...inequalities, abuse, virtual love affairs and more

...a week of heightened moments of the here and now* with added miserablist awareness of inequalities, all punctuated by a 21st Century love affair! Good grief...let’s start with the miserable eh.

As the BBC’s Panorama yet again exposed neglect and abuse in care services for elderly people and we all scrabble around looking for someone to blame, sack or make a scape-goat of, I can’t help wondering why we don’t just stop and ask why people abuse their power like this? Perhaps the answer is borne of the simple fact, that the people who are doling out the abuse, seem to have no power, or rather the only power they do have, is direct power over those worse off than themselves - the elderly, infirm and least able. Time and again it appears that the people with the least/fewest resources (emotional, educational and economic) take on the work that no one else wants to do, the poorly paid, the under stimulated and the ‘services’ we routinely hide-away. Spoon-feeding, shaving and mopping up all manner of bodily fluids. 

For those of us who traipse into care homes with our cultural interventions and who evangelise about the arts from our comfortable transient roles ‘transforming’ peoples lives as we go, it’s easy to forget the over-worked care assistant, who dosen’t want to take part in our cultural activity. The grim reality of care is that no one cares about the carers (or perhaps we do when it’s our own relative, but not when its one of a million anonymous others).

I’ve had a couple of stints as a nursing assistant in an old fashioned hospital for people with learning difficulties and in a smaller care home where, I toileted and brushed the teeth of adults. In the hospital, it was like a production line of ‘care’ and in the smaller home, at least the ratio of care was appropriate. But in both cases, I witnessed what I would describe as institutionalised behaviour and appalling attitudes to fellow humans, (I knew people who cared deeply too).

But bloody hell, the job is so demanding - exhausting - and emotionally draining and in both cases for me, I saw the job as a necessity, in between jobs - it certainly wasn’t my vocation. Yet again this reminds me of our unequal society and how, from positions of comfort and relative power, we can point at the ‘underclasses’ who we throw a few pennies to and ask to look after our feeble and aged relatives and then kick up a stink when it all goes wrong.

Surely we should understand inequalities by now. We’ve had Marmot illustrating them these last few years and we had Sir Douglas Black telling us a similar story in the early 1980’s. Come to think of it those early public health pioneers did something similar over 100 years ago and Dickens did a reasonable job of painting a picture of unequal societies, so by now, we should have a pretty good idea how economic, domestic and educational circumstances perpetuate inequalities.

As Kate Picket and Danny Dorling so eloquently suggest in Against the organisation of misery? The Marmot Review of health inequalities, we know all this, but we don’t have the political will to act.

“No reviews or policies ‘boldly go’ where all public health researchers know they need to go. And yet our evidence base for the social determinants of health proceeds apace; we learn more and more about the futility of trying to change individual behaviour, and more and more about the importance of influences in the womb and early years of childhood. Indeed, the Marmot Review could have gone much further, if it had only placed greater reliance on Sir Michael Marmot’s own research and that of his colleagues studying life-course effects on health in the British birth cohorts. In contrast to 1980 when the Black Report was published, we now, thanks especially to his work, know much more about the importance of psychosocial influences on population health. We also know much more about the biology of chronic stress (Sapolsky, 2005), about how rank and status harm health (Marmot, 2004). We know that children get the best start in life by being brought up in more equitable societies, rather than in rich ones (Pickett & Wilkinson, 2007). Why did the Marmot Review not make hard-hitting recommendations to reduce the harm created by great differences in rank and status? 

Whilst our ‘for profit’ care homes continue to be driven by the market value of each of its fragile ‘commodoties’, it will take a significant political shift to start valuing not only the oldest and most vulnerable people, but those who care for them too. With the average wage for care assistants being just over £7 per hour and only basic training on offer, care homes are competing with supermarkets for staff.

We are unequal at both ends of our life course - topped and tailed - so to speak. Only this week the report Why Children Die using data from the Institute of Health Metrics and Evaluation reveals that children under five in the UK are more likely to die than in any other western European country except Malta. The report in The Lancet exposes one specific factor: deaths rise with socio-economic deprivation. We should be appalled.

