Wales Feed

The Story Behind ‘The Greatest Gift’

2016-12-14T10:06:40+00:00

I’ve carried a donor card since my early teens. My mum shared her birthday with a school friend called Julie; sadly Julie had kidney failure and passed away when she was 10. Mum has often talked about her since and says it was this that prompted her to speak to me about organ donation all those years ago.

When the law changed last year in Wales I was intrigued to see how ‘presumed consent’ would work. By being given a three-part observational documentary series to make on the subject, I’d be able to find out first hand, predominantly working with the Organ Donation and Transplant Teams at the University Hospital of Wales.

Showing Both Sides of an Important Story

The ultimate aim was to show both sides of the story – those waiting for transplants and also those families making the heart-breaking, difficult and incredibly brave decisions to donate their loved ones’ organs on the Intensive Care Unit.
Finding the transplant patients was relatively straightforward. Many of them were already busy publicising the law change hoping that it would mean they may get their life-changing transplants sooner. Initially I met 32-year old Kimberly, who had cystic fibrosis; she was desperately ill and waiting for a double lung transplant.

When they agreed that I could follow their stories, it soon became obvious that like them, I would also have to wait for ‘the call’ to come. We set up a system to ensure that if their transplant call came, then I would also get a call. In total I spent around six months being on standby. I don’t like to compare this at all to what it’s like to wait for a transplant but, I suppose I had a tiny taste of what it’s like to constantly wait for the phone to ring.

Being On Call

I found it quite tough. I’m a mum of busy seven-year old twin girls - our weeks and weekends are always full and it was hard not to be able to fully switch off and be present with them. I became paranoid about my phone being on, with the battery fully charged and at exactly the right volume to wake me up during the night if needed. I tried to give myself alternative weekends off and plan trips to places where I could switch off as I wouldn’t be able to get back to Cardiff in time easily and my phone would naturally be out of range.

Sadly, people waiting for transplants can’t put any of these coping mechanisms in place. On top of all the waiting they are really unwell with failing organs, tied to dialysis machines, enduring endless treatment and medication rituals. Spending time with these patients and their families was a privilege. For many of them, their sense of humour helps and also the hope that they all have that their call will eventually come.

I knew that the hardest thing would be to gain access to follow donor families on Intensive Care. However, remarkably, very soon after the law had changed the first family agreed. Karen was approached by the medical staff and said that I could film her 67-year old dad, Bill’s, organ donation. Bill had suffered a devastating stroke and Karen explained how his brother who was also Bill’s best friend had received a kidney transplant which transformed his life. As a result of this, Bill had recently opted in to the new system in Wales. It was extremely difficult to remain composed as the family said their final goodbyes to him.

Two more families also agreed that I could follow their loved ones’ organ donations. So across the three episodes we learn not just that Bill saved two people with the gift of his kidneys, but also that 41-year old Steven saved three people with his kidneys and liver as did 60-year old Stuart. I will always remain humbled that their loved ones - Karen, Vicky and Angie were so open with me at the most difficult time in their lives.

“Someone’s generous gift can transform another’s life”

What was also incredible for me was seeing first-hand how someone’s generous gift can transform another’s life. I filmed with 32-year old Kimberly in Harefield Hospital just two weeks after her lung transplant. In front of me was a very different person, who needed no assistance with oxygen. Kimberly’s cystic fibrosis meant that the best her lung capacity has ever been was 30%. I had to choke back happy tears when she underwent a test which revealed that with her new lungs, just two weeks post-transplant, she now had a capacity of almost 70%!

It’s been an extremely emotional series to make; I’ve cried so many happy and sad tears whilst making it. Some while I’ve been with the patients, many sat in edit suites and lots privately. When people let you in to their lives at difficult times it’s quite overwhelming and impossible to not become emotionally attached. Apart from my daughters, the series is the proudest I’ve been of anything I’ve made. I hope that it’ll make people think about organ donation and share their wishes about it with their families whatever they are. My girls already know all about Kimberly, Anwar, Jade, Robin and Kim and I’m sure their grandmother will tell them all about her friend Julie when the time comes.

The third episode of The Greatest Gift airs on Tuesday, 20th December at 10.40pm, BBC One Wales. Episodes 1 and 2 are available on BBC iPlayer now.

A masterclass in the art of living

2015-07-21T14:13:05+00:00

Rowena Kincaid

Ladies and Gentlemen, tonight Before I Kick The Bucket goes to air. I can’t believe I just wrote that. It’s my first television documentary and I’m pinching myself repeatedly to double-check I’m not dreaming. Ouch. Ouch.

It seems like only yesterday that I first met Rowena Kincaid, the indomitable heroine and presenter of the programme. It was late last summer and I’d been asked to meet her in a pub. I knew nothing more than that she was terminally ill and had an idea for a television programme. I stirred my drink anxiously and eyeballed the clientele. Which one of these people looked the most ill?

Imagine my shock when Rowena introduced herself. The healthiest and happiest looking girl at the bar was, she told me, gravely ill. She told me her story. It was one of bad luck and heartache, punctuated with blue jokes that caught me off guard. Diagnosed with incurable breast cancer, she was now living in a state of limbo. Unsure what to do with what little time remained, she’d had the idea of making a documentary about bucket lists. I liked this girl. She was fearless and funny.

How everything unfolded, I’m not entirely sure. Within days Rowena had charmed BBC Wales into commissioning her idea and strong-armed me into making it with her. Fast forward 12 months and I’m still hanging onto her coat-tails. I’m franticly typing out this blog whilst Rowena prepares for her final day of press to publicise the programme. I’m pinching myself again.

