Dr Rosie Riley: I'd been completely duped as well. It was like I wasn't exploited, but it was sort of I felt like I'd been aiding trafficking, which I had been. And I think we all do, all the time.
Dr Rupy: Welcome to the Doctor's Kitchen podcast with me Dr Rupy, where we discuss the most important topics and concepts in the medicinal qualities of food and lifestyle. My guest today is Dr Rosie Riley, who is a clinical fellow in emergency medicine and founder of Vita. Now, you might think that this is an odd topic to bring up on a podcast that's focused on food, nutrition, lifestyle. But Rosie is passionate about seeing an end to modern slavery. And once you know about how pervasive modern slavery is in modern life, just life, you can't unsee it. Over the last five years, she has fought to transform the healthcare response and promotes the recognition of modern slavery as a major health challenge to individuals and societies. We have a really honest, open, pragmatic conversation about the company that she founded called Vita. And this was born out of a particularly traumatic experience where Dr Rosie shares her story of how she unknowingly as a teenager contributed to human trafficking. And it was out of this terrible experience where she suffered anxiety as a result that she founded an organisation working to ensure that victims who present to healthcare settings can be safely identified and supported, whilst advancing and facilitating national modern slavery prevention. It's now been delivered to more than 1200 frontline NHS care professionals. However, her aim is to make sure that this is mandatory. Anyone who works in a healthcare setting, regardless of your profession, regardless of your background, you should be aware of this in the same way that we are aware of safeguarding issues regarding children. I was pretty shocked actually at just how pervasive modern slavery is in our lives and it touches everything including food. We do talk about some websites that she mentions throughout the podcast. I'll make sure that those are linked to in the podcast notes on the doctorskitchen.com. For now, I don't really want to say too much. You can find the recipe that I cooked for Dr Rosie on the on the YouTube channel, The Doctor's Kitchen. And please do give this a five-star review if you found it useful. You can find my guest across social networks, the links will be on the doctorskitchen.com at Vita_network, VITA, and at Dr Rosie Riley, all one word as well on Twitter. For now, I'm going to stop talking, on with the podcast. So, today, as it's the morning, I'm going to, it's always difficult actually cooking for guests in the morning because I don't want to just do like oats or something like that. I actually want to give you something, you know, that.
Dr Rosie Riley: Lunchy.
Dr Rupy: Yeah, exactly. So today I'm doing a Middle Eastern style breakfast. Very, very simple. A lot of the stuff I've actually bought and it's just really placing it all together and it just, you know, you're a busy NHS doctor, you don't want to be like, you know, preparing everything from scratch. So these are a few elements that I've got. We're going to do some wilted spinach with a little bit of parsley. Any issues with parsley?
Dr Rosie Riley: No, I love parsley.
Dr Rupy: Some people do have issues with parsley, but that's great to hear. All I've done in advance is just simply chopped and roasted some aubergine in a little bit of olive oil and some salt in the oven for about 30 minutes, but you can buy like char-grilled aubergine that you can just get from a jar. Some hummus that I could make myself, but I didn't. I've just got a store-bought one. They're very good. You just want to look for the ones that have got.
Dr Rosie Riley: The lazy man's breakfast.
Dr Rupy: Exactly. Yeah. It is really, is, yeah. We've got some kobez, which are some Middle Eastern pitas. I'm just going to pop these in the oven that's still a little bit warm. So we've got those to enjoy with the breakfast.
Dr Rosie Riley: For me.
Dr Rupy: For you. Some olives, Kalamata olives that have been deseeded and some kefir as well. I would serve this with something called labneh. I don't know if you've heard of labneh.
Dr Rosie Riley: No, I haven't. And is kefir like a yogurt then?
Dr Rupy: Yes. Yeah. So kefir is a dairy, you can get non-dairy versions, but that's a dairy one. Labneh is like a thick Middle Eastern cheese almost, kind of like cottage cheese, but a lot smoother and it's absolutely wonderful and it's fermented food and it's very good for your gut, as we were talking, the microbiota.
Dr Rosie Riley: Exactly.
Dr Rupy: So I'm just going to prep all that together and then hopefully you'll have a wonderful breakfast.
Dr Rosie Riley: Great. I'm excited.
Dr Rupy: Good, good. I'm glad. So your mum's a chef?
Dr Rosie Riley: Mum's a chef.
Dr Rupy: And so you must eat pretty well at home.
Dr Rosie Riley: We eat really well. My mum and dad used to live out in Thailand and so mum probably learned Thai food when she was there. So we eat a lot of Asian food.
Dr Rupy: Oh, amazing.
Dr Rosie Riley: I was wondering if you're going to cook something Thai actually. I sneakily put it on the, by the way, I really like Thai food. I love Moroccan food and Middle Eastern food too.
Dr Rupy: Yeah, yeah, yeah.
Dr Rosie Riley: But yeah, she's a really good cook. Really good.
Dr Rupy: I'm kind of glad I didn't do anything Thai because if your mum's like the expert, wow. Yeah, that's, no, I'm, this is what I'm more comfortable with. So what kind of things do you kind of eat then at home? What's your favourite Thai dish?
Dr Rosie Riley: My favourite Thai dish is Tom Kha Gai, Thai green curry. But I also love Tom Yum Goong with prawn. And then actually my dad and my favourite, I and dad and I favourite is Pad Krapow, which is like Thai, you will know what it is, but it's Thai basil and sort of soy saucy kind of with some minced meat with rice. Really yummy.
Dr Rupy: That sounds amazing. And your pronunciation is on point, I must say.
Dr Rosie Riley: Well, my mum and dad speak Thai.
Dr Rupy: Oh, really?
Dr Rosie Riley: Yeah.
Dr Rupy: So how long were they out there for?
Dr Rosie Riley: Four years. But they're quite intense expats and they learned the language properly.
Dr Rupy: Oh, that's brilliant.
Dr Rosie Riley: Yeah.
Dr Rupy: And so I'm assuming you've, you've been to all different parts of Asia, right?
Dr Rosie Riley: Yeah, we, we then lived in Hong Kong. So we would go back to Thailand quite a lot and we'd visit, you know, Singapore and different parts where we have friends still out there. We're all going out as a family in a couple of weeks to Thailand again. So it's very, very familiar.
Dr Rupy: Uh-huh. And so tell me about how you got into medicine first of all. Like, what's your, what's your personal story?
Dr Rosie Riley: What happened? I actually remember never actively wanting to be a doctor until sort of decision moment lesson. I was like, I can be a world-class acrobatics pilot.
Dr Rupy: No way.
Dr Rosie Riley: So I, I was, you know, planning with my dad how to become a pilot through BA and how to learn and then go into acrobatics. Yeah, I was properly like on that road.
Dr Rupy: How on, what?
Dr Rosie Riley: And then in year 10, I watched in with biology class and they showed a video of open heart surgery and I was like, now I'm going to do that. So then I immediately wanted to be a cardiothoracic surgeon. Which is like the opposite of my character, but anyway, I wanted to be a cardiothoracic surgeon and then even my grandparents still think I'm going to become a cardiothoracic surgeon.
Dr Rupy: Really?
Dr Rosie Riley: Yeah. I changed as soon as I went to med school, I was going down the obs and gynae route and then changed, realised more and more I'm quite a generalist, so A&E and GP for me.
