Health and Social Care Needs of Chinese and Vietnamese People in Manchester
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Sheung Lok Well Being Centre
Report Authors: Louise Yuen Ming Wong (Community Development Worker) Stella Yim Shan Gradwell (Health and Social Care Team Leader)
Report Editor: Mark Greenwood (Health and Social Care Manager)
Wai Yin Society 66-68 Swan Street Manchester M4 5JU 0161 833 0377 [email protected] 1 January 2018 Contents:
1. Introduction
2. Recommendations for future action
3. Chinese communities in the UK and Manchester
4. Vietnamese Communities in the UK and Manchester
5. Brief Description and Findings of Research
Appendix 1: Brief description of Wai Yin Society
Appendix 2: Sheung Lok Older People’s Centre, Central Manchester: A place to be well. Précis of Doctoral Thesis 2016: Dr Naomi Wood
Appendix 3: Detailed Description of Research (July – November 2017)
Appendix 4: Case study: Radio Sheung Lok All FM
Appendix 5: References
2 January 2018 1. Introduction
In June 2017, NHS Manchester CCG commissioned Wai Yin Society to research the health and social care needs of the Chinese and Vietnamese communities in Manchester. This report is the result.
Two members of Wai Yin’s staff were charged with the research and writing of this report. Both staff members have worked for over 20 years for Wai Yin and consequently have a close and detailed experience of the Chinese communities in Manchester.
Both staff members recruited participants from Chinese service users of Wai Yin and Your (Tung Sing) Housing residents. One to one interview were carried out with 25 participants of whom 15 were Chinese and 10 Vietnamese. The detailed results and analyses are provided in Appendix 2
In 2016, Dr Naomi Woods completed her doctoral thesis which focused on the needs of Chinese older people in Manchester. She interviewed 40 participants in Sheung Lok centre. We have incorporated a précis of this work in Appendix 3
Over many years, both staff members have collaborated with research projects carried out with several academics from different universities. They have drawn a range of demographic, economic and social data from these sources. The full references have been included in Appendix 4.
Finally, we consulted Wai Yin staff and academic researchers to produce a series of recommendations for NHS Manchester CCG board to consider for future action.
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3 January 2018 2. Recommendations for Future Action
Continued funding for specialist health and social care agencies for the Chinese communities Manchester City Council and the CCGs (and previous health commissioners) have funded Wai Yin Society for many years, in recognition of the size and needs of the Chinese communities in Manchester. This needs to continue as the needs and nature of the communities are changing but still pressing.
Need to invest in Vietnamese support service There is no specialist support provision for the Vietnamese community in Manchester. We recognise that is will prove very difficult to establish such a service, even if funding was forthcoming. However, it would be possible to establish a partnership service between the Manchester CCGs, Wai Yin Society and the London based Vietnamese Mental Health Service. The latter was founded in 1989 and Wai Yin has co-operated with them on many projects and research over the years.
Funding for services across Greater Manchester Both the Chinese and Vietnamese communities are scattered across the Greater Manchester region. This reflects the migration and settlement patterns of previous generations. Although Manchester has a “Chinatown”, it is mainly a commercial centre and a leisure centre, not a residential area for the Chinese or Vietnamese community. Whilst most Chinese and Vietnamese people live in the city of Manchester, the communities as a whole are scattered all over the Greater Manchester conurbation. Given the current devolution of the Manchester health and social care agenda, we would recommend the funding of specialist services across the Greater Manchester area and not the exclusive funding at present from Manchester.
Our studies show that Chinese and Vietnamese participants come from multiple neighbourhood localities - such as Longsight, Levenshulme, City Centre, Cheeetham Hill, Ardwick, Harpuhey, Beswick etc. - to access culturally appropriate services like those at the Wai Yin Sheung Lok Centre. Thus a local neighbourhood approach is unsuitable for certain community identity groups such as Chinese and Vietnamese. A culturally sensitive approach needs to be considered by the Local Care Organisation.
Policies to tackle isolation and loneliness It is a stereotyped myth that the Chinese population “look after” their elders. As our research show, many older people experience isolation and loneliness just like all other communities. Manchester CCGs need to ensure that their strategic policies tackling isolation and loneliness also include the Chinese and Vietnamese communities.
4 January 2018 Invest in health and social care information dissemination through written and rural media The Chinese project Wai Yin Radio Sheung Lok at All FM is an award winning example of the disseminating health information to minority communities. Relatively small amounts of money, used imaginatively, can have a big impact in minority communities.
Invest in activities to help integration with non-Chinese services; e.g. theatre, dance, excursions outside Manchester Our research showed that isolation/loneliness among the Chinese and Vietnamese communities is exacerbated by non-integration in the wider Manchester /UK society. Small scale activities; e.g. trips to museums, theatres or outside Manchester can have a hugely beneficial impact on well-being and health.
Training for health and social care staff on the community profiles and needs of the Chinese and Vietnamese communities Whilst knowledge and understanding among health and social care staff have improved over the last twenty years, it is an on-going, never ending project to ensure that cultural awareness is continually raised at all levels. We can cite many examples of problems that have occurred because of the lack of awareness/understanding probably of all BME communities.
Increase research collaboration between Manchester and Salford Universities and Chinese Universities and Chinese NGO involved in health and social care service. Wai Yin has developed many research partnerships within UK and China/Hong Kong universities. Given the economic importance of the Universities for Manchester and Greater Manchester, we would recommend that Manchester CCGs involve and invest in future research in these areas.
