own lives as their only means of escape. Others develop a dependency upon the drugs and alcohol they are plied with in an attempt to block out the fear and pain they have been sentenced to.

Our public health response could be to identify and develop services to deal with these devastating emotional effects on young lives. Or as public health practitioners we could respond to their physical needs; screening and treating TB, HIV and other STIs, improving their poor nutrition and working to ameliorate their squalid living environments.

However, within India and neighbouring countries, for many there is still an unwillingness to admit that such problems exist. On the flight into Delhi one Indian passenger was adamant there were no issues with prostitution in India. “You will not be able to show me even one woman or child in prostitution. There is no problem here, this does not happen!”

Perhaps, therefore, our public health duty first and foremost should be to continue to raise awareness about this atrocity so that no one can honestly deny that the problem exists. Unless the issue and scale of human trafficking is recognised and acknowledged by all countries, and political pressure applied at the highest levels to invoke change, then those on the ground who fight daily against such evils will continue to fight alone.

“The only thing necessary for the triumph of evil is for good men to do nothing” – Edmund Burke

References:

1. UNODC. UNODC on human trafficking and migrant smuggling. Available at URL: http://www.unodc.org/unodc/human-trafficking/ (Accessed 8 May 2017)

2. UNODC. Global Report on Trafficking in Persons. Executive Summary. February 2009.

3. International Labour Organization. Summary of the ILO 2012 Global Estimate of Forced Labour. June 2012

4. Abha – not her real name. Notes from a personal conversation with a girl rescued from a brothel in Delhi, May 2017.

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