Dr Rupy: Yeah, yeah. And so I remember at the time when we first connected, you were doing A&E.
Dr Rosie Riley: Yeah, still doing.
Dr Rupy: And you're still doing A&E at the moment?
Dr Rosie Riley: Yeah, well, I was based at a major trauma centre in London for a couple of years. One year I did just in A&E because I'm crazy. Nearly caught burnout just in time, funnily enough, moved to rural Somerset to kind of live a different style of life and now down in Taunton A&E there.
Dr Rupy: Wow. Which is great.
Dr Rosie Riley: Yeah, that's amazing.
Dr Rupy: It looks delicious.
Dr Rosie Riley: Oh, so what are the little lemony things?
Dr Rupy: Yes, yeah. So I forgot to mention, preserved lemons, one of my favourite ingredients. They give like almost like a lemonade kind of flavour and it's quite typical in like Iranian dishes, any dishes from that sort of area. And it's like quite like unlike anything else that you've you've kind of, yeah, it's really, really good. But if you don't, if you don't have access to that, you don't need to put that.
Dr Rosie Riley: Is it nice in like tagines and things?
Dr Rupy: Yes, actually, yeah. So sometimes people don't like the the harsh sweetness of like a dried apricot or, you know, the sultanas or, you know, even the cranberries you can put in there. So it's actually quite, it's a it's a lot, it's a lot more acidic and so you get like a different flavour out of it. But still some sweetness is good for a tagine, I would say. So with the spinach, I'm doing a lot of stuff with my hands today, but I quite like that. So with the spinach, I've literally just put it in here and I'm just wilting it very, very gently. And that's going to just be served on the side. So at the moment, you're in your third year?
Dr Rosie Riley: I'm, I'm F4.
Dr Rupy: F4, okay.
Dr Rosie Riley: So I guess for non-medics, I'm on my fourth or fifth gap year in my life. But, no, just really enjoying not being on the training conveyor belt to the end. I'm really enjoying just being a SHO, senior house officer in A&E. Um, yeah. GP training from potentially August if I get in.
Dr Rupy: If you, I mean.
Dr Rosie Riley: Well, I got in before, but I didn't want to start then, but.
Dr Rupy: Oh, I didn't realise that you got in before.
Dr Rosie Riley: I was supposed to start in Greenwich.
Dr Rupy: Oh, really?
Dr Rosie Riley: Yeah, and then I wanted to leave London, so.
Dr Rupy: And I think that's probably one of the best decisions.
Dr Rosie Riley: I've had, I'm having a great time, yeah.
Dr Rupy: Yeah, because I actually wanted to go for GP training in London and I got Mid-Sussex. And I remember feeling like, ah, like a bit disappointed, but honestly, one of the best things that ever happened because getting out of London and actually learning about, yeah, about what like medicine is like on the peripheries. You have a lot more sort of community vibes, I think, with other medics as well. And you just learn about, not a slower pace of medicine, but just a different pace of medicine outside of London because, as you know, I mean, the rates of burnout are just crazy.
Dr Rosie Riley: Yeah. I think King's is probably one of the busiest A&Es in the UK. So going to a rural Somerset hospital A&E, and the, they're so friendly, the patients are lovely. I haven't been shouted at by a patient once.
Dr Rupy: Oh, no way. Really? Wow.
Dr Rosie Riley: I know. That's like a, that's unheard of. It's really nice. It's such a nice atmosphere and that's an unusual thing to say about an A&E department, but I'm really enjoying it down there.
Dr Rupy: Oh, great, great. I'm glad.
Dr Rosie Riley: What's this?
Dr Rupy: Okay, so this is za'atar. It's one of my favourite spices. I use it quite often in the Doctor's Kitchen here because it's just incredible. It's a, yeah, it's just a mixture of like dried oregano, marjoram, you've got some sesame in there, a little bit of cumin, gives a little bit of heat. And honestly, it's just like a wonderful sort of flavour that just goes on so many different things, root vegetables, and I've just put it here on the on the hummus for you. So, so tell me a little bit about your your background with with Vita and how that came to fruition.
Dr Rosie Riley: Well, I guess it's it's a a bit of a long story with how I became passionate about modern slavery. It all stems from when I was 18. I decided I wanted to go and do something nice in my gap year. So I went to Nepal with one of my best friends and we were going to go and, we did the voluntourism thing, which has now been dubbed voluntourism where we, you know, you feel good about yourself and you go and help some some people who are like less well off. But we went to live in an orphanage for a month and we lived in the orphanage. There were 20 children. It was absolute chaos. They were really grotty. But we really did love the kids. And then when, you know, we we were sort of ready to move on when we did, not really appreciating the impact of, oh, being another adult that meets lots of children that leaves them. So there's lots of quite significant harm that can come to that kind of voluntourism thing. The conveyor belt that I only now know about. But then in, actually three years later, I was I was starting medical school and I, my friend called me who'd went on my travelling with me, saying I need to sit down and watch this channel for unreported world documentary. And they, the whole 30 minutes was about my orphanage, Happy Home. And so they told the story of how they were undercover investigators looking into how these children had been trafficked to the orphanage. So they went around rural villages and took children from families, took their birth certificates, had the police on board so the families couldn't like reclaim their children. And then made them look really grotty and poor so that they could scam people like me to give money. And they found out on the program, they were sneaking into the orphanage I'd lived in to speak to Bishwa, the owner. And it's on, it's on channel 4, you can literally watch the show.
Dr Rupy: I'll definitely link to that, yeah.
Dr Rosie Riley: And you know, there's one family in the mountains where they hadn't seen their daughter in 10 years and Claire and I recognised her face and her name and there was a little kid that had escaped, they managed to interview with the mum and they were terrified they'd find them. And so we were like devastated. I mean, we couldn't believe what on earth we'd been conned into as well because we were like, we were trying to help. And so that, that's where it all really kicked off. It was very personal. I had a mini sort of breakdown after that thinking like, what is this? Looked into modern slavery, found out, you know, people are being exploited in a very intentional way. This is, I've never heard of this before. I thought slavery was old and dead and gone. And then essentially it was actually one of my friends who, and I was just sort of mid-breakdown going, it's so big, I can't, I've got to do something, I don't know what to do. And he actually said, look, you, you can't, it's too big. You tackle what you know. And at that point I was a medical student, so I thought, well, let's look at healthcare. And that's how this how you got into Vita sort of started.
Dr Rupy: Wow. I feel like we've just left it on a massive cliffhanger here.
Dr Rosie Riley: We can talk about more later.
Dr Rupy: Yeah, yeah, we'll definitely need to talk about that. But how old were you at the time when you?
Dr Rosie Riley: What with the orphanage?
Dr Rupy: Yeah.
Dr Rosie Riley: 18.
Dr Rupy: Oh wow. So I was a kid. I didn't know anything about anything. I had a pretty easy life and not really any major trials or tribulations and then it was my first exposure to like the darkness of humanity and it was really, it was really, really hard to deal with.
Dr Rupy: Yeah, yeah, absolutely. We should definitely get into that. But before, I'm going to serve you a delicious.
Dr Rosie Riley: Let's eat this. This looks good.
