Today’s guest blog post comes from Aris Grigoriou,  Student Recruitment Manager at Study Medicine Europe (SME). Aris explores the negative impact of stress using  SME’s new infographic which provides a good overview of the science behind stress, how stress affects the body, the dangers of chronic stress and how we can all reduce the impact of stress.

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Throughout the world, it’s safe to say that we’re all experiencing stress in some way, whether it’s due to financial challenges, health concerns or a demanding workload.

Currently, many people are either suffering from poor health or having difficulty minimising risk factors that cause illness or chronic conditions. We can’t argue with the data. Harvard Health Publishing reported that “the United States spends the most money on healthcare, and yet still has one of the lowest life expectancies of all developed nations.” In a nutshell, we need to pay attention to all the elements that impact on our health.

We can’t deny that stress is a huge barrier to our collective wellbeing even if paradoxically we’re able to practise good health habits elsewhere. In fact, the World Health Organization has declared stress the Health Epidemic of the 21st Century. The challenge with knowing how to identify and manage stress largely lies in the mythologies we have around it. Neuroendocrinologist and neuropharmacologist George Fink says, “Stress is a highly personalized phenomenon that varies between people depending on individual vulnerability and resilience and between different types of tasks.” Building upon this analysis, we need to remember that what promotes health is empowering data that encourages personal and social solutions to a unique problem.

Study Medicine Europe has published its ‘The Negative Impact of Stress’  infographic to help promote health and support people to learn more about this area of wellbeing. Not only is this graphic designed to provide explanations on the way stress affects the body, but it’s also deliberately been created to connect everyone with the straightforward information you might not get when you look for facts on this topic elsewhere. Above all, remember that health is considered to be multifaceted and there might be parts of your life that require attention even if you don’t think they’re related to stress. We hope this helps you in your pursuit of better physical, mental and emotional health.

About Study Medicine Europe

Study Medicine Europe is the leader in medical student recruitment with offices in the UK, USA and India. Having many years of experience in securing placements for prospective students from all over the world. More specifically, they officially represent and are affiliated with  Medical Schools in Europe (Armenia, Georgia, Ukraine, Serbia, Romania, Bulgaria) that offer English-language undergraduate and graduate programs in Medicine, Dentistry and Veterinary Medicine.  You can find out more about them here

Today’s blog post comes from Mariana Ndrio. Mariana is a second-year medical student at the University of Medicine & Health Sciences (UMHS) in St. Kitts and is currently serving as the President of the American Medical Student Association (AMSA) on campus.

Mariana has recently started volunteering with us as a research assistant and is supporting us as we conduct our fibroids qualitative study. She is also creating a fibroids and COVID-19 infographic which will be published shortly.  

Today, Mariana discusses the challenges that fibroids patients may be experiencing during this COVID-19 pandemic and shares some evidence-based self-care and stress management tips to help women with fibroids manage during this difficult period.

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As the COVID-19 pandemic continues to prompt stressful changes to our daily routine and lifestyle, health-related worries regarding ourselves and loved ones have undoubtedly intensified. While the growing uncertainties stemming from financial difficulties and social isolation impact the health and personal decision-making of everyone across the globe, women suffering from uterine fibroids are facing unprecedented challenges in their attempts to preserve their mental and physical wellbeing.

Uterine fibroids are the most common benign tumours among women. While some cases of fibroids are accompanied by no side effects, other cases contain patterns of heavy menstrual bleeding, long and irregular periods, pelvic pressure and pain, constipation, frequent urination, and in rare occasions, infertility.

Treatment for fibroids can range from no treatment at all to surgery, depending on the severity of symptoms. Aside from apparent physical symptoms, the psychological impact of fibroids should not be disregarded. In a 2013 national survey of 968 women suffering from fibroids, 79% of the surveyed women expressed fear that their fibroids will grow or experience further health complications. According to a 2014 study assessing the emotional impact of fibroids half of the participating women reported feeling helpless and that they had no control over their fibroids, because of the difficulty managing and predicting the heavy menstrual flow.

Black women are 3 times more likely to become diagnosed with fibroids than white women, just as they are more likely to develop fibroids at a younger age; moreover, their fibroid size, frequency, and symptom severity are much greater.

As a medical student that remains generally impressed by the increasing amount of existing medical and scientific knowledge, researching gynaecological diseases such as fibroids have led me to a stark realization: that despite the high prevalence of uterine fibroids among women, not enough high-quality data is available to formulate evidence-based guidelines that address patients’ needs adequately. This points to a larger, unforgiving gap in medical knowledge pertaining to common diseases affecting women, and when combined with the gap in medical knowledge regarding COVID-19, a mixture of increased emotional stress and confusion is to follow. Such stress can hinder overall physical health and may exacerbate fibroid symptoms by influencing cycle length, vaginal bleeding patterns, and painful periods. If you are feeling uncertain or anxious, know that you are not alone; your worries and feelings are valid.

For that matter, we compiled some scientifically-backed tips that could be helpful in restoring a sense of control and ease in these difficult and unprecedented times.