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5 January 2018 3. The Chinese Communities in Manchester and the UK
The 2011 census recorded 430,000 ethnic-Chinese in Britain. 6,721 people born in China were living in Manchester in 2011 (1.3% of the city’s population).
There are 28,000 people born in Vietnam living in the UK. 2,500 people born in Vietnam live in Manchester. These figures underestimate the Chinese and Vietnamese population as there are/were considerable barriers to registering for the 2011 Census return; these include language barriers and a cultural suspicion of officials and authority.
It should be noted that there are several Chinese communities in the UK, so inevitably there are variations in culture and languages. The largest population originate from Hong Kong and speak Cantonese or Hakka. The vast majority of Cantonese speaking Chinese settled in England between 1960 and 1980s, and many of them worked long hours in takeaway or restaurant businesses. They aspired to educate their children to university level to fulfil and replace something that they could not achieve in the past. Moreover, many of them take pride in the fact that they can sell up their businesses and retire early.
It is culturally important that they are seen to be successful, and hence able to retire early. However, our research has revealed significant problems when people retire early. They have a lot of energy which they often dissipate in socially unproductive ways such as gambling, or endless cruises. Although they are very active, they are virtually unemployable since they have rarely worked outside the “Chinese” economy and less likely to have the opportunities to retrain or to develop new work patterns. This is more likely lead to increasing isolation and increasing anxiety about inadequate resources for old age.
Despite living in the UK for over 40 years, the majority do not speak English, and hence face barriers to accessing health and social care services. This is the group that the Sheung Lok Centre in Brunswick (run by Wai Yin) supports.
However, since restrictions on foreign travel and emigration were lifted in 1992 in the People’s Republic of China, the Mandarin speaking Chinese communities have grown and prospered in the UK, and now constitute the second largest Chinese community here. Many came over as students and have subsequently settled as professionals and in businesses. They tend to have separate religious and cultural organisations from the older pre-existing Cantonese communities which sometimes cause problems as there is a lack of mutual organisation and communication across these communities.
We must also highlight the population of Chinese students at Manchester. In the UK, the number of Chinese students far exceeds any other nationality at 91,215. There are an estimated 7,000 students attending the three Universities in Manchester and Salford. The staffs at Wai Yin are frequently asked to help the
6 January 2018 universities’ student counselling services when emotional and psychological problems arise with Chinese students.
There are also smaller Chinese communities from countries such as Malaysia and Indonesia. Although they have their own local Chinese languages such as Hokien, most speak Mandarin, Cantonese and English.
The majority of Chinese are now British born and are descended from people who were themselves overseas Chinese when they came to Britain. Most are from former British colonies, such as Hong Kong, Malaysia, Singapore, Canada, Australia, New Zealand and Mauritius.
Chinese communities are found in many major cities including London, Birmingham, Glasgow, Manchester, Liverpool, Newcastle, Edinburgh, Cardiff, Sheffield, Nottingham, Belfast, and Aberdeen.
The population figure of 247,403 (approximately 0.5% of the UK population and around 5% of the total non-white population in the UK), cited from figures produced by the UK's Office for National Statistics (ONS), is based on the 2011 national census. 33% of the Chinese in Britain live in London, 13.6% in the South East, 11.1% in the North West. Birthplace: 29% in Hong Kong, 25% England, 19% Mainland China, 8% Malaysia, 4% Vietnam, 3% Singapore, 2.4% Scotland, 2% Taiwan, 0.9% Wales, 0.1% Northern Ireland.
Religious affiliation Population % 2001 Population % 2011
Not religious 52% 55.6%
Christianity 25.1% 19.6%
Buddhism 15.1% 12.6%
Other 7.8% 12.2%
It should be noted that in the United Kingdom, "Asian demographics" and "Chinese demographics" are separate. In British usage, the word "Asian" or "British Asian" when describing people usually refers to those from South Asia (India, Pakistan, Bangladesh, Sri Lanka, Nepal, Maldives, etc.).
Therefore, the actual figure is estimated at closer to over 600,000 according to interviews referred to in an article by the Economist 11 March 2017.
7 January 2018 4. Vietnamese Communities in the UK and Manchester
There are 28,000 people born in Vietnam living in the UK. 2,500 people born in Vietnam live in Manchester.
Vietnamese immigration to the United Kingdom started after the end of the Vietnam War in 1975, with the UK accepting refugees from Hong Kong, its colony at the time. Most early immigrants were refugee boat people fleeing persecution by the communists and were of Chinese ethnicity. There are in effect two Vietnamese communities; Vietnamese Chinese speaking and the Vietnamese.
There is a historic hostility between the communities (much diminished now) but this would explain why it is difficult for a Chinese organisation to work with the Vietnamese. Later, the rest were students, academics or business people.
Vietnamese refugees initially found it fairly difficult to settle into a British lifestyle. Because the Vietnamese community in the United Kingdom was then small, the new wave of immigrants found it much harder to integrate into their host country compared to immigrants in Australia or France or the United States, where the Vietnamese communities were much larger.
The early government policy of spreading newcomers thinly compounded matters by depriving them of vital mutual support. Many began gravitating towards larger cities such as London. However, the existence of much larger and more established overseas Chinese communities in the UK has had a significant though perhaps underreported effect in helping the new immigrants setting roots in their new country.
