Thousands turn out for "Save Lewisham A&E" hospital march

. . . and the Jeremy Hunt coconut shy went down a storm.

 

Yesterday Lewisham town centre was brought to a standstill as thousands of people took to its streets. They were voicing their their anger at proposals to close the A&E unit at Lewisham Hospital, and to downgrade the maternity service.  

The proposals come after the South London Health Care Trust ran up huge debts following an expensive PFI Initiative - as detailed in Rowenna Davis's New Statesman piece. However, that trust has nothing to do with the running of Lewisham Hospital - and there was clear anger among demonstrators that their local services were being cut in order to pay back a debt not of their making.

A local organisation, Lewisham People Before Profit, handed out song sheets with alternative Dad’s Army theme tune:

Who do you think you are kidding Mr Kershaw/ Our hospital is here to stay / We are the ones who will stop your little game / We are the ones who will make you think again / Cos we can find the money Mr Kershaw  / If we make the bankers pay.

Matthew Kershaw is the special administrator appointed by Andrew Lansley to tackle the financial problems of the South London Health Care Trust. It was his proposal to shut the A&E Department (only months after it reopened following a refit) and that the patients should be moved to the Queen Elizabeth Hospital in Woolwich to save money.

On the march, Brighton-based artist and educator Bern O’Donoghue said: “Both my children were born in the hospital, and we’ve used the A&E loads of times. We wouldn’t have coped if we’d have had to go six miles to Woolwich. It’s a ludicrous plan and one which will have a hugely damaging impact on the community.”

Many children on the demo were in buggies with ‘Born in Lewisham Hospital’ signs attached. I saw a mother marching with her children, carrying a placard saying “We’re here thanks to Lewisham A&E”.

Strikingly, the demo seemed to have brought together an incredibly diverse range of groups and organisations all united in opposition to the plans. I saw banners from various union branches and political groups, but there was also support from Millwall Football Club, who had even moved the date of a match so that their supporters could attend the demo. A local group called Islamic Awareness also displayed a Save Our NHS placard on their stall outside Lewisham Library as the demo passed by.  Even car drivers caught up in the march and unable to move were supportive, tooting their horns and cheering the marchers.

As the march passed by Lewisham Hospital itself, its staff - still in their medical uniforms - came out to applaud the demo, and were cheered in return.

At the final rallying point in Mountsfield Park, the atmosphere was positively charged as the crowds arrived and people began to appreciate the sheer scale of the march. 

And for those with frustrations left to vent, the Jeremy Hunt Coconut Shy was open, and doing a roaring trade. 

You can follow @Brixtonite on Twitter. 

A sign in a Lewisham window. Photo by @Brixtonite
Flickr/Michael Coghlan
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Why does the medical establishment fail to take women in pain seriously?

Women with mesh implants have been suffering for years. And it's not the only time they have been ignored. 

Claire Cooper’s voice wavered as she told the BBC interviewer that she had thought of suicide, after her mesh implant left her in life-long debilitating pain. “I lost my womb for no reason”, she said, describing the hysterectomy to which she resorted in a desperate attempt to end her pain. She is not alone, but for years she was denied the knowledge that she was just one in a large group of patients whose mesh implants had terribly malfunctioned.

Trans-vaginal mesh is a kind of permanent “tape” inserted into the body to treat stress urinary incontinence and to prevent pelvic organ prolapse, both of which can occur following childbirth. But for some patients, this is a solution in name only. For years now, these patients – predominantly women – have been experiencing intense pain due to the implant shifting, and scraping their insides. But they struggled to be taken seriously.

The mesh implants has become this month's surgical scandal, after affected women decided to sue. But it should really have been the focus of so much attention three years ago, when former Scottish Health Secretary Alex Neil called for a suspension of mesh procedures by NHS Scotland and an inquiry into their risks and benefits. Or six years ago, in 2011, when the US Food and Drug Administration revealed that the mesh was unsafe. Or at any point when it became public knowledge that people were becoming disabled and dying as a result of their surgery.

When Cooper complained about the pain, a GP told her she was imagining it. Likewise, the interim report requested by the Scottish government found the medical establishment had not believed some of the recipients who experienced adverse effects. 

