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Last Updated: Friday, 3 June 2005, 13:16 GMT 14:16 UK
Paul's daily diary: Living on £5
Dr Paul Williams
Dr Paul Williams lived for a week on £5 and a bag of food
GP Dr Paul William, who works with asylum seekers and refugees lived on just £5 a week and a bag of food to highlight their plight.

Here is his daily diary. It does contain some strong language.


Weight 73.6kg (measured in the gym yesterday at a cost of 50p!).

I started the week catastrophically.

Unlike everyone else, I was due to start at 11am (there was no way that the people I play five-a-side football with on a Saturday morning were going to let me off without paying the £3 match fee).

At 11.30am I ambled along to the newsagent to buy the Sunday paper.

As I was handing over £1.50 for my copy of the Observer I suddenly realised that this was almost a third of my weekly budget.

Clearly I won't be able to end this week until after 11.30am next Sunday.

Often we shop on the web and get our food delivered to the house from Tesco. That can cost £5 just for the delivery. If we did that this week we'd get an empty box!
Dr Paul Williams

I had to start again.

Beans on toast for lunch wasn't too bad, but I noticed the absence of margarine and pepper.

I helped my Dad take some stuff to the dump, then we met some friends in the afternoon at the David Lloyd sports club (cost about £50 per month) for badminton, a swim, then a game of tennis doubles.

Failed asylum seekers certainly don't have the privilege of playing indoor tennis and swimming in a heated outdoor pool in January.

Nor do they have a £40 tennis racket, £30 badminton racket, trainers, swimming trunks, goggles and all the other equipment needed for a sporting life.

On the way home we stopped at Safeway. The car needed filling up with petrol for work (£40 spent, but somehow not counted in the weekly budget).

We bought porridge oats, pasta, potatoes, reduced bread (29p) and rolls (29p), reduced carrots (10p a bag), reduced sausages (45p for eight), reduced beans (25p) and reduced salmon (99p for two).

As Vicky and I are both doing the '£5 and a bag of food week' we're pooling resources.

We bought two litres of milk that will have to last for the whole week.

Often we shop on the web and get our food delivered to the house from Tesco.

That can cost £5 just for the delivery. If we did that this week we'd get an empty box!

Dinner was grilled salmon (in our house we have the luxury of choosing to microwave, oven, grill, toast or barbeque food) with potatoes, carrots and beans. The only thing I have been without today is alcohol.


Up at 7am for porridge after a good night's sleep (helped by the absence of any alcohol, no doubt).

It was icy cold outside, but the thermostat-controlled central heating in our house had kept us warm in bed.

I have had a headache all day, presumably as a result of caffeine withdrawal
Paul Williams

I missed having a cup of tea, and drove to work. I spent the day seeing patients from Zimbabwe, the Congo, Iran, Iraq, Afghanistan and Liberia.

After listening to stories of death, rape and war I felt so lucky to be living a comfortable life in a safe country.

Not all stories are bad though. I visited a couple from Kosovo at lunchtime who had a new baby last week and who have had a visit from their parents over the Christmas period.

Seeing people, who have only ever presented to me with distress functioning normally in an extended family made me see how the refugee experience tears people away from their families and communities.

After yesterday's sporting activities I was ready to wolf down the pasta, sausage and sweet corn salad that I'd made for lunch.

In the afternoon I listened to a mother with her baby who have been cowering in a house in Stockton at night, terrified whilst racists outside shouted and threw bricks though the window. I felt ashamed to be British.

On a recent holiday to India I was treated with kindness and welcomed into the homes of people I had never met, and who had nothing to gain from offering me their friendship.

When people come here to seek protection we call them 'Pakis' and tell them to 'fuck off home'.

As the afternoon continued my hunger increased. Normally I have snacks mid-afternoon: biscuits, crisps, anything!

I found a banana in the office at 5.30pm and ate that.

After work I had a game of squash booked. I play in a league, and couldn't face the embarrassment of trying to explain why I couldn't pay - so coughed up £2.80.

Dinner was fish cakes - an old recipe that my Mum makes by mixing mashed potato and sardines - fried in lots of oil with baked beans.

It was filling enough, but I would have enjoyed a beer with it.

By 9.30pm I was exhausted, and after a shower lay on the bed to read Andrew Marr's book on journalism.