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8 January 2018 Appendix 1
Wai Yin Society
Wai Yin Society has been supporting, empowering and working in partnership with Chinese individuals and families since it was founded in 1988 by a group of community-minded Chinese women, Wai Yin has become one of the largest Chinese community centres in the UK, sustaining its operations through commissions and contracts with mainstream organisations.
As the society has grown, we have developed a range of employment, education and community services for Chinese men and women and for other ethnic minority groups, including Somali, Pakistani, Bangladeshi, Indian and many European nationalities.
In 2013, Wai Yin changed its name from Wai Yin Chinese Women Society to Wai Yin Society to reflect that we now reach out to many other minority communities, not just the Chinese community. We have always kept the needs of the Chinese community at our heart, and we will continue to be an organisation led by Chinese women, but we cannot ignore the needs of other ethnic minority groups in Manchester. By removing the words “Chinese Women” from our name, we want to show how inclusive we are to all of Manchester’s vibrant communities and how we have grown from our humble beginnings as a small network of Chinese women.
The Society aims to challenge all forms of discrimination and social exclusion through the provision of diverse and reactive services, delivered by a team of qualified social workers, nurses and other professionals.
The Society values equality, diversity and mutual respect. We are deeply committed to extending the reach of our services to all members of the community and many of the people who use our centre are non-Chinese. We are proud of being British and Chinese and we promote the positive expression of culture by working in partnership with BAME community groups
9 January 2018 Appendix 2
Sheung Lok Older People’s Centre, central Manchester: A place to be well. Dr Naomi Wood
Introduction
This report comes from my doctoral research study undertaken at Sheung Lok Older People’s Centre in central Manchester, between 2012 and 2016. The focus of the research study was on the relationship between health and place, in the context of migration. The research study was undertaken through regularly attending the centre and taking part in activities alongside the centre members. The following section gives a brief overview of Sheung Lok Older People’s Centre, and of Wai Yin Society, the organisation that it is part of. The remainder of the report then briefly discusses the key findings of the study; that more than being just a place to meet and socialise, the centre is a place in which its members provide an important source of care for each other and themselves.
Sheung Lok Older People’s Centre: a brief overview
Sheung Lok Older People’s Centre is part of the Wai Yin Society, which was set up in the late 1980s in order to offer support to Chinese women and their families in the North West of England. Wai Yin’s objectives are focussed on fostering wellbeing, building a positive identity, strengthening community support, and facilitating access to resources and information. It offers a wide range of services to its members, including (but not limited to): English and Chinese language classes, citizenship classes, youth work and family support projects, various services to support elderly people, Macmillan Cancer support, and mental health support.
As part of Wai Yin, Sheung Lok Older People’s Centre provides support to older and elderly Chinese people, with membership open to anyone over the age of 55. It provides a place in which elderly Chinese people can meet together to share food, take part in various activities, and access a range of health and social support services. One of its key aims is to promote physical and mental health through enabling its members to be physically active and socially engaged. It hosts a lunch club and various activity groups throughout the week, including Tai Chi, line dancing, table tennis, calligraphy, and mah jong. The centre provides a transport service to collect members who are unable to come to the centre on their own and to take them home after lunch, as well as home visits and delivery of meals to those who are unable to attend the centre. The centre also provides other services such as podiatry, eye tests, hair dressing, and help with filling in forms, reading and replying to letters, making phone calls, and translation and interpreting services.
10 January 2018 The majority of the centre members are retired and range in age from late 50s through to 70s and 80s. They are predominantly Chinese migrants from Hong Kong, China and Vietnam. Many came to the UK in the 1970s and 1980s and have now spent the larger part of their lives living in the UK.
Outcomes of the research: what makes Sheung Lok Older People’s Centre special?
The key outcome from this study is that the centre is much more than just a place for people to meet and socialise together. The participants in the study used the centre as a place in which to care for each other, and through this for themselves.
The study focussed in particular on the Tai Chi group, the Calligraphy group and the sharing of food through the communal lunch. All of these provided opportunities to engage in socially and culturally familiar activities that helped to establish and maintain an important connection with the centre members’ early lives outside the UK. As well as being familiar activities, the way in which the centre members participated in those activities was also important. For example, the relationship between Master and student in the Tai Chi group, the discipline of learning in a particular way in the group, the rituals of eating together and sharing food, and the memories and reminiscence evoked through practicing Chinese calligraphy. These activities and the ways in which the centre members engaged with one another through them helped to build a strong sense of identity and community within the centre. The benefit of this is threefold; in fostering friendship and support among the centre members; in building and maintaining a strong cultural identity; and the importance of both of these for maintaining health and wellbeing.
Part of the research study was to collect the migration stories of the centre members. These also played an important part in understanding the way that they used the centre. All of those who participated in the study were migrants from China, Hong Kong and Vietnam, and all came to the UK in the 1970s and 1980s. All had experienced living in two (and in some cases, more) very different countries, and had gone through the hardships and difficulties of rebuilding their lives in a completely new place. Most now have children and grandchildren in the UK, or outside their country of origin. There was a shared understanding of their experiences of migration, of rebuilding their lives in the UK, and of the changes to family life as their families grow and expand. Being able to reconnect with their early lives outside the UK, through participating in the community centre was an important part of the sense of community at the centre. This is a sense of community that is built around its members’ identity; as older and elderly people, as Chinese people, and as migrants.