Again, Picket and Dorling stress that much of the focus on inequalities is wrapped up in the language of “...economics, not social epidemiology or progressive public health. It is a language that has seeped into our everyday vocabulary and thinking…”

Of course I’m a great advocate for making all care-environments more creative, stimulating and culturally vibrant spaces - but let’s get real - we are skimming the surface of the water, and as Picket and Dorling conclude: 

“What is missing is the political courage to deal with the root causes of those social determinants. Why people smoke, rather than trying to get them to stop, why people eat too much, commit violence, trust each other less, invest more money in their children’s education, rather than trying to understand the social inequalities that stand in their way.”

Hilary Moss and Desmond O’Neill contribute an excellent paper to The Lancet called, Aesthetic deprivation in clinical settings. Here’s a paragraph to whet your appetite, and click on the bottle of Buxton Water above for the full article.

“...many clinicians, including those favourably disposed to a greater presence of arts in health care, remain uncomfortable with the often fulsome language and somewhat uncritical stance of evangelists of the arts and health movement. Phrases such as the “healing arts” seem to overstate potential benefits and contain uneasy echoes of obscurantism and mysticism. Indeed, many of us may associate the golden age of art in hospitals with the worst forms of speculative and unscientific treatment—the four humours, purging, and blood-letting.”

HA...and so to a 21st Century love affair. French newspaper Le Monde has startled its readers by serialising a graphic novel about an online love affair on its website. The novel illustrates virtual love in an Internet age where two people become friends through the internet communications site, Skype. They start to have remote sex without meeting. La Technique du perinea is by Florent Ruppert and Jérôme Mulot and coloured by Isabelle Merlet. Click on the image above to go to the story. Fancy yourself as a graphic short story writer? Read on...

Graphic Short Story Prize

Want to apply for the Cape/Observer/Comica Graphic Short Story Prize 2014? Click on the audience below for more details...

New Science & Society Community Challenge Grant Scheme 

The Department for Business, Innovation and Skills (BIS) has announced a new £500,000 grants scheme to support to create and run pilot projects that take science to diverse audiences. There will be 3 levels of project funding: up to £10,000, up to £20,000 and up to £40,000, depending on the size and difficulty of the project. The scheme is open to a wide range of people, including:

• Scientists and researchers
• Science centre or museum staff
• Educators, schools, colleges and universities
• Film makers
• Theatre producers
• Games developers

It is expecting to fund between 20 and 25 projects in the 2014/15 financial year. The deadline for applications is 16th May 2014. Read more at https://www.gov.uk/science-and-society-community-challenge-grant-scheme

The Peter Cruddas Foundation 

The Peter Cruddas Foundation is a grant making Foundation that aims to support charitable works that benefit disadvantaged and disengaged young people in the UK by ensuring that their funding reaches those most in need. Priorities for funding are:

Pathways/support for young disadvantaged or disengaged people in the age range 14 to 30 into education, training or employment

Work experience/skills projects for young people aged 16 to 30

Youth work in London particularly evening work for disadvantaged young people aged 16 to 30.

To be eligible for funding an organisation must be a registered charity or an organisation / individual supported by a UK charity. There are no minimum or maximum grants and projects can be funded for more than one year. The closing date for application is the 1st September 2014.  Read more at:http://thepetercruddasfoundation.org/how_to_apply.htm

Fancy working in Stockholm as an artist in residence? Click on the ice-cream eating nuns to find out more.

*Working from home, and seeing the sun come out, I had the opportunity to have my lunch in a graveyard - so took it (broad beans in the pod, lump of cheese and bread, an apple and a drink). A small church by the estuary as the tide was pouring in. The sun, shining through broken clouds after a week of rain. The sky full of flying things - mayfly, newly liberated from their nymph stage for a couple of days at the most, in search of insect intimacy - and midges by the tens of thousands. Sitting on a bench, dedicated to two long-dead lovers. In the newly mown grass, lay a freshly dead thrush, quite relaxed and oblivious to the fussing of the flies. Behind me, on a rise, a tiny old church, its ornately carved Norman doorway honey coloured in the sunlight. Daffodils who had lost their heads, but roses who were expectant with something altogether pinker and more secret. Two beautiful butterflies* dancing on unseen thermals laced with perfume-like pheromones. A thousand daisies crowded-out by a million bluebells and wild garlic that filled the air with something heady. The buzzing of the flies, the songs of unknown birds and an awareness of myself in the lattice-work of fields, imbued a deep sense of the here and now. Something quite delicious took over me. An intoxicating gravity. A gentle breeze as we turn through space, my feet heavy on the earth. A certain death below, before and after me. All these transient things. Having never meditated, I guessed that this was something like that, only instead of emptying my mind, it was focused down to this overwhelming nowness and some relaxed acceptance of things beyond myself. It’ll be alright, you are ok, everything will be fine.

