What would a Real Health Movement Look Like? - 3
What a Club can do for you
In the 1930s a world-famous enterprise took place in south-east London, known as The Peckham Experiment. I have mentioned it before. A great deal of charitable funding and social prestige was invested in it, and spent over a 5-year period: the onset of war closed it, but it would not in any case have lasted much longer in that form.
It sought to recruit 2000 families in a defined area of Peckham, but never enrolled more than a few hundred. These, however, became members of a very richly-endowed family leisure and social club, the Pioneer Health Centre. The ulterior motive of the directors was scientific, to define health and identify how to nurture it. That failed, inevitably, for reasons that Philip Conford and Justin De Syllas analyse brilliantly in their respective accounts. What succeeded however, and dramatically, was an explosion of spontaneous and self-directed activity and community-building – the flowering of a huge potential, latent up to then, in the families that chose to join the Centre. The war interrupted but did not extinguish it – the members, not the management, clamoured to have their Centre back, after its wartime requisitioning ended. Traces of this ardour lingered on in the character of those members, for the rest of their lives.
I witnessed a similar eruption of health – for that is what it was – much more recently, in the spring of 1990. I was recruited by Anglia Television to present a six-part television series to be called “The Health Experiment”, and based in Northampton. The producer already had rather firm ideas of how health could be monitored – measurements such as weight, height, skinfold thickness and blood pressure - and wanted to demonstrate the benefit over three months of improved diet and exercise. I went along with all this, but added a measure of well-being. It was simple, a 5 centimetre horizontal line on a questionnaire form, marked 0 at the left end and 50 at the right, asking respondents to put a pencil stroke across the line to show how well they felt at that moment. The less they thought about it, the better. The result was scored by measuring in millimetres the length of the line from 0 to the pencil mark.
We recruited 100 participants in each of 5 age-groups, the youngest being secondary school-children in one comprehensive school. Each age-group met four times at monthly intervals in a suitable local hall, and were screened by our locally-recruited team of nurses. The collective results were announced immediately – we had the benefit of computer analysis, though still in its infancy. There was a good deal of hype and rabble-rousing, for the camera’s benefit.
The physical measures did improve dramatically, between the first three meetings, but fell away by the fourth: we had, after all, done nothing long-lasting to remove the reasons for over-eating and idleness. The well-being score however, a subjective qualitative impression, went ballistic. The slope of the curve was still steepening as the series ended. And that was not all. There was a clamour from several of the participant groups, for the activity to continue. Anglia would not take that on, and I could not – living 100 miles away. The embers died.
These stories illustrate two things, very clearly. First, there is in any group of people a huge latent vitality, and will for self-improvement: this is probably more suppressed in urban neighbourhoods, and increasingly over recent decades. Secondly, the impulse to unleash that vitality and give health its head, must be local and draw only on voluntary self-help. Expense and dependency eventually kill initiative.
- - - - - - - -
The simplest way to get something going is to invite everyone to a party. It’s how newcomers to a neighbourhood introduce themselves, and it usually gets some sort of response. We were lucky, being the new doctor in the village, and got off to a flying start. Most people should expect to gain ground a bit more gradually, but you never know: you may be sitting on a social volcano.
Unless you really are new to your area, you can already identify the people to confide in. The post-master or corner shopkeeper, and of course the pub licensee, maybe a priest or minister, go on the list automatically: let them quiz you and pass the word. There is probably an issue – or several – exercising the neighbourhood, which you may already know about. Most people wait ages for a doctor’s appointment: some may be struggling to make ends meet: tenants may be waiting too long for repairs: buses may be inconvenient or non-existent. Separately, try personally inviting a couple of your long-resident neighbours round for coffee and biscuits, and in the course of your conversation, see what they think is on local people’s minds. It may be obvious what kind of self-help would be appropriate, or you may need to think about it for a while. Quite likely these same people will be happy to drink your coffee again a week or two later, by which time all of you will have chewed over what was said last time, and with luck have sounded out others.
Something should emerge that is strong enough bait to attract people to a meeting, at the school or pub, or community centre if there is one. The outlay for refreshments need not be much, and bar purchases will usually cover the use of a room in the pub. But you need to go prepared, with a local worthy or two on your side who can act as hosts and sponsors, giving you space to open a discussion. You nudge it towards whatever self-help and sharing options have occurred to you.
