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This is a guest blog.
Guest authors bring different perspectives and diverse voices to our blog. They do not always represent the views of The King’s Fund.

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A community in the shadows: experiences of a Somali community in Birmingham

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  • Suad Duale

    Suad Duale

When your voice has been blocked, and you’re not being seen, unable to meet your basic needs, it can sometimes feel that your life doesn’t hold any value. Imagine, you’re shouting at the top of your lungs, asking for help, but no one sees or hears you, and you feel like no one cares. You are living in the shadows.

I grew up as a Somali refugee. I am a community activist, a clinician, a mother and a researcher. Every day I see the Somali community suffering and being treated unfairly, which leads to a collective lack of trust in professionals, particularly in the health system. In my work, I try to address this issue by bridging the gap between the community and health and social care professionals.

In the UK, there is not one single society: some parts of society are validated, and others live in the shadows, where they feel their lives don’t matter. Houses are becoming graveyards for families, because of conditions like mould, which negatively impact our health. The community feels that health and housing professionals are letting them down and are not listening to the pain they are experiencing. I want to ask you, don’t those who live in the shadows deserve better? Do our children not deserve to feel safe at school? Does having houses that we can call home not seem important?

In Birmingham, where I live, eight out of 10 Somali children live in ‘poor’ households with low levels of economic activity and ‘high’ rates of mental health issues, such as PTSD. In the UK, six in 10 (59%) people in the Somali community live in overcrowded accommodation, compared to fewer than one in 10 (8%) of the overall population. Meanwhile, studies show that many Somali people find it difficult to access health and social care services, due to language and socio-economic barriers.

'Sometimes, I see people fear going into hospital, afraid they won’t get the treatment that they deserve.'

In my many conversations with the Somali community, I hear people say that if you are Somali, you are a second-class citizen. That when you use health and care services you're seen as a migrant with no value, even if you are a British citizen, and you’re working and paying your taxes. Sometimes, I see people fear going into hospital, afraid they won’t get the treatment that they deserve. Black women going to hospital to give birth know they have four times more chance of dying giving birth, compared to white women and that makes them terrified. Often the community tells me they are not treated with dignity and respect, and face stigma and discrimination when seeking treatment. They receive poor diagnoses and often do not get referred for the most appropriate specialist treatments. It feels like we have to look after ourselves, without the support afforded to other communities.

So, the community has started to work together to provide support and opportunities for each other. Dream Chaser Youth Club is a community group in Birmingham set up by Aisha in 2017– a single mum motivated to support the children in her local community. It now serves 3,000 young people and families, many of whom have experienced homelessness or are living in bad conditions that affect their health. Among many initiatives, the group provides information about health services to the community in the Somali language, and provides opportunities (such as football clubs) for young people. Dream Chaser is run by fewer than ten volunteers. My nickname within the community is the ‘mobile community call centre’. I get lots of calls for different reasons, but often people want to know how they can access health and care services, and who they can trust.

Some of the volunteers are professionals, or academics with degrees, and we see how the community is bleeding inside and out; we recognise the needs of the community, but no one is listening. Part of the problem is that despite the Somali population making up the largest African diaspora in Birmingham, there are very few Somali individuals in leadership roles in which they can advocate for their community.

'If policy-makers and those in charge were to take action, I would ask that they consider who is sitting at the tables for decision-making and who is advocating for the communities that live in the shadows?'

Those who are making decisions regarding our community need to have a connection with us and really listen to us. Birmingham is a multicultural city, however, those in positions of power do not reflect the city it represents. If policy-makers and those in charge were to take action, I would ask that they consider who is sitting at the tables for decision-making and who is advocating for the communities that live in the shadows?

I hope health equality is not divided by the colour of our skin.

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