Rowena with 'Before I Kick the Bucket' producer Huw Crowley

It would be a lie to say the process has been easy. Documentary-making is hard at the best of times, let alone when the crew comprises of a first-time filmmaker and a presenter being kept alive by chemotherapy. Health concerns have been real and disruptive and it’s been a struggle to helplessly watch a dear friend ride the roller coaster of cancer. Yet in truth, this project has been a privilege and pleasure to work on. Over the last few months I have witnessed humour, grace and dignity in the face of adversity. I have seen a human spirit that refuses to submit. Rowena, getting to know you has been a joy. I’m so proud to call you a friend.

Rowena Kincaid’s Before I Kick The Bucket is so much more than a film about dying. It’s a masterclass in the art of living. It is funny and frank and frighteningly brave. Rowena, you are an example to us all.

Before I Kick the Bucket, Tuesday, July 21, BBC One Wales, 10.40pm
bbc.co.uk/iplayer

Healthcare in Wales before the NHS

2015-01-23T09:16:11+00:00

Wales - and the Welsh people in general - played an important role in the creation of universal health care in the UK.

David Lloyd George and Aneurin Bevan were key figures in the creation of a ‘health for all’ culture but long before they came to prominence in the twentieth century, caring for less fortunate members of the community was an important part of Welsh society.

Rt. Hon. Aneurin Bevan, Minister of Health, speaking in 1942

During the Middle Ages people in Wales developed a tradition of collective loyalty within their communities, wherever or whatever those communities might be. Put simply, people in the village or town looked after their own! Family was at the heart of this collective care but it did not stop there. If someone was in need, help was usually at hand.

Of course, such help was usually quite primitive. Unless an injured man or woman was very lucky, something like a broken limb could well mean death; diseases such as the plague certainly did.

Treatment was limited to herbs and potions and while the reputation of healers and herbalists like the 12th century Physicians of Myddfai was undoubtedly well-deserved, by modern standards their remedies were basic in the extreme.

Despite this, general health care was surprisingly good in the isolated Welsh communities. The writer Giraldus Cambrensis, on his tour through Wales in the 1180s, spoke very highly of the health of the people.

Despite being of aristocratic Norman origin and naturally disdainful of the lifestyles of ordinary working people, Giraldus was clear that the Welsh were very stringent about cleanliness, comparing their practices most favourably to other nationalities in Europe. He particularly noted the way the Welsh cleaned their teeth using small hazel twigs.

Much of the help given to sick people was, for many years, in the hands of the local ‘wise woman’ or the elderly members of the family. Monasteries and other religious settlements could and often did offer beds and treatment to the sick with monks, friars and nuns putting their own safety to one side in an attempt to aid those in need.

Such help, naturally enough, depended as much on geographic location as anything else – put simply, it depended on whether or not there was a monastery in your area. The dissolution of the monasteries in the years after 1536 effectively put an end to such assistance.

The 18th and early 19th centuries saw a dramatic change from a rural environment to an industrial one as Wales, fuelled by copper, slate, iron and coal, became one of the industrial powerhouses of the world. Inevitably, in the new world that was being created health care was now linked to, and governed by, such things as the social and economic conditions that people were forced to endure.

By the end of the 19th century the population of Wales had risen from the fairly consistent 350,000 of the mid-17th century to an amazing two million. People came in their thousands to the industrial areas of Glamorgan and Monmouthshire, lured by the iron works and coal mines. And, of course, industry brought with it distinct problems in the area of public health.

Among other things, poor housing, overcrowding and lack of proper sanitation quickly proved to be a fertile breeding ground for diseases such as cholera and typhus. In the cholera outbreak of 1848 no fewer than 3,000 people died in Glamorgan alone. In Cardiff the death toll was just over 300 but overcrowded and unhealthy Merthyr Tydfil lost 1,389.

One of the results of this tragedy was the setting up of Boards of Health. By 1872 over one million pounds had been invested, by the government, in sewerage and water supply. Some of this, although clearly not all, was spent on the industrial areas of Wales.

The Public Health Act of 1875 was intended to further combat the squalid living conditions of people in urban environments but, unfortunately, its effects were delayed as the mine owners and iron masters were supposed to help pay for the improvements – something they bitterly resented and fought against.

In lieu of other help, many people in the mining communities and in port cities like Cardiff paid into insurance schemes or Friendly Societies – perhaps a penny a week – that would give them a fund to ‘tap into’ if they required medical treatment. That was fine, but it did not even begin to help those operating just above the poverty line or who were actually out of work.

Hospitals were usually provided by charities or, in cases like the miners’ hospital in Caerphilly or the Royal Hamadryad Hospital in Cardiff Docks, through the levying of a toll collected out of men’s wages. There were a number of small isolation hospitals across Wales, set up in the 19th century and catering for people with diseases like smallpox, scarlet fever and diphtheria – again, usually paid for by contributions from working men.

Rt. Hon. David Lloyd George in 1931

Lloyd George’s National Insurance Scheme of 1911 did provide some sort of help but worked on the basis of contributions from individuals, employers and the state. The only treatment it catered for directly was for people suffering from TB – Wales was one of the worst affected parts of Britain – and, crucially, it did not cover dependents.

When the Depression hit Wales in the 1920s there were immediate cuts in wages and many mines closed. In Merthyr Tydfil alone the unemployment figure rose to nearly 70%. The result was an immediate blow to the health of out of work miners and their families. By the time of the Beveridge Report in 1944 it was clear that something had to be done and Aneurin Bevan, Minister for Health in the post-war Labour Government – himself a miner before being elected to Parliament - forced through legislation to provide health care that was based on citizenship rather than employment, class or money.

Despite their fine and ancient traditions of health care, the people of Wales had suffered grievously in the aftermath of industrialisation. With the creation of the National Health Service an intolerable burden had been lifted from the shoulders of the working men and their families.

BBC Wales is looking at the health of our NHS in 'Health Check Wales' for a week from Sunday 25 January 2015 on TV, radio and online.

