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Case Studies

Case Study 1

Mrs S has four children who are 3 to 13 years of age. One of her children is disabled. She is an unemployed and full-time housewife. Her husband is the only earner in the family. He is a minicab driver, although, due to Covid -19, there was no work, and he also could not get out from home often because of health complications. So, during the pandemic period, their income was almost nil. They had no savings, so they were living almost hand to mouth. All other family relatives were struggling to manage their own livelihoods, so they had nobody as support. They were living on child and disability benefits. Subsequently, they have been seriously suffering from food poverty, and their young children were at risk. The family was even struggling to manage to feed their children properly and buy day-to-day essentials. When we delivered all the ingredients to their household, her children were so happy and excited. In seeing the face of Mrs S., however, we watched her eyes become tearful as she said, 'May Allah bless you'.

Case study 2

One of our families contacted us and reported that all the family members were suddenly going for quarantine as their elderly mother had died of COVID-19. They took her to the hospital for a different reason, but it had identified that she had the virus and that she had died. He has three children, and he starts crying and says he does not know what to do in this situation with little English and is unaware of either what to do or where to go. They had nobody to support them, and he was not even allowed to attend his mother's funeral. Mentally, the family were broken down. We engaged a psychologist to support the family, and at the same time, we supplied recipes and food ingredients for them. The family greatly appreciated our support. They said, 'We don't know how to thank you. Without your support, we might not be able to survive in our difficult times. Bless you.'

Case study 3

Maryam (pseudonym) is a 56-year-old British Pakistani woman. She lives in a council flat in Lisson Green estate. She has been diagnosed with a Heart condition, asthma and arthritis (she uses a walking stick). Her doctors have also informed her that she is at a high risk of developing Diabetes. Maryam's children are currently in their 20's and 30's; her grandchildren would often visit her pre-pandemic. She also has elderly parents who lived away from her, so when the pandemic hit, she became extremely isolated and noticed a decline in her emotional and physical health.

Maryam noticed that the more isolated she became, she began to lose a sense of routine and motivation to manage her health and get on with daily tasks. The rise in deaths for South Asian women as a result of Covid-19 also made her extremely anxious about leaving the house. Maryam noticed that she was managing her emotions by eating emotionally and not moving as much throughout the day; as a result, her weight was increasing, and her health was deteriorating. She noticed more aches and pains in her body.

It was becoming more difficult to get an appointment with the GP, and Maryam was feeling hopeless about how to manage her health. Maryam grew up eating curries with chapatis and rice; it's what her mother cooked and what she cooked when raising her own children. She was growing tired of hearing the doctors advising her to 'eat less and move more', and the 'good ones' sometimes advised her to eat 'boiled vegetables with a chapati'. The advice in regard to managing her health felt unrealistic to her, and she would often leave these 10-minute consultations with less motivation than when she walked in. Maryam also described feeling embarrassed about asking for help; she knew she couldn't implement the guidance into her life and would feel blamed for this by health professionals. 

Maryam began to lose touch with her friends, and being away from her family, children and grandchildren were making her feel depressed and hopeless. She described having little to do at home, which made it even harder to connect and interact with others, even over the phone. Maryam's family became increasingly worried about her; they noticed her mental and physical health decline. The family noticed that Maryam was not leaving the house and would often describe feeling fatigued and in pain.

As a result of the changing nature of the pandemic, all of our sessions took place online through Zoom, as requested by the women. At the start of each of our sessions, our Psychologist would often start with a conversation regarding mutual respect, confidentiality, hopes for the sessions and a commitment to make the space safe for all. To help create a sense of community among the members, the Psychologist supported women in having safe conversations regarding the fears they were experiencing at this time, especially in relation to the pandemic. Time was spent during the sessions for women to get to know one another and share ideas, strengths and recipes/remedies. The relationship between the women is what created a sense of collective ownership over the group. People had joint goals for health that they were then able to motivate each other towards. For Maryam, these moments supported her to feel safe to return to the space weekly; eventually, Maryam was the member who would contact the other members to make sure they were able to join. Maryam's motivation to improve her health significantly increased as her relationship with the other woman was strengthened through this platform. 

