Sahil Housing Association
Unit 2C Leroy House
436 Essex Road
Islington London N1 3QP
IPS reg 28267R
National Housing Federation
Federation of Black Housing Organisations
Association of London Somali Organisations
Mohamed Abdullah Chief Executive
07949 565 103 020 7226 4494
Aslaamu calaykum waraxmatulaahi wabarakaatu
Of all the desiccated, bitter, cruel, sun beaten wildernesses which starve and thirst beyond the edges of Africa’s luscious jungled centre, there cannot be one more Christless than the one which begins at the northern foot of Mount Kenya and stretches to the foothills of Abyssinia, and from there to the dried-out glittering tip of Cape Gardafui where the hot karif winds blow in from where the long sharks race under the thin blue skin of the ocean. You can never think of those wildernesses without thinking of daggers and spears, rolling fierce eyes under mops of dusty black crinkly hair, of mad stubborn camels, rocks too hot to touch, and blood feuds whose origins cannot be remembered, only honoured in the stabbing. But of all the races of Africa there cannot be one better to live among than the most difficult, the proudest, the bravest, the vainest, the most merciless, the friendliest; the Somalis. 
I knew an Italian priest, who had spent over thirty years among the Somalis, and he made two converts, and it amazed me that he got even those two. The Prophet has no more fervent, and ignorant followers, but it is not their fault they are ignorant. Their natural intelligence is second to none and when the education factories start work among them they should surprise Africa, and themselves.
“We are refugees. We are like the sufriye that people make use of to cook on the fire. When you use it the first time, it gets burned badly. But later it develops a thick layer of charcoal and cooks only slowly. Our hearts are like that. We have experienced so many things that we are now very strong. We have hardened with life.”
Together we can make a difference!
We are a Social Enterprise that aims to solve with the Somali Community and partners their issues by:
- · Managing and developing decent affordable housing for Somali citizens
- · Providing appropriate and joined up housing related solutions
- · Being a voice for and with Somali citizens
- · Working with partners to enable significant changes in the quality of life of an excluded community
Sahil wishes to:
- · Establish long- term sustainable relationships with Councils, Housing Associations, and all stakeholders
- · Provide a comprehensive excellent service for and with all Somali citizens
- · Assist with stakeholders’ responsibilities for community engagement
- · Build a model of excellence of BME services
The needs of the Somali Community
In July 2003 we launched significant research by Christine and Naomi Holman into the Somali Community in Hackney, and in October launched national research by Sheffield Hallam University into Somali housing issues at City Hall. We have assisted with research by the Information Centre on Asylum and Refugees at King's College, London and with research into the Somali community by the Government Office for London.
With the Association of London Somali Organisations, we are probably the lead body nationally into the needs of and solutions to the issues faced by the Somali community.
There are levels of at least 70% unemployment. Amongst Somali women only 5% are employable because of their poor language skills. It is a community in crisis, but as The Housing Corporation has commented, we must think not in terms of hard to reach communities but hard to reach services.
The Somali Community is:
- · A hidden community – due to weak or non-existent statistics and data; underdeveloped Somali organisations; widespread language barriers.
- · An underserved and socially excluded community mainly of refugees, suffering in deprived areas, with ill health, high unemployment, low educational attainment and poor housing,
- · A resourceful community – Rageh Omaar and Iman are Somalis. Many Somalis are qualified with degrees.
The Somali community, as an allegedly new community, although during the eighteenth century the preferred black servants of the wealthy in Britain were Somali, has for various reasons hit most of the markers of social exclusion.
A couple with five children live in a two-bedroom ground floor flat. Two of their boys, age six and five are autistic. The household have just moved from Locata Band C to Band B after 3 years. Possibilities of direct offers are being discussed. There are no support or care workers, no allocated social worker, no care packages. Children are at special school, but were in mainstream. Early diagnosis did not happen.
Family with five children under 7, one autistic, in temporary accommodation. Property not secure – autistic child can get out of front door.
A 90-year-old pensioner lives with her family in a 3-bedroom house. She has dementia. She lives upstairs as no toilet downstairs or way to get up and down easily. After three years she now has 4 hours care from Somali worker per day. Her daughter is 60, with her own health problems. Household believes they were threatened by hospital – if you do not take her from hospital we will put her in a home.
Another pensioner is homeless and stays with various different people. She is known to homeless persons and has been offered sheltered housing, which she has refused as she would not be able to communicate with her neighbours and would feel very isolated. She would be happy with a general needs studio flat. She has cataracts.
A Somali woman is a fully qualified Somali veterinary surgeon, trained at University, but has not worked for several years and her English needs improving.
A Somali woman is a Somali qualified teacher but again has poor English and has not worked in Britain.
Two Somali women, one’s husband possibly having affair with other. Wife smashing in door of other at four in the morning. Specific community involvement, translating ansaphone messages, warned might be evicted, stopped.
Household with major arrears – household with two children over 18, not done change of circumstance claim, almost evicted, went to court, suspended possession order plus amount off arrears. This is a very common problem – tenants put letters in dustbin. Households do not communicate their needs properly, nor know their rights. A common view is – you were a refugee living under a tree, what have you to complain about?
Overcrowding is very common; homework has to be done on the child’s bed. Children get detentions for not doing homework. Older boys getting into trouble – exclusions.
Culture and language are very important but the children are not in touch with their first language and culture. There are minimal mechanisms to build the community together. Boys need fathers – but many families are headed by single mothers.
Government wants to see a step change in the quality of public services. International experience has given some strong pointers to how to achieve excellence.
It is now agreed that solutions require working closely with specific communities to construct excellent services. Using the jargon, a whole system joined up person, family and community centred approach is needed. Actions required are:
- Competent strategic intelligence
- Seriously joining up services and budgets
- Setting up and appropriately resourcing specific community one-stop shops and floating support, advice, and problem solving systems.
Leading Change, a publication for the NHS Modernisation Agency comments:
“How can organisations fit to house the human spirit be created and sustained such that they meet the needs of individuals, communities and society at large”
Improving Opportunity, Strengthening Society
The Government’s strategy to increase race equality and community cohesion was launched by the Home Secretary, Charles Clarke at a Runnymede Trust conference on 19th January 2005. The strategy:
- · Signals the Government’s intention to develop more sophisticated, tailored approaches to meeting the specific needs of different minority communities, and to focus on those groups who still suffer particular disadvantage, rather than treating all minority groups as disadvantaged or having the same needs. This is the time to move on from one-size-fits-all approaches to meeting Black and minority ethnic needs.
- · Sets out a vision for providing such tailored, appropriate services as an integral element of delivering excellent public services.
These themes have more recently been commented on by Nick Raynsford
The point I am making is that if we don't want to see an inevitable decline in the standard of public services and their popularity, then we must ensure that the services people receive from local government are delivered in the way they want, they need and they value. In today's world people expect control and choice over the services they receive and there is no reason for local government to be an exception to that.
Canada has a very valuable model.
Immigrant Serving Organisations
There are hundreds of immigrant-serving organizations in Canada. Many are staffed by former newcomers to Canada, who understand the challenges that immigrants may face. They usually have people available who speak your language and can accompany you as interpreters. Citizenship and Immigration Canada supports many of these organizations financially, helping newcomers adapt to life in Canada.
Settling in will be much easier if you contact an immigrant-serving organization as soon as you arrive. The people who work for these organizations can help you find a place to live and can answer your questions about shopping, education for your children, transportation, language training and other important matters.
Immigrant-serving organizations can help you:
- · Find a place to live
- · Get your Social Insurance Number and health-care card
- · Enrol your children in school
- · Get language training
- · Find a family doctor
- · Find out about government and community services for newcomers
- · Look for a job
- · Develop a realistic budget; and
- Get emergency food aid, if it is needed.
Most immigrant-serving organizations offer, or can provide information on, the following Government of Canada programs:
LINC (Language Instruction for Newcomers to Canada)
LINC is a federal government program for all eligible adult immigrants. It offers:
- · Free language training for adult newcomers who want or need basic English or French
- · Language classes given by school boards, colleges and local organizations
- · The choice of studying part time, full time, evenings or weekends, depending on your needs and your schedule; and
- · Transportation and child minding, if necessary.
