The Need to Raise Awareness of Health Services among the Somali

Transcription

The
The
TheNeed
Need
Needto
to
toRaise
Raise
RaiseAwareness
Awareness
Awareness
The
The
The
The
Need
Need
Need
to
to
to
Raise
Raise
Raise
Awareness
Awareness
Awareness
Awareness
of
of
ofHealth
Health
HealthServices
Services
Servicesamong
among
amongthe
the
the
of
of
of
of
Health
Health
Health
Health
Services
Services
Services
among
among
among
among
the
the
the
Somali
Somali
SomaliCommunity
Community
Communityin
in
inCamden
Camden
Camden
Somali
Somali
Somali
Somali
Community
Community
Community
in
in
in
in
Camden
Camden
Camden
Camden
by
by
by
Agram
Agram
Agram
Muse
Muse
Muse
by
by
by
by
Agram
Agram
Agram
Agram
Muse
Muse
Muse
Muse
Accredited
Accredited
Accredited
Community
Community
Community
Empowerment
Empowerment
Empowerment
Course:
Course:
Course:
Accredited
Accredited
Accredited
Accredited
Community
Community
Community
Community
Empowerment
Empowerment
Empowerment
Empowerment
Course:
Course:
Course:
Course:
Development
Development
Development
and
and
and
Presentation
Presentation
Presentation
of
of
Research
Research
Research
Skills
Skills
Skills
Development
Development
Development
Development
and
and
and
and
Presentation
Presentation
Presentation
Presentation
ofof
ofof
Research
Research
Research
Research
Skills
Skills
Skills
Skills
2011-2012
2011-2012
2011-2012
2011-2012
2011-2012
2011-2012
2011-2012
Agram Muse
Agram Muse
Agram Muse
Contents
Page
Contents
Contents Page
Page
Contents Page ................................................................................................................ 1
Contents Page ................................................................................................................ 1
Contents Page ................................................................................................................ 1
Chapter 1: ....................................................................................................................... 2
Chapter 1: ....................................................................................................................... 2
Chapter 1: ....................................................................................................................... 2
(i) Introduction ................................................................................................................. 2
(i) Introduction ................................................................................................................. 2
(i) Introduction ................................................................................................................. 2
(ii) Literature review .................................................................................................. 4
(iii) Methodology ....................................................................................................... 6
(iii) Methodology ....................................................................................................... 6
(iii) Methodology ....................................................................................................... 6
Chapter 2 ...................................................................................................................... 16
Chapter 2 ...................................................................................................................... 16
Chapter 2 ...................................................................................................................... 16
Conclusions ............................................................................................................ 17
Conclusions ............................................................................................................ 17
Conclusions ............................................................................................................ 17
Bibliography .................................................................................................................. 19
Bibliography .................................................................................................................. 19
Bibliography .................................................................................................................. 19
1
1
1
The Need to Raise Awareness of Health Services Among the Somali Community in Camden
Chapter
1:
Chapter
Chapter 1:
1:
(i)
Introduction
(i)
Introduction
(i)
Introduction
This paper aims to research
the level of awareness of health services available
This paper aims to research the level of awareness of health services available
This
paper
aims
to research
of borough
awareness
of healthItservices
among
Somali
women
living in the
the level
London
of Camden.
is hopedavailable
that this
among Somali women living in the London borough of Camden. It is hoped that this
among
Somali
living ain funding
the London
borough
is hoped that
this
research
paperwomen
will inform
proposal
for of
a Camden.
project toIt encourage
health
research paper will inform a funding proposal for a project to encourage health
research
inform
a funding proposal for a project to encourage health
promotionpaper
amongwill
Somali
women.
promotion among Somali women.
promotion among Somali women.
I have selected this topic as I have 5 year experience working with Somali women
I have selected this topic as I have 5 year experience working with Somali women
Iand
have
selectedthem
this topic
I have
year experience
working with
women
providing
with as
advice
on5 welfare,
health, education
andSomali
employment.
and providing them with advice on welfare, health, education and employment.
and
providing
with advice
health,
education
employment.
During
this timethem
it became
clear toonmewelfare,
that poor
access
to healthand
services
was an
During this time it became clear to me that poor access to health services was an
During
thisissue
timetoit overcome
became clear
to me the
thatquality
poor access
health
services was an
important
to improve
of life oftomy
clients.
important issue to overcome to improve the quality of life of my clients.
important issue to overcome to improve the quality of life of my clients.
Somali women can be quite isolated and are at risk of suffering from poor health.
Somali women can be quite isolated and are at risk of suffering from poor health.
Somali
women
can answer
be quitethe
isolated
and
are at risk of suffering from poor health.
This essay
will then
following
questions:
This essay will then answer the following questions:
This essay will then answer the following questions:
 What are the health services currently available to Somali women?
 To what extent are they accessed by the community?
 What, if any, are the barriers preventing Somali women from accessing health
 What, if any, are the barriers preventing Somali women from accessing health
 What,
if any, are the barriers preventing Somali women from accessing health
services?
services?
services?
This paper is based on the analysis of 20 questionnaires distributed among Somali
This paper is based on the analysis of 20 questionnaires distributed among Somali
This
paper
is based
the analysis
of 20 questionnaires
amongShadow
Somali
women
recruited
as on
participants
amongst
my clients at distributed
my organisation
women recruited as participants amongst my clients at my organisation Shadow
women
as participants
amongst my
clientsWomen’s
at my organisation
Women’srecruited
Centre and
other local residents.
Shadow
Centre is a Shadow
Horn of
Women’s Centre and other local residents. Shadow Women’s Centre is a Horn of
Women’s
Centre organisation
and other local
residents.
Women’s
Centre
is a HornWe
of
Africa community
based
in KingsShadow
Cross, in
the borough
of Camden.
Africa community organisation based in Kings Cross, in the borough of Camden. We
Africa
community
based
in KingsSudan
Cross,and
in the
borough
Camden.
We
work with
womenorganisation
from Somalia,
Ethiopia,
Eritrea
andofwe
run health
work with women from Somalia, Ethiopia, Sudan and Eritrea and we run health
work
with women
fromadvice
Somalia,
Ethiopia,
Sudan and
Eritreaand
and
we rungroups,
health
awareness
workshops,
services,
employment
services,
women’s
awareness workshops, advice services, employment services, and women’s groups,
awareness
workshops,
advice
services, employment
services,
and
women’s
activities
such
as sewing
and educational
classes such
as ESOL
and
Somali groups,
literacy
activities such as sewing and educational classes such as ESOL and Somali literacy
activities
sewing
andgroups
educational
classes
asSomali
ESOL women.
and Somali
classes. such
I alsoasran
2 focus
run with
a totalsuch
of 10
As literacy
part of
classes. I also ran 2 focus groups run with a total of 10 Somali women. As part of
classes. I also ran 2 focus groups run with a total of 10 Somali women. As part of
2
2
2
Agram Muse
Agram Muse
Agram Muse
my research I also identified Camden based organisations targeting Somali women.
my research I also identified Camden based organisations targeting Somali women.
my
research I also
Camden
based
targeting
Organisations
wereidentified
contacted
by phone
to organisations
find out whether
they Somali
run anywomen.
health
Organisations were contacted by phone to find out whether they run any health
Organisations
were contacted
by phone
findthey
out whether
runthe
anybarriers
health
services and collect
their feedback
on to
what
perceive they
to be
services and collect their feedback on what they perceive to be the barriers
services
collect
their from
feedback
on what
perceive
to contacted
be the barriers
preventingand
Somali
women
accessing
healththey
services.
I also
2 GP
preventing Somali women from accessing health services. I also contacted 2 GP
preventing
Somali
women
from accessing
services.
I also
contacted
2 GP
local surgeries
to find
out whether
they havehealth
a support
system
in place
to meet
the
local surgeries to find out whether they have a support system in place to meet the
local
surgeries
toSomali
find outwomen.
whether they have a support system in place to meet the
specific
needs of
specific needs of Somali women.
specific needs of Somali women.
In my conclusion I will make recommendations to identify ways to improve access to
In my conclusion I will make recommendations to identify ways to improve access to
In
my conclusion
I will
makewomen.
recommendations to identify ways to improve access to
health
services from
Somali
health services from Somali women.
health services from Somali women.
This project has been completed thanks to the support of the Africa Educational
This project has been completed thanks to the support of the Africa Educational
This
been
completed
Trust project
and thehas
Evelyn
Oldfield
Unit. thanks to the support of the Africa Educational
Trust and the Evelyn Oldfield Unit.
Trust and the Evelyn Oldfield Unit.
3
3
3
(ii)
Literature
review
(ii)
Literature
review
(ii)
Literature
review
Recent research indicates that the Somali community is one of the largest refugee
Recent research indicates that the Somali community is one of the largest refugee
Recent
research
indicates
that the
community
oneforofmore
the largest
communities
in the
UK. Somalia
hasSomali
now been
in a civiliswar
than 30refugee
years;
communities in the UK. Somalia has now been in a civil war for more than 30 years;
communities
in the UK. has
Somalia
has now
in a civil
warinfor
more than
years;
the central government
collapsed
andbeen
the country
lives
economic
and30political
the central government has collapsed and the country lives in economic and political
the
centralAgovernment
hasofcollapsed
and the country
lives in economic
andfollowing
political
instability.
large number
Somali refugees
started arriving
in the 1980s
instability. A large number of Somali refugees started arriving in the 1980s following
instability.