Maryam said, 'A great space for people to come together and feel safe. Everyone is respectful and supportive, and it isn't common to have this sort of space. These sessions have been a 10/10; honestly, I look so forward to these sessions. I always make the time for these sessions. It's a great social thing because, after the pandemic, many people have been feeling isolated and lonely, so it's a great way to connect with new people whilst at home. I am also trying to be quite conscious of covid because it still exists, so it's great to know that there is space where you don't have to be too close but still be able to interact and have fun. The learning aspect has been great as well and something that I have been doing.'

Each of our sessions was co-produced with the women. For example, all the professionals worked with the members to design each recipe. One benefit of co-producing these recipes with the women is that it allowed the women to step into their position as experts. Maryam shared her Pakora recipe, which was then thoughtfully adapted by the chef, who then supported the other members to create this online in their own kitchens. Creating and enjoying these recipes together again helped empower women to make changes in their lives in a respectful, culturally sensitive, achievable, and meaningful way.

Maryam said, 'For example, making healthier versions of some of the dishes that we commonly love to eat, like the pakoras, has been fun to make, so I don't actually have to feel guilty about eating them anymore. Knowing what you could make out of one vegetable. The ingredients aren't expensive either and can be found in your home. These sessions have allowed me to be more open-minded about Food and share the knowledge with people I know. My friend was surprised when she tried the courgette cake, shocked it was made out of courgettes, but she loved it. It is so interesting to see how you could change up the ingredients slightly, just for it to taste just as good.'

We also dedicated sessions to the health difficulties that women faced. Maryam especially valued the discussions related to women's health, menopause and changes in eating as women mature. Our Dietician supported women in thinking about labels and nutritional content in a way that was easier for them to understand. The trust developed between the women made it a discussion where they could ask questions that they had previously felt embarrassed to discuss in health settings. Maryam said, 'I've already been trying to be health conscious about Food and realised how much we need to take care of ourselves because a lot of foods are high in carbs. So, it's good to know about the nutritional value, and calories of certain foods and know what to eat, especially for any specific health conditions. Also, being able to find alternatives with certain foods has been useful.'

We reflected on the mistrust of mainstream health services and discussed how misinformation was spreading in the community. We discussed in depth how these women would play a role in influencing change in other people's lives.

Maryam said, 'I would say our community is quite lost, in the sense that, especially the older generation, those who have been brought up back home, they sort of hold old beliefs and don't tend to question a lot. This includes sharing information from word of mouth and not knowing why or how these beliefs have been brought about. The older generation isn't as health conscious either. I like how these sessions make challenging recipes, being able to learn from mistakes that I have been making before. The help of an expert really tops your understanding and knowledge of Food.'

We are really lucky to have professionals, especially south-Asian women, on board, who are talented and share their words of wisdom. I felt able to ask anything and knew that they would work hard to find solutions for me. Some of the recipes I have continued recreating. I also educated my parents and children about some of the foods we already have and how we could make healthier versions of them.

This platform allowed Maryam to overcome her sense of isolation and feel more connected to others. Maryam's commitment to her mental and physical health significantly improved and she felt empowered to help herself and others. The sessions' pace meant that she could implement changes in her life over the duration of the programme and share her hopes and achievements within and outside of the group. Maryam said, 'I love how Zoom is great technology to bring people wherever you are and will always recommend this to friends and family. It has allowed us to understand how eating good foods can also help us mentally. You'd feel good about yourself. 

Overall, I would say this programme brings the community together and creates that sense of trust and sisterhood that has been missing for a while. The diversity allows us to learn new things from different cultures and brings us together as we are one at the end of the day.'

As a result of this programme, Maryam has stayed in touch with a number of women from the group, and they have continued to share health advice. Maryam attended our food festival and was a great volunteer on the day. She encouraged a number of local women to join the food festival to celebrate the great achievement. As said above, Maryam has continued to implement health advice from professionals. She has a new passion for improving mental health through Food and lifestyle, something that was previously not given the same importance. She has continued to adapt recipes to meet her health needs, something she expressed difficulties with doing in the past. She has become an advocate for women's health and is committed to sharing her learning with her loved ones and the wider community.