The Host Program is a federally funded program that matches newcomers with a Canadian family or individual. Host volunteers help you:
- · Overcome the stress of moving to a new country
- · Learn about available services and how to use them
- · Practise English or French
- · Prepare to look for a job; and
- Participate in community activities.
Your local immigrant-serving organization can direct you to a Host Program organization in your community.
Immigrant-serving organizations are prepared to help newcomers as soon as they arrive in Canada. These organizations can:
- · Refer you to economic, social, health, cultural, educational and recreational services;
- · Give you tips on banking, shopping, managing a household and other everyday tasks;
- · Provide interpreters or translators, if you need them;
- · Provide non-therapeutic counselling; and
- · Help you prepare a professional-looking résumé and learn job-searching skills.
The Immigrant Settlement and Adaptation Program (ISAP), a federal government program, pays for these services.
A list of immigrant-serving organizations across Canada can be found on the Internet at http://www.cic.gc.ca/english/newcomer/welcome/wel-20e.html
The World Health Organisation has noted the following principles for public policy.
- Prevention is better than cure
- The health of every individual, especially those in vulnerable and high-risk groups, must be protected. Special attention should be paid to disadvantaged groups
- Action should be based on the best available scientific information
- Development assistance should promote sustainable development
A 1985 study “The Enigma of Aboriginal Health – Interaction between biological social and economic factors in Alice Spring town-camps” attempted the immensely complex task of measuring health changes and relating them to the social cultural and economic environment in which they are expressed. The study used an ecological perspective, looking in detail at existing health patterns, causes and environmental factors. The study looked at nutritional status, infection rates and morbidity, exposure and length of exposure to European society, involvement in ceremonial life and traditional ways of thinking.
This study was part of a major change of thinking in its attempt to place organic disease in a larger societal framework that goes beyond the description of environmental factors like housing or nutritional habits.
A study of a Somali refugee camp in Kenya “Transnational Nomads” by Cindy Horst comments:
“This book presents a critique of the common depiction of refugee camps as isolated areas, which pays little attention to the processes beyond camp borders.
“The links that refugees maintained with relatives outside the camps were essential for their daily survival. “
“The bureaucratic needs of the international refugee regime and governments make it necessary to label the people that are entitled to assistance.”
“The assumption that refugees are passive victims needing charitable dispensation.”
“The assumed identity of refugees creates and imposes an institutional dependency”
“The self protective inability of human beings to understand the humanness in refugees and their experience.”
“Refugees are not simply victims, however tragic the experiences they undergo.”
“We are refugees. We are like the sufriye that people make use of to cook on the fire. When you use it the first time, it gets burned badly. But later it develops a thick layer of charcoal and cooks only slowly. Our hearts are like that. We have experienced so many things that we are now very strong. We have hardened with life.”
Risk assessment in social work uses a concept of mapping the social relationships someone has. Whilst it is true most Somalis do have good contacts with their community, the community itself is often unable to find solutions. This is not solely a matter of “capacity building”. There are professionals in this community. It is more that the mainstream organisations seem to be at a loss what to do. The Government’s intention of developing more sophisticated, tailored approaches to meeting the specific needs of different minority communities, and to focus on those groups who still suffer particular disadvantage, rather than treating all minority groups as disadvantaged or having the same needs is a logical way forward and should be a key corporate objective.
A Brief History of Somalia
The development of Somalia as a nation needs to be pieced together from an extremely chequered history, involving various bids for colonisation and control from European countries, sporadic conflicts with neighbouring countries, persistent internal clan-based territorial divisions and a succession of fragile attempts to establish more unified forms of governance.
The Somali people became Muslim in about the fourteenth century, in contrast with the historically Christian neighbouring Ethiopia, with whom there have been continuing disputes and very close amicable relationships. They have evolved a distinctive language, culture and religion, tending to be Sunni Muslims. The area of Somalia was first colonised by Western powers in the mid nineteenth century. Sir Richard Burton is the key explorer. He wanted Britain to move it’s by then significant base in Aden to Somalia because it made far better sense. France, Britain and Italy have had significant presences in Somalia. Sir Richard Burton commented about the Somali love of palaver – in fact most problems are believed to be soluble by Somalis if they are discussed enough in a very democratic manner.
From 1940 to 1950, the whole of Somalia was governed by Britain, following the defeat of Italy. Many Somalis have very distinguished war records from fighting in Commonwealth forces. The Somali experience of Britain was very benign, and explains the great love of Britain by Somalis. Britain established universal education, modern agriculture, competent justice and the basics of a successful country. Britons have reason to be proud about what was achieved in Somalia during wartime. 
Aneurin Bevin recommended to the UN that Britain assisted Somalia to independence. For various international political reasons, this proposal was vetoed by the US and USSR and Somalia was split – after being fully integrated for ten years – into an Italian and a British part, with separate educational, legal and administrative systems. English schools were closed in the South, and real tensions caused because a people who had been together for ten years were divided by colonial language, administrative and legal systems. From this recipe for disaster, the United Republic of Somalia was formed in 1960 and was reasonably successful until the underlying tensions began to show.
The famine in Ethiopia in the 1980’s caused huge problems. This famine is known for starting Band Aid and Comic Relief. In reality, Somalia was the largest donor of aid – they lost their nation as a result. Somalia accepted two million refugees into a nation of only seven million people. Imagine London’s population increasing by one quarter – and all of those are destitute – would London survive?
From the mid 80’s the country has been in a state of civil war. It is one of the few places on the planet without government. It is one of two countries that have not signed the UN charter on the rights of the child – because there is no one to do this.
The former British protectorate Somaliland declared its unilateral independence in 1991. By 1992, up to a third of all Somalis were facing starvation, as a combined result of the war and the drought, and one million Somalis (out of a total population of around 7 million) fled, mainly to Kenya, Ethiopia, Yemen and Djibouti in Africa and, for about 100,000 people, to Europe. The number of refugees peaked in 1992, remained high until 1995 and has since started to fall.
Black Hawk Down. In 1992 the United Nations attempted to take direct control of the government. US Marines landed, to safeguard relief supplies, and entered open conflict with the Somali resistance during 1993, before withdrawing in March 1994. By March 1995, the remaining African and Asian UN troops withdrew and the fighting subsided, only to flare up again at various intervals thereafter.
The pull of traditional clan divisions is as pervasive as ever. The country remains in a state of considerable tension and confusion. Somalia comprises six major clan-families, and this lineage is pivotal to the social organisation of the country. Four of the families are predominantly nomadic or semi-nomadic pastoralists and represent approximately 70% of Somalia’s population: Dir, Daarood, Isaaq and Hawiye. Two are primarily crop farmers and they represent 20% of the population: Digil and Rahanwayn.
In 1996, Somalia was ranked 172nd out of 174 countries on the UN Development Programme’s Human Development Index (HDI). It is difficult to underestimate the impact of the civil unrest in Somalia on population migration world-wide. According to UN estimates, there are 350,000 Internally Displaced Persons and 451,600 international refugees, out of the population of just over seven million.
By the rivers of Babylon
There we sat down, yea we wept we remembered Zion.
We hanged our harps upon the willows in the midst thereof
For there they that carried us away captive required of us a song and they that wasted us required of us mirth, saying Sing us one of the songs of Zion
How shall we sing the Lord’s song in a strange land?
If I forget thee O Jerusalem, let my right hand forget her cunning
If I do not remember thee let my tongue cleave to the root of my mouth if I prefer not Jerusalem above my chief joy.
Nuruddin Farah has written:
There is a certain urgency to the lives of refugees in the first few days after they flee, as the vastness of what has been lost makes itself known to them in unprepared for ways. The refugees celebrate their sadness, reminiscing. They engage a million man-hours of refugee time in introspection and self analysis; consequently they feel more depressed at the end of the day than when they woke up. To be a refugee is to be suicidal.
When you are high on a mix of booze and dope and you chew qaat for a long time, and you are entertained by a woman who does what you ask of her, you don’t know what fear is, your thoughts are emptied of self-doubt. I have killed when I shouldn’t, mutilated men and women, humiliated minors when I shouldn’t. I have done them all, no regrets. Knowing no fear. We were not human.
