Prevention, 3,2,1

When I got off the plane on Tuesday morning at Terminal 5, ready for my connection flight to Edinburgh… well everyone now knows what the overhead TVs were showing, and like everyone, I am so sorry for those who have suffered in so many different ways in Manchester. I am also moved by the families and friends and the expressions of solidarity and love that are being shown.

I have just come from running a conference on Block Island about the crisis of opioid abuse.  This brought another time of emotion, difficulty, other griefs and suffering, loss through overdose, or lives spoiled. Words are needed but awkward, and, like writing here, nothing comes out sounding good enough, there is no good enough, there is just trying to bear it as best as one can and keep the conversations going, to find out what is best to do. I so admire these people I see just doing that, working at being together.

I am however not terribly admiring of the official responses to Manchester’s distress, but let me explain that, because I am trying to be constructive, not carping. Our very warm and open-hearted speaker at the opioid conference offered us three kinds of “prevention”. He said that prevention comes under three headings:Tertiary – problem is bad, keep it from getting worseSecondary – problem is mild or even just potential, keep it that way

  • Primary — how to keep a problem from even happening

He told that story about the village beside a river where the inhabitants found they were very often having to rescue people from drowning as the river brought struggling individuals past their doors. And then someone thought maybe it would be a better idea to go upriver and find out what / how was causing so many victims to be thrown in to the river in the first place.

The response to Manchester, to security, is tertiary. It has to be, the police are stretched – but all Theresa May has done is say it is now “critical”. Jeremy Corbyn has for years been trying to bring the situation, or situations, back to secondary, deal with the conditions in which security problems arise. The Labour manifesto has actually returned to the concept of ethical foreign policy. Well done – if this sort of policy became part of foreign relations, it would indeed help secondary prevention.

What would a secondary response to disaffected teenagers look like? Both the Manchester bomber and Khalid Masood, the perpetrator of the Westminster Bridge attack, were known when they were young people to have problems. Such people come to our attention when they have gone from bad to worse, but no-one much seems to know how to keep their problems mild. What about listening to Mike Haines? After his aid-worker brother David was killed in Syria he founded Global Acts of Unity and he travels the country talking to young people. He has enabled some disaffected youngsters, those at odds with the society in which they found themselves, to find a different way to move forward. This is prevention further upstream. Prevention – what has not happened can’t be seen. Suppose we had more outreach community workers, cooperating with police and schools, of the kind that communities have said they need, not the sort that were highly criticised as not understanding the issues at all. It would mean more people on the ground, more support to attend to this kind of work, not just catching and dealing with those already drowning. Or our schools could have trained workers … with the time to do the outreach…not more work for the staff already doing their jobs, more staff of a specialist kind, working with local people with time for co-operation, to support everyone in “acts of unity”.

Sad. We have come a long way, as we talk about solidarity and love. I would like to see more action – pro-active action – to bring prevention to the lower levels. Sad, because there is little sign that this is going to happen with the unimaginative reactions of conservatives who can apparently only think about efficiency, cuts, and austerity, and then react: “its critical“. Of course they are sorry, who would not be? We need more than sympathy to create a society where security is not at “severe” or “critical”.

So, I am not admiring of official responses, they don’t even begin to get near to secondary prevention, let alone primary (that would really take a change in our tribal global interfering world). It is sad that Theresa May and the conservative government of the last six years cannot do better.

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5 thoughts on “Prevention, 3,2,1

  1. You have hit the nail on the head. In response to all horrendous acts of this sort, where does one find any meaningful effort to find and eliminate the root cause? Causes identified are usually part of the symptoms, and get nowhere near pinpointing the disease or what causes it.
    Admittedly, the emotional public at times like these are looking for more immediate action. That can be implemented to placate them, but pursuing the primary route you refer to should be done even more strongly.

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    1. Thank you – and I would go right back to what we used to have in this country – a real support system of health visitors who helped all parents with child care in a non-judgmental way. I can’t help but think that young parents from different cultures, let alone the indigenous who are suffering no work or poverty in work, all can lose their self-confidence, become anxious worried punitive and themselves turn to more fundamentalist thinking that doesn’t help the family, creates tribalism instead of generous interaction… hotbed for a few who get radicalised. The short-termism and resultant hopelessness / resentment is really bad – I expect you saw some of it on your holiday last year even though your visit was very much for your family and was successful.

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      1. I did have to bite my tongue a lot during our visit.
        Another prime cause which nobody has the courage to attack because of blind adherence to principles of freedom of speech and religion is the eradication of hate speech and of inflammatory myths within religion, and clamping down ruthlessly on those who spread them in such a way that a foundation for radicalisation is laid.

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