Jeremy Hunt said the blame culture in the NHS must change to avoid more scandals like those tragically exposed at Gosport War Memorial hospital (Report, 21 June). Of course, there must be consequences where neglect or deliberate actions have caused harm, but to shift to a “learning culture” he must incentivise accountability among staff to foster a culture of openness and honesty. Lessons are only learned through honesty, transparency and an acceptance that accountability doesn’t necessarily lead to blame and punitive measures. Staff are the NHS’s biggest asset and by getting its workforce culture right, not only will Hunt improve patient safety and prevent future scandals such as the one at Gosport hospital, he will reduce the burden on staff that is making so many want to leave the NHS after so many years of service. Dennis Bacon Executive chairman, Pulse UK,Norwich
• Safety is disaster-led. After the Herald of Free Enterprise ferry sank in 1987, killing 193, marine safety regulations were tightened. Shipping companies were made responsible for safety of life at sea, in addition to the duties of captain and crew. Safety improved. Working as a ship’s doctor from 2003-15, I witnessed a new development. A monthly prize was awarded to the crew member who reported the most significant safety concern leading to learning or a change of practice. A volte-face in the NHS would be to reward whistleblowers, especially those whose testament led to an increase in safety. We need to fundamentally change the current situation in which staff are still nervous about the personal consequences of whistleblowing, and are often unsupported or worse. How about an annual prize for the NHS organisation which has made the most safety improvements as a result of staff-reported concerns? Carrot and stick. Dr Ruth Taylor London
• Bribing or gagging well-intentioned whistleblowers, who have the interests of the patients at heart, is no way to improve quality control in the NHS, a matter which in my opinion has never been adequately addressed. The main problem is that the whistleblower feels they have no one to turn to. The post of matron has largely been abolished, and the medical profession has become the servant of managers, who are lay people, rather than the other way around, a fact which is reflected in their respective salaries.
Surely NHS staff should be given a statutory right to complain to management if they find it necessary, and have their complaint recorded and acted upon in a transparent manner, instead of having to endure the present culture of victimisation.
I recall as a junior doctor, working at a hospital in the south of England, complaining that when I was on call for cardiac arrests – a very urgent matter requiring immediate attention, obviously – no on-site accommodation was provided for me. The outcome? I was hauled up before the hospital manager and senior surgeon and accused of being a communist. Presumably communists have higher standards of care and compassion. Dr Andrew Norman Poole, Dorset
• In her article Call for action against senior officials over hospital deaths (22 June), Sarah Boseley refers to “life-shortening drugs” such as diamorphine. It is important to stress that although overdosage can be fatal, as long as they are given in appropriate dosage, carefully titrated against the patient’s need for pain control, these drugs do not shorten life. The common perception that they do can be very unfortunate if consequent reluctance to prescribe or accept them results in inadequate pain control in advancing but non-terminal cancer. Dr Peter Wemyss-Gorman Lindfield, West Sussex
• Join the debate – email guardian.letters@theguardian.com
• Read more Guardian letters – click here to visit gu.com/letters
Jeremy Hunt said the blame culture in the NHS must change to avoid more scandals like those tragically exposed at Gosport War Memorial hospital (Report, 21 June). Of course, there must be consequences where neglect or deliberate actions have caused harm, but to shift to a “learning culture” he must incentivise accountability among staff to foster a culture of openness and honesty. Lessons are only learned through honesty, transparency and an acceptance that accountability doesn’t necessarily lead to blame and punitive measures. Staff are the NHS’s biggest asset and by getting its workforce culture right, not only will Hunt improve patient safety and prevent future scandals such as the one at Gosport hospital, he will reduce the burden on staff that is making so many want to leave the NHS after so many years of service. Dennis Bacon Executive chairman, Pulse UK,Norwich
• Safety is disaster-led. After the Herald of Free Enterprise ferry sank in 1987, killing 193, marine safety regulations were tightened. Shipping companies were made responsible for safety of life at sea, in addition to the duties of captain and crew. Safety improved. Working as a ship’s doctor from 2003-15, I witnessed a new development. A monthly prize was awarded to the crew member who reported the most significant safety concern leading to learning or a change of practice. A volte-face in the NHS would be to reward whistleblowers, especially those whose testament led to an increase in safety. We need to fundamentally change the current situation in which staff are still nervous about the personal consequences of whistleblowing, and are often unsupported or worse. How about an annual prize for the NHS organisation which has made the most safety improvements as a result of staff-reported concerns? Carrot and stick. Dr Ruth Taylor London
• Bribing or gagging well-intentioned whistleblowers, who have the interests of the patients at heart, is no way to improve quality control in the NHS, a matter which in my opinion has never been adequately addressed. The main problem is that the whistleblower feels they have no one to turn to. The post of matron has largely been abolished, and the medical profession has become the servant of managers, who are lay people, rather than the other way around, a fact which is reflected in their respective salaries.
Surely NHS staff should be given a statutory right to complain to management if they find it necessary, and have their complaint recorded and acted upon in a transparent manner, instead of having to endure the present culture of victimisation.
I recall as a junior doctor, working at a hospital in the south of England, complaining that when I was on call for cardiac arrests – a very urgent matter requiring immediate attention, obviously – no on-site accommodation was provided for me. The outcome? I was hauled up before the hospital manager and senior surgeon and accused of being a communist. Presumably communists have higher standards of care and compassion. Dr Andrew Norman Poole, Dorset
• In her article Call for action against senior officials over hospital deaths (22 June), Sarah Boseley refers to “life-shortening drugs” such as diamorphine. It is important to stress that although overdosage can be fatal, as long as they are given in appropriate dosage, carefully titrated against the patient’s need for pain control, these drugs do not shorten life. The common perception that they do can be very unfortunate if consequent reluctance to prescribe or accept them results in inadequate pain control in advancing but non-terminal cancer. Dr Peter Wemyss-Gorman Lindfield, West Sussex
• Join the debate – email guardian.letters@theguardian.com
• Read more Guardian letters – click here to visit gu.com/letters
When I sat down to write Fat Is A Feminist Issue 40 years ago I never dreamed, or feared, it would still be in print today. I naively hoped my book would change the world. By analysing and suggesting solutions to body and eating problems, I imagined they would disappear. But in truth, of course, when I was writing about girls’ and women’s body and eating problems, I was writing about inequality, too. And inequality is stubborn. It didn’t look it in 1978, at the height of what we now call second wave feminism. Everything was up for being rethought – families, bodies, education, science, medicine, class, racism, money, sex.
When feminism first appeared, I hadn’t much understood it. At school, we were encouraged to compete with boys for Oxbridge places while soaking in knowledge which would, when the time came for marriage, delight and please our husbands. It seemed ever so dull. Then, suddenly the Sixties spoke to women about their own experience. There was a spectacular protest at the Miss America beauty contest in New Jersey in 1968. There, a woman’s body was marked up as a cow ready for butchering, while a “freedom” trash can was ready for women to dump in bras and hair rollers, and pots and pans. It was the first hint that the way we personally felt about (and suffered) beauty, bodies and caring was a social issue. It looked like the world was changing. And when I published Fat Is A Feminist Issue, the message was taken to a wide audience through women’s magazines such as Woman’s Own, aimed mainly at working-class mothers.
Fat Is A Feminist Issue talked about our lived experience: how preoccupied we could become with eating, not eating and avoiding fat. Emotionally schooled to see our value as both sexual beings for others and midwives to their desires, we found ourselves often depleted and empty, and caught up in a kind of compulsive giving. Eating became our source of soothing. We stopped our mouths with food, and I proposed we could learn to exchange food – when we weren’t hungry – for words.
