Be careful what you wish for…

It’s funny how things can turn out. Last week I wanted to write about chickens, and unfortunately, I ran out of space. Although a little sad, I knew that sooner or later the topic of chickens would come around again. Little did I think it would be so soon! Long-time readers of this blog will know I have a passion for all things ‘chicken’. I have often boasted that I have the largest chicken collection in the world, with some 6,000+ chicken artifacts filling our house. I don’t know if my claim is true or not these days, but I like to think so.

The one thing I don’t do with chickens is eat them. I’m a long standing vegetarian of well over 50 years. Back in the time of my childhood, in the middle of the 1950s, chicken was eaten as treat. Astoundingly, back then people in this country ate less than 2lbs of chicken in a whole year. It was a treat. These days, on average, non-vegetarians eat a staggering 55lbs of chicken in a year (or over 4 lbs a month). That is a lot of chicken. Unfortunately for the chickens, over 70% of the chickens that get raised for meat do so in intensive, industrial farming systems. They are bred to reach their slaughter weight between six and eight weeks. They will never see the daylight, or scratch and forage outside. In more natural conditions, chickens can live up to six years, although they may stop laying eggs every day before then.

The cost of chicken meat has risen over the past two years, but more so in the last few months. The price of eggs too. Equally, there have been shortages of both. There are well known reasons for these costs and shortages – see here – but it is the consequences of the H5N1 virus - bird flu - that has caused the most problems. It is a highly contagious disease and there have been national restrictions regarding the keeping of all poultry that have caused challenges for both the large industrial farms and backyard farmers like us. 

Our chickens have been kept indoors complete with a large aviary for them to run about in since the summer of 2022. They don’t like it, the goats don’t like it, and we certainly miss seeing them roaming around free.

We had to let our ducks go as it’s almost impossible and certainly unkind to try and confine ducks indoors, even with an outdoor aviary. The restrictions have also meant that large numbers of birds have been culled, both here and across the world. Up to the beginning of February this year, 15 million domestic birds (including chickens and ducks) have died from bird flu, while 193 million more birds have been culled. Cases have been found across the whole of the UK.

In the past, bird flu has not been thought to be dangerous to humans. Only 860 cases of people diagnosed with bird flu have been reported to the World Health Organization. That said, 56% of people infected died as a result of the disease. In the UK, the aptly named Andrew Gosling was one of the fortunate ones. He caught the virus in early 2022 after his ducks, (some of which lived in his house!) became infected. He survived.

The prompt for writing this blog however was the death of an 11 year old girl last Wednesday in Cambodia. She became ill on the 16th Feb and was finally diagnosed as being infected by the H5N1 virus on the 22nd, dying shortly after receiving the diagnosis. There are no effective treatments for humans infected with bird flu, let alone the H5N1 virus strain. Cambodia has reported 56 cases of H5N1 infections in people since 2014, 37 of which were fatal.

As I write this blog it is unclear if the girl had any interactions with birds who may have been carrying the virus. The alarming aspect to the story is that a further dozen people living in the same area as the girl are suspected of being infected with the H5N1 virus, and have been tested. Four of this group are symptomatic. This raises the awful prospect that the virus may be spreading from human to human.

Learning the lessons from the Covid19 pandemic, officials at the UK Human Security Agency (UKHSA) are currently modelling how a worst case scenario of a bird flu outbreak in humans might be addressed. One of the people working on this modelling is the epidemiologist, Professor Neil Ferguson. His modelling of the Covid outbreak led to the UK Government imposing the first lockdown. Following on from the experiences of Covid19, this worst case scenario is almost too difficult to contemplate.  The UKHSA have released their estimations of what a ‘mild scenario’ might involve. They calculate that one in 400 people who caught bird flu would die due to the virus. In the case of a more severe scenario, the rate could rise to one in 40 cases. Unlike the Covid pandemic however, a bird flu outbreak could put more young people at a higher risk of death than the elderly.

However, before we all get too gloomy and worried, the UKHSA have noted that there is ‘no evidence so far that the virus is getting better at infecting humans or other mammals’ and data suggests that H5N1 ‘does not pass easily to people’. I really hope they are right. The Covid pandemic undoubtedly raised the world’s level of awareness of the need to prepare for such disease outbreaks. As for me, I’m going to be careful what I wish for when it comes to writing my blog in the future. Whilst we can’t seem to get many vegetables at present (even turnips have mysteriously sold out), I have yet to hear of a pandemic that has been caused by plant-based products.      

