Revisiting the Dubhs Ridge from Howard Steen on Vimeo.

This inspiring video is about adventure, friendship and fun despite the limitations caused by multiple sclerosis (MS). It is a very moving account with wonderful photography of forty years following the diagnosis of MS at the age of 27 years for Dr Roger Chisholm, then a medical student, climber, hillwalker and sailor. Initially the unknown future spelt a life severely disabled with the loss of independence and of expeditions into the wild outdoors.

Although climbing was no longer a possibility, ‘sailing is really the life-saver’ as Roger explains. Focusing on what he could do led Roger to grasp periods of remission with both hands, for example walking the Annapurna Circuit in the days when roads there did not exist, skiing and qualifying as a Yacht Master taking on the skipper and navigator roles in his shared boat Martha Maria.

‘We really perform as a team on the boat as we used to on the hills and we get a tremendous amount of satisfaction from that’ Howard, Roger's friend, highlights in the film. Team roles and team culture are often talked about in the work context and here the team of friends is credited with ‘giving life a purpose and a great pleasure still’. Readers sharing Roger’s story with those affected by MS is strongly encouraged by the production team.

Atul Gawande in his book Being Mortal: Medicine and What Matters in the End, 2014, gives great emphasis to quality of life and to the importance of each individual defining what this is. He argues against assumptions that limit aspiration and ambition. This video actively shows how perseverance and commitment to the maximum possible quality of life, shared with friends, makes life worth living. Working with teams in organisations, this story reminds me to find out what ‘quality’ means for them and to take care not to limit their aspirations and plans through my making ungrounded assumptions.

A sign posted in the Chiltern Hills by Bedfordshire County Council asserts the benefits of exercise outdoors for physical and mental health. It mentions combatting depression and promoting good mental health. ‘Revisiting the Dubhs Ridge’ demonstrates this in spades. The disruption to a person’s anticipated future life by the onset of such a condition as MS may lead to reactive depression. As discussed by the mental health charity Mind 

‘If you have a long-term physical health condition it can also put you at risk of developing a mental health problem such as anxiety or depression. For some people, the impact on your mental health could become more of a problem than the physical condition itself. Exercise programmes and other treatments like cognitive behavioural therapy (CBT) and mindfulness have been shown to improve anxiety and depression, and quality of life for people with chronic illnesses.’

The mental health benefits of physical exercise include feeling better about yourself and lifting your mood leading to increased life satisfaction. Doing activities with other people and having fun together also provide social and emotional benefits, which improve wellbeing. The Guardian in g2 on 4 October 2017 drew attention to a new research study on this topic with  ' Feeling low? How exercise helps with depression and almost everything else' by Sarah Boseley.

Current Government mental health strategy2 continues to prioritise and include actions towards the implementation of the long term policy goal ‘to give equal priority to mental and physical health: We are clear that we expect parity of esteem between mental and physical health services.’The Health and Social Care Act 2012 introduced in legislation the first explicit recognition of the Secretary of State for Health’s duty towards both physical and mental health. In October 2014, NHS England and the Department of Health jointly published Improving access to mental health services by 2020. This set out a vision to ensure mental and physical health services are given equal priority in terms of access times and service quality.

In July 2016, NHS England published Implementing the Five Year Forward View for Mental Health, confirming that the NHS had accepted the independent Mental Health Taskforce recommendations (February 2016) for the NHS and Government to improve outcomes in mental health by 2020/21, and included a breakdown of additional funding from the Government. A workforce strategy announced in July 2017 by the Secretary for Health aims to support implementation.

 1 Department of Health, No Health without Mental Health; A cross-government mental health outcomes strategy for people of all ages, February 2011, page 2

2 Briefing paper Mental Health Policy in England  CBP 07547 by Elizabeth Parkin and Thomas Powell, House of Commons Library, August 2017

 

 

While on holiday with my adult son in May 2017 in South Asia, a subtext for me was to notice the culture, style, values and priorities of the different companies who provided us with ‘adventure’ treks. Two provided a stark contrast. Here I identify what practices made them so different and reflect on the underlying principles. 

Practices included: 

• The terrain and distances described on the website and the following email correspondence

• Information in advance on what kit would be needed each day and night

• Discussion with the trekkers updating the schedule at regular intervals on the trek

• Anticipation by the company of the trekkers’ specific needs 

• Efficient organisation so time was used effectively. 

Examples

Company A Company B
The website emphasised time in the jungle. In practice this took a small percentage of the trek, which was mainly through fields and villages on paths and wide tracks – hiking rather than trekking.  The description of the route as steep downhill in jungle, then flat river valley with 30 river crossings and later uphill through jungle was accurate. The distances and the detailed schedule were kept to. 

The website and email instructions did not explain what we needed to carry throughout and what we could collect from the driver on day two.
The briefing presentation gave clear essential information on practical points such as what to carry ourselves and what to give to the porters to carry for the whole trek. Advice was given when asked for. 

On day 1, the guide said there would not be enough daylight for the full boat trip and cave visit as promised so we agreed to miss that. In practice, we arrived at the overnight homestay at least four hours before dark. There would have been time for the full boat trip and the cave visit.
The schedule was kept to and was action packed with time for an unexpected swim (fully clothed and booted), breaks for snacks and delicious food for lunch and dinner. Day 1 included both the trek and then two hours in a river cave. Deadlines for moving to the next activity were given so we could gear ourselves to be ready on time.
Day two was to be a 20k trek. It was far short of that and we waited for the local guide in one village on the way for 30 minutes. No reason was given. Lunch took 90 minutes as 40 of them were for him to sleep. This lost us time that should have been in the jungle.  Meeting needs that would affect the trip experience was a priority for this company shown by the thought given to it. For example, handwash before meals, excellent provision of vegetarian food when requested, a stand-up changing tent at the campsite and an odour free composting toilet. 
The puppy at the accommodation provided by the company ran off with and then chewed a flip flop sandal needed in two days. The shoes were outside a required ‘shoes off’ area.   

 What made a difference

The guide and assistant guide in Company B conveyed strongly the company value of looking after the environment, for example collecting for recycling a bag full of empty cans up the final stretch of the jungle path. 

We heard about many training courses the guides were given by the company, for example, on safety in different settings and on use of equipment. 

Safety was paramount and the guides anticipated the value of a supportive hand during a river crossing or extra light in a dark, awkward part of a cave. 

Equipment was provided for purifying water, keeping mosquitos out of tents and lights for evening in the camp.

Relevance to my work

The practices of these companies were of interest to me in the context of my work with charity trustees and their governance role.  I observed the organisations in the context of The Charity Code of Governance published by a consortium in July 2017. The key positives that I appreciated in Company B were examples in that organisation of both strategic leadership, principle 2 Leadership and “recognising that the culture and behaviours of the charity and its board are as important as its governance structures and processes”, principle 3, Integrity. I firmly believe there is much in the charity sector that is relevant to commercial organisations and this code is one example.