Weight Clinic – The Next Generation

2014-08-07T09:19:32+00:00

The weight management clinic at the Aneurin Bevan Hospital, Ebbw Vale is one of the most welcoming places I've filmed. I've spent many hours sitting in a plain corridor; the nurses taking pity on me as I wait - camera in hand - outside the consulting rooms.

It's a very different experience for the clinic's patients on their first visit. Many of them will have languished on a three-year waiting list before getting an appointment. The wait in the corridor will have been nerve-wracking for them.

Staff at the weight management clinic at the Aneurin Bevan Hospital, Ebbw Vale

Who in all honesty would look forward to speaking to a stranger about their weight, waist size, eating habits and innermost secrets? When you're used to strangers staring at you because of your size and making remarks at your expense, the last thing you'd look forward to is a doctor telling you some home truths.

Almost every patient I have spoken to says their first consultation with Dr Nadim Haboubi was a jarring experience. The clinic's figurehead doesn't mince his words. He isn't afraid of telling patients the blunt truth about being obese. But he also exudes passion. He and his team want to make a difference and they relentlessly work towards motivating their patients. It's this combination of straight-talking and passion that seems to resonate with many patients.

There's nothing revolutionary about the clinic's prescription – eat sensibly and move more (although they go into it in incredible detail). But at the same time the staff appreciate the complexity of the problem and react to individual needs.

Haike in Weight Clinic - The Next Generation

All the patients I have met at Ebbw Vale have their own unique stories, and none more complicated than the youngest on the clinic's books. The life stories of James, Stacey and Haike who all feature in Weight Clinic – The Next Generation could have filled their own programmes.

They have all taken the brave step of talking publicly about their weight problems, despite all having suffered bullying of one type or another during their teenage years, and know from painful experience how people make snap judgements when they see an obese person.

The irony is that the majority of us are now overweight or obese. Our idea of what is an ordinary weight has become completely skewed. I am constantly asked how the individuals I film didn't manage to put the brakes on when they were 20 stone, or 25 stone? Why did they wait until they got to such an alarming size? But all these individuals have successfully dieted in past – some have been slimmers of the month – but as with all yo-yo dieters they've regained the weight.

The reality is there's no quick fix and we can all hijack our ability to make positive changes to our lives. Meanwhile we're constantly surrounded by all kinds of food that will make us gain weight, and every convenience to minimise our physical movement. Few of us have noticed how 'treat' foods have now worked their way into almost every space we inhabit.

Welsh Weight Clinic: The Next Generation is on Thursday 7 August at 10.35pm, BBC One Wales.

The Great Welsh Diet Experiment: One Year On

2014-08-04T12:03:58+00:00

What another fantastic experience catching up with my troop from the DVLA.

We were all so excited to be back together. I could clearly see some fantastic successes with most of the team but there had also been some setbacks.

Tara and Tracy

I know life isn't always sunshine and daisies and as we learn from Kirsty's turbulent 12 months, we have no idea what's around the corner. Obstacles are thrown our way and our world can be turned upside down. Thankfully, the outcome can still be positive and experiences help us to learn and be stronger.

But there are also lifestyle factors that we are in complete control of, and as I soon discovered from Tracy, many things hadn't changed.

I knew I had to do more than just show her how to exercise and eat. She needed to change her lifestyle. And when I revealed what I was going to do with her, I think she was shocked!

For lasting success with your lifestyle you need to look at everything around you: your support network, your mindset, your movement, nutrition choices, how you manage stress and your sleep.

Following our time together, Tracy did revert back to her old ways. Not completely, but enough to halt her progress towards her goals. I needed to take some dramatic steps and say some firm words to make her realise that she will seriously shorten her life and ability to do what she wants if she continues her unhealthy lifestyle.

What we did together was fun, educational and hopefully inspirational. I wanted to be able to help Tracy grab the opportunity to make a difference in her future forever and I am hopeful for the Tracy's future.

I really hope this programme has helped to inspire many to take action and get the right help. I'd welcome anyone to get in touch with their stories.

The Great Welsh Diet Experiment: One Year On is on Monday 4 August, 8.30pm, BBC One Wales.

X-Ray Health Special: Small steps to feeling good

2014-08-04T08:52:55+00:00

Those who work with me will know that I often appear in the office on a Monday morning with a lunch box generous enough to feed the entire X-Ray team.

It's not that I'm greedy (although I do love my food). Rather, I bring enough up the M4 to keep me going for the whole three-day stint I spend at Cardiff HQ.

Rachel and someone dressed as Carmen Miranda

Now, the size of my sandwich box stills packs a mighty punch, but since working on the X-Ray Health Special the contents have subtly changed. Gone are the crisps and the slice of cake - the little treats that were a staple to keep me going into the afternoon. That's what comes from learning how to read a food label. After analysing the contents of row upon row of vending machine sweets and crisps you can't help but question what you’re putting into your body.

The weekly food shop has had a mini-makeover too. Don't get me wrong, we have always consumed a healthy helping of fruit and veg, but gone is the the oh-so-wholesome looking Granola that sent the sugar-o-meter spinning.

It was hard to wean myself off it. Clearly I'd got used to a serious sugar hit of a morning, but it does feel like my tastes have changed. Just like Zak said in our diet challenge about his beloved pop, I don't really fancy it now, to be honest.

The children are tougher customers to convert. As any parent knows, you often have to sacrifice your principles to peer pressure. So a compromise in the lunchbox - it's chocolate OR crisps, not both. My eldest is not impressed.

Dietician Sioned Quirke illustrates why your plate size is important.

Perhaps though, the biggest revelation in the T-W household is the use of more sensible-sized crockery. Smaller plates = smaller portions is a no-brainer. Simple.

So no seismic shift in our eating habits, instead, some small changes. But it does feel good.

X-Ray Health Special is on Monday 4 August, 7pm, BBC One Wales.