Dr Rupy: So, I've just got these kobez. I'll take a couple out of the oven. These are beautifully warm. So, this, as you can tell, is a very, it's it's actually a lot simpler than it looks. So, a lot of the things have just been put together by me buying a few things from the supermarket and then placing them on the plate. So, to to go over it again, we have roasted aubergine with some black olives, a little bit of the preserved lemons, some parsley. I'm just going to dress that with some lemon juice that goes over the spinach as well. Some hummus with za'atar. Honestly, getting hummus from the store, putting a little bit of za'atar in it, a little bit of pomegranate molasses and olive oil, it changes your hummus completely. It's completely different experience.
Dr Rosie Riley: We have pomegranate molasses.
Dr Rupy: I know, right? I'm telling you, this is in most supermarkets now. Go get it. Go get it. And you can get it online if you can't find it, but it's absolutely wonderful. You don't you don't need the pomegranate molasses if you can't find it. Wilted spinach, it's just it's just spinach in a pan, no water, no oil, nothing. Just put it the lid on very low heat and it just naturally wilts and you can, you know, the whole bag can go down. Lemon juice, salt, and then some kobez and a little bit of sumac with the kefir, but you don't need to have the kefir if you don't eat dairy for whatever reason.
Dr Rosie Riley: No, I am. Yum, yum, yum.
Dr Rupy: Good. All right, let me get you a spoon and we'll let you dive into that.
Dr Rupy: In the break, we were chatting about your parents' farm. Tell us about WWOOFing. What is that?
Dr Rosie Riley: WWOOFing, I'm not going to say the acronym well, World Wide Organic something Farm. And it's where people travel around the world and they live on the land and they get to know a family and you become part of the family. Some, some are a little bit more workery, so you'll live in a caravan and work on a vineyard, but we have people from everywhere coming to stay throughout the year and they really do become part of the family. And it's great fun. We've got friends now from all around the world that we even have seen and visited. And they just, they work the land, they live with us, they eat with us, they cook with us, they do everything with us and it's really great. And my mum also gets a lot of help with the farm.
Dr Rupy: That's amazing. It sounds like a magical experience.
Dr Rosie Riley: It is. It's absolutely amazing. It's really good fun.
Dr Rupy: And it sounds like your parents adopt some people as well, right?
Dr Rosie Riley: Yeah, so one of, one of them made my parents her godparents. So it really went well.
Dr Rupy: That's great. That's what happens when you feed people, you know? Yeah.
Dr Rosie Riley: It's all about food. And we were also saying how like my family is obsessed with food and every holiday we ever have, we will, the whole day and the whole holiday is about where we're going to eat and what we're going to eat. We will only go places where we know the food is good. It rules out quite a few places.
Dr Rupy: Yeah, exactly how I am with my family. We spend most of our time like watching food programs or eating or planning the next meal that we're going to cook or where we want to eat and stuff. And it's, it's great. It's just such a connector as well. Yeah.
Dr Rosie Riley: We just discovered actually this recent, it's really old cooking show with, I can't remember his first name, something Floyd.
Dr Rupy: Keith Floyd.
Dr Rosie Riley: Keith Floyd. Oh my god, Keith Floyd. I mean, we literally were in hysterics. This guy is so drunk the whole time. He's always like gulping the wine and he's like talking to his director. It's so funny.
Dr Rupy: Yeah, actually, I've thought about doing a parody of Keith Floyd with my, my videographer actually, because I feel like he does, he's such an expert because if anyone hasn't seen it, there's regular clips of Keith Floyd on Saturday Kitchen every single week. And I'm obsessed with Keith Floyd because he's so natural and he can just do a meal and like talk to the camera.
Dr Rosie Riley: And it goes terribly wrong. And then the person, the real chef there is like, this is awful. This is awful, you're doing it all wrong. And he's like, well, and it's, it's just hilarious. I love it.
Dr Rupy: And he's, he's a genuinely like good cook as well. Yeah, yeah, and he's always doing fish and stuff. So, yeah, that was great. I, I, I've got a lot of time for Keith Floyd programs. They're brilliant. How was the food? I forgot to ask you.
Dr Rosie Riley: Oh yeah. Really, really good. Really loved it. Zesty, I think is the word for the meal. Really loved it. Really fresh and healthy.
Dr Rupy: Excellent. If you want to cook the recipe, you can follow it on the YouTube channel, the doctorskitchen.com as well, and you'll get all the stuff there. We were talking and we kind of left it on a bit of a cliffhanger.
Dr Rosie Riley: Oh, we did.
Dr Rupy: Yes. Oh, to bring the tone dramatically down.
Dr Rosie Riley: I know, yeah. But it's, it's incredible. I didn't realise that your realisation was actually when you were watching the program.
Dr Rupy: Yeah, yeah, yeah.
Dr Rosie Riley: That's incredible. Well, I mean, I, so a lot of people said, well, in hindsight, did you spot any signs? So when I was, Claire and I did, we, we did wonder because we, when we were there, we were wondering why some of them had, like a lot, most of them, pretty much all of them had parents. And we were like, why are you in an orphanage? But also, we didn't really know anything about exploitation or like organised crime, anything like that. So, you know, what you don't know, you don't know. So we just didn't really take, look into it at all. And then this show completely, I actually have like this picture that I've put up on my wall. I made it when I was having this sort of breakdown realisation. And it was, I just got all of the colouring pictures that they'd drawn for me and I just made it into a little montage, so I've got it on my wall so I can always like remember. I've written a message on the back like, I won't forget what's happened. But yeah, I think that's where, that's where it all stemmed from, really sort of, it just, it really opened my eyes and also just feeling a little bit like I, I'd been completely duped as well. It was like, I wasn't exploited, but it was sort of, I felt like I'd been aiding trafficking, which I had been. And I think we all do, all the time. But I was very acutely aware of how I directly funded this business. And so that was a very horrifying realisation, especially as I was so little.
Dr Rupy: Yeah, exactly. I mean, like, how on earth did you even begin to start processing that after your realisation?
Dr Rosie Riley: I had, I had a very supportive network. I lived in Bristol. I was at med school. So I had friends who were, were coming, talk it through. There was actually about two days where I didn't really want to leave the house. And so they would come to my house and they would like get me food and they were just talking it through and I was just like crying and like, I don't understand. And reading and reading and reading up about this world and it was a realisation that human beings are being bought and sold and conned and trafficked and forced into working or duping people for money. And it became more and more of an awareness and I heard about the term trafficking and I was really interested in what that was. But then the more I read, the more you realise how big it is. You know, stats that are not particularly helpful but can, you know, give you a clue as to the scale. There are more people living in slavery than at any other time in human history. It's the fastest growing illegal crime. It's well overtaken drugs. More people, more money is made from selling people than selling drugs. So these sorts of things were really like overwhelming. And I don't know, it's a bit cheesy, but you have you heard the Wilberforce quote of you may choose to look the other way, but you can never say again that you did not know. And I really had that kind of moment where I was like, I can't just move on and just pretend that didn't that I haven't just heard about this. So I, then a, my one of my best friends at the time actually really helped me because he was like, right, let's start with what you've what you've got in front of you, your own demographic, your own cohort of people that you can start to shift the culture a little bit and think about how you can target, try and take this down, but just with what you can access. And I was learning to be a doctor. So I was just thinking, you know, do people come into health services? I mean, this must have significant consequences on their mental and physical health of people who are exploited. So I was looking into it. I was asking doctors everywhere I could find and nurses everywhere I could find going like, have you heard of trafficking? Have you heard of human trafficking? I did a survey and people had heard of it, but they didn't really know what it was. But a lot of people were saying like, there have been a few times when I've been thinking about this patient or I've been worried about this pattern of activity in this general practice and I haven't really known, but I have no idea what to do. So I developed a training program as a third-year medical student. I'd barely clapped eyes on a patient by that point. I mean, it was Bristol, it's quite like lecture heavy.
