Author: Andre Coleman

Discrimination is a real and distressing problem that continues to exist in modern day society. A sociological term that describes the attitudes and treatments adopted by members of mainstream society towards persons of specific groups on the sole basis of group or category, it is often translated into harmful and diminishing behaviour by members of the dominant group towards other groups (Stone, 2005, p 23-49). Discrimination takes place against various groups on the basis of a range of factors including religion, race, gender, income, sexual preference, age and disability (Stone, 2005, p 23-49). Evidenced regularly in the behaviour of the more powerful segments of society against members of less powerful groups, discriminatory behaviour stems from deeply entrenched and socialised beliefs and is often unintentionally and unconsciously expressed. The recent statement by Barrack Obama comparing his bowling skills to those of the participants of the Special Olympics starkly illustrates the deeply entrenched attitudes of ridicule and condescension with which most “normal” people, irrespective of their education, achievements, stature, and position view people with disabilities (Riley, 2009, p1).

The last few decades, especially the ones that commenced with the closure of the Second World War, have witnessed an increasing awareness among advanced western nations of the special needs of physically and mentally disabled people, their inherent right to enjoy the privileges and dignities available to members of mainstream societies and the obligations that societies have with regard to meeting their requirements (Barnes, 2000, p 17-45).

This short essay aims to examine the causes of discrimination and oppression against disabled persons, the impact of such discrimination on the lives of disabled people and their carers, and the role of social work, especially through the use of anti-discrimination and anti-oppression theory and practice, in integrating them into mainstream society.

Disability Discrimination

Disability represents an umbrella description for limitation of activity, restriction in participation, and physical or mental impairment of any kind. Discriminatory behaviour on the other hand, whilst occurring in many forms, essentially involves some type of rejection or exclusion for members of specific groups.

Barnes, et al, (2002, p 168), states that disability theory is defined by its focus on oppression and social exclusion of disabled people. The barriers that lead to such exclusion and oppression are contained in the policies and practices that are fundamental to the medical model approach to disability. The individual/medical model of disability has for long dominated service delivery. It perpetuates numerous myths about disability and impairment, chiefly that such people are ill, helpless, and incapable of running their lives and furthermore useless (Miller, et al, 2010, p 17-39). Disabled people, in terms of the medical model, are reduced to the medical circumstances that account for their mental and physical characteristics, even as little account is taken of the economic or social circumstances in which people experience such medical conditions. The medical model perceives disability as an individual tragedy needing medical solutions, personal adjustment and professional rehabilitation (Miller, et al, 2010, p 17-39). With the problems of disabled people being perceived to be a result of their impairment, disabled people are categorised as people who have inadequately functioning bodies, who look and behave differently, and who cannot carry out productive work. Such perspectives are perpetuated by an environment in which normality and abnormality is decided by experts who wish to maintain and enhance the superiority of their expertise. The control and authority of these people over the circumstances of disabled people affects them inexorably and profoundly (Miller, et al, 2010, p 17-39).

The medical model is followed by organisations like the WHO and most agencies in-charge of delivering services like health, rehabilitation and education, as well as by employers (Miller, et al, 2010, p 17-39). Assuming specific assumptions about handicap, disability and impairment, such institutions socially exclude disabled people and isolate them into institutionalised lifestyles (Miller, et al, 2010, p 17-39).

Thompson (1997) advances sociological reasons behind discrimination and resultant oppression, stating that such behaviour occurs out of deeply entrenched personal, cultural and infrastructural perceptions. Personal attitudes relate to views held by individuals about certain groups of people and are essentially based on personal likes and dislikes. Such views are supported and enhanced by cultural views that arise out of communalities or shared values and beliefs. Cultural views arise from the interaction of individuals with other people in their social, cultural and working environment. Discriminatory and oppressive attitudes are finally enhanced through structural conditions that are provided by institutions, including the media, religion and government and serve to strongly consolidate personal and cultural biases (Thompson, 1997, p 21-43).

Impact of Discrimination upon Disabled Persons

History is replete with instances of torture of disabled people. The Spartans killed the disabled under legal sanction (Macha, 2001, p 1). Martin Luther authorised the killing of disabled children because they were believed to be incarnations of the devil. European Eugenicists, influenced by Darwinian theories about the survival of the fittest, terminated the lives of disabled people. Hitler exterminated disabled people because he thought that they did not contribute to society. Approximately four hundred thousand intellectually impaired girls were sterilised by force during the Nazi era (Macha, 2001, p 1).

Disability discrimination, whilst not exercised with such virulent and criminal intensity, continues to disadvantage millions of people across the globe (Barnes, 2000, p 17-45). The physical and mental handicaps of people with disabilities are substantially aggravated by the extensive discrimination they face in different social settings, including the job market and the environment in which they work (Barnes, 2000, p 17-45). Discriminatory attitudes in western society result in numerous disadvantages for disabled people in areas of employment, access to public transportation, access to public facilities and eligibility for housing. Most employers tend to perceive disabled employees as expensive problems and the chances of a disabled person, despite disability discrimination legislation, getting a job are far less than that of someone who is not disabled (Barnes, 2000, p 17-45).

David Ruebain, (2009, p1), a disabled person campaigning for the rights of individuals with disabilities, provides some starkly disturbing facts about the plight of the disabled in the UK, arguably one of the most advanced of global societies. Ruebain reveals that discrimination continues to be prevalent in UK society. Investigations reveal that the overwhelming majority of the polling stations in the general elections cannot be accessed by independently voting disabled people (Reubain, 2009, p 1). The chances of a non-disabled person being called for an interview against responses to public advertisements are 11.5 times that of a disabled individual. A study by the Mental Health Charity, MIND found that 47% of the surveyed people with mental health impairments had been publicly abused or harassed, even as 49% had faced abuse at home, 14% had suffered physical attacks, and 25% had faced rejection from insurance companies. The average income of disabled people is significantly lesser than the general average (Reubain, 2009, p 1). Barnes (2000) identifies a number of stereotypes for disabled people, including their being perceived as (a) pathetic and pitiable, (b) objects of violence, (c) evil and sinister, (d) curiosities, (f) supercripples, (g) objects of ridicule, (h) sexually abnormal and (i) burdens.

Discrimination affects disabled people in various ways. At one level it affects their right to lives of equality and dignity by denying them access to equality in jobs, accommodation and public facilities, thus relegating them to existences of poverty and hardship (Oliver & Sapey, 1998, p 7-33). At another level it extracts a severe emotional and mental toll by subjecting them to social exclusion and thinly veiled rejection. Children and young people with disabilities are made to feel different, inadequate and deficient in comparison with non-disabled youngsters (Oliver & Sapey, 1998, p 7-33). This causes loneliness, difficulty in understanding the reactions of others around them, difficulty in competing for academic honours or getting into educational institutions of their choice, and resentment at having to go to special schools and at the treatment given to them by others (Oliver & Sapey, 1998, p 7-33).

The carers of disabled people, especially of disabled children are also subjected to various kinds of emotional and financial pressure (Banks, et al, 2001, p 797-814). The negative and curious attitudes of other people often lead to defensive and over protective tendencies. Carers resent people asking questions about their children, feel misunderstood and isolated, and begin to feel that they have to carry the burdens of their children alone (Banks, et al, 2001, p 797-814).

Role of Social Worker in dealing with Service Users

Attitudes towards the disabled started changing in the UK and USA as recently as the 1960s with the growth of various progressive movements for establishment of equality and freedom from oppression with relation to race, colour and gender (Macha, 2001, p 1).

The impact of sociological thinking produced a more aware social work with greater stress on deprivation and inequality (Macha, 2001, p 1). The 1960s witnessed the first antidiscrimination legislation in the UK in the form of the Race Relations Act of 1965. This was followed by anti-discrimination legislation in different areas like gender, age, and disability (Macha, 2001, p 1). Anti-disability discrimination legislation in the UK commenced in 1970 with the passing of the Chronically Sick and Disabled Persons Bill. This was followed by the Disabled Persons (Representation, Consultation and Services) Act (1986), other legislation that focused on different rights of disabled people and finally by the Disability Discrimination Act, 2005 (Macha, 2001, p 1).

The emergence and progression of radical social work brought about focus on the political and structural context of social work and impact of oppression, discrimination and ideology on the lives of the disadvantaged (Barnes et al, 2002, p 14-53). Barnes, from the results of his study of institutional discrimination, states that the policies of modern organisations lead to inequalities between disabled people and others (Barnes et al, 2002, p 14-53). He asserts that the entrenched discrimination in paternalist welfare systems result in failure in meeting the needs of disabled people (Barnes et al, 2002, p 14-53).

Recent decades have seen the emergence of anti-discriminatory and anti-oppressive approaches that are specifically relevant to social work with disabled people. Thompson (1993) looks at anti-discriminatory practice as a type of social work practice that aims to reduce or eliminate discrimination and oppression of different types, including those directed at disability. Dominelli (2002) perceives anti-oppressive social work as a social work practice that tackles structural inequalities and social divisions in the work that is done with service users. It aims to provide suitable and sensitive services by tackling needs of users without regard of their social status. Such practice contains a person-centred philosophy, a classless value system, a methodology that looks at both process and results, and a method to structure relationships between individuals that benefits users by diminishing the adverse hierarchical impact of the work between social workers and users. Finkelstein (1980, p 21 – 28) states that whilst anti-discrimination legislation will help in reducing the social barriers faced by disabled people, social workers need to make special efforts in all their interventions to speed up their social integration.

“Once social barriers to the re-integration of people with physical impairments are removed, the disability itself is eliminated. The requirements are for changes to society, material changes to the environment, changes in environmental control systems, changes in social roles, and changes in attitudes by people in the community as a whole. The focus is decisively shifted on to the source of the problem -the society in which disability is created”. (Finkelstein, 1980, p 33)

Conclusion

Whilst significant advances have occurred in the UK in the last two decades for the integration of disabled people into society, especially in areas of legislation and in the provisioning of public facilities, much still remains to be done. Social workers are expected to play a major role in this integration through their mediating role between disabled people and mainstream society. It is important for them to remove discrimination from their own practice and confront it in the actions of others, as well as in the institutional constraints in which modern day society operates.

INTRODUCTION

Migration is a kind of movement of people to a new area or country in order to find work or better living conditions. But some time it creates problem for migrants and for the host country both. International migration is a common thing now days. People are moving for better living but they have to face much cultural and social diversity. It is not possible for all to adopt new culture easily and sometime for some migrants it is impossible to adjust in new social environment and in that situation they are spending very short time in that country. The migrants for whom it is difficult to live in unbearable environment they are moving to some other country or sometime they return to their homeland. But in some situations migrants cannot return back to their home countries due to some financial problem or family barriers. Then they are trying to adjust themselves in new environment. Migrants remain one of the most vulnerable social groups in any country, and women are particularly vulnerable to underpayment, sexual abuse and heavy workloads. The main aim of this paper is to highlight the social problems and social adjustment of the migrants in different areas or countries generally.. The paper concedes that although migration is not the ideal solution to come out from problems, it is an important rout to go for a better life.