Looking back on the Live Longer Wales season

2013-10-30T12:01:03+00:00

The Live Longer Wales season finished this last weekend and over the last three weeks our TV, Radio and Online services have looked at inactivity at work, diets, what's in our food, how you can cook and grow your own food, body image, Type 2 diabetes and a host of other subjects.

The weekend started on Friday with the Radio Wales Cook-along curated by Simon Wright and finished with Dudley's Grow It, Cook It, Eat It with the people of Ynysybwl on Sunday. And around 50 organisations from across Wales opened their doors for free last weekend to let us get a taste of what a more active life might be like.

Welsh chef Dudley Newbery

Most of our programmes are still available through our Live Longer Wales website and after that you will be able to access all the online material that’s been created alongside the programmes from tips to keeping fit and how to eat more healthily.

Thanks to all of you who have been in touch with us and kept up with the programmes. I know that the Live Longer Wales season has given rise to sometimes passionate debate and we have welcomed your comments whether you were sympathetic or disagreed.

We hope at least that the last three weeks have helped you get inspired about how you and your families can live a longer and healthier life.

Filming Ray Gravell: Life with Diabetes

2013-10-18T07:36:30+00:00

Back in 2007 I was asked to produce and direct a documentary following Ray Gravell and his recovery from a leg amputation. We hit it off from the word go - it was hard not to with such a character.

At the time I had just been through a traumatic experience myself. My daughter had gone through open heart surgery, so meeting Grav so soon afterwards was both emotional and inspirational. I could empathise with Ray's situation - we cried and laughed and got on well.

For me he was a legend, a rugby hero, but I soon realised he was much more than that. He was a loving father and husband and his roots were firm in the ground that his house stood on.

Ray Gravell

His strength and courage were remarkable. He seemed to cope with his situation in a way that I could never imagine and his humour kept us all entertained. His wife Mari and daughters Manon and Gwenan were his rock, and it was a privilege to spend time with them in a period when I know they were under great strain, but they made me feel so welcome.

We were a small crew - it was just a cameraman and myself. We visited physiotherapy sessions at Morriston Hospital and were able to see for ourselves the care and commitment of the staff under great demands.

We were with him for six months and he always sent text messages when the cameraman and I were travelling back home. We would be driving through Machynlleth and a text message would arrive: "I hope your journey back is ok, txt me to say when you are home safely." He genuinely cared about people.

When the news came of his death, I was in shock. He had fought so hard, I couldn't believe that such a strong force of life had cruelly been taken away. I had just started editing the programme - and then I was leaving the editing suite to attend his funeral. It was surreal.

The programme was shelved for five years. Then we spoke with Mari and it was decided that the documentary would be shown on S4C to raise awareness of diabetes and the seriousness of the condition.

Grav - 'Sdim Cywilydd Mewn Llefain ("There's no shame in crying") was shown on 1 January, 2013. We had filmed back-to-back, in English and in Welsh, and now Ray Gravell: Life with Diabetes is being shown as part of the Live Longer Wales season on BBC One Wales.

This programme includes a recent interview with Mari and the children and also looks at the diabetes research that's taking place at Swansea University. There's also an interview with Meurig Williams, a specialist in diabetes who was Ray's consultant at Prince Philip Hospital, Llanelli.

For me it has been an eye-opener. I didn't realise how serious diabetes is and I hope this programme will help raise awareness of the condition.

Ray Gravell: Life With Diabetes is on Monday 21 October, 8.30pm, BBC One Wales.

Live Longer Wales: Is My Job Killing Me?

2013-10-08T09:56:52+00:00

Working with the BBC for the programme Is My Job Killing Me? and the troop from the DVLA has been one of the most incredible experiences of my life.

When I took on the project I went into it wanting to help inspire and motivate a team of people to turn their lives around and become healthier with a more positive outlook on life.

Living such an active life myself, I didn't understand what it would feel like to spend working days being sedentary. Before I had the chance to interview some of the employees at the DVLA I thought people would be itching to move more after work.

I was wrong! I couldn't believe it. The more people sat around and rested, the more they wanted to rest.

Sit in the car to work, sit down at the desk, sit down during breaks, sit sit and sit! Didn't these guys realise how dangerous this is? The weight was piling on, they were weak, had back and joint problems and were stressed out and lethargic. It's like the most mundane groundhog day that nobody can get out of!

When my husband went from a manual job to a less active job in the DVLA, maybe it was easy for me to encourage him to make a few changes as we lived together. But would I be able to make such an impact on the team of six as well as the rest of the workforce?

I signed myself up to transform lives and that is exactly what I would do. This was my time to inject maximum enthusiasm into these people, whether they were ready for it or not. They needed something fresh, fun and exciting.

The last thing anybody wanted to hear is the same, boring stuff that's been going around for years (and doesn't work, by the way). So it was out with "exercise more and eat less" and time to switch people's thinking to "exercise less, eat more, but do it properly". A lot more appealing!

And it worked. They completed exciting challenges, did high-energy and fun 12-minute fat-melting workouts, ate incredible meals including some of their favourites and felt more motivated than ever. The team embraced all of the information and help that I offered and the results speak for themselves.

What an amazing team! They're fitter and happier that they have been in years, and the best part is, it's a lifestyle change.

Their journeys have been nothing short of inspirational and I'm confident that their stories will help to motivate others around them, including their work colleagues.

The way the world is developing now, the chances are there may be more and more doing jobs which mean sitting at a desk and not moving, but this project has proven that you can still stay fit and healthy around it, and enjoy life more.

So it's out with the excuses and in with the movement. Excuses won't get you results.

Is My Job Killing Me? has proven that you can find the time to exercise; you can prepare meals that are cost-effective and easy to make. We'll all have times where we feel we can't be bothered, but if it doesn't challenge you it doesn't change you!

Is My Job Killing Me? is on Wednesday 9 October at 9pm on BBC One Wales.

