Wednesday 25th July, 2018

Today we discuss a recent conference that we attended, the 63rd annual CARPHA Health Research Conference which was held right here is S Kitts.

Our gardening and health series is back and Abi Begho, in this two-part blog, focuses on fruit trees. In this article she discusses her sour orange and mango trees.

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I have really been enjoying my gardening journey, it has been fulfilling and rewarding in so many ways. I’ve grown enough okras and tomatoes to keep us going for months, overcome the challenges of growing peppers and delved into the world of sweet potatoes. This has given me a new-found love of the outdoors and provided an outlet to relieve stress, unwind and relax. I can’t begin to express the significant impact that just five minutes in the garden has on improving my mood and lifting the heaviness of a bad day. It’s been fabulous.

In my previous blogs I have covered vegetables and fruits that I have grown from seeds or cuttings, but in today’s blog  I want to focus on the lovely fruit trees that we inherited from the previous owners of our house.

We moved to St Kitts about ten months ago and when we moved into our new house we were just so happy about the fruit trees that came with it, and we have thoroughly enjoyed exploring each one of them, and they are:

• Sour orange
• Mango
• Soursop
• Guava

Today I am going to focus on our sour orange and mango trees.

Sour Orange

You may know sour orange by another name,  such as bitter orange, Seville orange, bigarade orange or marmalade orange.

It originated in south-east Asia and was believed to have been taken to Arabia in the 9^th century and then made its way to many countries in the years to follow. An interesting fact about its journey around the world is: it was the first orange to arrive in the Americas.

Sour oranges, to me, taste like a cross between an orange and a lime. They are too sour to eat on their own but that hasn’t stopped them from being used in many recipes – its juice and peel are the key ingredients in marmalade, its oil is used as flavouring, its fruit is used in the preparation of liqueur and the dried peel is oftentimes used as a seasoning. And, just about every part of the plant itself  (the flower, leaf, fruit, juice and peel) has been used for medicinal purposes  but caution is needed as bitter orange supplements have been found to be “possibly unsafe”, especially if taken in combination with caffeine which can lead to high blood pressure, heart attack, fainting etc.

Our Sour Orange Experience

When we arrived, our sour orange tree was laden with fruit and continued to produce fruit for a couple of months and then stopped for several months and now, about 8 months later, copious amounts of fruit are starting to appear again.

For us, we have kept it very simple with our sour oranges and have used them to make a refreshing juice, very similar to lemonade but with more of an orangy-lime flavour (delicious!). The trick to making the juice is getting your proportions of sour orange juice, water and sugar just right. After several tries, I think I mastered it. I found that the juice from two medium sour oranges mixed with 1L of water and sweetened with 1-2 tablespoons of sugar makes the perfect drink, we couldn’t get enough of it and were so sad when we had used up all our fruit. We can’t wait to make some more juice when the current batch of oranges ripen.

Mango

When we first saw the mango tree in our garden it looked like it was on its last legs – the leaves were brown and dropping, in what seemed like large numbers. We kept looking at the tree and thinking: ‘is it going to survive?’, but then a few months later there was a re-birth. We noticed new leaves, and the tree started to look really healthy. Then, in March, we were so excited when we noticed lots of little flowers and it was at that point that we knew we were going to be inundated with mangoes. And, sure enough, a few months later, in May, our tree was absolutely covered with young mangoes (yay!) and in June we had so many mangoes we honestly didn’t know what to do with them. We started giving bags of them away and we’ve also frozen bags, and bags, of mangoes, and still they keep coming, so we’re probably going to run out of space in our freezer soon.

So far, apart from eating the mangoes as is, we’ve made a lot of smoothies. We’ve tried the simple, so almond milk, banana and mango (nice), then moved on to adding pineapple (very nice) and then added some spinach (not as nice). We then tried mango, strawberry, banana and almond milk and that was delicious, the best so far.

I continued experimenting with recipes and made a  mango tart/pie (same concept as a French lemon tart, but I used almond milk to make it a bit healthier) and it was absolutely delicious. All I can say is thank God for the internet, I pretty much combined three recipes to get what I had pictured in my mind (I wanted a mango pie with a key-lime pie/lemon tart consistency) and it turned out much better than I expected. I highly recommend it.

Next I would like to make dried mangoes because I have liked buying them in the past as a quick and easy snack.  I’m also contemplating making mango ice-cream as I found a very straightforward recipe online. I will let you know how it all goes!

