A conversation with CAHN: Meeting the health needs of Caribbean and African communities

Black and minoritised ethnic communities who live in low income households face the worst health prospects in Great Britain, with lower life expectancy and higher rates of long term illness as well as mental health problems. We speak to Charles Kwaku-Odoi, Chief Officer of Caribbean and African Health Network (CAHN) in Greater Manchester, about making services more accessible and destigmatising mental and physical health problems to reduce health inequalities in his community.

Thank you for talking with us, Charles. Can you tell me about your background and work with CAHN?

I became involved with CAHN back in 2017 following a PhD research by the Chair of the organisation Dr Faye Bruce which was focused on why black people had poorer cardiovascular disease outcomes when compared to people of other ethnicities. Personally, I have always been an advocate for the Black community with a focus on improving health outcomes. I helped develop CAHN’s vision of eradicating health inequalities and wider disparities for Caribbean and African communities within a generation. We provide services for our community and deliver a range of programmes in line with our vision. Our mission is leading on strategic engagement on behalf of the Black community so we are not termed ‘hard to reach’. There’s a gap when it comes to decision-making, challenging and influencing policy. We’re trying to fill it.

Could you tell us a more about the influencing side of your work?

Our influencing aims are twofold: to ensure health provisions and services understand our community needs and are responsive to them; and to improve the health literacy of our community members. A notable example was During the Covid-19 vaccine rollout, take-up was low amongst Black and minoritised ethnic communities, so we started running weekly webinars led by myself and other doctors on why we have received the vaccine, the protection and benefits it can bring. At one of our webinars during the height of the pandemic we averaged 1,000 people on Zoom, a further 800 on YouTube, and it resulted in then vaccines minister Nadhim Zahawi joining the session. We were approached by the government as part of consultation on vaccine take up amongst our community, because it had been labelled as hard to reach, so what we do is try to convene real people and connect them with influencers and policy-makers to share their lived experience.

What were some other issues affecting the community during Covid-19?

Mental health was a big problem. There’s a lot of data about worse health outcomes for young Black men; they’re more likely to experience ill mental health, more likely to be sectioned. The deaths during Covid-19 increased this, and because of restrictions, bereaving families couldn’t be together to mourn. But the mistrust or lack of access to statutory provisions such as the Bereavement Hub set up in Greater Manchester meant that Black people were not using the service, while our small support network was getting tens of hundreds of requests.

You’ve got to remember as well that on the heels of Covid-19 was the George Floyd murder which intensified the complex bereavement trauma of our community. We saw more instances of suicide amongst young men, so we put on sessions on how to talk more openly about mental health, as well as a lot of suicide prevention work. We brought in counsellors to run sessions to give people an outlet for their pain, and to help them through their grief.

Can you tell me about a specific person you’ve helped support?

We helped a pregnant woman in her early 20s whose child was born prematurely and had to spend a couple of weeks in intensive care. They were discharged and stayed at home during lockdown, which impacted the mother’s mental health. One morning she was going to the shops to get more milk for her baby and saw that all her tyres had been slashed. It was the straw that broke the camel’s back for her mental health. It was a Sunday morning and she rang our helpline. She was living in social housing but couldn’t stay there so we moved her in to a hotel for a few weeks and took the issue to the police and her housing association, which insisted she could return once the perpetrators were found. For us we realised she was at risk, her mental health was at risk from staying there. We provided accommodation for over 2 weeks, helped her with child support, advocacy, and eventually we got her moved to more appropriate accommodation.

What are the causes of health inequalities in your community and why are Caribbean and African communities so adversely affected by ill health?

One big factor is around racism and how we sometimes shy away from addressing its causes. Our approach as an organisation is to look at the structures and systems that tend to consciously or subconsciously exclude Black people. For example, health campaigns have tended towards the glossy billboards or social media campaigns so that they have far reach, but ethnicity monitoring is not such a priority. Our community feels that nobody’s interested, so people aren’t going to respond to campaigns. It wasn’t until the vaccines campaign, which used research from Caribbean and African communities, that we began to see this change. They wanted diversity in the messaging and started using trusted Black voices. That’s when people started to respond. This kind of inclusion is how we begin to narrow health inequalities.

What’s been a particularly successful project that CAHN has delivered?

I think raising awareness is vital part of our work. One brilliant thing we’ve done is arrange Zoom health webinar sessions every Saturday morning with a GP or health consultant which we livestream onto YouTube and Facebook. Each week is based on a topic within our 6 health priorities - cardiovascular, mental health, cancer, respiratory, blood and immunological, and reproductive and sexual health. A Consultant or GP will present on a particular topic and then people from our community can ask questions. Something that’s really changed because of these sessions is the attitude towards prevention and medication. Initially much of our community avoided taking medication because they felt it meant becoming westernised, but we’ve been able to shift attitudes through accessible and informed sessions open to all of our community.

How important is improved cultural awareness in existing healthcare to improve the health of Caribbean and African communities?

Culturally appropriate and sensitive health provision is really important. It’s about what we call person-centered care, fulfilling the needs of every unique person. Lots of research points to the fact that when people are treated by people who understand them, understand their culture, then the outcomes are much more positive. We deliver a Black Health Improvement Programme which informs healthcare services of the different religions or attitudes that exist in the Caribbean and African communities. For example, if someone has high blood pressure and they’re given medication but week after week they’re coming back to be monitored and nothing’s changed, you have to understand that they might be taking herbal remedies instead or perhaps they feel that prayer will heal them. It makes GPs or nurses or whoever more open to have these discussions if there’s a basic understanding.

And finally, what does Black History Month mean to you?

People will argue that Black history should be important every day of the year and I think that’s true. However, the month of October is an opportunity to instill self-belief and reflect on the contributions we’ve made, often under very harsh circumstances. CAHN has a video on a slave from the 1700s who was instrumental in developing treatment for smallpox. Henrietta Lacks and her contribution to cancer treatment as well. There are so many examples where we’ve significantly contributed to healthcare since the arrival of the Windrush generation. So Black History Month is a chance for us to look to those who have come before us so that we can draw strength and encouragement to build a healthier future for our children.