*Female butterflies release perfume-like pheromones into the air. The male butterflies of many species can detect the pheromones from as far away as 2 kilometres. Some species of moths are sensitive to the presence of the females' pheromones up to five kilometres away.

Flora and Fauna

"...there is no such thing as the voiceless, only the deliberately silenced or the preferably unheard"

Last week I made a passing reference to indigenous Australians being defined, not as humans, but as flora and fauna. To answer the question of what on earth I meant, here is how New South Wales, Deputy Leader of the Opposition,  Linda Jean Burney has reflected on her childhood, when she was counted among the nation's wildlife.

“I am a member of the mighty Wiradjuri Aboriginal nation… For the first 10 years of my life, like all indigenous people at that time, I was not a citizen of this country. We existed under the Flora and Fauna Act of New South Wales. Growing up as an Aboriginal child looking into the mirror of our country was difficult and alienating. Your reflection in the mirror was at best ugly and distorted, and at worst nonexistent.”

This week, driving into work with the radio on, I’ve been further reminded of colonialism and GlaxoSmithKline’s (GSK) burgeoning success in positioning itself as global vaccine champions of an Ebola threatened ‘free world’. This is probably the greatest PR exercise GSK could hope for following their 2013 $3billion fine after they were found guilty of promoting two drugs for unapproved uses and failing to report safety data to the Food and Drug Administration - the largest healthcare fraud settlement in US history! Handy too, that the chase for the Ebola prize might detract from its recent $490million fine for bribery in China, a case which included amongst other things, prostitutes were procured to doctors to persuade them to prescribe GSK medicines, allegedly pushing up the prices Chinese patients pay for GSK drugs by as much as 30%.

So as dear old GSK announce, alongside the US National Institutes of Health, that each of the 20 healthy adult volunteers involved in its trial showed an “immunological response” and that the drug was “well tolerated”. Dr Moncef Slaoui, chairman of Global Vaccines at GSK, said: “We are very encouraged by these positive first trial results, showing this type of vaccine has an acceptable safety profile and can produce an immune response against Ebola in humans.”

First identified in 1976, it’s curious that only when it threatens to leave its otherworldly shores and infect the west, do the great gods of Big Pharma push through ‘rapid trials’ of vaccines. Of course it’s a serious issue that needs addressing, but far more informed voices than mine have long-discussed the public health measurements that can be put in place to address the spread of the virus. In a 2012 article published by The Atlantic, Nigerian writer Teju Cole exposed the white saviour industrial complex for what it is: a pathology of white privilege. With a backward glance to Cole, Robtel Pailey writing for Aljazeera, suggests that white saviours fundamentally believe they are indispensable to the very existence of those on the receiving end of their "interventions". Like some potted plants, they tend to bloom in "exotic" environments far removed from their natural habitats.

Here are two choice paragraphs to mull over from the Pailey article which summarises some of the key issues.

At the height of Ebola, the myth of the white saviour has resurfaced again and again, framing Africans as infantile objects of external interventions. The white saviour complex has placed a premium on foreign expertise, while negating domestic capabilities. We've been assailed with images of mostly white foreigners flown out of the Ebola "hot zone" with the promise of expert care abroad. As spokespersons for the thousands "left behind", they have been catapulted into the heady limelight of overnight stardom. We've been bombarded with a cacophony of non-African "expert" opinions about how to "save" Liberia, Guinea, and Sierra Leone from Ebola. Yet, Ugandan and Congolese specialists, who contained the virus repeatedly in their own countries, have been sidelined in the mainstream international press.