At the moment I have to admit that I am getting a bit tired of mangoes – we have waaay too many and as I type I have about 10 more that dropped overnight that I need to get from the garden. This is truely mango overload!

Mangoes are very well-known so I won’t say much more about them except that I have discovered so many creative, simple recipes that we wouldn’t have come across had we not had an abundance of mangoes to experiment with.  So,  if you’re looking for something tasty, healthy and tropical then mangoes are a great option as they are very versatile.

Next Time

Our fruit trees have really been a blessing and we’re enjoying experimenting with various recipes. It has been fun. In my next blog I’ll tell you about the final two trees, our soursop and guava trees.

See you next time and happy gardening!

Previous Blogs

If you missed the previous blogs in this series you can read through them here:

1. Improving Our Health and Wellbeing Through Gardening: An Introduction
2. How I Got Started
3. Growing Tomatoes
4. Growing Okra
5. Growing Peppers

You Can Get In Touch

Are you a gardener? Are you new to gardening or an experienced gardener? We’d love to hear your story and experiences with gardening and how its impacted your health and wellbeing.  You can email us at info@lakehealthandwellbeing.com with your experience and we’ll include it in this blog series.

At the thirty-ninth regular meeting of the Conference of Heads of Government of the Caribbean Community (CARICOM) on 4-6^th July, leaders made a commitment to tackle non-communicable diseases (NCDs) in the Caribbean.

Six priority areas were endorsed. These included:

• Establishing and maintaining a smoke-free status for the region
• Implementing policies geared to preventing childhood obesity including health-promoting school environments and improving front-of-package labelling
• Promoting the elimination of cervical cancer
• Support for mitigating post-disaster vulnerabilities related to NCDS, particularly nutrition, treatment and care
• Increasing international financing and technical support
• Strengthening accountability through national coordinating mechanisms

Leaders of the Caribbean discussed the upcoming UN High-Level Meeting on Non-Communicable Diseases which will be held in September. The theme of this meeting is: scaling up multi-stakeholder and multi-sectoral responses to the prevention and control of NCDs. It was felt that CARICOM member states should be well-represented at this meeting especially as, in 2007, CARICOM led the way on NCDs by hosting the first ever summit on NCDs.  This put the spotlight on this area leading to NCDs being included on the UN Development Agenda.

About CARICOM

The Caribbean Community (CARICOM) consists of a group of 20 states, from the Bahamas in the north to Suriname and Guyana in the south, working together under four main pillars:  economic integration, foreign policy coordination, human and social development and security. You can find out more about the work of CARICOM here.

More Information

For more information about the 39^th Regular Meeting of the Conference of Heads of Government of CARICOM held in July you can visit their website here or you can watch the videos below.

Opening Ceremony of the Regular Meeting of the Conference of Heads of Government

Closing Press Conference of the Regular Meeting of the Conference of Heads of Government

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Picture Credit: CARICOM

We’re delighted to announce that our July Fibroids Twitter Chat will be with Jenny Rosenberg on 25th July 2018 at 2pm EST (that’s 7pm GMT, or 2pm AST).

Jenny Rosenberg is the Executive Director of CARE About Fibroids and is an internationally recognized leader in health care policy and strategic communications. Mrs. Rosenberg served for more than a decade in senior-level policy and communications positions in the Obama Administration and Congress.

Previously, Mrs. Rosenberg was Director of Communications to former U.S. Surgeon General Dr. Regina Benjamin and former U.S. Assistant Secretary for Health Dr. Howard Koh. ​Her broad experience as a regulator, policymaker and communications expert brings a comprehensive, multifaceted approach to enhancing public awareness over critical public health issues.

CARE About Fibroids is a Washington, DC-based non-profit whose mission is to elevate uterine fibroids as a women’s health issue and drive change. Bringing together many of the nation’s most respected women’s health advocacy and policy-focused organizations to advance solutions, CARE About Fibroids is a catalyst for increased awareness, research and education about uterine fibroids, leading to earlier diagnosis and improved treatment.

Join our #FibroidsChat to find out more about the great work that CARE About Fibrioids is conducting. To take part in the conversation find us on Twitter on 25th July at  2pm (US EST and 7pmGMT ) and use the hashtag #FibroidsChat.

