Measles – catching your death…

I know about measles. I had it as a child and was pretty unwell with it, confined to a darkened room for over a week with concerns raised for my eyesight among other things. Decades later I still know about measles because I work with patients who have encephalitis because of it, and also families left bereaved by it. It is not the innocuous childhood illness that the uninformed and many opposed to vaccines would have you believe. It is serious and deadly. Measles kills. It’s that simple.

Roald Dahl knew about measles too[1]:

“Olivia, my eldest daughter, caught measles when she was seven years old. As the illness took its usual course I can remember reading to her often in bed and not feeling particularly alarmed about it. Then one morning, when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything.

“Are you feeling all right?” I asked her.

“I feel all sleepy, ” she said.

In an hour, she was unconscious.

In twelve hours she was dead.

The measles had turned into a terrible thing called measles encephalitis and there was nothing the doctors could do to save her.

What is measles?

Measles is a highly infectious viral illness. The virus is found in the millions of tiny droplets that come out of our noses and mouths when an infected person coughs or sneezes. You can contract measles by breathing in these droplets or touching surfaces where they might have landed (the virus can survive on surfaces for several hours).

People with measles are infectious from when the symptoms develop until about 4 days after the rash first appears.  It can be very unpleasant to endure even without experiencing any serious complications. Like many other highly infectious illnesses such as smallpox, polio and Hib meningitis, it was until recently, uncommon in the many countries where vaccination programs existed.

Anyone can get measles if they haven’t been vaccinated or haven’t had it before, although it’s most common in young children.

Initial symptoms occur around 10 days after you’re infected, and might include cold-like symptoms, sensitivity to light, sore red eyes, fever, and spots on the inside of your cheeks. A few days later, a reddish-brown rash will appear spreading across the body.

Most people will recover from measles around a week to two weeks after they first became ill however it can lead to serious complications, including life-changing disabilities and death. For example eye disorder, pneumonia, meningitis, encephalitis or even an ultimately fatal brain complication known as subacute sclerosing panencephalitis (SSPE), which can occur several years after the initial measles infection. There may also be other complications in pregnancy if the mother is not vaccinated against the condition.

Measles can however be prevented by having the MMR (measles, mumps and rubella) vaccination given in 2 doses when a child is around 13 months old, and a second dose at 3 years and 4 months. Adults and older children can be vaccinated at any age if they haven’t been fully vaccinated before.

  • 90% of unvaccinated people exposed to measles will become infected.
  • A single person with measles will be able to infect 90 other people who are not immune.
  • Between one and three people in every 1,000 who catch measles will die.

Deadly situation – measles, a once near-eradicated disease is again a public health crisis.

Worldwide, measles is still a major cause of death, especially among children in resource-poor countries. Over the last two decades however vaccination has dramatically reduced the number of deaths from measles.

In 1990 measles killed 872,000 people worldwide, in contrast to 2016 when it is estimated about 90,000 people died of measles, and in 2017 this had risen to 110,000 (300 people dying from measles every day).  It is estimated that over one in 5 of all child deaths averted have been due to measles vaccination. The World Health Organisation (WHO) estimates the first four months of 2019 has already witnessed 112,000 confirmed measles cases.

Since the measles vaccine was introduced in the UK in 1968, Public Health England estimates that 20 million measles cases and 4,500 deaths have been averted in the UK. However in 2018 there were 966 laboratory confirmed measles cases in England – an increase of 400% on 2017 (259 cases).

The MMR vaccine was introduced in the US in 1963 when measles cases were an estimated three to four million. In 2000 the US declared measles eradicated.  So far in the first four months of 2019 626 cases have been confirmed.

Numbers of measles cases are currently high in several European countries. There were over 82,500 measles cases in Europe in 2018 . This is more than three times as many as in 2017, and 15 times as many as in 2016. In 2016 and 2017 there were 49 deaths from measles in Europe, and 2018 saw another 72 deaths.

The increase in measles cases is due to gaps in vaccination coverage according the World Health Organization, with Unicef warning us there are nearly 170 million children worldwide (under the age of 10) unprotected from measles.  Half  a million of these are in the UK and 2.5 million in the US.  In low to middle-income countries the statistics make even bleaker reading.

How did we let this happen?

According to Unicef the current grim global vaccination picture results from a mixture of complacency, misinformation, scepticism about immunisations, and a lack of access to vaccination.

Whilst fear of vaccines is not new (opposition can be traced as far back as the 18thcentury) a significant catalyst for the current vaccine-hesitancy and the more mobilised anti-vaccine movement was the publication of a paper by disgraced doctor Andrew Wakefield in 1998. In the bad science of the paper (he had undisclosed conflicts of interest and his research methods were unethical) he asserted that, in a paper of only 12 (yes 12!) children that the MMR vaccine was responsible for autism-like behaviours. In 2010, over a decade on from its publication, and in large part thanks to a reporter called Brian Deer, The Lancet finally and fully retracted the paper. Wakefield was also struck off as a practicing doctor by the General Medical Council.

