Medics on anti-violence crusade deliver stark message to Scots pupils

PLEASE, Sir" asked the second-year pupil in a Glasgow school, "is it safe to be stabbed in the bum?" It's fair to say that when David Koppel, a consultant craniofacial surgeon, agreed to give school lessons on violence, he didn't expect pupils to inquire as to which areas of the body permitted a "harmless" stabbing.

There are none, of course. With even the briefest flick of the blade comes the potential to nick an artery, consigning the victim to the mortuary and the perpetrator to prison.

While teachers can argue this fact until they turn blue, words and warnings carry extra weight when delivered by the men and women who struggle each day to save lives, stitch violent wounds and break the tragic news that a loved son or daughter is dead by the hands and knife of another.

So this autumn a battalion of 75 medics, from a wide range of disciplines, such as emergency medicine, anaesthetics, maxillofacial surgery, orthopaedics, psychiatry and plastic surgery are set to roll out across schools in the west of Scotland as part of the next phase of Medics Against Violence, an organisation founded by Dr Koppel and colleagues Dr Mark Devlin and Dr Christine Goodall, with the support of the National Violence Reduction Unit in Glasgow.

The first phase involved training volunteer doctors in the best way of communicating their warnings, and in this they were supported by Gerry McDonnell, a headteacher on secondment from the Scottish Government.

"This educational input has been vital in ensuring the input we make in the schools is both effective and fits in with the school curriculum," says Dr Koppel, who is based at the Southern General Hospital in Glasgow.

"As part of the programme, we are utilising questionnaires to assess the effectiveness of the intervention so that we can make modifications if necessary.

"So far, we have trained approximately 55 volunteers and some will be visiting schools before the end of this academic year; however, the programme will begin in earnest next academic year."

Dr Koppel says the aims of Medics Against Violence are twofold: "We are hoping the effects of our visits will be long-lasting and that even deflecting only a few kids from violence and gang involvement will be worthwhile. We are also confident that we will be able to teach some avoidance techniques to help young people prevent themselves becoming victims in difficult situations."

According to the violence reduction unit, about 70 per cent of young people will be largely unaffected by crime, while 5 per cent will have serious issues that will bring them to the attention of the police. The remaining 25 per cent are considered vulnerable to involvement in violence, whether as a victim or a perpetrator, and it is that 25 per cent that Medics Against Violence are anxious to help.

Dr Christine Goodall, an oral surgeon, is all too aware that life can change with one flash of a blade. When she thinks about knife crime, it conjures up the face of a young girl. "I remember one young woman I saw when I was a senior house officer," says Dr Goodall, taking time out from her day job as deputy lead clinician at Glasgow Dental School.

"She had been slashed across the face during an argument with her boyfriend and had the most horrific scar, which she was likely to have for life. I just remember her sitting in front of me sobbing her heart out while she tried to express how this injury had completely ruined her life. She didn't go out, she had lost her job, she just felt her life was over."

It is the human cost and the fact a moment of madness can trigger consequences that last a lifetime that the group is keen to instil in second-year pupils. "We realised that, in order to have some chance of preventing young people getting involved in violence, we had to address the problem early – it was no good waiting till we saw them in hospital after an injury," Dr Goodall says.

"We realised we should be talking to young people before they accepted that violence was an inevitable part of their lives. That's where 'Medics' came from.

"We thought perhaps if we could take the doctors out of the clinics and operating theatres and into schools to talk about the consequences of violence from their point of view, we might have some chance of helping some young people avoid injury."

The most common misconception about Medics Against Violence is that it attempts to frighten pupils away from swinging their fists or picking a knife by displaying gory photographs of the possible consequences of such actions. In fact, narrative has proven more effective than graphic pictures.

"Everyone assumes that, because we have a medical background, we will show loads of gory photos," says Dr Goodall. "That would have been the easy thing to do, but we made a conscious choice not to.

"Instead, we made a short film, which we use in schools to stimulate discussion with pupils, called Your Choice. The film features real-life testimony from people who have been directly affected by violence – a young offender who committed a murder at the age of 14, a mum whose son was murdered and a young man who was paralysed from the neck down by a random act of violence.

Dr Goodall continues: "We do have one or two gory photos in there, but all the pupils say it's the real-life stories that make the biggest impact on them. I think the people in the film make the point very well that involvement in violence, whether intentional or not, carries with it very serious consequences, and young people seem to identify with these stories.

"We've had a very positive response to it so far. The other point about gory photos is many young people are almost desensitised to images of violence because of all the violence they see on TV and in computer games; therefore the impact of those sorts of images is less than you might expect."