We’re delighted to announce that our next set of chronic disease self-management courses will start in July 2019.
Following the success of our first chronic disease self-management course which ran from 2nd April to 7th May 2019, we will be hosting two more sets of workshops. The first will start on Tuesday 2nd July and the second on Wednesday 3rd July. Both workshops will be held at the conference room at the Ministry of Health in St Kitts from 5pm to 7pm.
The course is aimed at anyone living in St Kitts who is either living with a chronic health condition (like diabetes, high blood pressure, asthma, fibroids, heart disease, arthritis, chronic back pain etc.), is caring for someone with a chronic illness, is at risk of developing a chronic health condition or who is interested in the topic and would like to learn more.
Participants will attend one session a week for 6 weeks and during this period they will be provided with the information, skills and knowledge to live well with their health condition. This will enable those affected by a chronic disease to take control of their health and wellbeing and not be hindered in any way by their condition.
Over the six weeks, attendees will be taken through key self-management techniques such as action planning, problem-solving, symptoms management, medication management, communication skills, pain management and more. Additionally, attendees will have access to free health checks and relevant services to enable them to adopt a healthy lifestyle.
If you or anyone you know is living with a chronic disease or caring for someone with a chronic disease, then this workshop is just what you need.
You can register your interest by completing the registration form below and for more information or if you have a question about this course, please email us or call 765 8702.
No Fields Found.
Please note: The information you provide in the form above will only be used to contact you about our chronic disease self-management course. It will not be passed on to any third party and you won’t be added to our newsletter’s mailing list. To be added to our mailing list, please click here.
On 1st June 2019, we’ll be hosting a webinar on the emotional impact of fibroids, an issue that is often neglected, but we believe this is a very important area to focus on.
When many of us think about fibroids and its effects, we tend to think about the physical and medical symptoms, such as heavy menstrual bleeding, prolonged periods, abdominal pain, anaemia and back pain. The emotional and psychological impact of fibroids is not at the forefront of women’s minds or even their doctor’s, but it is very important that this is addressed to ensure a complete recovery.
We first identified the importance of exploring the emotional impact of fibroids in 2014, when we conducted a survey to understand the needs of women with fibroids. As we were analysing the results of the survey, we noticed that a significant number of women were describing how living with fibroids was affecting their mental wellbeing. For example, women said the following:
“I have hated life at times because of fibroids. I feel like I am being punished for something.”
“Depression from feeling that my only options were drugs or surgery”
“Fear of not being able to have children”
“Just a constant fear of what they could become”
As a result of this, we started to explore this issue further by speaking to women who attended our events and soon realised that this was a much wider problem. To compound this issue there was little information available, at the time, about the emotional impact of fibroids and no services to support women in addressing these issues.
We decided that going forward, the emotional and psychological impact of fibroids would be embedded in all our work. This would ensure that women are able to identify, understand and address the emotional impact of fibroids. We hope this will allow women to get help promptly and develop the resilience and skills required to improve their mental health, should it be affected by their experience with fibroids.
So far, we have organised two conferences aimed at women with fibroids, one in London and one in St Kitts, and both covered the emotional impact of fibroids. We worked with accredited counsellor Olivia Haltman to develop a fact sheet on this topic and we’ll soon be updating our fibroids booklet to include information on fibroids and women’s wellbeing. We were also delighted to see that Olivia Haltman has developed the first online course on the emotional impact of fibroids after our work together revealed this was much needed.
Our latest initiative is our webinar on 1st June which will feature Olivia Haltman, founder of OH Services and Jo-Ann Hamilton, founder of Rare Birds.
In this webinar, Olivia will take attendees through how living with fibroids can affect a woman’s mental health and how women with fibroids can improve their emotional wellbeing.
We’re also honoured to have Jo-Ann Hamilton, the Founder of Rare Birds, sharing her 10-year experience with fibroids, how this experience affected her mental wellbeing and how she overcame this challenging journey.
If you’ve been affected by fibroids, you are very welcome to attend this webinar. register for this webinar here or if you have any questions, please email us at events@lakehealthandwellbeing.com
From 2nd April to 7th May 2019, we facilitated our first chronic disease self-management course in St Kitts giving us the opportunity to support members in our community who have been affected by non-communicable diseases (NCDs).