At one time Somalia played host to one of the largest refugee influxes in the continent, with the guests from Ethiopia accounting for more than a quarter of the nation’s population.
They are unruly, crass in their talk, brash in their behaviour, arrogant in their dealings with other Africans. For a people who have brought a curse on their heads, they do not appear to have been humbled in any way. She spoke the generic term Somalis as though it were descriptive of a derangement. Forget Somalia, consider it buried, dead, think of it as if it no longer exists for you.
The background of refugees and asylum seekers.
Research has shown the majority of the world’s refugees have fled from war, escaping fighting and deliberate terrorisation. Wars can be “high intensity” or long term, severely psychologically damaging, fuelled by AK47’s drugs, murder, rape and looting. In other parts of the world, groups are persecuted, risking losing jobs, arrest, torture and execution.
Refugee children in Britain will have had widely varied exposure to traumatic events. A small number will have no direct experience of persecution, perhaps they were abroad when conditions changed, or have been protected. Other children are kidnapped and tortured, some witness the killing of parents, siblings and friends, some are separated from their parents or spend protracted periods of time in refugee camps. Not to be underestimated is the effect of poverty as a stressor.
A study of children in Beirut showed:
- 90% had been exposed to shelling or combat
- 70% had been forcibly displaced from home
- 55% had experienced grave shortages of food, water and other necessities
- 50% had witnessed violent acts like murder and rape
- 25% had lost family and friends
- 6% had been injured
- 0.2% had been forced to join militias.
Home from Home comments:
Refugee and asylum seeking children are especially vulnerable and at risk of having their rights denied. These children will have had traumatic experiences in their home countries, have suffered difficult journeys to the UK and continue to suffer while in this country. Many will face racism and discrimination, live in limbo whilst waiting for a decision on their asylum claim, and face loneliness and isolation.
They face many challenges, a new language, loss of identity, racism and poverty.
Some newspapers have attacked the presence of refugee children in schools and sought to blame them for “poor behaviour” and “disruption.” Schools play a vital role in assisting the recovery and supporting the well being of refugee children. School can help refugee children make sense of their experiences, provide them with friends and adults they can trust, and play a central role in regaining their self esteem and confidence.
For schools hosting refugee children there may be new challenges. Refugee children may arrive at any time during the school year and may be moved on after a short time. They will have diverse backgrounds and needs, including being new to schooling in the UK and needing to learn English. Refugee families may also have complex wider needs related to immigration, housing and health that can impact on children’s well being and progress.
Refugee Community based organisations are often the only organisations bridging this gap between these two bureaucratically created worlds.
The concept of the extended school, where health and social services are also available in co-operation with a school or group of schools, is a very important initiative, but to work properly organisations must know and be fully engaged with their local communities. This requires a sophistication of holistic governance that may be difficult to achieve with our long histories of silo working.
The refugee organisations are also typically overwhelmed with issues. For example, any household with a low standard of English and literacy will typically bring all their post to an adviser, as they have no way of deciding what is junk mail and what is not.
Refugees may feel that London, compared with their previous small village, pastoral or nomadic background, is like swimming alone in a huge ocean. Some refugees will lose a sense of direction – there are examples of refugees repeating basic skills courses year after year, and not making the progress they might if properly supported.
10% of Somali young people will not give details of their address to a Somali worker because of lack of trust about what might happen. They might be suspicious that the worker might claim benefits in their names or report them to authorities.
The Somali community feels cynical, over researched and over focus grouped. They attend conferences but don’t see anything happening.
Somali children are often out of school helping their parents with interpretation in courts, benefit offices and homeless family units. They will mistranslate bad news in letters from schools. In meetings between parents, teachers and children the children may not interpret what has been said properly.
An eleven year old in a school with only three or four Somali children, was beaten up and called a ‘black monkey’.
Unemployment is very high, mum will speak very little English, dad is chewing khat, the family is not working as a family – they may not be able to talk to each other that easily because of cultural and language issues. Parents have no skills to help with homework – have probably never been to school themselves. There will be no books in the house, and homework if done will have to be done on the bed or in front of the TV with a baby interfering.
If a refugee family, their benefits are lower, and they may be supporting other homeless refugees in their home, and sending money back to Somalia. They may all be continuously hungry and undernourished.
Housing Benefit may not have been claimed, leading to arrears and eviction. They may be moved completely without notice when NASS decides something. Their status may be insecure, so they are constantly anxious that their application to stay in Britain will be turned down. Social Services may be supporting the family in North Kent or Birmingham.
There are a very few excellent Somali workers whose help in resolving issues is not properly recognised and supported.
A typical “Supporting People Support Plan” does not really engage appropriately with these levels of need. Mainstream housing associations rarely become involved at the level of detail and complexity faced daily by refugee households. They may in fact avoid these issues because of the nomination rules that preclude them offering services to asylum seeking households.
What is to be done?
The Audit Commission Inspections of Supporting People services have commented in other councils.
The pace to develop services for client groups who currently have no provision is slow. This particularly applies to BME communities.
There is little awareness of the barriers that current policies put in place for some service users. Also the council needs to address the lack of a coherent and continuous monitoring framework for monitoring of related strategies such as the housing strategy that are important for the successful delivery of parts of the programme.
There has been a lack of focus on providing services for some client groups, such as BME communities.
Local authorities, with their strategic partners, have a legal duty to ensure community well being. How to achieve this has been reasonably well defined and put into practice by various initiatives around the world. There is an agreed framework for action that includes being pro – active, ensuring participation, and working in co-operative, open and transparent ways. There is an agreed business case for adopting these ways of working.
Demos have written the following in their publication “Holistic Government”:
The core problem for government is that it has inherited from the nineteenth century a model of organisation that is structured around functions and services rather than around solving problems. Budgets are divided into separate silos for health, education, law and order and so on.
The vertical links between departments and agencies in any one field and professional groups such as the police, teachers, doctors and nurses are strong. The horizontal links are weak or non-existent.
Nationally, the strategic partners have only recently begun moving along this road from silo governance and there are some excellent examples of best practice in Hounslow, especially in Health, Education, Hounslow Homes and Translation.
The problem is that these very different ways of working are not yet mainstreamed. Demos sets out the following rules of holistic governance.
1. Holistic budgeting: in order that services can be designed in the most effective way and closely targeted upon key groups in each area, budgets should be organised not by functions or organisations but around outcomes and geographical areas,
2. Organisations defined around outcomes: Instead of departments, and quangos being responsible for administering services, organisations should be charged with achieving outcomes and using their budgets to buy whatever services or functions they require.
3. One-stop shops should become the principle means by which the public deals with government. One-stop shops will organise what the public sector offers by the life events that trigger people’s needs for services. The functions and services that make up today’s public sector will become “back offices” and “content providers” for these one stop shops and will, over time operate and be managed in more integrated ways.
4. Case workers: The roles of frontline staff should be developed, empowering them to purchase services across health care, housing, social services, benefits and job training to bring together packages of customised solutions that suit the needs of the individual.
5. Contracts should be based on outcomes.
6. Every department, agency and tier of government should be audited to identify the balance of effort that it puts into preventative activity across the range of outcomes with which it is charged.
7. The role and status of preventive work should be enhanced in all professions.
Specific community strategies
Home Office and DWP research has many times emphasised the requirement for and logic of specific community based strategies, but the policy and practice implications of this strategy have not been thought through. Most of the issues faced by the Somali community – is this specific community clearly and consistently identified? – may be solved by moving to person, family and community centred strategies and actions. The current national situation tends to be ad hoc.
The Demos thinking can easily be put into practice by ensuring each specific community has properly resourced and managed one-stop shops. The Home Office has stated with regard to refugees, but this logic applies to any specific community, for example travellers and Orthodox Jews:
Reasons for providing refugee-specific initiatives
Scale and complexity of needs
The process of resettlement involves a wide range of issues that refugees have to address to establish their new life in Britain. Although agencies tend to address only one or two issues, such as applications for benefits or housing, refugees are having to cope with many other concerns at the same time, for example learning English, trying to find work, applying for family reunion and dealing with health problems.