Live Longer Wales: The Shape of Wales

2013-10-04T09:19:58+00:00

Stephen Evans is the BBC's Berlin correspondent and presenter of Live Longer Wales: The Shape of Wales.

When I started making a program about obesity in Wales, I came with a plateful of preconceptions – served with a side-order of scepticism.

I was very suspicious of what seemed like a widespread view that serious fatness was a problem largely for poor people. I wondered if there was a bit of snobbery in all of this, with the better-heeled sneering at the eating habits of those they saw as their social inferiors – what is sometimes called the "demonisation of the working class".

On this view, the poor, particularly in the south Wales valleys, were over-indulging on cheap and fattening food, pushed at them by fast-food chains. They were victims of rapacious capitalistic American companies. So ran the argument.

Perhaps the best example of the opinion that poor people really could improve their ways came recently from Jamie Oliver, the television chef and entrepreneur who has made a fortune from his own chain of restaurants.

He cited the "Sicilian street cleaner who has 25 mussels, 10 cherry tomatoes, and a packet of spaghetti for 60 pence and knocks out the most amazing pasta". The implication was that if the poor of Italy could eat well then so could the poor of Wales. It was a matter of effort and education.

So, I wondered, did obesity and poverty go together like fish and chips? It turned out that the answer was more complicated than I had thought.

In Wales, the latest figures (from the official Welsh Health Survey of 2012) indicate that, among the most deprived fifth of the population, 28 per cent are obese compared with 18 per cent in the best-off fifth of the population.

So obesity and poverty do seem connected, but with a significant proportion of the richest also badly over weight (nearly one in five).

And other research indicates that the two thinnest groups are likely to be poor men and rich women. This fits what we see around us – men on the lowest incomes often do physical work that burns off calories while rich women have the greatest economic incentive against obesity (fatness in rich and successful men doesn't seem to be the professional or marital barrier which it might be for high-flying women).

There haven't been many studies looking at links between "class" and weight but one of the few was recently done in Leeds. It showed, according to the leader of the research, that "although the prevalence of obesity is higher than desirable across the whole city, it appears that children living in the most deprived and most affluent areas of the city are at the lowest risk".

Is Cardiff different from Leeds in this respect? The detailed research hasn't been done, but it would be very interesting to find out if middle class areas had more of an obesity problem in children than the rougher parts.

What does seem clear is that obesity is a problem in Wales. All the figures indicate that it's worse in Wales than in other parts of Britain.

But what is far from clear is that it's a problem confined to the deprived parts of the south Wales valleys. And urging the poor to cook more broccoli (or Sicilian mussels) might make everybody else feel better about themselves but it won't get the fat off the bulging bellies of the better off.

After all, Jamie's Italian Burger served nicely on a plate at his chain-restaurant in the St David's Shopping Centre in Cardiff contains 1,033 calories. A McDonald's Big Mac contains 490 calories (figures correct as of October 2013).

Live Longer Wales: The Shape of Wales is on Monday, October 7, BBC One Wales, 10.35pm.

The Dreaded Disease - David's Story

2013-07-04T07:00:33+00:00

The Dreaded Disease - David's Story is a three-part series on BBC Radio Wales that tells us about dementia from the point of view of Welsh broadcaster Beti George.

Her partner of almost 40 years - writer, broadcaster and rugby commentator David Parry-Jones - was diagnosed with Alzheimer's in 2009. Here Beti shares a flavour of their life together.

His name was on the envelope - and of course he opened it. If I get to the post first and see an official looking letter addressed to David Parry-Jones, I open it to avoid the kind of confrontation that happened this morning.

"This letter says that the money belongs to me," he says. And with hackles rising he adds: "So where is it?"

"It's in your account in the bank", I say, "to use as and when you need help."

He doesn't understand "bank account" any more. He'd banked at our local little HSBC bank for decades. When his driving licence was taken away, I carried on with the routine and took him there every Thursday.

The staff knew him well and had followed his decline with great concern and sympathy. But the branch closed. He would have been completely lost in a bigger largely automated branch. So now I get money "from the wall" - which he finds totally ridiculous - he never used an ATM service.

I could say to him, I suppose, that as his carer I should be pocketing the £53, But that would really get him going - "It's mine not yours!" He doesn't understand I'm one of the unpaid carers who save the state £8 billion a year.

Beti George and David Parry-Jones (photo: Warren Orchard)

He'd dressed himself this morning, but then his anxiety about the money led him into a paddy and he decided to take off his shirt. "Please leave it on," I said. But he was angry and I said OK and yes - stormed off to the study. Five minutes later he was calling softly - "Apology. Accepted?"

"Of course," I said - and gave him a hug. "Do you love me a little?" he says. "I must do, or else I wouldn't be here - because you can be difficult." "Yes I know. It's the heat - up here," he says, tapping his head.

(I wish I were a scientist working on research into dementia - trying to follow every twist and turn of those wires in the brain. Living with someone with dementia gives one an intense insight into the behavioural aspects of the disease which cannot be described easily and in detail to a researcher asking pre-formulated questions.)

David's hair was in a mess - and I laughed and told him to go and take a look in the mirror. He came back in a good mood having combed his hair.

It's the Saturday morning after Lady Thatcher's death, and The Guardian has a spoof story on Lady Thatcher written by Posy Simmons - King Ironsides. He's amused by the caricature pictures of the Iron Lady. I tell him to read it so that he could decide whether she was worthy of his adoration. We laugh again.

It strikes me why more hasn't been done about how the brain of this powerful woman had been destroyed by dementia - and that it's a disease that desperately needs to be tackled before it overcomes us, leaving state and society unable to cope financially and emotionally.

The Dreaded Disease - David's Story is on BBC Radio Wales on Sunday at 1.30pm, then on Monday and Tuesday at 6.30pm.

