Salim’s Story

Utopian Realist, Ex-mill town boy done good!

The best way to understand someone’s vision and values, is to understand their personal and professional journey. Here, I focus mostly on my professional journey with a dash of the personal. Ten years in, I am changing the focus of Public Health by Design and I want old and new clients to understand where I’ve come from, and where I am going as the Founder of Public Health by Design.

I was born in Kampala, Uganda and came over to Preston. Lancashire, via London, as an Overseas British Citizen, when I was 4 years old. When Idi Amin, asked all Asians to leave Uganda. I lived on a cobbled terraced street, the ones you see in old movies about the Lancashire cotton mills and the industrial revolution. I loved those cobbles and that street! There were hardly any cars and you could play freely outside, just making sure not to hit your ball against a neighbour’s, or your own, front window! The street was a wide and long, cobbled, playground. I loved, and still do love, Preston, especially its brilliant Harris Library and Museum and its big bus station!

Going to Medical School in Leicester, was one of the major turning points in my life. It showed me how to develop sensitive, respectful and caring relationships with other people who put their health, wellbeing and their lives in my hands. It also showed me that I was interested in social medicine, population health and working directly with people in communities, where they are, and before they get ill. I made some great friends at Leicester, who continue to be good friends, university really is a bond that transcends time and space.

That’s why after medical school I went back to work in my home town of Preston. I worked in a small community centre, in a poor area, that was being run by a dear school friend. My school friends was one of the most generous and big hearted people I’ve ever met, he made me a generous and big-hearted person. I spent a year helping users of the centre to get into jobs. One of the highlights was writing and winning a proposal, to the local Council for Voluntary Service, for a small grant to run a healthy lifestyle drawing competition for a local schoo. All the money went on three top prizes and a small prize for each child who had the courage to enter the competition. I spent a year, thinking about my next move, watching my baby niece grow up and changing her nappies, while applying to the World Health Organization, Oxfam and PhD scholarships, with no success.

A new job, came up, as a volunteer coordinator, of a UK Department of Health funded volunteering project, at a bigger community centre, serving a wider community. The volunteering project encouraged and supported local people into local volunteering. The community also ran an older person’s lunch club every Wednesday and information technology-related access courses for local people. I learnt so much at this time about building relationships and rapport with people from all backgrounds, leading and managing people, finance and budgeting, about designing and creating leaflets, posters and marketing materials using just an old Windows 3.1 cathode ray tube monitor and computer, a black and white photocopier and a colour ink jet printer. I started as the Volunteering Project Leader but became the de facto Centre Manager when my friend and colleague, who filled that role, left for another job.

I still felt the call of public health and so I travelled down to London to do a Masters at the London School of Hygiene and Tropical Medicine (LSHTM). The place where I had done my medical school placement with Pete Kolsky on the impacts of urban surface water drainage three years earlier! At LSHTM, I did a very small MSc, the student group wast just 8 full-timers and 4 part-timers. It was great! Sadly that course no longer runs in the same way. The person who at the time I didn’t rate as highly, go figure, had the greatest future impact on me, obvious in hindsight! Carolyn Stephens, made me aware of healthy urban planning, design and policy, and how we can work in communities to improve health and wellbeing. This was through her own research work and also her use of Henrik Ibsen’s ‘Enemy of the People’ in one module where got us to do a role play as an assignment! . What was amazing about her, which I didn’t appreciate at the time, was how she brought literature and art into public health. As, very much an objective reality and science guy, while I appreciated arts and literature, at the time, I didn’t see their connections to population health and wellbeing.

I really enjoyed my time doing my MSc it was brilliant. I made some great friends. We had great times going out for dinner. I remember having some great conversations over coffee and rock cakes, the cheapest and most filling item, in the LSHTM canteen. We went as a group to see a Finnish movie, Aki Kaurismaki’s Drifting Clouds, recommended by a Finish classmate. I used my basic graphic design skills to create a poster and tickets for the end of year International Summer Party! I was also elected as student representative of my little group, which was cool. As student representatives, we worked on a number of projects including a discount book shop, more careers advice for students, and, of course, getting permission to hold the summer party! I also did some teaching on basic statistics, social science methods and methodologies, and environmental health.