Data has demonstrated that NCDs are becoming an epidemic in St Kitts and Nevis with 83% of deaths in the Federation being due to these conditions. To prevent these premature deaths and ensure that those living with an NCD can live well and have a good quality of life, support, information and guidance are required.
Providing patients with self-management skills is an effective and empowering way to ensure that those affected by a chronic disease can take control and improve their health and wellbeing. The Chronic Disease Self-Management Course helps us achieve this outcome.
The course that we facilitated is part of the Stanford University Chronic Disease Self-Management Program (CDSMP). This is an evidence-based prevention and health promotion program that addresses common issues faced by people with chronic conditions. The program has been implemented in 19 countries showing several benefits including:
Improved wellbeing
Improved health of participants
Fewer hospitalisations
Fewer days spent in hospital
Last year, we took part in the CDSMP training program which was delivered by the Ministry of Health in St Kitts. We were honoured to have come through the process and are now certified CDSMP facilitators allowing us to implement a free program of support for members in our community with an NCD.
Over the six-week period from the 2nd April to 7th May, we were delighted to guide our 18 participants through key self-management techniques. These techniques included action planning, problem-solving, decision making, medication management, communication skills, pain management, healthy eating, physical activity and more.
What we like about the course is that it is very interactive. Participants had the opportunity to take part in various activities, share their experiences, learn from one another and support each other. There was also homework every week to ensure that participants could start practising their self-management techniques immediately in their day-to-day life. It was wonderful to see and celebrate their successes every week.
We had a very engaged group who were a pleasure to work with. They got involved, asked questions and were keen to make the necessary changes in their lives to improve their health.
Facilitating this course has been one of the most rewarding experiences we have had in a long time. It was so touching to hear participants share how their lives have been impacted by the course. We look forward to seeing them continue to make great progress in taking control and more effectively managing their health.
A big thank you to everyone who attended and if you live in St Kitts and have been affected by a chronic illness like diabetes or high blood pressure and would like to attend a chronic disease self-management course, please do get in touch with us by email or call 765 8702
Our next 6-week course is due to start in July, all are welcome to attend.
“Thank you for the life lessons you have shared. Anyone who attends this course will never be the same again. The teachings will always be on one’s mind and heart. We must make a change! Eating, exercising and managing our lives better and being in control, this is an awesome feeling” – CDSMP Course Attendee
The documentary is narrated by the award-winning actress Viola Davis who has a strong family history of type 2 diabetes and who herself is pre-diabetic.
The World Health Organisation has reported that in 2014, 422 million people worldwide were living with diabetes. The majority of these patients, about 90%, are living with type 2 diabetes.
Type 2 diabetes is now considered by many to be an epidemic and the film, A Touch of Sugar, delves into this chronic condition by telling the story of the many people who have been affected. The film features interviews with patients, family members, doctors, advocates and thought leaders to raise awareness of diabetes, its impact on society and the importance of focusing on underserved communities.
You can watch the trailer for the documentary below:
You can reduce your risk of developing type 2 diabetes by maintaining a healthy weight, eating a healthy diet and taking part in at least 150 minutes of physical activity every week. If you have diabetes, speak to your doctor about the lifestyle changes that you can make to ensure that you’re managing your condition effectively.
In St Kitts and Nevis, diabetes is also a major health challenge, you can read about this here
We have started facilitating regular chronic disease self-management courses. These courses have been developed by Stanford University and have been proven to help those living with chronic conditions such as diabetes live well despite their condition.
If you live in St Kitts and Nevis and would like to learn more about managing chronic diseases, you can register to attend our next chronic disease self-management course, by sending us an email.
When it comes to the health and wellbeing of African people both on the continent and in the Diaspora at large, there are a number of challenges and health inequalities that exist. These inequalities include the black community having poorer health outcomes, being at an increased risk of developing a number of diseases and not always having access to adequate support to cope during periods of ill-health. In order to address these issues, many have suggested that the black community come together to develop solutions for us, by us. Before exploring unity as an approach to tackling some of these challenges, it’s useful to look back through history to understand the concept of unity so that if we are to come together, we develop partnership models that are most effective.
In today’s blog, we hear from guest blogger IC Blackman who takes us through the history of African unity and encourages us to think deeply about this concept.
