Shamim Ghani, BSc (Hons), RN, DN.
Formerly a practice nurse at Bromley-by-Bow Healthy Living Centre, LondonLike many areas of the country, Bromley-by-Bow in east London struggles to meet the health needs of a large ethnic-minority population. Among the Bangladeshi population living in this area, as with many other people of Asian origin, a high proportion have heart disease, diabetes and respiratory illness (DoH, 2000).
Like many areas of the country, Bromley-by-Bow in east London struggles to meet the health needs of a large ethnic-minority population. Among the Bangladeshi population living in this area, as with many other people of Asian origin, a high proportion have heart disease, diabetes and respiratory illness (DoH, 2000).
With winter fast approaching, preparations are underway across the country to ensure that vulnerable people are immunised against flu and pneumonia (DoH, 2000). Most practice nurses are well aware of the logistical nightmare of making sure that adequate supplies are ordered and immunisation clinics are adequately staffed. This problem is compounded by the fact that patients are not always willing to be immunised.
At our Healthy Living Centre, last year's campaign involved alternative means of convincing the local Bangladeshi community that flu immunisation is necessary to help reduce the number of flu-related deaths.
The centre runs a lunch club for elderly Bangladeshi men, where health advice can be given in a relaxed manner. The men meet after Friday prayers and are served Bangladeshi food. Although the centre is primarily a meeting place, the emphasis is on health. Using Bengali speakers has proved invaluable.
The centre also runs classes for those who wish to learn English. Using immunisation as subject matter during these classes was a convenient way to pass on information about the importance of the flu jab. The same method was previously used to encourage people to stop smoking.
Community outreach groups were well informed about the need to immunise and were able to pass on the message to the people that they supported. These groups targeted men and women, in a variety of clinical and nonclinical settings.
One advantage that the centre had was the fact that it had Bengali-speaking clinical staff, to whom patients were directed for more in-depth advice. This is perhaps one of the easiest ways of getting the message across. Although appropriate literature is a useful tool, discussion and face-to-face contact is probably more effective among the Bangladeshi community. The uptake of the vaccine increased by approximately 12% once people were talking about it. This year it is hoped that the campaign will yield a similar result.
There are many opportunities for communicating the message. Child immunisation clinics, travel immunisation clinics, diabetes clinics, GP and practice nurse consultations and reception contacts all provide opportunities to emphasise the importance of immunisation against flu.
Another approach might be to advertise in local halal butchers and grocery stores. Discussions, both informal and organised, could be held at local mosques and community centres. The emphasis should be on the spoken word and people should be given the opportunity to talk about immunisation. This is especially true within a community that has not grown up with the concept of immunisation. People may be confused and wondering why they are now being asked to have an injection when they are not ill. This problem is not unique to the flu jab. Nurses at the Healthy Living Centre have experienced a similar response from the Bangladeshi community with regard to child and travel immunisation.
It is vital that everyone in need of vaccination is given the opportunity. As nurses, we should consider all possible means of informing the communities we serve. Resourcing constraints place enormous pressure on our work, but despite this, we recognise that the patients' needs are paramount. Are we confident that our patients are fully aware of the services we offer, especially those we offer periodically and to a specific patient group? If not, then we need to extend and expand the methods we use to advertise them.
Department of Health. (2000)Flu Immunisation Campaign. London: HMSO.
Department of Health. (2000)Health Survey for England. London: HMSO.