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2.1.1 Ian Traenor

Figure 1
Ian Traenor

Ian Traenor used to be a former employee of Scottish Hydroelectric. At the time of the recording, he had ‘crossed over to the
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7 Audio clip 4: Paul

Paul was 30 years old when he was interviewed. He had been in and out of homelessness for most of his adult life, but had become a volunteer with the Cyrenians. He was living in a shared house with some other volunteers.

Paul spent much of his childhood in a caravan in Happy Valley, near the sea, with his parents, brothers and sisters. At 21, when he was living with his girlfriend and her parents, his daughter was born. When she was two months old, they were kicked out, and Paul went to
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6 Audio clip 3: Ernest

At the time of the interview, Ernest was 28 years old. He was living in the Cyrenians' hostel, where he had been for some time. He was trying to find employment, and was contemplating a move to independent living. However, he felt somewhat frightened at the prospect of leaving the security of the hostel, which he likened to a family.

Ernest is from Kenya. He first came to Britain, and Swansea, as a student, eight years before the interview. You will hear about the difficulties he faced
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5 Audio clip 2: Danny

Danny is 49 and sleeps rough in the city, as he has done for very many years. He was born and bred in Northern Ireland, and recounted some happy childhood memories. He became a civil servant in London, working for the Department of Health and Social Security, as a higher executive officer, but lost his job and his wife through drink. After sleeping rough on the streets of London for a while, he returned to Belfast. After robbing a chemist's shop, he was sent to prison for seven years, for rob
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4 Audio clip 1: John

In this first clip, Julia Johnson, from the Open University, talks to John, who had been sleeping rough in the city and living in an abandoned van in a car park for three weeks.

At the time of the interview, John was 43. He was born in a town near Swansea, but had spent much of his life in institutions. His childhood was spent in a large ‘mental handicap’ hospital, which has now closed. Some years after his discharge, he and his brother were arrested, and subsequently imprisoned for
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2 Schemes run by Swansea Cyrenians in 1999

A hostel, which provided accommodation for 13 people, predominantly men, in individual rooms and an overflow shed. It was run in partnership with the Family Housing Association. Three-quarters of its funding came from the Welsh Assembly, and a quarter from the local authority.

Another important source of revenue was Housing Benefit, through which residents were able to pay their accommodation charges. This varied enormously. Residents classified as ‘vulnerable’, like those with ment
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1 The Swansea Cyrenians

In this unit, you will hear from four people who have been helped by a secular voluntary organisation offering support and assistance to the homeless.

The Swansea Cyrenians is one of several organisations that are in touch with homeless people in Swansea. Since 1973, it has been helping some of the most vulnerable people in society, including those who have suffered from homelessness. At the time of the recordings, in 1999, the organisation was running a number of schemes to help
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3 Audio and activity

Activity 1

In these audio clips, you will hear about the Chinese Welfare Association. At the time of recording, Anna Manway-Watson was its Director, and Lily Sau Han Braid, the Community Development Worker for older people
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1 The Chinese Welfare Association's Carer Support Project, Belfast

This audio unit features a project that was set up in Northern Ireland specifically to support Chinese carers. It is one of several projects being run by the Chinese Welfare Association in Belfast at that time.

The Chinese Welfare Association

The Chinese Welfare Association is a voluntary orga
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Introduction

This unit will help you understand how it is possible to meet the needs of a particular minority community – the Chinese who live in Northern Ireland. The audio clips will give you an opportunity to listen to some first hand experiences and discover some of the problems that this community are facing. You will also hear about the needs of the community in terms of care and support, particularly in terms of meeting the needs of older Chinese inhabitants.

The audio file was recorded in
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Acknowledgements

Acknowlegements

The material acknowledged below is Proprietary and used under licence (not subject to Creative Commons licence). See Terms and conditions.

Grateful acknowledgement is made to the following sources for permission to use material in this unit:

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References

Airhihenbuwa, C.O. (1995) Health and Culture: Beyond the Western paradigm, London, Sage.
Antonovsky, A. (1984) ‘The sense of coherence as a determinant of health’, in Matarazzo, J.D. (ed.) Behavioural Health, New York, Wiley, pp. 114–29.
Antonovsky, A. (1987) Unravelling the Mystery of Health: How people manage stress and stay well, California, Jos
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8 Summary and key themes

In this unit you have been introduced to a diverse range of ideas about health. To recap, the themes and ideas you have met in this unit are:

  • The diversity of accounts of health. An important theme of this unit is that there is a great diversity in what people mean when they talk of health; sometimes these meanings conflict and sometimes they can coexist but health is a creative and multifaceted concept.

  • The importance of
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7 Moving to a positive paradigm

Aaron Antonovsky (1984) has called the emphasis on illness and disease the pathogenic paradigm and has stated that this disease-focused paradigm has dominated our healthcare system. He claims that there are five important consequences of this domination:

  1. ‘We have come to think dichotomously about people, classifying them as either healthy or diseased’ (p. 115). Those categorised as ‘healthy’ are normal, those categorised as non-healthy or ‘d
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6.3 Responsibility for health and illness

In Activity 6 you explored factors which influence people's experience of health and we noted that inequalities in health are clearly related to the conditions of people's lives, such as their housing, income and education. On the other hand, health education messages have tended to focus on behaviour – what we
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6.2 Concepts of Illness

Sontag (1979) wrote about the metaphors we use to describe illness. Metaphors are ways of speaking about something as if it were something else which is imaginatively but not literally applicable, for instance calling a new moon a sickle. Sontag was mainly concerned with life-threatening illnesses such as cancer and AIDS, and how the metaphors we use can serve to stigmatise the sufferers, for instance referring to AIDS as a gay plague. But people use metaphors to explain illness to themselves
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6.1 Introduction

Although clearly related, the concepts of illness and disease are distinct. People have illness and physicians diagnose and treat disease. Disease is an objective term which implies a malfunctioning of the body or part of the body. Disease is pathological and is diagnosed on the basis of recognisable signs and symptoms. Illness is the subjective experience of pain, discomfort or disorder. Although it is mostly safe to say that illness is the subjective experience of disease, it is possible to
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5 Quality of life

‘Quality of life’ is beginning to be seen as significant by health policy makers. But this raises all kinds of problems about evaluating initiatives to promote wellbeing and quality of life.

If health is difficult to define then quality of life is even harder. You will have difficulty finding a tight definition. As George and Bearon state:

On the whole, social scientists have failed to provide consistent
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4.2 People knowledge

Stacey (1994) has made a passionate plea to understand the ‘power of lay knowledge’ which she prefers to call ‘people knowledge’. Stacey claims that two fundamental assumptions underline the importance of listening to lay voices. One is that all people are of equal worth and so their views should be heard. The other is that people are health producers as much as they are health consumers. She maintains that patients do a great deal of hard work, whether it is direct as with labouring
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4.1 Introduction

As we said at the beginning of the last section, much of the impetus in earlier work on lay perspectives was to examine how far they deviated from the ‘true’ knowledge of experts. Now the emphasis has changed and there is a move to try to understand lay knowledge in order to inform expert knowledge, and in the process the distinction is increasingly being questioned. As Bury notes, the ‘opposition between the world of patients and doctors has been a major theme in medical sociology’ (
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