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I was asked to contribute this blog to help illustrate how varied the life of a medical professional can be. My career has combined my clinical knowledge with community development, so ensuring a holistic approach to the public’s health.
My career began studying medicine in Manchester. I undertook early housejobs in the area maintaining a strong attachment to north Wales, travelling there most weekends to visit family. In 1970, whilst doing a post-graduate degree in Oncology, I saw an advert for a GP post in the rural and predominantly Welsh-speaking village of Llanaelhaearn on the Llŷn peninsula.
I became the area’s only doctor, serving 1,200 patients. It was here that my first-hand experience of rural deprivation formulated my thinking on the relationship between the environment and health and what are now known as the wider determinants of health.
The importance of empowering our communities was first brought home to me when I saw the impact of economic decline on morale and the health of the population as the former granite quarries closed one at a time. Llanaelhaearn and district lost a third of its population in the post-War period with a significant impact on the well-being of the people, manifested in significantly increased morbidity.
A high prevalence of hypertension, diabetes and depression followed and in an attempt to address this, I successfully led the development of the first community cooperative in the UK, Antur Aelhaearn, which celebrated its 40th anniversary in 2014.
Forty years on, the villagers have built their own factory creating employment continuously in the intervening period; converted the chapel vestry into a community centre; established a village eisteddfod; developed a playing field for the children and the school, initially threatened with closure, remains an important part of the community.
In 2014, I was awarded the Alumni Medal for Social Responsibility by the University of Manchester for my work in the Llŷn peninsula.
I am also a passionate advocate of Welsh language and heritage, founding Ymddiriedolaeth Nant Gwrtheyrn (Nant Gwrtheyrn Trust) in 1978 and led the creation of the National Centre for Language and Heritage in the abandoned quarrying village of Porth y Nant on the Llŷn peninsula, where we now employ 33 people and an estimated 30,000 people have gained a taste of, or learned the Welsh language. These features all combine to re-empower the community of Bro`r Eifl. My belief is that with an empowered community, individuals are also empowered and these wider determinants can have a lasting impact on important health indices.
Additionally, I have been involved in a number of international public health projects throughout my medical career, including the NGO Medical Emergency Relief International’s (MERLIN) Tuberculosis programme in Tomsk, Siberia and the restructuring of primary care services in Cambodia with French children’s charity Enfants et Développment. I also initiated and became the first Chair of Dolen Cymru, the unique twinning of two countries - Wales and Lesotho – and was awarded an Honorary Fellowship of the RCGP for this work in 2015. I am now the Honorary Consul for Lesotho in Wales.
In a varied career, I have undertaken roles as a public health consultant in Gwynedd and Medical Director for Powys. In 2010, I was appointed as a Non-Executive Director of Public Health Wales to represent the interests of the third sector.
Most recently, I have published my autobiography Super Furries, Prins Seeiso, Miss Siberia – a Fi which provided me with an opportunity second-to-none to reflect on the relationship between a community`s well-being and health. Practice may have been demanding, even hard at times but, at a time where there are difficulties recruiting particularly to rural areas, it`s worth mentioning it gave me an experience I wouldn`t have missed and it gave me an excellent basis and understanding for everything I did in my subsequent career.
I believe it is important that as clinicians we champion the importance of public health and engage in supporting communities challenging the socio-economic causes of ill health. My career in medicine has been, and continues to be, varied in focus and never fails to inspire new challenges for me.
Dr Carl Iwan Clowes OBE is the Public Health Wales Non-Executive Director
An excellent summary of a rewarding, selfless and committed professional life. An inspirational dedication to empower communities and individuals and to tackle health inequities in disadvantaged populations.