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Global Health Cafe: The Role of Cultural Practices

The Global Health landscape is changing and its community is as enthusiastic as ever. In May we gathered at the Health Foundary and discussed the role of culture in Global Health. London School of Economincs student Dalia Majongwe presented on her work in Global Health Policy and then played us some delightful Mbira. London School of Hygiene and Tropical Medicine Masters student, Tarik Endale beautifully wraps the evening up in this guest blog.

“Both traditional healers and health facility can treat Degedege [local term for seizures] effectively. Sometimes we [traditional healers] instruct our patients to go to health facility when they suffer blood deficiency [anemia] and dehydration; but also there is a time that a patient from health facility is advised to come to traditional healers because there might be a scenario when the condition of the patient is seen as more spiritual than scientific; hence needs a spiritual intervention”


The passage above is from an interview with a traditional healer in rural Tanzania. As one of many who were interviewed for my research regarding knowledge, attitudes, and practices surrounding febrile convulsions, his response was not at all uncommon. In fact, it was illustrative of many of the key points presented by London School of Economics student and Global Health Policy researcher Dalia Majongwe (Twitter: @Dali_Lamah) on May 2 at the second session of the newly founded Global Health Café. Mainly that in Global Health, culture is inextricably tied to behaviors and policies, including:

  • Access and utilization of health services
  • Health-seeking behavior
  • Interactions between communities and formal or informal/traditional systems of healing
  • Marginalized/abused groups
  • Designing programs, policies, and advocacy strategies

From healing, such as in Haitian Voodoo Rituals, to HIV/AIDs among Malawian “Hyena Men” and from substance use and “Flash Blooding” in Tanzania all the way to the containment of Ebola in Sierra Leone, to ignore the role of culture is to miss some of the most interesting and important intersections of Global Health. In discussing the challenges and opportunities created by these interfaces of culture and health, the topic of hard to reach communities arose, a notion which special guest Dr. Titilola Banjoko promptly challenged by asking “Are they hard to reach or are you not reaching hard enough?”


Lively discussions like these are the lifeblood of the innovation and new connections that we need to build sustainable solutions for better health in Africa. This is what global health experts Dorcas Gwata and Adebusuyi Adeyemi sought to promote with this new platform and why the emerging community that is the Global Health Café is so exciting. Follow along at @TheGHCafe and we hope to see you at the next session on June the 27th at the Health Foundary


Tarik Endale (@the_etheropian)

LSHTM Candidate – MSc in Global Mental Health

Researcher at the Mental Health Innovation Network

Blog hosted by Dorcas Gwata. Director of Tribal Sands


Thanks to the Global Health Gang, Ade Adebusuyi, Dalia Majongwe and Tarik Endale


Feedback from gangs sexual exploitation training




Gangs course 1

Following a fatal stabbing of a yet another teenager in London recently, I delivered two training sessions to a group of young girls in London to address risk of youth violence and vulnerabilities in adolescents as they grow up and try and make sense of the world. There is great value in early intervention programs, we must do all we can to save young lives from knife crime and or sexual exploitation, this grassroots work seeks to challenge the notion of ‘hard to reach groups’ and appraise the value of innovation in early intervention. Here’s feedback on the sessions I delivered:

Dear Dorcas,

Thank you for the two sessions today. There were 25 girls in each session.

There was lots of meaningful discussion amongst the girls during your session. It was very helpful for them to hear your experience and the real life experiences of gangs, mental health and women’s experiences in these cases.

The students were able to think honestly about what they would do in difficult situations where mental health is a problem and what to do in those situations.

Students were exposed to some new and vital information around stigmas with mental health and vulnerable groups in society.

It was clearly very interesting and affected the students’ views.



Dorcas Gwata

Director of Tribal Sands

February 2017

Gangs and Minority Mental Health

Some months I was asked to write to brief on why I felt so passionate about minority mental health, I wrote from the heart:

A dark cloud hovers over  the lives of people of colour in Britain, and when the rains give way as they do, on this small island, they wash away our hard strained strenuous work and when the day ends over an unseen sunset, some will define us purely by the sum of our misfortunes rather than our efforts.

I have long been unsettled by the over representation of black children in care and mental health services. Our streets have become battle grounds in which our children fight over postcodes and territory. For every teenager that is stabbed or killed, those implicated end up in prison, adding numbers to an overflowing system that is filing with black children. A parent’s grieve for a child is deep and often silent, yet we soldier on, our trauma unobserved, because we are afraid of being misunderstood.

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There are parental and safeguarding challenges within our society, which are compounded by single parenthood, complex issues of identify, migration, domestic violence, emotional, physical abuse, language, culture and wider socio- economic factors. There is conversation to be had about the complex issues that cast a shadow over our resilience and our ancestral history, a progressive conversation which may well occasionally tread us into difficult waters but an urgent and necessary conversation nevertheless. By telling our own narrative, we validate our experiences and appraise the grassroots efforts that so many are engaged in for better outcomes in minority groups.