Parents with small children not yet in school, usually welcome a regular get-together where the children can play, and the parents present can chat. So long as the parents stay the whole session, you don’t get involved with child care regulations. We had one every week in the waiting room, brought out a selection of robust wooden toys, and usually had four or five babies and toddlers with their parents – usually mother. We provided hot and cold drinks and nappy changing facilities, and introduced a “thought for the day”, usually a simple tip that did not too much distract parents’ attention from their children. In a more built-up area, expect a larger group including some fathers and wider family members, minding children for their working relatives; and more frequent demand.
It is unusual for a group of neighbours at the same station in life not to talk about things they have in common. Parents with several children usually know things that first-timers will value. If you are nudging the group towards better health, then any opportunity for neighbours to share a tip, or help each other out with shopping or a lift, is valuable. Gradually, over months maybe, the scope of the group will widen. The more that members gain confidence in doing things for themselves or with their friends, the better.
This is the simplest form of social club that can extend community life, at minimum cost to anyone. We were deliberately unclear about the precise purpose, to avoid the standard preconceptions; but starting off in medical premises was a bit of a clue. A play-group will probably meet in someone’s home, but wider purposes may do better in a larger room at the community centre or local pub. Our club, of about 40 people, met twice a month on a weeknight in our waiting room, alternating a local topic and an invited speaker, always on a self-help and health-related theme – never medical. Membership was not confined at all – certainly not limited to people on our medical list. The programme was advertised locally in advance, which is easier now with social media. We kept notes on the meetings, which nowadays we would blog, or archive on a website. If you are not yourself computer-savvy, you need to get alongside someone who is.
Besides meetings, we began to organise a few weekend activities and outings. Members started saving their kitchen waste to add to the shared compost heap on a member’s allotment. Later in the season, the gardening member brought to regular meetings any produce in good supply, for people to help themselves. One or two members were keen enough to help out on the allotment in other ways, when the season demanded.
A particular success in our case, right from the start, was to provide organically grown local wheat that could be milled to order as wholemeal flour, in time for each meeting. It cost significantly less than shop prices, tasted much better, and made very dynamizing bread – the perfect cure for constipation. How to bake it best was the topic of one evening meeting. One or two bags of wheat became a regular purchase from a nearby organic grain farmer, and we invested in a small SAMAP electric mill which suited our scale perfectly.
Recycling has become mainstream now, but also lends itself as a club activity. This particularly applies to re-using unwanted items, rather than throwing them away. Children’s clothes work well, particularly when there isn’t a younger child in the same household to pass them down to. They would probably be offered individually to a family with a new baby, but a swap stall at meetings can also work well. If this proves popular, it need not be confined to clothes: garden herbs and pots of pickle are just as popular and useful.
When it really gets going, a club does need a bit of running. An annual meeting with simple rules for self-government is quite workable, without resorting to a formal constitution. One way or another, a successful and busy club will need a few members trusted to do secretarial work and admin, as they arise. Not many though, and the more members actively and informally involved in the regular life of the club, the better – for example, in our case, a miller and a compost-gatherer. If you do decide formality would be useful, it is easy to register as a charity and adopt the model rules published by the Charity Commissioners on their website, and it will cost you nothing.
Somewhere along this progression, without knowing when, you will light the blue touch-paper: the engine will ignite and community life will take off, on auto-pilot. This is not quite a certainty, because there are some formidable obstacles out there - we’ll get to that - and a lot depends on the resources, cunning and stamina at your disposal. But many communities have ignited in this way - another topic for later. Some have even spawned offspring, around the world.
The reason the Pioneer Health Centre did not, was its research ambition. They were seeking research grants, but had almost nothing to offer the large research charities. They could not market the vivacity of the place, because it could not be quantified. And institutions were distrustful of it, even when they had witnessed the PHC in action: the inspirational director, George Scott Williamson, could not be scaled up, and perhaps medical bodies felt their livelihoods would be threatened.
I consider that Peckham revealed at least 80% of what we need to know about health, in order for it to spread widely and strongly. I explored that legacy across a lifetime, and now I am sharing it with you.