So far so good. Many of us started challenging the homogeneity of what constituted beauty. We stopped worrying and dared to live from our bodies. But we never saw the backlash coming, or the ingenious forms it would take, from the now rather innocent (“Because you’re worth it”) to the downright nefarious practices of industries that were growing rich on the making of body insecurity. And that was way before social media and the beauty bloggers with their, yes, millions of followers, would begin to reap money as daily beauty labour got instituted in a way that before then perhaps only a Hollywood makeup artist would recognise. Beauty work became relentless and, with it, the ubiquity of judgment and failure. Judgments and failures which, once internalised, destabilised girls’ relationship to their bodies and – as if that wasn’t enough – created an insecurity that hurt their minds.
The story of the past 40 years is grim. It’s a story of malice, of greed and of mendacity. Not content with destabilising the eating of many western women and exporting body hatred all over the world as a sign of modernity, the combined forces of what investigative health reporter Alicia Mundy so aptly termed “Obesity Inc” set about to create new so-called disease entities; these would medicalise and pathologise people’s relationship to food and bodies so successfully that vast industries would grow up to treat problems that these industries had themselves instigated.
In January we learned that one in three women in the UK won’t go for their smear tests. Why? Is it because they don’t know about them? No, they are invited by their doctors by text, email and letter. Why then? Because they feel so bad about their bodies.
This should alarm us. And yet sadly it doesn’t, because we know how ubiquitous bad body feeling is. It is constantly stoked by visual images which invade us, by pronouncements disguised as health directives, by blandishments to do, be, brand, mark ourselves in ways that reward not the human body as a place we dwell in but as an object to enhance the profits of the beauty, fashion, diet, cosmetic surgery, food and exercise industries, no matter one’s age.
So what has changed? Go back 20 years. The porn industry is being mainstreamed. Fashion magazines are normalising pornographic images of girls. Pre-teen girls with legs spread wide apart are looking to camera with a combination of allure, innocence and nonchalance. The girls who read them start going for Brazilian waxes. They don’t learn about labias and clitorises in school, they learn about how to put on a condom. Their genitals are not to be in view for themselves. And when they are in view, they are presented as inadequate and available for labiaplasty.
The search for ‘likes’ is an often desperate search for approval, for safety, for body acceptance
If we go back four years, we see the development of cosmetic surgery apps, games marketed to little girls in which they prepare for the surgery they will have when they are old enough. Already at six they will have been targeted with make-up and fashion and bras. Hourly vigilance is yet to come but the notion of a body ready and available for reconstruction is firmly planted. Indeed, many a girl will already have seen baby pictures of herself that have been digitally altered, so that the idea of “perfecting” and “fixing” becomes part of just what is. It is as normalised as the troubled eating she can expect in her journey through life.
By the time they become preteens, girls have been living on their smartphones. That is where life happens and the saturation of the screen with images and likes, with its constant entreaty to be approved of, should give us pause. Beauty labour has become part of girls’ and women’s lives and now that feminism is back on the agenda we can say, once again, part of our oppression. But, of course, it isn’t experienced like that. It is felt as the expression of personal agency, with the promise that looking good is doing good. But I know from the young women I work with that the search for likes is rather more troubling than that. It is an often desperate search for approval, for safety, for body acceptance – a frequently elusive quest.
If that young woman comes to parenting, frantic body preoccupation may have so invaded and insinuated itself into her that she will have schemes for managing food and managing appearance. Midwives and health professionals tell me they have noticed a dramatic change. Today pre- and postpartum mums can show considerable anxiety about their body self, so much so that the rhythm of early bonding is interrupted by rules and regulations, rather than the getting to know of one’s own body’s capacities and the wishes of the baby. For many, the parenting websites with their contradictory and commercially led “advice”, from recommendations for tummy tucks after your C-section to making a bespoke spreadsheet to track your feeding schedule, have turned postpartum into a straitjacket in which getting into pre-pregnancy jeans is the goal. And the anxiety the mothering person might well feel will be inadvertently transmitted to their baby, who will journey through life frightened of food and confused about their body self. A further tragedy.
This is then exacerbated by a rapacious food industry – from the diet promoters to the so-called clean eating movement to the manufacturers of non-food foods. The sole aim of the latter is to produce replicas masquerading as potato chips or cheese for children’s lunchboxes but whose chemical composition strives to stimulate their bliss point: the umami, sweet, crispy feel that means taste buds are stimulated rather than hunger addressed. Appetite, desire, is being undermined by the smells and tastes which beckon all day and yet often don’t deliver the nourishment we crave.
When you grow up absorbing the idea that food is quasi-dangerous, it is hard to know how to handle it. There are no end of experts selling their wares whose books and products end up generating enormous profits, and Weight Watchers’ newest push into the teen market has been criticised for potentially leading to teenagers becoming fixated on dieting. So, too, with other food and diet fads. The desperation that exists to be at peace and dwell in our bodies clashes with the knowledge that such schemas promote or reinforce confusion about appetite and desire. They don’t deliver peace. They deliver confusion. They deliver hurt.
If we weren’t continually assaulted by the merchants of body hatred, we would not be as vulnerable to the assaults
Another huge industry is the world fashion market, worth $ 2.4tn. The UK market alone is worth £26bn a year, with a £1,000 spend per inhabitant. I love clothes but how have we been persuaded to buy that much? The penetration of visual culture says how we look is so essential to our existence that we must spend, spend, spend. And that spend doesn’t include the cost of the clean-up from the fashion industry, the toxins in the water and the sweatshop conditions here and in China and Bangladesh. If the industry continues at its current rate, it will be using a staggering 26% of the carbon budget in 2050. I mention these statistics because it is sometimes possible to feel that when we are talking of bodies we aren’t engaging in serious economic and social issues, but we are. We are talking of large industries and excessive hours spent in persuading us to labour over transforming while attempting to live from our bodies.
It’s hard to get the figures that big pharma makes from products aimed at our bodily transformations. They guard them. But we do know that when they launch a diet drug, they spend a fortune marketing and defending it even when it doesn’t work or causes medical damage. I could go on. There is the cosmetic industry, the cosmetic surgery industry, the doll market, the role of internet beauty bloggers who have followers in their millions and of course the horror for youngsters of living online and being continually scrutinised. But I want us to think for a moment about #MeToo and Time’s Up, where we can see a line, not such a wiggly line, from pervasive bad body feeling to the compromising positions women have been put into in all the spaces where they work and love. If we weren’t continually assaulted by the merchants of body hatred, we would not be as vulnerable to the assaults. I’m not saying they wouldn’t happen; misogyny ensures that. But the shame, the hiding, the confusions that beset us would diminish and we would be stronger in our fightback and our fight to control our own bodies.
The body has become a political project. From rape as a weapon of war to the internal belief that we must be constantly wary about our appetites, to limiting ourselves individually and collectively because so much of our energy is misemployed, we have to act together to find ways through these minefields. The energy from #MeToo, with its reinvigoration of feminism, can help us say enough is enough. There’s just too much anguish, too much sorrow. We need more rage, more refusal and more love.
When I sat down to write Fat Is A Feminist Issue 40 years ago I never dreamed, or feared, it would still be in print today. I naively hoped my book would change the world. By analysing and suggesting solutions to body and eating problems, I imagined they would disappear. But in truth, of course, when I was writing about girls’ and women’s body and eating problems, I was writing about inequality, too. And inequality is stubborn. It didn’t look it in 1978, at the height of what we now call second wave feminism. Everything was up for being rethought – families, bodies, education, science, medicine, class, racism, money, sex.
