While applying for my PhD in Infectious Disease Modelling at Imperial in 2019, I wanted to gain hands-on experience in infectious disease control. At the time, I was an undergraduate student studying Immunology at the University of Manchester. I applied for an internship with a laboratory on the edge of Accra, Ghana, providing infectious disease diagnosis to a local hospital. I was excited to be accepted and immediately went about booking flights and organising my visa.
It was only a week before my flight that I learned Ghana criminalises homosexuality, with physical homophobic attacks against LGBTQIA+ individuals being common. As a queer woman with a same-sex partner, I was nervous. Living in Manchester, with its famous gay village, I was very open about my sexuality and thought nothing of walking down the street holding hands with my girlfriend. Unsure of how to navigate being gay in Ghana, I eventually decided to tell people I didn’t have a partner, effectively returning myself to the closet.
This festive period, Three Wise Women from the Faculty of Medicine will be giving us the gift of wisdom.
Ubuntu (ooh-bun-too) is a concept, a philosophy, a way of living in Africa. It highlights the interconnectedness of all individuals and encourages people to recognise their shared humanity. Here, Dr Sungano Chigogora, Senior Teaching Fellow in Epidemiology in the School of Public Health, explores the spirit of Ubuntu and why it should be at the heart of teaching and learning.
In Central and Southern Africa, Bantu means ‘people’ or ‘humanity’ to hundreds of millions of individuals whose languages have common ethnolinguistic roots. To them, Ubuntu is a core characteristic of humanity that extends beyond the individual, and recognises not only their humanity, but how they belong to a deep community in which they can participate, share, and grow. As observed by the late Archbishop Desmond Tutu, “Ubuntu is very difficult to render into a Western language. It speaks to the very essence of being human. … to give high praise to someone we say … ‘he or she has Ubuntu’. This means that they are generous, hospitable, friendly, caring, and compassionate” (Tutu, 1999).
When it comes to healthcare, there are clear and stark inequalities between women and men. Marina Politis, Alice Witt, and Kate Womersley explain how, at its root, this gender health gap derives from a research and data gap, and how the MESSAGE project is working to improve accounting of sex and gender dimensions in medical research.
Everyone aspires to receive gold standard treatment when seeking medical care. What if, however, this standard, was only ever set out to be gold for one group of people? Much of our medical evidence base has been based on a male norm, with women underrepresented at all stages of the research pipeline. Subsequently, when a woman suffers an out-of-hospital cardiac arrest, she is less likely to receive bystander CPR than a man. Once in the hospital, she continues to be less likely to receive optimal care than her male counterpart.
The gender health gap in cardiovascular disease – poorer outcomes women experience due to the “male default” in health research and healthcare – is just one of many conditions for which there are disparities between women and men. From dementia to diabetes, and osteoporosis to obesity, sex and gender differences and similarities remain neglected in UK and international research.
The Imperial World Health Organization Collaborating Centre for Public Health Education & Training (WHOCC) was created in 2007 to support the work of the World Health Organization and its founding objective: ‘the attainment by all peoples of the highest possible level of health’. Established by the WHO Global Committee with the support of the British Government, the WHOCC has a special focus on global health issues and health services research, in addition to public health education and training. This year, Imperial WHOCC was redesignated for another four years- a huge achievement. Hear from Rachel Barker, Support Officer, at the WHO Collaborating Centre and Department of Primary Care and Public Health, about the WHOCC’s work.
Following an intensive and rigorous process, the World Health Organization Collaborating Centre of Public Health Education and Training (WHOCC) Imperial College London, has been re-designated for another four years, securing its vital work in improving global health and wellbeing until 2027. During the previous designation period, Imperial WHOCC shared its expertise with Low-and-Middle-Income-Countries (LMIC)to assist them with their endeavors towards meeting the UN Sustainable Development Goals (SDG). In respect to SDG 3, ‘Good Health and Well-Being’, Imperial WHOCC has collaborated with stakeholders, countries, and international organisations on improving access to Universal Health Coverage (UHC).
Commenting on the news, Professor Salman Rawaf shared his congratulations to the Imperial WHOCC team, “The WHOCC re-designation is quite the feat – thank you to our team for their hard work. This is our fifth re-designation – a record achievement for any WHO CC at a global level. As a direct result of our work, the WHO and many member states have benefited from the excellence of Imperial College London and its affiliated NHS institutions in research, service development, education and training. A sincere thanks to Professor of Primary Care and Public Health, and Head of the Department of Primary Care & Public Health, Azeem Majeed, Chair in Cancer Epidemiology and Prevention at the School of Public Health, Professor Elio Riboli, and Professor Deborah Ashby, Interim Dean of the Faculty of Medicine for their continued support over the years.”
Dr Lindsay Dewa, Advanced Research Fellow in Mental Health, and Pelumi Fatayo, co-producer of Nexus, reflect on their experiences of presenting together at an international conference, and the value of putting co-production into practice.
“Oof – long day that wasn’t it! Is it 11pm or 7am? Is it Friday or Saturday? I’m so confused!” – Lindsay
That was a question I had asked Pelumi following over 24 hours of travelling from London (and Manchester for Pelumi) to South Korea. But I could see it was already well worth the trip before we’d even stepped out of the taxi – the bright lights, the heat… the friendly taxi driver trying to figure out where our hotel was on his five digital devices… we were excited! But what I was most looking forward to was co-presenting about co-production in mental health research at a prestigious international conference – ISQua – with one of my young co-producers, Pelumi. The conference theme was “Technology, culture and co-production: Looking to the horizon of quality and safety” so we felt it was perfect for us to share our experiences.
