Woman's Hour - Womb transplants; Goblin Market; Leslie Kern

Episode Date: July 9, 2020

One in 5,000 women are born without a womb and many may have to have it removed because of cancer or other conditions. In the past decade there’ve been significant advancements in the development of human uterine transplants – with 56 having taken place world wide – though none have yet been carried out in the UK. Jenni talks to Mr Richard Smith, clinical lead at the charity Womb Transplant UK about the progress we’re making in this country and to Dr Gulzaar Barn, Lecturer in Philosophy at the New College of the Humanities in London, about her concerns about the global market and the protection of vulnerable young women in countries where regulations and protections may not be as stringent as in the UK.We already know that many everyday objects and medicines are not designed with women in mind, but what about our cities? Author of Feminist City Leslie Kern joins Jenni to talk about what an inclusive city might look like: one that puts friendship, pushchairs and more public toilets above skyscrapers and statues. Leslie is Associate Professor of Geography and Environment and Director of Women’s and Gender Studies at Mount Allison University, Canada.A new dramatization of the poem Goblin Market will be broadcast this Saturday 11 July on Radio 4. Woven into the recording are the testimonies of sisters whose real lives have been caught up in cycles of addiction. We hear from one of the pairs of sisters - Georgie and Sam Adams. Sam spent five years on heroin and spice and ended up homeless in Wrexham in Wales, but she has since recovered. Georgie has been working with health professionals and rehabilitation services to find a new model of helping people in Wrexham. She joins Jenni to discuss the effects of long term addiction on families, along with Chris Bermingham, a Service Manager from the charity We Are With You (formerly AdAction) in East Ayrshire in Scotland.Presented by Jenni Murray Produced by Sarah Crawley Interviewed guest: Richard Smith Interviewed guest: Gulzaar Barn Interviewed guest: Leslie Kern Interviewed guest: Georgie Adams Interviewed guest: Chris Bermingham

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BBC Sounds. Music, radio, podcasts. Hello, Jenny Murray welcoming you to the Woman's Hour podcast for Thursday 9th July. Good morning. In today's programme, what might a city be like if it were designed with women in mind? Lesley Kern is the author of Feminist City, Claiming Space in a Man-Made World. And a new dramatisation of Christina Rossetti's poem about sisterhood, sexual awaking and addiction, Goblin Market. We'll hear some of the poem and the voices of some contemporary sisters who are woven into the Radio 4 version, which will be broadcast on Saturday afternoon. One in every 5,000 women is born without a womb. Others may have had to have a hysterectomy because of uterine cancer or other conditions.

It means, of course, that it's impossible to conceive and nurture a foetus. Well, in the past decade, there have been significant advancements in human uterine transplants, some using a womb from a live donor, others donated like hearts or kidneys after death. 56 such transplants are known to have taken place worldwide, but none, as yet, has been carried out in the UK. What are the ethical concerns surrounding such practices, and how soon might they take place in this country? Well, Dr Gulzaban is a lecturer in philosophy at the New College of the Humanities in London.

Mr Richard Smith is clinical lead at the charity Womb Transplant UK. I spoke to them earlier this morning. How long would Richard say it will be before uterine transplants are carried out in the UK? That's a very interesting question. We were actually ready to go and our rota for brain dead donation transplant went live in January of this year and we were teed up to do a live donor transplant in March and then of course the COVID-19 pandemic came and the rota was obviously called off and the procedure which was planned in March for live donation was was also closed off. It's really all dependent upon what happens with the COVID-19 pandemic now. We have all permissions are in place

for both our trial for brain dead donor and for live donor transplants and we're completely now and rightly in the hands of NHSBT as to when they think it's appropriate for us to recommence. Which women might be likely to benefit from your work?

Because I understand not every woman who might not have her own uterus might benefit. So the principal group who are looking to benefit from this procedure are women with a condition called Myel-orokitansky-Hauser syndrome and those are women who've been born without a womb and there are somewhere in the region of four to five thousand women in the UK in that category. There are also obviously other women who have lost their uterus maybe they had a hemorrhage and had to have a hysterectomy or they had a cancer and had to have a hysterectomy. But on our list at the moment, the vast majority of people are actually women with Myer-Rokitansky syndrome.