The paper is presented in three sections, starting with the basic problems of migrants in which access to finance and to support services, language barrier, limited business management and marketing skills, low wage, cultural diversity and social adjustment is included. This is followed by a discussion on effects of migration on family structure which includes support of family, settlement of family, education of children, proper housing and social security. The last and main part of the paper provides social problems of immigrants in which poverty, acculturation, education, housing, employment and social functionality is discussed.

BASIC PROBLEMS OF MIGRANTS
Language Barrier

Basic problem of the immigrant is language barriers. So many problems arise due to language difference. They cannot get good job due to language barrier Migrant and the resident cannot communicate each other regarding important matters. It also affects health care. A survey conducted by Rand A. David and Michelle Rhee proved that language barrier has the great effect on migrant’s health because they cannot communicate with doctors. They cannot understand the prescription given by doctor. They say “language barriers between patient and physician impact upon effective health care.” (David. A.R and R. Michelle, 1998, p. 393). Another survey by Charlotte M. Wright proved that language barrier is the problem for patient and doctor both. (W. M. Charlotte,1983). A study by Seonae Yeo proved that difference between health care providers and patients increasingly impose barriers to health care (Y. Seonae, 2004, p. 60).

Language is the barrier which separates immigrants from native, both socially and economically. On the social side, immigrants more visibly foreigners due to lack of speaking skill or language barrier then they are easily discriminated by natives. On the economic side, weak language skills probably reduce productivity and therefore increase the immigrant-native earning gap. Strong language skills can increase the range and quality of job that immigrants can get (B. Hoyt 2003, p.1).

Language barriers badly affect the earning skills, educational attainment, social interaction and cultural behavior of immigrants.

Limited Business, Management and Marketing Skills
1.4 Low Wages
1.5 Cultural Diversity

Behavior of immigrants is always different because of their different cultural values. Cultural values are always different in different countries and people who are migrating; they have to adopt the culture of host country. But some time immigrants neither could nor accept some of cultural values of host country. The reason can be religious diversity or social system.

Social Adjustment

When immigrants come in different countries to work and live among the local people, they are bound to influence the original inhabitants by bringing in new habits, new thoughts, and a new outlook on life. Likewise, the inhabitants may influence the immigrants by the social usage of the community. The interaction between the immigrants and the local people naturally bring about various types of social change. (Chen. T, 1947, p. 62)

Intercultural adjustment

Berry and Sam (1997) have identified six types of individuals that need to deal with the issues concerning intercultural adjustment. Migrant groups that have intercultural contact voluntarily, for example, involve ethnocultural groups; permanent migrants involve immigrants, and temporary migrants involve sojourners. Migrants with involuntary contact with new cultures include indigenous peoples; permanent groups involve refugees, and temporary groups involve asylum seekers. ()

Irregular Migration

Irregular migration is the major problem for migrants and for the receiving communities both. Some irregular migrants lose their lives in transit, while all face difficult conditions after arrival. Receiving community may have inadequate resources to accommodate the needs of large number of undocumented persons. They are the most vulnerable populations. They receive low pay, have little or no access to health care and face limited educational opportunities. (T. David and G. Julia, p.31)

EFFECTS OF MIGRATION ON FAMILY STRUCTURE

Women are playing main role in the family. They need to pay much attention toward home and family for better environment of home. But after migration a woman get more rights in different environment like in Europe. An Asian woman can get more opportunity of work in Europe or UK than her own country. So she can move easily and work easily in new environment. Dr Priya Deshingkar wrote in her paper that:

“More women are migrating for work independently and not only to accompany their husbands. This so-called “autonomous female migration” has increased because of a greater demand for female labour in certain services and industries, and also because of growing social acceptance of women’s economic independence and mobility. In fact, the feminization of migration is one of the major recent changes in population movements.” (D. Priya, p.33)

Under the conditions of immigration, the husband loses his role of a breadwinner at least initially while the wife continues to take responsibility for running family affairs. As a result, resettlement workers often find that women adjust better and faster while their husbands often lapse into depression and become demoralized, angry, and complaining. This behavior puts a serious strain on the marital relationship, especially if the couple had experienced problems before. (B. Irene, p. 128)

If we see the family by this point of view in which a woman play an important role and she can make her home life better than support to a family is the sole duty of husband.

2.1 SUPPORT OF FAMILY
2.2 Settlement of Family

In family structure there are some important factors which matters a lot for family adjustment and settlement. These factors are family composition, existing marital problems, age , type of occupation, and expectations of each other by family members and of their new life in the host country. (B. Irene, p.127)

2.3 Education of Children
2.4 Proper Housing
2.5 Social Security

The immigrants become increasingly anxious, confused and tense when they are meeting with their caseworkers. These emotional changes occur when they begin to deal with the task of daily living: looking for an apartment, enrolling children in school, learning the basics of job hunting, etc. These tasks are new and frightening and trigger extreme emotional reactions. (B. Irene, p. 125). They feel lack of sense of social security due to these emotional changes.

3. SOCIAL PROBLEMS OF IMMIGRANTS
3.1 Poverty

Whether or not migration is poverty reducing. Migrants travel and lives under very difficult conditions. Poor immigrants usually stay in slums or even less secure accommodation. Even those who earn reasonable amounts face constant threats of deportation, disease, sexual abuse, underpayment and police harassment. (D. Priya, p. 33)

3.2 Acculturation

Acculturation is a critical factor to understand when examining the process of cultural adjustment and adaptation for Asian Americans (Birman, 1994; Liu et al., 1999). Specifically, acculturation refers to the manner in which individuals negotiate two or more cultures. It is assumed that one culture is dominant while the other culture is perceived to have less cultural value (Berry, 1995; La Fromboise, Coleman, & Gerton, 1993). Ward and Kennedy (1994) differentiated between the culture of origin, which is referred to as the national culture, and the culture of contact, which is referred to as the host culture. (Y. J Christine, P. 35)

The first scientists to study acculturation were sociologists and anthropologists, interested in group-level changes following migration. The first definition of acculturation was proffered by Redfield, Linton, and Herskovits (1936): (J.R Fones and P. Karen, p. 216)

“Acculturation comprehends those phenomena, which result when groups of individuals having different cultures come into continuous first-hand contact, with subsequent changes in the original cultural patterns of either or both groups.” (J.R Fones and P. Karen, p. 149)

Acculturation is defined as “culture change that is initiated by the conjunction of two or more autonomous cultural systems. …” (Social Science Research Council, 1954, p. 974). Graves (1967) has coined the term ‘psychological acculturation’ to refer to the changes that an individual experiences as a result of being in contact with other cultures. (L. Angeliki, 2001, p. 35)

3.3. Education
3.4 Housing
3.5 Employment

Many countries around the world are turning to international migration to solve their labor shortage problems. They are hiring cheap International labor to solve their social and educational expenditure and also solve the problem of keeping their cultural intact.

3.6 Social Functionality

Among the many losses suffered by immigrants, one of the most devastating for many is the loss of their social status. In their own countries like in soviet Union, social status -education, occupation, position- is the main source of feelings of self-worth and identity. For professionals especially, the loss of social status may be very threatening and demoralizing. (B. Irene, p. 125)

CONCLUSION

Historically, it is hard to trace the origins of social welfare or social policy in Britain. There is a debate when exactly the foundations of the welfare state were laid. Slack suggested that the welfare state was established by the end of the eighteenth century. On the other hand Roberts argued that the basis of the welfare state was laid between 1833 and 1854. However, most commentators incline to associate the term ‘Welfare State’ with the start of the modern welfare state of Britain in 1945 (Harris 2004, p.15).Contrary to this conception, in my view, the origins of welfare state could go back as the earliest medieval Poor Law which came into existence in 1349. Not to forget to mention, the idea of welfare emerged thousands of years ago in many societies and civilisations. Voluntary and charitable help was provided through individuals, the state and religious organisations (Day 2000).

The Poor Laws were introduced as a mechanism to tackle poverty amongst the poor by giving those help. Those poor people who are getting help including the sick and elderly were known as paupers. According to Oxford English Dictionary 2009 a pauper is ‘A recipient of relief under the provisions of the Poor Law or of public charity. Now hist.’ (http://www.oed.com/).The main criticism to the poor law was it paid more attention to the maintenance of public order rather than the relief of poverty. This raised a question, whether the start of the welfare system for the poor was an act of mercy and compassion or the fear that homeless people will involve in unlawful activities. Based on the historical facts, the poor laws were divided into the Old Poor Law and the New Poor Law. The 1834 Poor Law Amendment Act was regarded as the start of a new era of Poor Laws referred to as the New Poor Law. (http://www.workhouses.org.uk/)

The New Poor Law revolutionised the local and central governments relations. The Commissioners’ Report 1834 was the core of the 1834 Poor Law Amendment Act. The 1834 Poor Law Amendment Act known also as ‘PLAA’ had taken the administrative power from the local authority (parishes) to the central government authorities. It also reformed the Old Poor Law which was in place. Furthermore, the act dealt with the flaws of the Old Poor Law due to the bad administration of the local parishes. However, the act faced criticism from the local parishes opposing the idea of the central control, which will put limitation on their powers. Another criticism that the act restricted the relief to the poor and the conditions inside the workhouses were harsh and repulsive.( http://www.workhouses.org.uk/) . The commissioners’ report had also recommended the building of workhouses as a vital strategy to discourage claimants of the outdoor relief. However, many Northern Local Authorities opposed the building of warehouses, because they saw it as an expensive solution for the problem of unemployment (Harris 2004).

According to (www.workhouses.org) 2009, ‘The Oxford Dictionary’s first record of the word workhouse dates back to 1652 in Exeter – ‘The said house to bee converted for a workhouse for the poore of this cittye and also a house of correction for the vagrant and disorderly people within this cittye.’ However, workhouses were around even before that – in 1631 the Mayor of Abingdon reported that “wee haue erected wthn our borough a workehouse to sett poore people to worke”

Under the New Poor Law (The Poor Law Amendment Act 1834) the workhouse unions acted as a deterrent for the able-bodied to claim outdoor relief. However , the law also introduced the outdoor labour test premised the distribution of outdoor relief to able-bodied men in return for a task of work .The initial plan of the workhouses to build different workhouses to accommodate different types of need such as children ,women and elderly . But later the plans had changed in favour mixed workhouses to accommodate all paupers. Apart from deterring able-bodied men from claiming relief, the workhouses were also intended to be institutional accommodation to accommodate various sections of the population who cannot look after themselves in their homes or in community. However during 1830’s and the 1840’s many cases of abuse and neglect inside the workhouses were reported in the media. The editor of The Times published more than a hundred cases of cruelty inside the workhouses in that period (Harris 2004, p.49 -52). Although the workhouses were not a prison, people inside were called inmates. The situation inside the workhouses was tough, the food was basic, and they had to wear rough uniform and to sleep in common dormitories. The able-bodied were given hard work such as stone breaking and picking old ropes apart called oakum (www.workhouses.org).