First, don’t hesitate to reach out.

While staying home and self-isolating is the best way to stay protected from COVID-19 and prevent the spread of the virus, this should not halt or compromise access to necessary medical care for women suffering from fibroids.

If you need to see a healthcare provider for a gynaecological reason, reach out to your medical provider and try to see if they are able to set up a virtual appointment or address non-urgent concerns over the phone (such as prescription refills). 

While it is true that a lot of non-urgent appointments and elective surgeries are cancelled, many medical professionals and medical facilities are encouraged to use and have already embraced telehealth services which allow long-distance patient and clinician care via remote and virtual appointments, intervention, education, and monitoring. Telehealth services vary based on your location and medical provider. But even if you are having difficulties accessing gynaecological telehealth services locally, you might be able to reach out to service providers in other countries such as the U.K, U.S, or Canada. For example, USA Fibroid Centers provide virtual appointments you can schedule online. Women to Women OB GYN Care, located in Florida, states in their website that they welcome appointments from women internationally and the Caribbean. The Pan American Health Organization (PAHO) has also attempted to establish or expand telehealth services in a lot of Caribbean countries.

Keep up to date with your prescribed medications.

Keeping up to date with your prescribed medications can be confusing during a pandemic. You might feel like your regular access to your medical provider or pharmacy is compromised, you might worry that your current medications might be making you vulnerable to the COVID-19 or you might be feeling uncertain regarding the continuation of your current prescribed medications or supplements.

Nonetheless, it is important that you continue taking your prescribed medications and/or supplements unless otherwise advised by your physician.  If you are receiving preoperative therapy (Zoladex, Lupron, etc.) but your surgery is cancelled, ask your physician regarding the course of your current prescribed therapy. If you have been prescribed a drug called Esmya (Ulipristal Acetate), you must consult with your physician regarding its discontinuation; as of 2020, Esmya’s license has been suspended due to the risk of serious liver injury. As mentioned previously, do not hesitate to discuss any concerns you might have regarding your current medications and supplements with your medical provider.

Plan ahead.

Studies show that women with fibroids might present heavier, prolonged bleeding and frequent, irregular periods. While everyone during a pandemic is worrying and trying to secure produce and disinfecting supplies, women suffering from fibroids have to also think about stocking up on female hygiene products. Especially, since frequent trips to the stores must be limited due to social distancing/quarantine rules.

Ensure that you have enough gynaecological hygiene products at home, to eliminate frequent trips to the store and avoid exposure to the virus. This by no means should be considered as the green light to go into a buying frenzy. Try to remain conscientious of the needs of others.

If buying hygiene products in bulk is not an option due to financial difficulty or store availability, reach out to local non-governmental organizations (NGOs) or philanthropic entities, that might be willing to donate hygiene products such as the Days for Girls International Organization or even by reaching out directly to product manufacturers. Local grassroots organizations or associations in your region might also be able to donate hygiene items. Moreover, the governmental departments of public health or genders affairs might be willing to assist women in need of hygiene products.

This pandemic could also be a good time to consider reusable, more economical and environmentally friendly menstruation products such as washable pads, menstruation caps, or absorbent underwear.  Check Days for Girls .org and learn how to make sanitary washable period pads during the COVD-19 pandemic, diligently following sanitary safety precautions.

Maintain healthy eating habits. 

Research has shown that following a healthy balanced diet, filled with fruits and vegetables, could lower the risk of developing fibroids and may help to alleviate symptoms.

While access to your usual healthy foods might be compromised at the moment, try to make healthy dietary choices while in quarantine. More specifically, dieticians recommend an increase in the consumption of cruciferous vegetables such as cabbage, broccoli, and kale. This category of food contains a phytochemical called indole-3-carbinol which recent research has suggested may prevent the cellular proliferation of fibroids and consequently prevent exacerbation of fibroid symptoms.

For many years, there has been a significant amount of scientific evidence that vitamin D may inhibit fibroid growth. Get your serum vitamin D levels tested and supplement (with medical supervision) as needed to correct a deficiency. A few recently published studies assessing the role of vitamin D against COVID-19, suggested that there is a possible link between the two and that vitamin D can have a protective effect against COVID-19.

Stay hydrated by consuming adequate amounts of water during the day and eliminate alcohol and caffeine. Researchers are advising women to avoid alcohol and caffeine because these substances are metabolized by the liver adding more stress on it and making it work less effectively at metabolizing oestrogen in the body.  Additionally, amidst the COVD-19 pandemic, the World Health Organization (WHO) urged the public to reduce alcohol consumption because alcohol compromises the body’s immune system and increases the risk of adverse health outcomes, making people more vulnerable to COVID-19. In other words, by cutting out alcoholic beverages, you are protecting yourself from adverse outcomes from both the COVID-19 and fibroids.

In addition, researchers believe that endocrine-disrupting chemicals (EDCs) which mimic oestrogen activity, may fuel fibroid growth. Examples include processed foods which contain various oestrogen-like preservatives; bisphenol A in water bottles, canned foods and plastic containers; various pesticides, herbicides, insecticides; and additive hormones and steroids used in meats and dairy products.

