Speech delivered at MediaCityUK: From sick kids to SicKids – travelling to learn and returning to inspire

Turning the tide of child abuse and neglect in the UK and overseas


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13 January 2016, Making Research Count, MediaCityUK


Ladies and gentlemen, it is a pleasure to have been asked to talk to you today. I’m going to take you on a journey. A journey that begins here in Salford and returns here to Salford. A journey that involves professionals, children and young people from around the globe. And a journey that I hope will encourage you to Travel to Learn and Return to Inspire.



That journey will help you to understand how, with a few ideas, with a great deal of enthusiasm and with commitment to succeed we can all help to turn sick kids in to SicKids.


I’ll explain. And, of course, throughout this presentation you are welcome to use social media so please do keep your phones on. You’ll even need them at the end to send a quick text – but more about that later!



First, my declaration of interests.



The Winston Churchill Memorial Trust is an amazing organisation I’ve had the privilege of being associated with since the latter part of 2013.



A charity set up on the death of Sir Winston Churchill in 1965, they now fund around 100-150 British Citizens each year to travel abroad, gain new skills and knowledge and to return to recommend how our society can change for the better here in the UK.



Or, put more simply, you can’t stay in your corner of the forest waiting for others to come to you. You have to go to them sometimes.



On a journey that took me 35043 miles, to nine different cities in six different countries I have had the most amazing professional experiences that have, I believe, changed my career forever. In my report, Living on a Railway Line, that was launched here at MediaCityUK on 20 October 2014, I’ve made key recommendations to turn the tide of child abuse and neglect in the UK and overseas. Recommendations that I’m really delighted have been grasped by a number of organisations and we are starting to see implementation.



Ladies and gentlemen, we know that child abuse has always occurred – being reported ever since Roman times. We know that 50% of one year olds are hit weekly by a parent here in the UK. We know that each week at least one child dies from cruelty and we know that sexual abuse is rife amongst communities.



It was this community, whilst I was working in Cambodia, that inspired the name of my report, Living on a Railway Line, because some communities are physically living on a railway line and some communities and individuals back here in the UK are metaphorically living on that railway line never sure where the next insult to their emotional or physical integrity is going to come from.



The communities I’ve visited, the people I’ve met and the experiences I have had have very clearly taught me that we have to do something different here in the UK if we are ever going to make a difference to the lives of children and young people.



As I’m talking to you I’d like you to be thinking about what it is that you can do, either in your own communities or as professionals, to implement these seven steps to reducing abuse that I’ve formed from my work abroad.



Taking things in no particular order.



Education is one of the most important things that we as a community can do to try and change the way that our society views children and young people.



We know that missing from education is a risk factor for CSE, but we need to take a step back and consider in much more general terms, the impact that increased educational levels can have on decreasing adverse opinions communities may have about children and young people so that they are seen more properly as the valuable members of our community that they are.



Even if that education does mean their PE lesson is balancing on a railway track rather than on gym apparatus.



Because education really is the most powerful weapon you can use to change the world.



I genuinely believe that if we were to decrease chronic neglect in society, and to fully recognise protecting children as a public health priority rather than child protection being a social problem, we would make a real difference.



Organisations working in the community on child abuse prevention programmes should incorporate material related to Adverse Childhood Experiences (ACEs) and provide community education, to adults as well as children and young people, about recognising these ACEs and minimising them in our societies.



But understanding the key reasons in society WHY children are abused and neglected is the key to preventing it.


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I’ve deliberately blocked out the faces of those children and young people, who number more than one, as I didn’t think it was fair on them to show the exploitative situation they were involved in and mistake me not, it is beholden upon us all in society to recognise the vulnerabilities that exist within our communities and to do something about them.


But, looking critically at the themes we have just watched, am I really suggesting that they are transferrable to here in the UK? Am I really suggesting that children here might be being sold?


Well, maybe not for $300 as you have just seen. But you only have to look at some of the learning from, for example, the cases in Rochdale to realise that these themes are not a million miles, not a thousand miles, not even a few miles away from the parallels we have seen in cases here. I have no doubt that children and young people ARE being used as a form of currency here in the UK and that is something that our society has to put a stop to. Now.


The learning from work overseas has been immense ever since we set up our partnership between Salford University, a University and colleagues that have enthusiastic “can-do” mentalities, my NHS Trust and a social development organisation in Cambodia, called M’Lop Tapang. That partnership, to improve the health and social care of children and young people living on and around the streets and beaches of Southern Cambodia, has gone from strength to strength since it was launched in March 2015.



M’Lop Tapang envisions an environment where all children and young people are allowed to grow up in their families feeling safe, healthy and happy; a society where all children are respected and treated equally; a community where all children are given choices about their future.



When I first announced the partnership we have been developing a colleague of mine said, “well, that’s a one way partnership I suppose” seemingly indicating that knowledge transfer would be unidirectional – from the UK to Cambodia.


He couldn’t have been more wrong.