A large
Somali
refugees started
in the Somaliland
1980s following
independence
fromnumber
Britain ofand
the break-out
of civil arriving
war between
and
independence from Britain and the break-out of civil war between Somaliland and
independence
from
andofthe
break-out
of civil rather
war between
Somaliland
and
Somalia.
It is
theBritain
needs
Somali
migrants,
than UK-born
Somali
Somalia.
It is the needs of Somali migrants, rather than UK-born Somali
Somalia.
is this
the research
needs of
Somali migrants,
rather than UK-born Somali
communitiesItthat
is interested
in.
communities that this research is interested in.
communities that this research is interested in.
The Census 2001 identified 33838 Somali born people living in Greater London, thus
The Census 2001 identified 33838 Somali born people living in Greater London, thus
1
The
Census
2001
Somali
born peopleof
living
in Greater
London,
thus
making
London
theidentified
city with 33838
the highest
concentration
Somali
migrants
in the UK
.
making London the city with the highest concentration of Somali migrants in the UK 11.
making
London
the city
the percentage
highest concentration
of Somali
migrants
in the
UK .
The
Census
places
the with
highest
of Somali-born
population
in the
London
The Census places the highest percentage of Somali-born population in the London
2 in the London
The
Census
placesand
the Tower
highestHamlets,
percentage
of and
Somali-born
population
. This research
borough
of Ealing
3045
1353 respectively
borough of Ealing and Tower Hamlets, 3045 and 1353 respectively 22. This research
borough on
of Ealing
and Tower
Hamlets,
3045 and
respectively
. This
research
focuses
the Somali
population
in Camden
as 1353
it is where
I live and
started
my
focuses on the Somali population in Camden as it is where I live and started my
focuses
on organisation,
the Somali population
in Camden
as it is
where I live
started
my
community
Shadow Women’s
Centre.
Moreover,
the and
Somali
refugee
community organisation, Shadow Women’s Centre. Moreover, the Somali refugee
community
Centre.
Moreover,
the Somali
refugee
community organisation,
is the largestShadow
refugeeWomen’s
community
based
in the London
borough
of
community is the largest refugee community based in the London borough of
3
community
largest
refugee
in be
theclearly
London
boroughand
of
then
my belief
thatcommunity
their needsbased
should
identified
Camden3. Itisisthe
Camden3. It is then my belief that their needs should be clearly identified and
then my
that their
needs should
bepolicies
clearly for
identified
and
Camden . Itto isensure
addressed
that belief
the Council
implements
effective
its refugee
addressed to ensure that the Council implements effective policies for its refugee
addressed
residents. to ensure that the Council implements effective policies for its refugee
residents.
residents.
The needs of the Somali community are great and complex, ranging from enormous
The needs of the Somali community are great and complex, ranging from enormous
The
needs
of the Somali
community
are great to
anddealing
complex,
ranging
fromracism
enormous
cultural,
religious
and language
differences
with
trauma,
and
cultural, religious and language differences to dealing with trauma, racism and
cultural,
religious
and of
language
differences
trauma,
racism
discrimination.
A study
Somali refugees
hastoto dealing
considerwith
these
complex
factorsand
to
discrimination. A study of Somali refugees has to consider these complex factors to
discrimination.
study of
has to consider
make a seriousAattempt
to Somali
addressrefugees
the community’s
needs. these complex factors to
make a serious attempt to address the community’s needs.
make a serious attempt to address the community’s needs.
1
The Census 2001, Somalis in the United Kingdom,
1
1
http://en.wikipedia.org/wiki/Somalis_in_the_United_Kingdom#Population_and_distribution
2
ibid
2
ibid
2
3 ibid
Khan, S. and Jones, A, Somalis in Camden: Cchallenges faced by an emerging community, Camden Council,
3
3
2002
2002
2002
4
4
4
Agram Muse
Agram Muse
Agram Muse
Limited literacy, unemployment and poverty are sadly common among the Somali
Limited literacy, unemployment and poverty are sadly common among the Somali
Limited
literacy,
andbenefits
povertytoare
sadly
common
among
the Somali
community.
Manyunemployment
depend on state
meet
their
basic living
expenses
and
community. Many depend on state benefits to meet their basic living expenses and
community.
on is
state
benefits
to meet
their basic living expenses and
lack of unity Many
in the depend
community
another
important
issue.
lack of unity in the community is another important issue.
lack of unity in the community is another important issue.
Somali refugees often arrive in the UK under extremely difficult circumstances,
Somali refugees often arrive in the UK under extremely difficult circumstances,
Somali
refugees often
arrive
thewar,
UKtrauma
under and
extremely
circumstances,
having experienced
drama
suchin as
poverty.difficult
When in
the UK, they
having experienced drama such as war, trauma and poverty. When in the UK, they
having
experienced
such as
war, trauma
poverty.
When
the UK,
they
often continue
to livedrama
in poverty,
relying
on stateand
support
often
as ainresult
of poor
often continue to live in poverty, relying on state support often as a result of poor
often
continue toskills
live and
in poverty,
on state support
often asIt aseems
result of
poor
communication
lack of relying
qualifications/work
experience.
evident
communication skills and lack of qualifications/work experience. It seems evident
communication
skills
lack social
of qualifications/work
experience.
It seems
that the impact of
warand
trauma,
isolation, change
of status and
povertyevident
make
that the impact of war trauma, social isolation, change of status and poverty make
that
the impactprocess
of war trauma,
social
isolation,
changeattempt
of status
make
the integration
particularly
difficult.
Any serious
to and
meetpoverty
the needs
of
the integration process particularly difficult. Any serious attempt to meet the needs of
the
process
particularly
difficult.
Anydealing
serious with
attempt
meet theofneeds
of
the integration
Somali refugee
community
cannot
avoid
the tobaggage
trauma
the Somali refugee community cannot avoid dealing with the baggage of trauma
the
Somali
refugee
avoid
dealing
with the
baggageis of
Somali
refugees
oftencommunity
carry with cannot
them. The
Somali
refugees’
experience
so trauma
unique
Somali refugees often carry with them. The Somali refugees’ experience is so unique
Somali
refugees
often assessment
carry with them.
The be
Somali
refugees’
so unique
that I believe
a need
should
designed
and experience
introduced: isthis
enable
that I believe a need assessment should be designed and introduced: this enable
that
I believe
need
assessment
should
be designed
andofintroduced:
enable
agreement
onathe
priority
needs and
effective
allocation
resources this
to improve
agreement on the priority needs and effective allocation of resources to improve
agreement
the priority
needsmore
and effective
allocation
of resources
to improve
health and on
reduce
inequalities
effectively.
In 2001
the Camden
Council
health and reduce inequalities more effectively. In 2001 the Camden Council
health
and reduce
inequalities
more
effectively.
In 2001
the Camden
Council
commissioned
a study
where health
issues
in the Somali
community
where identified
commissioned a study where health issues in the Somali community where identified
4
commissioned
a study
where
the Somali
community
identified
. There
are health
seriousissues
healthinproblems
such
as liver where
diseases,
often
“in every aspect”
“in every aspect”44. There are serious health problems such as liver diseases, often
. There
serious
health problems
as liver
diseases,
“in every
linked
to aspect”
poor quality
of are
water
in Somalia
(causing such
Hepatitis
A, B
and C),often
TB,
linked to poor quality of water in Somalia (causing Hepatitis A, B and C), TB,
linked
to strokes
poor quality
of waterMental
in Somalia
(causing
Hepatitis
A, Brefugees
and C),being
TB,
diabetes,
and asthma.
health is
also poor
with many
diabetes, strokes and asthma. Mental health is also poor with many refugees being
diabetes,
strokes
and stress
asthma.
health isMental
also poor
with
many refugees
affected by
traumatic
andMental
depression.
health
problems
such as being
Postaffected by traumatic stress and depression. Mental health problems such as Postaffected
byStress
traumatic
stressare
andvery
depression.
healthasproblems
such as affect
PostTraumatic
Disorder
importantMental
to address
they particularly
Traumatic Stress Disorder are very important to address as they particularly affect
Traumatic
Stress Disorder are very important to address as they particularly affect
refugee communities.
4
Khan, S. and Jones,
4
Khan, S. and Jones,
4
2002, page 31
A, Somalis in Camden: challenges faced by an emerging community, Camden Council,
A, Somalis in Camden: challenges faced by an emerging community, Camden Council,
Khan, S. and Jones, A, Somalis in Camden: challenges faced by an emerging community, Camden Council,
2002, page 31
2002, page 31
5
5
5
(iii)
Methodology
(iii)
Methodology
(iii)
Methodology
The study is based on the finding of 20 questionnaires, 2 focus group and phone
The study is based on the finding of 20 questionnaires, 2 focus group and phone
The
study is based on the finding of 20 questionnaires, 2 focus group and phone
interviews.
interviews.
interviews.