Indian writer and human rights activist Arundathi Roy once said, "there is no such thing as the voiceless, only the deliberately silenced or the preferably unheard". Indeed, narratives about African ingenuity, African agency, and African heroism in the age of Ebola have been preferably unheard. As an African proverb aptly puts it: "Until the lion learns to write, tales of the hunt shall always glorify the hunter."

Through its mainstream reportage, Radio 4 feeds me a good deal of fetid compost to nourish this blog, and on the same day that GSK announced its vaccine, I was reminded too, that are dear chums at the National Institute for Health and Care Excellence (NICE) had given the green light to two new interventions to solve what many consider to be social, cultural and/or economic problems - obesity and alcohol addiction!

Like Ebola, the seriousness of obesity can’t be overstated, but the approval for mass gastric surgery represents yet another case of mopping up the problems and not tackling the root causes. With one in 20 people having type 2 diabetes in the UK and the numbers growing because of the obesity epidemic, it would be easy to just blindly accept the technological approaches that are thrown at us at every turn. but surgery! 

Prof John Wilding, a diabetes consultant and obesity specialist from the University of Liverpool, suggests that the number of NHS gastric operations could realistically rise to about 15,000 a year, with the cost of each operation being about £6,000. NICE argue that surgery will, over the long-term, reduce the annual £10m bill for care of diabetes and its complications. Not everyone is going along with this drive quietly and Prof Iain Broom, director of the centre for obesity research and education at Robert Gordon University in Aberdeen, suggests that NICE had missed lots of evidence.

“The Nice guidance could send tens of thousands of Britons towards unnecessary surgery, with its known morbidity and mortality, and costing taxpayers many millions of pounds, when all that is required is a different dietary and lifestyle approach including the use of low carbohydrate diets and low calorie diets,” Broom said.

An investigation by Channel 4 Dispatches, earlier this year, revealed that 'scientists advising health ministers on how much sugar should be in our diet are being funded by chocolate, ice-cream and fizzy drink companies as well as a lobby group for the sugar industry.' Specifically it exposed that members of the Scientific Advisory Committee on Nutrition (SACN) are preposterously close to the food industry. SACN advises Public Health England, who ultimately advise health ministers, who in turn have the power to influence how much sugar will be in all our diets. Professor Ian MacDonald of Nottingham University, who is a key member of the group, also sits on two advisory boards for Coca Cola and for Mars, as well as receiving funding from Unilever which is the world’s largest ice-cream manufacturer. These revelations are outrageous and should make us questions whether policy makers are too close to the food industry.

So too, it was on that very same drive into work, that I heard that the miracle pill that helps people cut down on alcohol is now available to people who drink at least half a bottle of wine or three pints a night. NICE has published formal guidance recommending nalmefene, also called Selincro, and costs £3, can be taken up to once a day, and is designed to be used whenever the patient wants to stave off the desire to drink.

The key is in that last sentence - we are all seen as patients! Pathologised and reduced to biomedical problems regardless of the journey that took us there. So we may wave our nanny state finger at the demonised, obese ‘underclasses’ for scoffing down their super-sized burgers and chips, quaffing their alcopops and bargain booze. All the products people are encouraged to consume by our sophisticated marketeers - just look at ‘black friday’ - who the hell came up with that? Our high streets are bursting with fast-food outlets and cut-price supermarkets, so we can all go and scuttle off home and get pissed in splendid isolation in front of our giant plasma screens, whilst being spoon fed all manner of ways we can ‘upgrade’ ourselves, improve ourselves, worship ourselves, hate ourselves.

So whilst we ignore the superb public health work of those on the ground in Africa and look to a magic bullet from the west for a multi-billion dollar Ebola ‘cure’ - whilst we conveniently forget the factors that drive us to reach for the bottle, or the pills, or the prescriptions that keep us sedate - conveniently ignoring the lack of work, education and money - and reach out for cheap food in one hand and a gastric band in the other...the marketeers are laughing all the way to the bank as we consume their products to satiate our boredom and loneliness, and of course, purchase their spurious miracle cures. People are making billions from us. Let’s forget the products and take a long hard look at our very sophisticatedly packaged, battery farmed lives. Hey, if you look beyond the hype for a moment and it makes you feel ill - don’t question it - your dissatisfaction is probably an illness - and there’s always medication for it, or even worse, surgery.