Refugee Specific Initiatives can provide an effective, local and economical response to this situation. The diversity of the refugee population makes it difficult for mainstream health, housing, education and welfare services to understand fully and cater for their needs. Refugee Specific Initiatives can be more flexible and responsive to individual need.
They can bridge the gap by providing assistance and support in using mainstream services (such as the Health Service) or by directly providing alternative and complementary services They can also provide employment for refugees within the RSI itself.
Clear differences in perceptions and practices between some refugee groups and the host society have been identified. These affect how services are used, studying and learning skills, perceptions of need and treatment, childcare practices, and job-seeking skills. For many refugees, learning about and understanding British institutions and practices takes time, but is a key element in long-term resettlement. In the short term, the availability of intermediaries with appropriate language skills and a degree of cultural awareness can ease resettlement.
Educating mainstream service providers
An obstacle to resettlement for refugees can be the ignorance of both the general public, and those from whom refugees seek help. There may be ignorance about their culture, their customs, their rights, and particularly the experience of being a refugee – of having lost everything, not being able to communicate, of having skills undervalued or not recognised.
Many Refugee Specific Initiatives, along with the Refugee Council and Refugee Action, see a significant part of their role as the education of professionals in mainstream positions with respect to these issues. This should promote a greater understanding amongst professionals who come into contact with refugees and ease access to the appropriate services. Refugees should be empowered to take responsibility for themselves as far as possible.
Specialist knowledge and experience should be shared with both refugee communities and mainstream service providers.
Access to mainstream services and agencies should be promoted, rather than seeing specialist provision as an end in itself.
Partnerships and good links between statutory, voluntary and community agencies provide the best basis for working.
Funding is short-term and insecure for virtually all RSIs, though they take the pressure off many mainstream services. Many staff hours are wasted in fundraising. Support and supervision could be offered to funded community groups to maximise the benefits from the resources available.
The range of services provided by refugee agencies, refugee-specific initiatives and community organisations is invaluable for the welfare of refugees in Britain. Regular and adequate resourcing of these activities is an investment which, in the long term, will assist refugees to rebuild their lives and doubtlessly make a valuable contribution to British society.
Sheffield Hallam University have commented that information management systems may make it very difficult to implement the person centred, household centred and community centred strategies that are needed.
Why are these statistics being collected in this form is a rarely asked question!
Research by Sheffield Hallam University recommends the employment of ethnic categorisations that go beyond the standard Census categories and allow disaggregation at the local level that is sensitive to the profile of the local minority ethnic populations. The Office for National Statistics has recommended a way to achieve this, but this has not filtered down to many organisations – strategic intelligence is still a low priority for many governmental organisations, and local authority departments for example do not have consistent methodologies, and cross organisation information management organisations are very rare.
This more sensitive categorisation can be aggregated up to the Census categories, but would ensure more relevant and appropriate information at the local level. Community planning cannot occur without this level of sophistication, which when done consistently will allow funding to follow need in a planned manner.
The Race Relations Act imposes a duty on public bodies to make appropriate arrangements with a view to securing that their various functions are carried out with due regard to the need to eliminate unlawful discrimination, to promote equality of opportunity and good relations between persons of different racial groups.
Fulfilling this duty involves promoting a culture of service monitoring and performance review and revision across the entire voluntary and public sector. Current practice in fact embeds poor ways of working – for example, the ethnic categorisation employed by the Housing Corporation (for example in the CORE and Investment Code systems) and adopted by housing associations replicates the inadequacies of the Census categories and do not allow disaggregation of ethnic categories in order to explore and understand the situations of specific populations, such as Somali households, at the local level.
The current categorisation does accommodate some nationalities (Indian, Pakistani and Bangladeshi), raising the question of why certain nationalities are recognised in the ethnic classification and others are not.
Census categories – The broad ethnic categorisations employed in the Census, which provide a template followed by the vast majority of ethnic monitoring systems, represent a rather clumsy mixture of nationality (Indian, Pakistani, for example) and colour (White, Black). In large part, this classification reflects the particular context in which the classification was developed i.e. to capture increasing diversity as a result of large-scale immigration from the Caribbean and South Asia during the post-war period.
There are now at least two problems with this classification:
- It has failed to keep pace with and reflect the growth of existing but relatively small communities (e.g. Somali) and the more recent arrival of new communities (e.g. from the former Yugoslavia etc.)
- It has failed to keep pace with ongoing developments in self-perception of ethnicity and identity.
Any system of ethnic classification is inevitably a normative process of squeezing complex identities into specific categories, but these two developments suggest the current classification is even clumsier and out of touch than it might otherwise be.
A key reason why we have ethnic categories and undertake monitoring is in recognition of the need to understand the discrimination and systematic disadvantage visited upon different groups and identities.
How can an ethnic classification facilitate such understanding if it does not appreciate the ethnic diversity of a population?
It is of note to compare practice here with practice in the world of learning difficulties. There the concept of person centred planning is central. Why are not identical principles used in issues of ethnicity? If we truly wish to meet real needs, we must recognise people as they are, with their specific histories, languages, religions and cultures. It is logical and sensible to use interpreters, mediators, and support structures that are specific community based.
There are excellent examples available, especially in Education and Health. Evolving specific community strategies and ways of working, with excellent strategic intelligence and clear specific person centred community based action plans will assist delivery of the step change in quality of public services that is required to tackle social exclusion.
A report in a London Borough has written:
Issues identified by Somali households
The local Somali community resides in neighbourhoods characterised by high levels of unemployment, crime and disorder issues and to some extent deprivation. Despite these issues, service users generally expressed a commitment to their local estates, underpinned by the benefits associated with living alongside other Somali households. Over 250 residents were assisted (February 2003 – December 2003) and overwhelmingly a sense of safety and security from living within a concentrated population of Somali households was expressed.
Racial Harassment is reported as a frequent and widespread experience especially in the current climate of mistrust relating to asylum seekers, immigration, Islamaphobia and visible identifiable clothing (Hijab) worn by Somali women. It has a corrosive effect on the community particularly if communities are left to manage the problem themselves. The problem is further compounded by the stigma of Somali households being identified as “asylum seekers”, irrespective of their present status. In the last financial year over 53 cases were dealt with in the realm of anti social behaviour and racial harassment. This represents a significant increase in the number of cases reported as victims are feeling more empowered to report incidences to the Community Development Officers. All cases were referred to both the Anti Social Behaviour Unit as well as the Sector Police/Community Safety Unit. All cases of racial harassment were reported by third party methods to the Racial Equality Council. The problem is further compounded by the community itself who rarely attach any priority unless the harassment becomes life threatening. The Community Development Officers have developed a third party reporting centre within the East African Youth Group and Somali Consortium. As a result of this, 19 referrals were undertaken to the Police/Anti Social Behaviour Team in the last financial quarter.
A number of reasons were given by existing service users to explain under reporting of harassment by Somali households. These included:
- · The omnipresent language barrier
- · Harassment as an everyday experience
- · Lack of knowledge regarding available support and assistance and significantly
- · Scepticism about the service providers’ response.
Focus groups suggested that only one in ten incidences were reported to Landlords or the Police. The ALMO was viewed positively in the main however, feedback to clients in respect of their case progress remains an issue. In relation to the Police, there seemed to be suspicion and widespread scepticism, as to whether an incident would be taken seriously by the Police, particularly when Somali youth are perceived to be targeted in relation to “stop and search” and a number of Somali women who had reported race crime to the police, perceived that nothing of value was achieved both in the charging of perpetrators or the often hostile and negative attitude of the police towards them.
Housing conditions and adaptations.
Many Somali and East African households are residing in severely overcrowded circumstances, which have a dramatic impact on their physical, mental and emotional well-being. Problems with housing conditions included damp and condensation, ineffective heating and security systems and poor quality repairs. Some households are reliant on the assistance of family or friends to report repairs issues, as illiteracy still poses a major issue. A great number of housing repairs cases were facilitated and resolved by the Community Development Officers. In a total of 68 cases of which 88.2% of the cases were resolved and about 11.8% are still pending awaiting an amicable outcome. Residents were contacted directly by the officers to gauge whether they were satisfied with the service afforded to them and over 84% were satisfied with the advocacy work of the officers. This initiative complements our decent homes standard target.