A questionnaire is a research method that allows researchers to present a statistical
A questionnaire is a research method that allows researchers to present a statistical
A
questionnaire
is a researchanswers.
method that
allows researchers
to present
a statistical
overview
of the respondents’
I designed
a questionnaire
to collect
feedback
overview of the respondents’ answers. I designed a questionnaire to collect feedback
overview
of the
respondents’
answers.
I designed
a questionnaire
to collect
feedback
from Somali
women
and produce
statistics
to identify
a general trend
about
Somali
from Somali women and produce statistics to identify a general trend about Somali
from
Somali
women and
statisticsofto health
identifyservices
a general
trend about
Somali
women’s
knowledge
andproduce
understanding
available
to them
in
women’s knowledge and understanding of health services available to them in
women’s
and understanding
of health
services
available
them
in
Camden. knowledge
The questionnaire
consisted of tick
boxes where
people
were to
able
to tick
Camden. The questionnaire consisted of tick boxes where people were able to tick
Camden.
questionnaire
consisted
of tick boxes where
people were
to tick
the choiceThe
that
most suited
their circumstances.
I distributed
andable
collected
the choice that most suited their circumstances. I distributed and collected
the
choice that
most
suited This
their was
circumstances.
I distributed
questionnaires
from
20 women.
a relevantly easy
method toand
use collected
because
questionnaires from 20 women. This was a relevantly easy method to use because
questionnaires
fromwhat
20 women.
was a
relevantly
easy
method
to use because
people understand
needs toThis
be done
and
the options
are
clear them.
people understand what needs to be done and the options are clear them.
people understand what needs to be done and the options are clear them.
The research is then based on feedback collected during two focus groups involving
The research is then based on feedback collected during two focus groups involving
The
research
is then woman.
based on
collected
during of
twoqualitative
focus groups
involving
a total
of 10 Somali
A feedback
focus group
is a method
research
that
a total of 10 Somali woman. A focus group is a method of qualitative research that
a
total one
of 10toSomali
A focus group
a methodfeedback
of qualitative
research
that
allows
collect woman.
more sophisticated
andissubjective
based
on the very
allows one to collect more sophisticated and subjective feedback based on the very
allows
one
to collect more
and subjective
feedback
based
on thetovery
personal
experiences
of thesophisticated
research participant.
I felt it was
important
to listen
the
personal experiences of the research participant. I felt it was important to listen to the
personal
experiences
of the
participant.
I feltme
it was
important
to listen
to the
experiences
and feelings
of research
Somali women
to help
produce
a more
informative
experiences and feelings of Somali women to help me produce a more informative
experiences
feelingsand
of Somali
women
to helpthat
mecan
produce
more
informative
and
accurateand
research
eventually
a project
aspirea to
meet
the real
and accurate research and eventually a project that can aspire to meet the real
and
accurate
research
eventually
projectgroup
that the
canresearcher
aspire to sets
meeta the
real
needs
of Somali
women and
in Camden.
In a
a focus
general
needs of Somali women in Camden. In a focus group the researcher sets a general
needs
Somali
womenand
in Camden.
In atalk
focus
researcher
setsbeliefs
a general
agendaoffor
discussion
participants
in agroup
groupthe
and
share their
and
agenda for discussion and participants talk in a group and share their beliefs and
agenda
and
participants
talk in a lots
group
and shareand
their
beliefs and
ideas. Infor
thisdiscussion
focus group
I asked
the participants
of questions
improvised
as
ideas. In this focus group I asked the participants lots of questions and improvised as
ideas.
this focus
group
I asked the
participants
lots of questions
and improvised
as
I went In
along,
to find
out people’s
opinion
about different
health issues.
I also used
I went along, to find out people’s opinion about different health issues. I also used
Iphone
went along,
to find
people’s
opinion
aboutdirectly
different
health
issues.
I alsoInused
interviews
to out
contact
people
working
with
Somali
women.
my
phone interviews to contact people working directly with Somali women. In my
phone interviews
people
working directly
with Somali
women.
In my
opinion
I think that to
thecontact
usage of
questionnaires
is good because
it’s an
easy method
opinion I think that the usage of questionnaires is good because it’s an easy method
opinion
I think
that the
usage
of questionnaires
is good because
an easy
method
to collect
feedback
from
a large
number of participants
when it’s
trying
to identify
a
to collect feedback from a large number of participants when trying to identify a
to
collect
feedback
from
large
number
participants
to identify
a
trend.
However
I feel
thata the
focus
groupofwas
the mostwhen
fruitfultrying
research
method
trend. However I feel that the focus group was the most fruitful research method
trend.
However
I feel
themany
focusquestions
group was
mostmanner,
fruitful research
because
it allowed
me that
to ask
in athe
flexible
therefore method
a lot of
because it allowed me to ask many questions in a flexible manner, therefore a lot of
because
it allowed
to askinformation
many questions
in gathered
a flexible manner,
therefore
lot of
more personal
andme
detailed
can be
rather than
using aa more
more personal and detailed information can be gathered rather than using a more
more
personal
andlike
detailed
information can be gathered rather than using a more
structured
method
questionnaires.
structured method like questionnaires.
structured method like questionnaires.
6
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During the questionnaire, due to perhaps their limited English some people didn’t
During the questionnaire, due to perhaps their limited English some people didn’t
During
the questionnaire,
due toasked
perhaps
English
some
people
didn’t
understand
the questions being
and their
that’slimited
why they
answer
within
the wrong
understand the questions being asked and that’s why they answer within the wrong
understand
questions
beingthought
asked and
that’s
why to
they
answerallwithin
wrong
context, forthe
example
people
they’d
have
answer
the the
questions
context, for example people thought they’d have to answer all the questions
context,
forof example
thought isthey’d
havesotohence
answer
all the
questions
regardless
what the people
actual question
meaning,
people
would
tick the
regardless of what the actual question is meaning, so hence people would tick the
regardless
of what
the actualwith
question
is meaning,
so hence
people
tick the
box about being
dissatisfied
the support
they receive
from
local would
organisations,
box about being dissatisfied with the support they receive from local organisations,
box
being reality
dissatisfied
with the support
from
organisations,
whenabout
in factual
the respondents
didn’tthey
evenreceive
know of
thelocal
existence
of such
when in factual reality the respondents didn’t even know of the existence of such
when
in factual
the respondents
didn’t
even know
of the
existence
such
organisation
andreality
the support
they can offer.
Conducting
phone
interviews
alsoofposed
organisation and the support they can offer. Conducting phone interviews also posed
organisation
support
they
offer.
phone
interviews
also posed
its challengesand
as the
it was
difficult
tocan
speak
to Conducting
the right person
and,
as the topic
of my
its challenges as it was difficult to speak to the right person and, as the topic of my
its challenges
it wasI difficult
to speaktold
to the
and,
as to
thedisclose
topic of any
my
questions
was as
health,
was frequently
thatright
theyperson
were not
able
questions was health, I was frequently told that they were not able to disclose any
questions
was health, I was frequently told that they were not able to disclose any
information.
information.
information.
ETHICS OF THE RESEARCH
Talking about health issues is a clearly sensitive issues and it is easy to imagine how
Talking about health issues is a clearly sensitive issues and it is easy to imagine how
Talking
about healthmay
issues
a clearlyto
sensitive
and it is easy
imagine
some participants
be isreluctant
share issues
their conditions
andtowhat
mayhow
be
some participants may be reluctant to share their conditions and what may be
some
participants
mayaccessing
be reluctant
to services
share their
conditions
and
be
preventing
them from
health
when
they need
to. what
Whenmay
asking
preventing them from accessing health services when they need to. When asking
preventing them
accessing
health
services
they need
When
participants
to be from
involved
by either
completing
thewhen
questionnaire
or to.
taking
partasking
in the
participants to be involved by either completing the questionnaire or taking part in the
participants
involvedthe
by either
the questionnaire
or taking
part inand
the
focus group,toI be
explained
naturecompleting
and purpose
of my research
very clearly
focus group, I explained the nature and purpose of my research very clearly and
focus
group,
I explained
the nature
and purpose
research
very
clearly Both
and
ensured
that the
people who
I approached
felt freeoftomy
decline
to be
involved.
ensured that the people who I approached felt free to decline to be involved. Both
ensured
that theofpeople
whogroup
I approached
felt free torespondents
decline to be
involved.
Both
the participants
the focus
and questionnaire
were
guaranteed
the participants of the focus group and questionnaire respondents were guaranteed
the
participants
of the focus
and
respondents
guaranteed
anonymity.