Dr Rupy: Yeah, yeah. I think a lot of people, just for those who are listening who aren't aware of the medical system, the first couple of years are quite lecture-based and a lot more sort of science before you even get let on to the wards where you can actually have conversations with patients. So by that point, you would have been pretty.
Dr Rosie Riley: I'd seen, you know, I'd met patients, but I was just starting to learn, you know, how to take a history and how to do an examination things. So, but then I had this program and I, you know, we offered it out to general practices. And so within a three-week period, I was invited to train eight general practices across Bristol and a sexual health clinic. So I had nearly 60 mostly GPs who were invited me to train them. I was a third-year medical student and I was blown away by the demand. They were like, yes, we see this, we're worried, we don't know what to do, come and tell us. And I was just so, I was very humbled because they were fully qualified and, but it was, it was really interesting and I looked at sort of the before and after confidence and knowledge in different categories and found that there was really a shift and an improvement. So I just continued rolling out this training wherever, alongside full-time med school and then into full-time junior doctoring. We moved to the Southeast then London. And I don't know when it sort of shifted into actually becoming more of a, I went to the Royal College of General Practice conference in 2017 and lots of GPs were coming up to me, we did a poster and people were interested in that one. But anyway, lots of GPs were like reading it and going like, come and train us, come and train us, we want to know about this stuff. And I was thinking, I'm literally max capacity, I'm going to like, I've never want to look at this again because I can't do this anymore, it's too many. So I started thinking about how to make it more sustainable. And that's sort of where Vita burst. It's the organisation of Vita, which is to advance the health response to modern slavery. And it's sustainable, survivor-focused and evidence-based. That's our core values.
Dr Rupy: Wow. I mean, there's so much stuff that I want to go back to in that. No, no, definitely. I mean, first of all, the statistics around drugs being less than drugs making less money in the illegal market than trafficking. The mind boggles because some of the richest men in history have been, you know, like Pablo Escobar and drug lords and stuff. And we're talking billions upon billions of dollars. And if trafficking is more than that, and we don't, if you ask most people on the street, they will think that slavery does not exist anymore. This is something that we abolished over 100 years ago, you know, with the revolution in America and all these different things. And I don't think people are aware at all. I mean, I feel very ignorant that I was even aware of those statistics.
Dr Rosie Riley: Yeah, no, it's, it's that one's one that people are like, whoa. I mean, the only stat, financial stat I've got is from 2012 and forced labour alone, so not the different other forms in which someone can be exploited, but forced labour alone was making more than 150 billion a year. And that's 2012. So, it's, and actually I heard an interview with a trafficker, an ex-trafficker, and they were saying, you know, you sell drugs and then they're gone. You've sold them. With a human, you know, you can make money again and again and again. So it's a low risk, high profit industry.
Dr Rupy: Oh my god. And with, what, I think perhaps we should define exactly what we mean by trafficking. What does that term mean? Because I think like, like you said, when you were a third year and you were asking nurses and other healthcare professionals exactly what we mean by trafficking, most people wouldn't be able to define it. So what, what exactly?
Dr Rosie Riley: So I, a consolidated definition would be it's the movement of people by force, fraud, coercion or deception with the aim of exploiting them. Human trafficking is, comes under the umbrella of modern slavery. The UK uses the term modern slavery as a legal term. The rest of the world, I don't think really does. They more talk about trafficking. But modern slavery is a bit more of an umbrella and it's a little bit harder to define, but it includes other sort of definitions like the term slavery, servitude and forced labour. It's a bigger umbrella.
Dr Rupy: Yeah. And I'm assuming within the world of trafficking and modern slavery, there are different industries. Sex is the one that comes to mind.
Dr Rosie Riley: That's usually the one that people think about first. Forced sexual exploitation, which is the forcible or deceptive recruitment of men, women and children for forced prostitution and sexual exploitation. So that, there's, I also, yeah, I mean, when I was, I went to a conference recently and there were a lot of survivors and they were talking about how it's very difficult to define when you, when someone is a victim sometimes because one day they'll feel a victim, one day they'll feel a sex worker and indifferent and one day they'll feel empowered and very much in control. And so there's, there's quite a grey here. I mean, it's difficult to say this camp, this camp, this camp. But what's interesting is actually globally and in the UK, by far the biggest form of exploitation is labour, forced labour. So we don't talk about that as much. In the states, it's even less recognised really. It's recognised legally but not in the public arena. But it's basically forced work under the threat of some form of punishment. So industries in the UK people are forced to work are usually low regulated, poorly regulated industries and that can be construction, agriculture, farming, car washes, nail salons, hospitality industries, restaurants.
Dr Rupy: With the gig economy, I imagine that there's going to be a lot of grey area, isn't there regarding workers' rights, the protections that you have, as well as being forced into certain practices without due compensation. Do you think that's going to have an impact on how we define modern slavery and how we actually change?
Dr Rosie Riley: With our economy? Yeah. I think that it's sort of difficult to predict. Most of this is sort of best guess. I think that you can look at theory, you can theorise what might happen if this happened. You know, even talk about Brexit. I mean, who knows what's going to happen to to modern slavery stats. It's best guess. I think that if without, it's the lack of regulation, it's the agency hiring, hiring from agencies and subcontracting out means that you're not responsible for your worker. Someone else is and they might be exploiting where you think, oh, I'm getting some farmers to help me with the harvest. And actually that agency is trafficking those people and they're not actually free to work.
Dr Rupy: I can imagine this is almost like a systematic process within certain industries who purposely will farm out, you know, the workers so they don't have to have responsibility. The one that springs to mind is clothing. So, you know, if you, if it's out of sight, out of mind, we're not directly employing slave workers, but our secondary companies that we work with might be. And then they get off scot-free. But I'm assuming there's some work that actually helps with the responsibility.
Dr Rosie Riley: Well, because it is important, exactly that, that the businesses are held accountable for anyone in their supply chains. So in 2015, the Modern Slavery Act came through the UK and that's one of the first sort of bills of its era in the world that was trying to nail down convictions, prosecutions and things in the UK. One of, one of the aspects is looking at transparency in supply chains. And so they've now, in that, in that law, mean that any company that earns more than 37, I think, million a year have to write an annual report about slavery in their supply chains.
Dr Rupy: Oh wow, okay.
Dr Rosie Riley: So it's not, you can tick that I didn't do it box, but the idea is to try and get people looking for it and being responsible for it. And there's actually, so Hope for Justice have a sort of social enterprise arm called Slave Free Alliance and they work with businesses to look into this and take this seriously and and appreciate, you know, we're all, we're all involved in this. How can we move forward rather than the kind of blame game, big bad business kind of culture.