Try to choose organic, locally grown and in-season foods that are hormone and pesticide-free. Attentively wash any produce and peel fruits and vegetables. Reduce the use of plastics whenever possible and avoid reusing plastic water bottles or microwave food in plastic containers.

Stay active.

Research shows that a higher BMI – body mass index – is linked to the development of fibroids. By exercising you can reduce your BMI and prevent the fibroids’ growth. It may also help alleviate symptoms caused by fibroids. At the same time, exercise improves mental health by reducing anxiety, depression, and negative mood and by improving self-esteem.

Continue performing simple or recreational household chores and find an indoor workout routine such as yoga or aerobic exercises that you can perform at home while keeping up with the rules of quarantine. Choose what works best for you, based on your physical fitness and medical advice.

Be gentle to yourself—your body & your mind

On days that you are feeling pain and other fibroid symptoms, rest up and give your body time to heal. Try to soothe cramps by applying heat and wear comfortable clothes.

It’s okay to spend a whole day in bed recovering. Be gentle with yourself and do not undermine what your body is trying to tell you.

We live in a society where time and productivity are precious and synonyms for money and self-worth. Yet, nothing is more precious than your physical and emotional well-being. Do not feel guilty for taking some time to rest and recover.

Although self-care looks different for everyone and should be based on your personal needs and situation, there are a few suggestions that could work for you and help you boost your mental well-being:

• Try to meditate and practice mindfulness. You can find a lot of free guided meditations online or on YouTube.
• Monitor your thoughts and feelings in a journal.
• Practice good sleep hygiene. Maintain a sufficient sleep schedule, stay away from electronic devices while in bed, and start a regular bedtime routine—such as drinking a soothing tea, taking a warm bath or shower, reading, etc.
• Limit the amount of media you ingest daily.
• If you live alone reach out to family and friends via phone or video. If you live with family, roommates, or a partner use this time to connect and nurture your relationships.

And remember, during these confusing and unprecedented times and while you are feeling that this pandemic is affecting you, in particular, a bit harder than the rest, there is always a community of women who are feeling exactly like you—you are not alone.

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Sources

1. Mayo Clinic website: “Uterine Fibroids.” – http://www.mayoclinic.com/health/uterine-fibroids/DS00078.
2. Seminars in reproductive medicine: “Uterine Fibroids: Burden and Unmet Medical Need.” – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193285/
3. CARE About Fibroids: “Uterine Fibroids: The Emotional, Physical, and Economic Toll.” – http://www.careaboutfibroids.org/toll-of-fibroids.html
4. The BMJ, British Medical Journal Publishing Group:  “Uterine Fibroid Drug Is Recalled after Case of Liver Failure Requiring Transplant Prompts EU Review.” www.bmj.com/content/368/bmj.m1112.
5. American Journal of Clinical Nutrition: “Dietary glycemic index and load in relation to risk of uterine leiomyomata in the Black Women’s Health Study.” – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2854903/
6. Journal of Obstetrics and Gynaecology: “Vegetarian diet and reduced uterine fibroids risk: A case-control study in Nanjing, China.” https://www.ncbi.nlm.nih.gov/pubmed/26458740
7. Reproductive Biomedicine Online Journal: “Quercetin and indole-3-carbinol inhibit extracellular matrix expression in human primary uterine leiomyoma cells” – https://www.sciencedirect.com/science/article/abs/pii/S1472648320300249
8. Fertility and Sterility Journal:  “Endocrine-disrupting chemicals and uterine fibroids.”- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051569/
9. Healthline Magazine: “How Alcohol Can Affect your Immune System.”- https://www.healthline.com/health-news/can-alcohol-hurt-your-immune-system-during-covid-19-outbreak
10. The Elusive Magical Solution: The Relationship between Vitamin D and Fibroids- https://scholars.direct/Articles/gynecology-and-obstetrics/ago-3-008.php?jid=gynecology-and-obstetrics
11. The role of Vitamin D in the prevention of Coronavirus Disease 2019 infection and mortality- (https://www.researchsquare.com/article/rs-21211/v1)
12. American Journal of Epidemiology: “Association of Physical Activity with Development of Uterine Leiomyoma.”                – https://academic.oup.com/aje/article/165/2/157/97971
13. Mayo Clinic: “ COVID-19 and Your Mental Health”- https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/mental-health-covid-19/art-20482731
14. Lake Health and Wellbeing: “Fibroids and your Mental Health.”- https://lakehealthandwellbeing.com/newsite/wp-content/uploads/2019/05/FibroidsANDEmotionalWellbeingVersion2.pdf

To contain the spread of COVID-19, the government of St Kitts and Nevis declared a State of Emergency on 28^th March 2020. Since that declaration, we’ve had a combination on 24-hour and partial curfew days and our borders have been closed.  This quick action by the government has been effective and the number of COVID-19 cases has remained fairly low. We have had 15 cases, 8 of those cases have recovered and we haven’t had a new case in over 10 days.