As a result, certainly in the UK, a public health scare around the vaccine ensued and it is this that fed much of the vaccine-hesitancy and anti-vax movement we see today. This scare spread across Europe and eventually over the Atlantic and to North America. Further misleading papers and theories emerged suggesting further vaccine-autism links such as mercury poisoning related to a preservative found in some vaccines, aluminium poisoning, and ‘antigenic overload’ (the need to spread out vaccines in order not to overload children’s immune systems).

Of course we must recognise that some people exercise their autonomy and legitimately oppose vaccine due to their personal or religious beliefs.  If vaccination rates provide a herd immunity to diseases like measles, then this means that wider society can accommodate these genuine personal choices.

However it is the anti-vax movement who tend to shout loudly about their misinformed beliefs. Why are their viewpoints not as legitimate and genuine as people who choose not to vaccinate due to their personal or religious beliefs?  Simply because, as Hussain[2]et al (2018) remind us:

 ‘Online anti-vaccination authors…tactics include…skewing science, shifting hypotheses, censoring opposition, attacking critics, claiming to be ‘pro-safe vaccines’ and not ‘anti-vaccine’, claiming that vaccines are toxic or unnatural, and more. Not only are these tactics deceitful and dishonest, they are also very effective on many parents.’

As my own work in narrative medicine recognises the growth of technology and our capacity to share our views and stories digitally is a really positive thing for people.  It can reduce isolation and loneliness as well as help educate and inform us about a myriad of things we otherwise might remain inexperienced or uneducated about.  However this also means that information about medicines and disease has shifted from being the sole province of the medical practitioner and is accessible to the lay-person.  The flip-side of this is that the creation and distribution of fictitious, fake and false information is possible.  A range of studies have been conducted looking at online vaccine and immunisation information, and demonstrated high percentages of opposing vaccination, with these digital footprints often having higher views and ratings than those that were pro-vaccination.

One caveat I will make at this juncture is that some of the proponents of anti-vax misinformation and campaigns affect some of the most vulnerable – parents who have lost children or whose children have life-changing disabilities are led to believe vaccination was the cause.  I have seen and heard from these parents – their loss and distress is palpable and heart-breaking. Along with patients and families affected by the complications of measles, these parents are also victims of an erroneous and misguided movement.

What needs to be done to address this preventable crisis?

People need to call it out.  In the same way they have done recently for issues around gender pay-gaps, sexual harassment, climate change and so on.  That’s why I am writing this blog.  I simply cannot be silent, sit back and watch more people die of a preventable disease.  I am not just watching this through the glass of a television screen, I and my team at the Encephalitis Society are dealing with the aftermath of this preventable public health crisis.   It is not just us however.  Our health systems are already overburdened and at breaking point.  Outbreaks of preventable diseases like measles, only serve to increase that strain.

Social media, talk shows, and other news platforms must not provide airtime and credibility to the wrongful, misinformed discrediting of vaccines and vaccination, nor their proponents.

We must make vaccination as accessible as possible, and meet head-on the anti-vax propaganda by overwhelming and overpowering it with the truth: that vaccines save millions of lives around the world each year.

Conclusion

  • The current measles epidemic is a global public health crisis.
  • Vaccines are not toxic, unnatural, nor do they cause autism.
  • The anti-vax movement promotes misinformation and is responsible for deaths from vaccine preventable diseases.
  • We must protest loudly until the voice of the pro-vaccine communities are louder than the voices of those promoting dishonest and false anti-vax propaganda
  • Vaccines save lives.

 

Bibliography and to learn more

https://www.encephalitis.info/measles-infection-and-encephalitis

https://www.who.int/immunization/programmes_systems/vaccine_hesitancy/en/

https://www.vox.com/science-and-health/2018/10/16/17964992/vaccine-autism-book-peter-hotez

https://www.who.int/immunization/diseases/measles/en/

https://www.nhs.uk/conditions/measles/

https://www.cdc.gov/measles/index.html

https://ecdc.europa.eu/en/measles

https://www.afro.who.int/health-topics/measles

https://www.gov.uk/government/news/measles-outbreaks-across-england

http://vk.ovg.ox.ac.uk/measles

https://www.thelancet.com/action/showPdf?pii=S0140-6736%2819%2930903-1

https://www.theguardian.com/society/2019/apr/25/nearly-170m-under-10s-unvaccinated-against-measles-worldwide

 

[1]https://www.encephalitis.info/Handlers/Download.ashx?IDMF=9ea058b7-fd6f-493e-8589-34d56e9ac164

[2]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122668/pdf/cureus-0010-00000002919.pdf

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Sabbatical, part 2

So it has taken a while to get round to writing this update on my sabbatical. Where does the time go?

As Sabbatical, part 1 [see previous blog] came to a close I was running out of time and had also begun the massive challenge of disentangling my work and personal life – as I write this remains a work in progress. A lot of it done but much more work involved than initially thought and so the plan is to complete this over Easter when I have booked two weeks off.  Nevertheless it was probably one of the singly most useful things I did whilst off that will contribute to my health and wellbeing in the long run.

It turned out that a lot of the latter part of my sabbatical has the themes of ‘awards’ running through it!

I was delighted to be invited to be a judge for some local awards that recognise good work in our local community – everything from new business to volunteers.  So one evening in early September was dedicated to going through tons of entries and on the evening of the 6th October we celebrated all the winners and runners-up at a glittery black-tie dinner courtesy of one of my favourite local haunts, The Talbot Hotel, Malton.