Not the blog I was going to write, but the best laid plans and all that…

In last week’s blog I reflected upon the catastrophic earthquake in Turkey and Syria. Alongside the war in the Ukraine, pictures and stories from the area have continued to fill our daily news programmes. Often these stories have been about individual triumphs. There have been many extraordinary stories, and some are captured here. Whilst some international rescue teams are beginning to leave the earthquake area, individuals are still defying the odds and being found alive. Last Thursday, 10 days after the earthquake a 17 year old girl was pulled from a flattened building, on Friday a 77 year old grandmother was rescued alive. Sadly, these stories of survival against the odds are becoming rarer.

The scale of what has happened almost defies understanding. As I write this blog over 46,000 people have died. Just last week I noted the number was 28,000. Millions of folk are now completely dependent upon aid in order to live. The area impacted by the earthquake is as big as Britain. The ground torn apart, in some places, by as much as 23 feet. Many buildings were flattened by the earthquake, and it’s estimated a further 85,000 buildings will need to be demolished because they are deemed unsafe. Nearly 1,600 children are being cared for by authorities in Turkey, including some 250 children who have yet to be identified.  

For many of us, there is little we can do practically to help other than perhaps make a donation. That said, every donation, however small, will make a difference. I believe that we should all try and keep those families and communities in our thoughts and prayers; it is going to take a long time for these people’s lives to return to any sense of normality.

In a weekly blog it can be difficult not to focus on events such as these. But there are other related stories to be told. Last week, for example I spent an interesting morning with colleagues from our estates and facilities departments. My eyes were well and truly opened. I started by visiting our Electrical and Biomedical Engineering department. Tucked away in a little building this fantastic team look after the hospital’s some 26,000 pieces of medical equipment. It was impressive work they were doing. I was pleased to see that half the engineers were female. The day before my visit the department had received a delivery of equipment to replace existing equipment across the Trust.

My MBA learning kicked in and I was able to ask the intelligent sounding question ‘so this is equipment that has reached its predicted depreciation value, although it still has some useful life left?’ – the answer was yes, and of course the new equipment was an updated and more technically effective version than the original. ‘What happens to the replaced equipment?’ I asked – apparently it is usually sold off through a specialist auctioneer, but in times of crisis such at the Turkey/Syria earthquake, the Trust looks for ways to make the equipment available to those providing relief and medical care. I have a note to see whether we have been able to do so.

I was able to meet colleagues from across the more traditional professions and trades associated with estates and facilities departments, such as catering colleagues (we have the only two award-winning top NHS Chefs in England working in the Trust), porters, domestics, electricians and so on. I also met some new folk, working in areas completely unknown to me.

One area was logistics. Knowing how much of everything we required or consumed is a critical insight needed in an ever increasingly cost conscious world. Likewise, I was fascinated by the conversations with my colleagues working in compliance. Our need to keep on top of health and safety regulations, building regulations and the like was equally compelling and critical. Much of our building stock (and that of many NHS buildings) is now very old and built during periods where the current regulations were not in force. Ensuring that wherever possible we keep our patient environment safe is an ongoing process of checking and restitution. 

It seems that the reasons there was so much damage to buildings in Turkey was that many were constructed ignoring the prevailing building regulations. I don’t know why this was the case, but strongly suspect it would be to save money and maximise profit. Whilst none of the NHS building stock would fail because of such reasons, the NHS backlog maintenance problem is huge and growing every day. Whilst this is a problem many NHS Trusts have to deal with, those with roofs made from reinforced autoclaved aerated concrete (RAAC) are in the frontline of the risk of catastrophic building failure. NHS England has already set aside some £685 million up to 2025 to try and resolve these problems. The cost is likely to be much higher as some affected hospitals will need to be replaced with new hospitals altogether. If you can bear to read the detail, and it is pretty depressing and worrying, have a look here.

However, none of the above was what I intended to explore when I opened my computer to write this blog. I wanted to post a more light-hearted blog about chickens. Admittedly my interest was sparked by the sad and puzzling death of one Japer Kraus. He died from a heart attack after one of his Brahma chickens attacked him and caught his leg with one of its spurs, causing catastrophic blood loss and death. Just to put such tragic things into a little perspective, worldwide, 136 million chickens are killed by humans each day. I’m a long time vegetarian so don’t look my way.