This strong sense of community creates a place in which the elderly Chinese community are able to take care of each other and themselves. This is achieved
11 January 2018 through participation in socially and culturally familiar activities; but also, and importantly, through participating in those together in ways that are also familiar. Underlying this is the implicit understanding of their shared experiences of migration and rebuilding their lives in the UK. All of this creates a place in which its members can be well - in the broadest sense of the term.
In summary:
In terms of the relevance for this submission, there are significant lessons to be learnt from Sheung Lok Older People’s centre, both in terms of supporting elderly people, but also other minority and migrant groups in the city. The centre provides a place in which elderly people in the Chinese community are valued and cared for. However, it also provides a place in which their experiences of migration and all the changes that come with it are understood and shared, and in which their identity - a blend of both Chinese and English as they have built their lives in Manchester over many years - is celebrated and maintained in a way that is also important for their health and wellbeing.
Informed consent was gained from each participant. Their identity was protected and treated strictly confidential, each participant was given a code which it was only identified by the researcher who did the data analysis. All interviews were audio-tape recording and transcribed into a written format. All personal details were removed during data transcription so identification cannot be made and data was anonymised before analysis.
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12 January 2018 Appendix 3
Detailed Research September – November 2017
Data Collection The research team recruit participants from Wai Yin service users and Yours Housing residents. One to one interview was carried out on 25 participants, 15 Chinese and 10 Vietnamese participants. Informed consent was gained from each participant. Their identity was protected and treated strictly confidential, each participant was given a code which it was only identified by the researcher who did the data analysis. All interviews were audio-tape recording and transcribed into a written format. All personal details were removed during data transcription so identification cannot be made and data was anonymised before analysis.
60% of the participants were interviewed at Wai Yin Centres - 8 (32%) at Sheung Lok Centre and 7 (28%) at Wai Yin Head Quarters ; 6 (24%) of the interviews were taken place at participants’ own home; 4 (16%) used telephone interview. (See Chart 1)
24 interviews were carried out in Cantonese, 1 interview was conducted in Vietnamese with language support by a Vietnamese interpreter.
Chart 1: Methods of Data Collection
16% 32% Sheung Lok
24% HQ
Home Visit
Telephone 28%
13 January 2018 RESULTS
Section 1: Profile of the respondents A total of 25 participants took part in this research project, 15 Chinese and 10 Vietnamese
1.1 Gender
Among the 15 are Chinese participants 5 are male and 10 are female. (see Chart 1.1); and among Vietnamese participants, 3 are male and 7 are female (see Chart 1.1a and 1.1b)
Chart 1.1b Vietnamese Chart 1.1a Chinese Participants Participants Gender Gender
3 Male 5 30% 33% Female 7 10 67% 70% Male Female
1.2 Age Range
Participants were asked their last birthday.
Chinese participant age range is between 24 and 78;
1 (7%) aged under 25 years old
3 (20%) aged between 26-39 years old
4 (27%) aged between 40-54 years old
2 (13%) aged between 55-64 years old
1 (7%) aged between 65-74 years old
4 (27%) aged over 75
Vietnamese participants’ age range is between 42 and 80,
3 (30%) aged 40-54 years old
2 (20%) aged 55-64 years old
5 (50%) aged over 75 years old (see Chart 1.2)
14 January 2018 Chart 1.2 Age Range 6
5
4
3 Chinese Vietnamese 2
1
0 under 25 26-39 40-54 55-64 65-74 over 75
1.3 Country of Origin
Chinese participants
4 (27%) were born in Hong Kong.
8 (53%) were born in mainland China
1 (7%) were born in Malaysia
1 (7%) were born in Macau
1 (7%) were born in England (see Chart 1.3)
All 10 Vietnamese participants were born in Vietnam
Chart 1.3 Country of Origin
7% 7% 7% China
Hong Kong 53% UK 27% Macao
Malaysia
15 January 2018 1.4: The length of stay in the UK
Chinese participants
3 (20%) stay in the U.K. under 5 years
1 (7%) between 5-9 years
2 (13%) 10-19 years
5 (33%) between 20-29
1 (7%) between 30-39 and
3 (20%) over 40 years
Vietnamese participants
1 (10%) 10-19 years
2 (20%) between 20-29
6 (60%) between 30-39 and
1 (10%) over 40 years (see Chart 1.4)
Chart 1.4: Length of Stay in the U.K.
6
5
4 Chinese 3 Vietnamese 2
1
0 Under 5 5-9 10-19 20-29 30-39 Over 40
16 January 2018 1.5 Language
1.5.1 Language speak at home
Chinese participant’s language speaks at home:
13(87%) speak Cantonese
1 (7%) speak Mandarin
2 (13%) speak Hakka
Some Vietnamese participants speak more than one language at home
6(60%) speak Cantonese at home
1(10%) speak Mandarin
6(60%) speak Vietnamese (see Chart 1.5.1)
Chart1.5.1 Language Speaks at Home
14 12 10 8 Chinese 6 Vietnamese 4 2 0 Canontese Mandarin Vietnamese Hakka
1.5.2 Language use for communication
Chinese participants
All 15 (100%) of Chinese participants speak Cantonese
6(40%) speak Mandarin
8 (53%) speak English, however, among these 8 participants 3 of them only speak simple English
2 (13%) speak Hakka
17 January 2018 Vietnamese participants
All 10 (100%) of Vietnamese participants speak Vietnamese; they also speak other language at home:
9 (90%) speaks Cantonese
4 (40%) speak Mandarin
3 (30%) speak simple English (see Chart 1.5.2)
