Richard Smith: Medical students and refugees: mutual benefit

Richard Smith

One of the worries about medical students is that they are not well connected to the real world. The come mostly from privileged backgrounds, enter the monastery of the medical school at 18, and spend the next 10 years focusing on passing exams and learning basic clinical skills. It’s not surprising that many come to feel uncomfortable in the messy, even ugly world of the NHS, cogs in a dysfunctional machine. Well, I’ve seen the answer.

And the beauty of the answer is that while doing great things for the medical students it does even better things for a very deprived group—asylum seekers and refugees. Many students and recent graduates from St George’s, University of London, and some students from other universities in the area, work with asylum seekers and refugees through the Klevis Kola Foundation.

St George’s is in Tooting, South London, an area that I’ve seen transformed from the grey dullness of my 60s youth to a multicoloured, multi-ethnic, and exciting but still poor area. The asylum seekers and refugees come mainly from Somalia, Ethiopia, and the Congo. Most have experienced hardship, and some brutality. Families are often split up, and the refugees arrive in an unfamiliar and sometimes threatening environment without being able to speak the language. It’s clearly important for them and for Britain that they manage to become fully functioning members of society, and this is where the foundation helps.

Unusually for an organisation that has grown out of a medical school the foundation provides a wide range of services. Indeed, as social services are increasingly squeezed and battered the foundation is doing more and more. It looks like the Big Society.

Working with families is the core of the foundation’s activities, and twice a week there are after school clubs—one for younger children and one for older ones. I’m a trustee of the foundation (but cannot take any credit for its achievements), and I’ve attended an after school club. The first hour is about learning and the second more about having fun, which is itself a very important part of learning. Some 50 children are in the building, and the energy levels are high. One child wanted to walk up me and do somersaults with me holding his hands, and even though I have three children of my own I found it tough to encourage his play but avoid him injuring himself. The medical students and other volunteers were much more confident working with the children at school work, painting, reading, play acting, and cooking “twists” (disgusting flour and water creations that I remember making in the Scouts.). I could see that the students had formed close relationships with the children.

The after school clubs are very popular with the children and with their mothers, who can both see their children adapting to British life and get a break. Even more popular are the holidays and trips that the foundation organises, and it takes more energy, enthusiasm, and confidence than I have to head off camping with 40 children, many of them very unfamiliar with the ways of Britain. You can imagine some of the complications that arise on these trips, and the medical students have to deal with everything from homesickness through asthma attacks to worries of abuse.

Individual medical students also mentor individual children, helping them with language and school work, but also taking them to places like the cinema and swimming pool. This is a considerable commitment, and the students have to be trained and agree to see the children regularly over a long period. For a 20 year old from a middle class background in the English shires it’s a very new experience to enter the flat of refugees recently arrived from a war torn area of the world. This is a test of the student as much as the child, and both learn together.

The foundation also organises coffee mornings for women and advocates on behalf of refugees with often unsympathetic public services. The students learn a lot at an individual level, including about being on the receiving end of public services, but they also learn about running an organisation. The foundation has now raised enough funds to have three employees, and the students and young doctors have learnt about strategy, fund raising, budgeting, marketing, governance, human resources, developing policies, legal issues, and all the other complexities of running an increasingly complex organisation. Most importantly they learn leadership, the “magic ingredient” that we all hope will save the NHS. I run workshops for students on leadership, and I’m sure that one hour of working at the top of the foundation will be worth more than a hundred hours of my prattling.

The Klevis Kola foundation is funded by Sir Walter St John Educational Charity, Children in Need, Evening Standard Dispossessed Fund, Putney Creche, Wandsworth Community Fund, Mazars, and Lloyds TSB.

Competing interest: RS is a trustee of the Klevis Kola Foundation and a member of the council of St George’s, University of London. RS was the editor of the BMJ until 2004 and is director of the United Health Group’s chronic disease initiative.