I took out a career development loan to do the MSc, so after finishing, I found a job in a new community centre in North Kensington. I developed a services plan for the different community activities that the centre would run: from IT access courses, a getting into work service, after school club, and a arts and culture centre. I then used the services plan to develop a range of fundraising proposals. I learned a lot of things during my time there. The most insightful was feeling like an outsider. I hadn’t felt like that before in the same way. In Preston, I spoke some of the languages that users spoke, so it was easy to connect and build relationships with users. In North Kensington, I didn’t, and that was a unsettling at the beginning, as I couldn’t connect as closely with the local community as I had back in Preston. I spent two years in North Kensington, I might have stayed there long term, but life had other plans for me!

I began to consider a research and teaching career. I discussed the idea with my MSc personal tutor Helen Dolk and she was kind enough to allow me to work with her, and have access to LSHTM. I became an honorary research assistant. It was during this time that I accompanied her to a morning meeting with local politicians, local government officers, representatives of the national Environment Agency, the operator of a local landfill, and representatives of the local community who were concerned about the extending the size and the operating life of the landfill. She was, and is, a noted international expert on the health impacts of landfills for hazardous waste. This was another major insightful and turning point in my life. I saw how formal and scientific and stilted my personal tutor seemed to be in the main meeting which was in a large hall, with at least 30 participants. Given how good a teacher she was, I thought this was odd an uncharacteristic. In the afternoon, we were invited for lunch, by the local community action group, who were opposing the extension of the size and operation of the landfill. At this meeting in a small slightly worn out community centre, my personal tutor was very different, she was relaxed, engaging, and answering questions in a simple and direct way. It struck me during the afternoon, that the first meeting, being a formal meeting, involving planning and environmental law, policy and regulations, was why my personal tutor needed to be formal, scientific and precise. In contrast, she could be more informal, engaging, less technical and more conversational because the community centre was a very different context.

This experience made me want to do a PhD! I developed my own PhD application for an Economic and Social Research Council and Natural Environment Research Council joint scholarship (in the UK we call them studentships), which is very rare and not done. Usually, academics develop a proposal and apply to the UK Research Councils to obtain funding a PhD student. They then advertise for a PhD student, just like applying for a job. I wrote my own application and Helen Dolk, Carolyn Stephens and Ben Armstrong kindly gave me references. I was also supported by Dan Osborn at a National Environment Research Council Centre. I got his name from the internet and contact him out of the blue! I spent six months kicking myself for wasting time and applying. I thought how do you expect to get something so competitive. It was one of the best days of my life when the tattered ripped sheaf of papers in a brown A4 manilla envelope dropped into the lobby of where I lived. I had won the PhD scholarship! I had done it! I researched and wrote my PhD on “Understanding Public Perceptions of Environmental and Health Risks and Integrating them into the EIA, Siting and Planning Process: using the case study of the siting of a waste transfer station”. The waste transfer station was linked to the redevelopment of Arsenal Stadium, in North London, and the building of new blocks of flats, as part of a multi-million pound development.

Finishing my PhD in 3 years and 3 months, while also being a student rep, throwing parties at our Taviton Street PhD base, was one of the best times of my life!

While I was doing my PhD, I had also applied to be a non-executive director of a Regional Health Authority, as in the UK at that time, regional health authorities focused on regional public health. I was keen to develop some public health experience and thought this would be a great way. There was no pay but there was a small honorarium of £5,000 a year. I applied and during my interview with Thelma Golding, who was Chair of a Mental Health Trust at that time, she told me that as there were only eight regional health authorities sy chances of getting into one were slim. She advised me to take up the role in any health organisationan even a Hospital Trust. Though I wasn’t keen I took her advice and I’m glad I did. I because a non-executive director at my local hospital NHS West Middlesex University Hospital, now part of NHS Chelsea and Westminster Hospital Foundation Trust. I spent 6 years there and I’m very please about the contribution I made there.

Doing a PhD and being a non-executive director had spoiled me, and I couldn’t imagine having a boss. It was then that I set up my first consultancy, Living Knowledge. It was because I got a project offer from a friend from my MSc days, Ben Cave, to come and work with him on a couple of health impact assessment projects. I thought he meant for free, as a friend, instead he said, no, it’s paid, I could use the help! It was great working with Ben and Sian Penner and they gave me my first experience of doing public health consultancy work. At Living Knowledge, I worked in partnership with Jacob Leveridge, and when he left to do other things, I decided to apply for a health impact assessment job at an environmental consultancy.