Participants
weregroup
asked
to questionnaire
sign an informed
consentwere
confirming
they
anonymity. Participants were asked to sign an informed consent confirming they
anonymity.
were
asked
an informed
they
understood Participants
that they were
taking
partto
in sign
a research
project consent
and that confirming
the information
understood that they were taking part in a research project and that the information
understood
that they
were
taking
in a
research
project and
that the
they volunteered
would
have
beenpart
used,
albeit
unanimously,
to inform
myinformation
paper and
they volunteered would have been used, albeit unanimously, to inform my paper and
they
volunteered
would
beenwomen
used, albeit
to inform
my paper and
ultimately
a project
to behave
run with
at the unanimously,
Somali Women’s
Centre.
ultimately a project to be run with women at the Somali Women’s Centre.
ultimately a project to be run with women at the Somali Women’s Centre.
GENERAL ISSUES WITH HEALTH SERVICES
Existing literature has found that there is a general lack of awareness of health
Existing literature has found that there is a general lack of awareness of health
Existing
has found
thatthe
there
is arefugee
generalcommunity.
lack of awareness
of health
services literature
available locally
among
Somali
This is particularly
services available locally among the Somali refugee community. This is particularly
services
locally among
the refugees
Somali refugee
community.
is particularly
worrying:available
a large number
of Somali
suffer from
complexThis
health
conditions
worrying: a large number of Somali refugees suffer from complex health conditions
worrying: a large number of Somali refugees suffer from complex health conditions
7
7
7
which, if left untreated, can have terrible consequences. Even when health issues
which, if left untreated, can have terrible consequences. Even when health issues
which,
if left
untreated,
cancan
have
terrible
consequences.
Even when
health to
issues
are minor,
if left
untreated,
leave
the person
feeling isolated
and unable
lead
are minor, if left untreated, can leave the person feeling isolated and unable to lead
are
minor,
untreated,
can to.
leave
person
feeling isolated
andstudy
unable
to lead
his/her
life ifasleft
s/he
would wish
In the
2001
the Somalis
in Camden
identified
his/her life as s/he would wish to. In 2001 the Somalis in Camden study identified
his/her
as s/hepreventing
would wishSomali
to. In 2001
the Somalis
in Camdenhealth
study identified
several life
barriers
refugees
from accessing
services
several barriers preventing Somali refugees from accessing health services
several
barriers preventing Somali refugees from accessing health services
effectively.
effectively.
effectively.
Communication was identified as the obvious issue. It was noted that there are very
Communication was identified as the obvious issue. It was noted that there are very
Communication
was identified
as the obvious
issue.surgeries.
It was noted
thatclearly
there are
very
few Somalis working
in hospitals
or in GP
This
creates
few Somalis working in hospitals or in GP surgeries. This clearly creates
few
Somalis working
hospitals serious
or in for
GPSomali
surgeries.
Thisas clearly
creates
communication
problems,inparticularly
refugees
they often
have
communication problems, particularly serious for Somali refugees as they often have
communication
problems,
particularly
serious
forthat
Somali
refugees
as they often
very limited English.
Moreover
it can be
argued
a lack
of experienced
staff have
from
very limited English. Moreover it can be argued that a lack of experienced staff from
very
limited
English. Moreover
it can
argued that
a lack
of experienced
staff from
a Somali
background
is preventing
thebecommunity
from
developing
an understanding
a Somali background is preventing the community from developing an understanding
a
background
is preventing
the community
from
developing
an understanding
ofSomali
how the
system works.
Simple systems
such as
booking
an appointment
with a
of how the system works. Simple systems such as booking an appointment with a
of
the system
works. Simple
systems
as booking
an appointment
withfor
a
GPhow
following
the surgery’s
rules have
beensuch
identified
as difficult
to understand
GP following the surgery’s rules have been identified as difficult to understand for
GP
following
surgery’s
rulesmany
haveaccessing
been identified
as difficult
to understand
for
many
Somali the
refugees
leaving
emergency
services
instead, even
many Somali refugees leaving many accessing emergency services instead, even
many
Somali
refugees
leaving many accessing emergency services instead, even
for minor
health
concerns.
for minor health concerns.
for minor health concerns.
Very interestingly the study highlighted that effective communication cannot simply
Very interestingly the study highlighted that effective communication cannot simply
Very
interestingly
thethe
study
that effectiveInstead
communication
cannot
simply
be achieved
through
usehighlighted
of Somali interpreters.
it promoted
the need
to
be achieved through the use of Somali interpreters. Instead it promoted the need to
be
achieved
through the
of Somali
interpreters.
build
an understanding
of use
the English
health
system. Instead it promoted the need to
build an understanding of the English health system.
build an understanding of the English health system.
The Camden Council study goes on to identify a wider range of barriers. These can
The Camden Council study goes on to identify a wider range of barriers. These can
The
Camden
Council
study goes on to identify a wider range of barriers. These can
be divided
in two
categories:
be divided in two categories:
be divided in two categories:
 barriers that exist because of the particular circumstances of the
 barriers that exist because of the particular circumstances of the
 barriers
that exist because of the particular circumstances of the
refugee community
refugee community
refugee community
 barriers that are created by the host community
Cultural differences can lead women to refuse treatment from men; isolation and lack
Cultural differences can lead women to refuse treatment from men; isolation and lack
Cultural
differences
lead
women
to refuseand
treatment
men; isolation
andshare
lack
of
trust often
impliescan
that
Somali
refugees,
womenfrom
in particular,
do not
of trust often implies that Somali refugees, and women in particular, do not share
of
trust
oftenconcerns
implies that
Somali
refugees,
and women
in particular,
do not share
their
health
which
may lead
to possibly
very dangerous
consequences
if
their health concerns which may lead to possibly very dangerous consequences if
their
health concerns
mayOther
lead to
possibly
very dangerous
consequences
if
the condition
remains which
untreated.
issues
identified
included: long
waiting times
the condition remains untreated. Other issues identified included: long waiting times
the condition remains untreated. Other issues identified included: long waiting times
8
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to see a GP and the limited amount of time available to discuss your concerns with
to see a GP and the limited amount of time available to discuss your concerns with
to
GP and the
limited inadequate
amount of time
available
to discuss
concerns
with
thesee
GP;atransport
problems;
access
to specific
servicesyour
such
counselling.
the GP; transport problems; inadequate access to specific services such counselling.
the GP; transport problems; inadequate access to specific services such counselling.
Sadly the study also identified responsibilities in the way health providers deliver
Sadly the study also identified responsibilities in the way health providers deliver
Sadly
the study
identifiedrefugee
responsibilities
in the
healtha providers
deliver
their services
to also
the Somali
community.
Thisway
include
limited ability
to
their services to the Somali refugee community. This include a limited ability to
their
services with
to the
Somali refugee
community.
This include
a limited
ability
to
communicate
non-English
speakers,
negative attitudes
and poor
customer
care,
communicate with non-English speakers, negative attitudes and poor customer care,
communicate
withand
non-English
speakers,
negative
attitudes
andrefugees
poor customer
care,
stigma from GPs
healthcare
professionals
against
Somali
and asylum
stigma from GPs and healthcare professionals against Somali refugees and asylum
stigma
from
GPs
and healthcare
professionals
against
Somali
refugees
andsensitive
asylum
seekers;
poor
levels
of commitment
to deliver
culturally
and
religious
seekers; poor levels of commitment to deliver culturally and religious sensitive
seekers;
poor the
levels
of commitment to deliver culturally and religious sensitive
services within
NHS.
services within the NHS.
services within the NHS.
It is obvious that such issues need to be addressed quickly and effectively to
It is obvious that such issues need to be addressed quickly and effectively to
It
is obvious
that such
issues refugees
need to and
be addressed
quicklytheir
and experience
effectively to
improve
the health
of Somali
indeed improve
of
improve the health of Somali refugees and indeed improve their experience of
improve
health
of Somali
refugees and indeed improve their experience of
essential the
services
in their
new community.
essential services in their new community.
essential services in their new community.
Unfortunately a later study commissioned by the Camden BME alliance did not
Unfortunately a later study commissioned by the Camden BME alliance did not
5
Unfortunately
a later improvement
study commissioned
by theidentified
Camden as
BME
alliance
did not
. The issues
barriers
preventing
record a significant
record a significant improvement55. The issues identified as barriers preventing
. The
issuesare
identified
as to
barriers
preventing
record refugees
a significant
Somali
from improvement
accessing health
services
very similar
those highlighted
Somali refugees from accessing health services are very similar to those highlighted
Somali
refugeesCamden
from accessing
veryaimed
similarattoidentifying
those highlighted
in the previous
Council health
study. services
This laterare
study
a BME
in the previous Camden Council study. This later study aimed at identifying a BME
in
the previous
Camden
Council study. This
studythe
aimed
at preventing
identifying aSomali
BME
needs
assessment
and recommendations
to later
address
issues
needs assessment and recommendations to address the issues preventing Somali
needs
assessment
and recommendations
refugees
from accessing
health services. to address the issues preventing Somali
refugees from accessing health services.
refugees from accessing health services.