During the 1800’s the notion of charity in response to the needy spread rapidly throughout the world. As a result this led to the emergence of Charity Organisation Society. The Charity Organisation Society shared the same values as the Poor Law and they complemented each other. There was a debate whether the charities made the poor more dependent on the help they receiving, which might discourage them from seeking work. Later, the Charity Organisation Society spread to the USA which was helped by the lack of consistent state support to the poor (Payne 2005, p.34-8).

From the origins of social work in the Victorian Charity Organisation Society (COS)

The idea of settlement houses was to bridge the gap between social classes, In order to achieve that, it was suggested that the rich and educated should spend time and live amongst the poor. According to Payne settlements emerged as a movement to educate the working class and to maintain the moral Christian social behaviour in poor neighbourhoods in the new cities. Those students involved would use their education and moral beliefs in activities which (Payne 2005)

The Seebohm Report was regarded as a landmark in the development of social work. Initially the Seebohm committee was set to find ways to reform local authority personal social services. The committee recommended the merge of local authority into social services department .As a result social work moved to be more generic, whereas before social work was specialised such as childcare and psychiatric social work . The object was to utilise resources. Consequently, the social work was modernised social work as it brought together the separate department offering social services to different client group into a single social services departments (James 2004) .Subsequently, social work in Britain reached its peak and saw massive state social work expansion by 1970 with the implementation of the Local Authority Personal Social Services Act 1970 which was an outcome of Seebohm Report. Additionally, this period saw the birth of British Association of Social Workers in April 1970 after the merging of 8 associations (Payne 2005). However, towards the 1980’s there been a move back towards specialisation especially in mental health and childcare. As the Mental Health Act 1983 made a condition that only approved social workers should be allowed to deal with mental health cases. Also, as a result of the rise in child abuse cases child protection teams became the norm within Local Authorities. Additionally in 1989 the government put ?10 million pounds towards child protection training programme (Johnson 1990, p. 161-2).

The Beveridge Report 1942 was regarded as the foundation for the modern welfare state in Britain. Lowne R states that, Despite its somewhat unglamorous title (and author) , the Beveridge report on Social Insurance and Allied services immediately acquired immense popularity , both at home and aboard , as a practical programme for the elimination of poverty , and it has subsequently come to be regarded as a blueprint for the welfare state. (Lowne 1999, p. 130)

Beveridge stressed in his report the need to eradicate the five evils: Want, Disease, Idleness, Squalor and Ignorance. Furthermore, he suggested measures to be implemented by the government to tackle to issues. However, the Beveridge report was not fully implemented by the various governments and was abandoned by the conservatives. The conservatives criticised Beverdige for suggesting a flat rate contribution. Following his report, the National Health Service (NHS) was born on 5th July 1948 . In my opinion, this was one of the most important outcomes of the Beveridge Report and a major event in the history of modern welfare state in Britain. However, some social policy commentators had different view. Glennerster stated that Beveridge is often credited with the founding of the National Health Service, which definitely he did not do. And goes on, he is more possibly credited with the founding of post war system of social security, the subject of his great report, yet in many ways this is also a mistake. Although he acknowledge the report had a great impact at the time (Glennerster 2000, p. 18).

Payne (2005, p. 31) suggests that social work in Britain evolved from three different sources : the Poor Law , charity organisation and the settlement movement.

When Margaret Thatcher came to power in 1979, social work started to decline. Different factors contributed to the deterioration of social work. There was a service failure especially in child protection. Social work was seen as a soft police. Thatcher government increased control over public expenditure.

After the child care scandals, social work got a negative image in the media and the public. Then social work was seen as the problem rather than the solution.

One of the huge dilemmas for social workers in the 21th century, the shift in social work culture. Nowadays, on the managerial level, more importance being put on budgets and targets. Social workers had massive caseloads to deal with, topped with numerous paperwork to fill, which somehow hinder the process of service delivery to the service user. The rise in the workload for social workers led to divert the focus from the quality to the quantity. It became the quantity rather than the quality.

“Academic theories about employee motivation, empowerment and performance are just that theories, they are of little practical use to business leader or their companies, with reference covered to the material cover on the OBL course, and the people management of one Employee of Choice, please evaluate the validity of this statement.

Organizational Behavior is the study of behavior of individual, group and people in the organization. It focuses in the relationship between individual and organization in the holistic manner. It focuses on meeting the social objectives, organizational level objectives and individual level objectives. (Leadership and Organizational Behavior, 2010)

In managing the organizational behavior with in the organization, there are various managerial theories being proposed by various people to meet the organizational and individual requirement. The role of business leader is to effectively manage the workforce with in the organization to achieve the maximum output from the employees. It is also required from the business leaders to increase the productivity of the organization, to reduce employee turnover, to increase job satisfaction, to reduce absenteeism among the employees, to establish organizational citizenship.

The productivity of the employees could be increased by increasing the motivational level of the employees and by imparting training and development programs. An organization is said productive if it converts its inputs into outputs at lowest operating costs. Organizational behavior studies help managers to understand the general behavior of the individuals, but not the exact behavior of the individual. For example Douglas McGregor’s Theory X and Theory Y give an idea about type of people in the organization. According to Theory X, people would tend to avoid the work and are not responsible, on the other hand according to Theory Y, people are self directed and self motivated. Now this theory does not highlight the exact reasons for being lazy and self-motivated. In this way organizational studies only direct the managers about the general concepts, but could not point the exact behavior of the individual. It is so because the behavior of individual may vary from situation to situation and may also differ from person to person. (Douglas McGregor-Human Relations Contributors, Theory X and Theory Y)

The turnover of the employee is another important managerial duty to be considered by leaders. The increase in turnover costs high for the organization by increasing the recruitment, interview, selection and training costs. It is one of the essential parameter to be considered by the managers for increasing the efficiency of the organization. There could be various reasons for increased in turnover. It could be because of work environment, job position mismatch, compensation and rewards, job stress etc. It is required from the leaders to find out the reason for the increase in turnover. As there could be various different reasons for the increase in turnover, the organizational theories could not find the exact reason for the increase in turnover. The method that could be used by manager to find exact reason for the increased turnover could be interviews or survey. With the help of organizational behavior theories leaders could find out the general behavior of the group of employees in the organization, but it is required to carry out individual analysis to find the exact reason for the absenteeism with in the organization.

Increasing the Job satisfaction is another important managerial duty. It is essential for leaders to maintain the job satisfaction level of the employees with in the organization. This would not only decrease the turnover of the employees but also generate the healthy environment with in the organization. Organizational Behavior theories help the managers to understand the general behavior of the employee about job satisfaction, but it does not showcase how to increase job satisfaction for a particular employee. According to dispositional theory individual who is happy in his life is happy at his job as well. According to this theory there are the factors affecting job satisfaction i.e. positive and negative affectivity, personality attributes and self evaluation. This theory as well does not find the actual reason specific to a particular individual and hence managers would need to carry out the analysis specific to the individual.

Another important function of the business leaders is to reduce absenteeism among the employees. The reduction in absenteeism is directly related to the job dissatisfaction and improper work environment. It is required for the leaders to understand the individual needs and expectations of the individuals from the organization and meet those expectations. It is also observed that unhealthy work environment creates problem for the employee and in turn reduced their efficiency and hence productivity of the organization. Here as well leaders have to sit individually with the employees and seek out the possible hindrances for the employees with respect to work environment. The reasons for the unhealthy work environment could be racial discrimination, manager-subordinates relationship, gender discrimination, work pressures etc.

Organization Behavior theories works as the general framework for the leaders but could not act as the specific solution for a particular organizational problem. It require extensive analysis and thorough understanding of the organization and individual behavior to meet the objectives of the organization.

Question 2:

With reference to Organizational Behavior leadership on gender inequity in organization, and you own work experience if relevant, evaluate the extent to which this issue will require further attention from public and private sector organization in the UAE now and in the future. How can local organization ensure that there is true equity of opportunity for their women Emirati employees and what will be the likely commercial benefits of doing this?

Answer:

Gender Inequality means differentiation between individuals on the basis of their gender. As per gender inequality the responsibility, human and social possibilities differ from men to that of women. (Long, 2001)

It is found that most of the theories showcase the organizational structure as the reason for gender inequality. It is as per organizational structure which causes differences in roles, difference in position, and difference in behaviors between men and women.

Materialist theory: As per this theory the connection of men and women with the society’s economic structure causes the gender inequality. As per this theory, women’s role of mother and wife in the society devalued its right to access high valued resources. Women are less paid as compared to the men in the labor class market. The reason for this is the social responsibility attached to women to take care of family and children.

Division between Domestic and Public Work: Their role of mother and wife devalued their role social roles and hence high profile. Women are bound with the domestic responsibilities and hence have to take care of the family and have to invest time there as well. On the other hand men are free from domestic responsibilities and have greater access to high valued resources.

It is noticed that there is inequality in pay of men and women, and women are paid less than men. It is also found that two-third of the women works in areas low profile areas like catering, cleaning, clerical jobs, caring jobs. The reason for women being paid less than men is that their job includes discontinuity because of maternity leaves, and to take care of family and children. Moreover still the ratio of highly qualifies women is less than that of men. This gives men an edge to work in high profile jobs and so being paid more than women.

Gender Inequality in UAE: The UAE government is trying their best to reduce the gender inequality in UAE. In the year 2008, UAE is participating actively in reducing the gap of gender disparity by organizing various conferences for the same. Dubai School of Government along with Centre of Arab Women for Training and Research and World Bank, organizes a conference to narrow down the gender gap in North Africa and Middle East. The conference named “Gender and Economics in MENA: from Theory to Policymaking” (ZPRESS, 2008). The main purpose of the conference was to highlight the importance of high education over women. In the conference, Nabeel Al Yousuf, vice chairman of trustee board in Dubai School of Government, focused on gender inequality for the social, national and economic development. Community Development Authority is coordinating with various government and non-government organizations to maintain gender equality. (ZPRESS, 2008)

In the recent years UAE has worked well in reducing the gender gap in the emirates. As per a report, UAE has topped in human development chart among gulf countries. Though the ratio of educated women is increasing, but still UAE needs to improve on gender equality. This gender inequality further drags the human development index of the country.

The gender equality could be improved with the help of combined effort from public and private companies.

Protect Women Rights: It is essential to get women aware of their rights and also make them aware how to fight against the violation of any basic right. This education would help them to fight for their basic rights. It is required for both public and private organizations to coordinate with Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) to protect the rights of women.

Women Education: To increase the status of women in the society it is required to further increase the level and quality of education for women. To achieve the same it is required for public and private educational institutions to work together to achieve the common objective.