I spent two years at Peter Brett Associates, now part of Stantec. I spent a year and half at their Reading office and six months at their London office. I really enjoyed my time there though it was challenging and thinking about health was seen as either, we already do it - air, water and soil pollution, or not needed housing, transport, recreation and leisure, culture, they were soft subjects compared to the hard topics of waste, geology, archeology and traffic and air pollution and waste contamination.

I was then offered a job by Fintan Hurley, at the Institute of Occupational Medicine (IOM) to head up their small Center for Health Impact Assessment. I had a great 6 years at the IOM building on my experience at Peter Brett Associates. I got to work on consultancy and research projects. I got to go to Edinburgh regularly, a city I love, especially in the summer, Edinburgh can be magical with the castle in the centre of the city, and the old and new city. As the London office was going to move further to the outskirts of London and would later close, I decided to set up my own consultancy.

So in August 2013, I set up Public Health by Design. I thought about calling it Salim Vohra Associates or Vohra and Associates but I want to pass on the consultancy at some point to someone who will continue to work with clients and communities to improve health and wellbeing globally. The best way I thought that would work is if the name of the consultancy was not that of the founder.

In July 2015 I got the chance to apply to become a public health lecturer at my local university, the University of West London. While I’ve enjoyed almost every minute and it has taught me a lot, in hindsight I wish I’d gone part-time and done more work leading Public Health by Design. I went down to 4 days a week 2 years ago post-COVID, and now I’m going down to 3 days a week, with the aim of going down further. I’d like to continue teaching the next generation of public health professional and I’d like to do that while also doing more UK and international health impact, healthy design and healthy policy consultancy and advisor work.

2023 is Public Health by Design’s 10th anniversary and I am aiming to do even more impactful, innovative and valuable health work over the next decade and two!

Salim’s Past Clients

Salim’s Past Projects

The projects are in order of most interesting and insightful.

Waste and Energy

Rose Energy Energy from Waste Health Impact Assessment with Human Health Risk Assessment

Client: Rose Energy, 2008-09
Partner: The Airshed

Led the this qualitative and quantitative health impact assessment of an energy from waste facility creating energy from poultry litter. The project was commissioned by a poultry farm conglomerate.

The Health Impact Assessment with Human Health Risk Assessment:

assessed the potential positive and negative health impacts on the residents around the proposed plant;
quantified key potential negative health impacts of the emissions likely to be generated by the proposed plant; and
identified mitigation measures to remove or mitigate any potential negative health impacts on the local community.

Rose Energy Biomass Fuelled Power Plant Health Impact Assessment with Human Health Risk Assessment Report

Addendum 1 - Health Risk Assessment of the Additional Dioxin Exposure in Breast Milk

Addendum 2 - Review of the BSE Risk and Prion Exposure

Research

Review of the Assessment of Health Impacts in the Development of New Policies in UK Government Departments

Client: PHAST

New Technology

Trafford LED Street Lighting Health Impact Assessment

Client: Trafford Borough Council

Transport

Northumberland Transport Plan Strategic Health Impact Assessment

Client: Northumberland County Council

Research

IMP3 Improving the Implementation of EIA

Client: European Commission

Waste

Wales 3 Regional Waste Plans Strategic Health Impact Assessment

Client: Welsh Assembly Government, Public Health Wales

Masterplan Design

Four Masterplan Health Impact Assessments and Health-Proofing Designs

Client: Stoke-on-Trent City Council

Mixed Use Development

HMS Ganges Mixed Use Housing Development Health Impact Assessment

Clients: Central Suffolk Primary Care Trust, Haylink Limited, 2004

Led the HIA for a mixed use development of 500 houses of various types and a range of commercial and community facilities including a marina. The potential positive and negative health effects of the proposed development were compared to leaving the site as it is. The report assessed the options for meeting the health and social care needs of the new community on the HMS Ganges site within the proposed new mixed use development.

HMS Ganges Mixed Use Housing Development Health Impact Assessment Report

Guidance

Fast Tip No 8: Health Impact Assessment

Partner: International Association for Impact Assessment, USA, 2009

Fastips aim to be a small but useful piece of practical and quick advice. They are designed to serve impact assessment (IA) professionals.