The United Kingdom is home to the largest Somali community in Europe, with an estimated 115,000 Somali-born immigrants residing here in 2010 according to the Office for National Statistics. The Somali community represents one of the largest Muslim groups in the UK. They are faced with several social challenges in terms of adjusting to life in the UK and the ability to adapt to western culture. In terms of how smooth this process may be depending on their prior experiences and expectations.
As a GP, I previously worked in Birmingham and currently working in London, I have seen the effects of these challenges on my patients. I have seen how their experiences have shaped their acceptance and expectations of the UK health care system – a system which requires active participation to gain results.
In a qualitative study carried out in the London Borough of Camden which tried to address the low uptake of cervical screening among Somali women, the researchers found that the knowledge of Somali women regarding the importance of the screening programme was limited. They also found that due to previous experiences such as undergoing Female Genital Mutilation (FGM), they were reluctant to undergo any gynaecological examination or procedures, which can also explain why they sometimes present quite late antenatal in labour without any prior antenatal care. Health professionals are recognising these difficulties and in particular the effect of prior experiences on how these women access healthcare services. In some areas, they have used community leaders to educate the local Somali groups about the importance of screening programmes such as breast and cervical screening as a preventative measure and to encourage them to take part.
According to the World Health Organisation (WHO), the common causes of morbidity and mortality in Somalia are diarrhea-related diseases, tuberculosis and malaria. This may be relevant as more and more Somalis are returning home for business purposes or families are spending their summers there. It is imperative that local doctors are aware of this and that they are more vigilant about signs and symptoms that may represent to you in the community, especially as malaria can be present up to a year post travel. Also, those who are travelling need to plan their trips better by ensuring they have received the necessary vaccinations and the adequate amount of malaria prophylaxis prior to their journey.
One of my biggest concerns about the Somali community is the low vaccination rate among Somali children especially the MMR vaccine (measles, mumps and rubella). There previously was evidence presented in the Lancet by Dr Wakefield where his research linked the MMR to autism. This paper was later discredited and the doctor was struck off and no longer allowed to practice as a doctor. Unfortunately, his findings although false left a lasting damage among communities which led to the low uptake.
When discussing with my patients about this, the common response in those whose children have been affected by autism seem to have displayed the signs of this illness when they received the pre-school booster including the MMR. So far, the research did not find a link and the first dose of MMR is usually given between 12-13months of age and children seem to continue to develop normally with no concerns. Unfortunately few studies carried out in Europe, in places such as Sweden and the UK, have found an increasing rate with children using the autistic services to be more likely from West and East Africa.
This is a hard issue to address, as we as clinicians still do not know what causes autism, so we need to support families and parents who are frustrated by this lack of knowledge. As a result they tend to believe anyone who may offer an answer to questions related to possible causes for this illness and disorder.
We have to continue to support these families and encourage them to understand that there is no link between immunisation and autism, and re-enforce the importance of the immunisation programme as a preventative measure to prevent deadly and disabling diseases such as measles and polio.
In conclusion, there seems to be a lot of misconceptions and misunderstandings among our Somali community here in the UK. There has been a lot of work carried out by health professionals, some of whom are increasingly from Somali backgrounds, which have put policies and guidelines in place in order to help improve the general health and well-being of our community here in the UK.BLOG COMMENTS POWERED BY DISQUS