The recommendations included
 running workshops in schools to educate the community on mental health
 running workshops in schools to educate the community on mental health
 running
workshops
in schools to educate the community on mental health
issues and
reduce stigma
issues and reduce stigma
issues and reduce stigma
5
Camden BME Alliance, Young People’s Conference , 2004
5
5
http://www.camdenbmealliance.org.uk/publications/YPconferenceRecommendations.pdf
9
9
9
working with religious groups to plan health care suitable to the needs of the
working with religious groups to plan health care suitable to the needs of the
working
with(i.e.
religious
to plan
health care
community
accessgroups
to spiritual
counselling
etc)suitable to the needs of the
community (i.e. access to spiritual counselling etc)
community (i.e. access to spiritual counselling etc)
 introduce schemes to encourage Somali workers to access employment in
 introduce schemes to encourage Somali workers to access employment in
 mental
introduce
schemes to encourage Somali workers to access employment in
health
mental health
mental health
 introduce social/cultural awareness training for health care staff so that they
 introduce social/cultural awareness training for health care staff so that they
 introduce
healthofcare
so that
they
are more social/cultural
prepared to awareness
meet the training
specific for
needs
the staff
Somali
refugee
are more prepared to meet the specific needs of the Somali refugee
are
more prepared to meet the specific needs of the Somali refugee
community
community
community
Many Somali women often live only within a very small community and moreover
Many Somali women often live only within a very small community and moreover
Many
women
often at
livehome.
only within
a verycannot
small community
and moreover
spend Somali
much of
their time
They often
access information
about
spend much of their time at home. They often cannot access information about
spend
of their
time This
at home.
access
information
about
servicesmuch
available
to them.
often They
meansoften
that cannot
they miss
out on
important social
services available to them. This often means that they miss out on important social
services
available to them. This often means that they miss out on important social
opportunities.
opportunities.
opportunities.
The mental health problems identified in a large proportion of the Somali community
The mental health problems identified in a large proportion of the Somali community
The
health problems
identified
in Somali
a large Mental
proportion
of the
Somaliwith
community
led tomental
the commissioning
of the
Camden
Health
Program
the aim
led to the commissioning of the Camden Somali Mental Health Program with the aim
led
to the commissioning
the Camden
Somali Mental
Health Program
the aim
to provide
mental health ofservices
to refugees
and migrants
though awith
community
to provide mental health services to refugees and migrants though a community
to
provide
mentalThe
health
services
refugees
and
migrants
though a services
community
health
approach.
Mental
health to
clinic
provides
a variety
of outpatient
for
health approach. The Mental health clinic provides a variety of outpatient services for
health
approach.
Mental health
clinic provides
a variety
of outpatient
servicesand
for
Somalis
includingThe
psychiatric
assessments,
medication
management,
individual
Somalis including psychiatric assessments, medication management, individual and
Somalis
including
assessments,
medication
management,
individual
and
group therapy,
andpsychiatric
case management
for adults
and children.
Day treatment
group
group therapy, and case management for adults and children. Day treatment group
group
therapy,
case
management
for adults mentally
and children.
Day Counselling
treatment group
services
provideand
help
for serious
and persistently
ill adults.
and
services provide help for serious and persistently mentally ill adults. Counselling and
services
help for
and persistently
mentally
adults.
Counselling
and
advocacyprovide
is provided
forserious
child abuse
victims and
victimsill of
domestic
abuse and
advocacy is provided for child abuse victims and victims of domestic abuse and
advocacy
is provided
for childhealth
abuse clinic
victims
andforged
victimspartnerships
of domesticwith
abuse
and
sexual assault.
The mental
has
Somali
sexual assault. The mental health clinic has forged partnerships with Somali
sexual
assault.
mental
health
clinichealth
has information,
forged partnerships
withtreatment
Somali
community
healthThe
clinics
to provide
mental
support and
community health clinics to provide mental health information, support and treatment
community
health
to readily
provideaccessible
mental health
information,
support
treatment
on-site so that
helpclinics
is more
by the
people who
need itand
most
on-site so that help is more readily accessible by the people who need it most
on-site so that help is more readily accessible by the people who need it most
One of the main research questions of this essay is identifying the current offer of
One of the main research questions of this essay is identifying the current offer of
One
the main
research
of this
essayborough.
is identifying the current offer of
healthofservices
available
to questions
Somali in the
Camden
health services available to Somali in the Camden borough.
health services available to Somali in the Camden borough.
Women can clearly access help and advice from GP surgeries, hospitals and any
Women can clearly access help and advice from GP surgeries, hospitals and any
Women
canagencies.
clearly access
help and
advice
GPcommunity
surgeries, organisations
hospitals and that
any
other NHS
In addition,
there
are from
several
other NHS agencies. In addition, there are several community organisations that
other
agencies.
In addition,
there are several
community
organisations
that
SomaliNHS
women
can contact.
I then completed
an online
research of
local community
Somali women can contact. I then completed an online research of local community
Somali women can contact. I then completed an online research of local community



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organisations and charities and I was able to contact via phone organisations. Out of
organisations and charities and I was able to contact via phone organisations. Out of
organisations
and charities
and I was able
contact
via phone numbers
organisations.
of
the 29 contacted,
only 19 answered.
The to
other
organisation’s
were Out
either
the 29 contacted, only 19 answered. The other organisation’s numbers were either
the
contacted,
onlywas
19 nobody
answered.
The other
organisation’s
were
either
not 29
working
or there
to answer
(despite
the fact Inumbers
attempted
to call
at
not working or there was nobody to answer (despite the fact I attempted to call at
not
working
or there
wasdifferent
nobody days).
to answer
the factfinding
I attempted
call at
different
times
and on
This(despite
is a worrying
as it to
probably
different times and on different days). This is a worrying finding as it probably
different
and onnearly
different
days).
This
is a worrying
finding have
as itnow
probably
indicates times
that possible
a third
of the
organisations
contacted
been
indicates that possible nearly a third of the organisations contacted have now been
indicates
possible
a third
of thenot
organisations
have why
now been
forced tothat
close
down.nearly
Whilst
I would
know the contacted
exact reason
such
forced to close down. Whilst I would not know the exact reason why such
forced
to close
down. exist,
Whilst
would
not know
the down
exacttoreason
why insuch
organisations
no longer
it isI fair
to assume
it is not
a decrease
the
organisations no longer exist, it is fair to assume it is not down to a decrease in the
organisations
longer exist,
it is probably
fair to assume
it is available.
not down to a decrease in the
demand for thenoservices
but more
in funding
demand for the services but more probably in funding available.
demand for the services but more probably in funding available.
Out of the 19 organisations I managed to contact, only 9 run projects involving
Out of the 19 organisations I managed to contact, only 9 run projects involving
Out of people.
the 19 organisations
I managed to
contact,
only 9 run
projects
Somali
Only 4 are organisations
working
specifically
with
Somaliinvolving
people.
Somali people. Only 4 are organisations working specifically with Somali people.
Somali
people.
Onlyfrom
4 are
organisations
working
with
Somali people.
Feedback
collected
these
organisations
has specifically
revealed that
organisations
run
Feedback collected from these organisations has revealed that organisations run
Feedbacktypes
collected
fromservices.
these organisations
revealed
organisations
different
of health
I think 3 runhas
projects
well that
designed
to meet run
the
different types of health services. I think 3 run projects well designed to meet the
different
types ofof health
3 run
projects
well designed
to meet the
specific needs
Somaliservices.
women.I think
King’s
Cross
and Brunswick
Neighbourhood
specific needs of Somali women. King’s Cross and Brunswick Neighbourhood
specific
needs
of Somali
King’s addressing
Cross and the
Brunswick
Association
(KCB),
runs awomen.
health project
needs Neighbourhood
of the Somali
Association (KCB), runs a health project addressing the needs of the Somali
Association
runs
a other
healthorganisations
project addressing
the that
needs
population in(KCB),
particular.
The
commented
theyofdothe
not Somali
have a
population in particular. The other organisations commented that they do not have a
population
in particular.
The run
other
organisations
thatworkshops
they do nottohave
a
specific health
project but
fitness
classes commented
and/or regular
raise
specific health project but run fitness classes and/or regular workshops to raise
specific
health
project
but run
fitness
classes and/or
regular workshops
to raise
awareness
of health
issues.
KCB
is an organisation
established
in 1980 to meet
the
awareness of health issues. KCB is an organisation established in 1980 to meet the
awareness
of health
KCBthus
is ancatering
organisation
established
meet the
needs of the
local issues.
community,
for people
fromina1980
wideto range
of
needs of the local community, thus catering for people from a wide range of
needs
of the However,
local community,
catering
for people
fromproject
a wide
range of
backgrounds.
they havethus
recently
introduced
a Somali
in response
backgrounds. However, they have recently introduced a Somali project in response
backgrounds.
they have
recently
introduced
project
in response
to an increaseHowever,
in the number
of Somali
people
living ainSomali
Camden.
As part
of their
to an increase in the number of Somali people living in Camden. As part of their
to
an increase
in thethe
number
living
in isCamden.