Remaining on the theme of awards I also attended a further black-tie dinner and ceremony in London during September where I was up for ‘Charity Chief Executive’ in relation to my day-job and my good friend Rebecca Adlington, the quadruple medal Olympic swimmer and all time legend was also up for Celebrity Charity Champion (also in relation to my day job and the  Encephalitis Society).  The team at work very kindly let me out of sabbatical for the glitzy night in London.  Neither of us won but it was great to be a finalist and I was the only woman in my category, and even managed to get myself  ‘hot date’ for the evening – not bad for a middle-aged misanthrope – and thank you Freddy for stepping up!

Watching from afar I was also thrilled to see my Encephalitis Society team smash two industry awards for our digital work, bringing home trophies from the Charity Times awards for Fundraising Technology, and from the Digital Impact Awards for Best Use of Digital by a charity.

During this sabbatical I had invested heavily in my health and fitness.  At the time of writing I have now been doing Pilates for 18 months and been back on a cross training regime for a year.  I have lost 22lbs and am probably in better physical health than I have been since my 20s or 30s.  

Then as you know I departed for Sri Lanka and there is a previous blog on this to read if you are interested in my merry jaunts around that beautiful country.

As those of you who know me or who have read other parts of this blog know, I lost my beautiful “Earl The Dog” in June 2017, and I still pine for him every day.  Whilst in Sri Lanka we spotted a dog online that we liked the look of and upon arriving back in the UK we drove the two hours to where he was for a “meet and greet”!  There would be a lot of work with him but he had a loving nature and although he suffered epilepsy we felt we could take him on and we collected him the following week having been fast-tracked through selection.  The latter should have sounded my alarm bells and what followed was two weeks of absolute hell.  I am only now able to write about it and plan my next blog to be about my experience of re-homing this poor chap and the cautionary tale of working with a rehoming centre who cared little beyond getting the dogs into a home – any home.  As I say a tale for another time so please watch out for next blog post.

After the return from Sri Lanka it was really only one week until I returned to work.  At this point I think it prudent to capture some of the vocational learnings I had as part of this sabbatical.  Of course my primary aims were to rest, reinvigorate and re-motivate myself.  I also wanted to get back on top of my health and wellbeing.  At varying levels I achieved all these.

It was extremely useful to watch the charity from afar.  Areas that needed work were much easier to identify when not in the thick of the day-to-day work – and there were two glaring realities that I knew would need focus when I returned.  I also returned to work with renewed confidence.  It was clear that before I departed I would sometimes avoid those difficult conversations because I was simply tired and couldn’t face them – understandable but not really what a chief executive should be doing.  

Just before I finished my sabbatical I began some work on emotional resilience at various levels – this is a work in progress and one I hope to commit more time to this year – this will hold a busy chief exec in good stead going forward.

Perhaps one of the biggest surprises was the sabbatical enabled me to realise I was not as emotionally attached to the charity as I thought I was, nor as other people thought I was – this was a bit chicken and egg on reflection as I can’t work out whether I ever really was emotionally attached or whether I adopted behaviours because other people thought I was.  This is not to say I am not highly motivated and passionate about what I do, I am, but I am not unhealthily caught up in it and this was both a surprise and a relief.

So sabbaticals are a funny thing – they need heaps of planning, and heaps of communication.  For anyone thinking about taking one then some of these pointers might help:

  1. Communicate, communicate, communicate with your team before you go and make sure everyone puts their expectations on the table and that you talk them through thoroughly and agree middle-ground where necessary.
  2. Having said that have your sabbatical is your sabbatical and do not take a sabbatical that is not your vision – it won’t work out if you take it to meet other people’s expectations of what your sabbatical should be.
  3. Plan your return and what that looks like before you go!
  4. Get a balance between personal and professional development.
  5. Decide what your priorities and goals are whilst off and stick to them.
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More Issues than Vogue!

So there we have it – a renewed CEO post-sabbatical.  How do I know it worked for me?  In short, I am fitter, emotionally more well and robust, I am physically less tired at times when I would previously have been on my knees, I am more confident and I am very grateful to my team and my Board for allowing me this incredible opportunity.  I just don’t think people can work all their lives without having more than two weeks off at a time – if you look at it like that then it just makes sense, right?

I might still have more issues than Vogue, but I don’t care!  

 

 

 

Sri Lanka

I have been meaning to write this blog since I returned from Sri Lanka in October this year.  However it was one week before my return from sabbatical, and life took over.  It has been hectic since my return to work however I am still keen to provide an outline of my Sri Lankan trip and adventures.

It was the first time that I had ever signed up for a ‘package-tour’.  Being a misanthrope means it does not fill me with delight to know that I will be in strangers’ company for two weeks, often in a confined space (i.e. a coach)!  On this occasion however I got off lightly as the majority were nice people and they didn’t demand undying friendship or express the need to exchange details, promising to visit soon….phew!  There was one chap who clearly thought he was better than everyone else, accompanied by his equally irritating wife who felt she needed to share the story of her life at every opportunity, however for the most part they kept themselves to themselves.