Healthy Work Environment: It is required for the private and public organizations to maintain healthy work environment for the women at workplace. It could be done by providing facilities for women like pick and drop from home, work from home etc.

The local organization could ensure the equal opportunity for women by ensuring that jobs are offered as per the qualification and not on the basis of gender. The pay should be equal as per the caliber and qualification of the individual. It is required for the local organization to create equal opportunities for both men and women and should not create any disparity between the two.

Gender equality would ensure equal status for the women in the society and would increase their standard of living. It would ensure right investment of the income and less wastage of money. It has been found that women invest 90% of her income on family whereas men only invest 35% of his income on family. This would change political and public welfare policies would increase focus on women as well. Increase in education level of women would reduce the health problems and diseases in the society.

Organisational design according to Mintzberg (1983) is defined as the “ways in which labour is divided into distinct tasks and then its coordination is achieved among these tasks”. Organisational design comprises of the component parts of an organisation such as the employees, the information and the technology and how they are integrated together. The relationship between the different parts of the organisation is a social construction. This social construction needs to be adequate to meet the goal of the organisation, in the case of social care organisations it needs to serve the service users best.

“[Social care is] a profession committed to the planning and delivery of quality care and other support services for individuals and groups with identified needs.”

Organisational design is used achieve the vision or mission of the organisation. The vision is defined by the managers and leaders of the organisation and the design is formulated around this vision. It is important to design an organisation around an agreed goal; this can be problematic if leaders cannot agree on a goal or they have different understandings of the goal. The Minister for Health, Mary Harney has a view of privatisation of service and more reliance on community involvement than state involvement in individuals care (such as care of the elderly) which conflicts with the policies in place for an equitable health care system (O Doherty, 2010). In many ways organisational structure and culture are interlinked and both must be addressed when examining organisational design. The design is often difficult to change because of the culture of agreed norms, values and expectancies within the organisation. Organisational design is integral in creating efficiency and effectiveness in the organisation therefore it is important in all organisations to implement a structure. Drucker (1999) argues that as situations vary there are no clear guidelines that can be given to identify the best structure to use and mangers must use their own judgement regarding which design to choose. The structure must however coincide with the service users needs and not what the organisation believes should be the structure.

Having an identified structure in an organisation is important to contribute to its functions. There are a number of designs outlined that managers may choose from but mangers need to acknowledge elements of the organisation when deciding which model to choose. These elements include: the specialisation of work, the chain of command, the span of control required, degree of formalisation required etc. Bureaucracy is the evident design applied in modern society. This may be influenced by Scientific Management and the military structure from history. The bureaucratic design is controlled and involves standardisation. Hierarchy is an important element of bureaucratic organisations, with departmentalisation and sub-groups evident. Having too many levels of hierarchy however can slow the decision making process within organisations, particularly social care organisations (Jones, 2007). The Quality Assurance in the Social Care sector report (2010) identifies also that an organisational design which values low levels of hierarchy is the best approach for effective communication between staff.

According to Kolb (1988) reflective practice and supervision is an important element in social care work. As an organisation adopts a more bureaucratic style the level of good supervision declines (Ruch, 2005). It is important to recognise that supervision in the context of social care works requires the supervisor supporting and guiding the employee towards best professional practice. Supervision involves reflecting on practice and recognising strengths and weaknesses of the employee in a positive way so as to improve the overall service for the service user. The lack of acknowledgement of the function of supervision in this way may be detrimental to the overall organisational goal. Social care workers are not to be seen as bureaucrats simply there to carry out tasks assigned by management but as individual problem solvers with skills for decision making (Thompson and Thompson, 2008). Therefore it is important to have an organisational design in social care organisations which incorporates supervision.

The health service in Ireland has undergone fundamental changes since EU pressure began in 1973. The Commission on Health Funding (1989) recognised that the health board system was failing due to management and administration and many layers of hierarchy and a new system needed to be implemented. Other recent reports also outline the need for changes and the need for clarity of decision making in the health care system such as the Quality and Fairness – A Health system for you (2001) report. It was outlined that the health boards operated as separate entities which led to inconsistency and did not address best practice. The Health Service Executive (HSE) was formed in 2005; it joined the former 11 health boards together. It consisted of three main parts: the National Hospital Office (NHO), the Primary Community and Continuing Care (PCCC) and Population Health. Unfortunately the HSE was not fully planned or organised. It underwent another organisational structural change in 2008 when the NHO and the PCCC were joined together under one manager.

The Health Information and Quality Authority (HIQA) was established in 2007, it incorporated the Social Services Inspectorate (SSI) to work in collaboration with the HSE. HIQA can be viewed as an affixed type of organisation, quality should have been built into the organisations structure but instead HIQA was set up to add in quality into the services provided by inspecting the level that the standards are upheld. This shows that organisation design is an important issue to be addressed. Equally important is the setting of a vision or a goal. The HSE’s budget plan is only up until 2014. Although the Quality and Fairness – A Health system for you (2001) report outlined what needs to be done, some issues are still outstanding.

The human element in social care organisations must be taken into consideration when applying a structure. Maslow’s (1943) theory of needs acknowledge that human need for self-actualisation is important for their well being. This would imply that organisations would need to involve employees in the decision making process within the structure as self actualisation means being involved in problem solving. Argysis (1957) argues that bureaucracies did not allow for this decision making process. Likert (year) also identifies that using design which involves open communications and trust is best used. There are arguments against this style of involving employees in decision making such as those by Vroom (1973) and Feidler (1967) who value the contingency style of management. Job satisfaction is difficult to access and achieve in service organisations. It is evident that work specialisation does not lead to job satisfaction in social care area; staffs need to be able to change their roles and rely on teams and supervision. The impact of staff burnout in social care is prominent.

In the Roscommon Child Care Case recently reported there are clear problems with the structure of the organisation. During the period when the health professionals were working with the families the legislation in the child care area was changing with the introduction of the Child Care Act 1991 and Children First National Guidelines for the Protection and Welfare of Children, 1999 and new implementations arose. The staff were not trained in the new developments. If they had been trained then the Roscommon Child Care incident perhaps intervention would have occurred earlier. One of the objectives of the Quality and Fairness (2001) report was to protect children and the need for early intervention. The family in the Roscommon case were known to the HSE since 1989 and the children were not taken into care until 2004. The lack of continuing professional development (CPD) was highlighted as a reason why the mistakes of the past were not learned and as to why new legislation was not implemented in this case. This can be seen as a failure of the system as well as the culture to provide CDP (Roscommon Child Care Case, 2010 4.16). The report also recognises the need for organisational change and identifies that the HSE has implemented systems of child protection in some areas but this highlights the need for it to be implemented across all organisations (Roscommon Child Care Case, 2010 5.1)

Within social care work the need for interagency work is fundamental to provide the best service possible for the service users. However the communication between the agencies needs to be clear and consistent to ensure that the best service is provided and essentially that children are safe and protected (Julius et al, 1980). Julius outlines that the structure of the organisation may hinder the interagency work and it is important to recognise this in work. The structure and culture of the organisation have an impact on the behaviour and attitudes of employees. The structure must be designed so that the employees behave in a manner that best benefits the goal of the organisation, in the case of social care it would be to best serve the service users.

When restructuring fails it leads to confusion and turmoil among those affected such as the managers, staff and service users. Models of design will unavoidably need to be changed according to the period of time. Organisations need to plan for the future, make predictions regarding changes that may need to be made by identifying opportunities and threats. Financial issues, new technology and changing population may require an organisation to change its structure. The structure needs to be examined to ensure that it is fulfilling its purpose and that is especially true in social care work where the impact of failure can lead to serious harm or even death to individuals.

This essay explores how the identity of ‘Looked after children’ (hereafter LAC) contribute to oppression and discrimination in two specific areas of Education and Health. The essay will analyse the role of legislation and policy in combating or promoting discrimination and oppression. The history, societal attitudes, diversity, views of the children and theories underpinning LAC will also be discussed. Finally I will focus on the implications and relevance to social work practice.

Cocker and Allain (2008) identify LAC and young people as children in the care of the local authority, through a Care Order made by a court or voluntary agreement with their parent(s) to accommodate them. They may be looked after in children’s home by foster carers, or other family members. All unaccompanied asylum seeking children are deemed LAC. For the purposes of clarity I will start by defining ‘oppression’, ‘discrimination’ and ‘stigma’. Thompson (1997) identifies oppression as the disregarding of individuals or group of people’s rights resulting in inhuman or abusive treatment with dominance and power by one group over another. For Thompson (2006), discrimination refers to a process of unfair or unequal treatment of individuals or groups resulting in undermining the interests of people from a less powerful category within society. Goffman (1963) highlights that stigma is constructed through social interactions. The individual who is stigmatised is seen as below societal expectations. Similarly, Parker and Aggleton (2003) associate stigma with an instrument that maintains boundaries between those with power and the powerless. This causes social inequalities that formulate into social norms that

promote power structures. Through such power, social inequalities are developed leading to creation of social norms. From the above definitions oppression, discrimination and stigma it can be deduced that the common elements are abuse of power and privilege resulting in inequalities and disadvantage. LAC are one of the less fortunate groups of people in society who experience such treatment because of their identity.

The last three decades have experienced a huge overhaul and introduction of legislation and policies seeking to address the needs of children. The Children’s Act 1989 reformed Law relating to children and in particular set out the framework for the provision of support for children and families and for the protection of children in England and Wales. This was in line with the United Nations on the Rights of the Child (UNCRC 1989) which was the first legally binding International instrument to promote the rights of children throughout the world. (Burke and Parker 2007). The Quality Protects (1998), Children Leaving Care Act (2000), Adoption and Children Act (2002), the Choice Protects policy, the Children’s Act (2004), Every Child Matters (2004), Care Matters (Green and White Papers) and The Children and Young Persons Act (2008) are some of the initiatives and legislation introduced to reinforce safeguarding children, and also as responses to reports of abuse, neglect, harm and safeguarding children in different institutions of residential care in the UK with the most publicised individual cases such as the deaths of Victoria Climbe (2000). It was revealed that Staff working with vulnerable children was not adequately trained, rigorously checked on recruitment, no support and vigilance towards diversity and openness. This led to Laming Report (2003) which revealed significant failings within individuals and organisations which were meant to be looking after children.

The Children’s Act (2004) emerged to implement and address the recommendations. In 2009 Lord Laming was also asked by the government to provide an emergency progress report on issues surrounding safeguarding children following the death of Baby P in 2007. He reinforced his earlier findings on systematic and individual failures as the cause of the death of Baby P (Laming report 2009).

Research has questioned the effectiveness of such initiatives in reducing discrimination of LAC. Examples of such research are : “Children experience of the Children Act (1989),” “Discrimination Against Young People in Care (1998)”: “Remember my message (1993)”, “The Multidimensional Treatment Foster Care in England Project (2006),” “Barriers to change in the Social Care (2000),” “Bursting at the seams (2010)” and the recent Panorama BBC programme on experiences of children leaving Care (5 October 2010).