Whilst this is all good news in terms of the pandemic, the closure of our borders and the lock-downs have been devastating to our economy which is heavily dependent on tourism. This has led to many businesses shutting their doors, school closures, and people being laid-off or placed on reduced hours. This has created a lot of anxiety and uncertainty about the future which the government has tried to address through a number of support programmes such as the COVID-19 Relief Fund, the expansion of the Poverty Alleviation Programme, moratoriums on utility bill payments, a range of social services to support the vulnerable and psychological support to address the mental health impact of the pandemic.

One service, which we have been delighted to be assisting with is the COVID-19 Helpline. This is a service established by the Ministry of Health and the National Emergency Management Agency  (NEMA) to give the public someone to easily reach out to if they have a COVID-19 related question, need support during this time and are concerned that they may have COVID-19 symptoms. When the public calls 311, their concerns are discussed with a friendly helpline operator (like us 😊) and then they are signposted to the relevant government department or an NGO for their issue to be addressed.

It has been very fulfilling volunteering with the helpline and being able to help those who are experiencing a number of challenges during this time. We’re just so happy that the support available in the Federation is comprehensive and holistic. So far, there has been a programme to address all the concerns we have had from callers and many have ended the call feeling happier and more at peace.

If you are based in St Kitts and Nevis and have a question about COVID-19, curfew timings, the COVID-19 relief fund, then please don’t’ hesitate to call 311 (it’s a free call). To find out more about the helpline, you can view the video below and for general information about COVID-19 in St Kitts and Nevis, you can visit https://www.covid19.gov.kn/

Many of us are at home due to the COVID-19 pandemic and are experiencing a range of emotions as a result of this health crisis. If you’d like to make sense of what you’re feeling, you can join Olivia Haltman of OH Services on Saturday 25^th April where she’ll be discussing the effect of COVID-19 on our mental health and how you can support yourself and others.

You can register for this webinar here

In addition to this webinar, Olivia Haltman will be delivering two free webinars as part of her “What is…?” series.

On Tuesday 28^th April, Olivia will be exploring ‘What is Sexual Abuse?” This is an issue which can affect anyone and this means we need to stay well informed so we can remain as safe as possible and keep each other safe and empowered. When an experience like this happens, it is bound to drastically shift the course of someone’s life as it impacts their mental health. It can be challenging supporting survivors of sexual abuse, but a huge part of the problem is being misinformed about this issue. So, this webinar aims to bring you relevant facts, information and knowledge so you can tackle this topic with confidence.

You can register here

Next month, on 26^th May, Olivia will be discussing ‘What is a Healthy Relationship?” She’ll be answering the question ‘What does a healthy relationship look and feel like?” In this webinar, you’ll analyse whether you have a healthy relationship with your partner, family, friends, employer and, most importantly, yourself.  Identifying the qualities of what a healthy relationship is crucial for our emotional wellbeing. This webinar will help you to understand why a healthy relationship is important and how you can set boundaries that will make you feel secure and safe, even when your relationships become challenging .

You can find out more about this webinar and register here

We hope you’ll be able to attend one of these interesting webinars. For more information about these events, you can contact OH Services here. 

Today, we’re delighted to share a guest blog post from the team at Mesothelioma Guide.  Mesothelioma Guide connects mesothelioma patients and their loved ones to top doctors, cancer centres and treatment options, plus legal resources. In today’s feature, they dispel the myth that the asbestos-related cancer, mesothelioma, has been eradicated since the introduction of legislation restricting the use of asbestos.

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In the latter half of the 20th century, the general public learned of asbestos’ dangers. They learned the substance is, in fact, a carcinogen, one which can lead to aggressive diseases such as mesothelioma.

The awareness of asbestos’ harm led to increased regulations worldwide and scrutiny of businesses which used the mineral. Most people expected asbestos-related diseases like mesothelioma to level off early in the 21st century and eventually fade into obscurity.

This has not happened — nor will it any time soon.

According to the World Journal of Surgery, pleural mesothelioma cases in the United States increased from 2004 to 2014. The World Health Organization revealed that around 43,000 people worldwide die from this cancer. Despite more than 60 countries banning the commercial use of asbestos, the mesothelioma mortality rate has increased worldwide since the 1990s. This is proof that mesothelioma isn’t going anywhere.

National Cancer Database on Mesothelioma

In 2004, there were 1,783 pleural mesothelioma cases in the United States. In 2014, there were 1,961 reported cases. That’s an increase of around 10%.

Pleural mesothelioma accounts for between 70% and 80% of all U.S. mesothelioma cases and the same is true globally. Peritoneal mesothelioma and pericardial mesothelioma comprise the other 20-30% of cases.

According to numerous sources, including the Centers for Disease Control and Prevention, there are usually between 3,000 and 3,300 new mesothelioma cases in the U.S. each year. From 2012-2016, there were on average 3,253 new cases each year. In 2016 alone, 3,096 mesothelioma cases were reported.