The Community Development Officers remarked that “in terms of making headway and improving access to services” the Repairs Call Centre centre’s role was exemplary.
It was identified that elderly members of the Somali community generally resided with their close relatives in homes that are devoid of additional disabled facilities despite Social Services involvement.
In the housing benefit and rent arrears field, officers once again identified language as a key barrier to residents understanding the present housing benefit infrastructure or the ability to claim housing benefit. Over 98% of residents contacted claimed income support and as such are entitled to full Housing Benefit. Conversely, a high number of households experience rent arrears at one time or another, in spite of being on income support continuously. Another point of concern was the completion of the Annual Housing Benefit Review Form which some residents failed to complete due to language barriers. In all of the above scenarios, Somali customers rarely get backdating Housing Benefits from the authorities even if they have rectified differences with them by providing them the required evidence.
In fact, the Community Development Officers have not known of any customer who has successfully received a backdated claim since the start of the project. In most cases it seems poor tenants are subjected to pay back an unfair and unjustified debt as a result of the arrears. In many instances, the Rent Recovery Team that gets the wrath and blame in the case of Council tenants, whereby responsibility needs to be apportioned to Revenue Services. This remains a highly problematic area for the refugee community. Officers dealt with 45 rent arrear cases and successfully resolved 88.9% while 11.1% are still awaiting resolution.
The transfer procedure poses similar problems as the circular is only available in English. Present turnaround time for translated copies has an adverse impact upon members of the Somali community bidding for properties. Evidence suggests that Locata has failed the Somali community i.e. residents waiting to be rehoused whether in overcrowded conditions or in temporary accommodation. Somali residents afforded with priority Band A and B have not been successful in this scheme. Many of those with Band C and D believe they are wasting their time to continue bidding. Nevertheless, residents are encouraged by the Community Development Officers never to stop bidding to maximise their chances of success. Some of them believe that Locata is a ploy to confuse BME people particularly refugees and to take away their statutory rights. The Development Officers assisted 39 residents to submit applications to this scheme.
Homelessness is common among young single people irrespective of age and gender. Severe overcrowding is widespread amongst many families in the Somali community.
Health is a major area of concern for the Somali community. As a result of the civil war in Somalia, disabilities, and both physical and mental health problems are widespread. Poor housing conditions (such as overcrowding) and Khat abuse (Khat is narcotic drug mostly used by the Somalis; it is imported from East Africa and Yemen and sold legally in the UK) have exacerbated their already dire situation.
Somalis have increasingly become prone to obesity (in the case of Somali women) and diabetes. Although, the number of cases have not been documented, we have come to know that diabetes is increasingly becoming common amongst the community. This may be attributed to the sedentary life style of women as a result of the fear of crime which prevents women and children, in particular, to go for a stroll in public parks, children’s play grounds and even in the streets outside their houses.
Community Cohesion is about making all sections of the community feel that that they belong. This includes people from different ethnic backgrounds, people with disabilities, people of all age groups and people from the lesbian/gay and transgender communities. We want everyone to feel welcome in Hounslow and we are working hard to make sure that everyone has the same opportunities and access to Council services.
The Home Office definition of a cohesive community is one where:
- There is a common vision and a sense of belonging for all communities
- The diversity of people’s different background and circumstance is appreciated and positively valued
- Those from different backgrounds have similar life opportunities
- Strong and positive relationships are developed between people from different backgrounds in the workplace, in schools and within neighbourhoods
The above Home Office definition gives a checklist against which to judge progress on these matters.
Hounslow Primary Care Trust discusses these issues in its publication – Refugees and Asylum Seekers – a review.
Recognised primary health care needs of refugees and asylum seekers
A focus on specific service needs of any particular population group creates a danger that differences within the group are ignored or neglected. It is therefore important to recognise the social and cultural diversity of refugees and asylum seekers as well as their common needs, and that the problems which they face are largely circumstantial and change over time as they adapt to their new situation. Part of the function of health services, like other services, is to assist them to rebuild independent lives. This was recognised in Health Service Circular 1999/107 which sees the purpose of special provision for asylum seekers and refugees
“To provide quality care to asylum seekers and refugees, so as to enable them to gain optimum advantage from the UK health and social care system and become and remain healthy and independent.”
Hounslow PCT reports that there is considerable consensus about the health care needs of refugees and asylum seekers. The complex factors that affect the health and health care needs of asylum seekers are recognised by all authorities.
In order to benefit fully from the UK health care system it is generally agreed that refugees and asylum seekers need at least:
- Access to primary care with full permanent registration
- Information about health services
- Appropriate and comprehensive health assessments including mental and physical
- Adequate access to translation, interpreting and advocacy services in appropriate languages
- Access to specialist services for survivors of torture and organised violence
- Adequate and appropriate responses to mental health problems
- Advice and information on health promotion
Health care provision must be complemented by adequate housing, income and social support, for asylum seekers to be able to maintain good levels of health. Although it is outside the direct remit of health providers, the reports agree that systems for referral to appropriate agencies are an essential element of health provision for asylum seekers and refugees. Many health providers have also challenged government policies that lead to the impoverishment and even destitution of asylum seekers with harmful consequences for their health.
To facilitate planning and delivery of the direct services appropriate to meeting the above needs, studies recommend that PCTs:
- Establish or improve systems for collecting numbers and demographic characteristics of refugees and asylum seekers in each area
- Involve local refugee communities in the planning and delivery of services
- Recognise the resource demands on practices with large numbers of refugees
- Provide information and training for NHS staff, including both health care workers and support staff, such as receptionists, on refugees’ rights, and services available for this group
- Work to develop coordinated action between districts and agencies for some services.
The PCT report notes that there are clear “perverse incentives” to achieving the above Home Office and Health vision.
“At the time of writing, charges for non-emergency hospital treatment have recently been introduced for “failed” asylum seekers. A consultation is currently underway on charges for primary care for the same group. Such charges not only affect “failed” asylum seekers but also those awaiting a decision and risk undermining the trust which underpins the doctor/ patient relationship.
Under the National Health Service (Charges to Overseas Visitors) Regulations 1989 regulations, which have been operative in primary care until now, all asylum seekers, at whatever stage of their claim are entitled to free NHS care. The BMA has consistently re-iterated the right of asylum seekers to be fully registered with an NHS doctor.”
Studies of health services for refugees and asylum seekers
The PCT report notes that there are a few recent regional or local studies of general health service provision for refugees and asylum seekers. Health issues are also discussed in general reviews of social provision for this group and there are a few local needs assessments on mental health which explore service provision.
All these studies identify major gaps in provision and a large amount of unmet need.
There is much less investigation and reporting of good practice. Few services have been systematically evaluated or service models compared. Many, though not all services have annual reports, but these can be of variable quality and do not always indicate problems in service provision and development.
Developing a framework for health services for asylum seekers and refugees
The PCT report has a discussion about possible frameworks for health services. This does provide a useful basis to think about all services, and to aim for comprehensive whole system joined up services.
The framework distinguishes between:
- Core services offering full registration of asylum seekers with a primary care practice, which should include providing comprehensive health checks and a standard primary care service,
- Gateway services facilitating access to such services, and
- Ancillary or supplementary services. These include translation services, mechanisms for continuity of care for mobile populations, health promotion, access to specialist services especially for survivors of torture, mental health services, advocacy and information, social advice and support, and involvement of refugee communities in planning and delivery of services. Where asylum seekers are registered in separate specialist practices, appropriate mechanisms for transfer to mainstream practices with suitable provision also represent ancillary service needs.
Summary framework for comparing primary care service models for refugees and asylum seekers
Gateway services Facilitating full registration with a practice
Core services Offering full registration and comprehensive primary care
Ancillary services Supplementing mainstream services with specialist provision
Mainstream or specialist services
The PCT framework makes no assumptions about whether core services are provided by dedicated or mainstream practices. General reports on health needs of refugees and asylum seekers and professionals delivering services to this group agree that a goal of health policy for asylum seekers should be to integrate them into existing mainstream services with the same rights to high quality treatment and care as others.
Given the special service needs of asylum seekers, this may require, for a time, special models of service delivery or the need for specialist personnel or services. This does not, however, imply a stark dichotomy between specialist and mainstream services, but rather criteria for identifying what model or combination of models can most effectively deliver high quality and appropriate care.