How does it work for a woman who wants to conceive? Will she have functioning ovaries as part of the transplant? So our current criteria are that, in fact, you have to have a number of embryos stored. And the current criteria for the trial are that those are made from one's own eggs. So the women who are in our first group certainly are all people who've got their own ovaries. Women who've got myocardial cancer syndrome all do have their own ovaries. The thing that they're missing is their uterus.

Now you say you have permission to carry out operations from live donors as opposed to necessarily using a womb from someone who's donated it after death what's the benefit for the recipient of a live donor a lot of it's actually down specifically to the logistics so if it's a live donor and our the group of people we've got who are looking for live donation are actually all mother-daughter pairs. So it's mothers looking to donate to their daughters. And of course, you've got a procedure which you can plan, whereby both the donor and the recipient come into the hospital on a day and the following day or that day, they get their procedure procedure the mother has her uterus retrieved once the uterus is shown to be appropriate at the back table stage then

the recipient is opened and prepared and then the uterus transplanted whereas with the brain dead donor setup obviously that all happens It's quite a scramble. And in fact, in the first three months of this year, the team were scrambled three times to do brain dead donor transplants. But on each occasion, in fact, no retrieval took place. How do you ensure a live donor hasn't been coerced into what is a very serious operation? Oh, absolutely. So there's a huge process that the people who come to us go through

which involves multiple psychological assessments as well as medical assessments. So it's exactly the same processes that go on for other life donation procedures, for instance kidney transplant. So it's extremely long and involved. Cool. From what Richard says, regulation in the UK is very strict but what concerns do you have about the ethics maybe in other parts of the world? Yeah so it seems that there are robust guidelines and procedures in place here but we know that in other countries which have more deregulated industries in assisted reproduction, that clinics are actually able to operate in more

exploitative ways. So for example, we know that the surrogacy industry in India was able to operate in quite an exploitative way because the women who typically chose to become surrogates were quite vulnerable, poor, uneducated, brokers were actually used to recruit them and so these factors despite surrogacy now being outlawed remain in place which could make a market in Utrecht prime to develop. Now what's your response Richard to the idea of a womb fertility industry or a market as schools are put it? I think really quite abhorrent to be honest that's not where we should be going at all and I mean the people who we're seeing it's all entirely altruistic and what's also fascinating is I mean we've been inundated with women saying

that they would like to donate their uteruses to our programme. So people wishing to be live donors, but we've never had anybody coming forward looking for money for that. Everybody wishing to do it altruistically. And I would draw a very clear distinction between those two things. Gulzar, how reassured are you by what Richard says? Yeah, that is reassuring that it would never happen here in the UK. But because of the kind of globalised nature of the world that we live in, we know that if an industry did develop elsewhere,

as it has done in places like India, Thailand, Ukraine, Britons can actually go there and use those services. So we actually need to have more of a joined-up model of regulation. We talk about altruism, but there is a tremendous amount of pressure on women to have a baby. How convinced are you, Gulzar, that this is always altruistic and no one is saying, oh, you really ought to have a baby and, oh, your mum really could actually give you her womb? Well, precisely. I think even in the case of altruistic donation, informed consent is really still really tricky to obtain. It's still a tricky issue because we need to consider, you know,

where is this uterus coming from? Will it be coming from a close family member, a close friend? Could there be an element of pressure there, compulsion there? Mothers would do anything for their daughters. And also there are very distinct risks associated with uterus donation that mean that informed consent actually needs to be at a higher standard. So we know from the consequences of menopause, the consequences of hysterectomies, that there are huge risks and long-term harms typically associated or can be associated with this kind of donation.

So, for example, early menopause, loss of psychosexual functioning, urinary problems because you lose the support of your uterus. So all of these factors need to be considered and they're still really relevant, even if someone is altruistically donating their uterus. Rachel, we've heard a lot this week about the review carried out by Baroness Cumberledge and concerns that women's health problems are often ignored or dismissed. What worries has her report prompted in you putting forward this very complex procedure? See, I would actually take it the opposite way around.