Healthy Hearts Grants 
Heart Research UK has announced that its Health Hearts Grants Programme will re-open for applications in January 2015. Heart Research UK Healthy Heart Grants support innovative projects designed to promote heart health and to prevent or reduce the risks of heart disease in specific groups or communities. Grants of up to £10,000 are available to community groups, voluntary organisations and researchers who are spreading the healthy heart message. The closing date for applications will be the 28th February 2015. Read more by clicking on the sparkly heart above.

Foyle Foundation Small Grants Programme 
The Foyle Foundation is inviting small local charities to apply for funding through its Small Grants programme. Through its Small Grants Programme, grants of between £1,000 and £10,000 are available to smaller charities in the UK, especially those working at grass roots and local community level, in any field, across a wide range of activities. Applicants will need to demonstrate that the grant will make a significant difference to their work.
Applications can be made at any time. Read more at: 

http://www.foylefoundation.org.uk/small-grants-scheme/ 

Austin & Hope Pilkington Trust 
The Austin and Hope Pilkington Trust which awards grants to registered charities in the United Kingdom has announced that the next closing date for applications is the 1st June 2015. During 2015, the Trust is seeking to fund projects that promote Community development and Medical - Research and non-research. Grants are usually between £1,000 and £3,000 and are awarded for one year. Previous grants awarded include:

http://www.austin-hope-pilkington.org.uk/what-we-fund/

CREATE
Another glossy publication of perspectives on the value of art and culture from Arts Council England, which includes a piece by Prof John Ashton on health. Create is a new journal that aims to stimulate discussion about the true value of art and culture to our society. See more by clicking on the can of cultivation above. 

. . .

Over the next few days a couple of exhibitions are opening, one in Buxton and one in Kaunas, Lithuania. Sėkmės... 

The CELEBRATIONS project has been led by Buxton artists Adrienne and Langley Brown, and inspired by conversations with patients, families, staff and volunteers of Ashgate Hospice, Chesterfield. The work will become a permanent feature in the Hospice's reception, where it will be a welcoming presence and an absorbing talking point. This project has been especially inspired by the life and work of Alison Creed, and the project was initiated and generously supported by Francis Creed and the Creed family.

This is an open invitation to a free preview of CELEBRATIONS, together with working drawings, notes and photographs, will be on display from 10.30 to 5.30 on December 6th and 7th at Buxton’s Green Man Gallery. On Saturday 6th from 2.00 to 3.30pm there’ll be nibbles, wine, soft drinks, music, and a brief introduction to the the project by Sharon Herriot, Art Psychotherapist at Ashgate, and Langley Brown, Arts for Health Research Fellow at MIRIAD in the Manchester School of Art, Manchester Metropolitan University.
For more details please contact Langley Brown langley.brown@mmu.ac.uk

SPALVŲ METAMORFOZĖS (Colour Metamorphosis)
On the 4th December, artwork created by nurses and health workers from Kaunas Republican Hospital and Hospice and Kaunas Republican Public Hospital Care Clinic alongside the artists Marijona Sinkevičienė and Lina Drižiūtė-Malinauskiene who have been exploring the health, wellbeing and welfare of workers within the healthcare system in Lithuania. This work has been managed by Socialiniai Meno Projektai. The exhibition opens on the 4th December at Kaunas County Public Library and will be opened by esteemed Professor of sociology, and singer/guitarist, Leonardas Rinkevičius. With the health and wellbeing of the workforce a key priority for governments across Europe, this is the start of an important workforce public health programme in Lithuania.

Morpurgo backs 10 year old's library campaign
One of the world's most successful childrens authors is backing a ten-year-old boy's campaign to protect the library service in Cornwall. It comes as council cuts across our region leave the future of hundreds of libraries in doubt, with some facing closure and others having to reduce their opening hours. Click on the rabbit contemplating the moon for more details.

The Recoverist Manifesto has gone to press…