When feminism first appeared, I hadn’t much understood it. At school, we were encouraged to compete with boys for Oxbridge places while soaking in knowledge which would, when the time came for marriage, delight and please our husbands. It seemed ever so dull. Then, suddenly the Sixties spoke to women about their own experience. There was a spectacular protest at the Miss America beauty contest in New Jersey in 1968. There, a woman’s body was marked up as a cow ready for butchering, while a “freedom” trash can was ready for women to dump in bras and hair rollers, and pots and pans. It was the first hint that the way we personally felt about (and suffered) beauty, bodies and caring was a social issue. It looked like the world was changing. And when I published Fat Is A Feminist Issue, the message was taken to a wide audience through women’s magazines such as Woman’s Own, aimed mainly at working-class mothers.
Fat Is A Feminist Issue talked about our lived experience: how preoccupied we could become with eating, not eating and avoiding fat. Emotionally schooled to see our value as both sexual beings for others and midwives to their desires, we found ourselves often depleted and empty, and caught up in a kind of compulsive giving. Eating became our source of soothing. We stopped our mouths with food, and I proposed we could learn to exchange food – when we weren’t hungry – for words.
So far so good. Many of us started challenging the homogeneity of what constituted beauty. We stopped worrying and dared to live from our bodies. But we never saw the backlash coming, or the ingenious forms it would take, from the now rather innocent (“Because you’re worth it”) to the downright nefarious practices of industries that were growing rich on the making of body insecurity. And that was way before social media and the beauty bloggers with their, yes, millions of followers, would begin to reap money as daily beauty labour got instituted in a way that before then perhaps only a Hollywood makeup artist would recognise. Beauty work became relentless and, with it, the ubiquity of judgment and failure. Judgments and failures which, once internalised, destabilised girls’ relationship to their bodies and – as if that wasn’t enough – created an insecurity that hurt their minds.
The story of the past 40 years is grim. It’s a story of malice, of greed and of mendacity. Not content with destabilising the eating of many western women and exporting body hatred all over the world as a sign of modernity, the combined forces of what investigative health reporter Alicia Mundy so aptly termed “Obesity Inc” set about to create new so-called disease entities; these would medicalise and pathologise people’s relationship to food and bodies so successfully that vast industries would grow up to treat problems that these industries had themselves instigated.
In January we learned that one in three women in the UK won’t go for their smear tests. Why? Is it because they don’t know about them? No, they are invited by their doctors by text, email and letter. Why then? Because they feel so bad about their bodies.
This should alarm us. And yet sadly it doesn’t, because we know how ubiquitous bad body feeling is. It is constantly stoked by visual images which invade us, by pronouncements disguised as health directives, by blandishments to do, be, brand, mark ourselves in ways that reward not the human body as a place we dwell in but as an object to enhance the profits of the beauty, fashion, diet, cosmetic surgery, food and exercise industries, no matter one’s age.
So what has changed? Go back 20 years. The porn industry is being mainstreamed. Fashion magazines are normalising pornographic images of girls. Pre-teen girls with legs spread wide apart are looking to camera with a combination of allure, innocence and nonchalance. The girls who read them start going for Brazilian waxes. They don’t learn about labias and clitorises in school, they learn about how to put on a condom. Their genitals are not to be in view for themselves. And when they are in view, they are presented as inadequate and available for labiaplasty.
The search for ‘likes’ is an often desperate search for approval, for safety, for body acceptance
If we go back four years, we see the development of cosmetic surgery apps, games marketed to little girls in which they prepare for the surgery they will have when they are old enough. Already at six they will have been targeted with make-up and fashion and bras. Hourly vigilance is yet to come but the notion of a body ready and available for reconstruction is firmly planted. Indeed, many a girl will already have seen baby pictures of herself that have been digitally altered, so that the idea of “perfecting” and “fixing” becomes part of just what is. It is as normalised as the troubled eating she can expect in her journey through life.
By the time they become preteens, girls have been living on their smartphones. That is where life happens and the saturation of the screen with images and likes, with its constant entreaty to be approved of, should give us pause. Beauty labour has become part of girls’ and women’s lives and now that feminism is back on the agenda we can say, once again, part of our oppression. But, of course, it isn’t experienced like that. It is felt as the expression of personal agency, with the promise that looking good is doing good. But I know from the young women I work with that the search for likes is rather more troubling than that. It is an often desperate search for approval, for safety, for body acceptance – a frequently elusive quest.
If that young woman comes to parenting, frantic body preoccupation may have so invaded and insinuated itself into her that she will have schemes for managing food and managing appearance. Midwives and health professionals tell me they have noticed a dramatic change. Today pre- and postpartum mums can show considerable anxiety about their body self, so much so that the rhythm of early bonding is interrupted by rules and regulations, rather than the getting to know of one’s own body’s capacities and the wishes of the baby. For many, the parenting websites with their contradictory and commercially led “advice”, from recommendations for tummy tucks after your C-section to making a bespoke spreadsheet to track your feeding schedule, have turned postpartum into a straitjacket in which getting into pre-pregnancy jeans is the goal. And the anxiety the mothering person might well feel will be inadvertently transmitted to their baby, who will journey through life frightened of food and confused about their body self. A further tragedy.
This is then exacerbated by a rapacious food industry – from the diet promoters to the so-called clean eating movement to the manufacturers of non-food foods. The sole aim of the latter is to produce replicas masquerading as potato chips or cheese for children’s lunchboxes but whose chemical composition strives to stimulate their bliss point: the umami, sweet, crispy feel that means taste buds are stimulated rather than hunger addressed. Appetite, desire, is being undermined by the smells and tastes which beckon all day and yet often don’t deliver the nourishment we crave.
When you grow up absorbing the idea that food is quasi-dangerous, it is hard to know how to handle it. There are no end of experts selling their wares whose books and products end up generating enormous profits, and Weight Watchers’ newest push into the teen market has been criticised for potentially leading to teenagers becoming fixated on dieting. So, too, with other food and diet fads. The desperation that exists to be at peace and dwell in our bodies clashes with the knowledge that such schemas promote or reinforce confusion about appetite and desire. They don’t deliver peace. They deliver confusion. They deliver hurt.
If we weren’t continually assaulted by the merchants of body hatred, we would not be as vulnerable to the assaults
Another huge industry is the world fashion market, worth $ 2.4tn. The UK market alone is worth £26bn a year, with a £1,000 spend per inhabitant. I love clothes but how have we been persuaded to buy that much? The penetration of visual culture says how we look is so essential to our existence that we must spend, spend, spend. And that spend doesn’t include the cost of the clean-up from the fashion industry, the toxins in the water and the sweatshop conditions here and in China and Bangladesh. If the industry continues at its current rate, it will be using a staggering 26% of the carbon budget in 2050. I mention these statistics because it is sometimes possible to feel that when we are talking of bodies we aren’t engaging in serious economic and social issues, but we are. We are talking of large industries and excessive hours spent in persuading us to labour over transforming while attempting to live from our bodies.
It’s hard to get the figures that big pharma makes from products aimed at our bodily transformations. They guard them. But we do know that when they launch a diet drug, they spend a fortune marketing and defending it even when it doesn’t work or causes medical damage. I could go on. There is the cosmetic industry, the cosmetic surgery industry, the doll market, the role of internet beauty bloggers who have followers in their millions and of course the horror for youngsters of living online and being continually scrutinised. But I want us to think for a moment about #MeToo and Time’s Up, where we can see a line, not such a wiggly line, from pervasive bad body feeling to the compromising positions women have been put into in all the spaces where they work and love. If we weren’t continually assaulted by the merchants of body hatred, we would not be as vulnerable to the assaults. I’m not saying they wouldn’t happen; misogyny ensures that. But the shame, the hiding, the confusions that beset us would diminish and we would be stronger in our fightback and our fight to control our own bodies.