It wasn’t to be. Alas the best laid plans (or in this case eggs) don’t always come to fruition. I have kept chickens for over 50 years and have never been attacked once. Gregory Peck, our current cockerel knows that in the hen house, I’m head of the pecking order and that works well. We have a respectful relationship. However, I know that in our house, J is head of the pecking order which works equally well.

There but for the grace of God, go I.

Well, there was much to reflect upon last week. For example, the recent news of the grotesque and unplanned profits announced by both Shell and BP appeared to, quite rightly, get a backlash from folk. Possibly because not only were the sums astounding, but they were also a direct result of international turbulence and conflict and not a planned business success. These obscene profits were literally a windfall gift for Shell and BP. The backlash focused upon how the wealth of a few had increased, while most of us continued to struggle with the ever increasing cost of living. The current cost of living crisis is partly caused by high household energy costs; costs which are likely to rise for the majority of us yet again in March.

The war in Ukraine has been said to be at the root cause of these cost of living problems. Today is day 354 of this dreadful war, with no resolution in sight. Indeed, with the call for the West to supply fighter jets to Ukraine, there is a sense that things are set to escalate even further. My sincere hope is that collectively the West continues to stand with the Ukrainian people until such time as this senseless conflict is over. I don’t believe that we cannot do so. Like others, I continue to practically support the Ukrainian people, and keep all those impacted by the war in my thoughts and prayers.

The continued industrial action across the public sector in the UK seems similarly intractable, with no resolution in sight. I try to avoid overtly making political statements in this blog, but I do think the apparent intransigence from government does not bode well for anyone, least of all the Conservative party. Sooner or later people will have to get around a table and start to negotiate a way forward. Indeed, in Wales, Scotland and some parts of England, local agreements appear to be taking shape, so why not across the wider public sector. I’m not an economist but I do know that for every 1% added to the UK public sector pay bill, it costs the country around £2.5 billion. Sounds a lot I know, but let us not forget that the current government spent more on unusable PPE than it would have taken to double the salary of every nurse working in England. And please don’t talk to me about the £30 billion cost to the UK of the disastrous Liz Truss mini budget.

I know I shouldn’t, but I get really frustrated and angrier every day when I see no resolution in sight for my nursing and allied health and social care colleagues. The industrial action is clearly hurting some nursing colleagues who lose a day’s salary for every day they are on strike. Some will inevitably find it difficult to keep up their strike action. I guess other forms of industrial action will be contemplated. Likewise, the industrial action is having a negative impact on reducing the historically high waiting lists. As I have said before, waiting lists are not simply numbers on a spreadsheet; they represent real people affected by the long waits for a diagnosis or treatment. Some will not get their needs met in a timely way and will suffer avoidable harm. Some may even die unnecessarily. As I write this blog, I can’t find the numbers of possible avoidable deaths in England, but the latest Office of National Statistics data shows a steadily increasing non-Covid related death rate. Currently it’s a death rate higher than the last 5 years’ average.

Of course, worrying as these events and occurrences are, they are all eclipsed by the awful, desperate situation in Turkey and Syria, following last week’s earthquake. This morning I read that well over 28,000 people have died. It is a death toll almost too difficult to comprehend. The pictures filling our screens have been simply horrific and so painful. 

I have to admit to my sadness filling my eyes and spilling down my cheeks when I saw the picture of Mesut Hancer holding the hand of his 15 year old daughter Irmak last week. She had died in the earthquake, asleep in her bed. The photograph, taken by Adem Altan, captured her father sitting by her still trapped body, holding her hand. The pain and despair seen in his face were almost unimaginable.  

Mesut’s sorrow and anguish has been replicated across many parts of Turkey and Syria. Indeed, across the world, relatives of those caught up by the earthquake have shown their disbelief and pain at what has happened to those they love back in Turkey and Syria. The fact that death came so suddenly and terribly while most people were sleeping adds to the trauma being experienced. I cannot imagine the sense of loss so many people, families and communities will be going through.

The sad situation being faced by so many in Turkey and Syria, make me realise how much I have to be grateful for. The war in Ukraine made me realise how much I (we possibly) take for granted. Likewise, this tragedy reinforces how fragile and vulnerable our very existence might be. I have said it before and I will keep on saying it. We are here one time. None of us knows what tomorrow will bring. We should try and live each and every day to the full. Although difficult to achieve at times, we perhaps should try and make every moment count. Likewise, let’s do all we can, however small an act, to try and make a difference to all those who find themselves impacted through war, poverty, natural disaster, illness and trauma. It could be any one of us tomorrow.