One cannot deny the importance of an accurate grasp of history, particularly ancient history, for possessing a deeper understanding of our position, or lack thereof, in the world. Much has been argued about the relevance and authenticity of the terms ‘black’ or ‘African’ to describe peoples richly melanated in skin – for the purposes of demonstrative example as to the challenges of the realization of unity, we hold no fast consensus as to what we would prefer to be called. Arguments rage – all valid, I might add – for and against nomenclature that honours our history and invaluable contributions to the development and advancement of civilization. This begs the question: did we ever have a consensus, and if so, when, and how does this impact our concepts of Pan-Africanism, or black unity, today? The term to which one leans, whether black, African or some other, may be telling about how one views oneself vis-à-vis the world: identity, links to a certain landmass, being referenced as a colour or caste, and the legal implications and historical connotations of the latter.
To examine this predicament of a consensus beyond merely what we choose to be called, but in terms of the more pressing issue of unity, we ought to start from the beginning, or as close to the beginning as we can. Because of its startling symbolism, I choose to start with one of the most recent supercontinents and also the best known, Pangaea. There were other supercontinents that preceded it, but the further back I go, the more pushback I may get from certain scientific quarters about the presence of ‘thinking’ man in those times. Personally, I believe Homo sapiens sapiens is much older than the record books will allow.
As I describe certain geological phenomena in this post, one should also in tandem remember the Law of Correspondence. Hold tight – there is method to my madness.
The earth’s outer shell is made up of plates. Most activity occurs where plates meet or divide. Plates move in three ways: convergent (moving towards each other, even colliding in some instances), divergent (moving away from each other), and transform (where plates slide past each other). Movement of plates produces volcanic eruptions, underwater volcanoes, earthquakes, and, specifically by convergent plates, mountain ranges; thus, there are several cycles of creation and destruction, periods of volatility and rest, all natural, all inevitable, all a part of existence. The most volatile processes create new forms, it would seem, adding to the topographical features of the earth – mountains and valleys, the highs and the lows. Movement can occur slowly or violently, changing the architecture of Planet Earth. Each continent as we know it today rests on these plates, that is, tectonic plates. They are in constant motion and interaction, a process called plate tectonics.
Using geological time collapse, let’s agree on a single landmass called Pangaea – a supercontinent, consisting of lakes and rivers, which existed before the latest continental drift, i.e. the divergent movement of major plates that created the large and distinct landmasses we call continents today, in their latest configurations and geographical locations. Let us also agree that easy human migration out of Africa was facilitated by the most recent supercontinent Pangaea and its many incarnations prior to the most recent and significant continental drift. We can further argue about the origins of the name Africa, but if we are to have a consensus about nothing else, it should be about coming to terms with the usage of this epithet.
Let us also observe the signature feature of African civilizations to form along rivers, the best known being the Nile Valley civilization, from its origins in the south heading down the Nile to the north, its pinnacle manifesting as Kemet or Egypt. It is important to note here that rift valleys occur where a continental landmass is ripping itself apart – this happens in geological time. Modern Africa, i.e. the continent we know today, is projected to split along the Great Rift Valley system sometime in the very distant future, forming a double continent. In other words – change is supreme, movement is inevitable.
And like nature, like tectonic plates, we as a people are in constant motion, a constant state of flux, producing what I call the Dispersion Factor. This first manifested as migration to all continents before they were so-called, and the subsequent development of distinct civilizations on these landmasses after continental drift. One mindset, but a myriad of manifestations. Physical unity, then, would seem to go against this natural tendency towards dispersion and dissemination, as opposed to the more challenging but urgently needed spiritual and mental/thought unity.
Encoded in the DNA of African peoples may be the genetic roadmap for dispersion and multicentricity. We know that Africans as a group have more variations in their DNA within their group than between Africans and other groups. This phenomenon of what I call genetic non-cohesion may well be the reason why breeding farms in chattel slavery in the New World, which used a high degree of consanguinity, could produce ‘normal’ populations for far longer than logic would dictate. It could also be the reason why as a group we will adapt, include, and assimilate with ease. The downside is that this will occur in hostile as well as conducive environments, the former producing cultural distortion and disintegration, the latter producing cultural catalysts. There is no doubt that both processes have global knock-on effects and implications. We do ourselves a disservice to underestimate the profound effect of our state of being, both positive and negative, on the planet at large.
