Sally Marlow talks to some of the men and women who have self-harmed, and the experts who treat them, to find out what is driving so many people to self-harm. Clinical guidelines define self-harm as any act of self-poisoning or self-injury carried out by a person irrespective of their motivation. However, research reveals a worrying association between self-harm and the risk of suicide. While rates of self-harm are particularly high among teenage girls, the true picture is far more nuanced. Rates have gone up in all age groups and both genders and, more recently, in groups such as middle-aged men. So what is driving so many people to hurt themselves, and what can be done to help them? The media is quick to point the finger at social media, but Sally discovers that the reasons behind this question are as varied and complex as the people who do it. Producer: Beth Eastwood

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It's 25 years since London suffered three vicious nail bomb attacks - holdalls filled with 4-inch nails and hand-made explosives planted in Brixton market, Brick Lane and in the bar of the Admiral Duncan pub in Soho, intended to cause damage to those in the immediate vicinity and to the notion of a tolerant, diverse capital city.   The attacks are recorded in photographs shared at the time by the press - of London streets strewn with damaged buildings and injured people, an x-ray of a toddler with a nail embedded in his skull, the wedding photograph of two victims (one killed, the other severely injured) and the police mugshot of the perpetrator, a far right terrorist who hoped to start a 'racial war in this country'. Fragments looks again at these images - some taken by Chris Taylor who happened to be on assignment in Soho's market photographing vegetables - to consider what it means for an instant to be captured and to endure in our memories and understanding of traumatic events. Including contributions from photographer Chris Taylor; Jonathan Cash, who survived the Soho attack, Emdad Talukder, who was injured in Brick Lane and business owner Leo Epstein.  Music composed by Alan Hall, with Eleanor McDowall (chimes) and Alan Hall (trumpet) Producer: Alan Hall
A Falling Tree production for BBC Radio Four (Photo credit: ChrisTaylorPhotography.com)

Fragments - The London Nail Bombings

How many medicines can you think of created for just one person?  The likelihood is none - which is why the world hasn’t heard of milasen yet.  But its creation, and the efforts behind it, could build a pathway towards some of the greatest advances in genomic medicine, and a new initiative being trialled in Britain has a huge role to play in making this happen.   At the age of seven, Mila Makovec became the first person in the world to be treated with a medicine created just for her.  A bubbly young girl from Colorado, Mila suffered from a very rare genetic disorder called Batten disease, which leads to a painful early death in children. Mila’s mother, Julia Vitarello, resolutely sought out scientists to try to discover a way to save her daughter.  After relentless efforts, one doctor, Timothy Yu from Boston Children’s Hospital, imagined a possible treatment for Mila. The challenge was it involved making a completely unique treatment for Mila’s specific genetic mutation. It would be novel and very expensive - but it was her only option.   Julia raised the millions of dollars required through a charity she set up in her daughter’s name, and in 2018 Mila became the one patient in the world to receive the drug milasen.  Initially, it worked, and Mila’s condition stabilised and improved. However, the treatment was given after the disease had done a great deal of damage to a small child, and Mila died when she was ten years old. There are an estimated 7,000 rare diseases in the world, affecting more than 400 million people - and most are genetic. The majority have no effective treatment.  New medicines for these conditions can’t be put through clinical trials on groups of patients because they are so rare. So, currently, such novel therapeutics can only be legally given after lengthy and costly work that is uncommercial for drug firms.    Having got so achingly close to saving her daughter, Mila’s mother is now leading efforts to make these new genetic medicines available to other children with rare diseases - and Britain is where her campaign is about to take a huge step forward.  The launch of the Rare Therapies Launch Pad is bringing together efforts from Mila’s Miracle Foundation, the UK medicine’s regulator the MHRA, Genomics England and Oxford University in an world leading attempt to build a new streamlined regulatory pathway to allow one-off drugs to be designed and approved for use in individual patients with rare diseases.  Natasha Loder, Health Editor at the Economist, tells this very personal story of how one mother’s determination to try and save her daughter could lead to a revolution in personalised medicine - one that has the potential to bring hope to millions of families.  Producer: Sandra Kanthal

Mila’s Legacy

Take a trip around the supermarket and you'll see shelves of products claiming to be 'high in protein'. Scroll through your social media and you'll find beautiful, sculpted people offering recipes and ideas for packing more protein into your diet.  Science presenters Dr Julia Ravey and Dr Ella Hubber have noticed this too. They wanted to unpick the protein puzzle to find out what it does in our bodies and how much we really need. Can this macronutrient really help us lose weight, get fit and be healthier? Along the way, they speak to Professor Giles Yeo from the University of Cambridge, Bridget Benelam from the British Nutrition Foundation, Paralympian hopeful Harrison Walsh, and food historian Pen Vogler. Presenters: Dr Julia Ravey and Dr Ella Hubber
Producer: Alice Lipscombe-Southwell
Editor: Martin Smith Credits: @thefitadam/@TSCPodcast/@tadhgmoody/@meg_squats/@aussiefitness

Protein: Powerhouse or Piffle?

Victoria Uwonkunda makes an emotional journey back to Rwanda, where she grew up. It’s the first time she’s visited since the age of 12, when she fled the 1994 genocide with her family. Victoria retraces her journey to safety out of the capital Kigali, to the border with the Democratic Republic of Congo. Along the way Victoria speaks to survivors of the violence – both victims and perpetrators – to find out how the country is healing, through reconciliation and forgiveness. Victoria meets Evariste and Narcisse, who work together on a reconciliation project called Cows for Peace. Evariste killed Narcisse’s mother during the 1994 genocide. Cows are important in the Rwandan culture. Evariste and Narcisse explain their own journeys to forgiveness, healing and reconciliation. And Victoria meets Claudette, who suffered unimaginable horrors at the hands of a man, Jean Claude, sitting next to her as she tells her story. Victoria Uwonkunda finds that Rwanda, and its people, are healing. There are those who say that the steps Rwanda has taken do not go far enough and question freedom of expression in Rwanda. But Victoria finds hope in the country, a desire to move on for a younger generation – and she finds her own peace with the country that she was born in.

Rwanda Thirty Years On

One baffling online scam – involving a £138 dehumidifier – and a humiliated BBC producer who will not rest until she has a return address for it. January 2024. Polly Weston’s toddler has a terrible cough, no one in the house is getting any sleep, and, as is traditional for Bristol Victorian Terraces, her house has a lot of damp patches. So she decides to invest in a dehumidifier.  A very convincing review online, by a real consumer journalist called Luke Edwards, recommends one company.  The company's sleek website reads “Dewett UK – Better Air, Better Life.”  Sold. She orders one for £138… Then it begins.  Luke, it turns out, had his identity stolen. Day after day he receives the same desperate phone calls from people across Britain who have fallen victim to his “byline”. The story is always the same. Once the dehumidifier arrives, it doesn’t work, and you can’t return it –  Dewett will not give you a return address. It's come from China, they say, and there is no point in you sending it back. The email exchanges become increasingly wild.  But what starts out as the story of one BBC producer, on a vendetta to find a return address (and to prove, despite being duped, she’s still a good journalist)… will take us to corners of the world we never could have predicted. It might just end in us accidentally blowing the lid on something much, much bigger...  Produced and presented by Polly Weston
A BBC Audio Bristol production

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