We took a red-eye flight out of Heathrow direct into Colombo arriving 9th October (this reminded me that another of my pet hates is people putting seats back on planes and so this has been added to my dislikes on my ‘About’ page of this blog).  We were greeted by what at first impressions appeared to be a rather jaded tour guide (turned out to be a good bloke actually).  Having flown all night and excited about the pending trip I was hoping for a cheery “Welcome to Sri Lanka!!” however the reality was “stand over there – we are waiting for the rest of the group.  I will be with you in a minute.”  We transferred fairly swiftly to the amazing Jetwing Lagoon Hotel in Negombo, about 30-45 minute drive up the coast.  This hotel did not disappoint and I have to say it was in fact the hotel highlight of the trip.  We had a beautiful room with comfy bed and pillows and a stunning bathroom.  The hotel is also equipped with the most amazing 100 metre swimming pool!  The food was also the best we had our entire trip.  We were very impressed and it was a fantastic start to the trip – we only wished we had spent more than one night there!

The following day I was greeted by the team who were to be with us over the next few days – our tour guide, our driver and a ‘handler’ who dealt with a range of things.  The latter of which greeted the ladies every morning with a flower for their hair…very smooth!  We visited the ‘drying fish’ markets as we headed out of Negombo toward the 1st century caves of Dambulla, a UN World Heritage site.  The caves are within a vast granite outcrop, and each cave (there are five in total) are preserved with frescoes and Buddhist statues.

As a committed animal lover I was struck during the first day by the number of street dogs in Sri Lanka.  Some of them were a very poor sight however they also seemed to live in a strange kind of harmony with the human communities.  The other thought I was left with as a health researcher and encephalitis expert was why the Rabies vaccination had not been recommended before my trip given the level of street dogs (I also acknowledge the Sri Lankan Health ministry has made great strides in eliminating Rabies in the last few years).  Perhaps my thoughts around vaccination will form part of a future blog!  I can hear the controversy now! Stopping off for a refreshment on route to our next destination we also encountered a ‘snake-charmer’ and whilst I recognise the need to earn a living in often-difficult circumstances, I still couldn’t help feel sorry for the snake – the lid being lifted and it being poked to perform at even the most random sight of a potential tourist.  As always I did not engage – it is only through tourists refusing to engage in such practices will they cease to exist.  There is an irony in this statement however and a shame I feel which will come all too clear later tin this blog.  

That evening we arrived at Habarana Village by Cinnamon.  After the five star Jetwing Lagoon I would be lying if I said this didn’t feel a bit of a letdown.  However it was three-star acceptable – each ‘room’ was in fact a stand alone ‘chalet’.  The ‘room-service’ menu choices left something to be desire: Peanut butter, Nutella and bacon sandwiches, and fries served with Nutella and whipped cream to name just two!  The hotel had a fantastic ambience in the evening (along with resident street dogs – mum, dad, and puppy) as well as a fantastic local band called ‘Apple’ knocking out anything from Pink Floyd and The Rolling Stones to the Eagles!

The next day we visited Sigiriya Rock (Lion Rock), known locally as the Eighth Wonder of the World, and a highlight of my trip – a personal challenge to climb the 600 ft granite tower with sheer cliffs on all sides – the remains of a 1500 year old royal palace.  It requires a good level of fitness to climb and given I had been working on my health and fitness during 2018 so it really felt like achieving this climb was evidence of the progress I had made.  Sadly the toll the climb could have taken had I not have been investing in my body was made all the more evident when I later learnt that one of the previous trip the same time the year before, collapsed and died on the rock.

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On top of Sigiriya Rock! Result!

The following morning we headed further inland, passing through traditional Sri Lankan towns and villages, and countryside that contained coconut groves, pineapple fields and paddy fields, often with resident water buffalo.  We visited a spice garden where many plants and spices are grown to support the Ayurvedic medicine system of Sri Lanka – one of the world’s oldest holistic healing systems, developed more than 3,000 years ago. It is based on the belief that health and wellness depend on a delicate balance between the mind, body, and spirit.  The tour and talk were very interesting.  I also had a wonderful back and neck massage there.  However then came the ‘hard sell’ in the shop we were all corralled into.  Given I am a fairly robust individual with a scientific background, I can only assume it was the heady nature of being carefree and on holiday that saw me spending eye-watering sums of money that resulted in my husband having a strange, almost twisted look, that would, in other circumstances, have translated into an exclamation of  “How much??” (you have to do that in a northern, preferably booming Yorkshire accent).  Anyway the massage oils are lovely but the supplements for a range of other ills really do not work, I assure you!  I was even asked if I wanted something for my Rosacea (redness of the face).  I don’t have Rosacea (my head knows this to be a fact) and yet I still spent the next few days examining in fine detail my insulted face!

We then arrived at the Kandy Cinnamon Hotel where we had a lovely room and balcony overlooking the river.  Kandy is the royal capital of Sri Lanka and is bordered by the Mahweli River on one side and steep forested hillsides not he other.  In the evening we ventured out and experienced Kandyan traditional dance as well as fire-eating and walking.

