Alternative nursing therapies beyond the bedside, treating the whole person: A Case study of Bevan Psychiatric Intensive Care Unit/Low Secure Unit, doing the same things differently.

Holistic nursing is not necessarily something that you do. It is an attitude, a philosophy, and a way of being. Using available spaces indoor on sunlit windowsills, outdoor on concrete floor and raised beds to grow mostly edible plants we connect with ecology embracing our unique environment.

Growing plants with each other helps us deal with change like being in hospital against our wish and diagnosed with a mental illness or living with it. Yes, just like growing plants recovery also takes too much time and needs more patience. Maybe it is time to accept it and relax into your ‘new life’. Keeping hope and motivation alive rather than seeing living as a battle to be won.

The Aloe vera project started with plantlets donated by Regional Neurological Rehabilitation Unit (RNRU) grown on their windowsill. They are doing well indoors in a shady corner. We started the garden pea project in February and it took us four months involving patients and staff in planting, fertilizing with homemade organic liquid fertilizer transferring seedlings to outdoor space, watering and harvesting in June. It was a lovely summer gardening activity with many photos.

Miller (1992) suggests that hope is the anticipation of a continued good state, or a release from a perceived entrapment. Hope is an anticipation of a future which is good and which is based upon mutuality, a sense of personal competence, coping ability, psychological well-being, purpose and meaning in life, as well as a sense of “the possible”.

A growing body of research shows that simply being around greenery profoundly benefits the mind and body, from lowering blood pressure, improving mood, reducing the perception of pain to promoting relaxation amongst other general wellbeing.

Our current garden project indoors on our windowsill is the green vegetable ‘Callalloo’ with seeds (Amaranthus sp.) imported from Cameroon in West Central Africa. Callaloo is a Caribbean dish that originated in Africa. In Nigeria ‘efo-tete’ is used extensively and also appreciated in many West African countries. The amaranth leaves or ‘African spinach’ make ravishing dishes rich in vitamins and minerals for regenerative nutrition and health.

A similar therapeutic gardening project can be initiated in collaboration with other health professionals in the UK and all you need to do is contact us and we will be willing to support you.

Our seedlings are on sale and sometimes presented as gifts to patients, carers, friends and colleagues. All funds raised are used to support the project to be sustainable. For those who may not wish to buy our seedlings, your kind donation to Bevan Ward (PICU/LSU) Therapeutic Garden Project will be greatly appreciated and acknowledged.

Ir. Mrs. Suzanne Mbi Enoh-Arthur (RMN; M.Sc. Oxon), Life Skills, Activities and Alternative Mental Health Recovery Link, East London NHS Foundation Trust, City and Hackney Centre for Mental Health, Homerton Row, London E9 6SR, UK. Tel: 02085108031 Email: suzanne.enoharthur@eastlondon.nhs.uk

ECOLOGY AND GARDEN THERAPY WITH STAR WARD EDIBLE GREEN CORNER

The Life Skills, Activities and Alternative Mental Health Recovery Link at East London NHS Foundation Trust supports my work on ecology and garden therapy, which started with the ‘Joshua Ward psychiatric inpatient experience’ registered as a Capital Growth space in London in May 2011 with funding in 2012 for three raised beds on NHS site.

In March 2012, I travelled abroad on career break to lecture in the School of Agriculture and Natural Resources at the Catholic University Institute of Buea (CUIB) in Cameroon, facilitating ‘Rural/Urban Food Crop Production and Entrepreneurship’- 'Case studies on Moringa oleifera Lam.', inspired undergraduate entrepreneur based groups: 'Emerald group'- producing Emerald moringa soap from moringa trees I planted and bio-processed into added value dried leaf, leaf powder and seeds on campus, winning the most engaged student entrepreneurs, most innovative and most marketable product. Also the 'Green Vision Group' – that provides services in consultancy, research and project realisation. This group won the prize for the most innovative business entrepreneurial idea during the CUIB Entrepreneur Fair in April 2013 gracefully marking the end of my Cameroon Consultancy contract and UK sabbatical leave. Extending my sustainable partnerships abroad, I facilitated a small smallholder value added Moringa oleifera entrepreneur development in the UK (Hackney, London). Anni's Funky Soap online sales-‘ebay’, produces moringa soap, moringa shampoo and moringa cream with dried leaf, leaf powder and seed products supplied directly from rural/urban tree crop production from Akafro 'Moringa oleifera Research Initiative' Nursery and cooperative farms of  'Akafro Moringa Farmer's Association' in Cameroon and Ghana. These evidence based research practices are supporting local farmer's household income generating business and my doctorate study in Applied Biological Sciences at the University of Ghent in Belgium. (Funky Soap-Akafro Moringa Project link

https://www.facebook.com/permalink.php?id=335871596542625&story_fbid=384594851670299)

