Critical Hope at the Sharp End of Inequality

Image credit: Margaret Greenfields

For health systems to work for everyone, we need to understand how they work in practice. So often, important decisions are made without meaningful inclusion of the people that they affect. Co-create have been working with the Mobilising Community Assets to Tackle Health Inequalities programme to understand how using creative approaches to include people with lived experience can transform research and services.

To get a full picture of how a system works in practice, we need to view it from all sides. The view from the lived experience side can tell us what’s actually happening, how it feels, and what else is needed. Systems designed without the people who are most affected by inequalities can perpetuate the problems they’re designed to solve.

Our work is happening at a particular moment in the UK – one characterised by rapid political change, increasing division, and intensifying hostility towards some marginalised groups. Critical hope for us means facing that reality honestly, while envisioning and working towards better futures.

Over the last few years there has been a huge amount spoken and written about people seeking asylum. I think it’s fair to say that the amount of discussion around asylum seekers is disproportionate to the effect that these issues have on the lives of people who have British citizenship (compared to, for example, the cost of living). In our work, we have heard how this unwanted focus is making existing health inequalities even worse.

We are hearing from different parts of the country that people seeking asylum, refugees and other migrants are feeling less safe. For example, one project has shared how people seeking asylum had been prevented from joining a creative health activity that had been popular and effective because they no longer felt safe to leave the hotel where they had been placed. The wonderful voluntary sector organisation that supports them has been putting in huge amounts of (unfunded) time to support people to continue to participate.
MigRefHealth, a project working with refugees and migrants to understand their health needs and improve access to healthcare services, describe how:

“on exiting the railway station in one study location the first sight you see is a vivid display of national flags which have caused considerable concern and triggered anxiety amongst the relatively small, highly visible migrant, refugee and asylum seeking populations.”.

They describe how the fear that migrant, refugee and asylum seeking people live in shapes their lives directly as well as the support that they are able to receive. Research activities have been scaled back or postponed due to safety fears. A map to show people organisations that offer support cannot be shared publicly because agencies and support organisations are receiving threats, assaults and police warnings.

There is no denying these are tough times. So where is the hope? Despite challenging times, Mobilising Community Assets projects, along with many others across the country, are providing safer spaces where people can connect with each other. Co-create are collecting stories, films, pictures and other creative works that help us to understand more about people’s experiences, and visions for a better future. Researchers and community partners are working hard to translate their learning into practical changes for public policy.

It’s important to me to keep reminding ourselves of the power of small acts. Listening to and sharing stories can be hugely powerful. Something that strikes me repeatedly when I’m reading or listening to news stories about people seeking asylum is that they are about people, not with people. When we listen to and share stories or other creative work, they help us to build a connection with others, whether their experiences are similar or different to our own.

We need to keep working together, listening to each other, and sharing what we hear. Working creatively allows us to express things, including deeply difficult ones, in new and constructive ways.

About contributor
Co-create is a disabled-led consultancy that supports others to include lived experience in their work. We use our combination of lived and professional experience to build bridges between services and people who use them.