I would say that our project in some ways epitomises the difficulties for women suffering from absolute uterine factor infertility. When I say exemplified, we've taken a very, very long time to get to the place that we're at because we've been so so keen to make sure that we've ticked all the boxes and done this absolutely correctly and you even get this sort of discrepancy gender discrepancy coming and i would have said probably in terms of being able to achieve funding and as you know we've always been charitably funded and it's actually very difficult for us to raise money and that's an ongoing issue

and it has been for the whole of the project. How successful, Richard, is this procedure in terms of live births? Oh, the answer to that is very. There are now more than 70 live donor procedures resulting in more than 20 births, and there are more than 10 deep brain-dead procedures resulting at the moment in three births, which is why the Brain Dead Project is very much a clinical trial

between the University of Oxford and Imperial College. Why is the uterus removed after successful pregnancy? So it's usually, in fact, after two pregnancies, and that's to minimise the length of time that the women will have immunosuppressive therapy. Because the longer you're on immunosuppressive therapy, the more likely you are to get infections and also it increases the risks of cancer.

But by doing it this way, the embryos are put into the uterus six months post-transplant, nine months later you have a baby, a year after that, another embryo transfer, nine months after that, next baby, assuming you want two babies, and then a few months after that, the womb comes back out. So it's relatively short exposure to immunosuppression. Now, it is a costly procedure. As you say, you've only done it on charitable funding so far, but I think £30,000 is the cost of the procedure.

How likely is it to happen ever on the NHS? So from the point of view of the brain-dead donor, we've already applied to NHS England with a view to funding cases, and that process is running in tandem with our trial. It's really important, I think, to remember that if you look at the number of potential uteruses that would be available in the UK, in a DBD setting, there's probably going to be somewhere between 10 and 20 per annum. And that's the number of transplants in a DBD setting one would be talking about.

So it's relatively small numbers. So just explain what's a DBD setting. Brain dead donor. Apologies, apologies. So brain dead donor program, which ties in with all the other organ retrievals, which the vital organ retrievals that go on for heart and lungs and liver. If you actually look at the number of women who fulfill the category in to donate,

then it's actually, you come down to this relatively small number of probably somewhere between 10 and 20 organs per annum. Gulzar, should it be available on the NHS? Oh, gosh, well, I mean, that's something that would need to be weighed. The harms and the benefits and the cost-benefit calculation would need to be appropriately weighed by the policy experts. But I do really kind of question the kind of very fundamental need and yearning and insecurity that this kind of transplant does seem to tap into. And I wonder whether there are other things that we could do as a culture rather than medicalising it or intervening medically to address this issue of childlessness. So I think there still exists a very strong norm, a societal norm to have one's

own genetically related children. And we have these norms surrounding the nuclear family unit. But I wonder whether there are other things that we could do as a society to kind of address these issues. What sort of things? Well, I guess showing, depicting other kinds of families as normal, other kinship models, being more communitarian, and trying to move away from this rigid idea of the nuclear family and this kind of individualistic atomized nature of the family. I was talking to Dr Gulzar Ban and Mr Richard Smith. And we would like to hear from you on this question. If you have this problem and you would be willing or prepared to go ahead with this kind of surgery, we'd love to hear from you.

You can send us a tweet or, of course, you can send an email. And by the way, Gulzar is one of the 100 new generation thinkers, academics who use their research to make talks for the radio. There's a link on our website for more information about how to join that list and applications are now being accepted for 2021. Now as I said we've heard a great deal recently about how little of the world has women in mind. Everyday objects are rarely designed for us and medical researchers often concentrated only on men. So what about the cities in which we live, work and raise our children? For years, I complained about how unfriendly public transport was to a woman with a buggy

and how you couldn't find a public toilet to save your life. Well, Leslie Kern is Associate Professor of Geography and Environment and Director of Women's and Gender Studies at Mount Allison University in Canada. She's the author of Feminist City, Claiming Space in a Man-Made World. Leslie, what would you say essentially is wrong with the way cities serve women now? Good morning. Thank you for the question. Cities have been set up with a fairly narrow ideal of who the typical citizen is, who is the typical user of things like public transportation that you just mentioned.