It is, as expected, an insightful and gripping read - but it only kept my attention for ten minutes. I don't normally get to sleep before midnight.


I have had a headache all day, presumably as a result of caffeine withdrawal.

Porridge greeted me again for breakfast - it was filling and appropriate for a cold winter's morning.

He was only 19, but had packed into his short life more bad experiences than everyone else in the room
Dr Paul Williams

I spent the morning in my practice teaching medical students.

Three people seeking asylum came in to tell their stories to the students and explore the effect of the asylum process on health.

The first man was so distressed and frightened at the possibility of being returned to his country that he said he would rather kill himself.

He gave an eloquent description of how members of his family had been kidnapped and persecuted by the authorities as a result of his behaviour.

He didn't want to bring them any more trouble, so fled while his father faked his funeral.

To return would only bring more trouble for his family. The second man had just won asylum - the right to stay in the UK as a refugee.

He showed the students the 'iron-shaped' marks on his skin where he had been repeatedly burnt as part of his torture.

His joy at getting a 'positive' decision is still tempered by the pain he feels when he is reminded of what happened to him.

Swimming pool
He enjoys life luxuries such as gym membership

Our third 'patient' this morning gave a harrowing account of his involvement in one of Africa's civil wars.

He described being imprisoned for months by soldiers during which time he was hit with sticks, tied up and repeatedly raped.

It was obvious to all present that he was clearly telling the truth, but his asylum case failed due to 'lack of evidence'.

Here was a man actually living on £5 per week.

He still wore the same clothes that he had on when I saw him last week. He told us how he relied on friends for a bed, and had slept on the streets and in a toilet.

He was only 19, but had packed into his short life more bad experiences than everyone else in the room.

Yesterday Michael Howard spoke about 'genuine refugees' and 'economic migrants'. This man was from a rich family who had land and wealth in Africa, yet he lives in poverty in the UK.

He hasn't been given refugee status, but is certainly not an economic migrant.

He helped me to understand how unfair the asylum system is, and how important it is that we should continue to treat people with dignity and respect.

I work at the University of Durham on a Tuesday afternoon, so after lunch of soup and a roll I facilitated a seminar involving medical and social work students talking about team-working and dealing with professional inadequacy.

After a 40 length swim I met two friends in the pub on the way home, and had to work hard to resist their attempts to buy me drinks.

The rules that we have agreed say that we can't rely on other people's hospitality for food or drink - as failed asylum seekers usually don't have wealthy friends to buy them dinner and drinks.

At home Vicky had made a sausage, tomato and kidney bean casserole with rice.

I'm going without snacks, but am managing to go to bed without feeling hungry.

Watched a bit of the football of the TV (Sky costs more than £30 per month) and checked e-mails using broadband (£30 per month) on my laptop computer.

I'm well aware that most of the things that I need to live a comfortable life are already paid for, or go through on direct debit so I never notice the money.


Porridge again for breakfast, and a drive to BBC Radio Cleveland for an interview on the breakfast programme.

It cost £1 to park, but I have not been counting travel expenses in the £5 that I have had to survive on.

We want to explain to a wider audience that people whose asylum claims fail are not bogus
Dr Paul Williams

I explained some of the difficulties that I have been encountering in a broadly sympathetic interview.

Obviously we are not just doing the '£5 and a bag of food' week just for the experience.

We want to explain to a wider audience that people whose asylum claims fail are not bogus.

They have often suffered imprisonment, rape, torture, war and bereavement, but are either unable to prove it or cannot demonstrate that it would happen again if they were returned to their country.

Often they can't be sent home because their countries are too dangerous (Iraq, Somalia, Zimbabwe) and they live in poverty under our noses.

They are not allowed to work, and if it were not for Faith groups and the Mary Thompson Fund giving tiny amounts to them they would literally go hungry.

Into work where I spent the morning writing medical reports for patients who wanted evidence of beatings or torture for court cases, making telephone calls, processing results and answering letters.

A lot of the work of a GP takes place behind the scenes, and my practice needs careful administration. A female GP works with me on a Wednesday morning.

Football club
Luxuries such as football tickets were not included in the total

She enables my patients (around 30% of whom are women, and half of these are Muslim) to have to choice of seeing a woman.