The World Health Organization estimates that 10,000 new mesothelioma cases each year are diagnosed collectively in Australia, Japan, North America and western Europe.

In the United Kingdom, the incidence of mesothelioma has increased steadily each year from the 1950s (153 cases) to 2010 (2,360 cases). Like we said earlier, this disease isn’t going away.

But…

Mesothelioma Treatment Is Improving

 Science continually evolves, which means treatment for diseases continuously improves. Mesothelioma treatment is getting better, which is good news for patients and their loved ones.

Earlier in 2019, The U.S. Food and Drug Administration approved the Novo TTF-100L medical device for pleural mesothelioma treatment. It is limited to humanitarian use device distinction, but this approval was a significant moment for mesothelioma patients and doctors.

Peritoneal mesothelioma treatment is expanding as well. Many patients receive cytoreductive surgery, plus heated intraperitoneal chemotherapy (HIPEC) immediately after the operation. In a study published by the Annals of Surgical Oncology, around 55% of participants who underwent this treatment combination survived for at least three years. Roughly 37% survived for at least five years.

This study only included a few peritoneal mesothelioma patients, and other studies have reported different percentages:

• Between 50% and 65% for three-year survival
• Between 35% and 47% for five-year survival

Mesothelioma Patients Undergoing Treatment More Often

The best route to healing from mesothelioma is undergoing treatment. Surgery is the first choice followed by chemotherapy and radiation. If more patients receive medical help, then more of them will survive longer.

In 2004, treatment and survival rates in the U.S. were as follows:

• Approximately 34% of pleural mesothelioma patients underwent treatment.
• Around 37% of them survived for at least one year after diagnosis.
• Roughly 9% survived for at least three years.

In 2014, the rates were better:

• Around 54% of mesothelioma patients received treatment.
• Roughly 47% survived for at least one year after diagnosis.
• Approximately 15% survived for at least three years.

So, more people are getting treatment for their mesothelioma, and more people are surviving for longer after diagnosis.

How to Find Mesothelioma Treatment

We at Mesothelioma Guide can help patients find quality treatment and potentially extend their lives. Our patient advocate and registered nurse, Jenna Campagna, has connections to the top cancer centres in the USA.

If you or a loved one has mesothelioma, remember that treatment now is better than ever before. Jenna works with patients every day to improve their quality of life and prognosis. Email her at jenna@mesotheliomaguide.com if you wish to explore your treatment options.

More Information

If you have any questions on mesothelioma or would like any further information, you can leave your question for Mesothelioma Guide in the comments section below. Alternatively,  you can visit Mesothelioma Guide’s website here,  like their Facebook Page or follow them on Twitter.

Sources

1. Largely Unchanged Annual Incidence and Overall Survival of Pleural Mesothelioma in the USA. World Journal of Surgery. Retrieved from: https://link.springer.com/article/10.1007s00268-019-05132-6. Accessed: 08/23/2019.
2. Global mesothelioma deaths reported to the World Health Organization between 1994 and World Health Organization. Retrieved from: https://www.who.int/bulletin/volumes/89/10/11-086678/en/. Accessed: 04/22/2020.
3. Global mesothelioma epidemic: Trend and features. Indian Journal of Occupational and Environmental Medicine. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280782/. Accessed: 04/22/2020.
4. Update on the management of malignant peritoneal mesothelioma. Translational Lung Cancer Research. Retrieved from: http://tlcr.amegroups.com/article/view/23788/18535. Accessed: 08/23/2019.
5. Effect of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy on Quality of Life in Patients with Peritoneal Mesothelioma. Annals of Surgical Oncology. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/31069554. Accessed: 05/16/2019.
6. Survival prognostic factors in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy treatment: analysis from a single oncological center. WorldJournal of Surgical Oncology. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4815060/. Accessed: 04/12/2019.

KMT Rising is hosting a series of monthly online Zoom sessions dedicated to women’s health improvements around Fibroids.

The Womb-an Series is a safe and confidential platform for women to meet (in the comfort of your homes), to find out more about what contributes to fibroid growth and acceleration, what lifestyle choices and dietary factors impact on womb-wellness, what strategies can we incorporate into our lives to reduce fibroid symptoms, and what are the range of holistic approaches towards getting our health back into balance, and towards fibroid elimination.

The sessions will be facilitated by a qualified Holistic Health Practitioner and you will have the opportunity to ask questions regarding your own personal health challenges.

The sessions will include:

• Understanding Fibroids (Wednesday 20th May 2020, 8.30-9.15pm)
• Creating a space for healing the womb (Wednesday 24th June 2020, 8.30-9.15pm)
• Holistic Strategies to Womb-Wellness (Wednesday 22nd July 2020, 8.30-9.15pm)

You can register for this series here

The COVID-19 pandemic has left many of us feeling anxious and uncertain about the future and with this in mind, we are delighted to share some tips from NJC Therapy Practice to help you find some inner peace during this difficult time.