Dr Rupy: Exactly, yeah. So I think we were talking a bit about this off air as well, where I think we're becoming as a consumer a lot more aware of the animal issues and the issues around our food supply in terms of animal cruelty, but we're not really focusing on the humanitarian issues that are going and that plague our food supply chain. I was wondering if you could talk a bit about that because.
Dr Rosie Riley: Well, I think that that's exactly what my impression was that, you know, there is a shift in terms of people, the demand is more for eco-friendly products now, which is fantastic. I think that businesses are responding to that, so it's very attractive for them, they know that it's a very good marketing tool for them to make it sound as eco-friendly as possible. And they're making moves because that's what the demand is saying. If we did that for human cruelty-free products, then that would be the same. I think there's a sort of two, two-pronged approach. There's a top-down and a bottom-up. Like we as consumers can have a responsibility to look for, ask, encourage businesses, you know, buying products that we can see are, they've made a move to away from human cruelty. But then also at the same time, it's, it's legal, targeting businesses, making sure that they're accountable for their workers.
Dr Rupy: Yeah. The two things that I absolutely love, as you are probably aware, are coffee and chocolate. And so they're the two things I looked up because I knew you were going to ask me.
Dr Rupy: I'm glad. I'm so glad.
Dr Rosie Riley: So coffee and chocolate are my two favourite things. I always look for certain like stamps and labels and it makes me feel better as a consumer that I'm making a concerted effort to at least choose products that label themselves as cruelty-free or have a fair trade pathway. You gave me the unfortunate news a few months back that those labels aren't always as reassuring and reliable as they could be.
Dr Rosie Riley: I think that with fair trade with chocolate is probably the easiest way to ensure that the company is taking reasonable steps to make sure that workers are valued and paid well and they're not, you know, destroying communities. Cadbury's, for example, was making sure that all their dairy milk products were fair trade in 2009 and I think by 2016 they were like, well, we're not going to do fair trade, we're going to do our own sustainable program, which is obviously not independent and you can't completely trust a company doing their own thing. And they're part of Kraft, which is not so good with other things. So you know that, and actually now I think Kraft own Green & Black's or something. Cadbury's own Green & Black's. So actually there's some changes there. I don't know, it's really, it's hard to.
Dr Rupy: I've noticed a trend and this isn't a big like anti-corporate spiel or whatever because I think we do need to work with big industries and there are ways in which we can do that efficiently. But I am noticing a trend whereby bigger businesses are capturing and acquiring smaller businesses that have a very good sort of ethical standpoint, a very good consumer base that trusts them implicitly. The one that comes to mind is like Pukka Herbs, for example. I love Pukka Herbs. I think they're great. They've got great teas and all the rest of it. They were started by two founders who who had genuine sort of ethical standpoint in terms of making sure that their workers were compensated and they they sourced them ethically. But they've been acquired by a big corporation. I think it was Unilever a couple of years ago. And so that kind of makes me feel a little bit uncomfortable, but at the same time, I think we as consumers also need to appreciate that maybe some of these corporations do have some social backbone.
Dr Rosie Riley: Yeah. But then I think it's, I think it's interesting because they, for example, I think Cadbury's, is it Cadbury's that that bought Green & Black's? It was Kraft. I think they said they were going to run it as an independent entity so that it could retain its organic, but already the organicness is slightly slipping away. And I think, you know, it's really hard to be completely independent and be part of a big machine that doesn't necessarily prioritise.
Dr Rupy: I think that's the standard sort of thing when any big business acquires a smaller business. They keep a lot of the managerial roles and the employees in place to maintain the sense of culture, but gradually over years, months or whatever, they will change the business to be a lot more profitable and to perhaps sometimes relax some of the things that are less of a priority, so to speak. So, I and I I've noticed that with a few things actually.
Dr Rosie Riley: Yeah, I agree. I think it's quite difficult to follow. And it's very difficult to sort of really truly be aware as a consumer. There are some products that, you know, you can know their whole ethos is about, you know, valuing their workers and paying people well and not completely destroying, uprooting communities in the process. So you can, you can go for brands that actively have this as their whole core. But it's difficult with the more high street stuff that we know that, you know.
Dr Rupy: So the other thing that I love, obviously, is coffee.
Dr Rosie Riley: Yeah. Oh, well, on the good food guide, I was looking at it this morning. And I was, I was seeing which brands because they, they do the traffic light system. And second was Greggs.
Dr Rupy: Really?
Dr Rosie Riley: I was really surprised at that. Well done, Gregg.
Dr Rupy: Wow, I'm super surprised.
Dr Rosie Riley: I don't think it scored very high on necessarily environmental, but the people, the fair trade was well stamped, it seemed.
Dr Rupy: Interesting. And how do good food guide actually do the sort of due diligence and investigation? Is it based on?
Dr Rosie Riley: I think they look at policies and also if there's any kind of campaigns against these organisations and they look through media stuff and I'm, I think it's, they've got a sort of methodology section.
Dr Rupy: Yeah, yeah. Because I know there's a lot of attention being given to like clothing and that sort of arena, but food, I haven't really thought about because the supply chain, as we were talking about before, is just so complicated.
Dr Rosie Riley: Yeah, yeah. Incredibly so. It is. And I think probably with chocolate, the main concern was child labour. And I think that of the children that were working for our chocolate, I think that the stat I saw was that half were under 14. And if you're, if if you're in a household where a child is in that industry, then a third of them don't go to school. So it's massively impactful for the whole future community as well. So yeah, it's really, it's important and it's very distant from us. I think the more layers in between, I think you were mentioning earlier, the less you tangibly feel the consequences of.
Dr Rupy: 100%. It's it's like how I view animal cruelty and you know, the choice that I make whenever I'm out to essentially buy only plant-based or vegetarian foods when I'm in restaurants and stuff where I can't guarantee the quality of animal products and the care that they've they've been undergone. But this whole notion, and this isn't to, you know, rag on anyone that's vegan or 100% plant-based for ethical reasons, but this whole notion of cruelty-free really annoys me because I think it completely misses another massive untalked point about human cruelty.
Dr Rosie Riley: Yeah, I completely agree. It's so untalked about. It's just not, it's not on the agenda at the moment for consumers. I mean, it is for a smaller proportion. But, yeah, you're right. It's all about free from animal cruelty and eco-friendly production. Both important, but absolutely human cruelty is so important and it's not, it's very untalked about.
Dr Rupy: Yeah, and the notion that you can eat just plants or, you know, go to your grocery store or whatever and be cruelty-free, I just think it's, it's very naive and I think if you truly want to be conscious consumers, we need to be a lot more aware and talk about these, you know, uncomfortable points, which is why I was so glad that, you know, you came on and we wanted to talk about this. But, the other side to that is that it's incredibly difficult to do in a modern era. And I don't want to like get people to think, okay, fine, I've got to, I've got to eat only plants and I've got to be mindful about where I get my products from and all these different things, but it definitely adds up and we're not going to actually change our landscape that goes beyond food and our humanitarian landscape unless we actually make these choices as consumers.
