Eradicating poverty through empowerment: what’s the responsible thing to do?

Posted by Stephen Crossley, Senior Lecturer in Social Policy, Northumbria University

On this day, 17th October, in 1987, at the instigation Father Joseph Wresinski, the founder of ATD Fourth World, an anti-poverty movement, around 100,000 people congregated in Paris to honour victims of poverty, hunger, violence and fear. Five years later, and following the death of Father Wresinski, the United Nations announced the day as the International Day for the Eradication of Poverty, and published a resolution by the General Assembly that, amongst other things, ‘invited all states to devote the day to presenting and promoting, as appropriate in the national context, concrete activities with regard to the eradication of poverty and destitution’.

This year is the 27th anniversary of that resolution and the theme of this year’s observance is ‘Acting Together to Empower Children, their Families and Communities to End Poverty’. Themes such as this matter. How people in poverty are spoken about has consequences for how they are viewed, and the solutions that are put forward to address poverty. Discourses of empowerment are often used by governments and service providers to encourage people to view themselves as active agents with the ability, if not the responsibility, to change their circumstances for the better. This reflects attention away from what governments themselves can do.

In an examination of ‘dimensions of family empowerment’ within the ‘troubled families’ discourse in England, Sue Bond-Taylor (2014) highlights the merging of empowerment talk with encouraging families to take responsibility for both their situation and the improvement of it. This occurs not only in the ‘troubled families’ discourse, but also in the practices of family workers, suggesting that families are empowered ‘only in so much as they are compliant and accept the normalising discourses of the services through engagement with their agendas for change’ (2014: 12). She argues that families’ participation in the programme ‘merely legitimates existing power relations under a veneer of empowerment discourses’ (2014: 8). 

In another similar research project examining how education services engaged with disadvantaged families, Fretwell et al (2018: 1056) highlight how a project exhorted parents to take greater responsibility for the educational performance of their children and to take measures to address it. Notions of empowerment were deployed, particularly when discussing employment:

This aspect of the programme was couched in a discourse of empowerment. The parameters of choice are firmly circumscribed, though. Parents can choose which activities to pursue, but they are not free to choose just anything; they must make the right choices. Empowerment is thus restricted to making choices within conditional limits and is itself a strategy of government; a sanctioned means for producing the kind of active citizen demanded by neoliberalism (2018: 1056).

One of the most powerful organisations in the world
is encouraging us to 'act together' to end poverty 

It is therefore interesting, perhaps even worrying, to note that one of the most powerful organisations in the world, made up of over 190 national governments, is encouraging us to ‘act together’ to ‘empower children, their families and communities to end poverty’, as if the responsibility for ending poverty lies primarily with ‘us’ as individuals or with the people experiencing poverty. Not only are impoverished groups expected to deal with and be ‘resilient’ about their own hardship, and the problems that come with it, but they’re now also expected to be the solution. Nelson Mandela argued powerfully that overcoming poverty was an act of justice, not a gesture of charity, and John Veit-Wilson (2000, 144) has noted that the responsibility for ending poverty ultimately rests with governments:

“Ensuring that all the members of society, residents in or citizens of a nation state, have enough money is a clear role which governments can adopt or reject, but they cannot deny they have the ultimate power over net income distribution.”

It is shameful that this is where we are at in 2019. Poverty continues to exist because of political and economic decisions, by powerful groups, regarding the allocation of resources, both nationally and globally. Impoverished communities lack political power because they lack economic power. Nobody feels the need to empower millionaires or politicians to take greater control of their lives. Perhaps if we increased the economic power of those living in poverty, we might find that they were more fully able to participate in society and there might be less need for ‘empowering’ projects and services. That would be the responsible thing to do.