As partDoctor’s
of their
commitment
to meet
needsof
of Somali
Somali people
residents,
KCB
running weekly
commitment to meet the needs of Somali residents, KCB is running weekly Doctor’s
commitment
to meet
theclients
needscan
of Somali
KCB
is running
weeklydoctor
Doctor’s
Sessions where
Somali
accessresidents,
advice from
a Somali
speaking
on
Sessions where Somali clients can access advice from a Somali speaking doctor on
Sessions
whereofSomali
accessinclude
advicewelfare
from a Somali
doctor
on
a broad range
issues.clients
Othercan
services
advice, speaking
ESOL and
sewing
a broad range of issues. Other services include welfare advice, ESOL and sewing
a
broad and
range
of issues.
Other classes.
services include welfare advice, ESOL and sewing
classes
women
only fitness
classes and women only fitness classes.
classes and women only fitness classes.
Among the organisation working exclusively with Somali communities, I contacted
Among the organisation working exclusively with Somali communities, I contacted
Among
organisation
working
exclusivelyIt with
communities,
Kentish the
Town
Somali Welfare
Association.
is anSomali
organisation
based Iincontacted
Camden
Kentish Town Somali Welfare Association. It is an organisation based in Camden
Kentish
Town
Somali
Welfare
an organisation
based awareness,
in Camden
supporting
Somali
people
on a Association.
broad range Itofisissues,
including Health
supporting Somali people on a broad range of issues, including Health awareness,
supporting
people
on and
a broad
range
of issues,
Health awareness,
recreationalSomali
activities,
Yoga
welfare
advice.
Theirincluding
health related
programme
recreational activities, Yoga and welfare advice. Their health related programme
recreational
Yogaoccasional
and welfare
advice. on
Their
health
related
programme
includes yogaactivities,
classes and
workshops
broad
range
of health
issues.
includes yoga classes and occasional workshops on broad range of health issues.
includes yoga classes and occasional workshops on broad range of health issues.
11
11
11
GlSCYA (Greater London Somali Community Youth Centre) provides health, advice
GlSCYA (Greater London Somali Community Youth Centre) provides health, advice
GlSCYA
(Greater
London
Somali Community
provides
health, Centre
advice
and training
support
to Somali
communities.Youth
TheCentre)
Kingsgate
Resource
and training support to Somali communities. The Kingsgate Resource Centre
and
training
Somali
communities.
The aKingsgate
Centre
Somali
Elderssupport
Groups to
offers
services
for people from
wide rangeResource
of communities,
Somali Elders Groups offers services for people from a wide range of communities,
Somali
Elders
Groups
for services
people from
a wideintercultural
range of communities,
including
Somali.
Theyoffers
have services
very good
including
counselling
including Somali. They have very good services including intercultural counselling
including
Somali. They
very counselling
good services
including
intercultural
counselling
and psychotherapy,
and have
HIV/AIDS
projects.
However
when I called
them
and psychotherapy, and HIV/AIDS counselling projects. However when I called them
and
psychotherapy,
and HIV/AIDS
projects.
However
I called
I found
out that the project
workerscounselling
are not Somali
speakers.
I amwhen
therefore
not them
sure
I found out that the project workers are not Somali speakers. I am therefore not sure
Ithat
found
outreally
that good
the project
workers
are not
Somali speakers.
am therefore
sure
such
services
are easily
accessible
to Somali Imigrant
womennot
whose
that such really good services are easily accessible to Somali migrant women whose
that
such
services
easily
accessible
to Somali
migrant women
whose
English
is really
often good
limited.
When Iare
asked
how
they manage
to communicate
with Somali
English is often limited. When I asked how they manage to communicate with Somali
Englishthey
is often
limited.
howand
they
manage
to communicate
Somali
clients
replied
that When
they doI asked
their best
use
strategies
like speakingwith
slowly
etc.
clients they replied that they do their best and use strategies like speaking slowly etc.
clients
replied
that
they do their
best
and use strategies
speaking
slowly
etc.
I think they
this has
both
advantages
and
disadvantages.
I thinklike
it is
good that
Somali
I think this has both advantages and disadvantages. I think it is good that Somali
Iwomen
think this
both advantages
I thinkcommunities
it is good that
Somali
are has
encouraged
to interactand
with disadvantages.
people from different
as they
do
women are encouraged to interact with people from different communities as they do
women
are encouraged
to interactHowever
with people
from different
communities
as they
do
live in city
with great diversity.
as English
is such
a barrier for
Somali
live in city with great diversity. However as English is such a barrier for Somali
live
in city
with I great
diversity. that
However
as English
such
a barrier
for Somali
migrant
women
am concerned
the service
may notis be
easily
accessible
and as
migrant women I am concerned that the service may not be easily accessible and as
migrant
concerned
that the service may not be easily accessible and as
useful aswomen
it couldI am
be to
them.
useful as it could be to them.
useful as it could be to them.
The British Somali Community also provides health activities such as health drop-ins
The British Somali Community also provides health activities such as health drop-ins
The
Britishwomen’s
Somali Community
and other
only project.also provides health activities such as health drop-ins
and other women’s only project.
and other women’s only project.
The next step in my research was to determine the awareness Somali women have
The next step in my research was to determine the awareness Somali women have
The
next step
in myavailable
research them
was toand
determine
Somali
have
of health
services
identify the
anyawareness
barriers they
maywomen
face when
of health services available them and identify any barriers they may face when
of
health services
available them and identify any barriers they may face when
accessing
them.
accessing them.
accessing them.
As part of my research I designed and distributed 20 questionnaires among refugee
As part of my research I designed and distributed 20 questionnaires among refugee
As
part women
of my research
I designed
distributed
20 questionnaires
among refugee
Somali
living in the
Camdenand
borough.
Questionnaires
were distributed
at the
Somali women living in the Camden borough. Questionnaires were distributed at the
Somali
living
in theinCamden
Questionnaires
were
distributed
at the
Shadowwomen
Women’s
Centre
Somali borough.
so that I could
easily target
women
with limited
Shadow Women’s Centre in Somali so that I could easily target women with limited
Shadow
Women’s Centre
Somali so
I could method
easily target
women
with limited
English. Questionnaire
wasinselected
as that
a research
to collect
feedback
from
English. Questionnaire was selected as a research method to collect feedback from
English.
Questionnaire
was selected
as number
a research
collect
feedback were
from
a large number
of people
on a large
of method
topics. to
The
respondents
a large number of people on a large number of topics. The respondents were
a
large between
number of
large
topics.
The they
respondents
women
thepeople
age of on
21 aand
61 number
and overofand,
crucially,
all agreewere
that
women between the age of 21 and 61 and over and, crucially, they all agree that
women
the age for
of Somali
21 and women.
61 and over and, crucially, they all agree that
health isbetween
a major concern
health is a major concern for Somali women.
health is a major concern for Somali women.
Here are the main findings emerging from the analysis of their responses.
12
12
12
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A clear majority of respondents, 88%, reported having health problems. They were
A clear majority of respondents, 88%, reported having health problems. They were
A
majority
of arespondents,
88%,have
reported
having
healththey
problems.
all clear
registered
with
GP. When they
a health
problem,
repliedThey
that were
they:
all registered with a GP. When they have a health problem, they replied that they:
all
registered
with a (100%),
GP. When
havetoafamily
healthand
problem,
replied
that they:
attend
GP surgeries
askthey
for help
friendsthey
(65%)
or access
local
attend GP surgeries (100%), ask for help to family and friends (65%) or access local
attend
GP surgeries
(100%),
ask Itforwould
help to
family
andthat
friends
(65%)
or access
local
community
organisations
(20%).
then
appear
some
progress
has been
community organisations (20%). It would then appear that some progress has been
community
(20%). It wouldby
then
appearCouncil
that some
progress
been
made sinceorganisations
the studies commissioned
Camden
in 2001
and has
2004
as
made since the studies commissioned by Camden Council in 2001 and 2004 as
made
studiesdoes
commissioned
Council in 2001 and 2004 as
accesssince
to GPthe
surgeries
not seem toby
beCamden
a problem.
access to GP surgeries does not seem to be a problem.
access to GP surgeries does not seem to be a problem.
However, only 5% of respondents reported being very satisfied with the support of
However, only 5% of respondents reported being very satisfied with the support of
However,
only 55%
5% ofofrespondents
beingthat
verythey
satisfied
with the whereas
support of
GP surgeries.
respondentsreported
commented
are satisfied,
a
GP surgeries. 55% of respondents commented that they are satisfied, whereas a
GP
respondents
that the
theyservice
are satisfied,
whereas
a
totalsurgeries.
of 30% are55%
not of
satisfied
or verycommented
dissatisfied with
(10% don’t
know).
total of 30% are not satisfied or very dissatisfied with the service (10% don’t know).
total
30%
are notprovided
satisfiedby
or community
very dissatisfied
with the 45%
service
know).
As forof the
support
organisations
are(10%
very don’t
dissatisfied,
As for the support provided by community organisations 45% are very dissatisfied,
As
thenot
support
provided
by community
45% (35%
are very
20%forare
satisfied
and 0%
feel satisfiedorganisations
or very satisfied
diddissatisfied,
not know).