The UK is a multicultural society with diversity which policy makers and legislators need to acknowledge. Blaine (2007) views diversity as the presence of differences in society in relation to gender, race, ethnicity, religion, social class and sexual orientation. These differences are neither good nor bad; however some of the differences are associated with inequality and disadvantage. Social work practice is concerned with addressing these differences and disadvantages (Burke and Parker 2007).

There is no exact figure for LAC but DfE Statistics (2010) reveal that there were about 64,400 LAC as at 31 March 2010 while the BBC Panorama ( 2010) mentioned around 70, 000 LAC as of 5 October meaning the number is increasing. The main reasons of being in care were abuse or neglect (52 per cent). There were 3,400 Unaccompanied Asylum Seeking Children (UASC) who were looked after at 31 March 2010. This is a decrease of 12 per cent from 2009. There is a decrease in the Unaccompanied Asylum Seeker Children (UASC) (DfES 2010).

Hogg and Vaughan (2002) views identity as associated with the process an individual becomes who they are in the sense of personhood and other’s view of who they are. Furthermore a person has multiple identities which need to be seen as part of the whole individual as disregarding some aspects would be misleading and reductive of the individual’s identity. Graham (2000) highlights that identities have different meanings and are not fixed but change over time as a result of environment, personal circumstances and outside influences. These influences will significantly affect the social experience and the self image of those defined, through, for example the experience of negative discrimination.

All aspects of a child’s identity need to be recognised and acknowledged regardless of gender, race, ethnicity or religion. By developing a positive identity children are motivated and their self esteem is enhanced for them to feel a sense of value, belonging and worth Blaine (2007). However Cocker and Allain (2008) argue that not all environments are positive in fostering this idea. When this occur the child becomes withdrawn and shy to open up and engage. Having a LAC identity endangers a child to be different, socially excluded, marginalised and denied equal opportunities in accessing services.(Assessing Children in Need 2000). As such social workers need to adopt and work with a culturally sensitive approach and apply the balancing act to enhance the resilience concept. (Masten 1994 cited in Daniel et al 2002).

Burke and Parker (2007) highlight that the social work context and the involvement of a social worker in a child’s life apply and identify the child as different. From my experience in social care practice I agree with Burke and Parker when they note that the bureaucratic and comprehensive paperwork, regular review and educational meetings, visits, contact arrangements and procedures and guidelines are associated with the LAC; these are not experienced by most children in normal life settings. However this argument is dismissed by Garret (2003) cited in Burke and Parker (2007) when he affirms that paperwork and bureaucratic procedures are essential tools for a social worker to use in helping them identify and address important developmental needs of the child but should however encourage more one- to -one contact with the child rather than spending time on paperwork.

Because of their identity a ‘LAC’ they are disadvantaged and discriminated against at school and in matters related to Education. They most likely risk being expelled from School due to behaviour (DfE 2010).Statistics show that a third of LAC obtains a GCSE and a further fifth obtain fewer than five GCSEs. Although these figures are lower than a few years ago, they are still much higher than for children as a whole: more than half not obtaining five or more GCSEs compared to less than one in ten children as a whole (DfE 2010)

The Social Exclusion Unit (2003) published a document “A Better Education for Children in Care”, (Thompson and Thompson 2003) which highlighted five reasons for the low attainment levels ranging from instability caused by insecure placements, bullying, lack of support and encouragement at home, time out of school due to expulsion, support and encouragement and emotional, mental or physical health.

Schofield and Beek (2009) suggest that parents and people at home where the child lives need to be supportive and encouraging to the child learning success. School environment should promote learning that develops a child holistically to facilitate the self discovery method and accepting themselves as they interact with other children. They also note that this is not always the case as children are disrupted of continuity in settling and making friends if placement breaks down. Sometimes bullying at school results in low self esteem. Although most local authorities have put in place a number of inter disciplinary services looking at the physical, mental well being of children discrepancies still exist. However in Jackson and McParlin (2006) in their article “The education of children in care” professionals are seen to be making assumptions and jumping into conclusions ending up giving labels and long prescribed long term solutions to short term problems unnecessarily. This is associated with neglect and discrimination. More training and awareness of diversity, anti discriminatory practices and individualised person centred approach should be reinforced (Every Child Matters 2004).

Morgan (2010) argues that the problem of poor school performance in LAC lies in the care and education system not in the children. He argues that the care and education systems do not address pre care experiences of the child’s low attainment and also fail to address the aftermath or the impact of separation when children are removed from their families. The child may be suffering from undiagnosed post traumatic stress which can erupt in any confined environment such as school classrooms. He also contends that teachers have no knowledge of the child’s history. Teacher training does not equip teachers with knowledge of the care system and on addressing behaviour from LAC.

Jackson et al (2005) cited in Morgan (2010) carried out a research with students in Higher education who had a care background over a five-year period. The respondents experienced a high level of trauma, abuse and neglect but were placed in foster homes that were supportive and valued education. The findings revealed that foster families who support education and celebrate the child’s achievements are more likely to compensate to some level of the pre care experiences and promote higher attainment in education. It is important to place children in placements which are supportive to the child’s success in education, foster resilience and offer a safe place to grow and achieve. To support children’s wellbeing the government has put in place the Children and Young Persons Act (2008) with a commitment to promote the wellbeing of children and those who are involved in their care. Children and Young Persons Act (2008).

Dunnett et al (2006) acknowledged the initiatives by Government such as the improvement of health of LAC as important and the proposed Care Planning for LAC and Care Leavers to be implemented April 2011. However according to research a number of health deficits still prevailed such as ill health, poor diagnosis, and dental neglect, neglect of routine immunisation screening, poor diagnosis, limited attention to chronic ill health and limited attention to mental health problems. A study carried out by Loughborough University for the Department of Health (2006) revealed inconsistencies and concerns on consultation and treatment. Also studies revealed that teenagers in care found it difficult to discuss sex education due to fear, lack of privacy and trust. They wanted a significant trustworthy person to confide in. As such most of their health needs are overlooked and not met as they are labelled, stereotyped and marginalised. Axford (2008) in her article exploring social exclusion noted this difficulty as more prevalent among children from Black Ethnic Minority background who face a cultural, language and racism within organisations that are meant to support and look after them especially asylum seekers. In the article LAC experiences of the Children Act (1989) highlighted that there are continuing myths about the Act which are still disadvantaging LAC. The children still feel they are not fully aware of their rights under the Act as they face day to day regulations and successive barriers. Children still feel they do not receive what the law says they should. A typical example was in socialising with restrictions on risk assessments for overnight stays by teenagers in care. This has brought a sense of discrimination and marginalisation as it is for normal teenagers to do overnight stays. Prout (2000) cited in Glenny and Roaf (2008) further picked up another conflict and tension among within government departments and targets when he mentions that control and self realisation are both present in legislation and policy but in tension. On one camp there is the idea of viewing children as individuals with a capacity for self realisation within a safe societal environment while in the other camp there is the idea of viewing children as vulnerable and requiring control, regulation and surveillance. One example is the “Youth Matters Four Challenges” to help teenagers achieve the Every Child Matters outcomes. ( DfES 2005)

Social workers need to listen, engage and work in partnership with looked after children. In a research by Holland (2010) exploring the ‘Ethics of Care’ as being

marginalised, not being implemented and recognised, it was evidenced that lasting relationships are disrupted by placements as children often acknowledged their links to their past and significant people in their lives. This highlights the importance of their individual pathway in promoting their wellbeing and interpersonal relationships and future achievements. Clarke (2010) emphasises the need to sustain and promote lasting care relationships with formal carers and social workers to avoid the consequences of loss, neglect and worthlessness by listening to their story, exploring and putting their needs and choices first. Oliver et al (2006)’s “Briefing Paper Advocacy for LAC” unveiled that research has highlighted that there were some ambivalence within professionals as to what extent children must be involved in decision making to matters concerning their care as well as resource barriers. To overcome these constraints Winter (2009) suggested regular contact, feedback, advocacy and putting the needs of the child first need to be priority as children value being listened to and having their wishes fulfilled by active participation in matters concerning their wellbeing.

In a consultation exercise with young persons leaving care as part of my coursework, they highlighted that sometimes they did not receive any satisfactory feedback from social workers when they need it. Also they mentioned that there was a lot of bureaucracy such as reviews or educational meetings which made them feel treated differently. Social work regular visits at school made them feel stigmatised. The respondents felt they wanted to be treated as normal children not service users. Barriers to Change in the Social Care (2000), a report by the Joseph Rowntree Foundation, supports that there should be a human rights approach in working with LAC.

Glenny and Roaf (2008) suggested early Intervention is essential to support children and families before problems either from within the family or as a result of external factors, which have an impact on both the child and family. Statutory and voluntary organisations have an obligation to work in partnership for the success of early intervention agenda. Teamwork will establish protocols which will help to ensure early indications of being at risk of social exclusion are addressed and receive proper attention.

McLeod (1998) highlighted the need to acknowledge Child development which enable children accept and discover themselves through stages and exposure to promote self awareness, confidence, self esteem and positive attitudes. McLeod highlighted Freud’s psycho-analysis theory (1859-1939), Erickson’s psycho-social development theory (1950) and Bowlby’s attachment theory (1969). This view is shared in the literature review by Hunt (2003) cited in Ritchie (2005) which highlights that although there is no concrete evidence of kinship care over non kin foster care there are indications that chances are the former promotes the child’s wellbeing and welfare than the latter. It is important for social workers to be aware of child developmental needs and how valuable family ties are. Schofield and Beek, (2005) cited in Shaw (2010) affirms that past relationships with family and professionals has an impact on the child’s wellbeing and ability to cope with life on their own. Active parenting focusing on the child’s needs and positive engagement with the child will help and promote skills to deal with difficult situations in life. Social workers need to promote resilience to empower children to face challenges and deal with their past and future (Daniel and Wassell 2002) .

Bates et al (1997) suggests that assessment framework should foster identity and acknowledge diversity in order to promote a child’s perception of themselves and their environment. Social workers need to employ anti-discriminatory practice with opportunities and resources for self discovery through interaction (Assessment for Children in need Practice 2000). The Children and Young Persons Act (2008) also emphasises its commitment to promote a child’s well being and the people involved in the care of the child.

This essay discussed a particular aspect of discrimination and oppression among LAC and extent to which legislation, policy, practice and services relevant to social work exacerbate or assist in overcoming negative experiences of LAC. Although there has been notable initiatives in addressing the needs of LAC for the past ten years a lot still has to be done in terms of societal attitudes, resources and safeguarding. To achieve the every child matters outcomes all the stakeholders need to work together by putting the needs and act in the best interest of the child. By listening and engaging with LAC practitioners will be able to improve Children’s quality of life. Anti discriminatory practice, empowerment, diversity and equal opportunities practices are part of the answer.

