Against the odds

The once seemingly unstoppable tide of alcohol-related gang violence is turning. The Medics Against Violence charity has played a prominent role in an education initiative to make the streets safer

30 July, 2015 / indepth
 Tim Power    Mike Wilkinson

When emergency medicine consultant Alastair Ireland came to work for his evening shift at the Glasgow Royal Infirmary he knew it was going to be a busy night. In three separated cubicles his colleagues were dealing with three individual stab victims.

He described the scene: “One had his chest already open as the medics tried to try to save his life. The other had a sword sticking out of his eye. Another young man had horrific wounds all over his body from multiple machete attacks. He died… well, they all died.”

Alastair was describing what had become an all too common Saturday night in Glasgow around 10 years ago for a video produced by Medics Against Violence (MAV). The hard-hitting production is being screened to show today’s schoolchildren the dangers of alcohol-related gang violence.

The statistics speak for themselves and it’s with young people where the change is happening

Christine Goodall

Two hundred and fifty MAV volunteers have been visiting schools since 2009 and so far have spoken to more than 17,000 children, mostly across the Central Belt and also in Dundee where they run their intervention programme.

Christine Goodall was one of the original founders of MAV, after being appalled at the level of senseless violence that was enveloping young people in Glasgow. As an oral surgeon training in oral and maxillofacial surgery at the time, she witnessed the bloody results of this type of “recreational violence”, dealing with multiple facial fractures from blunt trauma – from baseball bats and fists – and also knife-related injuries, such as slashes and the infamous “Glasgow smile”.

Ten years ago Glasgow was dubbed the “murder capital” of Europe and had violent assault statistics to rival New York. However, today it’s a different story, thanks to the impact of the Police Scotland’s Violence Reduction Unit, set up by Strathclyde Police in 2005, and the work of organisations like MAV and other community initiatives across the city.

Today, Glasgow’s – and Scotland’s – annual murder rate has more than halved, from 39 in 2004-05 to 18 in 2014, with similar reductions in attempted murder, serious assault and people carrying knives.

What is interesting about the crime statistics is the reduction in the numbers of young people involved: the majority of violent crime is now committed by people in their 20s and 30s.

Christine explained: “There really is a sea change in attitudes. The statistics speak for themselves and it’s with young people where the change is happening. The messages are getting through as they are drinking less and not getting involved in violence as much as before – they are really making this happen.”

Christine and her MAV colleagues average around 50 school and youth club visits a year, speaking to classes of second to fourth years about the dangers of drinking and getting involved in violence. The team are also regular visitors to HM Young Offenders Institution Polmont during the summer.

Today, she is at the Cardinal Winning Secondary School which caters for 120 children with special or additional needs in the east end of Glasgow, where she is giving her talk as part of the school’s Health Day.

The schoolchildren are transfixed by the new video, which pulls no punches. It features CCTV footage of gang violence on the street, graphic photography of hospital A&E teams trying to save stab victims, as well as thoughts of a surgeon, ambulance driver and a forensic pathologist on the repercussions of such violence. However, the most powerful message comes from two young men currently under a long sentence for murder in Polmont who regret the day they got involved in a mindless knife fight at the age of 14, which resulted in the taking of a life.

Christine has met these boys many times and said they are truly repentant: “They wanted to be involved with our video and to warn others about the dangers of getting involved in violence – I think their words are very powerful and resonate with other young people.”

During the group discussions after the video some of the boys admit to drinking on the street and realising how this made them vulnerable. One admitting to being in a gang and getting into fights but turned away from violence when he realised that he could have put his family at risk if a rival gang came after him.

Christine said MAV’s message has changed over the years: “We’ve moved away from ‘don’t carry a knife’ to broader messages about keeping safe, not drinking on the street, being aware of what’s going on around you and walking away from trouble.

But we now emphasise to young people that things have changed for the better in Scotland regarding gangs and violence, and that they are and need to be part of maintaining that change.

This is an important message as we want to normalise that change for them – to make them realise that if they are not changing like others then they are actually unusual. This is powerful because kids have a great desire to be like their peer group.”

After each session the children are given feedback forms to assess what they picked up from the video and group discussions.

She added: “Feedback shows that we’ve been effective in raising awareness and, to an extent, in changing attitudes to violence.

Some kids say they have learned they should not get involved in violence and that they should walk away, but many – and this is a common theme – also say they have changed the way they think about the victims of violence. A lot of them have the perception that victims of violence are ‘losers’, but now they realise that some people are victims for no fault of their own – sometimes it’s just down to bad luck.

They are saying they now have much more sympathy for victims and this is helping to reinforce their attitudes to violence in general.”

Christine is able to give MAV sessions to three classes at the school before she has to rush off at lunchtime to get back to her day job, which she splits between oral surgery for the NHS and academic research based at the Glasgow Dental Hospital and School and the University of Glasgow.

I’m very grateful to Professor Jeremy Bagg, head of the dental school, who is very supportive of this initiative as it is part of the university’s mission to engage with the community. It’s ironic as I would not have been able to do these talks ten years ago – I would have been too busy to get out of hospital because of the prevalence of these kind of assaults.”


Violence Reduction Unit

In 2005, Strathclyde Police established the multi-disciplinary Violence Reduction Unit (VRU) to reduce all types of violent behaviour, particularly knife crime among young men in Glasgow. The VRU adopted a public health approach to violent crime, similar to projects in the US, which showed that primary intervention and collaborative prevention work are essential in reducing violence.

In 2008, the VRU established the Community Initiative to Reduce Violence (CIRV) programme which brought together many different agencies and professions into tackling the issue of youth violence. In an effort to meet the issue head on, the VRU invited gang members to attend a meeting where they were told what to expect going forward: a zero tolerance police response if violence did not stop, whether they were involved or not. But also on offer was help with education, training and job finding from various agencies and charities if they turned their back on violence. After the first year, the programme had led to a 49 per cent reduction in violent offending and a 59 per cent decrease in knife carrying by those engaged with the initiative. The CIRV finished in 2011 and the VRU is now engaged in other projects such as Mentors in Violence Prevention now operating in 50 schools across Scotland.


Medic on a mission

Although Christine Goodall trained in academic oral and maxillofacial surgery and worked in that field for 12 years, she now splits her time between surgery and
academic research.

Her main research interests are alcohol and injury, particularly alcohol-related facial injury, and violence including youth violence, domestic abuse and sexual assault.

She is member of the Community Oral Health Research Group but she works with a wide range of different professionals on research projects including fellow surgeons, public health specialists, psychologists, psychiatrists, nurses, statisticians, criminologists and the police.

She has also has an interest in the role of the dental team in screening for alcohol misuse and domestic violence.

She explained: “I do a lot of training around teaching professionals, such as dentists, vets, doctors, fire service and even hairdressers, to raise the issue of domestic abuse so they can signpost people towards help.

If someone came into a surgery with a black eye, a lot of dentists would not bring it up because they are very unsure about what to do about it. It’s not that they are ignoring it, it’s that they worry about opening that big can of worms.

I give them tools to have that conversation with the person which limits their involvement but helps them signpost people to organisations that are more expert at dealing with this situation.”

The service has been going since 2010 and since then about 700 dentists have undergone the training.

I’ve developed the service along with the Violence Reduction Unit and provide the training. I’m now looking at making it sustainable with more trainers on board,” added Christine.

For more information:

If you are interested in domestic violence education training, contact Christine at Christine.Goodall@glasgow.ac.uk

Tags: Christine Goodall / Dentists / Gang Violence / Gangs / MAV / Medics / Medics Against Violence / Recreational Violence / Safer / Streets

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