The following day we visited the very beautiful Royal Botanical Gardens in Kandy, planted over 150 years ago and covering 150 acres.  They hold thousands of plant species and tropical trees as well as a range of commemorative tress planted by UK royals.  They also have some cheeky Macaques playing among the foliage and entertaining those passing through.

The following morning we were up very early as we were to visit the Temple of the Tooth – the most sacred shrine on the island.  It was to be very crowded later in the day and so our guide had us there at the crack of dawn (Ok, maybe a bit after that).  It was most impressive but I guess buildings and shrines dedicated to religion don’t give me as much pleasure as other things and so my overwhelming memory from this is of Raja – a stuffed tusker elephant!  He was majestic and massive but I admit to shedding a little tear when I considered his life – captured, sold, enforced obedience, loneliness and isolation, and even after his death being stuffed.  

We then proceeded to drive into increasingly mountainous terrain as we headed toward Sri Lanka’s tea-growing areas.  Winding upwards we snaked through tropical jungle and tall pine forests where the tea plantations covered the landscape like a huge green carpet.  We visited Glenloch tea plantation and learnt how tea there is rolled, dried and graded.

We finished the afternoon 7000 ft above sea level at Nuwara Eliya where it was a little chillier to say the least and stayed for one night at the Jetwing St Andrews hotel – a colonial style hotel but one in need of some work I’m afraid.  

The following morning we left the mountains and headed toward the ‘dry zone’ where we saw the beautiful Lake Gregory as we left and the planting flats.  We made our way out of the mountains and to the Centauria Wild hotel – a relatively new hotel which was very nice but which has an unfathomable problem with flies which I spent much energy eradicating in our room.  We witnessed a tropical thunderstorm one afternoon from the comfort of our room and balcony and I learnt not to leave chocolate on my bedside as it became a haven to an army of ants when I returned later that day!  

The following day we experienced a safari in Udawalawe National Park where we saw a range of animals and wildlife.  Although not all in the park, I recorded sightings of the following during my two weeks in Sri Lanka:  A range of Lizards, Egrets, Greater Egrets, White-necked Storks, Fruit Bats, Macaques, Goldfish, Koi Carp, Elephants, Dragonflies, Butterflies and Moths, Large ants, Mosquitoes, Feral Dogs and Cats, Cows, Cobras, Pelicans, Ducks, Terrapins, Chipmunks, Frogs, Bare-faced Monkeys, Crocodiles, Water Buffalo, Peacocks, Monitor Lizards, Jackals, Storks, Spoonbills, Ibis, Eagles, Bee-eaters, Kingfishers.  Not at all bad – methinks!

That afternoon we visited the much-anticipated Elephant Transit Home run by the Born Free Foundation.  I have to say that before booking this holiday I did much research into the places we would be visiting particularly those responsible for animals in order to ensure we would only be supporting responsible animal welfare.  This was made easier by the help on the Responsible Travel website where I am able to reassure myself that the elephants at this sanctuary would be reintegrated back in to the wild where possible and that tourists were kept a good distance from what are ostensibly wild animals.  We had the best seats on the viewing platform and it was an absolute treat to see the babies running for their milk and feeding.  Personally I generally never feel the need to touch or invade the space of animals and wildlife I encounter – I simply gaze in awe of nature and the gift of being able to share a few precious moments that leave me feeling humbled and grateful.  As you will read shortly however this turned into a bitter pill later in my trip and one that still provokes anxiety in me.

The following day we travelled to Galle stopping on one of the many beaches (in this instance Tangalle) to buy a few gifts and to stare in awe at the traditional Sri-Lankan fishermen.  In Galle we explored the fort walls and lighthouse, as well as shopping at Embark, a charity shop dedicated to transforming the lives of Sri Lanka’s street dogs, before arriving at our final hotel destination of the tour the Jetwing Lighthouse Hotel, where that evening we enjoyed a buffet dinner and more traditional dance.

The following day we visited the Mangroves by boat and Cinnamon Island where a local family explained the process of extracting cinnamon oil from leaves and preparation of cinnamon sticks from the bark of the tree.  Later we visited a Turtle Conservation Centre which, like Raja the stuffed elephant, reduced me to tears.  First was because I am not convinced this conservation centre had the best interests of the turtles at heart.  They were lifted out of tanks and we were encouraged to hold them.  I am ashamed to admit now I did this as I it is completely out of character for me to want to invade the space of any creature I encounter.  My husband refused and my shame enveloped me as soon as I realised my folly.  The second reason was that some of these creatures, often blind and deformed and who would never be reintegrated back into the wild, thus forced to spend their life in a concrete tank with nothing in it, should in my personal view have been euthanised.  Finally some turtles who appeared healthy were, we were told, not able to be reintegrated and yet they seemed to be being retained for the purposes of tourists in my view.  Finally the way our human actions devastate their environment and lead to often slow, tortuous death for these magnificent creatures.  I was overwhelmed by sadness and was grateful my sunglasses hid my shame and distress.  

The following two days were relatively uneventful, strolling the hotel beach and chilling out in our room.  We relished this after such a busy ten days – perfect time to rest before the return flight home.  We agreed we were a bit tired of buffet dinners so we treated ourselves to the tasting menu at Nihal’s one of the hotel’s restaurants one night and dined there a la carte on our final evening.  The food was divine!