On Wednesday morning Beti will join Jason Mohammad to discuss some of the issues explored during the series with listeners.

The Story of Tŷ Hapus

2013-01-28T16:50:38+00:00

The Story of Tŷ Hapus traces a year in the life of a remarkable place in Wales – the only centre of its kind in the whole of the UK which caters for younger people with dementia.

Before I delved deeper into the subject I had the assumptions many of us hold – that Alzheimer’s and other forms of dementia are an old people’s disease. But the real picture hit home powerfully when I learned the youngest referral to Tŷ Hapus was a mother of 44, the same age as me.

The presenter of our two-part series – Fiona Phillips - knows only too well how this incurable, degenerative and terminal brain disease can strike younger people. Her mother developed it in her mid-50s – one of the 15,000 people in Britain who show symptoms before the age of 65. Fiona, whose family roots are in Haverfordwest, lost her father to Alzheimer’s too.

So when she was asked to become patron of Tŷ Hapus, Fiona felt an immediate connection with the people behind the project and was impressed and encouraged by their aims.

“When I got involved I met two remarkable Welsh women who are each making a major impact on how we should cope with and combat this cruel disease,” Fiona explains.

“One is driven by her personal circumstances to change how we care for those with early-onset Alzheimer’s. The other is devoting her professional life to researching a possible cure.”

The women Fiona describes are Justine Pickering and Professor Julie Williams. I shaped the series through their perspectives.

Justine’s mother Annie developed Alzheimer’s at 55. As the disease changed this vibrant former civil servant into someone who required round the clock care, Justine was distraught to find how little provision there was for younger people with Alzheimer’s. The only respite centre available catered for the elderly, leaving Justine’s mother feeling unhappy and isolated.

So Justine decided to do something about it. She began fundraising – initially persuading a group of friends to embark on a sponsored cycle from Windsor Castle to Cardiff Castle. Her campaign took flight. What started as a modest plan to fund a single respite care worker for her mum grew into a major project to provide a pioneering day centre for younger people with Alzheimer’s.

An elegant home from home

Justine took a lease on an Edwardian building in the middle of Barry and, begging favours from interior designers and furniture stores, transformed it into an elegant home from home. Complete with cafe where family and friends can drop in, beauty treatment room, dining room and lounge, the ambience of Tŷ Hapus is more boutique hotel than day centre.

Tŷ Hapus welcomes Sir Graham Henry and his wife Raewyn (Courtesy of Barry & District News)

With the help of the Alzheimer’s Society an expert team of carers was put in place and Tŷ Hapus welcomed its first guests at the start of 2012. Providing respite care and activities for up to five days a week, it is a ground-breaking concept.

Funded entirely by charitable donations, Tŷ Hapus has proved an absolute lifeline for families struggling to cope with the devastating impact of early-onset dementia. And sadly there is nothing else like it in Wales and the rest of the UK. There must be so many families desperate for similar facilities.

As I visited Tŷ Hapus to gather interviews for the series, I was deeply moved by the warmth of its atmosphere and the remarkable bond between carers and guests. Support worker Alison Thomas explained why the connection was so strong: “We’re all the same generation so we relate to what the guests are going through so much.”

Remarkable breakthroughs in Alzheimer’s research

Just a few miles away the quest to find a cure for Alzheimer’s continues. Professor Julie Williams and her team at Cardiff University are at the forefront of global Alzheimer’s research. They collaborate with scientists across the world. And with a database of 100,000 dementia case studies to draw on they’ve made some remarkable breakthroughs.

In the series Julie explains how they have identified 20 genes which make us more susceptible to the disease:

“There are new ways of looking at the disease and new avenues for treatment. If I can see just one treatment come out in my lifetime I’ll be very happy,” says the Merthyr-born scientist, who is also a patron of Tŷ Hapus.

Julie and Justine just happen to be good friends - Julie’s husband is head of communications for the Welsh Rugby Union (WRU) while Justine is married to WRU chairman and former Wales captain David Pickering. Their involvement with Alzheimer’s has brought them even closer. Together these two Welsh women are making a significant impact on a disease that is expected to affect one million people in the UK in less than 10 years.

As Julie concentrates on a cure, Justine aims to improve how we care for younger people with Alzheimer’s. Her dream is to see a concept she created to help her mother Annie benefit thousands of people with early-onset dementia across Britain.

“The Alzheimer’s Society has said they’d like to use Tŷ Hapus as a model for the rest of the UK,” says Justine. “I really hope it can happen. There is a desperate need for age-appropriate, dignified, loving, stimulating projects like Tŷ Hapus all over the country. It doesn’t take too much to do and it just gives so much back.”

The Story of Tŷ Hapus is produced by Carolyn Hitt and is a Presentable production for BBC Radio Wales. The first programme is available on the BBC iPlayer.

Programme two, which features a visit to Tŷ Hapus by Sir Graham Henry is broadcast on Sunday 3 February 2013 at 5.30pm on BBC Radio Wales.

The Hamadryad hospital ship

2012-09-27T10:15:26+00:00

Visitors to Cardiff in the early 1890s would have been amazed to see three old wooden warships moored in various parts of the docks area. These were not museum pieces or historical artefacts, they were working ships, all of them carrying out useful tasks almost 100 years after they first went down the slipways.

The Thisbe was Cardiff's gospel or chapel ship. Run by the Missions to Seamen, she was moored in East Bute Dock from 1860 until she was finally towed away for breaking in 1892.

The second “woodenwall” was the Havannah, an industrial training ship laid up on the mud close to Penarth Road. She offered care and industrial training to semi-delinquent boys and ran until 1905.

The third and by far the most famous of the three ships was the Hamadryad. The brainchild of Dr Henry Paine, medical officer of health for Cardiff from 1855 until 1887, the Hamadryad was the port's Seaman's Hospital. Dr Paine was very concerned about sailors bringing infectious diseases like cholera, smallpox and typhoid into the docks from where they might spread into Cardiff itself and was very vocal in his comments on the condition of houses in the docks area.