The body has become a political project. From rape as a weapon of war to the internal belief that we must be constantly wary about our appetites, to limiting ourselves individually and collectively because so much of our energy is misemployed, we have to act together to find ways through these minefields. The energy from #MeToo, with its reinvigoration of feminism, can help us say enough is enough. There’s just too much anguish, too much sorrow. We need more rage, more refusal and more love.
When I sat down to write Fat Is A Feminist Issue 40 years ago I never dreamed, or feared, it would still be in print today. I naively hoped my book would change the world. By analysing and suggesting solutions to body and eating problems, I imagined they would disappear. But in truth, of course, when I was writing about girls’ and women’s body and eating problems, I was writing about inequality, too. And inequality is stubborn. It didn’t look it in 1978, at the height of what we now call second wave feminism. Everything was up for being rethought – families, bodies, education, science, medicine, class, racism, money, sex.
When feminism first appeared, I hadn’t much understood it. At school, we were encouraged to compete with boys for Oxbridge places while soaking in knowledge which would, when the time came for marriage, delight and please our husbands. It seemed ever so dull. Then, suddenly the Sixties spoke to women about their own experience. There was a spectacular protest at the Miss America beauty contest in New Jersey in 1968. There, a woman’s body was marked up as a cow ready for butchering, while a “freedom” trash can was ready for women to dump in bras and hair rollers, and pots and pans. It was the first hint that the way we personally felt about (and suffered) beauty, bodies and caring was a social issue. It looked like the world was changing. And when I published Fat Is A Feminist Issue, the message was taken to a wide audience through women’s magazines such as Woman’s Own, aimed mainly at working-class mothers.
Fat Is A Feminist Issue talked about our lived experience: how preoccupied we could become with eating, not eating and avoiding fat. Emotionally schooled to see our value as both sexual beings for others and midwives to their desires, we found ourselves often depleted and empty, and caught up in a kind of compulsive giving. Eating became our source of soothing. We stopped our mouths with food, and I proposed we could learn to exchange food – when we weren’t hungry – for words.
So far so good. Many of us started challenging the homogeneity of what constituted beauty. We stopped worrying and dared to live from our bodies. But we never saw the backlash coming, or the ingenious forms it would take, from the now rather innocent (“Because you’re worth it”) to the downright nefarious practices of industries that were growing rich on the making of body insecurity. And that was way before social media and the beauty bloggers with their, yes, millions of followers, would begin to reap money as daily beauty labour got instituted in a way that before then perhaps only a Hollywood makeup artist would recognise. Beauty work became relentless and, with it, the ubiquity of judgment and failure. Judgments and failures which, once internalised, destabilised girls’ relationship to their bodies and – as if that wasn’t enough – created an insecurity that hurt their minds.
The story of the past 40 years is grim. It’s a story of malice, of greed and of mendacity. Not content with destabilising the eating of many western women and exporting body hatred all over the world as a sign of modernity, the combined forces of what investigative health reporter Alicia Mundy so aptly termed “Obesity Inc” set about to create new so-called disease entities; these would medicalise and pathologise people’s relationship to food and bodies so successfully that vast industries would grow up to treat problems that these industries had themselves instigated.
In January we learned that one in three women in the UK won’t go for their smear tests. Why? Is it because they don’t know about them? No, they are invited by their doctors by text, email and letter. Why then? Because they feel so bad about their bodies.
This should alarm us. And yet sadly it doesn’t, because we know how ubiquitous bad body feeling is. It is constantly stoked by visual images which invade us, by pronouncements disguised as health directives, by blandishments to do, be, brand, mark ourselves in ways that reward not the human body as a place we dwell in but as an object to enhance the profits of the beauty, fashion, diet, cosmetic surgery, food and exercise industries, no matter one’s age.
So what has changed? Go back 20 years. The porn industry is being mainstreamed. Fashion magazines are normalising pornographic images of girls. Pre-teen girls with legs spread wide apart are looking to camera with a combination of allure, innocence and nonchalance. The girls who read them start going for Brazilian waxes. They don’t learn about labias and clitorises in school, they learn about how to put on a condom. Their genitals are not to be in view for themselves. And when they are in view, they are presented as inadequate and available for labiaplasty.
The search for ‘likes’ is an often desperate search for approval, for safety, for body acceptance
If we go back four years, we see the development of cosmetic surgery apps, games marketed to little girls in which they prepare for the surgery they will have when they are old enough. Already at six they will have been targeted with make-up and fashion and bras. Hourly vigilance is yet to come but the notion of a body ready and available for reconstruction is firmly planted. Indeed, many a girl will already have seen baby pictures of herself that have been digitally altered, so that the idea of “perfecting” and “fixing” becomes part of just what is. It is as normalised as the troubled eating she can expect in her journey through life.
By the time they become preteens, girls have been living on their smartphones. That is where life happens and the saturation of the screen with images and likes, with its constant entreaty to be approved of, should give us pause. Beauty labour has become part of girls’ and women’s lives and now that feminism is back on the agenda we can say, once again, part of our oppression. But, of course, it isn’t experienced like that. It is felt as the expression of personal agency, with the promise that looking good is doing good. But I know from the young women I work with that the search for likes is rather more troubling than that. It is an often desperate search for approval, for safety, for body acceptance – a frequently elusive quest.
If that young woman comes to parenting, frantic body preoccupation may have so invaded and insinuated itself into her that she will have schemes for managing food and managing appearance. Midwives and health professionals tell me they have noticed a dramatic change. Today pre- and postpartum mums can show considerable anxiety about their body self, so much so that the rhythm of early bonding is interrupted by rules and regulations, rather than the getting to know of one’s own body’s capacities and the wishes of the baby. For many, the parenting websites with their contradictory and commercially led “advice”, from recommendations for tummy tucks after your C-section to making a bespoke spreadsheet to track your feeding schedule, have turned postpartum into a straitjacket in which getting into pre-pregnancy jeans is the goal. And the anxiety the mothering person might well feel will be inadvertently transmitted to their baby, who will journey through life frightened of food and confused about their body self. A further tragedy.
This is then exacerbated by a rapacious food industry – from the diet promoters to the so-called clean eating movement to the manufacturers of non-food foods. The sole aim of the latter is to produce replicas masquerading as potato chips or cheese for children’s lunchboxes but whose chemical composition strives to stimulate their bliss point: the umami, sweet, crispy feel that means taste buds are stimulated rather than hunger addressed. Appetite, desire, is being undermined by the smells and tastes which beckon all day and yet often don’t deliver the nourishment we crave.
When you grow up absorbing the idea that food is quasi-dangerous, it is hard to know how to handle it. There are no end of experts selling their wares whose books and products end up generating enormous profits, and Weight Watchers’ newest push into the teen market has been criticised for potentially leading to teenagers becoming fixated on dieting. So, too, with other food and diet fads. The desperation that exists to be at peace and dwell in our bodies clashes with the knowledge that such schemas promote or reinforce confusion about appetite and desire. They don’t deliver peace. They deliver confusion. They deliver hurt.