It has been argued that the choice of specialist or mainstream models to address needs of refugees should reflect the ability of different models to “accommodate (their) special service needs” in terms of both public health and human rights criteria.
Public health principles stress the social determinants of health and the importance of reducing health inequality, while human rights principles stress rights to services, including the responsibility of health services to advocate for clients where the denial of their human rights adversely impacts on their health.
In relation to marginalised groups, these principles may require that some services be delivered to specific groups with needs which are not necessarily shared by the mainstream population.
Whether or not such services are delivered as separate, specialist services outside the mainstream, or within the broader infrastructure of the mainstream has been debated by a range of authors, especially in other healthcare settings. The argument has focused on the dangers of ghettoisation of specialist services against the need for such services to fill gaps in service provision. In Britain, this issue has not raised very much controversy, partly because of most asylum seekers’ legal entitlement to NHS services. It has been raised mainly in relation to specialist primary care practices rather than to other types of service.
It has been suggested that the question is largely a practical one since separate services may be difficult to deliver where there are no large concentrations of refugees, as in some dispersal areas. On the other hand they claim that it is refugee workers who are strongest in advocating specialist services since they are most aware of the difficulty of registering refugees with GPs.
One issue raised in some discussions with professionals, although not found in the literature, was whether specialist services for a range of “vulnerable” populations necessarily serve very different population groups adequately. Several professionals commented on the difficulties refugees and asylum seekers faced in practices that looked after both them and homeless people. One practice originally serving local homeless people found that homeless people were being edged out as the numbers of asylum seekers increased. Staff who had been very available to homeless people were now busy with others. Resentment by the original patients led to scuffles and racist abuse in the waiting room “especially if they were stoned or drunk.” Besides suffering abuse the asylum seekers recognised that the other clients were not the normal mainstream. But more importantly, this service marginalised asylum seekers rather than helping them to feel they had a future within the general population (Personal communication with provider).
Specialist practices as a model exist both in London and dispersal areas where systems can be developed linking healthcare providers with NASS and accommodation providers, so that registration, health checks and interpreting can be routinely provided to new arrivals.
Where data exist on new arrivals they can be identified and directed to a dedicated service, and indeed the arrival of large numbers within a short time has been offered as a reason for such a service, since existing GP practices often find it hard to cope with large numbers of new registrations.
Other forms of specialist service such as outreach to improve access, more comprehensive health checks and screening and specialist mental health services for survivors of torture and war, are ancillary to mainstream services rather than substituting for them, and in that that sense, are not different from other specialist services serving the general population.
Oxfam GB’s work in the Horn of Africa, East and Central Africa
Oxfam GB’s Horn, East and Central Africa region (HECA) Region encompasses 11 countries – Democratic Republic of Congo, Rwanda, Burundi, Ethiopia, Eritrea, Somalia, Somaliland, Sudan (with the southern part of the country managed separately as an entity in its own right), Tanzania, Uganda and Kenya.
With the exception of Kenya, all of these countries fall into the category of being amongst the poorest countries in the world, in terms of human development indicators. There are similarly poor statistics for health, education, food security and the position of women. Overall the acute needs and pressing issues of the region pose huge challenges.
Pervasive poverty is illustrated by the fact that the majority of the region’s 253 million people lack secure access to productive resources and to high quality basic services. They endure the loss and destruction of violent conflict, and suffer the shocks caused by economic adjustment or environmental decline. In many cases, the absence of effective governance denies them the opportunity to exercise their rights as citizens and to reach their full potential.
Naz Project London
241 King Street
London W6 9LP
Phone 020 8741 1879
Fax 020 8741 9609
Naz Project London (NPL) is the oldest and most broadly based black and minority ethnic (BME) charity addressing the sexual health and HIV/AIDS needs of its communities. Currently, it provides sexual health and HIV/AIDS prevention and support services to South Asians (including Bangladeshis, Indians, and Pakistanis), Muslims (including Middle Easterners and Africans), Horn of Africans (Eritreans, Ethiopians, and Somalis), Portuguese speakers (including Angolans, Brazilians, Mozambicans, and Portuguese), and Spanish speakers (mainly Latin American).
NPL exists to challenge myths and prejudices that exist about and within BME communities and to ensure that these communities have access to care, support, and culturally and linguistically appropriate information.
We aim to educate and empower our communities to face up to the challenges of sexual health and the AIDS pandemic, and to mobilise the support networks that exist for people living with HIV/AIDS.
NPL is committed to service users playing an important role at all levels within the organisation.
Horn of African Introduction
It is generally accepted that there is a correlation between the high prevalence of HIV in the Horn of Africa and the level of HIV infection among Ethiopian, Eritrean and Somali communities in the UK. However these high levels of HIV infection have not yet led to an increased level of awareness among these communities. At present, 50% of Naz’s women’s sexual health services are focused in these communities. NPL’s work aims to increase the awareness of HIV and improve the quality of life of those affected by HIV/AIDS in the HOA communities. Specifically, this means informing people of the choice of services available, reducing the stigma, fear and prejudice of HIV and increasing practical and emotional support for all those infected or affected by HIV/AIDS.
Recently the NPL women’s team conducted a preliminary survey on the sexual health needs of Black and Minority Ethnic women (BME). A comparison was made between the Horn of African (HOA) women (Ethiopian, Eritrean, and Somali) and the other BME women (e.g., Middle Eastern, African, Afro-Caribbean, South Asian and Latin American) on awareness of HIV/AIDS, sexually transmitted infections, contraceptives and sexual health clinics. While no significant difference was seen in the level of knowledge of HIV/AIDS between the two groups of respondents, the HOA women were found to be much less aware of STI’s, contraceptives and sexual health clinics.
Although BME women have more knowledge, it does not indicate their total protection from any kind of STI infection. They must also deal with other relevant factors shared with the wider community of BME women such as migration patterns, cultural and religious background, lack of negotiation of sex, low self image and high risk sexual practices.
To increase awareness on HIV/AIDS and sexual health among Horn of African communities in London, we organise health events in partnership with the community based organisations. We provide information on World AIDS day, International women’s day and cultural and community events.
Mohamud Yasim of the NAZ project is HIV positive and said that there are 400 HIV + Somalis in London and 11 in Hounslow. Health services are good, issues are people denying they are HIV+, not going to hospital, denying there are problems, and interpretation. Stigma and denial means they do not trust other Somali interpreters. Mohamud does a lot of this work, not only with HIV, but also TB and Hepatitis.
Female genital mutilation and the position of African refugee women in Britain
Journal no.3 1992. pp7-8.
Uta Ruge talks to Hadiyah Ahmed of the African Women’s Welfare Group
On International Women’s Day 1991 the African Women’s Welfare Group, together with others, organised a training day on Understanding the effects of Female Genital Mutilation, in North London. The day was dedicated to information and discussion, especially in relation to African women living in Britain, and was sponsored by FORWARD, which has campaigned since 1980 against female circumcision, and worked nationally educating for change.
At the end of last year 1 met Hadiyah Ahmed from the African Women’s Welfare Group at their tiny meeting place in a north London church to ask her about their work. The group was established in 1988 to work with refugee women from the horn of Africa. “Two days a week, on Tuesdays and Thursdays, we provide English classes for women and a creche for their children. We hope to increase this to five, but lack of funding means we can’t yet. I asked the women what they needed most. Another main area is health because there is a lack of communication between health workers and those who need their help because they don’t speak the same language. What we did then was to go to health centres and find out what services they can provide for us.”
“We are now using the Prince of Wales round the corner from here, which runs a women’s health clinic. The women go there with an interpreter for all those examinations like smear test, breast examination, family planning etc. The majority of these women don’t use any form of family planning and they have large families to cope with under difficult circumstances. The difficulty for us is that we still haven’t enough money for interpreters. So, I have to be there every day, whenever the clinic is open. And I don’t get any money for it.”