At a public meeting in March 1866 it was proposed that a receiving house or a hospital ship be brought to the docks. It was hardly a unanimous decision as many felt extending the new infirmary on Newport Road would be a better option. But the proposal for a hospital ship was agreed, and the Admiralty offered to loan the old frigate Hamadryad as the base for the establishment.

The Hamadryad was brought from Devonport – where she was lying, awaiting breaking – and duly converted into a hospital ship. It cost £2,791, a charge of £160 being made for the tow from Devonport to Cardiff, and nearly £1,500 for the conversion itself. As well as beds and wards for patients, accommodation was also provided for a medical superintendent, a matron and a number of nurses.

Rat Island

Originally moored in East Bute Dock, the Hamadryad was soon moved to a patch of land, waste ground, donated by the Marquis of Bute. Ominously, it was called Rat Island. Alterations complete, the Hamadryad opened as a hospital on 1 November 1866 with Mr Vavasour as the first medical superintendent.

In the first year of operations over 400 patients were treated, most of them from ships in Cardiff Dock but some from places such as Swansea and Barry. Over the years of her existence thousands of sailors – and people from the immediate locality – were helped.

The hospital ship was funded by a levy of two shillings per 100 tons of shipping using the docks, paid to shipping agents or the captains themselves. So successful was the enterprise that by 1871 a wooden annexe had been built on the river bank alongside the ship to take excess patients.

No women policy

Sailors of all nationalities were treated in the hospital, either as day patients or as full admissions. In 1897 Dr Hughes, the medical superintendent at the time, reported that 379 people had been admitted while many more had been treated as casualties and day patients. Interestingly, while men of all nations were admitted, no women were allowed – and neither was anyone suffering from scabies or lice.

After admission all patients were given a bath and a haircut and were then issued with hospital clothing. It was a practice that continued right up into the 20th century.

The Hamadryad was already old when she was first loaned by the Admiralty. By the closing years of the 19th century it was clear that she was well past her prime and so, to mark the diamond jubilee of Queen Victoria, it was decided to create a permanent seaman's hospital close to the mooring site of the original ship. This opened on 29 June 1905.

Hamadryad Hospital was opned in June 1905

With the Hamadryad now totally obsolete it was time to send her to the ship breakers. And so, many tons of ballast (pig iron and stone) was removed from her hold and a channel was excavated to allow the old ship access to the sea. Then she was towed away by the tugs Frank Stanley and Stormcock, first to the Roath Basin and then to Appledore where she was finally broken up.

The Hamadryad Hospital continued its work once the old ship had gone. The name was retained and it continued to run until 2002.

The Hamadryad, like the two other wooden warships in Cardiff, was hardly the most hygenic of environments, particularly for men who might be grievously ill. But it was, at least, an attempt at providing care and treatment in a century that was notoriously cavalier with things like the health of ordinary working men. And for that, if nothing more, she deserves recognition.

The physicians of Myddfai

2011-08-18T08:05:53+00:00

The Red Book of Hergest is one of the most ancient manuscript volumes in existence, dating from the years immediately following 1382. Now kept in the Bodleian Library on behalf of Jesus College, Oxford, as well as containing early prose and pieces of poetry the red vellum book also holds a collection of herbal remedies from the Physicians of Myddfai.

The Physicians of Myddfai were herbalists, living and working in and around the Carmarthenshire village of Myddfai. Their origins and dates are a little unclear but certainly the Lord Rhys - the same man who instigated the first eisteddfod - established and sponsored a new monastery at Strata Florida in about 1177.

Strata Florida means layers of flowers and, before too long, the monastery had become a centre for herbal healing. The Lord Rhys had a personal physician called Rhiwallan who probably received his training there and he and his three sons - Cadwgan, Griffith and Einon - were given land in the village of Myddfai in recognition of their work.

The legend of the Physicians of Myddfai originates from this period, a time of new ideas and of great cultural development, not just in Wales but in the whole of Britain. And over the years the knowledge of these physicians, their healing arts and remedies, were passed down from one generation to the next.

Remedies were made from only natural products, over 170 of them, grown locally in the Myddfai area. They included cures for such things as headache, sunburn, swellings and pain in the legs, coughs and sneezes. It has been claimed, with some justification, that the birth of modern medicine can be traced back to these Physicians of Myddfai.

While the monasteries at places like Strata Florida and Talley continued their work, Myddfai also achieved fame as a centre of medical help. People came from all over the country to find cures and help for ailments, and the physicians were in constant demand - not just for people with money but for ordinary folk, too. For over 100 years the village of Myddfai was a place of great learning and excellence in the healing arts.

Of course, as the fame of the physicians grew so, too, did legends and stories mystifying their craft and origins. One of them suggested that their powers had fairy origins. It is a story that is told in the Mabinogion and, like the list of the physicians' herbal remedies, is contained in the Red Book of Hergest.

According to this story a farmer of Blaensawdde in Carmarthenshire - born as the first flowers broke through on the Black Mountain - saw a beautiful woman sitting on a rock in Lyn-y-Fan Fach, the lake on the mountain. After three attempts to woo her he was at last successful but she agreed to marry him only if he promised to treat her well. Three causeless blows, she said, would return her to the lake. Vowing never to do such a thing the farmer took her as his wife and the family moved six miles down the mountain to the village of Myddfai.

Naturally, three blows were struck, soon after the birth of each of their three children. They were just taps on the back or arm but they were engendered through lack of understanding.

The lady had delayed going to the christening of their first child because the baby would have been harmed by the sun. She cried at a wedding because she knew the bride would soon die. And she laughed at the bridegroom's subsequent funeral because his suffering was over and she was happy for him. The farmer, her husband, could not possibly know these things as he did not have her fairy powers.