Stephen is currently working with Kayleigh Garthwaite (University of Birmingham) and Ruth Patrick (University of York) on an online project exploring representations of people living in poverty in the UK. This blog also appears on their website www.whatstheproblem.org.uk



References:

Bond-Taylor, S. (2015) Dimensions of Family Empowerment in Work with So-Called ‘Troubled’ Families, Social Policy and Society, 14 (3): 371-384. DOI: https://doi.org/10.1017/S1474746414000359

Fretwell, N., Osgood, J., O’Toole, G. and Tsouroufli, M. Governing through trust: Community‐based link workers and parental engagement in education, British Educational Research Journal, 44 (6): 1047-1063. DOI:  https://doi.org/10.1002/berj.3478

Veit-Wilson J (2000) Horses for Discourses: poverty, purpose and closure in minimum incomes standards policy. In: Gordon D and Townsend P (eds) Breadline Europe: The Measurement of Poverty. The Policy Press, Bristol, pp 141-164. https://policy.bristoluniversitypress.co.uk/breadline-europe

The website for the International Day for the Eradication of Poverty can be found here:
https://www.un.org/en/events/povertyday/

Images:

1. Courtesy of the United Nations Department of Economic and Social Affairs: https://www.un.org/development/desa/socialperspectiveondevelopment/international-day-for-the-eradication-of-poverty-homepage/2019-2.html
2. 'I like the campaign so far, Bob- I've already made my poverty history' by David Austin via University of Kent, British Cartoon Archive (Reference number: 86494, Published by: The Guardian, 02 July 2005, with thanks to Copyright holder: Janet Slee): https://archive.cartoons.ac.uk/Record.aspx?src=CalmView.Catalog&id=86494

Research journey for hospice evaluating its innovative dementia care

Posted by Nicola Kendall, Namaste Lead, St Cuthbert’s Hospice and Dr Sonia Dalkin, Senior Lecturer in Public Health and Wellbeing and Lead of the Fuse Healthy Ageing Research Programme

To celebrate World Hospice and Palliative Care Day, we wanted to share part of St. Cuthbert’s Hospice’s research journey, in collaboration with Northumbria University. Specifically, we wanted to share some of the innovative activity that has been taking place in practice surrounding ‘Namaste Care’ and the evaluation of it with Fuse funding.

What is Namaste Care?

As dementia progresses, family carers describe a changing relationship and sense of loss, which can cause significant distress. Finding new ways of communicating is important to help the family carer and person with dementia to maintain a good quality of life. ‘The End-Of-Life Namaste Care Program for People with Dementia’ (Namaste Care) challenges the perception that people with advanced dementia are a ‘shell’, a ‘living death’; it provides a holistic approach based on the five senses. Early evidence suggest that it can improve communication and the relationships families and friends have with the person with dementia.

How has St. Cuthbert’s Hospice used it?

St Cuthbert’s Hospice in Durham has started to provide Namaste Care in the person’s own home, as opposed to its more traditional use in care homes. We train volunteers who are then matched with a person with dementia, in terms of personality, abilities and interests, for example. Volunteers visit the person, usually weekly for two hours and try to build a bond with the person living with dementia and the family.

Why did we want an evaluation?

Evaluating Namaste Care has proved challenging for many organisations. It is straightforward to measure reduced number of falls, less infections and reduced agitation, but teasing out the nuances of why the approach works requires more detailed study. Also, we were aware that our use of Namaste was somewhat novel, with only one other hospice in the UK implementing Namaste Care in people’s own homes. A team at Northumbria University, led by Dr Sonia Dalkin applied to the Fuse Pump Prime fund and was successful in attaining a small pot of funding to do some preliminary evaluation of our use of Namaste Care.

What did the evaluation find?

The preliminary research found that when used in people’s own homes Namaste Care has positive outcomes, such as increasing engagement and social interaction. Previously, social interaction had potentially been overlooked in the literature as an important outcome of Namaste Care. This was particularly important for carers who felt that their loved ones with dementia often didn’t have any interaction with others, beyond those living with them. The importance of matched volunteers was also highlighted, and special relationships were built between volunteers and the person with dementia. Family members would often use the time when the volunteer was present as respite as opposed to taking part in the session, and this highlighted interesting perspectives on their involvement in Namaste. The evidence suggested that those who care for a person with dementia at home provide continuous care and have little input from other services, therefore provision of two hours contact with a trained Namaste Care volunteer allowed them to concentrate on other things, knowing that the their loved one was in safe hands. This is in contrast to the usual delivery of Namaste Care in care homes, where family members may feel more able to get involved as they do not provide continuous care.