It’s very conceivable that the theory of Pangaea holds true – at the very least, it makes perfect sense. If you look at all the continents on the planet, they do appear to potentially fit together, much like the pieces of a jigsaw puzzle. Let’s continue to entertain the Law of Correspondence here. It is also conceivable that man existed at the time of Pangaea, or a forme fruste of Pangaea, and migrated outward from a pivotal focal point of creation. I call this point, adapting a term from embryological science, the pluripotent stem cell, from which all major cells of the human body originate – the pluripotent locus, or the progenitor cell from haematological science, the mother cell of all haematological bodies (red blood cells, white blood cells, platelets, etc.). These cells, being multi-hued and multi-functional, together form an efficient body system. That pluripotent locus, or primogenitor cell, we know today as the continent of Africa, remembering that it was once part of a contiguous landmass. For those who want to call it the Garden of Eden, I have no ready rebuttal. Whatever we choose to name this pivotal location, we must appreciate that now these disparate landmasses have been christened continents with bestowed names, some of which have changed over time, e.g. India was once Hindustan, and perhaps the continents were perceived differently prior to continental drift and after it, including in name.
Map courtesy National Geographic
Anthropological evidence and copious historical data would indeed confirm an ‘African’ presence on what we now know as the seven continents. Perhaps more accurate would be First Man and Woman, Ancient or Aboriginal Peoples. Genetics would suggest they were very diverse people.
Herein lies Ponder Point No. 1. This multifocal presence and the early civilizations it birthed aren’t as well-known as one would think. It certainly isn’t taught on the scale it should be, despite the evidence to support it. Africans therefore have been as a group multicentric, dispersed, and migratory from their very inception, and have had varying phenotypes, and within recent times, lighter hues in certain regions of the Earth. They set up civilizations wherever they landed – the Indus Valley civilization, the Nile Valley civilization, the Olmec civilization – and kept it moving. This has been a modus that has taken many incarnations throughout history, and up until modern times, it does not seem to have slowed, though immigration laws have had an impact on the freedom of movement enjoyed in antiquity.
The push and pull factors that sustain such movement are however very different, perhaps more unfavourable, but not at all exclusive to negative experience, than in the past – pioneering waves of voluntary, exploratory migration vs the more recent exploitative waves of forced migration. Ponder Point No. 2 eagerly cranes its neck for keen observation – the concept of unity, especially physical unity, I would therefore challenge further, is a very tenuous one. We tend to use ‘Africa’ as one would a collective noun, but there would be no harm in saying one was African and Senegalese, for example, or African and Ghanaian, or African and Guyanese, understanding that as one leaves the continent more qualification is required. You may also want to add Christian or Muslim, for example. We should be used to complexity by now. We’ve been here from the beginning. Our history is complex – multilayered, multidimensional, multifocal, and multiethnic. We’ve been here from the beginning – it is complex. And that complexity lends itself to both confusion and a timely consecration. One would be more inclined to speak of, and place greater store on, a core African mindset with its many global manifestations, i.e. cultural diversity even within the collective – on the mother continent of Africa, and in the Diaspora at large. Here, we may need to entertain further clarification and qualification of an ancient vs a modern Diaspora.
And while we’re at it, we may also need to make a distinction between ancient Africans and modern Africans (an ever-evolving entity). A distinction also needs to be made, using a chronological timeline, as to when this conversion – ancient to modern – took place. I would set that time at 1492 and the expulsion of the Moors from what we now know to be Spain – the Iberian Peninsula may be a more accurate term. For this pivotal historical event would generate a series of further historical events – the Spanish Inquisition and the Crusades, chattel slavery, colonialism and neocolonialism. All these would produce the modern African, who would be designated many names and pseudonyms through space and time, all with a growing patina of mistrust, disrespect and contempt (I’ve excluded some for good reason) – Ethiops, Ethiopian, Maure, Moor, blackamoor, Negro, black.
Superimposed on this, and perhaps contributing to our wounding in 1492, subsequent conquest and present predicament, we must also appreciate ancient African civilizations in decline, their peak in Kemet (Egypt). These would include the fall of the empires of Kush, Mali, Benin, Axum and Songhai and the kingdoms of Ghana and Mossi, and the phenomenon of infighting amongst nations and their weaker neighbours, a growing insularity of thought and the emergence of maladaptive forms of self-preservation in response to repeated foreign invasion. This decline, and it would happen over millennia, would also herald a new African, or modern African, and a new Africa. Stronger nations usurped weaker ones, and their captives, the spoils of war or POWs, created fodder for the transatlantic slave trade. Empires fell due to loss of life and loss of intellectual property, the draining of resources, human and mineral, brain and brawn. We, however, seem to have moved from physical wars and battles to ideological ones with physical elements and consequences – wars of class, wars of colour, wars of identity, fueled by hubris, greed, deception, envy and a forgotten self-knowledge.