If we weren’t continually assaulted by the merchants of body hatred, we would not be as vulnerable to the assaults
Another huge industry is the world fashion market, worth $ 2.4tn. The UK market alone is worth £26bn a year, with a £1,000 spend per inhabitant. I love clothes but how have we been persuaded to buy that much? The penetration of visual culture says how we look is so essential to our existence that we must spend, spend, spend. And that spend doesn’t include the cost of the clean-up from the fashion industry, the toxins in the water and the sweatshop conditions here and in China and Bangladesh. If the industry continues at its current rate, it will be using a staggering 26% of the carbon budget in 2050. I mention these statistics because it is sometimes possible to feel that when we are talking of bodies we aren’t engaging in serious economic and social issues, but we are. We are talking of large industries and excessive hours spent in persuading us to labour over transforming while attempting to live from our bodies.
It’s hard to get the figures that big pharma makes from products aimed at our bodily transformations. They guard them. But we do know that when they launch a diet drug, they spend a fortune marketing and defending it even when it doesn’t work or causes medical damage. I could go on. There is the cosmetic industry, the cosmetic surgery industry, the doll market, the role of internet beauty bloggers who have followers in their millions and of course the horror for youngsters of living online and being continually scrutinised. But I want us to think for a moment about #MeToo and Time’s Up, where we can see a line, not such a wiggly line, from pervasive bad body feeling to the compromising positions women have been put into in all the spaces where they work and love. If we weren’t continually assaulted by the merchants of body hatred, we would not be as vulnerable to the assaults. I’m not saying they wouldn’t happen; misogyny ensures that. But the shame, the hiding, the confusions that beset us would diminish and we would be stronger in our fightback and our fight to control our own bodies.
The body has become a political project. From rape as a weapon of war to the internal belief that we must be constantly wary about our appetites, to limiting ourselves individually and collectively because so much of our energy is misemployed, we have to act together to find ways through these minefields. The energy from #MeToo, with its reinvigoration of feminism, can help us say enough is enough. There’s just too much anguish, too much sorrow. We need more rage, more refusal and more love.
When I sat down to write Fat Is A Feminist Issue 40 years ago I never dreamed, or feared, it would still be in print today. I naively hoped my book would change the world. By analysing and suggesting solutions to body and eating problems, I imagined they would disappear. But in truth, of course, when I was writing about girls’ and women’s body and eating problems, I was writing about inequality, too. And inequality is stubborn. It didn’t look it in 1978, at the height of what we now call second wave feminism. Everything was up for being rethought – families, bodies, education, science, medicine, class, racism, money, sex.
When feminism first appeared, I hadn’t much understood it. At school, we were encouraged to compete with boys for Oxbridge places while soaking in knowledge which would, when the time came for marriage, delight and please our husbands. It seemed ever so dull. Then, suddenly the Sixties spoke to women about their own experience. There was a spectacular protest at the Miss America beauty contest in New Jersey in 1968. There, a woman’s body was marked up as a cow ready for butchering, while a “freedom” trash can was ready for women to dump in bras and hair rollers, and pots and pans. It was the first hint that the way we personally felt about (and suffered) beauty, bodies and caring was a social issue. It looked like the world was changing. And when I published Fat Is A Feminist Issue, the message was taken to a wide audience through women’s magazines such as Woman’s Own, aimed mainly at working-class mothers.
Fat Is A Feminist Issue talked about our lived experience: how preoccupied we could become with eating, not eating and avoiding fat. Emotionally schooled to see our value as both sexual beings for others and midwives to their desires, we found ourselves often depleted and empty, and caught up in a kind of compulsive giving. Eating became our source of soothing. We stopped our mouths with food, and I proposed we could learn to exchange food – when we weren’t hungry – for words.
So far so good. Many of us started challenging the homogeneity of what constituted beauty. We stopped worrying and dared to live from our bodies. But we never saw the backlash coming, or the ingenious forms it would take, from the now rather innocent (“Because you’re worth it”) to the downright nefarious practices of industries that were growing rich on the making of body insecurity. And that was way before social media and the beauty bloggers with their, yes, millions of followers, would begin to reap money as daily beauty labour got instituted in a way that before then perhaps only a Hollywood makeup artist would recognise. Beauty work became relentless and, with it, the ubiquity of judgment and failure. Judgments and failures which, once internalised, destabilised girls’ relationship to their bodies and – as if that wasn’t enough – created an insecurity that hurt their minds.
The story of the past 40 years is grim. It’s a story of malice, of greed and of mendacity. Not content with destabilising the eating of many western women and exporting body hatred all over the world as a sign of modernity, the combined forces of what investigative health reporter Alicia Mundy so aptly termed “Obesity Inc” set about to create new so-called disease entities; these would medicalise and pathologise people’s relationship to food and bodies so successfully that vast industries would grow up to treat problems that these industries had themselves instigated.
In January we learned that one in three women in the UK won’t go for their smear tests. Why? Is it because they don’t know about them? No, they are invited by their doctors by text, email and letter. Why then? Because they feel so bad about their bodies.
This should alarm us. And yet sadly it doesn’t, because we know how ubiquitous bad body feeling is. It is constantly stoked by visual images which invade us, by pronouncements disguised as health directives, by blandishments to do, be, brand, mark ourselves in ways that reward not the human body as a place we dwell in but as an object to enhance the profits of the beauty, fashion, diet, cosmetic surgery, food and exercise industries, no matter one’s age.
So what has changed? Go back 20 years. The porn industry is being mainstreamed. Fashion magazines are normalising pornographic images of girls. Pre-teen girls with legs spread wide apart are looking to camera with a combination of allure, innocence and nonchalance. The girls who read them start going for Brazilian waxes. They don’t learn about labias and clitorises in school, they learn about how to put on a condom. Their genitals are not to be in view for themselves. And when they are in view, they are presented as inadequate and available for labiaplasty.
The search for ‘likes’ is an often desperate search for approval, for safety, for body acceptance
If we go back four years, we see the development of cosmetic surgery apps, games marketed to little girls in which they prepare for the surgery they will have when they are old enough. Already at six they will have been targeted with make-up and fashion and bras. Hourly vigilance is yet to come but the notion of a body ready and available for reconstruction is firmly planted. Indeed, many a girl will already have seen baby pictures of herself that have been digitally altered, so that the idea of “perfecting” and “fixing” becomes part of just what is. It is as normalised as the troubled eating she can expect in her journey through life.
By the time they become preteens, girls have been living on their smartphones. That is where life happens and the saturation of the screen with images and likes, with its constant entreaty to be approved of, should give us pause. Beauty labour has become part of girls’ and women’s lives and now that feminism is back on the agenda we can say, once again, part of our oppression. But, of course, it isn’t experienced like that. It is felt as the expression of personal agency, with the promise that looking good is doing good. But I know from the young women I work with that the search for likes is rather more troubling than that. It is an often desperate search for approval, for safety, for body acceptance – a frequently elusive quest.
If that young woman comes to parenting, frantic body preoccupation may have so invaded and insinuated itself into her that she will have schemes for managing food and managing appearance. Midwives and health professionals tell me they have noticed a dramatic change. Today pre- and postpartum mums can show considerable anxiety about their body self, so much so that the rhythm of early bonding is interrupted by rules and regulations, rather than the getting to know of one’s own body’s capacities and the wishes of the baby. For many, the parenting websites with their contradictory and commercially led “advice”, from recommendations for tummy tucks after your C-section to making a bespoke spreadsheet to track your feeding schedule, have turned postpartum into a straitjacket in which getting into pre-pregnancy jeans is the goal. And the anxiety the mothering person might well feel will be inadvertently transmitted to their baby, who will journey through life frightened of food and confused about their body self. A further tragedy.