What next? 

Book for organisations and carers
interested in using the approach

• Delivery of Namaste Care in various settings
The ethos of the Namaste Care approach has proved transferable into various care settings at St Cuthbert’s hospice. We now run a Namaste inspired ‘Potting Shed’ Men’s Group and we deliver Namaste Care at the bedside in an acute hospital. We are also in the early stages of discussions about taking Namaste Care into prisons, either via staff training or training prisoner buddies. We are very proud to say that due to this and other work we have been shortlisted as finalists for ‘Best Team Award’ in the 10th National Dementia Care Awards 2019.

• Spreading the word
The Hospice has developed a training programme which is steadily gaining popularity. Nicola Kendall (Namaste Lead) has also written a book as a guide for other organisations and carers who are interested in using the approach: ‘Namaste Care for people living with advanced dementia - A practical guide for carers and professionals’. The book is now available from Jessica Kingsley Publishing.

• Research
Nicola has just attended the Namaste Care International Conference and continues to take Namaste Care from strength to strength at St Cuthbert’s Hospice. We are now planning to further evaluate our work, building on the findings of the preliminary evaluation and the guide book… Watch this space!

Policy, procedure, practice and plate-spinning - how to achieve a work-life balance

Posted by Susanne Nichol, Better Health at Work Award Programme Coordinator, Northern TUC

I regularly wish for an extra hour in the day, or a day in the week and I even more regularly feel like my frenetic movement from place to place whilst grabbing various coats, bags, children, laptops, papers and other extraneous articles is accompanied by the Benny Hill theme tune. And I know that I am absolutely not alone in this daily plate-spinning, multi-tasking blur that is reality for the vast majority of parents, carers – and well, everyone else!

However, I am fortunate to work for an employer that has a raft of measures in place to help me restore some balance. For example, having flexi-time means I can get a much needed hit of endorphins by going to the gym or out for a power-walk on my lunch hour, or before I have to sprint through the school gates lest my youngest child becomes an accidental boarder.

The Better Health At Work Award (BHAWA) is a regional flagship public health programme that is the result of a long-standing (currently celebrating a decade of making workplaces healthier), progressive partnership between 11 of the regional local authorities. This was evaluated in 2012 by Durham University, received a RAND Europe award in 2018 for its impact on health and wellbeing, and due to cross-organisational working between Local Authority specialist public health practitioners, academics and Fuse, was a featured element in the Prevention stream of the recently awarded regional NIHR Applied Research Collaboration (ARC) funding.

As BHAWA Coordinator I have contact with literally hundreds (currently over 400) workplaces across North East England and Cumbria, who cumulatively employ nearly a quarter of a million workers. One of the mandates of the BHAWA is that participants survey their staff biennially (at a minimum) and ask them what topics/ issues they’d like to see addressed or get more information/ support on and more often than not, work-life balance is ubiquitous in the top 5.

To me, this presents more of a challenge for both employer and employee than some of the other regular top 5 entries such as healthy eating, physical activity and mental health. Work-life balance encompasses all of those things and more, and whilst the application of all health topics is subjective, this even more so, as we all have our fulcrum in a different place – with a large measure of economics thrown in. Most of us would like to work less time for the same pay, but currently business demands and finances often make this unviable; conversely, whilst going to 3 days instead of 5 might give you perfect work-life balance, most of us wouldn’t be able to sustain a 40% reduction in salary.

Unfortunately, there is no quick fix or magic wand. However, there are multiple ways and means to mitigate work-life imbalance and to actively facilitate a redress in the right direction. The BHAWA takes a holistic approach to workplace health that emphasises making positive changes to all aspects of the workplace, from the infrastructure and logistics, to the pervading culture of staff and management engagement and interaction – and everything in between.

So, how do they do it and what does ‘good’ look like? Well, based on my six years of experience I can safely say that the best employers take a wholesale approach and embed health and wellbeing into the holy workplace triumvirate of policy, procedure and practice.