Looking after every child matters, now more than ever!

I’m guessing that many readers of this blog would not know who Ralph Ehrmann was. I include myself in this number. However, last week on the fabulous Radio 4 programme ‘Last Word’, I heard of his death on 10th January. He was 97 years old. Whilst I may not have known of him by name, I certainly knew about his wonderful contribution to my childhood. He was the man responsible for the hugely successful Airfix phenomena. Now you do need to be of a certain age to understand the attraction of Airfix models. During the 1960s and 70s Airfix was one of the UK’s leading toy manufacturers. The Airfix model kits being second only to Raleigh bikes in the hearts of children – me included!   

If I may beg your indulgence for a moment, I want to make a slight detour. In 1948 the Massey-Ferguson tractor manufacturer asked Airfix to produce a model of their new TE-20 tractor, later to become known as the ‘little grey Fergie’, as a promotional marketing item. It was a huge commercial success. Owning a ‘little grey Fergie’ has long been one of my life’s ambitions. I did very briefly actually own one, buying it on an eBay auction, but sadly never got to keep it for reasons you don’t need to know dear reader. I know one ought not to have regrets, but that was a life episode that hurt.

Anyway, back to the story, the model tractor kit inspired Ralph to make more models and the rest is history. For most of my childhood years I would get an Airfix model for birthdays and Christmas, and I loved them. I made countless aeroplanes (favourite was the Spitfire of course), cars (loved the British sports car range), and ships (I think it was the Golden Hind I first attempted). Each was built from a kit made up of parts that had to be first detached from a plastic frame, and then glued together using a solvent glue that probably would be banned today. 

Once completed, each model would be painted using little, tiny pots of paint with equally tiny paint brushes. Sadly, Airfix went bust in 1981, although you can still buy their model kits on eBay. The Airfix models, and the making of them was a wonderful part of my childhood.

I was reminded just how important the role of toys and play might have on the development of children and young people last week when I visited our children’s service, Treehouses. I knew straight away that this was a non-adult environment. The colours, pictures, furniture, and whole space was designed with children in mind. I couldn’t quite get to the bottom as to why the unit was called Treehouses, but there was a general jungle, farm, and zoo theme running through everything about the place. It was here that I met my first play therapist ever.

My first thought was what a dream job. However, playing with children, keeping them distracted, engaged and happy in times of anxiety, pain and separation from mum and dad is a real skill. Experience of my own grandchildren tells me I can manage that for a few hours before I’m glad to hand the children back to their parents. Indeed, I take my hat off to all my colleagues working with children and young people.

I was only able to see the in-patient services on this occasion, which given the wide age range of children being assessed and treated, I thought was simply wonderful. My next stop in a couple of weeks is to spend some time with my colleagues providing services to children and young people in our communities. It is something I’m really looking forward to.

Our children and young people are also our future. We are seeing across the world the potential impact on societies where the birth rate has fallen and there is a growing imbalance between an ageing population and a reduced number of people entering the workforce. For all countries it is critical that there are sufficient working-age individuals to drive the economy and ultimately support an ageing population.

In the UK, the birth rate has shown a steady decline over the past five years. I have no ideas as to how we address the downward trend in births, and actually I think I have done more than my fair share in adding to the population. That said, we need to do more to ensure our children have the best start in life possible. It would have been impossible to miss the launch last week by Her Royal Highness, The Princess of Wales, of the ‘Shaping Us’ awareness-raising campaign aimed at increasing the public’s understanding of the critical importance of the first 5 years of a child’s life. HRH Katherine said at the launch of the campaign ‘The way we develop, through our experiences, relationships, and surroundings during our early childhood, fundamentally shapes our whole lives. It affects everything from our ability to form relationships, thrive at work, and to our mental and physical well-being as adults and the way we parent our own children.’

If you have not yet seen the launch video capturing years of research in just 90 seconds, have a look here. Although it reminded me of those Lurpak advertisements from a few years ago, it is well worth a look. As is the Children’s Mental Health Week website. Next week is children’s mental health week – the theme of which is ‘Let’s connect) – making better connections with each other. Have a look, and even think how you might get involved. We can all make a difference, and now more than ever, looking after every child matters.