Then came time for the flight back to Heathrow.  So what do I make of my time in Sri Lanka.  It is a very peaceful country in both its people and its environment – there’s a tranquility about it that is calming and soothing.  I learnt that I can still be vulnerable to tourist trap sells despite thinking I won’t have the wool pulled over my eyes – there is something humbling in this and profound, at least for me, lessons to be learnt.  All in all it was a wonderful break and I did realise that if you are time limited then a package tour is the way to see the best a country has to offer in a short space of time.

Thank you Sri Lanka – you certainly left an impression on me and I am grateful for your teachings and the treasures you shared with me.

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Sabbatical Adventures, Part 1.

This post is about the first half of my sabbatical – what I have done and what I have learnt or achieved.

Unashamedly I am going to admit to the first month being (I am on a three-month sabbatical from my role as CEO of the Encephalitis Society) somewhat hedonistic. Not having to be up in the small hours to travel, and even when I am in the offices I am usually there before most other members of the team.  It is not unusual for me to start work at home at 06.00 – I work best in the morning you see!  I usually have dogs in my life (although not at the moment) and so I finish earlier than most in order to catch the last rays of the day walking with them.  Then it’s not unusual for me to do a bit more I the evening.  So the novelty of not having to rise at a certain time was luxury.

I did what all the books on taking a break from work tell you to do and I went away immediately, on my own, landing in Gibraltar on the 1st August!  Big fan of monkeys and I had always wanted to visit Gibraltar since I was a teenager so it made sense to me.  If felt safe there too, being just a small island.  I met the monkeys, walked the botanic gardens, visited a small animal sanctuary and visited the Great Siege Tunnels.  I was also fortunate enough to be there when they had live gigs happening for free in the evenings at Casemates Square and so I enjoyed one of my favourite past times – listening to some good music.  In fact my favourite was a local band to Gibraltar called Jetstream.  They also play the UK and if you get a chance they are worth checking out.

When I came back a week later I did some of those things around the house that never get done – the boring, but oh so satisfying stuff, like sorting out cupboards, bundling stuff off to the charity shops and so on.  I also did a lot of cooking as I love to try out new recipes.  Through a friend of ours I also got to see the band Texas in concert which was a real throwback to my days in the 80’s, and I also volunteered for the latest innovation in my home town, the Marathon du Malton which was a foodie spin on completing a 10K!  I proceeded on to London and met up with a chum to go and see Hamilton.  I was very excited about having got tickets and although innovative and clever I am sorry to say I left a little disappointed.   For me it lacked some light and shade – the music continued throughout in the same vein and it turns out that rapping can inhibit clarity in speech so at times the story was hard to follow.  I would also have liked to have seen more fusion in the dance – bringing together the traditional musical with modern day dance fitting the theme of the show such as hip-hop.  There is one group I love who do this splendidly, in their case mixing folk and hip-hop – check out the Demon Barbers if you ever get a chance!

From London I headed down to Tylney Hall Hotel for a Spa Break which was really lovely – the grounds were spectacular and being on my own the staff made a fuss of me as it was my birthday.  In normal circumstances it might appear a random place to go and why would I want to be on my own on my birthday?  However there was a reason…I was attending a memorial on the Sunday of a young man aged 17 who had died of encephalitis – it was the 10-year anniversary and having supported his parents through undoubtedly the worst time of their life, I had promised to attend despite being officially on sabbatical from the day-job.  It was so lovely to see all his friends, all now grown and in their mid-to late 20’s still wanting to come back and honour his memory with his family – I was honoured and humbled to be there.

Returning home I got to grips with a lot of ‘life-admin’.  I reviewed and assessed our pension-planning.  I had a massive clear-out of old paperwork and files from the year-dot.  I submitted an application to the Guide Dogs for the Blind to re-home one or two of their dogs that don’t make the grade.  This follows the passing of my much moved chum

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#EarlTheDog

#EarlThe Dog who passed on 22nd June 2017 and for whom my heart still breaks.  I updated all those things that never get updated like LinkedIn, my research profile on ResearchGate, my CV (if my employers are reading this – its not because I’m leaving, its because I need up to date CVs for our research work!!), my twitter feed and of course, I set up this blog!  I pored a lot over whether to keep my Instagram – I barely used it and I admit to being tired of seeing various aspects of people’s bodies and apparently ‘oh-so-perfect’ lives being thrust in my face.  Lets face it we all know social media is a heavily edited version of reality, right?  In the end I decided I just use-it or lose-it.  So I have upped my game with it and am posting more than before because there were some people whose lives I genuinely did want to keep up-to-date with and moving away from Instagram would have meant that was not possible.

I submitted a synopsis to my publishers for a follow-up book to a book I wrote in 2016 called Life After Encephalitis and this is currently out for peer-review.  A further book they wanted me to write because apparently I am ‘uniquely placed to do so’ came back from peer-review with resounding reviews.  One reviewer even said they had read the synopsis and said to themselves – ‘damn, I wish I had thought of this’.  So since no-one else has thought of it and they have now formally commissioned me, we are keeping the subject matter under wraps – so watch this space!