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Memory loss is an example. Alzheimer’s is the most common type of dementia. Dementia is not a specific disease. It’s an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities.

Symptoms and signs of dementia

While symptoms of dementia can vary greatly, at least two of the following core mental functions must be significantly impaired to be considered dementia:

Memory

Communication and language

Ability to focus and pay attention

Reasoning and judgment

Visual perception

Many dementias are progressive, meaning symptoms start out slowly and gradually get worse. Loss of memory for recent events is a common early sign. Some people at the middle stage become very easily upset, angry or aggressive – perhaps because they are feeling frustrated – or they may lose their confidence and become very clingy. At the last stage, the person may also become increasingly frail. They may start to shuffle or walk unsteadily, eventually becoming confined to bed or a wheelchair.

Impacts

As a carer, we are likely to experience a range of very different, and often quite extreme, feelings. Some feelings commonly experienced by carers of people with dementia include distress, frustration, guilt, grief and loss, exhaustion, annoyance, frustration and anger. Some of the most common feelings families and caregivers experience are guilt, grief and loss, and anger. And for the clients themselves they may suffer the stresses from the society and the people around them

The consequences of the people with dementia in relation to individual:

People living with dementias often have mental health problems — especially depression and anxiety disorders — as well as dementia. Memories they have always relied on become hazy and uncertain. Knowledge and skills cultivated over a lifetime diminish. Relationships change or are lost. People with dementia can become deeply sad, fearful and/or angry. Sometimes their behavior becomes a challenge for people who care for them.

The consequences of the people with dementia in relation to the family

The family of the people with dementia will find it is very hard to care for the patient. And they may feel distress, frustration, guilt, grief and loss, exhaustion, annoyance, frustration and anger. They are facing lots of problems with the patient. They will have the very heavy stress from the caring process and the society or the people around them. So it is important to inform the patient`s family how it is going on when the carers are caring for the patient.

The consequences of the people with dementia in relation to the carers

As a carer, we are likely to experience a range of very different, and often quite extreme, feelings. Some feelings commonly experienced by carers of people with dementia include distress, frustration, guilt, grief and loss, exhaustion, annoyance, frustration and anger. Caregivers face many obstacles as they balance caregiving with other demands, including child rearing, career, and relationships. They are at increased risk for burden, stress, depression, and a variety of other health complications, the effects on caregivers are diverse and complex, and there are many other factors that may exacerbate or ameliorate how caregivers react and feel as a result of their role. Numerous studies report that caring for a person with dementia is more stressful than caring for a person with a physical disability.

The way to reduce the stresses for the individual, family and carers.

For all of those 3 kinds of people, they can get help from relax, they are supposed to have the Quality sleep and rest, Quality relationships. They need to be Feeling safe and secure. And the sense of connection to the family and community should be nice. For the carers themselves, they have to learn how to enjoy themselves and get rid of stress. Individuals and families can be both informed the treating process and the good things. They will be getting better when they get encouragement.

The diverse dynamics of the family:

Each family member may act differently in response to coping with an individual with dementia. Some family members may feel resentful or angry while others cope by seeking support and information. And others may simply fall into a place of denial and avoid the situation.

Caring for a family member or friend with dementia can be both a very rewarding and challenging experience. It can also be very physically, emotionally and financially demanding and affect our lifestyle and life choices

As a dementia progresses, the need for caring and supporting is increasing. It is that carers take the time to look after themselves and to respond to their own needs and emotions

Caring for someone with dementia impacts every aspect of daily life. As a patient loses one`s ability after another, caregivers face tests of stamina, problem-solving, and resiliency. During this long and difficult journey, communication diminishes, rewards decrease, and without strong support, caretakers face challenges to their own well-being. Maintaining emotional and physical fitness is crucial. Preparing and protecting yourself, working to understand your loved one`s experience, and embracing help from others can minimize the hazards and enhance the joys of your caregiving experience.

The code of rights for the people living with dementia:

People with dementia and their carers have the right to be provided with accessible information and the support they require in order to enable them to exercise their right to participate in decisions which affect them.

People with dementia and their carers have the right to live as independently as possible with access to recreational, leisure and cultural life in their community.

People with dementia and their carers have the right to full participation in care needs assessment, planning, deciding and arranging care, support and treatment, including advanced decision making.

People with dementia and their carers have the right to be assisted to participate in the formulation and implementation of policies that affect their well-being and the exercise of their human rights.

People with dementia and their carers have the right to be able to enjoy human rights and fundamental freedoms in every part of their daily lives and wherever they are, including full respect for their dignity, beliefs, individual circumstances and privacy.

Public and private bodies, voluntary organisations and individuals responsible for the care and treatment of persons with dementia should be held accountable for the respect, protection and fulfilment of their human rights and adequate steps should be adopted to ensure this is the case.

People with dementia and their carers have the right to be free from discrimination based on any grounds such as age, disability, gender, race, sexual orientation, religious beliefs, social or other status.

People with dementia have the right to have access to appropriate levels of care providing protection, rehabilitation and encouragement.

People with dementia have the right to help to attain and maintain maximum independence, physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life.

People with dementia and their carers have the right to access to opportunities for community education and lifelong learning.

People with dementia have the right to access to social and legal services to enhance their autonomy, protection and care.

People with dementia have the right to health and social care services provided by professionals and staff who have had appropriate training on dementia and human rights to ensure the highest quality of service.

People with multiple impairments

Multiple disabilities are a disability category under IDEA. Children with multiple disabilities have two or more disabling conditions that affect learning or other important life functions. To qualify for special education services under this category, both of the student’s disorders must be so significant that her educational needs could not be met in programs that are designed to address one of the disabilities alone.

Symptoms and signs of multiple impairments

People with severe or multiple disabilities may exhibit a wide range of characteristics, depending on the combination and severity of disabilities, and the person’s age. There are, however, some traits they may share, including:

Limited speech or communication;

Difficulty in basic physical mobility;

Tendency to forget skills through disuse;

Trouble generalizing skills from one situation to another; and/or

A need for support in major life activities (e.g., domestic, leisure, community use, vocational).

It is a cross-classification of disabilities that involves significant physical, sensory, intellectual, and/or social-interpersonal performance differences. The need for extensive services and supports is evident in all environmental settings.

Impacts

For the clients themselves, they may be suffered the Discrimination from others, they may have the pressure on themselves, so there should be a positive person to care them. And for their family, they are going to have a long-term pressure from the society and they may have some problems with the finance.

The consequences of the People with multiple impairments in relation to individual:

For the clients themselves, they may be suffered the Discrimination from others, there are multiple stresses on this client because they have more than one kind of impairment. There should be a positive person to care them. Support and encourage them to have a good mood in order to let them getting heal. People with multiple impairments can become deeply sad, fearful and/or angry. Sometimes their behavior becomes a challenge for people who care for them.

The consequences of the People with multiple impairments in relation to their family:

The family of the people with multiple impairments will find it is very hard to care for the patient. And they may feel distress, frustration, guilt, grief and loss, exhaustion, annoyance, frustration and anger. They are facing lots of problems with the patient. They will have the very heavy stress from the caring process and the society or the people around them. So it is important to comfort the family while caring the client.

The consequences of the people with multiple impairments in relation to the carers

As a carer, we are likely to experience a range of very different, and often quite extreme, feelings. Some feelings commonly experienced by carers of people with multiple impairments include distress, frustration, guilt, grief and loss, exhaustion, annoyance, frustration and anger. They are at increased risk for burden, stress, depression, and a variety of other health complications, the effects on caregivers are diverse and complex, and there are many other factors that may exacerbate or ameliorate how caregivers react and feel as a result of their role. So the caregivers are supposed to relax and do not take it so hard, they need to find some ways to decompress

The way to reduce the stresses for the individual, family and carers.

For all of those 3 kinds of people, they can get help from relax, they are supposed to have the Quality sleep and rest, Quality relationships. They need to be Feeling safe and secure. And the sense of connection to the family and community should be nice. For the carers themselves, they have to learn how to enjoy themselves and get rid of stress. Individuals and families can be both informed the treating process and the good things. They will be getting better when they get encouragement.

The diverse dynamics of the family:

Different family may act differently in response to coping with an individual with multiple impairments. Some family member may feel resentful or angry while others cope by seeking support and information. And others may simply fall into a place of denial and avoid the situation. Caring for a family member or friend with multiple impairments can be both a very rewarding and challenging experience. It can also be very physically, emotionally and financially demanding and affect our lifestyle and life choices

Caring for someone with multiple impairments impacts every aspect of daily life. As a patient loses one`s ability after another, caregivers face tests of stamina, problem-solving, and resiliency. During this long and difficult journey, communication diminishes, rewards decrease, and without strong support, caretakers face challenges to their own well-being. Maintaining emotional and physical fitness is crucial. Preparing and protecting yourself, working to understand your loved one`s experience, and embracing help from others can minimize the hazards and enhance the joys of your caregiving experience.

The code of rights for the people living with multiple impairments:

The people with multiple impairments should always be treated with respect, including respect for your culture, values, beliefs and personal privacy.

No-one should discriminate against the people with multiple impairments or push you into doing something or making a decision that you are not comfortable with.

The care for the people with multiple impairments and treatment let you live a dignified, independent life.

the people with multiple impairments have the right to be listened to, understood and receive information in whatever way you need. Where possible, an interpreter should be provided if you need one.

It is your decision whether to go ahead with treatments or not and the people with multiple impairments are able to change yourthe mind at any time.

In most situations, the people with multiple impairments can have a support person of the choice with the people with multiple impairments if he/she wish.

Multidisciplinary working is work undertaken jointly by workers and professionals from different disciplines or occupations Pearson Thomas 2010:342 and it has evolved at varying speeds over the past 30 years or so in response to imperatives of central government. Mental health was among the first professions to adopt teams of workers from different professions. The community mental health team is widely regarded as the model for multi-disciplinary working. (Community Care, 2010). Relating this to social work the distinctive quality is demonstrating a holistic approach, by working with a range of situations, people and having an attribute for developing multi-disciplinary and partnerships,(Higham,2006:) c

The crisis centre is run by a Local Council and NHS Trust based in a local community. Which corresponds with the 1975 White Paper ‘Better Services for Mentally Ill’, professions working together to provide a community based service. (Scie, 2010) The crisis centre provides beds for four adults suffering a mental health, social crisis, who have been referred to them by the Crisis Resolution Home Treatment Team, the service users for instance can be referred from in their home or accident and emergency. Next they complete an assessment inline with local authority guidelines and procedures, then produce a care plan and risk assessment. If they decide the service user is in crisis and can’t return home, then they contact the crisis centre for a place with the goal of leaving the centre after the crisis, normally within two weeks. Once the service user is placed, there are numerous methods of contacts from the Crisis Resolution Home Treatment Team and social workers through emails, phone calls and visits.