Chart 1.5.2 Language use for communication 100% 100% 100% 90%
80% 53% 60% Chinese 40% 40% 40% 30% Vietnamese 13% 20%
0% Cantonese Mandarin English Vietnamese Hakka
Session 2 Connect with People
2.1 Participants were asked about whether or not they could get out and about as much as they want.
14 (56%) of the total 25 participants said that they can get out and about as much as they want. Among them 9 Chinese and 5 Vietnamese
(See Chart 2.1a; and Chart 2.1b)
Chart 2.1a Participants are able to get out and about
36%
Chinese 64% Vietnamese
18 January 2018 Among 14 participants
9 (60%) Chinese participants (5 male and 4 female) and
5 (50%) of Vietnamese participants (2 male and 3 female) state that they were able to get out and about with some restriction and need some kind of support for doing so (see Chart 2.2)
Chart 2.1b Connect with people
70% 60% 60% 50% 50% 40% 50% Chinese 40% Vietnamese 30% 20% 10% 0% Able to go out and about Unable to go out and about
2.2 Factors affect participants going out and about
2.2.1 Factors support participants going out
Chinese participants
All 9 Chinese participants expressed that somehow they need company to go out with them especially consultation with health professionals or attended hospital appointments.
3 said that they could go out and about only when transport was available.
1 said they would use mobile phone to help time.
1 said that this could happen only when they felt well enough to go out.
Vietnamese participants
Among the 5 Vietnamese participants 4 stated that they need company, but 2 of them unable to find anyone; and 1 said they need available public transport (see Chart 2.2a).
19 January 2018 Chart 2.2 Factors support participants going out 14 12 4 10 8 6 Vietnamese 4 9 Chinese 2 1 2 0 1 1 1 Need Transport Feeling well Use mobile Obtain company information
2.2.2 Factors hinder participants going out and about
For those who expressed that they were not able to go out and about as much as they want.
2 Chinese participants were carers, they contributed most of their time to look after their love one, and expressed that they could not find any spare time for themselves.
5 participants (4 Chinese and 1 Vietnamese) were due to health problems, either physically they were not capable to walk a far distance or mentally they felt a lack of motivation to get out the house.
4 participants (3 Chinese and 1 Vietnamese) expressed that due to language barriers, they did not have confidence going out on their own, for example they were not able to tell a driver their destination when they purchase travel tickets (see Chart: 2.2b).
Chart 2.2b: Reasons for unable to go out and about
4 4 3.5 3 3
2.5 2 Chinese 2 Vietnamese 1.5 1 1 1 0.5 0 Carer Health Problems Language barriers
20 January 2018 2.3 Participants were asked whether or not they could find company who can trust
Session 3 Participants Self-Assessment of their Health Status
3.1 Participants were asked to rate their health from 0 (the lowest) to 10 (the highest).
Participants found that it was difficult to rate their health for the reasons of their health was unpredictable especially for older people.
“We cannot predict our health, and I was easily to catch a cold. The weather here is good… I feel better now. Yeah, I cannot predict the future”
(C15: 59 years old Chinese male)
I: How would you rate your health from 0-10, 10 is the highest
P: (Laugh) I really don’t know, if I don’t feel dizzy, I will give me 5, but if I feel dizzy, then will be less than 0. I really don’t know what to do
(V3: 43 years old Vietnamese female with long term conditions)
Only a total of 15 participants (10 Chinese participants and 5 Vietnamese) were able to give a score to their health status (see Chart 3.1).
Chart: 3.1 Self Assessment -Health Score
6
5 2
4 Vietnamese 3 1 1 Chinese 2 4 1 1 2 2 1 1 0 1 2 3 4 5 6 7 8 9 10
21 January 2018 3.2 Participants were asked their means of staying well
Participants were aware of the importance of maintaining their physical wellbeing and they use variety mode of exercise to keep them well and to fit in their life style (see Chart 3.2)
The majority of participants 11 (44%) felt that walking was the easy way to keep up their physical wellbeing
I: Is it the secret to maintain good health by forcing yourself doing walking exercise?
P: Yeah, doing exercise in the morning, do it in the house, walking up and down from here to there. I get up 4o’clock in the morning, walking from here to there till 5am
I: Everyday wake up at 4 and walking for an hour in the house?
P: Yeah, because I can’t sleep and waking up early, what can you do in this early morning? All I can do just walking here and there in the house.
(V8 - 80 years old Vietnamese male)
20% (3 Chinese and 2 Vietnamese) practice Tai Chi,
16% (3 Chinese and 1 Vietnamese) playing table tennis and
8% (2 Vietnamese) practice singing.
All of them regard these exercise are more cultural appreciate for them, especially singing Karaoke in their own language.
“… they drink English tea, but we drink Chinese tea; their exercise use force, but ours is light and soft, a combination of the body and mind.”
(C1: 51 years old Chinese male)
Participants engaged in table tennis, Tai Chi, gardening and cycling are more likely attached to Wai Yin and engaging in activities at Wai Yin.
For those who were carers and manual worker, they expressed that they did not have any spare time spending on exercise; they also thought that they had have enough exercise through their work.