And women's work in cities, women's movement through cities and women's safety in cities have typically been afterthoughts to urban design, urban planning and architecture. What made you feel this personally? Well, like you, when I became a mom and I was living in London at that time, I suddenly realized that the city was, it felt like it was out to get me. All of the things that I had really taken for granted about being able to do in my day-to-day life as an able-bodied person moving through the city, it was suddenly the city was saying to me, nope, you can't go here. You're not going to be able to live your life the way that you want to. And really, maybe it would be better if you just stayed home.

Now, public transport, I have to say, has improved since I struggled and presumably you struggled. There are more spaces for buggies now. How much of an improvement has that been? I agree there's been an improvement and I think gradually as public transportation systems take all levels of accessibility more seriously, so elevators and buses that lower down that you can roll onto are really important. But often we're kind of forced to compete in terms of our needs. If you have a person with a disability using a wheelchair, elderly people, people with their shopping and people with strollers and young children, the few spaces that of a problem in Canada than it would be in England. And you say there's a male-centric planning in the removal of snow from city streets. Now, what do you mean by that? Sure. Well, typically the kind of snow plowing plan for cities involves clearing the major freeways that lead from suburban or residential areas into the central business district to facilitate the travel of your driver, your driver of your car. And sure, snow is not discriminating. But what this means is that we're prioritizing a particular user of the city in a

particular city function. So some cities like Stockholm, for example, and now in Canada, Ottawa are trying to do more of a gender equal snow plan, snow plow plan, where they plow residential areas, they look at sidewalks and public transit areas and bike lanes because they want to encourage walkability, the use of bikes and public transport and to get everybody moving in the city, not just those with cars. Why do you quote Vienna as a good example? city that has really taken on what we call gender mainstreaming, which is the idea that all of your city's policies, plans, developments, and budgets are kind of run through a gender equity lens. Like, will this new development bus lane, school zone, increase gender equity or not? And Vienna has really taken that on by surveying people in the city, finding out what their needs are, and developing spaces that kind of link up these different areas of the city, finding out what their needs are and developing spaces

that kind of link up these different areas of the city in ways that are more convenient for women and others as well. Why would you say the city is so often seen as a frightening place for women? Well, women are socialized from the time of being little girls into fear of stranger danger, the fear of the dark alley, the fear of the public park or public spaces. And as we grow up, we have internalized these messages. We see stories sensationalized in the media and in popular culture. And of course, on a pretty regular basis in our daily lives, we might also experience street harassment, which some people think isn't a big deal, but it really adds up over time. And again, is this message being sent to you like, you don't belong here. And at any moment, you can be stopped, interrupted and made to feel uncomfortable and unwelcome. How would you suggest safety can best be improved?

Sure. So there's a complex kind of mix of design elements that can help to improve things, but also we need broader cultural shifts. So of course, cities in many places have taken on projects like improving lighting or making sure that public transportation systems have ways for people to women's attention or that women should be responsible for our own safety in public spaces and recognize that everybody has the right to the city. Why do you believe that gentrification has caused problems? Well, it's interesting because gentrification can be seen, you know, this movement back into the city can be a way for some women to sort of solve some of the problems of having to juggle paid work life, unpaid work

in the home, child care, family, and so on, because things are closer together in the city. But increasingly, because so many central cities are so expensive to live in, only very affluent, privileged women can really be enjoying those benefits. And so many other people, women included, are being pushed into less well-serviced areas, areas that are less walkable, less safe, and have less of those services that could make city life so great for women. You do argue in the book that female friendship should be the basis for any future urban planning. What exactly do you mean by that? Well, I mean to use friendship as an example of a kind of kinship relationship that would allow us to expand our view of how people can live together as communities and as families and households in the city. Because for so long, we've really been focused on just a traditional sort of nuclear family model.

