Introduction

This chapter draws on the authors’ experiences during the period 1998-2001 (Moran et al, 2002) when they developed a participatory research project (Nichter, 1984; Maguire, 1987; Whyte, 1991; Burkey, 1993; Chambers et al, 1996; Nieuwenhuys,1997; Smith et al, 1997) in Manchester, England with people from Somalia recently arrived as refugees fleeing war. It begins by setting out a brief historical background to the situation in Somalia, then describes how members of Manchester's Somali community and academic researchers together developed their methods for finding out about – and improving – health (De Koning and Martin, 1996) among Somalis in Manchester.

After drawing some connections between a theory about ‘language creation from below’ (Volosinov, 1986) and community participation research processes where lay and researcher knowledge are respected as different and equal (Moran and Butler, 2001), the chapter describes and explains the process of evidence base development that began deep inside the Somali community with religious elders before moving out into the wider Somali community. It presents and discusses an early empirical example from the study that demonstrates how women from Somalia who are living in Britain are experiencing – and overcoming – barriers to their health needs within the primary care system, through creative interactions with healthcare practitioners. With the agency that is represented by one of the Somali women mentioned above as its starting point, the chapter analyses how our research approach has created a qualitative and quantitative dataset that is being incorporated into contemporary participatory action research protocol. It concludes by discussing the potential within this research approach for experiencing equality between academic and community-based researchers and community members.

Coming from Somalia

Somalia is on the east coast of Africa. It has a very low population density and is an extremely poor country with an average life expectancy at birth of 48 years compared with 78 in the UK; its infant mortality rate is 133/1,000, compared with 5/1,000 in the UK; its under-five mortality rate is 225/1,000, compared with 6/1,000 in the UK; only 29% of the population are using improved water sources; and only 25% are using adequate sanitation (Bellamy, 2004). It has a predominantly rural economy and the main religion is Sunni Muslim.