“Exercise? I have enough moving him around. HE, is my exercise. I am slim enough. He makes me doing this, doing that.”(C2 – 77 years old Chinese female carer) 22 January 2018 “ I work here walking up and down 3 hours and half an hour walking from home, enough exercise for me!”( C10 – 45 years old Chinese female manual worker)
Chart: 3.2 Type of exercises
6 5 4 3 2 Chinese 1 0 Vietnamese
3.3 Participants were asked where they would seek for help and advice if they worry about their health.
7 (47%) of Chinese participant will seek help from their GP.
9 (90%) of Vietnamese participants will go to see their GP.
Due to the health condition, 1(7%) of Chinese participants and 2 (20%) of Vietnamese participants were advice to see their specialist consultants if they concern any change in their health condition.
Participants who are at their younger age and live in this country less than 10 years are more likely not aware of the current health system. When they concern about their health condition, they would either go to A&E or did not go to see doctor at all, one Chinese participant even consider going back to their home town for further medical advice (see Chart 3.3).
Chart 3.3 Action taken when concern about thier health 90% 90% 80% 70% 60% 47% 50% 33% 40% 30% 20% 20% 30% 13% 13% 20% 10% 7% 7% 10% 7%10% Chinese 10% 0% Vietnamese
23 January 2018 For those who seek for alternative advice was due to the waiting time and consultation time with their GP, especially for the new immigrants who are not aware of the health care system in the U.K.
P: Doctor in here, too much trouble seeing them, I don’t like it. You have to book an appointment and wait... I need to see doctor only the time when I feel very bad, then I’ll go to A&E (C11: 33 years old Chinese female, lived in the UK 2 years)
I: When did you have a check up?
P: Never
I: How long ago you have your blood test?
P: It was when I was pregnant
I: So it was a long time, how old is your son now?
P: He is seven
(V10: 42 years old Vietnamese female live in the UK 10 years)
Only Chinese participants (3 ; 20%) said if they have any concern, they would go to see their practice nurses.
For the Vietnamese participants, due to a lack of Vietnamese organisations was available for them, therefore both 5(33%) Chinese and 3 (30%) Vietnamese participants would only seek help from Chinese community centres or support from their workers
“If I have any problem, I can seek help from here (Wai Yin Centre). Here help me to make phone call” (C6: 62 years old Chinese female)
2(13%) Chinese participants sought advice from internet when technology and skills were available
I searched from internet to make my own diagnosis. …GP consultation time is in a very short time slot. Their advice – go home, take some medicine and rest. ... If you go there to get advice for health, they will give you advice, but not a practical advice. So it is better go online, it is convenient. Going to see my GP, the waiting time for an appointment is a week.(C14: 24 years old male)
Other alternatives for them to seek help and comfort when they concern about their health: 24 January 2018 1 (10%) Vietnamese participant said that they would seek for blessing from Buddha Temple
1 (7%) Chinese participant said that they would go back to their home town and
1 (7%) would use Chinese medicine.
(see Chart 3.3)
Chart 3.3 Action taken when concern about thier health 90% 90% 80% 70% 60% 47% 50% 40% 33%30% 30% 20% 20% 13% 13% 20% 10% 7% 7% 10% 7%10% 10% 0% Chinese Vietnamese
3.4 Communication Needs
Participants were asked whether or not they need interpreter when communicate with non-Chinese speaking workers or organisations, especially going to see health and social care professionals
11 (73%) of the Chinese participants required language support, among them 3 (20%) of them speak simple English
10 (100%) of the Vietnamese participants required interpreters, even though 3 (30%) of them speak English.
25 January 2018 Chart: 3.4 Communication Need
100% 100% 90% 73% 80% 70% 53% 60% Chinese 50% 33% Vietnamese 40% 30% 30% 20% 10% 0 0% Need Interpreter Don't Need Interpreter Speak English
As speaking English is participants’ second language, it is not only affect their communication with health professional, but also have a great impact on social life of the participants, this includes affecting their chance of meeting new friends and developing their interests and skills and also hinder their volunteering opportunities
Reduce chances for meeting new friends
“It was a little bore, my colleagues, we speak the same language, and some speak English. Mainly, we went to casino, this type of place.”
(C 5: 72 years old Chinese male)
“I come here playing table tennis occasionally. Well, when I was in China, I played tennis, but here I can’t find anyone to play with.”
(C15: 59 years old Chinese male)
P: I only get one friend, every year he will phone up and say, “let’s meet up and yum cha (having a meal in restaurant)”. Only once a year!
I: Only once a year, it is so precious!
P: He has been living in Birmingham for a few decades and I am living here. So we meet up once a year, have a chat then we go home
(V8: 80 years old Vietnamese male)
Hinder developing new skills and hobbies
I: What about activities run by non-Chinese organisations? 26 January 2018 P: No, I won’t go, because it is about the “language” that I am not familiar with. (C12- 49 year old Chinese female speaks fluent English)
Decrease volunteering opportunities
I: What is the reason for you coming to Wai Yin doing volunteer work?
P: Because here speak Chinese and have Chinese people.