I am now back in the UK and have started the ‘PICU Bevan Ward Gardening Group experience’ supporting therapeutic group activities, promoting ‘Urban Food Production Nursery and Entrepreneurship’, Recreation and Meaningful Engagement. Evidence based practice (Nursing Times; 104: 45, 28–30) by Page (2008) in “Gardening as a therapeutic intervention in mental health”, is used to encourage participation in the phenomenon of hope, a key factor associated with recovery. Miller (1992) suggests that hope is, the ‘anticipation of a continued good state, or a release from a perceived entrapment' in his paper; “Coping with Chronic Illness: Overcoming Powerlessness”. 'Hope is an anticipation of a future which is good and which is based upon mutuality, a sense of personal competence, coping ability, psychological well-being, purpose and meaning in life, as well as a sense of “the possible”.’ Using these guidelines I hope to support good practice on ecology and garden therapy for the gardening group activity.

Ecology online

One of the enjoyable things about having been involved in this blog, is that it makes me more aware of discussions about gender equality in science.

It makes me appreciate the success of the women around me even more.

And it has also made me more attentive to the way in which female academics in general are treated.

It surprises me a little (although it shouldn't!) that as a result I've observed many more positive things than negative ones.  One experience in the last week was particularly interesting.

Over the weekend I attended a coding workshop, designed exclusively for female students interested in programming languages and creating websites.

Whilst this may not seem directly relevant to the practice of ecology, it is the many many hours spent writing code in the statistical software R which has made this area more interesting and accessible to me. In addition, as I work on the impact of oil palm management on the biodiversity of Borneo, I also consider it pretty essential to use the internet to disseminate my results where-ever I can. Unless the conclusions are accessible, they remain irrelevant to real-life conservation efforts. I may well end up finding that writing a website has far more impact than writing a PhD thesis.

And so, I found myself at a coding workshop, in a room full of enthusiastic young ladies, an inordinate number of laptops, and an exciting range of complimentary teas.

There was a brief introduction from the organisers, thanking everyone for attending, and explaining the structure of the day. And then we set about playing around in text editors, trying out new bits of script, and solving the inevitable problems that prop up in nearly every line but without which the whole enterprise wouldn't be nearly as satisfying.

Whilst everyone attending the course was female, both of the formal instructors were male. This could potentially have reinforced the gender stereotypes that put off women who might otherwise be interested in computer programming.

However,  absolutely no mention of these stereotypes was made.  In fact, there was no reference to the fact that all the students were women. There was no discussion of why women might find it harder to get involved in coding and building websites. If you hadn't looked around the room, you might have completely missed the fact that there were no men amongst the students.

And instead of this meaning that the course was less well tailored to the needs of women, I think it made it a whole deal more successful. Having signed up to a workshop which stressed the lack of women gaining that particular set of skills, I had sort of assumed that some time would be spent on discussing gender issues. But it was actually very refreshing that on the day, this did not happen. The whole session was just about delivering the tuition everyone had gone there to receive. Completely ignoring the fact that women might be at a disadvantage in the computer programming world made the whole day a lot more empowering. It was implicitly assumed that everyone was highly motivated and perfectly capable, and so that issue seemingly did not need to be addressed.

So it made me think - some of the issues around gender stereotyping and inequality are best resolved by being completely ignored. Whilst it is essential to have high-profile discussions, and to ensure that special treatment is given to female employees where necessary, there will be some occasions in which gender inequality is surmounted by completely forgetting that it is an issue in the first place.

An uplifting start to the day...

Like nearly everyone working at a desk on some part of their PhD, my day started with opening up the web browser and blinking a little sleepily at the Google search homepage. Very occasionally the google search doodle provides a nice little bit of procrastination - today was one of those days. 

Aside from the little touch of nature making it into the world of letters and numbers and screens of digitised information, the story behind the picture is also pretty charming. 

If you haven't read it already, or missed out on it, I recommend the following article on the artist and adventurous entomologist Maria Sibylla Merian. She crafted stunning images of previously undiscovered animals and plants, raised insects herself (dispelling the notion that they appeared spontaneously from the mud) and made it through a pretty nasty bout of malaria in order to produce her beautiful book of wildlife from Suriname.