That's the kind of housing we build. That's the sort of family we assume uses the city. But if we start with friendship and not just stop at friendship, but think about all sorts of other familial kinship and collective care relationships that we could have, we could perhaps start to imagine ways of sharing the care work that goes on in cities in different ways and new economic relationships as well. How realistic is it, though, to think that such changes can be made when certainly in this country local authority budgets have been reduced and regeneration tends to fall to private developers? Yes of course and I don't recommend that we bulldoze the cities that we have and try to rebuild them in a new feminist vision but what I think we can see is that there are opportunities for doing things differently.

And in this kind of COVID pandemic moment, we're seeing some of these things that can happen when the will and the need is there. So cities are repurposing public spaces to make them used in different ways and more accessible to different groups of people and hopefully safer as well. Cities are recognizing that actually a lot of the care work that's done in cities, the work of the essential worker, the hero worker, is feminized work, it's underpaid and undervalued, but it's essential to keeping the economy running and to keeping all of us safe and healthy. So without redesigning the city as a whole, there are ways that we could start to shift how we prioritise the work and the life of cities.

Lesley Kern, thank you very much indeed for joining us this morning. And I will just mention the title of the book again. It's Feminist City, Claiming Space in a Man-Made World. Thank you. Still to come in today's programme, a dramatisation of Christina Rossetti's Goblin Market for Radio 4, combined with the experiences of sisters who've been caught up in a cycle of addiction, and the penultimate episode

of the serial, Six Suspects. Now last week we spoke to avid gamers of all ages, women who do not conform to the stereotype of the teenage boy living in his bedroom glued to his console. Bridget and Liz from Lincolnshire are both in their mid-seventies. Sam from Leeds is fifty. I don't really understand why people sneer a little bit at the fact that you're a gamer. I always have been and probably always will be. A lot of people still think that we're a bit mad. That you're a bit mad. Yeah, because we're...

You're a bit eccentric. What on earth do you play those things for? Because they're good, they're entertaining. Enjoy it. Enjoy it. You do different things. do you play those things for us because they're good they're entertaining enjoy it enjoy it you do different things it uses your brain if you've got one of them or if you've got brain if you've got one but kids have a little bit of a brain to get out of some of the challenges don't you yeah how often do you get together to play? Whenever we can. Yeah, there's no set time. There's no set time.

It depends what game we've got. If we've got a new one... And we're both on it. ...then we're both into it. Which happened a lot earlier on. But we've digressed now. We'll go to each other's houses and play. Yeah, or Bridget's going, look, quick, quick, left, left, on the left, quick.

Where, where? I particularly enjoy playing games where there's a world to explore and it's quite an open, free, wandering-type world, or where I can be particularly creative. And maybe I don't get out of games what people traditionally think of games which is that you run around hectically shooting people live online I don't play that sort of games and there's such a massive range of games that I think perhaps when they are shocked that I'm a gamer it's because they're thinking of the gaming world as one particular thing

and it's not a lot of our friends look at us as if we're crackers. Yeah, and they say, get a life. Except Sue. I've got loads of lives, I'm a gamer. My friend Sue, she likes games, but she does The Sims and things like that. But apart from Sue, there's nobody else that we... of our age, rather, I said, they just don don't what do you play them for because it's good it relaxes me i can forget the outside world i think it's also good for your coordination going

to get all the buttons and everything no i love it i won't be without my games consoles bridget and liz were talking to Lotta Haig, and tomorrow Jane will be talking to women who are making a career in the gaming industry. Now, on Saturday afternoon, the Radio 4 drama will be a new version of Christina Rossetti's famous poem, Goblin Market. It's about sisterhood, sexual awakening and addiction. And it begins with

the goblin men calling out about the fruits they have to sell. Melons and oranges, plump, unpecked cherries. Melons and raspberries, bloomed and cheat peaches. Swat-headed mulberries, wild free-born cranberries. Crab apples, dewberries, pineapples, blackberries. Apricots, strawberries, all right together in summer weather. Morns that pass by fairies that fly come by come by

come by You may remember that the two sisters Laura and Lizzie react differently. Lizzie covers up her eyes but Laura is tempted and ends up parting with one of her red locks in exchange for the fruits the goblins are selling.