This is not a rare phenomenon when it comes to women's health. Their health problems are repeatedly deprioritised, until they are labelled “hysterical” for calling for them to be addressed. As Joe Fassler documented for The Atlantic, when his wife's medical problem was undiagnosed for hours, he began to detect a certain sexism in the way she was treated:

“Why”, I kept asking myself, when reading his piece, “are they assuming that she doesn’t know how much pain she’s feeling? Why is the expectation that she’s frenzied for no real reason? Does this happen to a lot of women?”

This is not just a journalist's account. The legal study The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain found that women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively. 

An extreme example is “Yentl Syndrome”. This is the fact that half of US women are likely to experience cardiovascular disease and exhibit different symptoms to men, because male symptoms are taught as ungendered, many women die following misdiagnosis. More often than should be acceptable, female pain is treated as irrelevant or counterfeit.

In another significant case, when the news broke that the most common hormonal birth control pill is heavily linked to a lower quality of life, many uterus-owning users were unsurprised. After all, they had been observing these symptoms for years. Social media movements, such as #MyPillStory, had long been born of the frustration that medical experts weren’t doing enough to examine or counter the negative side effects. Even after randomised trials were conducted and statements were released, nothing was officially changed.

Men could of course shoulder the burden of birth control pills - there has been research over the years into one. But too many men are unwilling to swallow the side effects. A Cosmopolitan survey found that 63 per cent of men would not consider using a form of birth control that could result in acne or weight gain. That’s 2 per cent more than the number who said that they would reject the option of having an annual testicular injection. So if we’re taking men who are afraid of much lesser symptoms than those experienced by women seriously, why is it that women are continually overlooked by health professionals? 

These double standards mean that while men are treated with kid gloves, women’s reactions to drugs are used to alter recommended dosages post-hoc. Medical trials are intended to unearth any potential issues prior to prescription, before the dangers arise. But the disproportionate lack of focus on women’s health issues has historically extended to medical testing.

In the US, from 1977 to 1993, there was a ban on “premenopausal female[s] capable of becoming pregnant” participating in medical trials. This was only overturned when Congress passed the National Institutes of Health (NIH) Revitalisation Act, which required all government funded gender-neutral clinical trials to feature female test subjects. However, it was not until 2014 that the National Institutes of Health decreed that both male and female animals must be used in preclinical studies.

Women’s exclusion from clinical studies has traditionally occurred for a number of reasons. A major problem has been the wrongful assumption that biologically women aren’t all that different from men, except for menstruation. Yet this does not take into account different hormone cycles, and recent studies have revealed that this is demonstrably untrue. In reality, sex is a factor in one’s biological response to both illness and treatment, but this is not as dependent on the menstrual cycle as previously imagined.

Even with evidence of their suffering, women are often ignored. The UK Medicines and Healthcare Regulatory Agency (MHRA) released data for 2012-2017 that shows that 1,049 incidents had occurred as a result of mesh surgery, but said that this did not necessarily provide evidence that any device should be discontinued.

Yes, this may be true. Utilitarian thinking dictates that we look at the overall picture to decide whether the implants do more harm than good. However, when so many people are negatively impacted by the mesh, it prompts the question: Why are alternatives not being looked into more urgently?

The inquiry into the mesh scandal is two years past its deadline, and its chairperson recently stepped down. If this isn’t evidence that the massive medical negligence case is being neglected then what is?

Once again, the biggest maker of the problematic implants is Johnson&Johnson, who have previously been in trouble for their faulty artificial hips and – along with the NHS – are currently being sued by over 800 mesh implant recipients. A leaked email from the company suggested that the company was already aware of the damage that the implants were causing (Johnson&Johnson said the email was taken out of context).

In the case of the mesh implants slicing through vaginas “like a cheese-wire”, whether or not the manufacturers were aware of the dangers posed by their product seems almost irrelevant. Individual doctors have been dealing with complaints of chronic or debilitating pain following mesh insertions for some time. Many of them just have not reported the issues that they have seen to the MHRA’s Yellow Card scheme for identifying flawed medical devices.

Shona Robison, the Scottish Cabinet Secretary for Health and Sport, asked why the mesh recipients had been forced to campaign for their distress to be acknowledged and investigated. I would like to second her question. The mesh problem seems to be symptomatic of a larger issue in medical care – the assumption that women should be able to handle unnecessary amounts of pain without kicking up a fuss. It's time that the medical establishment started listening instead. 

 

Anjuli R. K. Shere is a 2016/17 Wellcome Scholar and science intern at the New Statesman

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