The Bengali community in Tower Hamlets is the largest outside Bangladesh. The community suffers from poverty, high levels of unemployment, the highest overcrowding in London, poor housing and language and cultural barriers to accessing health services.
A study in 2000 showed that:
- Bengali patients were presenting with more advanced stages of cancer than non-Bengali patients;
- healthcare professionals involved in patient care felt that their medical training was inadequate to overcome the language and cultural barriers;
- many Bengali patients were not literate in their own language and so were particularly vulnerable due to the lack of culturally sensitive verbal and written information.
The Bengali Cancer Health Advocacy and Cancer Awareness Service, a partnership between Macmillan Cancer Support, Social Action for Health and Barts and the London trust, was initially funded in 2001 from the New Opportunities Fund to set up a cancer awareness programme in the community and offer cancer health advocacy services to patients and carers within Barts and the London trust. From May 2004, Macmillan Cancer Support became a partner and provided funding for continuation of the service until this June.
The project aimed to:
- provide clear information and assistance to Bengali patients and carers in an understandable form, thereby encouraging informed choice and consent;
- provide an outreach service to potential users to raise awareness of cancer within the Bengali community, thereby promoting early referral;
- identify barriers to accessing early diagnosis and cancer services, especially accessing primary care;
- Train staff (hospital and community based) in development of appropriate intercultural communication
- reduce anxiety and enhance a sense of control over physical and psychosocial well-being;
- offer a locally adapted and culturally sensitive information provision about all aspects of cancer, including self-management;
- establish, facilitate and develop a support group for the patients and carers.
As a result of effective partnership working with community, voluntary and statutory organisations and the creation of strong working relationships between primary care practitioners and the Bengali community, the project was successful in meeting many of its aims.
In addition, the project established a sustainable Bengali support group and will be providing Tower Hamlets PCT with an end of project report with evidence supporting the continuation of community projects. Learning outcomes from the end of project conference included:
Access to services
- use multimedia methods to reach audiences;
- use community leaders as influential champions;
- raise awareness in identified target communities.
Earlier presentation of symptoms
- group attendance at screening events;
- health promotion within school curriculum - health promotion events.
- sustain the Bengali support group for users and carers with a community focus;
- encourage involvement in support group by word of mouth and publicity;
- link with healthcare professionals to carry out educational events.
Community awareness sessions
- need to be continued;
- develop knowledge and awareness of cancer through face to face communication;
- community workers and advocates to continue roles.
Information and support
- engage directly with local communities;
- outreach methods – community groups, community leaders to ask for what they want, in which format and in which language.
Networking, partnerships and understanding have been major features of the work so far and will need to remain the emphasis.
The successful partnership working and funding of this project has provided an opportunity to further understand the needs of the local community of Tower Hamlets and ensure, as healthcare providers, we are responding with appropriate communication, information and support for equitable access to healthcare.
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