In the rapidly evolving landscape of healthcare, few topics have garnered as much attention and controversy as prostate cancer screening in the UK. With approximately one in six men destined to face this diagnosis in their lifetime, the urgency to address this issue is undeniable. To provide clarity amidst this complexity, Rebecca Wright, Honorary GP Teaching Fellow at the School of Public Health, and Azeem Majeed, Professor of Primary Care and Public Health, and Head of the Department of Primary Care & Public Health, at Imperial College London, delve into the heart of this debate, seeking to balance the critical factors of risks, resources, and outcomes in prostate cancer screening in England.
Prostate cancer screening in England has become very topical and attracted considerable recent news coverage. Around one in six men will get prostate cancer at some point in their lives with incidence increasing with age. Another major risk factor is ethnicity; black men are at highest risk of prostate cancer and Asian men are at lowest risk. Other risk factors include family history, obesity and genetics; for example, those with a fault in their BRCA 2 gene (genes that produce proteins that help repair damaged DNA) have a two times higher risk of developing prostate cancer. (1)
Lesbian, gay, bisexual, transgender, queer, questioning, intersex or aseaxual (LGBTQIA+) travellers can face unique challenges when travelling abroad. That’s why, Rosie Maddren, Lucy Okell, Beth Cracknell-Daniels, Joseph Hicks and Christina Aitchison from the School of Public Health set up the LGBTQIA+ International Support Group at Imperial to help improve the overall experience of going abroad for LGBTQIA+ staff and student travellers.
“So are you married?”
I freeze. How do I respond? It seems like a simple enough question, but I’m gay (and so is my spouse). The question is being asked by a taxi driver in a country where not only is same-sex marriage illegal, but so is homosexuality in general. And it’s not just something imposed by the government. A recent poll suggested that 90% of this country’s citizens have a negative view of LGBTQ people. So how do I respond? How would you?
Travelling abroad for work is a rewarding opportunity that can come with challenges for any student or staff member. For those identifying as part of the LGBTQIA+ community, such travel can be associated with further complications. Legal restrictions and societal norms of some countries may make LGBTQIA+ staff and students feel anxious, unwelcome or unsafe. Unfortunately, in certain environments being your true self can directly impact your safety. On the other hand, presenting a censored version of yourself may negatively impact your mental health and wellbeing. There is no single correct way to navigate such situations, and there is limited guidance on this topic provided not only by Imperial, but wider networks across the globe. Last year, a group of us started working together to help build support for LGBTQIA+ staff and student travellers at Imperial.
I am a GP, researcher, and work at the Imperial College Healthcare NHS Trust sport and exercise medicine clinic. Part of my work is to help people become more physically active – important because it is one of the few interventions that can improve health in many different ways. If we had a similar drug or intervention that reduced the risk of heart disease, diabetes, dementia, depression, risk of falls, and several cancers, then everyone would probably be on it. The problem is that almost one-third of people in the UK are not physically active enough for good health. This is partly because barriers to being physically active exist across individual and cultural factors, such as illness, pain or different conceptions of what physical activity or exercise mean; infrastructure aspects such as safety, facilities and lighting, through to national and global policy. Therefore, this wonder medicine is not equally available to all.
Recently, the UK Government announced that offers of first and second Covid-19 vaccinations will come to an end after 30 June. Ahead of World Immunisation Week, Professor Azeem Majeed from the School of Public Health discusses this major change in national vaccine policy, and why it’s important to stay up to date with Covid-19 booster vaccinations.
The announcement from NHS England that first and second doses of Covid-19 vaccines will no longer be offered to adults after 30 June 2023 signifies a significant change in national vaccine policy. We will all remember the start of the Covid-19 vaccination programme in December 2020, the rapid rollout of vaccines by the NHS, and the enthusiasm for vaccination amongst most sections of the population. Vaccination curbed the impact of Covid-19, leading to large falls in hospital admissions and deaths, and allowing the government to end Covid-19 restrictions.
We are now though entering a new phase in which Covid-19 vaccination will be restricted to older people and those in medical problems that place them at higher risk of adverse outcomes such as hospitalisation and death. The very highest risk groups – such as the immunocompromised and people aged 75 years and over – have been offered booster vaccines every six months for the past two years. Other population groups – such as NHS staff, those aged 50 and over, and people with significant medical problems – have been offered annual booster vaccines.
There is nowhere in London that meets the World Health Organization’s (WHO) Air Quality Guidelines (AQGs). The main reason for this is road traffic. So why has the Mayor’s plan to expand the Ultra Low Emission Zone (ULEZ; an area of London that more polluting vehicles have to pay £12.50 to enter) to include the outer London boroughs sparked so much resistance? Professor Frank Kelly who leads the Environmental Research Group at Imperial explains that there are strong health grounds for expanding the ULEZ.
An overwhelming body of evidence exists that the health effects of air pollution are serious and can affect nearly every organ of the body. Recent studies and large research programmes have also shown that these harmful health effects are not limited to high exposures but can also occur at very low concentrations. Consequently, the WHO has had to update its AQGs, which now recommend substantially lower air quality limits for PM2.5, PM10 (particulate matter less than 2.5 and 10 μm in diameter respectively), and the gaseous pollutant nitrogen dioxide. One of the most significant sources of these air pollutants in urban areas is road traffic. It is also the source that has repeatedly been shown to affect our health. In London this is particularly true because of the size of its population and the density of its road network.