During this observation multidisciplinary working was witnessed between the crisis centre staff and the Crisis Resolution Home Treatment Team about a service user already in the centre through a phone call. The crisis resolution home treatment team seemed to be following the National Occupational Standards key roles section three, by supporting the individual, representing their needs, views and circumstances by acting as an advocate (Higham 2006: 98) as they were informing the crisis centre of what was happening. The crisis centre staff were asking questions in a way that was treating the service user as an individual by listening to their individual case, respecting and maintaining dignity by only asking questions relevant to the crisis centres needs and criteria. They also spoke clearly and discussed the dynamics of other service users (respecting confidentiality) already in the centre declaring any conflict or positive interactions that had arisen since their last visit (GSCC,2010).These skills are fundamental to social work practice as they are valuing the individual and having a holistic approach.

Furthermore, in the 1990’s new labour recognised that problems cannot be addresses by people and organisations working in isolation. So the Department of Health 1998 introduced the white paper Modernising Social Services, which had multi-disciplinary working as a key objective. (Wilson, et, al, 2008:388). In 2000 No secrets actively promoted that multidisciplinary teams, empower and promote well-being of vulnerable adults, through the services they provide and the need to act in a way, which supports the rights of the individual to lead to independence. (Department of Health 2000)

This was observed, by the service user, crisis centre and Crisis Resolution Home Treatment Team via staff communicating frequently throughout the day and providing an environment where service users can come and go freely, yet still have support, during their crisis, they were also encouraged to cook and clean for themselves .This was seen during the observation also in Tony Ryan’s (2010) evaluation of crisis centre and Crisis Resolution Home Treatment Team, asked service users what they valued best about their stay, their responses “I was on the lowest rung of the ladder in terms of depression and self esteem. Now I can cook and iron. It has restored my ‘get up and go’.” and “It is given me a sense of life back and helped me to find myself. I couldn’t have gone on any longer. Staff have taught me to cope better and manage my panic attacks.” This demonstrates partnership working with the service user and multidisciplinary working. The White Paper Our health, our care, our say also emphasises the importance of people having more control over their lives and access to responsive, preventative services by working together in multidisciplinary teams. (Department of Health 2006). The crisis centre fulfils this.

Throughout the day through discussions and observation it appeared that the crisis centre staff and Crisis Resolution Home Treatment Team encouraged emancipatory practice by involving the service user in their support which shows good practice also staff were not routinized as each day was different, they discussed how each individual was unique with a unique situation. If social workers become oppressed by working in routines this does not always benefit the service user, it is not good practice and is not fundamental to social work values. An example of this was observed when a member of the Crisis Resolution Home Treatment Team came to the crisis centre and completed a visit with a service user. During her visit to the crisis centre she was constantly contacted from her office through phone calls, one of which was a new service user needing to be assessed urgently, she had already one visit booked in after the crisis centre, but had to re -evaluate her cases as the new referral was seen to be more of a priority. She did this by speaking to her manager on the phone and re -arranging for another colleague to see her service user and then asked the office to let the service user know about this change.

The above paragraph demonstrates multidisciplinary working and partnership working with the service users are fundamental and collaboration is needed for social work and the interpretation from the staff involved demonstrates good practice. To show the importance of partnership working with service users in the crisis centre Tony Ryan (2010) completed a service evaluation of the crisis centre and Crisis Resolution Home Treatment Team, they asked service users how they felt about staff. Service user’s responses “Any questions or anything you are upset over, you can go and ask the staff” and “Staff are very supportive and help sort problems out.” As social work is about working with people to help them to sort their problems out. Also each individual brings unique skills and experience into the working professional relationship. (Thompson. N. Thompson, S. 2008:24)

So far this essay has demonstrated positive multidisciplinary working through observation at the crisis centre. However, in reality multidisciplinary working can be negative and can be totally dysfunctional. As when a group of diverse people with varied skills come together into a team, things don’t always go smoothly. (Community Care, 2010) Cree, 2003:163 believes that multidisciplinary working can be positive but also frustrating, isolating and difficult. (Dalrymple Burke 2006:139) Wilson et al (2008) also agrees multi disciplinary working does not always work effectively and such failures have been documented in such finding of Victoria Climbie enquiry and baby Peter, lastly Thompson (2005) believes that multidisciplinary can do more harm than good and can make situations worse.

During the course of the day it was bought to attention through a staff handover that one of the service users in the crisis centre had at first experienced a positive interaction of multidisciplinary practice, but sadly it turned into a negative experience. Conquesenlty, this seemed due to the breakdown of communication between multidisciplinary teams such as his social worker, Crisis Resolution Home Treatment Team, crisis centre staff and medical staff. According to Thompson (2009) without effective communication the notion of multidisciplinary becomes unobtainable. Staff at the crisis centre believed it was due to lack of budgets and lack of communication. During this handover reflective practice was witnessed, as, as a team they spoke about what, why and how things had gone wrong for the service user and how they could approach the situation to get the best outcome for the service user.

The staff at the crisis centre spoke about how they valued supervision meetings as it gave them the chance to voice any concerns they had and also gave the manger chance to deal with any systematic practice that was leading the staff to become unfocused. (Thompson. N. Thompson, S. 2008). As supervision meetings demonstrate good practice and in social work codes of practice, developing ones self through development opportunities to strengthen skills and knowledge.

This essay has demonstrated through observation that it is important to work with other professionals as one person cannot solve another person’s problems and dilemmas alone (Thompson. N. Thompson, S. 2008:19) and that multidisciplinary working is a fact of live for social workers and many other professionals also, this essay showed a balance outlook on multidisciplinary working as it has positive and negative points.

Health, Wellness and Nutrition
Introduction

In this assignment, I will discuss various aspects of nutrition in a Residential Care setting. I will look at the opportunities and challenges a social care worker has in addressing the holistic and nutritional needs of the clients and staff. I will look at some of special dietary considerations and the social factors that are involved in a residential care setting.

Residential Care

Residential Care is an alternative care for young people whose family are unable to care for them. These centres are managed by the Family Support Agency, now Tulsia, or by a voluntary or private Company. There are usually between two and six young people living in each house. In 2013, there were 321 children in residential centres. (www.dcya.gov.ie)

The children who live in residential care deserve the very best care that social care workers can provide. To achieve this, their nutritional needs have to be met to ensure that each person can reach their full potential. Social care workers have a duty to look after and provide good wholesome food at the centre. Food is an important part of everyone’s life therefore social care workers need to support children in residential care to make healthy choices and give them practical skills and knowledge to enable them to make the right choices for their health and wellbeing.( Caroline walker Trust) The food pyramid is the recommended guide that is use in Ireland. Foods are divided into different parts in the pyramid to show the recommended intake of each food group. It states that you should eat

Plenty of bread, rice pasta and other starchy foods preferably wholegrain varieties with six or more servings for all ages. Although men and boys may eat up to twelve servings depending on how active they are.
Plenty of fruit and vegetables, at least six or more portions
Three servings of milk, cheese or yoghurt. Children and teenagers will need more.
Some meat, fish, eggs beans, pulses, and other non-sources of protein. Two servings is sufficient.
Very small amounts of fats and oil.
A very small amount or none of foods or drinks that is high in sugar.( Safe food.)

A report published in England by Save the Children in 1998, Look Ahead: Young people in Residential Care and Food stated that, many young people who had left residential care were unequipped to live independently. For example, they did not have the skills to shop and cook and this led to unhealthy lives. Young people who had left the service said that they did not learn enough food skills. Less than half of the young people said they had never helped to prepare a meal most of the actives they had taken part in involved setting the tables, washing up or peeling the vegetables. Less than a third said they had a role in the menu planning. The study also showed that a major barrier in residential care was the Health and Safety regulations that excluded young people from the kitchen. (eatingwellchildren2001pdf)

Special Dietary Considerations

Children and young people need the right balance of food and nutrients to enjoy a healthy life. The key is to get the balance right, to provide essentianal vitamins, minerals, protein and fibre into the diet. If there are insufficient nutrients in the diet, this can lead to diseases and bad health. Childhood obesity has increased over the past few years. Obesity affects children in a number of ways including physical mental and emotional wellbeing. If it continues into adult life, it can have serious affects on health such as diabetes, heart disease stroke and some types of cancers. section 3 nutrition guidance scotish download.

Putting into practise a healthy eating plan in a residential care setting, needs to be approached in a sensitive way. It may take time for young people, to adopt a healthier eating plan and to feel comfortable eating in a group. Some young people may choose eat a vegetarian diet. The staff must ensure that this type of diet is varied as much as possible to make sure that good sources of iron, zinc, protein and calcium are included in their diet.

Some children in residential care may have a food intolerance or food allergy, which is a reaction to a food or ingredient. Some foods can cause a severe allergic reaction (anaphylactic shock) to such food as peanuts, shellfish or eggs. This should be highlighted in the child’s care plan. Anaphylaxis is the most serious type of allergic reaction and you could die without the proper medical intervention. Although food is the most common allergic reaction insect stings and sometimes exercise can cause anaphylactic shock. The symptoms usually occur within minutes but it can also take a few hours after exposure. As social care workers, it is crucial to be aware of the signs and symptoms as it can happen to anyone at any time. ( www.anaphylaxis.ca)

Unlike this serious life threatening allergy are those who suffer from celiac disease. This disease causes the person to react to gluten which is the protein found in wheat. People with celiac disease have an intolerance to wheat products such as bread, cakes, and biscuits. It causes damage to the lining of the small intestine and thus prevents the absorption of nutrients. The only way to manage celiac disease is to avoid all foods that contain gluten to prevent further damage. (Celiac society of Ireland)

Diabetes like celiac disease is also an autoimmune condition that results in the body unable to burn up sugar (glucose) properly. This happens when the pancreas does not produce sufficient insulin a natural hormone that regulates blood sugar level. Insulin helps the sugar in the blood enter the cells of thee organs in the body. Without this process to much sugar would build up in the blood. As a result, this can cause faintness weakness and coma. There are two types of Diabetes;

Type 1 Diabetes occurs mostly in children and young people. It requires the person to take insulin injections as well as a healthy nutritious diet and exercise. In the residential centre, the staff would have to monitor the person’s diet to make sure that the amount of insulin is carefully balanced against the food that supplies the sugar and the amount of excise that is burning off the sugar.

Type 2 Diabetes is on the rise and it is generally seen in older adults. It can be kept under control with a good healthy diet usually there is no need for insulin but some people need to take tablets. (Kirkpatrick, 2004)

Social factors

Mealtimes are an important part of our culture. It is where children learn about behaviour and develop new skills. It also offers a sense of belonging. Children in residential care may never have experienced this with their own family. Mealtimes should be an enjoyable experience where staff and children can share stories. When planning a meal it is important to take every person likes and dislikes into consideration. Children who have special diets or those who are vegetarian need a variety of suitable nutritious food. Child care (Placement of Children in Residential Care) Regulations, 1995, Part 111, Article 11. www.dcya.gov.ie xxxxxxxxxxput in

It is important to build good relationships between staff and children. The care workers ought to look for the views of the children around food and food-related issues. This should be a fundamental part of day-to-day activities at the centre. Social care workers at residential centres have an opportunity to improve children’s experience and health and wellbeing in areas of food practise. It is important for staff to adopt a healthy eating plan, as this will serve as a good example to the children. Children need to develop practical skills around budgeting, buying, preparing and cooking of food as this will prepare them for when the leave the centre. www.Scotland. Gov.uk.