Dr Rosie Riley: Well, one of the things I think I've, I've been thinking about recently when talking about like the world's problems is I think it's very, you can't care about everything because it will destroy you. With modern slavery, I can't fathom the extent of it. So there are, what's my demographic? Where can I impact and where can I impact well? And I think that because every area is talked about so much, there's a lot of guilt and shame that comes from, well, you're not doing enough, you're not doing enough. And it's, it's actually completely counterintuitive. It actually switches people off. So I'm, I'm not anti, you know, my thing, I'm so excited about the move towards an eco-friendly, you know, my battle is not necessarily that. So I will support and encourage people who do that. My battle is with human cruelty and what that looks like in our day-to-day. And actually more, more, my passion is the health impact of this, the public health and prevention response, but also the health impact of modern slavery on an individual and a community and the whole society. You sort of pick your thing and you do it really well and you're excited about other people doing their thing.
Dr Rupy: And you have this ripple effect that will, um, you know, permeate through your local community and the people that you can actually influence. I read, um, your medium post, I think it was published a year ago or so, where you have this experience where you're in A&E and, you know, you come across a patient and, you know, your thoughts kind of come out afterwards after having that interaction. I thought maybe you could share that because that was.
Dr Rosie Riley: Which one was it? Oh, you've got quite a few. The one where I think, um, you, it's a Romanian patient who comes on and he's the same age as your brother.
Dr Rupy: Yes. No, my, oh gosh, that one. I was literally on the train here like just having a look and I completely remember him. So, he's a 17-year-old in the middle of the night in A&E and I'm in minors. Me and an emergency nurse practitioner in a major trauma centre minors by by myself pretty much and it was just awful. Trying to keep afloat. And then I see this 17-year-old, you know, come in with a knee injury, playing football, sort him out, send him off to X-ray. And then, um, I hear one of the nurses mention that he was from Albania. And then I sort of sort of suddenly realised I was like, hang on, so he's 17, he's on his own, it's the middle of the night. Where is anyone else in his life? And he's from Albania. And I was just thinking like, the reason Albania twigged is because actually looking at the people who've been identified as being exploited and victims of modern slavery in the UK, Albania is one of the highest origin countries for men and women, like massively so. So I just, um, it just sort of all shifted for me. I was like, okay, I actually need to think a bit more about this teenager. And then I, I think it really hit home actually because he just looked very similar to, well, he just, he didn't look very similar, but he just reminded me strongly of my brother. And I was just saying, so like, where do you live? Who do you live with at the moment? And he was saying he lives with three friends. He's come over by himself. He was fleeing troubles, he said. And I didn't, you know, it's not actually sometimes okay to delve into someone's deepest trauma just because I'm nosy. So I didn't go near there. But, um, he was just, I just couldn't, I was so shocked. I was like, this little boy who's on his own, he's a child still, a child completely, brain doesn't fully develop until you're 25. You're not actually an adult biologically until you're 25. And he's just on his own. He's in the asylum seeking process. He's waiting for his status to be assessed by the home office to get refugee status. And I just thought he is absolutely prime, prime suspect for being targeted because he's a young, fit, well young man who, you know, England doesn't really care about. No one really cares about. And, you know, he could just, hey, look, I've got a job working on a farm. Do you want a bit of work? You're not allowed to work until you're a refugee. Look, you can get some cash in hand, come with me, we've got some work for you. It's just so, I was so nervous in the moment. I was like, oh my gosh, he's not safe.
Dr Rupy: Yeah, yeah. There's so many things that I pulled out from that article that I read and then chatting to you about it. Two main things were, A, oh my god, have I missed something like that? Because the number of times I've been in A&E in the middle of the night in North London or West London or wherever I've worked, and people come in and they have a story like, I was playing football and it's a minor injury and you don't think anything of it. You don't think to think about their background. You don't think to think of, you know, outside of paediatrics where we're very, we're much better at safeguarding because that's part of our mandatory training. We are with young kids. I'd say with adolescents, we're really stuck. Definitely, yeah, because then that in between stage where there's always this fight about whether they should be in paediatrics, whether they should be in adults and stuff. And I think that again is another massive grey area. But also, when people see, particularly those coming from Eastern European countries, or reality is Central European countries, but, we don't care about them. We just think, we think of them as, you know, the freeloaders, the hostile environment thing.
Dr Rosie Riley: That really infuriated me as well because I was thinking this is a young boy and actually this is someone's possibly son or brother. And England doesn't welcome him. He's here, he's in the system, he's getting this, you know, he's got the council accommodation through the asylum process. But actually, he's not particularly safe. Is he got like a setup? Has he got, has he been plumbed into a little community? Like how, it made me a bit angry. I was like, someone will look at him as a stat, an immigration stat. And you can't look at them in the face and go, you're an immigrant. I just, it's really hard. Any of the people who make the policies, if they come and actually meet someone, I think it's really hard to to speak in the same language.
Dr Rupy: Yeah, which is why I'm so glad that you're doing a lot more things with the government at a, you know, at a huge top-down level. When you talk to health professionals, as you do as part of your courses with Vita, do you ever get any, not backlash, but any resistance on the basis of the number of things that we as health professionals need to do or be aware of? Because I know certainly when I talk about culinary medicine and the importance of nutrition, even though, oh, they're like another subject that we're trying to fit into a curriculum. Exactly. Even though the statistics clearly state that diet is the number one reason as to why we're seeing so many issues that lead to A&E as well as secondary care admissions, it there's still that that sort of resistance against that. And I'm wondering whether you've ever come across that or whether people actually actually take to the subject matter given the huge statistics that you were talking about earlier.
Dr Rosie Riley: I've not had that. And I think it's because I tell a story. It's not a, it's not, firstly, it fits within safeguarding. One of the things I'm very passionate about is what is safeguarding? You know, you you learn it as a medic, you have hundreds of hours of online crap that just doesn't change, sorry, I'm not allowed to say that. It doesn't change the way that you actually do anything on the shop floor. It's not applicable to your everyday. It's really hard to know how on earth I learn all this stuff and like list of red flags, speak to your safeguarding lead. My, I mean, one of the things that I'm really try with my training is you you come to the training, you learn about what do you do when someone is in front of you? What kind of language can you use? How can you phrase, how can you phrase things in a way to get an accompanying person out of the room without raising their alarm bells so that you can speak to someone on their own? How do you create a safe, confidential space so that if someone chose to disclose to you safety issues, they felt safe to and it was their control over the situation, not me trying to grab information because I need to tick some boxes. So like language that you can practice, you we use actors, so you role play these scenarios with actors and the actors give feedback and sometimes there it's a very clear case of abuse and, you know, there's a clear line of action. Sometimes it's very much like up in the air. I have a gut instinct something's wrong, but this is an adult, they have capacity, they want to leave, they're not telling me anything. What do I do? So most of it is learning what I can do as an as a doctor in an A&E setting or a GP setting or wherever, what the limits of my, what can I do? And actually one of the things that I really emphasize is you, it's so, it's massively impactful to a person to have a space where for the first time probably in a long time or their whole life, they are empowered, they're in control of the scenario. I'm not trying to coerce, I'm not trying to force information from them. I'm trying to give them a space where they feel safe to tell me if they're worried that something's going on. And if they don't, that's okay. But then to emphasize, if you ever feel unsafe, if you ever feel threatened, if anyone makes you do something you don't want to, you can come to A&E. This is a safe place to come and we'll we'll be here to help. You know, it's about planting a seed of, you know, you're an individual worthy of dignity and care. So when you're ready, this is a safe place, not brave doctor rescues victim. So my, my, you know, it's difficult, I can't even remember your original question. It's not about, you know, trying to add something to a curriculum necessarily. I think for me, it's more about replacing with an actually practical piece of education. So most of the time people see this as a part of safeguarding. And they've been very excited about it. I mean, we're rolling out and I, since last summer, you know, you must experience this. People are like, oh, come and teach us, or come and teach us. I'm like, actually, I've, this is a lot and I, can I be paid for my time? Like simple things. But this is a sustainable program now. It's, it's funded, it's being paid for by NHS trusts across London and the Southeast. You know, we've got plans to roll out across the whole of wider London. I want to roll this out nationally for, well, we're targeting F1s and F2s, so first two years of doctor's whole career. It's really exciting. We've got, you know, 1200 people who've been trained. And these are doctors that, I'm so excited because they're going out and they're going to have kind, empowering encounters with their patients. And I don't need more people to be identified because sometimes that's not the safest thing for someone. It's not necessarily because our government system's not quite, yes, it's not built to support them, is it? It's, it's there and it's probably one of the better ones in the world, but it's, there are serious issues, which we don't need to go into today, but like immigration issues and things. So actually a real, you know, a positive outcome we're really trying to impart is you're an individual that's worthy of dignity and care. So planting a seed, starting to challenge the behaviour they've only experienced. So that's, that's, that's the training.