Six Principles to Nurture Balance and Peace in Your Life

1. Find your calm before you start anything (e.g. deep, slow breaths; visualization; whatever works for you)
2. Know you control your thoughts (limitless possibilities)
3. Know you control your actions (pause and decide how you’re going to act)
4. Everything is neutral (until you give it meaning i.e. how you look at it e.g. cup half full or empty)
5. Each day, find the joy in simple things (do what makes you laugh out loud/grin)
6. Begin and end your day with gratitude (appreciate someone or something)

About NJC Therapy Practice

NJC Therapy Practice aims to help their clients use their unique inner strengths and passion to take control of their lives. They offer a variety of life-enhancing and holistic programmes that are tailored to your individual needs incorporating the following approaches:

• Life coaching
• Hypnotherapy
• Educational Performance Programme
• Self Help Publications and Audio Recordings
• Hypnosis Meets Sports
• Specialisms: Stress management, weight control and performance management

To find out more about NJC Therapy Practice, you can visit their website, follow them on Twitter or send them an email

Photo Credit

Ian Kiragu

As part of our My Healthy Heroes pilot project, we worked with two fourth grade classes in St Kitts to highlight the importance of healthy eating.

As part of this project, we sought to use creative ways to consolidate what students learnt in our sessions. Therefore, one of the tasks we gave students was to write either a short story, rap or poem featuring one of our My Healthy Heroes characters.

Today, we’re delighted to share a few of the short stories with you. We hope you enjoy them.

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A Mangolicious Dream

By: Rainier Martin

In the night, Amelia ate her dinner. Afterwards, she went to sleep, to wake up the next morning.

When Amelia was finally asleep, she had a great dream. There were characters, Miss Mangolicious and her healthy fruit and vegetable friends.

Miss Mangolicious and her friends, Tommy Tomato and Potato Head Jed were on a great mission.

“We have to save Amelia!” exclaimed Miss Mangolicious.

“Amelia is suffering from a severe case of Lack-of-Healthy-Eating-itis” said Tommy Tomato.

“We need to meet Ameilia at her usual eating spot right now. Quick, to my Mangolicious Carriage!” exclaimed Miss Mangolicious.

“There she is, sitting under the shady trees,” said Potato Head Jed.

“Amelia!” shouted Miss Mangolicious.

“You need to eat healthy foods,” said Tommy Tomato.

“Let us teach you the importance of healthy eating,” they all said.

“It is good to eat fruits and vegetables because you get a lot of vitamins and your bones become stronger,” said Potato Head Jed.

After all that Amelia learned in her dream, she started eating healthy from then on. Every day, Amelia eats fruits, vegetables and of course, mangoes!

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The Adventures of Professor Cornilious Cob

By: Kailynn Browne

 One day, the Sugary Drink Assassins and the Junk Food Villains were trying to take over Healthy Land.

Professor Cornilius Cob said, “Stop right there!”

The Sugary Drink Assassins and Junk Food Villains exclaimed, “We’re not going to listen to you!”

Professor Cornilius Cob needed some help from his friends. He called Miss Mangolicious, Captain Splash, Potato Head Jed and Mama Elegant.

Professor Cornilius Cob said, “We are going to fight them with facts.”

They all thought this was a great idea.

Professor Cornilious Cob said, “I am rich in vitamin B12, folic acid and iron.”

With that said, Frenchy the Frier disappeared into thin air.

“I have vitamins A, C, B6 and potassium,” said Miss Mangolicious. Donutter Dennis turned into dust.

Captain Splash exclaimed, “I am very important.” Juicer Jones turned into a puddle.

Mama Elegant exclaimed, “I have a beautiful colour which makes people want to eat me,” Greasy Greg Chicken Led turned raw.

After that day, the Junk Food Villains and Sugary Drinks Assassins went back to Unhealthy Land and never came back.

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We hope you enjoyed these two stories. Please do give our young writers a bit of encouragement by leaving a comment below and we’ll share more in our next blog post.

Update: The State of Emergency that went into effect on Saturday 28th March 2020 has now been repealed and as of 31st March 2020 at 7 pm, St Kitts and Nevis is under a 24-hour curfew until Friday 3rd April at 6 am. You can read the new regulation here and view a news piece from ZIZ News about the curfew below.

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Today, Saturday 28th March 2020, the Prime Minister of St Kitts and Nevis, Dr the Honourable Timothy Harris announced a state of emergency to protect the public from COVID-19.  This means that effective from 7 pm today all residents are subject to a curfew from 7 pm to 5 am daily for the next 14 days, outside of these hours the public’s movements will be restricted and any movement during this period should involve social and physical distancing.

You can view the full COVID-19 Emergency Powers Regulations below for in-depth information about what is and isn’t allowed during the next 14 days.

If you have any questions, you can contact the COVID-19 hotline by dialling 311.

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SAINT CHRISTOPHER AND NEVIS

STATUTORY RULES AND ORDERS

Emergency Powers (COVID-19) Regulations

In exercise of the power conferred by section 5 of the Emergency Powers Act, Cap. 19.02, the Governor-General, makes the following Regulations:

1. Citation and duration.

(1) These Regulations may be cited as the Emergency Powers (COVID-19) Regulations, 2020.