I have broad experience of working with deprived and excluded communities with specific focus on safeguarding issues for children and families of black and ethnic minority backgrounds and Gender Violence. My research explores culturally adjusted interventions in mental health. This year I was appointed as Trustee for AFRUCA charity, a honour and a responsibility to carry this work forward.

Dorcas Gwata

Tribal Sands December 2016

Arise TV: Trump, Africa and Obamacare


I discussed the Trump outcome on Arise TV in mid November. More to the point, we Africans need to improve our governance systems and reduce aid dependence and mass migration. These global elections are telling us again and again that migration is a major deciding factors for voters all around.

Thanks to News Anchor, Charles Aniagolu and team at Arise for having me again

Dorcas Gwata

Director of Tribal Sands

December 2017

Gangs: Taking the clinic to the streets

Alex Davis talks to an award-winning RCN member who is providing innovative health support to young people involved in and on the fringes of London gangs.

Westminster is one of the wealthiest boroughs in Britain. In the iconic setting of Parliament, Downing Street and Big Ben, house prices regularly fetch over £1 million. And yet, alongside the prestige, the city has a serious problem: gangs.

Dorcas Gwata is an expert in these matters. A clinical nurse specialist, she works within Westminster Council’s multi-agency Integrated Gangs Unit (IGU), providing physical and mental health support to young people and families affected by gang culture.

Following the 2011 riots, a Home Office report identified unmet mental health needs among gang members in London. Crucially, many were unable to access traditional mental health services. “You have to consider the geographical nature of ‘beef’ between gangs,” Dorcas explains. “Some gang members cannot travel freely across London without putting their lives at risk. As a result, many vulnerable young people don’t access health services. We’re also observing high levels of parental mental and physical health conditions associated with stress, poverty and deprivation, all of which contribute to poor health and social outcomes.” The solution? An experienced clinical nurse specialist working alongside other professionals within the IGU.

The unit operates in partnership with social services, the police and community protection. It is made up of a range of professionals, including gang workers who work at grassroots level and engage innovatively with young people in their homes, for example, as well as youth clubs, prisons and hospitals.


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Complex needs “Visibility is really important,” Dorcas notes. “We work with children and young people, mostly aged 10 to 21, and their families. Most of the young people have complex needs such as substance misuse, anxiety and trauma – from stabbings, for example. “The IGU is very much about early intervention because these things can have a huge impact on people in later life and behaviours are often copied by younger siblings.” As a result, much of her job is outreach work. Dorcas regularly delivers talks to young people in schools and youth centres, and provides “street clinics” where she visits local areas and speaks to young people and their families. In other words, she integrates.


A powerful suggestion

Prior to becoming a qualified nurse, Dorcas worked as a health care assistant until a young patient with anorexia encouraged her to go into nursing. “We established a good therapeutic relationship and I always felt that it was a powerful suggestion, coming from a patient,” she explains.

After undertaking nurse training at City University School of Nursing and Midwifery, Dorcas worked in Hackney and Hammersmith, before spending many years in the A&E department of St Mary’s Hospital in Paddington. In many ways, it was this frontline work which intrigued Dorcas and set her up well for working with marginalised and hard-to-reach groups. But what of the danger of working with gangs? “Working in A&E is much more dangerous as there is a regular risk of being attacked by a drunk and disorderly person,” Dorcas says. “We work very closely with the police and we carry out thorough risk assessments before engaging with any young people. We have a well-structured system.”

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Since joining the IGU in 2013, Dorcas has worked with approximately 80 families and up to 100 gang members. One of her current clients is a 17-year-old boy on the fringes of a gang. His parents are very concerned for their son’s welfare which escalates into shouting during a meeting. Dorcas, though, highly experienced in dealing with families, remains calm and puts the room at ease. “Parents want the best for their children and I find they’re often tired of hearing how badly they have raised their child,” she reflects. “To help a child you need to improve the relationships within the entire family.” Dorcas is sensitive in tone and especially careful in the language she deploys.


“We would never use the word gang in front of parents. Instead we would talk about peer groups or healthy relationships,” she says. The IGU’s achievements have not gone unnoticed. The unit won a national nursing award for innovation in 2015 and was the Metropolitan Police team of the year in 2013. Dorcas acknowledges the support she has received from her team but has herself won impressive accolades. In 2015 she won the Nursing Standard Mental Health Nursing Award and was nominated for the Zimbabwe International Women’s Award the same year. And yet, despite her achievements she insists the biggest reward has been changing the lives of young people. “Keeping young people on the right track is what matters most to me. There’s no feeling quite like it.”