 

CASE STUDY 4

Rana (Pseudonym) is a 43-year-old British Bangladeshi woman living in Westminster. She lives in an overcrowded flat with her husband and four sons (aged 13, 11, 4 and 1). Rana heard about our programme through a neighbour who could see that she was struggling at home. Rana talked about feeling overwhelmed with household chores and managing the needs of her four children. She spoke about not having the time to socialise with friends and family, which made her feel isolated and disconnected from others. As a result of her demanding lifestyle, she was unable to prioritise herself and was noticing a decline in her physical and mental health.

Rana joined weekly and said 'the sessions have been really good and very different to what you'd expect. It has been nice to build relationships with these women. Rana was often one of the members that were able to speak both Bangla and English fluently, and through building strong relationships with the women, she was then empowered to support the other Bangladeshi women to express their needs and ideas in the space. 

Rana was one of the many women who spoke about how inaccessible healthcare services were. She spoke about how often health advice would feel tokenistic or not tailored to south-Asian communities. She said, 'It has been helpful that the south-Asian professionals have been able to speak about the research done about certain health conditions. It reminds you of how to take care of your health and what steps you need to take.'   

Rana recently gave birth again in her early 40s. She talked about how different and difficult this pregnancy was in comparison to when she first gave birth 13 years ago. Rana also shared how difficult it had been to seek support for this, as it felt shameful to do so. At Rana's request, our professionals tailor a session specifically for pregnancy and postpartum physical and mental health. Rana felt listened to and supported to share her own struggles with being an older mother and the changes she was facing with her body. 'It has been great to have these sessions tailored to specific topics/themes, having that discussion because this isn't very common in our community. These discussions have been catered towards everyone so it doesn't actually leave anyone out. The requests have been taken on board and really have been listened to.'

When we first met Rana, she spoke about being determined to be healthy but not having the knowledge or time to implement the learnings. Rana spoke about always drawing on the foods that she grew up eating, often meat or fish curries. She expressed that the lack of time and resources meant that she often felt rushed and didn't want to waste money trying new foods that her family might not like. This project allowed Rana to take risks with Food that she may otherwise have never tried. After attending our sessions, she said, ' It has been quite adventurous in terms of the recipes, having to step out of your comfort zone but also realising that some of these foods taste very good. For example, the lemon artichoke recipe is something most people have never heard of or even tried, but I've really enjoyed making them. I would say I have always been quite conscious of Food, especially after pregnancy, but it has been reassuring hearing from the Dietician and chef about healthy lifestyle changes that we should implement.'

 

Rana is also a carer for her elderly mother, who has a number of health conditions, such as Diabetes and high blood pressure. Rana spoke about how fearful she was of developing similar health conditions as her mother. Our sessions supported Rana in thinking about her mothers' nutritional needs and how to cook to prevent health conditions. Rana and others spoke in detail about how difficult it was to support elders in their communities to make dietary changes. As a result, we spent sessions making healthy curries and other south-Asian snacks. Rana said, 'I would definitely be recreating some of these recipes again. Thankfully I don't have any long-term health conditions, but it is good to be aware of them. I've said to myself it is good to live your life as if you already have these health conditions. That way, you don't have to worry about when you actually have these conditions and prevent them from happening. It's also great how these sessions have recipes that are from our traditions but also are adapted with a healthier twist.'

Rana spoke about how little knowledge she had about the health of south-Asian communities and how this differs from the white-British population. 'These sessions have raised awareness of how important it is to take care of ourselves as this is often neglected in the South Asian community, the fact that our bodies are fighting for us to live, and we should do the same by taking care of ourselves. We don't want to end up having some health problems the older generation has faced. However, implementing these lifestyle changes isn't easy, especially since some foods can be tempting and say if someone brings you Food, you can't exactly say no.'

Rana spoke about how eating healthy was something that she was now determined to pass on to her children. In the past, she would often cook whilst they were at school or opt for easy meals that often didn't have good amounts of nutrition. This project motivated her to cook with her children, which inspired some of the other women in our group to join our sessions with their children. She said, 'It's a good influence for the kids as well if you implement healthy eating; they are more likely to follow in that footsteps.'

I would definitely recommend this to friends and family, and zoom is a great platform to connect. It's nice to share new ideas and tips with one another. As they say, sharing is caring. It's an open space for people to talk about their feelings and something I look forward to.

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