As a result, she becomes listless, ill, prematurely aged, and is brought to the verge of death. In the end, she is saved by her sister. Well, what makes this new dramatisation different is that woven into the poem are the testimonies of sisters whose real lives have been caught up in cycles of addiction. In this excerpt, Georgie Adams and her sister Sam, who spent 15 years on heroin and spice and ended up living rough for five years. They were in Wrexham in Wales. I can remember a point where I was in a white quilt by outside shoes, though, in Wrexham,

and my sister drove past in a car with the kids, and I can just remember seeing my sister's little and just looking at me in the car when I was, like, with a white quilt wrapped round me, thinking, oh, my God, do I wave? Don't I wave? What do I do? looking at me in the car when I was like with a white quilt wrapped around me thinking oh my god do I wave don't I wave what do I do that's that's a memory I'll always have in my head and the same as her I think that was like that touched her massively it was like you both clocked each other yeah we did there was no hiding that was the safest place for me to sleep because there was

I know there was lots of people going past but at least I would have been found if anything had happened to me. I used to miss her more than anything. I didn't sleep for five years, six years fully through the night. I literally didn't sleep. I used to just be, I'd go to sleep and wake up and then I'd just be thinking what you were doing and then I'd just toss and turn and obsess. I guess I watched her just drift away. Deteriorate. Deteriorate, yeah. And hide away. And lie and it was really difficult

but I think that was, but beyond everything, the hardest thing I've ever had to deal with was the lies was because we'd always been so close and we'd been so open and then she had to lie to me to keep me safe and, like, that was difficult. You wake up every morning, the first thing you want to do is go and score because initially it's a first thought.

But it's like the poisoned apple and it is like a poisoned apple. I think for me, seeing Sam on the streets was the most difficult and traumatic experience to witness. There were times that, you know, I saw people really taking advantage of her. You know, she'd be sort of in situations where she'd been beat up, left on the floor, and her purse was emptied,

and God knows what else had happened to her. You can't imagine. And she used to help me, didn't you? Yeah. Well, since she helped her sister, Georgie has been working with health professionals and rehab services trying to find the best way to help people through recovery she joins me now along with chris birmingham a service manager from the charity we are with you it used

to be called ad action and she's in east ayrshire in sc in Scotland. Georgie let me start with you, how did you convince Sam to go into detox and rehab in late 2018? Hi Jenny, well firstly I think it was really a combined effort and I think it always comes down to the individual and the context that they're in. And for Sam in particular, she was very vulnerable. She was in a very bad situation in an abusive relationship. And there was a time where her partner was actually in prison. And for me, that seemed like the best time to sort of interfere, if you like, because she was fully engageable.

How resistant was she, though, even though it was a period when you could talk to her on her own without anybody else being involved? So there was many periods of time over that 15 years where we got in touch with Women's Aid and we made plans for her to move on and things and unfortunately that addiction I think almost to her partner rather than the substance itself she kept on going back and putting herself into these volatile situations and trying to convince somebody who is totally and utterly lost it's really difficult. Chris obviously it can be very difficult to persuade someone to seek help why is it especially hard if they've been suffering from their addiction for a long time? I think that if people are involved with drug use for long periods of time, then, you know, as Georgie says, they become really vulnerable.