Working with people from 40 different countries means that it is impossible (and wrong) to make cultural assumptions about patients, but there are some cultures who prefer a doctor of a particular gender.

I resisted offers of coffee, and had lunch of baked potato, tuna and sweet corn.

We had corned beef hash for dinner with baked beans, before I drove to play five-a-side football for an hour between 9pm and 10pm.

My team won, but I wasn't able to avoid paying the £3 subs again. By 10.30pm I was in bed, as I had an early start in the morning.


The alarm went off at 5.30am, and I left the house 15 minutes later with a bowl of porridge that I ate in the car at the traffic lights.

I caught the 6.30am train to London and read by book and some medical journals on the journey.

I travelled to Westminster for a sitting of the Health Select Committee.

Last year the government made failed asylum seekers ineligible for free NHS care from hospitals, except in urgent situations (where they would be treated and then presented with the bill) or for certain infectious diseases.

This year they are trying to make all non-urgent Primary Care ineligible too. As all failed asylum seekers I know are destitute, this means that they are effectively being denied most health care.

I have already heard stories of pregnant women in London being denied antenatal care because they could not pay, and people with HIV being told that they could not have treatment.

The Health Select Committee was looking at the impact of denying NHS HIV treatment to what they call 'overseas visitors'.

I wanted to be at the hearing, especially as I have been speaking and campaigning on this issue for a while and colleagues who were giving evidence planned to use the session to widen the debate from HIV to other types of health care (such as antenatal care, help for mental health problems, care for diabetes and asthma, and immunisations).

My ticket to London (£110) was bought last week, but I reflected on how differently I travelled to my patients.

Some of the people I look after travel to London to see friends and relatives, or to get legal advice.

Whereas they take the overnight bus for £20 and take seven hours, I was able to arrive in London at 9am, two and a half hours after leaving Darlington.

As we reflected on the week we realised that we had all managed adequately on the £5 and the bag, but only because of all of the other comforts that we had in our lives. And we only had to do it for one week.
Dr Paul Williams

On arriving at Portcullis House where the Select Committee meets, I was devastated to see the sign on the door prohibiting food and drink.

My packed lunch and a bottle of water were in my bag, but I couldn't take them in.

I tried negotiating with the security man on the door - explaining my predicament - but he was having none of it.

I had to scoff several carrots and drink my water, and then place a plastic tub full of rice and tuna in the dustbin. What a waste!

The select committee was 20% success and 80% failure.

The MP's accepted the economic and 'public health' arguments that HIV treatment should be provided for free on the NHS - but the HIV lobby were satisfied with this and did not bring up the moral and political arguments for keeping all health care free to failed asylum seekers (and other undocumented migrants).

I felt let down and frustrated. They had obviously done this tactically and had achieved what they set out to achieve, but only a very few failed asylum seekers have HIV.

I discussed the morning's events with the vice-president of Medact, an organization of medical practitioners interested in global health issues, in the pub next door over a glass of water.

It was then time to wander up towards Trafalgar Square, where I cheated on the '£5 and a bag of food week' by going to the café-in-the-crypt of St Martin-in-the-Fields Church and having a bowl of soup and a roll for £2.75.

After the disappointments of losing my lunch and the morning's events I needed some nourishment.

I caught the 3pm train, and by 5.45pm I was not only back in the North East, but was having a swim in the David Lloyd pool.

With the energy (and a certain guilt) from the soup I swan 64 lengths before driving home.

I ate some of the sausage casserole left over from Monday before spending a couple of hours answering the 40 e-mails that I had received.

Still no alcohol or caffeine.


Up at 7am for porridge (I should just cut and paste that for every day!) and drove to meet with the Health Visitor and Practice Nurse that I work with.

We discussed families that had health problems. Primary Care demands good team working and effective communication. We enjoy having this get-together every fortnight.

I saw some patients for a couple of hours, then drove to James Cook Hospital where the medical students that I have been running a project for in the last fortnight gave an entertaining and informative presentation to their peers entitled 'Who wants to be a refugee?'.

They used the game show format to put across some serious points about the health problems that people seeking asylum have - including living on £38.96 a week (for an adult over 25, younger people get less), not being allowed to work and living in some of the tougher neighbourhoods.

They also talked about the difficulty people seeking asylum have in accessing health care because of language barriers, lack of knowledge about how to use health services, multiple health problems and the lack of training and cultural awareness in NHS staff.