I've so far been lucky enough to escape malaria whilst doing tropical science, didn't have to sail out to  my field sites in Borneo to do my work either (though I would have loved to if I'd had the time), and don't expect to be ignored by the scientific community for not writing in Latin. And despite having an easier time on all those counts, the tiny little sketch book I take to the field is still mostly empty!

As I mentioned in an earlier blog, I particularly like to hear about inspiring women ecologists, and hopefully you also will enjoy Maria Sibylla Merian's story. 

Womens contributions to the leading journal Nature

Nature’s sexism

The top journal Nature recently featured an article discussing the contribution of women to the publication, and the focus on female scientists within its pages. On their editorial board they have a respectable 54% women, but the number of female scientists appearing in other sections of the journal and its production is much lower. 

Only 19% of the Comment and World View articles have a female author and of the scientists profiled by journalists, only 18% are women. Even more disappointingly,  the number of women requested to act as referees is a paltry 14%.

As the article points out, this is in part due to the lack of female scientists in top positions. Unfortunately, changing the gender composition of the highest rungs of academia is a challenge too large for one journal to take on alone. However, the editors of Nature have, encouragingly, used the article to pledge that they will do their very best to introduce a "gender loop" into their thinking: taking the time to check which women could be commissioned to contribute to any particular article or task. If the team at Nature successfully manage to do this, they could well have a very positive impact on the coverage talented female ecologists get in one of the most important publications in their field. 

Read this article (and the interesting things it links to!) here.

Sexual assault: an issue for women in ecology? Or for everybody, everywhere?

I am, by nature, an optimistic person with a positive outlook on life.  Any experience I have, whether good or bad, I manage to find a beneficial consequence.  This blog post is not so much about being a woman in ecology, but about being a person.  More specifically, a person who has been subjected to sexual assault and how this can impact a positive attitude to life and work.  It just so happens that my life and work is ecology and conservation.  I suppose sexual assault is a topic more commonly associated with impacting people of my gender, but I would like to propose that it is not, and that ignorance of this fact is, if anything, making everyone more vulnerable.

My Story 

Alone at night in a developing country – was I asking for it?

Let me give you some history.  I am a woman.  I work in conservation, primarily in the developing world.  Recently, I spent six months living and working in Sinai, Egypt.  As a western woman living in a small but relatively touristy town, despite always wearing modest clothes (at least by my standards, i.e. covering my shoulders and upper arms and my legs to at least below the knee), I was subject to constant attention, from wolf whistles and honking cars to frankly obscene comments.  All of this was irritating, but didn’t really feel threatening and was just something I tried to ignore and reduce the provocation for as much as possible.  Incidentally, the one time I covered my head with a scarf, I was openly laughed at.

 One evening, I was walking home from seeing friends.  It was dark, but as Egypt gets dark between 5 and 6.30pm throughout the year, this was not something that could be avoided so was not usually a problem.  It was full moon, and for once the wind that usually tears through the Gulf of Aqaba had abated and the sea was beautifully calm.  I chose to walk home along the quieter sea front to enjoy the peaceful sound of the waves before I got back to my dark and stuffy home.  There is only a small portion of the seafront that lacks street lamps or doesn’t pass in front of either restaurants or houses, so I didn’t think I would be in any danger.

However, as I rounded a corner onto the only dark strip, I saw a man standing facing the wall.  I assumed he was urinating (not uncommon) and ignoring him, kept walking.  From what happened next, I had clearly been mistaken.  The details are unnecessary, but suffice to say, I believe I escaped rape only through good luck, my level-headedness and a few choice words of my very basic Arabic, which maybe illustrated that I was not ‘just’ a young tourist who would leave without telling anybody.

The Consequences

Freedom, confidence and trust stolen

I was extremely fortunate to escape with relatively little physical or emotional harm, but the consequences have stayed with me.  For the following couple of weeks, I was unable to walk down the street past young Egyptian men calling out their usual ‘greetings’ without my heart racing, my chest going tight and struggling to breathe.  As I had not got a good look at my attacker’s face, he could have been any of those people I walked past on a daily basis.  My implicit trust in human nature was damaged, and has still not been fully repaired.

Whereas I used to feel confident and almost invincible, I lost the freedom I used to feel to be able to do anything or go anywhere I wanted.  I wondered how many other women it affected; if it could happen to me then surely it could happen to anyone, and not everybody would feel they could tell someone.  I thought of the thousands of women who are assaulted everyday, all too often in ways much worse than me, and how that must affect the collective psyche of women on earth.

