The Somali community in the UK: What we know and how we ... - ICAR

Health
Despite the importance of the issue, there are as
yet comparatively few recent studies that focus
exclusively on the topic of health, 107 which also
receives somewhat cursory treatment in regional
studies of the Somali community. 108 When the
health group reported to a session of the Somali
Community Meeting hosted by Jeremy Corbyn
MP at the House of Commons (29.03.03) the
document mentioned the high rate of infectious
diseases - hepatitis, tuberculosis - and the
prevalence of chronic conditions such as cancer,
hypertension, and diabetes. It also expressed
concern over the growth of HIV/AIDS. There
is little here which is Somali-specific. Various
conditions associated with a western lifestyle,
such as the growing incidence of obesity, are not
yet mentioned in research as a problem. On the
contrary, according to a Somali health advisor
at Oxford House, a Tower Hamlets community
centre, the danger is more one of malnutrition,
exacerbated by poverty and the practice of sending
money back to families at home (Green, 2001:
B3). But other conditions, asthma for example,
are making their appearance, and the basic profile
of physical health is shared by many deprived
communities, both indigenous and refugee.
The contributing causes of ill health are wellrehearsed.
Poor housing is one. Local authorities
have an obligation to house those with refugee
status and leave to remain, but the social housing
stock is dwindling, and refugees often find
themselves in the oldest accommodation, plagued
by damp and vermin. 109 Asylum seekers without
leave to remain will be housed in temporary
accommodation which includes hostels, bed and
breakfasts and short-life property. There are also
problems associated with more recent housing
- when lifts in tower blocks break, families with
young children are confined indoors. Somalis
also suffer a particular problem of overcrowding.
Through restrictions on birth control and a cultural
emphasis on the procreative capacity of women,
Somali Muslim families tend to be large - to have
six or seven children is not unusual. In addition,
new arrivals often have difficulty finding somewhere
to live, and take advantage of norms of family or
clan obligation to move in with relatives. British
housing is not designed for large households, and
the health of members inevitably suffers.
Access to health care is another problem, common
to many groups of refugees. In his study of the
needs of Somali and Eritrean women refugees
in Haringey, Bernard-Jones (1992) found that
this was a particular site of stress. In theory, all
asylum seekers and refugees are entitled to the
same NHS care as the indigenous population, but
what is required is a basic understanding of the
system which Somalis often lack. They also need
ready contact with a GP, and good communication
with health professionals. But many face an initial
problem of registering with a doctor - in areas
with a mobile population and a high proportion of
refugees, doctors may be reluctant to open their
lists. This is both because of perceived pressure
of numbers (Green, 2001: 24) and also because of
communication - arranging translators presents
a severe financial and logistical problem to the
present NHS. In April 2002 a Dr McAvoy, with a
dedicated Sheffield practice, explained his reasons
for closing his doors. His 6,100 patients speak
37 languages between them – including Somali
– and a third have little English. Translators are
sometimes available in person or by phone, but the
consultation will then take from twice to ten times
as long. 110 For the patient, lack of good translation
can sabotage their health care. In Harper-Bulman’s
study of Somalis and west London maternity
services (1997), language and communication
107. Exceptions include Marianne Green’s report on Somali health needs
in Tower Hamlets (2001), and Kate Harper-Bulman’s thesis on Somali
women’s experiences of West London maternity services (1997). See also
Mohamed (1993), Musa and Marks (1996) and Mullock and Duale
(1999).
108. E.g. the brief overview of the problems in accessing health provision
for Somalis in Leicester in Daahir and Duale, 2002: 33-35.
109. For Somali housing conditions in Liverpool see the survey by the
Granby Toxteth Community Project, 1993: 41-49. Holman and Holman
(2003) have researched housing conditions in the London Borough of
Hackney, whilst Cole and Robinson’s recent report (2003) is the most
thorough investigation of Somali housing experience to date.
110. Drinkwater, James, The Guardian 25.04.02
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