(C13: 35 years old Chinese female, speak little English)
Participants were asked to rate their quality of life, some participants found it was difficult to give themselves a score, due to circumstances might change and these changes could affect their quality of life. Only just about half of the participant (8 Chinese and 6 Vietnamese) were able to score of their quality of life (see Chart 3.5)
Chart: 3.5 Quality of life score 2 2 2 2
1 1 1 1 1 1 Chinese Vietnamese
1 2 3 4 5 6 7 8 9 10 High
3 Chinese participants their quality of life could achieve 9 score and above; while Vietnamese counterpart could only achieve 8, which was their highest score.
A high score of quality of life is not necessary associated with a high score of health status; however, a low score of quality of life is severely affected by their health conditions. Three themes emerge from participants who either have a highest score or lowest score:
Theme 1: The need of maintain mental well-being
I: Only 3, why?
P: Because I am not happy
I: why don’t you feel happy?
27 January 2018 P: not happy, boring and too much trouble my mind
(C4: 47 years old Chinese female, health score 5, quality of life score 3)
I: What is your secret to have this score?
P: Always smile and be happy, less rigidity towards things…(for example) more flexible with my daughter’s homework, and change according to the time suit her TV programme…there is no point to give yourself pressure, making myself and my daughter miserable. (C9: 37 years old Chinese female, health score 7, quality of life score 10)
Theme 2: The needs of developing social network
“…if you go to a place where the environment and language you are not familiar with, it is very difficult to come across, because you need to adjust the change, the foremost important thing is to do is to learn the language, never mind going to see a doctor… you need to connect the outside world. For example, even you go to supermarket, everything is there, but you still need to have connection with the society…”
(C12: 49 years old Chinese female, health score 8, quality of life score 9)
“My health is bad, but I try to endure it. It is important to have a good mood, don’t get depressed, coming out to meet new friends and being active” (C6: 62 years old Chinese female, health score 5, quality of life score 10)
Theme 3: The needs of feeling safe with their support network
“I feel content to what I have, and I have a good plan for my future. My two daughters will look after me” (V5: 78 years old Vietnamese female, health score 6, quality of life score 8)
“…I have friend to chat on line and sing Karaoke…My quality of life is good, any health problem I will go to see my doctor” (V6: 53 years old Vietnamese female, health score 8, quality of life score 8)
P: If I were in my home town, when I was ill, I would be well look after, and have friends…then I will be able to join (activities), but everyone is busy here, they cannot look after my child.
I: What is your biggest worry?
P: When I faint, I cannot regain consciousness (sob, interview terminated)
(V3: 43 years old Vietnamese female, health score 5, quality of life score 3) 28 January 2018 “I have no friend here, very stressful as a carer. No personal space and time”
(C3: 67 years old Chinese female, health score 5, unable to score her quality of life)
29 January 2018 Appendix 4
Case Study – Radio Sheung Lok All FM
Radio Sheung Lok is a partnership project with All FM and Wai Yin Society to tackle isolation and loneliness and promote mental health in the Chinese community. Participants are trained in making their own show based around the theme of positive mental health in accordance with their cultural beliefs.
Radio Sheung Lok is a live show, broadcasting in Cantonese and English on every Fridays between 1pm and 2pm at All FM 96.9. Participants embarked on their Radio Sheung Lok training in February 2016.
The evidence is based on gathering from participants’ feedback, content of Radio Sheung Lok shows and researcher’s observations. Participants here will be referred to as trainee presenters.
Planning and ambition of the project
In August 2016, the group were involved with Vintage FM radio shows broadcasting on ALL FM. After two days training, they were part of a live broadcast and celebration at the Whitworth Gallery on 30 September in Manchester (see Note 1). Participants had learnt so much from “how to pick up new skills to make a radio show” to “live broadcast to discuss our own culture in our own language on the radio”. It was a fantastic experience for them.
Based on these experiences, the project “Mental Health FM” attempts to pursue the success of the two days radio training pilot project in September 2016. This partnership project – ALL FM working with Wai Yin Society is aiming to challenge discrimination against mental health service users and reduce isolation and loneliness.
Engaging Chinese communities and meeting their needs
The philosophy of this project is based on equality and inclusion. 10 participants were recruited in the first training group. They came from different educational and professional backgrounds (see Table 1) the training commenced on the 3 February 2017, a whole day training for six weeks.
30 January 2018 Table 1: Background of the participants
Age range Under 50 2 Over 50 8 Gender Male 5 Female 5 Educational level Degree or above 2 Primary /Secondary 8 schooling Employment Part time employment 2 Unemployed 1 Student 1 Retired 6 Communication in Excellent 1 English Good 3 Manageable 3 Very Difficult 3
Impact on participants
Overcoming barriers
The training was delivered in English. A mixed group of participants whose English is the first language as well as participants who spoke very little English took part. The advantage of a mixed group is it allowed them language exchange in this setting. It is especially helpful for those who struggled to understand the terminology uses for broadcasting. Even the person for whom English is her first language learnt Cantonese.
Furthermore, some participants had little knowledge of IT skills, they were not familiar with using social media, and some of them even struggled with using their mobile phone. However, none of them were familiar with the IT used at the radio station, it was a completely new challenge for them all, but everyone helping each other advanced their knowledge to the required level.
Empowerment
The feature of the show was designed by the group members. Each member took their initiative to take on various roles in the show. For example, collecting broadcasting information, being a presenter, desk driver or producer etc. Each member has a chance to play different roles in the show when they are ready.