I don’t want sexual assault to be a taboo subject.  I don’t want women who have experienced it to feel that they are alone or that they cannot overcome the consequences.  On the other hand, I do not try to pretend that I have any notion of what it is to deal with cases worse than mine.

The Other Side – An Egyptian males view

Are some women provoking the assault of others without knowing?

When I described what had happened to me to a male Egyptian friend, he was sorry, but gave me an insight into the other side of the story.  As a diving instructor, he claimed that he and his friends experienced sexual abuse at the hands of western women on a regular basis.  He said that, all too often, women came to Egypt to dive, to get drunk and to have sex with young Egyptian men.  They would seemingly purposefully change directly in front of their dive guides and make sexually explicit comments.  After a days diving, my friend received a phone call from his client saying, “Where do you live? I’m coming to have sex with you.”  Other women regularly touch their dive guides inappropriately underwater where they can do little to defend themselves.  One woman, whilst my friend was driving her to a dive site, apparently grabbed his crotch.

The majority of dive guides and instructors come from distant parts of Egypt, which are often more conservative than the town I stayed in, and infinitely more than the western world.  If they are not married, many of these men have never even held a girl’s hand, let alone had any kind of sexual relationship, so the presence of young women in bikinis, drinking and dancing provocatively in bars in the evenings and coming on to them is understandably extremely uncomfortable and disturbing.  To the naïve newcomer, the overriding perception of a western woman is one with very few morals who is happy to have sex with any person at any time.  So is it really surprising that my attacker considered it acceptable to do what he did to me?

The sexual assault and rape of women in Egypt, both Egyptian and others, is a relatively well-publicised problem.  But I have never heard any mention of the abuse tourists inflict on the men they visit, which is potentially an equal if not greater problem.  Additionally, it can only exacerbate the potential for abuse of women.

Looking Forward

Consequences for my career, and maybe yours too

After my experience in Egypt (although I should state that I believe it could just as easily have occurred in Britain, or anywhere else in the world I have worked), I no longer feel happy to walk home alone after dark, or in places I do not know.  As a woman working in ecology and conservation in the developing world, I often have to work unusual hours in remote places in cultures very different from my own.  Whereas before I would have gone into these places carefree, now I might think twice, only go with other people or at certain times, or even not at all. 

Sometimes I am angry with the person who attacked me for taking that freedom away from me.  But other times I am grateful.  I came away relatively unharmed, but more aware of the potential dangers in the world.  Perhaps my awareness now will prevent something far worse happening to me in the future.  And I hope that by sharing my story, I might make some of you other seemingly invincible young women (and men) a little more cautious and safe, and maybe think a little about the image of western women you contribute to when working in different cultures.  As I said, I always try to find a positive outcome from every experience.


What do you think?

I do not claim to be an expert on any of the topics covered in this blog.  I speak only from my own experience and from discussions with friends, male and female, British and Egyptian, so I would love to hear anyone else's thoughts or experiences which are relevant.

African Women Unite for Community Forest Management

I was absolutely delighted last week to stumble across the recently formed African Women's Network for Community Forest Management (REFACOF Réseau des Femmes Africaines pour la Gestion Communautaire des Forêts). According to Cécile  Ndjebet, (President) the network, which consists of members from 14 countries across Central and Western Africa, aims to "reverse gender inequalities in forest governance and legal frameworks through a variety of context-driven approaches, including advocacy and lobbying campaigns, promotional  communication, and dissemination of key publications and written works."

The network was born out of the African Women's Declaration (Yaoundé 2009: International Conference on Forest Tenure, Governance and Enterprise) which "illustrates the significant role that women play in forest management and in the broader scope of socioeconomic development in Africa, as well as the main challenges African women face throughout the continent in forest and land management and expectations for future action." 

They have just held their second meeting, a Regional Workshop on Gender and Land and Forest Tenure in Africa (8th -15th October 2012), and I am excited to hear the results of it. You can download the interview with the President, Cécile Ndjebet here .

This is of particular interest to me as I have been reading up for some time on the environmental degradation of the Congo Basin (Mongabay: Deforestation in the Congo Rainforest) and the gross inequalities faced by women in Central Africa. The Congo has been labelled the "worst place on earth" to live if you are a woman because of the use of rape as a misogynistic warfare method (The worst places in the world for women: Congo). The REFACOF gives me hope because it has provided a forum for the women of Central Africa to be represented and for their rights to land tenure, equality and dignity to be heard. And maybe through this platform some action for sustainable environmental management will be achieved because the key actors are actually engaged in the process.