This is then exacerbated by a rapacious food industry – from the diet promoters to the so-called clean eating movement to the manufacturers of non-food foods. The sole aim of the latter is to produce replicas masquerading as potato chips or cheese for children’s lunchboxes but whose chemical composition strives to stimulate their bliss point: the umami, sweet, crispy feel that means taste buds are stimulated rather than hunger addressed. Appetite, desire, is being undermined by the smells and tastes which beckon all day and yet often don’t deliver the nourishment we crave.
When you grow up absorbing the idea that food is quasi-dangerous, it is hard to know how to handle it. There are no end of experts selling their wares whose books and products end up generating enormous profits, and Weight Watchers’ newest push into the teen market has been criticised for potentially leading to teenagers becoming fixated on dieting. So, too, with other food and diet fads. The desperation that exists to be at peace and dwell in our bodies clashes with the knowledge that such schemas promote or reinforce confusion about appetite and desire. They don’t deliver peace. They deliver confusion. They deliver hurt.
If we weren’t continually assaulted by the merchants of body hatred, we would not be as vulnerable to the assaults
Another huge industry is the world fashion market, worth $ 2.4tn. The UK market alone is worth £26bn a year, with a £1,000 spend per inhabitant. I love clothes but how have we been persuaded to buy that much? The penetration of visual culture says how we look is so essential to our existence that we must spend, spend, spend. And that spend doesn’t include the cost of the clean-up from the fashion industry, the toxins in the water and the sweatshop conditions here and in China and Bangladesh. If the industry continues at its current rate, it will be using a staggering 26% of the carbon budget in 2050. I mention these statistics because it is sometimes possible to feel that when we are talking of bodies we aren’t engaging in serious economic and social issues, but we are. We are talking of large industries and excessive hours spent in persuading us to labour over transforming while attempting to live from our bodies.
It’s hard to get the figures that big pharma makes from products aimed at our bodily transformations. They guard them. But we do know that when they launch a diet drug, they spend a fortune marketing and defending it even when it doesn’t work or causes medical damage. I could go on. There is the cosmetic industry, the cosmetic surgery industry, the doll market, the role of internet beauty bloggers who have followers in their millions and of course the horror for youngsters of living online and being continually scrutinised. But I want us to think for a moment about #MeToo and Time’s Up, where we can see a line, not such a wiggly line, from pervasive bad body feeling to the compromising positions women have been put into in all the spaces where they work and love. If we weren’t continually assaulted by the merchants of body hatred, we would not be as vulnerable to the assaults. I’m not saying they wouldn’t happen; misogyny ensures that. But the shame, the hiding, the confusions that beset us would diminish and we would be stronger in our fightback and our fight to control our own bodies.
The body has become a political project. From rape as a weapon of war to the internal belief that we must be constantly wary about our appetites, to limiting ourselves individually and collectively because so much of our energy is misemployed, we have to act together to find ways through these minefields. The energy from #MeToo, with its reinvigoration of feminism, can help us say enough is enough. There’s just too much anguish, too much sorrow. We need more rage, more refusal and more love.
When I sat down to write Fat Is A Feminist Issue 40 years ago I never dreamed, or feared, it would still be in print today. I naively hoped my book would change the world. By analysing and suggesting solutions to body and eating problems, I imagined they would disappear. But in truth, of course, when I was writing about girls’ and women’s body and eating problems, I was writing about inequality, too. And inequality is stubborn. It didn’t look it in 1978, at the height of what we now call second wave feminism. Everything was up for being rethought – families, bodies, education, science, medicine, class, racism, money, sex.
When feminism first appeared, I hadn’t much understood it. At school, we were encouraged to compete with boys for Oxbridge places while soaking in knowledge which would, when the time came for marriage, delight and please our husbands. It seemed ever so dull. Then, suddenly the Sixties spoke to women about their own experience. There was a spectacular protest at the Miss America beauty contest in New Jersey in 1968. There, a woman’s body was marked up as a cow ready for butchering, while a “freedom” trash can was ready for women to dump in bras and hair rollers, and pots and pans. It was the first hint that the way we personally felt about (and suffered) beauty, bodies and caring was a social issue. It looked like the world was changing. And when I published Fat Is A Feminist Issue, the message was taken to a wide audience through women’s magazines such as Woman’s Own, aimed mainly at working-class mothers.
Fat Is A Feminist Issue talked about our lived experience: how preoccupied we could become with eating, not eating and avoiding fat. Emotionally schooled to see our value as both sexual beings for others and midwives to their desires, we found ourselves often depleted and empty, and caught up in a kind of compulsive giving. Eating became our source of soothing. We stopped our mouths with food, and I proposed we could learn to exchange food – when we weren’t hungry – for words.
So far so good. Many of us started challenging the homogeneity of what constituted beauty. We stopped worrying and dared to live from our bodies. But we never saw the backlash coming, or the ingenious forms it would take, from the now rather innocent (“Because you’re worth it”) to the downright nefarious practices of industries that were growing rich on the making of body insecurity. And that was way before social media and the beauty bloggers with their, yes, millions of followers, would begin to reap money as daily beauty labour got instituted in a way that before then perhaps only a Hollywood makeup artist would recognise. Beauty work became relentless and, with it, the ubiquity of judgment and failure. Judgments and failures which, once internalised, destabilised girls’ relationship to their bodies and – as if that wasn’t enough – created an insecurity that hurt their minds.
The story of the past 40 years is grim. It’s a story of malice, of greed and of mendacity. Not content with destabilising the eating of many western women and exporting body hatred all over the world as a sign of modernity, the combined forces of what investigative health reporter Alicia Mundy so aptly termed “Obesity Inc” set about to create new so-called disease entities; these would medicalise and pathologise people’s relationship to food and bodies so successfully that vast industries would grow up to treat problems that these industries had themselves instigated.
In January we learned that one in three women in the UK won’t go for their smear tests. Why? Is it because they don’t know about them? No, they are invited by their doctors by text, email and letter. Why then? Because they feel so bad about their bodies.
This should alarm us. And yet sadly it doesn’t, because we know how ubiquitous bad body feeling is. It is constantly stoked by visual images which invade us, by pronouncements disguised as health directives, by blandishments to do, be, brand, mark ourselves in ways that reward not the human body as a place we dwell in but as an object to enhance the profits of the beauty, fashion, diet, cosmetic surgery, food and exercise industries, no matter one’s age.
So what has changed? Go back 20 years. The porn industry is being mainstreamed. Fashion magazines are normalising pornographic images of girls. Pre-teen girls with legs spread wide apart are looking to camera with a combination of allure, innocence and nonchalance. The girls who read them start going for Brazilian waxes. They don’t learn about labias and clitorises in school, they learn about how to put on a condom. Their genitals are not to be in view for themselves. And when they are in view, they are presented as inadequate and available for labiaplasty.
The search for ‘likes’ is an often desperate search for approval, for safety, for body acceptance
If we go back four years, we see the development of cosmetic surgery apps, games marketed to little girls in which they prepare for the surgery they will have when they are old enough. Already at six they will have been targeted with make-up and fashion and bras. Hourly vigilance is yet to come but the notion of a body ready and available for reconstruction is firmly planted. Indeed, many a girl will already have seen baby pictures of herself that have been digitally altered, so that the idea of “perfecting” and “fixing” becomes part of just what is. It is as normalised as the troubled eating she can expect in her journey through life.
By the time they become preteens, girls have been living on their smartphones. That is where life happens and the saturation of the screen with images and likes, with its constant entreaty to be approved of, should give us pause. Beauty labour has become part of girls’ and women’s lives and now that feminism is back on the agenda we can say, once again, part of our oppression. But, of course, it isn’t experienced like that. It is felt as the expression of personal agency, with the promise that looking good is doing good. But I know from the young women I work with that the search for likes is rather more troubling than that. It is an often desperate search for approval, for safety, for body acceptance – a frequently elusive quest.