Although child labour has fallen by one third, there are still 168 million children and young people around the world forced to work. I’ve seen at first hand in Cambodia the effects that children having to work has on them and their communities. But I’ve also seen some of the solutions that have been adopted in the region where M’Lop Tapang operates – providing employment for families so children can go to school and training those people who missed out on their education so that they can offer a sustainable future for their families and communities.



Throughout the world neonatal and childhood mortality is still too high. But the learning from resource-poorer communities, who don’t have the facilities that we have access to here in the UK, can really teach us skills of rapid service improvement. The attitude of the multi-professional staff at M’Lop Tapang is inspiring in its own right and if we could only transfer a little part of that back to here in the UK our health and social care system would be dramatically more efficient and sustainable.



The significant negative consequences of violence against children in Cambodia is a humanitarian disaster; but aside from the health and social consequences of such attacks on the physical and emotional integrity of some of the most vulnerable members of our society, the economic costs are staggering.


Fully recognising that those consequences are having deleterious effects here in the UK too is a starting point to try and change the minds of those with political and financial responsibility who may be reluctant to invest new money now to better protect children and young people in the future, instead of face the economic costs for generations to come of failing to act today.



Because building a better society for the future is easier, and more successful, if the building blocks are intact than it is if we are trying to rebuild a community after it has fallen.



M’Lop Tapang offers a viable alternative for the future. An alternative whose programmes and ethos are very much the kinds of solutions that I think we should be looking for here in the UK. Bidirectional learning at the very heart of our partnership.



Respecting children and young people for the valuable citizens that they are is one of the fundamentals tenants a society must abide by if we are to make any headway into reducing the abuse and neglect that they suffer from, wherever they live in the world.





Providing children and young people with the social scaffolding and social resilience to grow up stronger, and more able to launch a defence against the physical and emotional attacks that come their way, gives an opportunity for the whole community to network together to better protect the children within it…



…and recognising the community-specific risk factors that exist within the individual society, which place children and young people at risk of harm of all kinds, is crucial to be able to address the issues. That requires us to take a much more local approach to the specific vulnerabilities that exist within our communities and to tackle them at a grass roots level.



Empowering girls and women to better be able to stand up to threats that exist in the communities that they live in and not forgetting that boys can also be victims of child abuse – something that is very difficult to do in Cambodia where the approved child protection examination proforma only has female anatomical drawings on it and not male ones – is at the bedrock of making our society a less unjust place for children and young people to grow up in the future.



In Cambodia it’s the women who play a key role in raising their children and taking care of their families. These women live in a remote rural location, far away from clinics and schools, so they have an even greater responsibility to ensure their families are safe and well.


At M’Lop Tapang we provide outreach medical services and community educational programmes to many remote areas like this. In a country where poverty, ill health and domestic violence are prevalent it is vital that women and children are empowered with knowledge and confidence to ensure their families grow up feeling healthy, safe and happy. Knowledge and confidence that we would do well to learn from here in the UK.



Cambodia has one of the youngest populations in South East Asia, with 41% aged 18 and under. It is also one of the poorest nations in the region with the average salary being less than $3 per day. But there is good news, even facing such adversity the under five mortality rate dropped from 116 per 1000 live births in 1990 to 40 per 1000 in 2012. Still too high, of course, but another example of where partnership working between countries and organisations can tackle health and social care problems collaboratively.



We know that missing from education and home is a significant risk factor for CSE and I’ve been superbly impressed by the skill of the M’Lop Tapang social workers, on their yellow motos, being able to track down children and young people throughout the city and the surrounding jungle, ensuring as best they can that the decisions they make are the safest possible ones.


I simply wish we could have a society here where people living in our communities would look forward to the involvement of social services and would actively seek out the input of a social worker rather than the very different situation that we are often faced with in child protection here in the UK.





If we could make Greater Manchester a ChildSafeUK community where children and young people are actively protected from forms of abuse by the community itself, such as I’ve seen on the streets and beaches of Southern Cambodia, our region, and others around the world, would be



a safer place for those children to grow up in.



Recognising the effects that our social situation and housing has on adverse health and wellbeing, and actively doing something about it, is a key factor involved in the prevention of abuse. You saw in the earlier video why one family had to go to the last resort of selling their child and I think we have to really recognise that those children and young people who are being exploited, in all ways, around the world are not involved in this by choice; they did not grow up with a life ambition to be exploited, they became involved because they needed something they couldn’t otherwise get – be it a roof over their heads, food to eat, clothes to wear or money to exist.



Tackling those social problems as well as poverty, because…



…poverty isn’t something that just affects children abroad, is at the root of dealing with the chronic neglect that exists in our societies; neglect that has to be resolved for those same societies to become safe places for children to grow up in the future.



And so, to just give one example, whilst it may seem counterintuitive to not buy from children who are selling lovely goods on the beaches of your next holiday destination, would it not be far better…



…to buy those same products from a shop where adult caregivers are provided with employment so their children can go to school?



Because increasing employment in our societies is something that leads to better economic and social development of those societies and, consequently, over time less poverty and less need for children to be involved in abusive situations through no fault of their own.



Sustainability is key to everything that M’Lop Tapang undertakes and here you can see the amazing team working hard on behalf of the children and young people in the region – a team with just 3 international employees and the rest being local Cambodian people.