(2) These Regulations shall come into operation once a state of emergency for the novel coronavirus or COVID-19 is declared by Proclamation, published in the Official Gazette.

2. Restriction on freedom of movement.

(1) A curfew is imposed every day from 7:00 p.m. to 5:00 a.m. except as provided in these Regulations or as may be approved by the Commissioner of Police.

(2) Freedom of movement every day from 5:00 a.m. to 7:00 p.m. shall be exercised in accordance with these Regulations.

(3) These Regulations shall not apply in the case of a medical emergency.

3. Work remotely from home.

(1) All businesses and offices may continue their business operations by allowing their employees to work remotely from home utilizing virtual means, unless they are permitted to work under regulation 5 or are designated as being essential workers under regulation 7.

(2) Where a business is unable to continue its business operations by its employees working remotely from home, the business shall cease its operations.

4. Public Service, Statutory Bodies, State-owned Enterprises and Courts.

(1) Subject to sub-regulation (2), all members of the public service shall work remotely from home, except as otherwise directed by the Secretary to the Cabinet.

(2) Where the Secretary to the Cabinet directs that specified public officers

attend work, the Government shall take reasonable steps to

(a) ensure safe transport of the public officers in accordance with regulation 13; and

(b) comply with the physical distancing protocols in accordance with regulation 6.

(3) Subject to sub-regulation (4), all employees of Statutory Bodies and State-owned Enterprises shall work remotely from home, except as otherwise directed by the Chairperson of the Board

(4) Where the Chairperson of the Board directs that specified employees attend work, the Statutory Bodies or State-owned Enterprises as the case may be shall take reasonable steps to

(a) ensure safe transport of the employees in accordance with regulation 13; and

(b) comply with the physical distancing protocols in accordance with regulation 6.

(5) Subject to any relevant the Eastern Caribbean Supreme Court Practice Direction, the Courts shall remain accessible, shall adhere to physical distancing protocols and the persons employed within the public service shall work remotely from home as far as reasonably practicable.

(6) In this regulation, “the Court” means the Magistrates Courts and the Eastern Caribbean Supreme Court.

5. Closure of businesses and exceptions.

(1) Every non-essential establishment or business shall remain closed except for the following businesses which may remain open for any period within the specified time

(a) wholesale or retail grocery stores; commercial bakeries; or fruit and vegetable vendors from 8:00 a.m. to 5:00 p.m., and for the first two shopping hours seniors, disabled persons and essential workers with identification shall be granted priority;

(b) doctor’s offices, hospitals and medical facilities;

(c) pharmacies and medical supply establishments;

(d) gas stations from 6:00 am. to 5:00 p.m.;

(e) hardware stores from 6:00 a.m. to 5:00 p.m;

(f) hotels, excluding any casinos, spas, gyms, discotheques and restaurants therein, however, such restaurants may offer takeaway or room service;

(g) banks, credit unions and money services business from 8:00 a.m. to 2:00 p.m., on Mondays to Thursdays and 8:00 a.m. to 4:00 p.m. on Fridays;

(h) commercial ports and related businesses between 6:00 a.m. to 5:00 p.m., subject to any variation by the Ports Authority;

(i) airports subject to regulation 10(1)(a);

(j) commercial courier flights;

(k) businesses licensed to provide security guard services

(l) take away food vendors from 6:00 a.m. to 5:00 p.m.;

(m) the National Caribbean Insurance Company or other health insurance companies;

(n) such other businesses or undertakings as may be specifically exempted in writing by the Commissioner of Police

provided that the owner or operator of an establishment specified in paragraphs (a) to (n) shall adhere to social distancing and physical distancing protocols pursuant to regulation 6.

(2) Subject to sub-regulation (3), all works of construction of any sort (apart from urgent plumbing, electrical, roof repairs or other emergency repairs for a home or business) shall cease.

(3) Where it is necessary for the purposes of health and safety and with the written approval of the Commissioner of Police, pre-existing works of construction may continue.

6. Social distancing and physical distancing protocols.

All business establishments shall make the necessary arrangements to facilitate social distancing and physical distancing and shall

(a) ensure that all customers and staff maintain physical distancing of at least six feet (6ft.) in or outside of their business if in a line to enter the business;

(b) determine the number of persons that may be permitted in the establishment at any one time by permitting one person for every thirty square feet of store space;

(c) place distance markers at least six feet apart, indicating where each customer must stand on a line at a check out point or other line;

(d) place distance markers at least six feet apart on the outside of the establishment, indicating where customers must stand while waiting to enter the establishment.