Hadiyah told me that the members of the Group are from many different national and ethnic backgrounds. “We are caring for 70 women, and we can’t take any more because our premises are so small, but there are 300 women on our waiting list. The Somali and Eritrean women are in the majority, but there are also Ethiopian and Sudanese, and perhaps four or five women from Zaire. But in principal we are open for all African women. Most have problems even getting here, they don’t take the bus because of their language problems, they can’t work out which bus goes where, etc. That is why our English classes are so very important. For these women any emergency is a very real problem, especially if they are isolated and sitting in their homes. They can’t even call the doctor when they need one.
“We provide for those 70 women not only English classes but also support – 24 hours a day – with any problem that arises, welfare rights, health service, housing problems, any problem that comes up, really. We then make the contacts between them and the people who can help. There are still many more things we would like to do. Some women want sewing classes for instance, but we just haven’t enough money to do it all.”
“Besides our twelve volunteers, we have only one paid worker who is the tutor for our English classes. There are five professional creche workers who should be paid directly after their three-hour sessions. Sometimes we haven’t even that money, so they only get their payments a week or so later, that’s how we have to run our services, we desperately lack funds.”
I asked Hadiyah if the different religions create any problems in the group itself or with its ‘clients’ but she said “we are sisters, because the daily problems are so dire for all of them, hey can leave their religions aside” adding that the women respect each other’s religions.
Initially she had been told by countless people that the project would never work, partly because of the national and religious diversity of African women in north London. But rather than give up, she went from house to house explaining what the project was about, and what it was not about, Since the establishment of the language classes, she says, it is working very well because lack of English is the uppermost problem for all of them. Language is a problem between them as well. Zairean women peak French and Sudanese and Somali women generally speak Arabic. Added to that is the problem of illiteracy so that religion, nationality and the ideologies of patriarchal (or clan) society seem to be weakened under these circumstances.
Many African refugee women are single parents, whether because their husbands have been killed or have disappeared in civil wars, or are fighting or imprisoned at home. The women are left to go on with life. And life in this society demands, for quite practical reasons, that they should ‘go forward and learn’, as Hadiyah puts it, and not think about whether or not they are ‘allowed to’ by tradition.
We then came to the problem of genital mutilation. Why has the African Women’s Welfare Group taken this issue onboard? Firstly, for very practical reasons. Countless infibulated women are having babies in British hospitals and the unsuspecting midwives may put those women and their children at risk because they don’t know what to do. One of the demands of the campaign against it is therefore to inform and train health workers to safeguard the health and well being of those women who have already been subjected to this practice as children. Of equal importance however is the education of African women themselves about the health risks and psychological scarring of ‘circumcision’ as it is traditionally called. Although now illegal, in Britain and in many African countries, it is still considered part and parcel of a conforming woman’s life and is, if anything, on the increase. Whether for reasons of ‘authentication’ of traditional African versus Western values, or as a falsely stated Islamic demand on women’s lives, it is estimated that 90 million women in more than 20 African countries have undergone this trauma as children, and that about 10,000 girls living in Britain are at risk even now.
“To other women it is a joy and happiness to have a baby” Hadiyah said “but to Eritrean and Somali women it is a quite terrible experience. Already the marriage is not easy. Others might look forward to their wedding day and wedding night, but to us it is very, very difficult because it means being ‘de-infibulated’ that night. And that is not easy. The bride will have been infibulated or circumcised at the age of eight or nine. The vagina with all its scar tissue etc. has become the normal state for her, and now she is broken again. That night she will be in pain, and you have to remember that, again, the small cut that might be made then is done without anaesthetic. When giving birth again it is a cut and will be much more painful than labour is anyway. Then, women demand to be stitched up again, for traditional reasons. So that means they will have to go though all that again, child after child.
“I love my culture, but this part of it has to be abolished! I can’t sit here and let men who are not affected, or who even think it is alright and done for their pleasure persuade me to be in favour of it, to tell me that it is our culture when I know it means our oppression and torture. And more and more women think like that now, only often they have already done it to their children and so our discussion makes them feel guilty. What we tell them then is that they are, or will be, grandmothers too, and that they should encourage their children not to let it happen to the next generation. We have to educate every generation.
But what about the wider community? I asked how they reacted to this campaign. Hadiyah drew in a sharp breath and told me about the reaction of some Somali men a few months ago. It had happened in Cardiff at a meeting where she shared a platform with Louise Panton, producer of the BBC documentary Female Circumcision and A Cruel Ritual 1990, to discuss the films.
The people from the office of Racial Equality were not happy about the film. They claimed that certain sequences had not been properly done, that parents of schoolchildren who had been filmed had not been asked permission etc. To me all that was rubbish. Later we were invited to answer these allegations in front of a meeting of the Somali community in Cardiff. Louise Panton was aggressively told that she, as a white British person had no business making such a film and should not meddle with ‘our affairs’. Between them they called me names in their own language while this was going on. I understood what they were saying but I didn’t speak until I was asked. Then I said, “Where are the women? Why don’t they say anything? Of course only men had been talking. One woman asked me “Why are you saying all this in public?” And I answered: “Because I am Somali. And we have to face the truth. Do these men know what you are going through when you give birth? No, they don’t. Nobody knows, except you. And as a mother you have to protect your child, too!” She looked at me and became less certain: “Ali, yes, um so, perhaps you could tell us more…” So the women started to look at me differently and while we talked it transpired that they had been told to be there that day in order to protest against those sequences, and nothing else. And the men then started to make noise and to shout at me. They sensed the danger that would follow from women talking between themselves.”
Hadiyah didn’t see this as a response in any way rooted in national, religious or racial beliefs, but simply as a male reaction to women’s attempts to talk about their bodies and, in the end, to liberate themselves.
“In any society, any culture, men would always interfere and not accept that their women are changing and liberating themselves. In my case it is, because I am African, this mine of argument: “You act as a Westerner, you want to abolish your culture, you are a traitor because you give out information about us which should be confidential etc, why do you tell the British, and so on. Well, that’s quite ridiculous. The British colonised half of Africa and have known about it for decades anyway.”
I asked about the people who put forward he anti-racist, minority rights argument, people in the health and social services, racial quality workers and so on. As far as they are concerned the whole affair should be treated as one of a ‘different culture’ and no business of the white/ western/majority society. Had they hampered the campaign?
“Yes, or at least they don’t quite want to take it on board themselves” she said, “especially your sisters and brothers who are actually taking part in policy-making on councils and committees, they just don’t want to face it. They hide from it rather than attacking us openly. Still, we don’t get any support whatsoever precisely because we have taken on board the issue of female genital mutilation. They think we simply open our community to criticism from the white community, which is always looking for faults in our culture anyway. They tell us we can’t do this because in a racist society it will weaken our position. But I think that’s rubbish. For me it is also racism, not to protect black children from physical abuse of this very severe kind.”
African refugee women in Britain, especially those who have arrived quite recently from the Horn of Africa, would in most cases maintain that they are going back as soon as their countries provide a safe environment for themselves and their children. For them there is every reason to ‘go forward and learn’, as Hadiyah likes to say, because life for women is not going to get easier without a fight, either here or there. Sometimes there are threatening phone calls, but this courageous young journalist laughs it off. “It shows I’m threatening them. Well, I’m quite happy to do so, it shows I am going forward.”
African Women’s Welfare Group can be contacted at United Reform Church, Colsterworth Road, London N15 4BN. Tel. 081 8855822
There are 400 Somalis in the London Borough of Bromley, comprising 120 households. There are 47 female heads of households who cannot read and write in English or Somali and who do not speak English.
The Somali community is extremely concerned about the quality of health services.
Somali households have the following GP’s
Sole GP – 94 Somali patients – one quarter of Somali population. No Somali specialist services.
Sole GP – 58 Somali patients – no specialist Somali services
Sole GP – 52 Somali patients – No Somali specialist services.
23 homeless male Somalis have no GP.
There are 41 Somali children at Malcolm Primary School. No specialist Somali services, not an extended school. Somali households are very concerned about Royston School.
24 Households are overcrowded. 23 single males are homeless, another 24 have returned home after leaving, and there are 16 adult females living with parents after having lived away. There are related issues of poor quality housing and temporary housing.
Strengthening Somali Civil Society Organisations
NOVIB (Oxfam Netherlands) is a key member of the Oxfam International family. Novib’s involvement in Somalia/land initially started with support for the development programmes of sister NGOs including Oxfam GB and ACORD. Since 1995 Novib has been more directly engaged with Somali civil society organisations (CSOs) and has funded several CSO networks comprising approximately 100 local NGO members all over Somalia/land.