All of these could be significantly ameliorated if we saw ourselves as privileged beyond the banal or the physical. One would argue these character chinks and ideological imbroglios were with us before 1492 – that we grappled with these human failings more and more as civilizations declined over time – but were exacerbated, perhaps entrenched by the Maafa. If one studies African mythology deeply in all its facets, for example Yoruba or Akan – the roadmap that would assist us in this journey of becoming whole or indeed returning to wholeness – they all address these human foibles.
One would argue that the first real unification or semblance of physical unity occurred in the West, i.e. the Americas, and under horrific conditions – nations and empires gelling under the remit of one plantation and one master. Ponder Point No. 3: is there any doubt, therefore, as to why unity is such a challenge? In a thriving plantocracy, betrayal was rewarded – the Meritorious Manumission Act of 1710 – while gathering in public was punishable by death, that is, laws prevented congregation. Non-cohesion was ratified in law.
But was ancient African success ever leveraged on physical unity, or was it a unity of mind and principles, a spiritual unity – a quantum mindset/thought, intangible yet effective? Certainly, unity, if it is to occur at all, would not be sustained if forged from the negative – anger, hate, dissatisfaction or a preoccupation with adversity, that is, under duress. (The adversity, however, should be recontextualized as a perfecting catalyst, refining thought back to the depths of the visionary, the mystic and the natural scientist. Challenging? Absolutely.) But take heart, this volatile process of unification seems to mirror the earth.
Should we be seeing unity as the Ancients would suggest, that it isn’t about the physical at all? Is the challenge mental, internal, and will it eventually manifest naturally in our external world? Is this a call to transcend the physical domain and its vicissitudes and aim even higher, to a more symbolic existence beyond the mundane, beyond the constraints of a dominating cultural lens? Perhaps we fell low to rise higher than we’ve ever been – ascension. Perhaps it’s all in the mind – we should be in one mind. The time is now. If we don’t get it, who will?
More and more it would appear that as Africa and Africans go, so goes the earth. This is our life-altering inheritance as the Mother and Father. If there is to be any pre-occupation, it should be, how do we honour the Mother and Father? What does it look like, feel like, taste like, sound like? Is it truly all in the mind? How we perceive it may be everything. And here’s the good news – despite the Great Rift Valley divergence, the earth’s tectonic plates continue to move, their motion slowly bringing the continents together again. Pangaea will be re-formed, a new supercontinent by a different name that may bear little resemblance to the Pangaea of old. Symbolic? Think about that Law of Correspondence and rest your mind there – as within, so without; as without, so within. It would seem feasible to conclude that continental drift is as inevitable as its reversal. How quickly or slowly the process unfolds may be within our grasp; certainly the process of continental rift is. This is not a hypothesis, but an inevitable process that will also reverse, and at a pace we determine. You don’t have to agree, just consider.
We would like to say a big thank you to IC Blackman for this very insightful blog piece. If you have any comments or questions, please leave them in the comments section below.
You can find out more about IC Blackman and her work here or you can follow IC Blackman on Twitter.
From 29th April to 3rd May 2019, the counselling department at Verschilds High School hosted their Health and Wellness Week and we were delighted to have been invited to take part in two of their planned events.
On 29th April, we spoke, bright and early, at the school’s assembly on the topic of stress management. During our 15 minute presentation, we talked about what stress is, what types of situations cause stress, the impact of stress and how we can manage stress.
We encouraged students to think about their own personal situations, especially during this exam period, to see how they can address any stressors that may be affecting their wellbeing and provided tips on managing these, which included – identifying stressors, elimination/delay of stressors, preparation, stress relief techniques, building resilience and getting support.
We had a great session with the student body and therefore were very happy to return on the 3rd May for their health and wellness fair.
During their health and wellness fair, we set up a stall and promoted living a healthy lifestyle. We spoke to students and staff about the importance of children and teenagers getting enough exercise and physical activity (WHO recommends 60 minutes per day), drinking more water, eating 5-7 portions of fruit and vegetables per day and cutting down on sugary drinks.
We had information showing how much sugar is in many popular soft drinks and students and teachers were shocked to learn that one can of coke contains 8 teaspoons of sugar.