Food can work as powerful symbolic medium where thoughts, feelings, and relationships are played out and it can be a useful tool for children who have experienced neglect. Through food, children can experience consistency and nurture and develop autonomy with a sense of control. It can demonstrate trust and care. Food is a simple way for a social care worker to monitor the ethos and the culture of the centre. By reflecting on the food practices and attitudes towards food, you can see how your centre is doing in many ways.

Reflection

I have found this module both interesting and challenging. I did not realise how complex and intense it would be. I have really enjoyed learning about nutrition and I have integrated this new knowledge into my family life. It has changed the way I look at food. I would also like to do a course on nutrition, as it is such an important aspect of overall health and wellbeing. I have a good understanding now on infections and diseases, which is so important to social care practise and in my own personal life. The subject that has had the most impact on was the subject of child abuse. I found it very informative and very challenging. This subject has really opened my eyes to the realness of the work that is involved in social care practise.

I feel this module is central to social care practise and it has prepared me for social work. I have gained practical every day skills that I will require, to work as a social care worker.

The True Spirit of Healing in Medicine: Norman Bethune

Introduction

Henry Norman Bethune was a Canadian doctor who became famous for his selfless service of people in the Second Sino-Japanese War. His service endeared him to Mao Zedong, who hailed him as a communist and supporter of the Chinese people’s efforts for liberation. Even today, Bethune’s popularity in China stands undisputed with his statues present all over the country. There is no doubt that Bethune had in him the true spirit of healing, a unique spirit, because doctors often perceive their professions as scientific pursuits or even money making endeavors. This is illustrated in the manner in which pharmaceutical companies and doctors work hand in hand to achieve profits and market prominence by selling medicines. Bethune’s dedication to his profession was illustrated in the manner in which he served in the World War I and the Spanish Civil War before his stint in the Sino-Japanese War, in spite of his open contention that wars were meant to make profits (Shepherd and Levesque 147). He was known repeatedly state that “the private economic profit” (Clarkson 40; Stewart and Stewart 317; Wilson 75) should have no place in medicine. In addition, he was also a proficient inventor, who designed and altered several surgical instruments, such as the portable blood transfusion system he developed in the Spanish Civil War (Stewart and Stewart 92, 95). Moreover, many of his inventions continue to be in use today (Stewart and Stewart 92, 95). It is also notable that while Bethune passionately and dedicatedly adhered to his professional ideals, he also had clear political ideologies. In the Spanish Civil War, he sided with the democratic republic and during the Second Sino-Japanese War, he sided with the rural population in China and accepted communism as opposed to Imperialism. However, today he is heralded in China for his communist ethoses, which were very different from the communism that was practiced in China under Mao Zedong. This paper contends that Bethune was not simply a doctor by profession but also a healer at heart who formed political ideals according to the welfare of humanity, and thus, his image as a communist leader in and outside China might be somewhat misconstrued.

Discussion

Bethune’s ideology behind traveling all the way to China in 1938 and to serve the people in the Sino-Japanese War was to aid the suffering and poor people there. This was in line with his endeavors in his life thus far, that is, in World War I and the Spanish Civil War. He also carried out crisis surgical procedures on the casualties in the war as well as instituted training for medical personnel for the same (Stewart and Stewart 32). He also refused to treat the casualties by considering their race, culture, political side, or even the side in the war (Stewart and Stewart 32). Clearly, he was dedicated to the cause of serving his patients, irrespective of the social conditions. As a doctor, he treated the people who were suffering and sick. He was also believed in the communist ideologies, that is, those that had been propounded by Marx and was a member of the Canadian Communist Party (Stewart and Stewart 124). This was in spite of the fact that in those days, it was illegal to be a part of the communist party in Canada (Stewart and Stewart 124). However, this was naturally because of the conflicts between what would become the allied and axis powers in the World War II. In fact, most people in Canada associated communism with Stalinist and Nazi policies of control (Stewart and Stewart 371). Moreover, the United States’ staunch anti-communist policies must have also influenced the Canadian policies. However, in Bethune’s philosophy, the poor, proletariats, who were subjugated under capitalism or were the casualties in war, should be side he supports. Consequently, he became a part of the communist party in Canada, because he believed in Marxist philosophies, which communists promised to practice. Clearly, his political ideology was founded in his dedication to his professional and moral ideal of serving the suffering and the weak.

When Mao Zedong welcomed Bethune as a communist comrade, he was impressed with Bethune’s dedication to the communist ideals. Bethune illustrated his ideals with his dedication to his profession and by serving in the frontlines in the war. As mentioned before, this was not different from the manner in which he served in World War I and the Spanish Civil War. However, Mao interpreted Bethune’s work and ideologies as his dedication to the communist cause and the cause of the people. It must be remembered that under Mao’s rule, there was no growth of the proletariats and the Chinese economy collapsed as all the contributing members to the economy, such as, doctors, owners of industries, and lawyers were banished from their jobs to serve in the rural areas. In such conditions, the overall suffering, illness, and pain experienced by the Chinese people were probably worse if not as bad as in Imperial China. Although Bethune died in China of blood poisoning, while serving in the Second Sino-Japanese War, he was, nevertheless, unaware of the true ethos of the brand of communism that would be practiced by Mao. Considering his ideals, he would have probably never wanted to be a part of this kind of communism. Ultimately, Bethune was a man who wanted to serve the people and not simply have a political ideal, where personal and profit goals were in focus. Today, it can be said that communism and democracy have both failed in the ability to separate the profit making processes from the social serving ones. Given these facts, Bethune would have probably sought to be a part of a more humanitarian political ideology.

Notably, Bethune’s legacy rests on the fact that Mao published an essay on him—In the Memory of Norman Bethune in 1939—for unselfishly serving in the Second Sino-Japanese War. This essay was considered essential reading in Chinese schools then and even today, students are required to be familiar with this essay. Indeed, the philosophy of the essay is in tune with Bethune’s philosophies. Consider the following excerpt from the essay:

We Chinese Communists must also follow this line in our practice. We must unite with the proletariat of all the capitalist countries, with the proletariat of Japan, Britain, the United States, Germany, Italy and all other capitalist countries, for this is the only way to overthrow imperialism, to liberate our nation and people and to liberate the other nations and peoples of the world (Tse-tung)

Clearly, Bethune would have been glad to be associated with such ideologies. He expressed his views on his profession by stating that, “medicine, as we are practising it, is a luxury trade” (Allan and Gordon 130). He further abhorred the use of monetary ends in practicing medicine and believed individualism, which is always associated with democracy and never with communism, as the reason for such a state of affairs (Allan and Gordon 130). However, Bethune died well before the Chinese Cultural Revolution of the 1960s started. This was a time when millions of Chinese died because communism had turned to totalitarianism (Yan and Gao 2). The death toll in the Chinese Cultural Revolution has not been released by the Chinese government until date (Yan and Gao 2). However, this was a time when people were ruthlessly massacred by governmental encouragement of mobs and by authorized attacks on civilian populations by military personnel (Yan and Gao 2). Moreover, the anti-democracy stand Bethune held would have probably been shaken if he had lived to experience the shock the world felt when the truth that Hitler carried out genocides in Germany was publicly known and acknowledged after World War II. However, since he never lived to experience such events, and thoroughly believed communism to be anti-exploitation, he stood by it while practicing his medical ideologies.

It can also be recalled that Bethune was virtually unknown in Canada well after he died. Canadians and the rest of the Western world did not know about him until 1952, when Ted Allan and Sydney Gordon published their book, The Scalpel, the Sword: The Story of Doctor Norman Bethune (a new version is mentioned in the works cited section of this paper). However, unfortunately, they hailed him as a communist hero in this book. However, the timing could not have been worse, because in this Cold War era, anti-communist feelings thrived in Canada (Stewart and Stewart 327). Thus, Bethune’s contributions to science and his altruism were well forgotten until much later. Only in the past few decades, especially since China has cautiously opened its doors to the western world for trade has Bethune’s abilities and work been acknowledged. Today it is known that Bethune was among the original advocates of socialized medicine, which is in high demand in Canada and in the rest of western world—the Obamacare policies next door are perhaps the best examples of this. Bethune also formed the Montreal Group for the Security of People’s Health (Stewart and Stewart 371), which established the need for socialized medicine. Bethune has also visited the Soviet Union to understand and learn about socialized medicine (Stewart and Stewart 122). Such endeavors eased his way into the political ideology that was communism and thus, he became a part of the Communist Party of Canada. In the most unbeknownst manner, he became a part of a political thought that defied the altruism fundamental to his ideologies.

Conclusion

This paper illustrated the manner in which Bethune contributed toward the development of medicine and struggled to treat the injured and the sick as a doctor. Undeniably, he endeavoured to achieve his professional idealism through his research and treatment as in shown by his inventions. Similarly, as became aware of the social and economic characteristics of disease, he adopted a political thought that he believed cared for the proletariats and the suffering as he did. However, he was not well informed about the nature of such communism or even to of democracy. As time showed, both were capable of exploitation, and in fact, communism enabled totalitarianism—a concept that Bethune would have definitely abhorred considering his ideologies. It can be thus concluded from the facts presented in this paper that Bethune was indeed a dedicated doctor, who truly adhered by the Hippocratic Oath as well as formed political ideals keeping the welfare of humanity in mind. However, his image as a communist leader in and outside China has been misconstrued over the years, since he died well before the harms of communism were experienced by the world.

Work Cited

Allan, Ted and Sydney Gordon. The Story of Doctor Norman Bethune. Dundurn Press: Dundurn. 2009. Print.

Clarkson, Adrienne. Extraordinary Canadians: Norman Bethune. Toronto: Penguin Canada. 2009. Print.

Stewart, Roderick and Stewart, Sharon. Phoenix: The Life of Norman Bethune. Toronto: McGill-Queen’s Press .

Shephard, David A. E, and AndreI?e LeI?vesque. Norman Bethune: His Times and His Legacy. Ottawa, Ontario: Published by the Canadian Public Health Association, 1982. Print.

Tse-tung, Mao. In Memory of Norman Bethune. 1939. Web. Accessed on April 15, 2015 from https://www.marxists.org/reference/archive/mao/selected-works/volume-2/mswv2_25.htm.

Wilson, John. Norman Bethune. Dundurn: Dundurn Press. 1999. Print.

Yan, Jiaqi, and Gao Gao. Turbulent Decade: A History of the Cultural Revolution. Honolulu: Univ. of Hawai’i Press, 1996. Print.