If that young woman comes to parenting, frantic body preoccupation may have so invaded and insinuated itself into her that she will have schemes for managing food and managing appearance. Midwives and health professionals tell me they have noticed a dramatic change. Today pre- and postpartum mums can show considerable anxiety about their body self, so much so that the rhythm of early bonding is interrupted by rules and regulations, rather than the getting to know of one’s own body’s capacities and the wishes of the baby. For many, the parenting websites with their contradictory and commercially led “advice”, from recommendations for tummy tucks after your C-section to making a bespoke spreadsheet to track your feeding schedule, have turned postpartum into a straitjacket in which getting into pre-pregnancy jeans is the goal. And the anxiety the mothering person might well feel will be inadvertently transmitted to their baby, who will journey through life frightened of food and confused about their body self. A further tragedy.
This is then exacerbated by a rapacious food industry – from the diet promoters to the so-called clean eating movement to the manufacturers of non-food foods. The sole aim of the latter is to produce replicas masquerading as potato chips or cheese for children’s lunchboxes but whose chemical composition strives to stimulate their bliss point: the umami, sweet, crispy feel that means taste buds are stimulated rather than hunger addressed. Appetite, desire, is being undermined by the smells and tastes which beckon all day and yet often don’t deliver the nourishment we crave.
When you grow up absorbing the idea that food is quasi-dangerous, it is hard to know how to handle it. There are no end of experts selling their wares whose books and products end up generating enormous profits, and Weight Watchers’ newest push into the teen market has been criticised for potentially leading to teenagers becoming fixated on dieting. So, too, with other food and diet fads. The desperation that exists to be at peace and dwell in our bodies clashes with the knowledge that such schemas promote or reinforce confusion about appetite and desire. They don’t deliver peace. They deliver confusion. They deliver hurt.
If we weren’t continually assaulted by the merchants of body hatred, we would not be as vulnerable to the assaults
Another huge industry is the world fashion market, worth $ 2.4tn. The UK market alone is worth £26bn a year, with a £1,000 spend per inhabitant. I love clothes but how have we been persuaded to buy that much? The penetration of visual culture says how we look is so essential to our existence that we must spend, spend, spend. And that spend doesn’t include the cost of the clean-up from the fashion industry, the toxins in the water and the sweatshop conditions here and in China and Bangladesh. If the industry continues at its current rate, it will be using a staggering 26% of the carbon budget in 2050. I mention these statistics because it is sometimes possible to feel that when we are talking of bodies we aren’t engaging in serious economic and social issues, but we are. We are talking of large industries and excessive hours spent in persuading us to labour over transforming while attempting to live from our bodies.
It’s hard to get the figures that big pharma makes from products aimed at our bodily transformations. They guard them. But we do know that when they launch a diet drug, they spend a fortune marketing and defending it even when it doesn’t work or causes medical damage. I could go on. There is the cosmetic industry, the cosmetic surgery industry, the doll market, the role of internet beauty bloggers who have followers in their millions and of course the horror for youngsters of living online and being continually scrutinised. But I want us to think for a moment about #MeToo and Time’s Up, where we can see a line, not such a wiggly line, from pervasive bad body feeling to the compromising positions women have been put into in all the spaces where they work and love. If we weren’t continually assaulted by the merchants of body hatred, we would not be as vulnerable to the assaults. I’m not saying they wouldn’t happen; misogyny ensures that. But the shame, the hiding, the confusions that beset us would diminish and we would be stronger in our fightback and our fight to control our own bodies.
The body has become a political project. From rape as a weapon of war to the internal belief that we must be constantly wary about our appetites, to limiting ourselves individually and collectively because so much of our energy is misemployed, we have to act together to find ways through these minefields. The energy from #MeToo, with its reinvigoration of feminism, can help us say enough is enough. There’s just too much anguish, too much sorrow. We need more rage, more refusal and more love.
The early days of the NHS were so exciting. We never had any doubt that it would work. I was in the first cohort of training nurses, in a hospital in Lincoln, just shy of 18 years old. In our first nine months, we weren’t allowed to do anything technical, but just made ourselves useful – we helped in the kitchen, passed things to the doctors, and studied in technical college at the same time. Then we went to PTS [preliminary training school], where we learned how to give bed baths, do dressings, take temperatures and make poultices. It was hard work, and we had to be in at 11pm at night. And remember there was nothing disposable back then – aprons, syringes, everything had to be boiled. And we never wore gloves, apart from in the theatre.
Nursing during the polio epidemic has never left me, really. I remember some of the nurses went home, they were so frightened by the isolation hospital. I had to nurse people in iron lungs, including a lovely little girl who was only six. She was a great fan of [the radio thriller] Dick Barton, and I remember the chap who played him coming to see her. Years later, I read she died, and found out she had been the youngest person to live in an iron lung. I think of the progress we’ve made with ventilators, and I see her.
To learn to cope as a nurse, you’ve got to have the ability to forget about yourself. You have to strengthen that ability to focus on the people you’re looking after. I still take that rule. If you dwelled on your own feelings, you’d be overcome.
There was so much money coming into the NHS in its early days. Before, hospitals had [separate] concertina screens, and now we had [fitted] curtains! Lincoln had a lot of industry back then, and we had a lot of men coming in with hot metal in their eyes from the furnaces. The best part of the job was the satisfaction you felt when you were on night shift, making the beds on one side of the ward, making the patients comfortable. That was lovely.
Evelyn Lamb photographed at her home in New Milton. Photograph: Antonio Olmos for the Observer
Lincoln had a student nurse committee quite early, and a hospital representative committee – I was on both, and that stood my work in good stead. Listening to those voices is so important. I left Lincoln after getting married and had three children, but picked up part-time district nursing around that. District nursing was always changing, with different managers having different ideas. We should look to that managerial level when we think about the NHS now. Managers need to think about how to make better use of the skills of their staff. Skills aren’t properly used, and when you’re using your skills, you enjoy your job.
Since retiring, I’ve carried on being a champion of the NHS. We don’t realise how fortunate we are to have it. Two years ago, I fell and fractured my femur. I had to be screwed together and everyone who looked after me was wonderful. To not have to worry when something like that happens, to be looked after properly, for everyone to be treated the same, is what it’s all about. Imagine having to find the money to get yourself an ambulance right there and then.
When I look back at my early days, I can relate to Call the Midwife very much. I can’t relate to Casualty or Holby City at all! It’s not the NHS that’s failed people. It’s certain people within it. But I loved nursing – I never wanted to do anything else.
My advice for anyone starting today would be to keep on learning and studying. All my life I worked for improved academic support for nurses – it makes such a difference. This sounds strange, but you’ve got to be a toucher too. You’ve got to be comfortable with putting your arm around a stranger. And you’ve got to like people. That’s the most important thing of all.
For several months, health workers have been battling to contain an Ebola outbreak in the Democratic Republic of the Congo. A total of 60 cases, 28 of them fatal, have been reported around the town of Mbandaka, though authorities say the outbreak is now under control.
Politicians, nevertheless, remain nervous. Thousands died in the West African Ebola outbreak of 2014 after the virus – which probably spread from infected animals, such as fruit bats – triggered widespread cases of severe, sometimes fatal, internal bleeding.
Ebola is one of a series of previously unknown diseases – others include Sars and Zika – that have recently appeared without warning and devastated communities, having jumped from animal populations to humans. HIV spread to humans from chimpanzees, for example.