But the slaps or blows, innocuous as they were, were enough to cause the lady to immediately return to the lake. No matter how fast the farmer ran she was always ahead of him and soon she had reached the lake and disappeared into the water, leaving the farmer heartbroken and alone.

As the three sons grew they turned their knowledge and powers, knowledge and powers inherited from their mother's fairy lore, to the healing arts. They could have been great warriors, says the legend, they became, instead, great healers. Using the herbs found in the Myddfai area, a long line of physicians or healers was created.

The legend, of course, is part of the mystifying process of medicine - a process that lives on today. And while Myddfai may no longer be the centre of healing and medicine that it once was, the region did receive some degree of celebrity when, in 2007, Prince Charles bought a house in the area. There are those who would say the story has come full circle!

The history of Whitchurch Hospital in Cardiff

2011-05-10T13:18:49+00:00

Most people in Cardiff know of Whitchurch Hospital. The huge and elegant buildings lie alongside one of the main roads into the city and, while many of those who come to Cardiff to work or shop may never have entered the place, they will certainly have seen the buildings from the upper deck of their bus or from their cars.

The idea for Whitchurch Hospital, formerly the Cardiff City Mental Hospital - or Cardiff City Asylum as it was sometimes known - was first mooted at the end of the 19th century.

Even though it did not formally open until 1908, Whitchurch was undoubtedly a product of Victorian Age thinking and medical practice. Arguably this is something from which it has suffered ever since.

There was very little provision for people who were mentally ill during the early part of the 19th century, mental illness being closely associated - in the minds of the general public - with poverty and crime. The wealthy could afford to hire doctors or nurses for members of their family who had mental health problems, could even place them, if necessary, in private hospitals or asylums.

For the poor, however, there was little provision - just a small scattering of public hospitals or, inevitably, the workhouse. As the Industrial Revolution changed the make up of society the problem of vagrancy and of paupers with significant mental health problems became significant. As a result county asylums were created, places where "pauper lunatics," as they were known, could be conveniently herded - and forgotten.

Cardiff saw an enormous rise in its population as the 19th century unfolded. In 1851 it was 18,351 - 20 years later that figure had risen to nearly 40,000. Inevitably there was a growing need for mental health provision.

By the closing years of the century there were 476 Cardiff residents "boarded out" in the Glamorgan Asylum, and a further 500 to 600 being held in hospitals in places as far away as Chester and Carmarthen. The need for a specific provision, for the town of Cardiff alone, was clearly apparent.

Whitchurch Hospital took 10 years to build and cost nearly £350,000, an amazing sum of money for those days. The main hospital building covered nearly five acres and was designed to accommodate 750 patients.

Banded brickwork and the 150 foot water tower dominated the site which consisted of 10 hospital blocks, five for men and five for women. A self contained farm was to be an important feature of the hospital, providing food and therapeutic work for patients.

There was much controversy over this farm, which was originally intended to cost some £4,000. The plan was castigated in the Welsh press, with cartoonists in particular having a field day. The proposed plans were soon altered and the cost reduced to £2,000.

The first medical superintendent was Dr Edwin Goodhall and the first patients arrived at the hospital on 1 May 1908. By the end of June more than 600 patients, mostly male but a large contingent of women as well, had been admitted.

Within a few years Whitchurch Hospital had acquired a remarkable reputation at the forefront of mental health care. This was down to the quality and commitment of the nurses and medical staff and, in particular, Dr Goodall. Concern for the welfare of patients went beyond simple custodial care and there was a very real desire to help people with their problems and, if possible, to assist them in taking a place in society, however limited that involvement might be.

During World War One the hospital was run by the military as a general medical and surgical institution, its patients having been disbanded to other mental hospitals around the area. In 1919 things returned to normal, patients returning from their enforced stays elsewhere.

During the 1930s the hospital constantly received good reports, a high proportion of the nurses being qualified in both general and mental health nursing. Until the late 1930s, however, those nurses worked a 60-hour week, living in the hospital where their private and social lives were stringently governed and controlled.

Research into the causes and treatment of mental illness was always a part of Dr Goodall's programmes, and Whitchurch was well equipped with laboratories and research equipment. The number of patients discharged from Whitchurch was better than almost every other similar institution in Britain, and after-care was equally as important to Goodall and his team.

During World War Two part of the hospital was again in use by the military. Eight hundred beds were handed over to the military, making Whitchurch the largest emergency services hospital in Wales.

Unlike World War One, 200 beds were retained for civilian mental health patients. Over the six years of conflict British, American and occasionally even German soldiers were treated there for wounds and for the psychological trauma of modern warfare.

On 5 July 1948, however, the hospital was taken over by the Ministry of Health as the National Health Service came into existence. The hospital continued to be well-used throughout the 1960s and '70s, even though many were now questioning the viability of large, outmoded institutions such as this.

Care in the community was considered preferable in many cases and, as a consequence, Whitchurch came to be seen by many as little more than a last ditch resort where containment was more important than care and treatment. It was an emotive point and the hospital retained many ardent supporters. Even so, it was clear that the physical environment - perfect, perhaps, in the 19th century - was somewhat limited for modern medical needs.

In the early years of the 21st century plans were made to close the old hospital with its echoing corridors and looming shadows. A combination of day care, specialised provision at nearby Llandough Hospital and a small, purpose-built set of wards on the site of the old Harvey Jones Adolescent Unit would be in the best interests of patients and staff.

However, financial restrictions prevented the plans from going ahead and, for the moment at least, Whitchurch Hospital survives. It has a wonderful history - the task now is to make sure the future is equally as impressive.

Phil Carradice is lead writer for the Whitchurch Project a creative writing project that encourages the production of people's written (patients, ex-patients and staff) and oral memories relating to Whitchurch Hospital.