20% are not satisfied and 0% feel satisfied or very satisfied (35% did not know).
20% are
notfriends
satisfied
and to
0%befeel
satisfied
or veryform
satisfied
(35% when
did not
know).
Family
and
appear
then
the favourite
of support
having
a
Family and friends appear to be then the favourite form of support when having a
Family
and friends
to be then
thevery
favourite
formand
of only
support
having
a
health concern:
65%appear
being satisfied,
25%
satisfied
the when
remaining
10%
health concern: 65% being satisfied, 25% very satisfied and only the remaining 10%
health
concern:
65%dissatisfied.
being satisfied,
25%
veryconcerned
satisfied and
only the
remaining
10%
reporting
to be very
I was
quite
by these
results,
especially
reporting to be very dissatisfied. I was quite concerned by these results, especially
reporting
to betovery
I was quitewith
concerned
by provided
these results,
especially
with regards
thedissatisfied.
levels of satisfaction
services
by community
with regards to the levels of satisfaction with services provided by community
with
regards to
the spoke
levels to
of the
satisfaction
with and
services
provided
organisations.
I then
respondents
it became
clearby
thatcommunity
they had
organisations. I then spoke to the respondents and it became clear that they had
organisations.
I then
spokeoftohealth
the respondents
and it became
clear they
that had
they ever
had
mistakenly rated
all forms
support regardless
of whether
mistakenly rated all forms of health support regardless of whether they had ever
mistakenly
forms of
support regardless
of whether
theyinterpreted
had ever
accessed it.rated
After all
speaking
to health
the respondents
they explained
that they
accessed it. After speaking to the respondents they explained that they interpreted
accessed
it. After speaking
to the
explained
thathealth
they interpreted
being dissatisfied
as the fact
that respondents
they did notthey
even
know that
support is
being dissatisfied as the fact that they did not even know that health support is
being
dissatisfied
as the factorganisations.
that they did not even know that health support is
available
through community
available through community organisations.
available through community organisations.
Respondents were very clear about what they believe to be suitable indicatives to
Respondents were very clear about what they believe to be suitable indicatives to
Respondents
very
clear women:
about what they believe to be suitable indicatives to
improve healthwere
among
Somali
improve health among Somali women:
improve health among Somali women:
100% would like to see more health awareness classes
95% believe that Somali women need to attend fitness classes
90% of respondents believe that introducing more women-only services would
90% of respondents believe that introducing more women-only services would
90%
of respondents
introducing
women-only services would
encourage
and improvebelieve
access that
to essential
healthmore
services
encourage and improve access to essential health services
encourage and improve access to essential health services
70% would like to see more healthy eating classes
13
13
13
65% would like more counselling services
A perhaps surprising 40% only would like to have interpreters at GP appointments.
Health is a very personal issue and so are the barriers that prevent individuals from
Health is a very personal issue and so are the barriers that prevent individuals from
Health
is a essential
very personal
issue and
arereason
the barriers
from
accessing
services.
For so
this
I ranthat
twoprevent
focus individuals
groups where
accessing essential services. For this reason I ran two focus groups where
accessing
services. For
this reason
I ran two I believe
focus groups
respondentsessential
had the opportunity
to share
their experiences.
the factwhere
that I
respondents had the opportunity to share their experiences. I believe the fact that I
respondents
had can
the opportunity
share their
experiences.
I believe
the factwhere
that I
am Somali and
speak the to
language
helped
creating an
environment
am Somali and can speak the language helped creating an environment where
am
Somali
canfreely
speak
language helped creating an environment where
people
couldand
speak
andthe
honestly.
people could speak freely and honestly.
people could speak freely and honestly.
In the focus groups it was clear that whilst they all have access to a GP, respondents
In the focus groups it was clear that whilst they all have access to a GP, respondents
In
groups
it was
clear that
whilst
all have
to a GP,
respondents
dothe
notfocus
feel they
have
adequate
access
to they
a broad
rangeaccess
of services
to improve
their
do not feel they have adequate access to a broad range of services to improve their
do
not feel they have adequate access to a broad range of services to improve their
health.
health.
health.
The focus groups identified the following as ongoing issues:
1. Language problem
1. Language problem
1. Language problem
2. Cultural differences
3. Religion
3. Religion
3. Religion
4. Lack of awareness
5. Lack of accessible services
In particular they commented that it is impossible to talk about health issues with the
In particular they commented that it is impossible to talk about health issues with the
In
theylanguage
commented
that itthey
is impossible
to talkthat
about
health
issues with
the
GPparticular
due to the
barrier;
also explained
health
services
are not
GP due to the language barrier; they also explained that health services are not
GP
due to
language
barrier; environment.
they also explained
that health
services
not
provided
in the
a culturally
sensitive
Unfortunately
this means
thatare
many
provided in a culturally sensitive environment. Unfortunately this means that many
provided
in a culturally
environment.
Unfortunately
means
that many
Somali women,
who do sensitive
not mix with
other people,
will not bethis
able
to access
such
Somali women, who do not mix with other people, will not be able to access such
Somali
do not
mixand
with education
other people,
will are
not be
ableanto issue.
accessOther
such
services.women,
Poor who
literacy
skills
levels
also
services. Poor literacy skills and education levels are also an issue. Other
services. Poor literacy skills and education levels are also an issue. Other
14
14
14
Agram Muse
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respondents also explained that they cannot access health services as they do not
respondents also explained that they cannot access health services as they do not
respondents
also
explained
that they
cannot
access
health services
theyofdotheir
not
have the time
(many
are single
parent
solely
responsible
for theascare
have the time (many are single parent solely responsible for the care of their
have
the More
time (many
are single
parent
for thethat
care
of need
their
children).
importantly,
women
at thesolely
focusresponsible
groups stressed
they
children). More importantly, women at the focus groups stressed that they need
children).
More
importantly,
women at the focus groups stressed that they need
Somali only
services
and groups.
Somali only services and groups.
Somali only services and groups.
The following were identified as initiatives useful to improve access to health
The following were identified as initiatives useful to improve access to health
The
following were identified as initiatives useful to improve access to health
services:
services:
services:
a) Health awareness
a) Health awareness
a) Health awareness
b) Create Elderly lunch clubs
c) Create Somali women clubs
d) Language classes
d) Language classes
d) Language classes
e) Healthy Eating classes
f) Interpreters at GP
g) Culturally sensitive Counselling
In order to gain a broader and more comprehensive understanding of the issues I
In order to gain a broader and more comprehensive understanding of the issues I
In
order
to gain2a local
broader
more comprehensive
understanding
of theso
issues
also
contacted
GP and
surgeries.
2 GPs were then
asked questions
that II
also contacted 2 local GP surgeries. 2 GPs were then asked questions so that I
also
2 local
GP surgeries.
2 GPs
thentoasked
questions
that I
couldcontacted
present their
perspectives
on what
couldwere
be done
improve
access so
to health
could present their perspectives on what could be done to improve access to health
could
present
their
perspectives
on what
could be done
access toissues,
health
services.
I was
only
able to speak
to receptionists.
Duetotoimprove
DATA protection
services. I was only able to speak to receptionists. Due to DATA protection issues,
services.
I was only
able to speak
to receptionists.
to DATA
protection at
issues,
they
were unable
to comment
on how
many SomaliDue
women
are registered
their
they were unable to comment on how many Somali women are registered at their
they
were Both
unable
to comment
how that
many
Somali
arespecific
registered
at their
practices.
practices
could on
confirm
they
don’t women
have any
services
for
practices. Both practices could confirm that they don’t have any specific services for
practices.
Both practices
confirm
thatwomen
they don’t
have any
specific
services
for
Somali women.
However could
they can
provide
GP when
requested
and
can book
Somali women. However they can provide women GP when requested and can book
Somali
women.
However they can provide women GP when requested and can book
an interpreter
if needed.
an interpreter if needed.
an interpreter if needed.
15
15
15
Chapter
2
Chapter
Chapter 2
2
Conclusions
Conclusions
Conclusions
One of the main findings of this project is that there is very much limited data on the
One of the main findings of this project is that there is very much limited data on the
One
ofand
the the
main
findings
of this
project
is that
therecommunity.
is very much
limitedresearch
data on into
the
needs
issues
faced
by the
Somali
refugee
Further
needs and the issues faced by the Somali refugee community. Further research into
needs
and the
issues
faced bytothe
Somaliexisting
refugeeservices
community.
research
into
such issues
is very
important
improve
and Further
better plan
for future
such issues is very important to improve existing services and better plan for future
such
is verythat
important
to improve
existing
and better
plan
for future
ones.issues
It is evident
more research
needs
to beservices
undertaken
to better
understand
ones. It is evident that more research needs to be undertaken to better understand
ones.
It is evident
that more
research
to be undertaken
to better
the barriers
preventing
Somali
women needs
from accessing
appropriate
healthunderstand
providers.
the barriers preventing Somali women from accessing appropriate health providers.
the
barriers
Somali
women
fromidentified
accessing
providers.