An amazing achievement for British nurse Maggie Eno MBE who co-founded the organisation over a decade ago.



And the partnership we are continuing to develop gives outreach support twice a year both in the clinic – and all I can say about this photograph is that I’m pleased the light is dim so you can’t see just how hot and sweaty I was –



… as well as in communities living on this railway line.



Communities that have taught me adaptability and using my clinical skills



in ways I both wouldn’t have expected – but also wouldn’t advocate in any UK medical student exam! Looking at other wider aspects of heath of children and young people brings me to healthy nutrition…



…because eating a nutritious diet is a major part of maximising the health of children, whatever their background or social disadvantage. And because of the link between good health, good social care and better protection from harm, even the basics are things that we should get right both here



and abroad.



Focussing on health, as well as social care, is important to protect all of the children in our communities and a renewed push to have child protection seen as the public health problem it really is, will help us to tackle it over time.


But before I go on to move to what we can do here in the UK, I want to introduce you to some of the amazing team I work with each time I go across to Cambodia.


M’Lop Tapang end of year review 2015



We’ve got to remember ladies and gentlemen that to some people this beach – Otress Beach – is a place where there are calm waters, golden sand and idyllic sunsets. To others, it is their home.



As my talk draws to a close I want to reflect on how some children and young people have really grasped the challenge of making a difference to our society themselves here in the UK.


Those risk factors I talked about internationally, the seven steps we can take to decrease levels of abuse in society and the superb effects of peer to peer education, are things that we can do here in the UK.


I want to introduce you a group of children and young people



from here in our own region who are tackling the problem of CSE themselves.



That’s the presenters standing next to me in the photo – and you’ll hear more from them in a moment.



We know about some of the risk factors for CSE that exist in our communities – risk factors that are common to the UK and communities abroad and here is how one group of children and young people are tackling them themselves in their own version of a sort of ChildSafe scheme fit for their community.


The NGY Show



No matter what anybody tells you, it is words and ideas, such as the words and ideas of those children and young people, that can and will change the world.


Children and young people that I’m delighted to be able to continue to engage with this year on projects they want to undertake to draw attention to health issues affecting children and young people as well as education for their communities about the dangers that can lead to, and the protections that exist from, CSE.


Children and young people that I very much hope will be part of the work that we have commenced here at Salford University and in my NHS Trust, in a project supported by NHS England, to develop a child abuse risk assessment tool with children and young people and to develop it into a format that is suitable to transfer across health and social care settings throughout the country.


But what has all of my experienced taught me personally?


I said at the start that the award of my Churchill Fellowship, and the experiences that I have had since then, have changed my professional life for the better in a way that I could never have imagined. And having returned bursting with ideas of things we can do to make our society a healthier, safer and happier place for children to grow up in



I have now founded a brand new registered charity here in the North West of England. A charity that has five awesome trustees who are as committed as I am to making our communities, both here and in Cambodia a better place for children and young people to live and prosper.



Every child should have every chance of good health, every chance of happiness and every chance of protection from harm.



A charity that will support us delivering outreach healthcare in Cambodia, a charity that will help us to improve the development of children with disabilities by providing sensory room facilities, a charity that will allow children and young people themselves to remind the rest of the community that they still need protection and different forms of support even when others within that community fail to recognise them as still children, and a charity that will help to draw attention to, and combat, the adverse health consequences of homelessness.



With values that are crucial to ensure we act with equity and diversity, having just launched and become registered in October 2015, I very much hope that



2016 will be a happy new year for all of us and that we will be looking forward to exciting fundraising times ahead.



With a goal to relieve sickness and preserve health



Improving health care experiences for children…



Whether that is by providing outreach support to rural communities in Cambodia



By providing clinical and educational support, such as through our monthly skype clinics that we have now set up with the team in Sianoukville, or by transferring and applying that learning from abroad to here in the UK, it is very clear to me that we can make a huge difference to the lives of children and young people in two geographically distant areas, but socially connected communities, and I know, from a very personal view, that my involvement with the team in Cambodia has developed me in a way I could never have imagined.



And as I have shaped a new future, full of exciting possibilities and boundless enthusiasm from my colleagues, so that future will shape me once more.



The knowledge I’ve learned from abroad and applying it here in the UK can and will make a huge difference to children and young people living side by side in our communities with us. Because being involved in this kind of work is vital to make our society a healthier, safer and happier place for children and young people to grow up in the future.



Because, ladies and gentlemen, what IS the use of living if it be not to strive for noble causes and to make this muddle world a better place for those who will live in it after we are gone?



And now, in closing, I said right at the start that you’d need your mobile phones not just to update your social media accounts throughout this talk but now for a final task before we move to the panel discussion.


If you want to support the work our new charity will be doing, work to improve the health and social care of children and young people in our community and our new partner community in Cambodia, work that will, over time, help us to really turn the tide of child abuse and neglect in the UK and overseas, then all I need you to do is to text the number on the screen behind me and you can be confident that your donation will mean a huge amount to those people who are the present and the future of our global society.



I wish you all a very happy 2016. Thank you very much indeed.