Dr Rupy: I remember like at the start of this conversation, we were talking about the things that you can do within the locus of your control, within your own community. And luckily for you, that is the medical community that are more likely to come into direct contact with modern slaves.
Dr Rosie Riley: Yeah, and we've got an amazing opportunity to be completely independent. You know, the EU, we can, we don't need to talk about it today, but the the issues of charging people who don't have recourse to public funds. So if they're in the UK legally, then they have to pay for their care after A&E. But other than that, we've got a person who's a person and it doesn't matter who or where they're coming, where they come from. And trafficking, by the way, it sounds like it's an immigration issue. You know, highest number of people identified are from the UK. So it's not just people coming from abroad. But you've got an independent case.
Dr Rupy: I think that's a really important part of the conversation because I think perhaps most people listening are thinking, okay, well, this is far away. You know, this is happening in countries where they don't have as many regulations, perhaps in war-torn countries or parts of Europe where they don't have regulations. This is happening in our own backyard.
Dr Rosie Riley: Yes. And one of the things that I, I usually start when I'm talking to say, um, directors of medical education who are thinking about getting this training for their trainees is the first story I tell is of a patient I saw called Joe. I've changed the name, who was actually disruptive, rude, he was causing a right ruckus, he was intoxicated and the nurses were like, please can we just boot him out because he was being a pain. And I went and spoke to him and he was, he was all tough and just like, why am I here? And oh, I've got pain here and it was, he was really challenging. I was really pulling on the like deepest part of patience here. But after a while, I asked him what he did for work and he was say, and he so stopped and slowed and everything kind of took it down and, and I, he told me he'd just left his work, he worked in a kitchen. And then I was like, did you get paid when you worked there? Which is an unusual question, but a really easy one that I usually ask after. And he, he said he'd worked there for months. He was forced to sleep on the premises. He wasn't allowed to leave. He never got paid for the work that he did. He worked constantly. He had to sleep on the floor. He was beaten up occasionally by the owner and he's just run away. And now he's homeless. So I, that is how trauma can present in someone, you know, fight, flight or freeze. These are self-protection strategies people take on to push you away because why would I trust you? I've only been abused by anyone. So, um, I thought that was a really interesting story. And there was a, there was a report that's recently come out looking at rough sleepers in London and of the 9,000 rough sleepers in this report, one in 10 had experienced modern slavery. So we all see homeless people constantly. So this is everyone, everyone's coming in contact with people who have been exploited. And I, I presented that to Catherine Henderson at the Royal College of Emergency Medicine and she came up to me at the end and she said, I've seen thousands of Joes and I've never once thought of modern slavery.
Dr Rupy: Yeah. As you were telling me the story, the number of people that I'm flashing back to in the last month that I've been in contact with over the A&E, I never think to think of that question, did you get paid? What do you, what do you do for a living now? Or are you free to leave your job if you wanted to?
Dr Rosie Riley: 100%.
Dr Rupy: And we, we deal with a lot of, especially in A&E, we deal with a lot of aggressive patients that we just assume are aggressive people and they are unreasonable. But actually, like you were saying, you have to dig really deep to find that empathy and compassion to figure out exactly why this certain person is reacting this way. Human beings are, naturally, I'm a firm believer that human beings are moral and naturally kind. There has to be something really, really traumatous for someone to behave in that manner in an environment where you're actually, you know, dealing with people who are who are employed to look after you.
Dr Rosie Riley: Yeah. I think it also works in that, um, you know, often traffickers use lots of different control mechanisms and one of the things they can say is, you know, the authorities will deport you, they'll imprison you, they won't listen, they won't believe you. The lawyers are in our pockets, we pay the lawyers. So, um, why would they trust me? And so actually, if I'm trying to coerce and get as much information about their trauma as I possibly can, then from their point of view, I'm just coercing them like their traffickers do. So I'm actually, I've got an opportunity to kind of challenge that and in the sense of like, no, this is your, this is your space and I'm not going to try and make you do anything you don't want to do. And also, one of the things is not seeing everyone as a victim of trafficking. You're not going to know what abuse someone has seen most of the time. Someone's sitting in front of you and you're, you've got a bit of a gut instinct or you're kind of concerned about the dynamic between the two people in front of you. I'm not necessarily going to uncover this person has been trafficked for sexual exploitation or farming. But I'm going to get this person out of the room. I'm going to give this person a bit of time. I'm going to let them know that whatever they say to me is confidential unless I'm concerned about their safety or if they're a child. And then I'm going to get a translator, an independent translator, and I'm going to change my body language and ask them, do you feel safe? Does anyone make you do anything you don't want to? I'm going to meet their medical needs as much as I possibly can because if I'm worried someone's trafficked, then it's highly likely that they're not going to necessarily come back. If someone's got, you know, early pregnancy vaginal bleeding and I'm worried it's a miscarriage, where normally if, you know, they're stable, then you can send them to the early pregnancy unit the next day. I might get the obstetrics reg down to scan them now because at the end of the day, I don't know it's something more dangerous like an ectopic. I'm going to give them the antibiotics into their hand now because I don't trust that they'll go away with their, you know, prescription form and go and get it from the pharmacy.
Dr Rupy: It's the small things that you can do as a medic that actually maintain the continuity of care because like you said, if you can't guarantee that someone's going to fulfill that prescription or come back for the EPAU, then, you know, you have to change your practice. And that's, I mean, I'm just such a big fan of what you do with Vita and I think it's so necessary and I, I feel very ignorant to the the wider world and the fact that we actually have huge responsibilities as medical practitioners to be aware of this and how this spans beyond medicine as well and actually goes into the consumer sort of field because that's only that's how we're going to have change in the UK.
Dr Rosie Riley: But I imagine, you know, you do these things and most of the doctors I know are kind and they're empowering their patients. It's just there are extra, it's adding to the skills I already have. And phrases and sometimes often people don't feel confident with things like getting someone out of the room because, you know, if they say, actually, I'd rather stay here, then what do you do? It's a bit awkward.