It all starts with having fit for purpose policies in place, specifically such as Flexible Working; one of our workplaces operates a best practice ‘Adult Working’ policy, which is uber-flexible, employee-led and based around a mutually trusting relationship, so if Costa is a conducive place for them to deliver their work in between school-runs or meetings, then so be it. More and more participants are also introducing ‘stuck not sick’ policies that allocate a bank of ‘reserve’ hours that people can use to deal with unexpected issues, such as an ill child or a flooded kitchen.

Then there are underpinning procedures like regular and supportive line management, meetings/1-2-1s that start with the question ‘How are you?’ which allows for an open dialogue and an easier conversation around any issues and hopefully a subsequent resolution. But, what is of paramount importance is the active implementation of policy and procedure. If an employer has the best policy in the world, yet nobody actually knows about it, then it’s not worth the paper it’s written on. Awareness, buy-in, good communication/training and a practical approach is imperative here.

Having managers who are properly supported to understand and apply the policy in practice is fundamental. They can do this in various ways; by advertising jobs as flexible from day one, supporting a range of flexible working options such as home-working, flexi-time, or compressed hours; reminding colleagues that they can (and should) take their lunch break/leave and can attend medical appointments or workplace campaigns or activities like on-site flu jabs, or a lunch-time yoga class, without it being detrimental to pay.

One thing is for certain - work-life balance is for life and not just for a week



Image:

1.  'plate spinning' by Clancy Mason via Flickr. Attribution-NonCommercial 2.0 Generic (CC BY-NC 2.0): https://www.flickr.com/photos/clancy123/1805082629
2. 'I'm working through my lunch hour. Work - life balance survey' by David Austin via University of Kent, British Cartoon Archive (Reference number: 84983, Published by: The Guardian, with thanks to Copyright holder: Janet Slee): https://archive.cartoons.ac.uk/Record.aspx?src=CalmView.Catalog&id=84983

This is my truth, now tell me yours

National Poetry Day was launched in 1994 with the aim of inspiring people to enjoy, discover and share poems.

To mark this year's event on the theme of Truth, we issued a challenge to our followers on Twitter @fuse_online to write a poem about public health research.

Below are the literary masterpieces we received!



Wordsworth's Work-Balance

Mark Green, Senior Lecturer in Health Geography, University of Liverpool
@markalangreen

I wondered lonely as a cloud,
Over the summer where I found,
That working was not always for me,
Papers and grants failed to bring me glee.

So I chose to work a little less,
And I admit I must confess,
I’ll write a little less this year,
But be happier, and smarter, without that fear.



Changing the story

Emma Halliday, Senior Research Fellow, Lancaster University
@halliday_e

Illustration © Joe Decie 2018

We were ranked deprived,
left behind, always maligned;
that place - nobody moved to.
Public health called time
on booze and smoking islands.
Newspapers traded fears of
crime and wild west violence -
no one counted the human cost
or listened to the local voice.
When did reality get so lost?

So, the community took control
of a more powerful story -
it started with a conversation
about the decisions they’d make
to improve their place;
what they wanted to change
to reclaim this space.
Now, carnivals attract crowds,
lanterns of hope light the town;
residents fight back with pride.

These days, when they label us;
we don’t believe what they say.

A poem inspired by the Communities in Control study



Buckfast Free Zone

John Mooney, Senior Lecturer in Public Health, University of Sunderland
@StandupforPHlth

Once upon the Tyne, there was disorder, there was crime,
Cos’ everyone was pickled on the bevvy,
But that all came to grief,
When the Police and the Council Chief,
Introduced a top-up charging late night levy!

Now stags and hens all go tae Durham
Cos’ there’s nothing left here ‘fur them’
An all-night drinking parties have been banned!
They've installed the impact zone on their google map and phone
And the Toon’s the safest city in the land!



A poetic reflection on Public health alcohol policies in Newcastle, which have included the introduction of a late night levy and a cumulative impact zone for alcohol licences. 

Extract from my Stand-up comedy set: ‘Buckfast Free Zone’ performed at The Stand Comedy Club as part of Bright Club Newcastle.