You can find out more about CARE About Fibroids here: www.careaboutfibroids.org and you can follow CARE About Fibroids on social media:

Twitter: @CAREAbtFibroids

Facebook: @CareAboutFibroids

Are you interested in this topic? Then please do sign up to our fibroids mailing list here

Back in December 2017 the European Medicines Agency announced that it had started an in-depth review on Esmya (ulipristal acetate), a drug widely used to treat fibroids. This in-depth review was conducted following four reports of serious injury with three of these patients having to have a liver transplant. After receiving these reports an initial assessment of these cases was carried out and it was determined that Esmya was indeed the cause of the liver damage, therefore the EMA started a more comprehensive review.

The EMA has now concluded its review on Esmya and in June 2018 published new measures to minimise the risk of rare but serious liver injury that could be caused by Esmya. They recommended that the use of Esmya be restricted and that more research be conducted to gain a better understanding of how Esmya effects the liver and whether the measures they have introduced will, in fact, be effective at minimising the risk of liver damage.

EMA’s Safety Measures for Esmya

The specific measures that the EMA has introduced are:

• Esmya should not be prescribed to patients who have liver problems
• A liver test should be performed before a patient starts taking Esmya and if the test is abnormal the drug should not be prescribed
• Patients should have liver tests during and after treatment
• If no liver problems are detected, a single course of Esmya can be used in women who are about to have surgery for their fibroids; Esmya can be used for more than one course only in women who cannot have surgery
• A card should be included in the package for Esmya with information on the risk of liver damage and the need for liver monitoring
• Patients should stop treatment and contact their doctor immediately if they develop symptoms of liver injury, which include tiredness, yellowing of the skin, darkening of the urine, nausea and vomiting
• Patients with questions or concerns about their treatment should speak to their doctor or pharmacist.

More Information

For more information about the EMA’s review, please visit their website here or download their information sheet below.

Keep up-to-date on fibroids news as well as our upcoming fibroids webinar series by signing up to our fibroids newsletter here

Disclosure: this post contains an affiliate link. Find out more here

Wednesday 11th July, 2018

Today we provide an update on two upcoming events – our Chronic Disease Self-Management Course and our Fibroids Self-Care Webinar Series. We also talk briefly about changes to our podcast schedule.

We love attending health conferences. They’re a great opportunity to discover the latest advances in the field, learn something new and meet interesting people. Since moving to St Kitts about 10 months ago we haven’t had the opportunity to attend any conferences and so when we learnt that the 63^rd Annual CARPHA Health Research Conference was going to be held right here in St Kitts, we jumped at the opportunity and registered immediately and started counting down the days until conference day.  In today’s blog we’re going to share some of the highlights of the conference from our point of view, but first, you may be asking: who or what is CARPHA?

CARPHA – Who Are They?

CARPHA stands for the Caribbean Public Health Agency and they are the only regional public health agency in the Caribbean. They provide strategic direction  in analysing, defining and responding to the public health priorities set out by CARICOM in order to prevent disease, promote health and respond to threats to the public’s health and emergencies. Their programme of work falls in the following categories

• Emergency responses to disasters (hurricanes, earthquakes, flooding),
• The surveillance and management of non-communicable diseases (NDCs) that have reached epidemic proportions such as obesity, cancer, heart disease and diabetes.
• The surveillance and management of communicable diseases (CDs), including HIV / AIDS; re-emerging diseases, like tuberculosis in association with HIV/AIDS; and new communicable diseases that are now endemic in the region
• The surveillance and prevention of injuries, violence and job-related illnesses.
• Contribution to global health agreements and compliance with international health regulations

CARPHA Conference

Every year CARPHA hosts their health research conference which provides Caribbean researchers, at every level, with the opportunity to showcase their work and disseminate their research findings.  This provides the perfect environment to determine how cutting-edge research can contribute to the development of effective evidence-based policies, programmes and practices to tackle the Caribbean’s health challenges.

This year’s conference was the 63^rd conference, making this event the longest running health research conference in the English-speaking Caribbean and it brought together policymakers, researchers, health professionals and public health officials from the Caribbean, Latin America, North America and Europe.

The theme for this year’s conference was ‘Sustainable Health Systems for Economic Growth, Development and Wealth.’ The aim of the conference was to provide an opportunity to raise awareness of Caribbean research that can provide the evidence and information to create stronger health systems in the region.

The conference was a three-day event, packed full of presentations, concurrent sessions, panel discussions, feature lectures, poster presentations and an exhibition, giving attendees an engaging, informative and diverse experience.