Dr Rupy: Yeah, exactly. It's like how I used to practice taking sexual health histories. And the way I practice, you literally have to practice it, right?
Dr Rosie Riley: You have to practice. Yeah.
Dr Rupy: And I feel like I was lucky to work in Brighton where we had like one of the best run GUM clinics in the UK and one of the most busy as well. And that's what, it was like baptism of fire. You just had to get on with it. And now, like using that experience of asking these super awkward questions, you know, you can take histories and you can be a lot more sort of comforting and, you know, the vernacular completely changes.
Dr Rosie Riley: Yeah, yeah. A lot of it is confidence. Absolutely. But I find that what we are trained to do at the moment is not, there's a huge amount of just between knowledge and informing safeguarding lead. And I'm even seeing new training that's coming out, safeguarding training this, safeguarding training this. And I look at the learning outcomes and it's all background knowledge, inform your safeguarding lead. I mean, there is quite a hefty amount that happens in between that. And there's a massive impact of being a person, a professional person who someone discloses, you know, some form of abuse to, the impact that can have if you, you go, actually, this is a very important moment for that person. I must validate them. You know, this is really brave of you to tell me. Thank you for telling me. Because the courage that it must take to break some of the layers of their fear and coercion to tell you something like that. And if you miss it, you miss it. So it's more important our, in our manner to mark those occasions and be like, thank you for telling me that. That was so brave. For any form of abuse. And we learned that a little bit for domestic, domestic abuse as well. Validation is so essential. And it's just a little thing that will make them go, and I've seen people's shoulders drop as soon as I validate what they've just said. They're like, oh, like because they're terrified they've done the wrong thing.
Dr Rupy: Yeah, yeah. I think as medics, we love process, we love an algorithm, we love, okay, if this happens, this is what I do. Whereas actually, there is that human connection that we as healthcare practitioners should be pretty fluent with, but there are little things that you just said there, validation, you know, the way you communicate with someone, the way you get other people out of the room, for example. Those small things really, really do help in terms of, you know, ultimately helping ameliorate the situation for that person.
Dr Rosie Riley: Yeah, absolutely.
Dr Rupy: With Vita, you've already told me about your sort of plans to roll out across the UK. The training, yeah. Exactly. What, what does the ideal scenario look like for Vita in terms of your mission over the next five years?
Dr Rosie Riley: That's a good question. I think, taking us, before answering that, I think just to help picture what Vita is in its essence, it's not just a training program. So training is one of the prongs of our approach. The other two are research and advocacy. So myself and my colleagues are, the expertise we speak to the Home Office, we speak to the NHS, we speak to the Independent Anti-Slavery Commissioner and until recently, the World Health Organisation. So we advise from, you know, policy from the top-down approach and then research, we're really passionate about everything being evidence-based. You know, what we're doing, what we're teaching, what we're telling organisations to do needs to be evidence-based. So my ideal is to see, I think Vita is filling the gap for the health voice in this world. You know, there's a lot of emphasis on the immigration and the legal and the criminal justice aspect, which is always how it's been talked about. And yes, that's always the most important thing to get a nation on board with. I think the next thing is looking at health, prioritising the health and also the public health approach. So I think to answer your question, I'd like to see the training delivered, the right training delivered to the right level and the right roles. So junior doctors receiving training that's appropriate for their level. But then actually, we want, we're looking to develop a training that's specifically for safeguarding leads, people who'll be receiving the training, sorry, receiving referrals from people like me on the shop floor. And then also, I want to see what we are looking into research-wise and advising being taken on board into the recovery process. So once people are identified and safeguarded, they can, they can have a health approach to their recovery, a health focus to their recovery. I'd love to see medical specialists who who understand trauma, how how trauma rewires your brain, rewires your physiology, like working with people when they're in the crisis and then through their recovery. I don't know if that's five years, that might be much longer than that, but I think maybe five years, I think we're focusing on rolling out the training at the right sort of stages.
Dr Rupy: Yeah, I love the ambition with particularly the research element, looking at rewiring the brains because we know, as you said earlier, you know, our brains are still developing up to the age of 25. And there's also, we're a lot more that we're learning about neuroplasticity even at later ages and actually how deep-seated trauma can present itself and manifest in lots of different ways. And, you know, that as a mechanism for addictive behaviours, substance misuse, as well as, you know, lack of connection and communication among their own society. So I think that's absolutely critical. And I think, you know, it expands beyond modern slavery in a sense as well. There's, there's so many things that we need to be paying more attention to, but because it's quite, it's not, I don't want to disrespect it by saying it's a fluffy subject, but it's not tangible to those in powerful positions who want to see, you know, data and actually, you know, specific changes over a four-year political cycle. But yeah.
Dr Rosie Riley: Well, I think also that reactively, everything's done on a reaction basis of like, right, let's try and reduce the harm of that, reduce the harm of that. And actually, it needs much more of an upstream approach. You need to look at the determinants that lead people into a situation of vulnerability where they're likely to be exploited. And that's, you know, going to have massively more powerful impact than, you know, once it's started or once it's finished and recovery.
Dr Rupy: Yeah. And for, for those who are listening who are outside of the medical community, what sort of advice or resources would you suggest that people go and check out and actually tangible things that they can do today to actually become a more of a conscious consumer?
Dr Rosie Riley: I think that, well, because we're, we're talking about food, the good shopping guide is a good resource. If you are a business person, you run a business, there's so much you could do with that. I think contacting the Slave Free Alliance through Hope for Justice to look at your supply chains and making sure you are deeply embedding human being value in your organisation. We're NHS England clinical entrepreneurs. You know, we've got our colleagues, our cohort are setting up new tech firms. Look at what your supply chain, where are you getting your metals for your tech gizmos? Where are you getting your, I mean, I don't speak tech. We're both like, I don't really understand what anyone else is talking about. But, you know, they're starting new companies. So getting these things in early, like prioritising the like human beings early, rather than going, oh, well, we've subcontracted out four levels down. So now we're a little bit like, well, we can't really do much about that.
Dr Rupy: Yeah, you need to get those processes in early. Yeah, absolutely. Because if it's not front of mind, it will fall by the wayside and it won't be a priority later on.
Dr Rosie Riley: One of the things that actually is a priority for me within Vita and actually the organisation and hopefully which will grow and more employees and things is, is prioritising that within the organisation, like the workers' health and well-being of ourselves. And that's partly what I think we all need to learn in the NHS. You know, we, we, we put on a pedestal those consultants that stay in until like midnight every day and come in at the first in the morning. Like actually that, that's not what I want to be like. The people, you know, that's, they've sacrificed themselves for the system. And yes, it looks all good because they get the gold stars, but actually like that's not a healthy person in my opinion. You know, you're, you're worthy of like freedom. I was walking my dog yesterday and I was like really stressed out. I've got emails, I've got, you know, Vita's becoming a thing and it's all kind of churning. And then I was like, I'm free to walk through a field, like and just be in the moment and walk through a field. That's amazing. And just feel like little things, just being like really grateful, really looking to what freedom looks like in your life, freedom and health and well-being of a workforce. Put that in your business early.
