As you approach Port Talbot along the M4 the first thing you see is a torrent of steam spewing from a trio of cooling towers and a huge flame the size of a house bursting from what looks like a North Sea Oil Rig which never managed to leave land. As you go on, the next few miles are littered with huge industrial buildings of ever increasing size, all competing to release the greatest man-made cloud into the sky. And in front of all this are rows of tiny Welsh terraced houses, line after line as part of the town lies in the shadow of these huge monsters of iron and steel.

I have often looked at this industrial town as I drove past with some fascination at our ability to build such huge things but also intrigued to know what it was like to live with them as the view from the bedroom window. I took these photos from a housing estate situated on the edge of one of the largest steel works. As I wandered around I noted how aware I was of the major industry going on a hundred metres away. The sight, the smell or the noise served as a constant reminder, both of those industries still active and those which died out many years ago. But so was the knowledge that this is where thousands of people lived and made their lives. A child’s bike, washing on the line and a man walking his dog all indicative of normal everyday life.

The man walking his dog saw me taking the photos and came over. He asked me what I was doing so I told him. ‘It’s an oppressive place to live’ he said. Over the next ten minutes I found out he’d lived there all his life and had worked, like most of the men, in one of the works. That was until he sustained a debilitating injury* in an industrial accident. He’d had to retire due to sickness at age 38 (that’s when he got his dog – a Labrador called Earl) and had lived on benefits ever since.

* personal details altered to maintain anonymity

Apparently this was quite a common occurrence too. I asked if he could have tried any non-manual work but he said he ‘didn’t have the education for office type stuff’ and was ‘far too old’ to do any further training – not that there was any on offer – at least none he could find. He was quite chatty and I got the impression he was glad of the company. He went on to say how his wife had left him a year later and his children only occasionally visited. He was a regular at the local pub where he enjoyed a drink and a smoke ‘most afternoons like’.

As we said goodbye, I started to wonder if anything could have been done which would have changed these years of this man’s life. Apart from perhaps better safety standards at the works I wondered about the role of doctors involved in his care at the time and afterwards. Could they have tried to encourage him more into seeking additional training or pointing him in the direction of some? Surely his health, both mental and physical, would be better had he spent the last 15 years able to work. Maybe they did and he wasn’t interested.., but I think it more likely that they didn’t. Then I started to think about the role of health care professionals in such a community as a whole. The media is always telling us of the high rates in such housing estates of crime, unemployment, teenage pregnancy, drug use etc… the list is a long one. And whilst it is not everyone who is affected by such issues, sadly the percentage is greater than for those who live in the leafy suburbs. Obviously there is an important role for teachers, the police as well as society in general but I also realised there is an important role for the health professional, the doctor. Educating patients, encouraging them, liaising with other organisations as well as involving the patient fully in their treatment and the options available are all vital in giving them the most important things available – their health and a good quality of life. They can then go on to do whatever they want whether it’s providing for their family by working at the plants, looking after young children at home or studying to go to university, the role of the local doctors is vital in such communities. One day I hope to be lucky enough to provide such a service.

When taking the photographs I must admit I felt glad I didn’t have to live there. After speaking to the man walking his dog I got the feeling that many people who lived there didn’t through their own choice. As this was a council estate many had been placed there by the council. Due to writing this piece, I have thought about how doctors can act to help change and hopefully improve the lives of people who live there. Whilst being a G.P. in such an area might not have as much ‘sex-appeal’ as a top surgeon in a top London hospital, I realized that such a job could be even more rewarding in making a difference to peoples lives. Thus my view of the place changed from ‘I wouldn’t want to live here’ to ‘wouldn’t it be great to make a difference?’.