It can affect their mental health, and it can become more and more difficult to seek help. People often think there isn't help out there, which obviously there is but um they don't know people who are in recovery from addiction so they don't necessarily know that you know the treatment works and they can get help um and it's challenging for them to access services approach services is um so so if someone like georgie came to you chris and said look i need some help in broaching the question to my sister or my partner or whoever it is how would you help her broach that question i think for a lot of people they become quite emotional when they're talking to folks. So, you know, we talk to people about not being emotional, you know, trying to address things calmly and in a non-judgmental way,

talking about how they feel about things rather than what's happening with their loved one. So it's about how they feel about the situation. And I think just being non-judgmental, it can be really distressing being a family member. Sometimes we ask people to write letters, because that's easier if they can just write someone a letter, if they don't feel they can say what they would like to say. We also deliver interventions in a lot of our services,

a specific intervention called Community Reinforcement and Family Therapy, which helps people to motivate their family members to get help and also helps the family member to look at their own self-care, looking after themselves. Because, as I said, it can be really stressful. It can affect their mental health and their well-being. So, yeah. Can you remember, Georgie, what it was you actually said to Sam? What were the words you used?

Well, I think it wasn't so much the words I used. It was a very long period of time. In my opinion, especially where we live, our traditional model of the social care system doesn't accommodate a holistic approach to health and well-being. So there's no active link between all of the bodies involved. So it's really hard for an individual to navigate their way through the current system.

I mean, it's difficult for you or I to make our way through that system, let alone somebody who's homeless and addicted to substances. So it really is about a lot of people playing a key role and linking in together to get that one individual out of that circumstance. At the time, I actually shouted out a lot and highlighted what was going on. And luckily enough for my sister, it had a positive effect and people did rally together

and we managed to save her effectively and unfortunately as we talk about sisterhood one of her sisters if you like on the streets who was going through a very very similar journey because perhaps her story wasn't highlighted she she actually was found dead in a car park. How is Sam now, then? She is doing amazing. She really is the most inspirational person. She's a hero. And she basically went from detox into rehab,

and they put her into a nice little sleepy town. And now she's just got her own apartment literally at the end of our street she's now got her relationship back with her son and her family but you know her journey's not over yet and again when I talk about that we don't have this holistic approach to health and well-being that's exactly what I'm talking about you know we get people through recovery and then it's we close the door and that's not the end of anyone's journey and for anybody that you know as humans we go through cycles of life and we need to be able to have stage appropriate interventions for everybody i know georg, I know you've been working on a model in Wrexham of how things might be different. How does it work the way you want it to work?

So basically, sort of without going into too much detail, myself and my partner met a couple of years ago during an evening I hosted called A Night of Change. And from that moment, we've been looking at my sister, really, as a case study and other like-minded people and understanding sort of where the pitfalls are along the journey. And so what we've done is we've created a model based on Maslow's Hierarchy of Needs. And it's essentially connecting people to the to communal resources have you ever heard of what social prescribing is no okay so social prescribing is something that it's it's something that NHS England do but it's actually sort of all over the UK and essentially you know you go to see your GP if you're depressed ond mae'n ymwneud â phopeth arall y DU. Ac yn y bôn, rydych chi'n mynd i weld eich GP os ydych chi'n ddipresnus neu'n anghwysol,

ac yn y bôn, byddant yn eich prysgu gyda chyfnodau antidepreswm, ac ati. Felly, mae prysgu cymdeithasol yn golygu postio arwain cyffredinol. Byddant yn ceisio eich rhoi i mewn i rywun sy'n mynd i'ch helpu. Ac mae hynny'n effeithiol iawn mewn llawer o amgylcheddau, ond os edrychwch ar NHS England, byddant yn dweud i chi bod gweithio ar gynllunio cyffredinol yn gweithio'n gwell i bobl sy'n hyderus a'n ddigon sgiliau i ddod o hyd eu hunain drwy gwasanaethau ar ôl cyfrifiad bryd. Ac rwy'n meddwl ein bod angen i ni ddeall fel dynion, weithiau, ein bod angen ein llawdrinio ychydig. Felly rwy'n gweithio ynghyd â

rai o bobl eraill yng Nghymru sydd hefyd â fysg cyd-ddydol lle rydyn ni'n gweld So I'm working alongside a few other people in Wrexham who also have a like-minded vision where we see sort of connecting people is the way forward and understanding that communities and tribes are what make people thrive. coming shame and stigma which are so often attached to addiction and which I suspect affects the people close to the person who has the addiction as well as the person themselves? I think it's very important for people in their recovery journey to address that. That's something that we do on a daily basis with people. People are, you know, shameful about what they put their families through, you know, the activities that perhaps fund their drug use, wishing they'd been more present with their children. So these are things that we try to address in the early stages when people come to us and help them to develop coping strategies to