To encourage children to swap their unhealthy snacks for healthier snacks, we had some lovely mangoes for staff and students to sample and this included some dried mangoes. Dried mango is a great alternative to candy and chocolate and it tastes great – the students (well…most of them) loved it.
We also held a competition where we asked students how many minutes of physical activity children and teenagers should take part in every day and three lucky students won a comic book – congratulations.
Finally, it was great to connect with the other stallholders, some of whom were familiar faces, such as the team behind Mother Becky Bush Tea and Sugar Town Organics. It was nice meeting the Gideon Force Organic Agriculture Cooperative, Close to Nature and the Drugs and Substance Misuse Team and learning about the great work they are all doing.
We had a great time at Verchilds High School and would like to thank the staff for their kind invitation and both staff and students for their warm welcome, visiting our stall and asking some great questions.
On 26th April, we attended the Ministry of Health’s focus group on sugar-sweetened beverages (SSBs). This event was part of the Ministry’s consultation process to get feedback as well as inform the public and key stakeholders on the progress being made to develop a national SSB policy.
This event was a follow-up to the Ministry’s SSB National Consultation which took place in November 2018 and provided an update on the policy imperatives that were presented last year.
From the focus group we learnt that the updated policy recommendations are:
A 32% excise only tax on SSBs
The tax will apply to calorically sweetened beverages including carbonated drinks (sodas), sweetened carbonated water, sugar-sweetened juices, sports drinks, energy drinks, tea and coffee drinks, sweetened milk/milk alternatives, milk powdered blended drinks, powdered drink mixes and drink mix syrups
Excluded from taxation would be fresh fruit juice (no sugar added), unsweetened milk/milk alternatives, infused water, unsweetened carbonated drinks and non-caloric sweetened drinks
Alternatives to SSBs will be suggested to the public. These would include: fruit/vegetable infused water, plain water, unsweetened carbonated water, unsweetened herbal (bush) tea and fresh-poured coconut water (unsweetened coconut water)
Thetax revenuewill be used to provide: a water infrastructure, water fountains in schools, reusable water bottles in schools, healthier school meals, public health campaigns, National Health Insurance, implementing a marketing ban to children, policy development for safe school zones and to improve agriculture education especially in primary schools
What About Artificially Sweetened Beverages?
One area still to consider, which is an interesting one, is whether to tax artificially sweetened beverages (ASBs).
ASBs are drinks that have been sweetened with non-nutritive sweeteners which include saccharin, acesulfame, aspartame, neotame, sucralose and stevia.
The field of ASBs is a confusing one. It has been hard to answer the simple question of whether they are beneficial or not. Therefore WHO funded a large global study to answer this question, but this still didn’t answer the question with health officials stating the following:
“The inconclusive results of the review of the evidence suggest that we need to see better, bigger and longer-term studies of non-sugar sweetener use, to find out for sure their benefits and risks. The review suggests that there could be some benefits in terms of preventing weight gain, but the evidence so far is not strong and does not show consistent enough results to be sure.”
Whenever there is doubt, we recommend that the public keeps things simple and uses products where there are clear health benefits and there is no doubt. The best option at the moment is to consume unsweetened beverages.
In the meantime, the Ministry will evaluate whether ASBs should be taxed as part of their SSB policy.
Why Tax SSBs?
Childhood obesity is a significant challenge here in St Kitts and Nevis. A PAHO report revealed that 33% of secondary school children in the twin-island state were overweight and 14% were obese. More recently, in 2017, a UNICEF report published that 26% of children in St Kitts and Nevis are obese.
SSBs have been linked to weight gain and obesity. Therefore, the taxation of SSBs has been utilised throughout the world as a method of tackling obesity by creating a deterrent which leads to a reduction in the purchase and consumption of SSBs.
Taxation of SSBs has three important aims. The first it to incentivise manufacturers to reformulate or replace their products to create healthier options, the second is to deter the public from purchasing and consuming SSBs by making them unaffordable and the third is to raise funds from the tax revenue that can be used to support initiatives aimed at improving the health of the public.
Next Steps
The Ministry of Health will now take all the feedback from their consultation, focus group and other engagement activities to draft a policy which will be circulated to stakeholders for any final comments before it is sent to Cabinet for approval.
March was International Women’s Month, Women’s History Month and International Women’s Day, the perfect opportunity to put the spotlight on the pressing issues that women face every day.