I hope
to bepreventing
able to build
on the
findings
in appropriate
this researchhealth
and produce
a
I hope to be able to build on the findings identified in this research and produce a
Imore
hopespecific
to be able
to on
build
the findings
identified
this research
and produce
a
paper
theon
issues
preventing
Somaliinwomen
from accessing
mental
more specific paper on the issues preventing Somali women from accessing mental
more
thelocal
issues
preventing
Somali
from accessing
mental
healthspecific
supportpaper
fromonthe
health
providers.
It women
would also
be interesting
to
health support from the local health providers. It would also be interesting to
health
support
from the
health providers.
It would
also be
to
determine
how issues
suchlocal
as literacy/English
levels,
employment
andinteresting
other factors
determine how issues such as literacy/English levels, employment and other factors
determine
issues such
literacy/English
employment
and this
other
factors
like single how
parenthood
affectasaccess
to health levels,
support.
I believe that
research
like single parenthood affect access to health support. I believe that this research
like single
affectresults
accessif to
health support.
believe that
this research
could
haveparenthood
produced better
respondents
were Iidentified
amongst
different
could have produced better results if respondents were identified amongst different
could
have produced
better
respondents
identified amongst different
demographic
groups and
theresults
resultsiffor
each groupwere
compared.
demographic groups and the results for each group compared.
demographic groups and the results for each group compared.
However, I hope that this study can still contribute to highlight the perspectives and
However, I hope that this study can still contribute to highlight the perspectives and
However,
I hope that
this refugee
study can
still contribute
to highlight
and
ideas
of ordinary
Somali
women
living in Camden
as the
I amperspectives
confident these
ideas of ordinary Somali refugee women living in Camden as I am confident these
ideas
of ordinary
Somali
refugee
womenservices
living inresponding
Camden as
am people’s
confidentneeds.
these
are crucial
to create
patients
led health
to Ireal
are crucial to create patients led health services responding to real people’s needs.
are
crucial
led health
services
responding
to real
people’s
needs.
Much
work to
stillcreate
needspatients
to be done
to ensure
that Somali
refugee
women
are able
to
Much work still needs to be done to ensure that Somali refugee women are able to
Much
needs
to beservices.
done to ensure
that
Somali
refugee
women
able to
accesswork
the still
relevant
health
I believe
that
to achieve
this,
healthare
providers
access the relevant health services. I believe that to achieve this, health providers
access
relevant
services.
I believe that
to achievesuch
this, as
health
need tothe
work
with health
local Somali
community
organisations
the providers
Shadow
need to work with local Somali community organisations such as the Shadow
need to work
with
localare
Somali
community
such
theadvantage
Shadow
Women’s
Centre.
These
well placed
in theorganisations
community and
haveasthe
Women’s Centre. These are well placed in the community and have the advantage
Women’s
Centre.
These of
aretrust
welland
placed
in the community
andservice
have the
advantage
of having built
a rapport
understanding
with their
users.
This is
of having built a rapport of trust and understanding with their service users. This is
of
having what
built aemerged
rapport from
of trust
understanding
with
users.lifestyle
This is
definitely
theand
report
completed at
thetheir
endservice
of a healthy
definitely what emerged from the report completed at the end of a healthy lifestyle
definitely
emerged
the report completed
the endThe
of aproject
healthyaimed
lifestyle
promotionwhat
project
run byfrom
my organisation,
Shadow atWomen.
to
promotion project run by my organisation, Shadow Women. The project aimed to
promotion
by my
organisation,
Women.
Theawareness
project aimed
to
encourage project
womenrun
to use
health
services; itShadow
also aimed
to raise
of the
encourage women to use health services; it also aimed to raise awareness of the
encourage
womengenital
to use mutilation
health services;
aimed
to raise
of the
risks
of female
(FGM),it also
breast
cancer
and awareness
coronary health
risks of female genital mutilation (FGM), breast cancer and coronary health
risks
of female
genitalto mutilation
(FGM),
and coronary
health
problems.
We worked
improve the
qualitybreast
of life cancer
of the socially
excluded
and
problems. We worked to improve the quality of life of the socially excluded and
problems. We worked to improve the quality of life of the socially excluded and
16
16
16
Agram Muse
Agram Muse
Agram Muse
disadvantaged refugee women, and particularly the elderly, from Somalia and
disadvantaged refugee women, and particularly the elderly, from Somalia and
disadvantaged
women,
and particularly
thewas
elderly,
from and
Somalia
and
Ethiopia living inrefugee
the borough
of Camden.
The project
successful
supported
Ethiopia living in the borough of Camden. The project was successful and supported
Ethiopia
in thelevels:
boroughparticipants
of Camden.were
Thegiven
project
successful
supported
clients onliving
different
a was
healthy
lunch atand
a social
club
clients on different levels: participants were given a healthy lunch at a social club
clients
different
were
given
healthy
at aavailable
social club
twice aon
week;
they levels:
reportedparticipants
feeling more
aware
of athe
healthlunch
services
to
twice a week; they reported feeling more aware of the health services available to
twice
a week;
they
feeling
aware aofsocial
the health
services
availablethe
to
them in
Camden
andreported
were also
able more
to establish
network.
Unfortunately
them in Camden and were also able to establish a social network. Unfortunately the
them
Camden
and
were
able to has
establish
social network.
Unfortunately
projectincame
to an
end
andalso
no funding
been asecured
to replicate
this work. Itthe
is
project came to an end and no funding has been secured to replicate this work. It is
project
to an
end andwill
no be
funding
hastobeen
secured
to replicate
thisnew
work.
It is
hoped came
that this
research
useful
inform
the planning
of a
health
hoped that this research will be useful to inform the planning of a new health
hoped
that project
this research
be Shadow
useful to
inform the
planning of a new health
awareness
to be runwill
at the
Women’s
Centre.
awareness project to be run at the Shadow Women’s Centre.
awareness project to be run at the Shadow Women’s Centre.
I believe that the most worrying finding of this research is the inability of mainstream
I believe that the most worrying finding of this research is the inability of mainstream
Iorganisations,
believe that the
worryingrepresented
finding of this
is the inability
of mainstream
as most
for instance
by research
GPs surgeries,
to effectively
meet the
organisations, as for instance represented by GPs surgeries, to effectively meet the
organisations,
as women.
for instance
effectively
needs of Somali
It is represented
than hoped by
thatGPs
the surgeries,
finding of to
this
researchmeet
and the
the
needs of Somali women. It is than hoped that the finding of this research and the
needs of Somali
women. Itcollected
is than hoped
thatSomali
the finding
of this
the
experiences
and feedback
from local
women
couldresearch
be usedand
as part
experiences and feedback collected from local Somali women could be used as part
experiences
and feedback
collectedtofrom
local Somali
women
could betoused
as part
of an awareness
raising campaign
sensitize
local health
providers
the need
of
of an awareness raising campaign to sensitize local health providers to the need of
of
an awareness
campaign to sensitize local health providers to the need of
Somali
women in raising
Camden.
Somali women in Camden.
Somali women in Camden.
It is evident that more research needs to be undertaken to better understand the
It is evident that more research needs to be undertaken to better understand the
It
is evident
that more
research
needs
be undertaken
to better
understand
theI
barriers
preventing
Somali
women
fromtoaccessing
appropriate
health
providers.
barriers preventing Somali women from accessing appropriate health providers. I
barriers
from accessing
health
hope to preventing
be able to Somali
build onwomen
the findings
identified inappropriate
this research
andproviders.
produce aI
hope to be able to build on the findings identified in this research and produce a
hope
to be able
to build
the findings
identified
this research
and produce
a
more specific
paper
on theonissues
preventing
Somaliinwomen
from accessing
mental
more specific paper on the issues preventing Somali women from accessing mental
more
thelocal
issues
preventing
Somali
from be
accessing
mental
healthspecific
supportpaper
fromonthe
health
providers.
It women
would also
interesting
to
health support from the local health providers. It would also be interesting to
health
support
from the
health providers.
It would
also be
to
determine
how issues
suchlocal
as literacy/English
levels,
employment
andinteresting
other factors
determine how issues such as literacy/English levels, employment and other factors
determine
issues such
literacy/English
employment
and this
other
factors
like single how
parenthood
affectasaccess
to health levels,
support.
I believe that
research
like single parenthood affect access to health support. I believe that this research
like
affectresults
accessif to
health support.
believe that
this research
couldsingle
have parenthood
produced better
respondents
were Iidentified
amongst
different
could have produced better results if respondents were identified amongst different
could
have produced
better
identified amongst different
demographic
groups and
the results
results ifforrespondents
each group were
compared
demographic groups and the results for each group compared
demographic groups and the results for each group compared
17
17
17
Bibliography
Bibliography
Bibliography
1. Harris, H. (2004) The Somali Community in the UK: What we know and how
1. Harris, H. (2004) The Somali Community in the UK: What we know and how
1. we
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The Need to Raise Awareness of Health Services among the Somali

Transcription

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