31 January 2018 For some, it has been a long time that had not practiced writing. At the beginning of the training, they struggled with their writing and presentation skills. Not until they got to know each other, it was embarrassing to disclose their difficulties in front of the group. However, with patience and support from the experienced trainers, participants felt that there was a sense of care and support from the group members, then they become more comfortable and less stressed in planning and presenting on the show, and regained their confidence at learning new skills.
Enhance confidence and self-esteem
Participants also expressed that at the beginning, they were very shy and their hands were shaking in front of the microphone, but now, they can speak out with confidence to the audience. It was a big step forward, an incredible journey.
Promoting wellbeing through learning
Each week, participants need to collect information for presenting a topic in the show. In a sense, they force themselves to explore a topic of interest each week, for example, healthy eating, and the connection between health body and mind. The wide ranging topics were related to food, physical activities, narratives and stories from ancient times but applied to everyday living e.g. Art of War relating knowledge of self, the others and of the environment in order to achieve our goals.
A sense of belonging and professionalism
Participants felt that they were in position of giving out information to wider audiences beyond Manchester (all Radio Sheung Lok shows can be listened to at Wai Yin Website, at Mixcloud/radio sheunglok). Therefore, information presented in the show must be accurate and must from trustworthy sources. They are so proud of themselves being presenters, one participant even made name badges for each group member to show their identity and insists that they must put the badge on when they come to ALL FM.
A dream that can live on
Participants expressed that they never dreamt that they could be a presenter in a radio show. They said it was only by chance that they have this opportunity, and they want this opportunity to be extended for as long as possible. It is their commitment to the show and the group that will promote its continuity and contribute to the on-going dream.
32 January 2018 Impact on audience in a wider community
The Mixcloud page was set up after the first live broadcast on 21 April 2017. Since that the Radio Sheung Lok show has had over 1,500 hits. They have a Facebook page too with links to the shows and they know for sure from their comments that relatives and friends living in other countries are listening to their broadcasts.
Further developing the project
The researcher have identified general advice and counselling skills training are essential for radio presenters who promote mental health. The initial aim of this project proposed to develop a telephone helpline. The project will work closely with the IAPT providers to deliver this type of trainings, therefore, continuous recruitment of new volunteers and training participants working towards a recognised training programme is not only for personal development, but also hopefully to create job opportunities for participants.
Expend broadcast actively and involvement to wider communities
Participants are encouraged to visit community centres, to take part in the local event and networking, for example carer event, Age Friendly Manchester event, Ambition for Ageing networks in their local area. They bring back their involvement to broadcast on the radio show. With the existing network, we are aiming to establish potential partnership with local communities. We are involved with the Team Challenge of the National Citizen Service who will be coming to meet us for making promotional material (See Note 2).
Conclusion
The participants are receiving continuous personal development and support while they are involved with the project. Evidence has shown that the uniqueness of this project is participants build up their confidence in an environment where they feel safe to explore, improve their interpersonal and communication skills by actively joining the broadcasts; taking time to appreciate their surrounding, collecting local information and keep learning. Moreover, the impact on the Chinese community is twofold – on one hand listeners get to hear about the local community, listen to songs in their own language, increasing their awareness of local resources and activities whilst on the other our presenters are developing networks with the wider community. Whilst it is impossible to measure the positive outcomes of listeners we have some statistics to show that people are listening to our recorded broadcast on the internet.
33 January 2018 Note 1: https://m.mixcloud.com/ALLFMVintageFM/vintage-fm-broadcast-from- whitworth-gallery-30th-september-2016-1pm-hour/.
Note 2: http://www.ncsthechallenge.org/programme/
Appendix 5 References 1. Pieke, Frank N., Pál Nyíri, Mette Thunø & Antonella Ceccagno. 2004. Transnational Chinese: Fujianese Migrants in Europe. Stanford: Stanford University Press. 2. "National Statistics 2006" Archived from the original on 3 July 2010. 17 April 2017. 3. "Office for National Statistics (ONS) - ONS". 18 March 2015. 4. United Kingdom Census 2011: DC2201EW - Ethnic Group and Religion ONS. 5. "Raise the Red Lantern". The Economist. 2017-11-03. 6. Higher Education Staff Statistics. March 2017 7. Staying Part of the Family: Transnational Defamilisation/Familisation Measures of Chinese Older People in Britain 2015 Dr Sam Yu, Dr Susan Su, Ms Anna Wong, Department of Social Work, Hong Kong Baptist University Dr Ming Ming Cheng, Department of Social Work, Shanghai University Dr Ruby Chau, Dr Liam Foster, Department of Sociological Studies, The University of Sheffield 8. Flynn, M. (2010). Who is motivated to extend working life beyond retirement age? Typologies of older workers. Personnel Review, 39, 308-324 9. Lin, X., Bryant, C., Boldero, J., & Dow, B. (2014). Older Chinese immigrants’ relationships with their children: a literature review from a solidarity–conflict perspective. The Gerontologist. ONS. (2012). Average age of retirement rises as people work longer. from http://www.ons.gov.uk/ons/rel/mro/news-release/average-age-of-retirement-rises- as-people-work-longer/pension-trends.html Song, M. (2015). The British Chinese: A Typical Trajectory of ‘Integration’? Chinese Migration to Europe: Prato, Italy, and Beyond, 65. Vincent, J. A., Patterson, G., & Wale, K. i. B. (2001). Politics and Old Age: Older Citizens and Political Processes. Aldershot: Ashgate Publishing Limited.
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