International Women’s Day was on the 8th March and this year’s theme set the tone for the month.
This year’s theme was #BalanceForBetter and aimed to stress the importance of creating a gender-balanced world.
This campaign didn’t just begin and end in March but continues all year long. The team behind the #BalanceForBetter theme is hoping that over the year society can work towards gender-balance in all sectors so that we can see more gender-balanced boardrooms, governments, media coverage, wealth, businesses and more.
Since March, organisations throughout the world have launched their own #BalanceForBetter campaigns to either explore what needs to be done to create a more gender-balanced world or to showcase women in various fields who are creating gender-balance through their work. One such organisation was Noire Wellness and we were delighted to have been featured in their campaign (thank you!).
Noire Wellness’ campaign focused on balance in the wellness sector. Their campaign featured women in this sector, showcased their work and explored what balance means to them.
We took the opportunity that this campaign presented to call for gender-balance in public health approaches.
Having spent the last few years slowly developing a fibroids health and wellbeing programme, we have seen first-hand the effect of not creating gender-balance in public health.
By not taking gender into account many health conditions, particularly gynaecological conditions, are overlooked with their impact not being fully appreciated. This means that women with conditions like fibroids lack the information and support that they require to make informed decisions about their treatment, to improve their own health and wellbeing and navigate the many challenges that living with fibroids presents. Furthermore, there is a lack of research and a lack of understanding of the causes of fibroids.
We aren’t the only ones calling for a gender-balanced approach.
We recently attended a webinar on women and non-communicable diseases (NCDs) and it was stressed that there needs to be a more gender-balanced approach to public health to avoid placing women at a disadvantage. One of the speakers explained that when it comes to medical research the male body is well-known, most research is conducted on white men and data is simply (and with a false expectation) extrapolated to women. This means there is no appreciation of the biological differences that exist between males and females and how this impacts health. The speaker stated that, for example, we now know that:
Women’s lungs are smaller than men’s which has an impact on women’s risks of developing lung diseases and the type of lung diseases that women develop
Women’s hearts are smaller
Women are more likely to develop a different form of bowel cancer
Women process alcohol differently
These gender differences, and others, have gone unnoticed by the medical profession and this has led to misdiagnosis and inappropriate treatment. This would not have been the case if there was a gender-balanced approach in the health sector.
More work is needed to address the gender imbalance that has been created in public health and medical research. By creating gender-balance in these areas we can begin to address the gender inequalities that exist and ensure that we can improve the health of all women.
Early in April 2019, the Task Force for Fiscal Policy for Health published their report ‘Health Taxes to Save Lives.’ This report explores the effect of taxing tobacco, alcohol and sugar-sweetened beverages (SSBs) on the purchase and consumption of these products.
These products are the focus of this report because they contribute significantly to increasing a person’s risk of developing a non-communicable disease (NCD).
They explain that the introduction of well-designed excise taxes can significantly reduce the consumption of tobacco, alcohol and SSBs and as a result improve the public’s health, save lives and raise a significant amount of revenue that can be used to tackle NCDs.
In order to reap the benefits of taxing these products, the Task Force recommends that the imposed tax should be an excise tax (as opposed to a sales tax or increasing customs duty) and the level of tax should be high enough to deter consumption from those in both high and low-income brackets.
“If all countries increased their excise taxes to raise prices on tobacco, alcohol, and sugary beverages by 50 per cent, over 50 million premature deaths could be averted worldwide over the next 50 years while raising over the US $20 trillion of additional revenues in present discounted value. Raising taxes and prices further in future years would save additional lives and raise even more revenues.”
The report stresses the importance of the taxation of these three products as a strategy for tackling NCDs as data has shown that 10 million premature deaths per year could be prevented by reducing the public’s consumption of tobacco, alcohol and SSBs.
The report also addresses industry’s opposition to taxation, which the Task Force describes as “flawed” and they further state that industry’s arguments against taxation are “false or greatly exaggerated, and none justify inaction.”
In the report, the Task Force takes each of industry’s arguments and addresses them showing why they are flawed, false or exaggerated. Industry’s arguments include:
A decline in government revenue
Loss of employment
A negative impact on the poor
Illicit trade, tax avoidance, and tax evasion
They also explain how industry has tried to influence and undermine public policy in unethical ways to halt the progress of taxation. Industry has sought to confuse the public, censor scientific research on the harms of their products and have used other such tactics to disrupt work by public health officials and policy workers.