During these first few weeks of the sabbatical I also spent some time thinking about who I am.  When you become an ‘expert’ in something – in my case, encephalitis – your own identity gets blurred and in some cases lost.  I had forgotten who Ava was and if I am honest I had fallen out of love with my personal self.  So I decided to reassess my values for this latter part of my life – what were the values that were going to be important to me going forward?  What follows are the top-six (in no particular order) by which I intend to assess my future plans and decisions:

  • Acceptance – to be open to, and accepting of myself, life, others, etc.
  • Adventure – to be adventurous; to actively seek, create, or explore novel or stimulating experiences.
  • Fitness – to maintain or improve my fitness; to look after my physical and mental health and wellbeing.
  • Self-development – to keep growing, advancing or improving in knowledge, skills, character, or life experience.
  • Kindness – to be kind, compassionate, considerate, nurturing, or caring, toward myself and others.
  • Mindfulness – to be conscious of, open to, and curious about my here and now experience.

I guess you will be able to judge for yourself how I am going with these as this blog develops and do please leave me any comments telling me about the values that are important to you, and why.  The good news is this sabbatical time has enabled me to reconnect a bit more with myself and to learn to love myself a little again – its a work in progress however I suspect!

Then I started a project that will undoubtedly be the biggest contributor to my health, well-being and work-life balance when I return to work…I began to disentangle my work world from my personal world.  This involved buying an iMac for home and beginning the epic task of transferring all my personal files (documents, videos, photos, music) off my laptop and various old laptop hard-drives to my home computer.  it might not sound a big deal but it is, and it is going to take longer than my sabbatical to sort however it will mean that when I return to work I can delete all my personal stuff and keep the laptop solely for work use.  Therefore I won’t need to open it on days off and be drawn back in to work things I didn’t get finished during the week.  I have also decided to no longer have my work email come in on my iPad when I return to work as this is something I often use in the evenings and when you see those little email notifications I become distracted and drawn back into my work world.  Of course, if one of those emails happens to be a curve ball (as is so often a case for a CEO) then a good mood can so quickly turn and as my poor, long-suffering husband could attest to, I can go from 0-60 on the Rant-richter scale very quickly, often ruining both our evenings! So I will have a computer and an iPad solely for personal use.  My phone, will, of course, continue to receive work emails, calls, social media, etc.

So where am I now – rapidly running out of sabbatical and wondering how on earth I am going to do everything else I had planned!  However in recognition of my new value of Acceptance I will try not to beat myself up and keep taking small steps towards all that I wanted to achieve, both during the sabbatical and when I return to work.

There will be a further blog about the second half of the sabbatical and no doubt other blogs in the interim.

Thanks for reading and do please leave any comments!

Sabbatical

If you google ‘sabbatical’ the definition that pops up first is thus:

sabbatical
səˈbatɪk(ə)l/
noun
1. a period of paid leave granted to a university teacher or other worker for study or travel, traditionally one year for every seven years worked.
“she’s away on sabbatical” 

I think the concept of having a sabbatical in academic circles is relatively common and not considered out of the ordinary.  Not so for many other professions and my world – the charity/non-profit world is one of them.

The problem is that I had worked for my employer for 18 years and to put it bluntly I was knackered.  I was still motivated by my cause and also by the amazing team I had around me but I was tired and my health was suffering.

As well as a high-level and often stressful job (anyone responsible for generating money in to their charity will know what I mean) I travel a lot in my role, both in the UK and abroad.  Now the life of planes, trains and automobiles along with airports, train stations, and hotels is not all its cracked up to be.  If I had a £1 for every time someone coo’d when I said I was off to London, or Cape Town, or Barcelona…and don’t get me wrong I am incredibly grateful for the opportunities my career has offered (but I have also worked hard for it).  The reality is often far less glamorous – stressing over lost suitcases (I haven’t travelled with hold luggage now for years no matter where I go or for how long!); eating on the run (there is only so many Marks and Spencer or Waitrose sandwiches one can eat) and pining for a hot meal; beds….oh the beds! – its a hit and miss affair what type of room you will get, where it is located in the hotel (opposite the elevators is a absolute no!) and the calibre of the pillows and mattress; Noise – hotel room noise – you have a 09.00 lecture to deliver however the rest of the hotel is in hen and stag mode until the early hours; The Flight – the person in front of you wants to have their seat reclined for the entire journey and you have no room to watch the little box tv in front of you, nor hold a book to read, nor to eat food should any arrive (travelling the entire way back from Sydney like this has scarred me for life (as you will learn as you get to know me through my blog patience and tolerance are not virtues I was at the front of the queue for when they were being handed out), then there are the lovely kiddies who want to kick the back of your seat for hours.  Another issue is our penchant for iPads and other hand-held devices – and those folk among us who want to watch them without earphones – on trains, on planes, in the restaurant on the table next to you – if I wanted to watch the footy or the latest Tomb Raider then I would do so with MY EARPHONES IN – I do not need you to share your interests with me! …OK sorry I have gone in to rant mode…back to the issue of the Sabbatical!