I was proud to see that some of the group had changed their minds about asylum seekers as a result of having talked with and listened to real people's stories.

I met some of the rest of the group doing the '£5 and a bag of food' week at the North of England Refugee Service at lunchtime, where I ate spicy corn chowder (without the cream) that Vicky had made last night. It was lovely.

As we reflected on the week we realised that we had all managed adequately on the £5 and the bag, but only because of all of the other comforts that we had in our lives.

And we only had to do it for one week.

Porridge was the dish to start the day

I had a busy afternoon clinic booked, and particularly spent a long time with a new patient from the Democratic Republic of Congo.

She had just been moved to the area, and was clearly very frightened and traumatized.

She had been raped and told me that she had 'many problems in her heart', with tears in her eyes.

I know that I need to build up a relationship of trust with her, as I have done with so many others in her position, so I can start to help her to move on from the horrors that she has experienced.

By the end of the afternoon I felt as though all of my patients had taken a little bit from me, leaving me drained of energy.

I stayed until 5.45pm doing paperwork, but left some un-answered letters until Monday.

I was hungry. 'Too hungry to think' I remember saying.

Normally I would have some chocolate or a banana in these situations.

I swam another mile in the pool, then weighed myself. I was surprised that I now weighed 71.9kg. I had lost 1.7kg (3.7lbs) in six days.

I bought some mince, an onion, some mushrooms and some reduced sausages with the last of the money on the way home, and cooked a chilli-con-carne for dinner.

It would have been nicer with a glass of red wine.

Got a text from Pete who has also been doing the '£5 and a bag of food week'.

He apologised for having 'given up' on the alcohol front, but I wanted to continue for a bit longer.

How many failed asylum seekers ever get to go to FA Cup matches?
Dr Paul Williams

We watched 'The Big Lebowski', a film by the Coen brothers, on DVD before another early night.

I don't think I've ever had so much sleep in a week as this one (except on holiday).


Stayed in bed until 7.30am, had porridge (for the last time!) and drove to Newcastle.

Every eight weeks on a Saturday morning I meet with a group of professionals working with refugees to discuss important issues. This morning's topic was 'suicide and alienation'.

After catching up with some friends and colleagues we were treated to a talk and discussion about suicide and we shared anecdotes.

None of my patients have yet committed suicide, but every week I have someone tell me that they would rather end their life in the UK on their own terms than be sent back to their own country.

It is really important to discuss how to react to this kind of problem with colleagues.

The Medical Foundation for the Care of Victims of Torture host the meetings, and they will soon be opening a North East England office that will raise the profile of some of the issues that I work with locally.

I had to leave the meeting early, as I needed to go to see someone at the request of their solicitor to collect medical evidence for their asylum claim.

In a tower block close to the centre of Newcastle I spent 90 minutes with a man from Cameroon listening to him telling me how he was imprisoned, repeatedly beaten on the back with a piece of rubber tyre, beaten on the soles of his feet with a baton, and then made to run up and down over broken rocks in his underpants.

The tears in his eyes as he was talking said much more to me than the fading scars on his back.

As a doctor trained in the medico legal documentation of torture I see one or two people each week to take testimony and record their scars, giving an independent opinion as to the likelihood of the scars being sustained in the manner described.

Almost all the people I see are telling the truth, but sometimes the worst forms of torture leave only psychological scars that are much harder to prove.

By 2.30pm I was at a friend's house, and four of us (including Vicky) walked to St James Park where we watched on of Newcastle United's better performances of the season (beating Coventry 3-1).

I had bought the tickets (£21 each) a few weeks ago, but how many failed asylum seekers ever get to go to FA Cup matches?

After a week of abstinence when Nick suggested a quick trip to the pub on the way home I gave in (the knowledge that your colleagues have also given in makes it hard to continue).

He kindly bought us a drink and we chatted enthusiastically about a cycling trip from Geneva that we plan to make in May.

The evening was spent watching the last ever episode of Auf Wiedersehen Pet (a colleague had bought the video to the meeting for me this morning as we'd missed it over Christmas) and typing this diary.

I have been asked to read excerpts on the Faith programme on BBC Radio Cleveland in the morning, and will have a 6.15am start.

It's already 11.45pm, so it's time for bed.

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