Our Conference Highlights

The conference on a whole was excellent, there was something for everyone, but for us certain presentations and pieces of work, really stood out for us. These included:

Assessing the impact of the Barbados Sugar Sweetened Beverage (SSB) Tax on Grocery Store Beverage Sales – with many countries  around the globe introducing a sugar tax it was interesting to hear about the experience in the Caribbean. This presentation summarised the findings, so far, from the introduction of a 10% tax on SSBs in Barbados in August 2015. It was promising to hear that following the tax there was an increase in water purchases, a 4.3% reduction in SSB purchases and a 5.2% increase in the purchase of non-sweetened drinks. It was interesting to note that the decline in SSB purchases was in expensive drinks and there was evidence that consumers were switching to cheaper SSBs.

Diabetes Distress and Diabetes Self-Care in Barbados – this presentation was insightful as we had never come across the term diabetes distress, which refers to the emotional impact of diabetes where patients may experience fear, frustration and guilt. It was interesting learning about this and how promoting self-care and self-management may address this issue.

Obesity and Weight Misperception Among Adults in Eastern Caribbean– this was a very well-presented and engaging talk that explored the extent to which people misunderstand their weight. Researchers found that in their study weight misperception was very common with the majority of people  under estimating their actual weight. This is a problem because it means that people who are overweight or obese don’t realise it, and if people don’t realise they have a problem with their weight they won’t take steps to address this. This leads to people remaining at risk of a number of health issues when they needn’t be. You can find out more about this study here.

Our Voices: Women’s Perspectives on Breast and Cervical Cancer Screening and Treatment in the English-speaking Windward Islands – this presentation really struck a chord with us as we conducted a similar piece of work exploring black British women’s beliefs about breast cancer and their help seeking behaviour. It was interesting to hear that their findings were very similar to what we found around fear, fatalism and stigma

Finally other highlights for us were, being new to the Caribbean, it was just wonderful meeting people, exploring the important health issues in the Caribbean (e.g. NCDs and mosquito borne diseases) and learning about interesting projects like ECHORN, the new Caribbean Cancer Registry Hub and The Seth Fund, as well as innovative methods of care like that being delivered by the Caribbean Cancer Centre Network – a partnered care hub and spoke model.

In Conclusion…

This was three days well-spent and a great introduction into the research being conducted in the Caribbean. We highly recommend this conference to anyone in the Public Health field and we look forward to next year’s conference. Every year the conference is hosted on a different Caribbean island, and we’re also looking forward to the announcement of which of the beautiful islands will host the conference next year.

More Information

To find out more about this year’s conference you can visit the conference website here and you can learn more about CARPHA here

Wednesday 4th July 2018

Today’s episode is the final episode in our childhood obesity series and our volunteers Vikell and Marecia discuss the solutions to childhood obesity.

Lake Health and Wellbeing in collaboration with the Department for Gender Affairs in St Kitts are aiming to provide support to men in St Kitts with chronic diseases such as heart disease, diabetes, cancer, high blood pressure and lung disease. This support will be delivered through a free 6-week self-management course, starting on 2^nd October, that will provide men with the information, skills and knowledge to live well with their health condition.

Our project will focus on men, to ensure that men in St Kitts who suffer from a chronic disease receive the support that they need as research suggests that men are less likely to access health services.

The course being utilised for this project is 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 will provide patients with information on appropriate exercise, diet, managing symptoms, medication usage, dealing with side effects and improving communication with healthcare providers, friends and family. Classes will be held at the National ICT Centre on the Bay Road and will be facilitated by trainers certified by the Stanford University Chronic Disease Self-Management Program.

The program has been implemented in 19 countries around the globe showing a number of benefits including:

• Improved wellbeing
• Improved health of patient
• Fewer hospitalisations
• Fewer days spent in hospital

If you or anyone you know is living with a chronic disease or caring for someone with a chronic disease then this course may be of interest to you.

For more information and to register, please visit Eventbrite,  email events@lakehealthandwellbeing.com or call 668 1518.

Want to be kept up-to-date on events like this? Then please subscribe to our newsletter here.

Wednesday 27th June, 2018

Our volunteers are back with another episode in their childhood obesity series. Today, is a quick podcast with Marecia, Eurecia, Jorecia, Chris and Vikell sharing how they stay healthy. In this episode they provide some great insight on easy ways to adopt a healthy lifestyle. They’re on a mission to make the Caribbean a healthy place.