We looked long and hard at the concept of sabbatical before formulating our policy on it – and given that the charitable sector has been in for a bit of bashing in recent years (Kid’s Company anyone? The sad death of Olive Cooke.  The more recent safeguarding scandals in large charities – I could go on and I could write a blog about it – 🤔 hmmm, perhaps I will…) we were concerned about how providing a sabbatical may be construed.  We all agreed I needed one and we also all agreed that the reputation of our charity was important too.  So we started doing our due diligence and researching options.  Fortunately the concept of leaders in charities and non-profits taking sabbaticals is not as rare in the US as it is here in the UK and we found lots of evidence to suggest not only was a sabbatical important for the individual (reflection, revival, regeneration) but also for the company – in particular in two important ways:

1. It helped in succession-planning (what were the gaps if your current leader was absent, for whatever reason) and it also provided leadership opportunities to others in the organisation.

2.  The costs associated with providing a sabbatical to a senior leader are significantly lower than the costs associated with vacant senior posts and recruitment-costs associated with filling senior roles.

Indeed in the US and Canada there are some organisations set up to provide grants to enable non-profit leaders to take sabbaticals.   The concept of taking a sabbatical even has a term – ‘creative disruption’.  If you are at all interested in more detail about looking after your staff then a great starting point is a 2009 study conducted on facilitating sabbaticals in non-profit organisations:

Having said all of this I do think sabbaticals need thoroughly researching for any organisation and a clear policy needs to be drawn up – this is an opportunity to be clear about the rationale for sabbaticals in your organisation and also provides transparency – a word that some elements of the charitable and non-profit sectors have yet to embrace.  Procedure is more problematic and having had time to reflect on the way we delivered my sabbatical then processes and procedures of delivering a sabbatical need to be tailored to, and built around, the individual in question.

In respect of the value of sabbaticals Rick Tobias, Executive Director of Toronto’s Yonge Street Mission says:

If people in the academic world need sabbaticals, I would argue that the need is higher among those working with broken and wounded people, or healthy people with high needs, such as new immigrant families.

He goes on to point to the high rates of burnout, compassion fatigue and rapid turnover among people working in these areas of the charitable sector, and believes that sabbaticals are effective at combatting this burnout.

Now some of you may still be sceptical about sabbaticals in the charity/non-profit sector or indeed about the need for sabbaticals at all.  So this bit is for you…

In January I had a routine check-up with my doctor.  My heart was tachycardic (over 100 beats per minute) and we established I was operating like this a good deal of the time.  My resting heart rate even when asleep was still in the 80’s and so I was bundled off for an urgent cardiology appointment…turns out I wasn’t yet about to drop off my perch but this was a real wake-up call for me that has resulted in not only the sabbatical, but a will to lose some weight and get fitter – all three of which you will be pleased to hear I am on with.  For those of you who need hard-evidence below is a screen shot from my Fitbit which shows my resting heart rate in the month before my sabbatical (on the left) and my resting heart rate half-way through my sabbatical (on the right).

I am not suggesting the sabbatical and my absence from working life is solely responsible for the dramatic reduction in my resting heart rate in only six-weeks but I am arguing that the reduction in stress and the TIME to dedicate to myself, my fitness and my body IS responsible, and so ladies and gentlemen I leave you with the concept of The Sabbatical.

My next post will be soon and about what I have been doing on my sabbatical!
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Musings and Meanderings of a Middle-aged Misanthrope

I thought I better make my first post about why this rather odd title for my blog.

I think there are a number of reasons and they are not perhaps as odd as they may first appear:

Musings:  I think a lot.  Too much, some might argue.  I suspect my capacity for thinking too much is a vice as well as a blessing.  It is a blessing because it makes me self-aware, informed and reflective.  It is a vice because it means I have the capacity to over-think, to perseverate, and sometimes think about problems and issues which in fact exist nowhere, except in my head.

Meanderings:  I travel a lot!  24 countries at the last count.  Mainly for my work but I also love travelling personally.  So I spend a lot of time in hotels, airports, on trains and experiencing the cultures, diversity and landscapes of a range of countries.  I also wish that I documented some of my adventures but I never do.  Largely because my job is full-on and I don’t have time.  However my second blog post will likely talk a little bit about why that is set to change and therefore this blog will document some of my meandering going forward.

Middle-aged:  Need I say anymore?  It is a sad fact that I am now most likely closer to death than I am to my birth and my musings on this make me quite ill-at-ease with this fact of life.  I suspect this blog is a sort of validation of my existence and there will no doubt be a forthcoming blog about my issues around death and end of life.

Misanthrope:  I did toy with not including this in my blog title however it began with M and I do like alliteration, and to be honest it’s probably quite true, at least to a certain extent.  Of course there are many good and wonderful people out there.  However there are also some very toxic and unpleasant people.  I have had my fair share of both.   However it is a sad fact of the human condition that the latter often leave the greatest impact on us.  Over time, I suspect this has led me to withdraw a little in my personal life.  Resultantly when I am not networking, platform speaking around the world, and generally being the front face of the amazing charity I work for, I like to take refuge in my home, retreat to the countryside, and snuggle with my dogs.

So these are the origins of my blog title.  I hope you enjoy reading the posts to come and that you perhaps find some sense of connection with what I have to say and where my life takes me.

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Selfie with the late, great, and very loved #EarlTheDog