The report concludes with a call for countries to take urgent action to reduce the consumption of tobacco, alcohol and SSBs. The Task Force, at the end of its report, recommends the following:
Countries should rapidly and significantly increase tobacco taxes and continue to raise taxes over time to make tobacco products less affordable, to reduce use, and to prevent unnecessary death and disease.
Countries should rapidly and significantly increase alcohol taxes and continue to raise taxes over time to make alcohol less affordable, to reduce consumption, and to prevent unnecessary death and disease.
Countries should actively implement policies directed at reducing consumption of sugar as it is a significant contributor to the rise in obesity, diabetes, and other associated noncommunicable diseases.
Countries should design their health taxes to be easy to administer, hard to manipulate, and difficult to game.
In addition to significantly raising health taxes in the short term, countries should improve excise tax administration and enforcement in order to reap the full benefits for health and revenues.
The international community – including international financial institutions and UN agencies, governments, civil society, and the research community – should take action to support countries to adopt, implement, and significantly raise effective health taxes.
At the end of last year, we started developing our two-year strategy after a year of exploring the public health landscape in St Kitts and Nevis, and the wider Caribbean region.
After careful consideration, we settled on focusing on women’s health and the prevention of childhood obesity. In a previous blog we explained why we decided to focus on women’s health and today we’ll discuss why we’re also going to focus on childhood obesity.
Why Childhood Obesity?
Childhood obesity is a major health issue in the Caribbean with 1 in 3 children being overweight or obese. The rate of childhood obesity in the Caribbean is higher than the global average and is reported to be on the rise.
Being obese and overweight in childhood is linked to the development of several health issues such as type 2 diabetes and hypertension, and it also negatively impacts a child’s mental health. These health issues can follow children into adulthood with children affected by obesity, or who are overweight, having an increased risk of becoming overweight or obese adults and developing non-communicable diseases (NCDs) such as cancer and heart disease in later life.
Childhood Obesity in St Kitts and Nevis
Childhood obesity is a significant challenge here in St Kitts and Nevis. A PAHO report revealed that 33% of secondary school children in the twin-island state were overweight and 14% were obese. More recently, in 2017, a UNICEF report published that 26% of children in St Kitts and Nevis are obese.
Data has demonstrated that NCDs are becoming an epidemic in the Federation with 83% of deaths in St Kitts and Nevis being due to NCDs. We must do something about this to prevent our citizens from dying prematurely and one approach is to tackle childhood obesity.
To combat childhood obesity, we have to ensure that children adopt a healthy lifestyle and we also have to create a healthy environment at schools, in homes and within society so that children can make healthy choices.
Tackling Childhood Obesity in the Caribbean
The Healthy Caribbean Coalition (HCC) is a civil society member organisation that was established to combat NCDs and their associated risk factors.
One of their key focus areas is childhood obesity prevention and as part of their work, they published their Civil Society Action Plan for Preventing Childhood Obesity in the Caribbean. This plan provides guidance on how HCC members (we are a member) can strategically address this significant health challenge in their specific island states.
Lake Health and Wellbeing is thus aiming to align its strategy for childhood obesity prevention in St Kitts and Nevis with the following HCC priority areas:
Trade and fiscal policy (taxation of unhealthy foods)
Nutrition literacy (mandatory front-of-pack-labelling of foods)
Early childhood nutrition (enacting legislation related to the International Code of Marketing of Breast Milk Substitutes)
Marketing of healthy and unhealthy foods to children (Banning the marketing of unhealthy foods and beverages to children)
School and community-based interventions (Banning the marketing and sale of unhealthy foods and beverages in and around schools, mandatory physical activity in schools)
What We’ve Done So Far
We’ll be taking our time and starting slowly with the implementation of our childhood obesity prevention strategy. We’re delighted to say that we have started making some progress and have achieved the following:
We took part in the HCC’s regional campaign which aimed to raise awareness of childhood obesity in the Caribbean and influence the region’s leaders to champion and implement critical policies that will improve the health of our children and reduce childhood obesity. One of the key parts of this campaign was their childhood obesity prevention petition (call-to-action) which called on our Heads of Government to enact key policies and legislation which have been demonstrated as effective measures to combat childhood obesity. We got involved by gaining support for the HCC’s petition in St Kitts and raising awareness of this issue through a four-part podcast series. You can find out more about this here