Overall Novib’s engagement with Somali civil society aims at contributing to the achievement of the following:
- The strengthening of all partners in moving from an activity driven agenda towards becoming strong, proactive organisations
- Building of the capacity of partners, particularly network members, in the education sector in terms of vision, activity development and access to other donors
- Building of the capacity of partners in the sector of food security, especially pastoralist oriented groups (National Resource Management network)
- Increasing of the lobbying capacity of partners, particularly around the issue of illegal trade
- The linking of efforts to work towards a sustainable peace in the country in order to counteract the divided history, which perpetuates the conflict. This entails building a coalition that shares a joint vision of the future, inside the country, as well as presenting a harmonised reaction to outside actors
- The strengthening of women ’s political inclusion
In 2000, the current project, ‘Strengthening Somali Civil Society Organisations’ (SCS) was established and is funded by the European Commission. This project provides support to civil society as a sector, which makes it different from other Novib support that is direct funding to organisations. The overall SCS project objective is to support the achievement of justice, lasting peace and sustainable development.
The specific project purpose is to strengthen Somali civil society in addressing their concerns through inclusive strategies so that they are enabled to provide services and are able to defend the interests of their members and constituencies. Additionally, civil society is being empowered to promote the improvement and maintenance of good governance as well as peace in the country and establish working relations with both state structures and the private sector.
The SCS project was formulated as a response to the protracted Somali conflict and the lack of conviction on the part of the international community that Somali civil society has the potential to play a role in re-building the country. Novib is one of the very few actors working closely with local organisations on a non-operational basis. A re-division of access to and control over wealth and power is necessary, and in turn requires that all sectors be addressed. As a strategic actor, Novib, with EC funding support, is not only able to establish direct linkages with a larger number of local organisations but also opts to do so on the basis of the principle of inclusion.
Since the large-scale interventions of the early 1990s, Somalia/land has largely disappeared from the agenda of the international community. Following the failure of UNOSOM, Somalia/land has received much reduced aid and attention from the outside world. Yet during this time Somalia/land has not stood still, despite decades of dictatorship followed by the collapse of the state and civil war, the Somali people have learnt to rehabilitate their country themselves and not to rely on external development assistance.
Despite the enormous challenges of poverty and instability, the Somali people have ensured the survival of the economy, the existence of a school system and rudimentary medical facilities.
In the absence of a central state or meaningful international intervention, the Somali people have represented and organised themselves and individuals and organisations have taken on many of the traditional roles of the state, filling the vacuum in service provision and opening channels of debate. It is in this context that Somali civil society has flourished and is now more vibrant than ever.
Somali Civil society has strong traditional roots. Somali culture is based upon negotiation and consensus building and allows space for diversity, in particular through the use of poetry and theatre, which are mediums frequently used to express challenging positions and opinions. The Islamic Sufi traditions and ‘Tarikas’ dominant in the Somali context have also promoted diversity, tolerance and respect for local governance arrangements.
Somali civil society can be loosely divided into three categories. Firstly, elders continue to be relevant representatives of communities and in the absence of central authority have in fact played a strengthened decision-making role in the past few years. Secondly, there has been a proliferation of ‘modern’ civil society actors in Somalia/land, particularly NGOs and media organisations. The third category includes non-traditional civil society actors who in Somalia/land certainly contribute to the spectrum of public life; these include community associations, professional associations, the business community, artists and performers.
For the purposes of this project civil society can be defined as comprising all individuals or groups who do not posses legislative or executive powers, are unarmed and that actively pursue the well being of the society at large through peaceful means. Yet whilst civil society organisations have certainly expanded and contributed to the development of Somali society in recent years, Somali civil society continues to face several challenges. Chief amongst these are:
- Acquiring funding is a major problem for all NGOs and organised civic groups, a problem that is compounded by the nature of funding which, when available, tends to be given specifically for project activities and rarely for institutional development, although this is a critical need for the development of civil society structures.
- A related problem is that civil society organisations (CSOs) face issues of both visibility and credibility. NGOs have proliferated in recent years and vary widely in quality. As a result, the perception of local NGOs from inside the country as well as outside tends to be negative. This perception has led to reluctance on the part of aid organisations to trust and therefore invest in the operational capacity of the local NGO sector. Even within the country the mushrooming of NGOs has negatively influenced the attitude of the private sector and political powers.
- Leadership of CSOs is a key issue to be addressed. The leadership of currently existing CSOs is in general poor. Somalia/land has suffered a massive ‘brain-drain’ and therefore lacks skills in key areas. This lack of leadership capacity consequently creates weaknesses within CSOs, including poor transparency, accountability and service delivery.
- There is relatively little collaboration and cooperation between the different actors in Somali civil society, in part due to the scarcity of both human and financial resources but also reflecting the divided history of the country. This leads to a lack of harmonisation and common strategy within the civic sector – resulting in duplication and failure to utilise available resources most effectively.
- Somali CSOs face a challenge in the scope of their activities. CSOs have had to focus on the provision of basic social services and have perhaps failed to fully develop in the areas which are traditionally important for civil society; the promotion of good governance, peace, democracy and human rights.
Chinese National Healthy Living Centre
The Chinese National Healthy Living Centre was founded in 1987 to promote healthy living, and provide access to health services, for the Chinese community in the UK. The community is widely dispersed across the country and currently makes the lowest use of health services of all Minority Ethnic groups.
The Centre aims to reduce the health inequality between the Chinese community and the general population.
Language difficulties and long working hours in the catering trade present major obstacles to many Chinese people in accessing mainstream health provision. Language and cultural barriers can result in their being given inappropriate health solutions.
Isolation is a common problem amongst this widely dispersed community and can lead to a range of mental illnesses. The Centre, based close to London’s Chinatown, provides a range of services designed to tackle both the physical and psychological aspects of health.
The Chinese National Healthy Living Centre is currently funded by the New Opportunities Fund and works closely with both statutory and community organisations in order to deliver our mission. Current Funders include:
- Big Lottery Fund: (formerly known as New Opportunities Fund ) provides the core funding for the healthy living project from June 2000 to 2005.
- Association of London Governments: provides funding for the Disability Support Scheme Officer’s salary and subsidises the Carers Support Scheme.
- Department of Health: DoH funds the Drugs Misuse Needs Assessment.
- National Health Service provides funding for various projects and services, e.g. Chinese Walking to Health project and Smoking Cessation Scheme.
- British Heart Foundation are contributing to the Healthy Eating Project.
- King’s Fund, City Parochial Foundation ,European Social Fund &CEMVO provide funding towards the London Advocacy Project.
- The Countryside Agency: provides funding for the Chinese Walking to Health project.
- The Health Foundation supports our Chinese Health Information Website and Internet Drop-in project.
Heritage Lottery Fund provides funding towards the Chinese Reminiscence Project
 Gerald Hanley Warriors – Life and death among the Somalis Eland London 2004 isbn 0 907 871 83 6
 Traditional Nomads Cindy Horst PHD Project Amsterdam Research Institute for Global Issues and Development Studies C.Horst@inter.NL.net
 Environment and Health WHO ISBN 92 890 1126 2
 Eduard J Beck Australian Institute Of Aboriginal Studies Canberra 1985 ISBN 0 85575 152 5
 Traditional Nomads Cindy Horst PHD Project Amsterdam Research Institute for Global Issues and Development Studies C.Horst@inter.NL.net
 Mohamed Osman Omar The Road to Zero Haan ISBN 1 874209 75 8
 Nuruddin Farah Yesterday Tomorrow Cassell isbn 030470702-3
 Jill Rutter Supporting Refugee Children in 21st century Britain Trentham 2003 isbn 1858562929
 Demos Holistic Government ISBN 1 898309 04 3 1997
 MEETING REFUGEES’ NEEDS IN BRITAIN: THE ROLE OF REFUGEE-SPECIFIC INITIATIVES Jenny Carey-Wood Edited by Claire Nee and Tony Marshall, Home Office Research and Statistics Directorate © Crown copyright 1997 ISBN 1 85893 995 X