And in future new killers will emerge as humans spread into previously inaccessible areas and come into contact with infected creatures, causing deadly new pandemics.
Chimpanzees have been linked to transmission of the Aids virus to humans. Photograph: David Greyo/Barcroft Media
Now a group of scientists believe they have solution. They have launched a remarkable new project which aims to spot the next pandemic virus. The international initiative is known as the Global Virome Project (GVP) and it aims to pinpoint the causes of fatal new diseases before they start to make people ill.
Advocates of the project say they will achieve this remarkable task by genetically characterising viruses found in wild animals – particularly those that have been major sources of viruses deadly to humans. By pinpointing viruses at greatest risk of infecting humans,, counter-measures, such as vaccines can be prepared.
“We are about to start initial work in China and Thailand by studying bats, rodents, primates and water birds there,” said Peter Daszak, of the EcoHealth Alliance, one of the main supporters of the project. “We aim to find out as yet unknown viruses that could infect men and women and so pinpoint ways to protect them.”
A pilot study, known as Predict and backed by the US Agency for International Development (USAID), has already pinpointed more than a thousand viruses in animals that have the potential to infect humans. The GVP will aim to boost that number significantly. Indeed, if it is to succeed fully in its task it will have improved on these figures by several orders of magnitude for it is thought there are around 1.6 million yet-to-be-discovered viral species living in animals. Finding out which could infect humans is a tremendous challenge that could take decades, though in the short term GVP scientists believe they could at least be able to identify them.
Much of that work will have to be done in the field. Sending samples back and forth from central facilities will not work on this scale. The GVP will therefore requirerequire extraordinary organisation – and a fair amount of funding – about $ 1.2bn. However, this represents value for money, Daszak insisted. Three out of four new or emerging infectious diseases are now spread to humans from other animals. Action to block these transmissions is urgently needed.
“The project is currently in an incubation phase and while its price may seem high, it is a fraction of the cost of just one major outbreak, like the West African Ebola epidemic,” said Daszak. Governments including those of the US, China and Thailand have given support and the aim is to raise further funds over coming years, he added.
Not every expert agrees with the project’s approach, however. In a paper in Nature this month, one group of researchers, led by Professor Edward Holmes, of Sydney University, claimed its hopes of carrying out meaningful prediction of new pandemics were misguided.
“There aren’t enough data on virus outbreaks for researchers to be able to accurately predict the next outbreak strain. Nor is there good enough understanding of what drives viruses to jump hosts, making it difficult to construct predictive models,” he said.
Holmes and his colleagues argue that even it were possible to identify which viruses are likely to emerge in humans, thousands of candidates could end up being identified, each with a low probability of causing an outbreak. Instead they propose that the screening of people who are already exhibiting symptoms of a disease would make a better avenue of approach to the problem – the best time to tackle an emerging disease.
“Once an emerging outbreak virus has been identified it needs to be analysed quickly to establish what type it is, which molecular mechanisms … enable it to jump between individuals … and how it affects those infected,” they state.
However, Eddy Rubin, chief scientist at the biotechnology company Metabiota, which is supporting the GVP, argued that only responding to a disease after an outbreak was no longer acceptable. “We make preparations against hurricanes and earthquakes. We need to do the same with diseases. We need to start to collect data and make predictions about where new outbreaks might occur,” he told the Observer.
“If we have information about tens of thousands of these viruses then we can use artificial intelligence to look for common features and so could make counter-measures and vaccines against whole categories of viruses. This could transform the way we deal with infectious diseases and viral outbreaks.”
For several months, health workers have been battling to contain an Ebola outbreak in the Democratic Republic of the Congo. A total of 60 cases, 28 of them fatal, have been reported around the town of Mbandaka, though authorities say the outbreak is now under control.
Politicians, nevertheless, remain nervous. Thousands died in the West African Ebola outbreak of 2014 after the virus – which probably spread from infected animals, such as fruit bats – triggered widespread cases of severe, sometimes fatal, internal bleeding.
Ebola is one of a series of previously unknown diseases – others include Sars and Zika – that have recently appeared without warning and devastated communities, having jumped from animal populations to humans. HIV spread to humans from chimpanzees, for example.
And in future new killers will emerge as humans spread into previously inaccessible areas and come into contact with infected creatures, causing deadly new pandemics.
Chimpanzees have been linked to transmission of the Aids virus to humans. Photograph: David Greyo/Barcroft Media
Now a group of scientists believe they have solution. They have launched a remarkable new project which aims to spot the next pandemic virus. The international initiative is known as the Global Virome Project (GVP) and it aims to pinpoint the causes of fatal new diseases before they start to make people ill.
Advocates of the project say they will achieve this remarkable task by genetically characterising viruses found in wild animals – particularly those that have been major sources of viruses deadly to humans. By pinpointing viruses at greatest risk of infecting humans,, counter-measures, such as vaccines can be prepared.
“We are about to start initial work in China and Thailand by studying bats, rodents, primates and water birds there,” said Peter Daszak, of the EcoHealth Alliance, one of the main supporters of the project. “We aim to find out as yet unknown viruses that could infect men and women and so pinpoint ways to protect them.”
A pilot study, known as Predict and backed by the US Agency for International Development (USAID), has already pinpointed more than a thousand viruses in animals that have the potential to infect humans. The GVP will aim to boost that number significantly. Indeed, if it is to succeed fully in its task it will have improved on these figures by several orders of magnitude for it is thought there are around 1.6 million yet-to-be-discovered viral species living in animals. Finding out which could infect humans is a tremendous challenge that could take decades, though in the short term GVP scientists believe they could at least be able to identify them.
Much of that work will have to be done in the field. Sending samples back and forth from central facilities will not work on this scale. The GVP will therefore requirerequire extraordinary organisation – and a fair amount of funding – about $ 1.2bn. However, this represents value for money, Daszak insisted. Three out of four new or emerging infectious diseases are now spread to humans from other animals. Action to block these transmissions is urgently needed.
“The project is currently in an incubation phase and while its price may seem high, it is a fraction of the cost of just one major outbreak, like the West African Ebola epidemic,” said Daszak. Governments including those of the US, China and Thailand have given support and the aim is to raise further funds over coming years, he added.
Not every expert agrees with the project’s approach, however. In a paper in Nature this month, one group of researchers, led by Professor Edward Holmes, of Sydney University, claimed its hopes of carrying out meaningful prediction of new pandemics were misguided.
“There aren’t enough data on virus outbreaks for researchers to be able to accurately predict the next outbreak strain. Nor is there good enough understanding of what drives viruses to jump hosts, making it difficult to construct predictive models,” he said.
Holmes and his colleagues argue that even it were possible to identify which viruses are likely to emerge in humans, thousands of candidates could end up being identified, each with a low probability of causing an outbreak. Instead they propose that the screening of people who are already exhibiting symptoms of a disease would make a better avenue of approach to the problem – the best time to tackle an emerging disease.
“Once an emerging outbreak virus has been identified it needs to be analysed quickly to establish what type it is, which molecular mechanisms … enable it to jump between individuals … and how it affects those infected,” they state.
However, Eddy Rubin, chief scientist at the biotechnology company Metabiota, which is supporting the GVP, argued that only responding to a disease after an outbreak was no longer acceptable. “We make preparations against hurricanes and earthquakes. We need to do the same with diseases. We need to start to collect data and make predictions about where new outbreaks might occur,” he told the Observer.
“If we have information about tens of thousands of these viruses then we can use artificial intelligence to look for common features and so could make counter-measures and vaccines against whole categories of viruses. This could transform the way we deal with infectious diseases and viral outbreaks.”