deal with this so that they can move on with their lives. Georgie how come you managed never to give up hope that Sam would get better? You know it's difficult to answer that question, but I really, really adored my sister. And as a child, I really looked up to her. She was this sort of really magical, fascinating creature that used to go off to all these wonderful parties and things and come back and tell me these stories. And it was really difficult to watch her go from that to the shell of a human. And I knew she was in there somewhere and I knew that I had to get her back. And so it was not a case of ever giving up. It was sort of always being alongside her, perhaps from a distance and sort of poking away in the background.

And, Georgia, we must make the point that Sam is fine with you talking about her in this way. She is. She's sat listening right now. Yeah, she is. We had to make that point. Say hi to Sam. Hi, Sam. I was talking to Georgie Adams and Chris Birmingham and, of course, saying hello to Sam. Vivian Evans, the chief executive of the organisation AdFam, emailed to say, Good to hear that stigma around addiction extends to families and friends. As a national organisation supporting these families, we're only too aware of this. And our research reveals that one in 10 people in the UK are affected in this way.

On gaming, at expert Fafa said, I've loved hearing about the women gamers, especially the older ladies. I have two sons who are big Xbox fans. So I tried Fortnite, but it's a bit too busy for me. Although I enjoyed the wild swimming and did a lot of hiding, but I was obsessed with Sims back in the late 90s. So much so, I swore I'd have to wait until I was retired before I signed up for it again. I shared an account with my BF, now husband, which he hated as I focused on coupling up with his guys. I think now I might be more interested in my career. On Leslie Kern and the feminist city, Maureen said in an email, there are many other gender frightening places than cities. Great palaces, castles, manor house and rural life are not necessarily woman friendly. Only privileged men and women occupied

these places. As a child, London was a place I could go to any time by train, tram and trolley bus, often to protest with my unemployed father. And Isla says, in 1990, I had two children under the age of three and used a double buggy. At the time in Nottingham, there was a large C&A which had six opening glass doors and stocked lots of lovely baby stuff, but there was no way I could enter the store. Wrote to the manager, suggesting at least one door was reversed to allow double door access, and it happened, together with a nice letter. Had the same issue with lifts in a shopping centre. But no joy there. And then on uterine transplants, Mrs Burt Bibby said,

Listening to this, despite being a big organ donor supporter, my instincts are screaming, Hell no! If my donor consent extends to my womb, I'd be opting out. Well, just to reassure you, there is no assumption that allows the removal of your womb. You would have to opt in if you were prepared to do it. Now, do join Jane tomorrow when she'll be discussing Olive Morris. This Sunday marks 41 years since her death. She was a prominent feminist and a civil rights campaigner in the 1970s. So who was she? And who are some of the other historic black British activists we should know more about? Join Jane tomorrow morning, just after 10, to find out. And from me, that's all for today.

Bye-bye. Hello, I'm Dr Hannah Fry. And I'm Dr Adam Rutherford. And we present the curious cases of Rutherford and Fry, that's me and her. Certainly do. And every week, what we do, we take a listener question, an everyday mystery, if you will, and we try and investigate it using the combined powers of science books and occasionally the internet sometimes we just look it up but anyway we are back with a new series that's investigating queries like why do our tummies rumble can we make it rain and what

exactly is the point of wasps what is the point of wasps it's the end bit the other end of their faces lols i was really pleased with that you can hear all the answers to these questions It's the end bit, the other end of their faces. LOLs. I was really pleased with that. You can hear all the answers to these questions and more by subscribing to The Curious Case of Rutherford and Fry on BBC Sounds. Or wherever you get your podcasts. I'm Sarah Trelevan, and for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies. I started, like, warning everybody.

Every doula that I know. It was fake. No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby.

It's a long story, settle in. Available now.