 Dorcas Gwata

Director of Tribal Sands

November 2016

Zimbabwe Female Blogger Nomination interview

This summer I was delighted to be nominated for the Zimbabwe International Female Blogger Award, a surprising and flattering nomination. After weeks of vigorous voting the winners were announced at a prestigious event in Birmingham, England. Tendai Marowa was announced the winner of our category, a deserving Zimbabwean blogger making her mark in South Africa. Tendai interviewed me on her blog, Legacy of True Beauty, this blog covers our warm chat.

Tell us about yourself and what you do

I am a Zimbabwean Global Health Public Health Specialist and African affairs news analyst. My blog seeks to drive a positive African narrative and provides a platform for discussions of all things African with particular focus on women development, travel, health and culture. The blog also captures my Global Health experiences in Uganda, Tanzania, Malawi, Zimbabwe and my liaisons with frontline health professionals involved in the Ebola crisis as well as my travel experiences around the globe.

When did you start blogging and why?

The blog was borne out of a restlessness and an unsettled feeling that the positive experiences of African lives and in particular African women were not being fully captured on many platforms. The courage, resilience and spirit which embodies Africans even in the depth of suffering and challenges is often missed, and I wanted to provide a platform that reflected just that. I started blogging late at night, after working long hours, totally unpaid, but when you are truly passionate about something, effort is not hard. I often blog during my travels, writing is about vision, taste, smell, and what we hear, I am intrigued by human life and experiences.

Ziwa 1

What challenges did you face and how did you get over it?

Initially I lacked confidence in writing/blogging. There is a level of vulnerability in sharing yourself and your inner depth in a world that is often so critical and unforgiving. I attended a seminar talk with one of my favourite writers Ngozi Chimamande Adichie, when I asked her a question about writing in the Diaspora, she replied “You must write about Zimbabwe and Africa, the world needs to hear those stories” and that was it, I was off with no apologies.

What motivates you every day?

My mother was a teacher and she very charitable, she took in everyone she felt sorry for which drove us crazy when we were young. She died just after my 21st birthday, its her spirit that gets me up every morning. My heart is warmed by the many acts of kindness from friends and strangers, it reminds me that that world is still a wonderful place to live in.

What is your passion and are you pursuing your passion?

I am Public Health Specialist with a passion for grassroots programs. African women carry the heaviest burden in terms of health and social outcomes and yet they are also the most innovative and resilient people in our planet. My passion is to advocate for better health outcomes for all Africans with particular focus on African women and children wherever they are. Its not enough to watch the horrible scenes of Ebola virus wreaking havoc in our continent, or to be complacent in rates of gender violence in women and young girls in Africa, my passion is to make event human count particularly vulnerable groups. I provide analysis on these very issues on African media platforms such as BBC Africa, Arise TV and Resonance Radio, so yes I am doing what I love to do.

Advice to Zimbabwean women?

Zimbabwean women are renowned for their confidence and intelligence. When I work on our HIV-Psychological Program in Harare, Zimbabwe I meet some of the most humbling yet poor women who remind me everyday that empowerment is not embedded in wealth and material but in spirit. We need to foster this growth and support it wherever we can.

Do you think Zimbabwean women are empowered enough?

Yes in many ways Zimbabwean women are absolutely empowered otherwise we could not have survived the major challenges that have periodically been thrown at us, that said I think we could do a lot more and work collectively and not compete against each other. We achieve much more when we work together rather than as individuals.

What, in your opinion are the issues we face as women and how can we overcome them?

Poverty and gender violence issues are major issues affecting African women and our African cultural practises further complicate these issues. When we educate a young girl we empower her to make informed decisions about her life, including the power to ensure safe sex which can prevent HIV infection. There are aspects of our culture which are incredibly heart warming and empowering and equally there are aspects of our culture which need modernising because they disempower women. A true African man is one who can rise above these issues and foster a cultural environment in which women and children can strive.

How did you feel about nominated for the ZIWA Female Blogger Awards?

I was hugely surprised and flattered to be nominated for the ZIWA Awards. To be listed among such amazing Zimbabwean women was heart warming and encouraging. Ultimately the winner was Zimbabwe, our country can be proud of its achievements and the women that are doing amazing work in its development.

What is the change you want to see in yourself and why?

I would like to be able to write a lot more than I currently do, I believe there is a book buried in me somewhere, a book that will capture the Zimbabwean experience. I need to create the write space and time in my life to birth this book. I am working on hosting a radio show with focus on African women affairs, I want to make a lot more noise about women empowerment issues in Africa, the world will need ear plugs.

The travel experiences of African women are poorly captured if at all understood. This is because media is not particularly interested in Africans going on safari or Africans freely globe trotting around the world, which many of us do. There is more to us than cleaning and bending hoes in fields, and I want to capture that too.

Dorcas Gwata

Tribal Sands October 2015