7. Shelter in place.

(1) Subject to sub-regulation (2) and in an effort to prevent the spread of the novel coronavirus or COVID-19, every person shall remain confined to their place of residence, inclusive of their yard space, to avoid contact outside of their family, except

(a) essential workers, who are required to report to work;

(b) workers required to work under regulation 4 or 5;

(c) for essential travel to the doctor, grocery store, bank, credit union, money services business, pharmacy or to refuel vehicles;

(d) for outdoor exercise, whether alone or together with family members living under the same roof, between the hours of 5:00 a.m. to 6:00 p.m.,

provided that such person must ensure at all times to distance themself at least six feet (6 ft.) from any other person.

(2) For the purposes of this regulation, an “essential worker” includes essential officers of

(a) the Royal Saint Christopher and Nevis Police Force;

(b) the Saint Christopher and Nevis Defence Force;

(c) the Fire and Rescue Services Department;

(d) the prisons, correctional facilities, or other similar establishments;

(e) the Social Security

(f) the Department of Social Services;

(g) the Department of Environmental Health;

(h) the Department of Immigration;

(i) the Customs and Excise Department;

(j) waste disposal and sanitation companies;

(k) any hospital, health care or medical facility;

(l) Saint Kitts and Nevis Red Cross;

(m) Air and Sea Ports Authorities;

(p) Accountant General’s Department and Inland Revenue Department;

(o) any water, electricity or other sector encompassing the provision of electronic communications including print and electronic media.

(3) All essential workers shall at all times carry personal identification.

8. Education and religious instruction.

(1) All religious and educational places of instruction or worship shall remain closed.

(2) Subregulation (1) does not prohibit—

(a) any activity referred to therein by electronic or virtual means;

(b) individual attendance at a place of worship for private individual prayer while practicing social distancing and physical distancing

9. Restriction on social activities.

No person shall host or attend

(a) a private party which includes any person from outside of the immediate household;

(b) a recreational or competitive sporting event or other types of public entertainment;

(c) a wedding which hosts ten or more persons other than the bride, bridegroom, official witnesses and the marriage officer;

(d) a banquet, ball or reception;

(e) any other ceremony in any facility or public place which involves the participation of any member of the general public or a gathering of ten or more persons;

(f) a funeral, except 10 members of the immediate family and at least one officiant and essential mortuary;

(g) a meeting of a fraternal society, private or social club or civic association or organization that exceeds a total of 10 persons; or

(h) any other type of social event, for a nonessential purpose, where more than 10 persons are gathered together.

10. Restriction on international travel.

(1) For the purposes of preventing, controlling and suppressing the spread of the novel coronavirus or COVID-19, with immediate effect

(a) except with the prior written permission of the Air Ports Authorities, all airports including private airports and fixed-base operations shall be closed to incoming international flights;

(b) all sea ports shall be closed to regional and international seafaring and private boating; and

(c) a visitor shall not be permitted to enter and disembark for any reason, including transiting through Saint Christopher and Nevis.

(2) The restriction contained in paragraph (1) does not apply to

(a) outgoing flights or outgoing ships, as the case may be;

(b) cargo flights or cargo ships, as the case may be;

(c) commercial courier flights;

(d) emergency medical flights;

(e) emergency flights approved by the Air Ports Authorities;

(f) a flight carrying any diplomat.

(3) Notwithstanding sub-regulation (2), no crew member will be allowed or granted shore leave, unless for the purposes of operational difficulties and upon receiving permission from the Airports Authorities or the Ports Authorities.

11. Restriction on domestic travel.

No person shall offer for hire or seek to travel on any inter-island private commercial sea transport, provided that the Ports Authorities may vary any of the requirements by an Order.

12. Restriction on road traffic

(1) No person shall drive a vehicle on any public or private road for a purpose other than stated in regulation 5, 7, 9 (c) or 9 (g).

(2) The Saint Christopher and Nevis Police Force and the Saint Christopher and Nevis Defence Force shall have powers to stop any vehicle and inquire as to the purposes for which that vehicle is being utilised, and to arrest anyone found in violation of this restriction.

(3) For the purposes of this regulation, “vehicle” includes a motor vehicle or motorbike.

13. Public transportation

(1) No person shall offer for hire or seek to travel on

(a) any motor omnibus unless there is or would be no more than one passenger per row in the motor omnibus in a staggered formation;

(b) any hiring car or taxi, unless there is not more than one passenger in the vehicle;

(c) any passenger ferry unless there is or would be no more than persons per row.

(2) In this regulation, “motor omnibus”, “hiring car” and “taxi” have the meanings assigned under the Vehicles and Road Traffic Act, Chapter 15.06.

14. Restriction on visitation.

(1) No person shall visit or be permitted to visit

(a) any place of quarantine or isolation station;

(b) a patient in a hospital or residential care establishment or facility, including an elderly nursing home;

(c) a detainee in prison.

(2) Notwithstanding sub-regulation (1) (b) but subject the protocol of the hospital, a patient of a hospital may be allowed one visitor per day.

15. Penalty.

A person who contravenes or fails to comply with these Regulations shall be liable on summary conviction to a fine not exceeding five thousand dollars or a term of imprisonment for a term not exceeding 6 month or to both and to forfeiture of any goods or money in respect of which the offence has been committed.