Today’s blog post comes from Deji Ajose-Adeogun. Deji shares his 20-year battle with weight loss and explains how a recent change in mindset gave him the motivation and discipline to succeed in his quest to lose weight.

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I have been dealing with being overweight since I left college.  I never thought about what I was eating when I was younger because  I was extremely active, so my eating was never an issue.  Hours playing sports and lots of activity kept my weight in check.  Well, as college finished and I proceeded out into the real world and got a job, my physical activity levels decreased drastically, but my way of eating did not change.  So, I was eating more calories than I was burning.  The math meant that I was going to gain weight.  The pounds kept creeping up until last year when I topped out somewhere between 285-295 pounds. My clothes were not fitting me.  Can you imagine that I left for college at 180 pounds, then I dropped to 165 in my first year of college. This was partly due to all the walking because that was the only mode of transportation and campus food was ok.  Over the years,  I have tried to lose weight.  It has been like a yoyo, up one minute, down the next. This has been a battle for the last 20 years and it needs to end.

This is how the cycle has been.  I joined the gym about 18 years ago, which I have been to on and off. One minute I am heavy with the gym, another minute I am not.  In my 20’s it was easy to drop the weight, and it has also been a battle of the wits.  When you lose that weight you start to feel good and like you can take on the world. Then you feel you can control it, and start back to old eating habits because I am lighter, next thing you know you are back up in weight again. Mind you, I thought I had it all under control. This is how the yoyo diet works.  Your eating habits are only temporary until the weight is off.  This is what it has been like for about 20 years.  Then one day you say, “I give up” you start putting on weight, you get discouraged, you drown yourself in more food.  It becomes self-defeating.  I have been on cholesterol medication and blood pressure medicine.   My doctor said I really need to do something about this so I am not on this medication for the rest of my life. I am not sure when it struck me.  Was it my mom’s health situation and her passing in 2019? It might have been, but I knew that I had to deal with this immediately.  I had to show my children, by example, what it means to eat well.  I also have to be there for my kids, I know we are not promised tomorrow, but it did not mean getting there in a race car.  It was embarrassing that I could not even get on a ride at an amusement park with my children about a year or two prior.  I had to wait outside.  I said to myself,  the next time we came back, I am going on that ride with my children.

I had to figure something out that works for me and will not be a fad diet.   I started to hear about intermittent fasting. I started to do more research to see if it will work for me.  It involved fasting for 16 hours a day and eating in an 8-hour window.  So, I would go from 8 pm to 12 pm the next day.  This is a way of eating for many cultures.  Some only eat one meal a day.  The more I started to read about this way of eating, the more it made sense to me – the 16 hours give your organs a chance to rest and can help control blood sugar (as long as you are cutting back on sugars).  I started eating more salads realising that what I was doing before had my organs constantly working.

I started in August 2019.  The first month was a struggle, it was hard getting used to the new way of eating.  I lowered my sugar intake drastically and ate more greens.  I started to watch more videos about our diet and learnt that most people lack vitamin D, Vitamin K, potassium, good fats, good cholesterol, certain B vitamins, etc.  I even started to learn that not all meats/proteins are good for you, partly because of all the chemicals and hormones in them. I started to try and eat as many organic items as possible. If not organic, anything that was less processed,  such as farm-raised eggs, grass-fed cows, almond milk, etc. I started to eat out less and cook more.

There is so much more to losing weight than just eating less.  It is also about eating correctly and getting the correct nutrients in your diet to help with your overall health.   When I started to focus on health and not just weight loss that was the trick.  Doing it for the right reason, my health,  made me more disciplined and the pounds started to come off.  I was not stressing if I did not lose the pounds, I was focused on just being healthier.  Also measuring myself helped because you can gain muscle mass, which can mean your weight can remain the same, but your measurements can decrease.

At the end of the day for parents, it is key you teach your kids from a young age to eat properly, and exercise.  You may want to exercise with them because that is where the habits will grow. It has taken me a lifetime to figure this out.

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We would like to say a big thank you to Deji for sharing is weight loss story with us. We hope that through his experience, you can get a little bit of inspiration to help you achieve your weight loss goals.  Have a question for Deji? Want to give him some encouragement? Then please do leave these in the comments section below.

Today’s blog post comes from Aaron D’Souza, a second-year medical student at the University of Medicine and Health Sciences in St. Kitts. While he has been active at school in multiple areas including playing soccer for the school and teaching high schoolers neuroscience with the BrainBee project, he is helping us as a new volunteer.

Aaron discusses the emotions and challenges faced by caregivers of patients with multiple myeloma. By recounting his mother’s experience as a caregiver, he identifies barriers that a caregiver may struggle with and provides scientifically supported practical advice to help those who have recently become caregivers of a loved one with multiple myeloma.

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Cancer is a group of diseases that everyone is familiar with in some form. Formally, it is the uncontrolled replication of cells leading to various problems. One particular cancer that will be the focus of this post is multiple myeloma (MM). Specifically, we will focus on the caregiver burden of those caring for someone with MM, as there is a lack of emphasis on their well-being and personal experience, but first, a bit of background information.

What is MM? MM is a type of blood cancer that is progressively debilitating, painful and ultimately fatal (most commonly due to infection).

Who is at risk? It occurs 1.6x more often in males than in females. It is 2x as often in the Black population than in the Caucasian population. Additionally, Black people are more likely to get it at a younger age.

When is it usually diagnosed? The median age of diagnosis is 65 years old. In cases diagnosed and treated early, 60% of patients will survive up to 5 years; only a fraction will survive 10 years after diagnosis.

What causes it? While there is a confirmed genetic role, there is also evidence of many other factors contributing to its onset. Such factors include exposure to radioactive substances and certain chemicals, such as benzene. Usually, a large dose of benzene can only be acquired from being exposed to factory emissions for several years or wastewater.

What are some symptoms? MM has systemic complications ranging from severe bone pain/ osteoporosis to kidney failure and infection. Throughout the progression of the disease and administration of treatment, it is standard to see periods of remission, periods of high severity and periods where the side effects feel worse than the disease.

Can it be treated? Sadly, the majority of people with MM will pass away. Recovery is possible if the patient is diagnosed early and started on therapy. Treatment ranges from conventional chemotherapy to stem cell transplantation. You can find more information on how these treatments work on the American Cancer Society’s website.

Unfortunately, MM patients are often misdiagnosed or are diagnosed late because there is a lack of experience diagnosing it among physicians. The latter happened with my grandfather, and within 1 year of diagnosis, he passed away. While many understand the suffering of a cancer patient, not many understand the challenges the caregivers face; a role that my mother fulfilled for my grandfather. A caregiver is someone responsible for the needs of the patient, often without any compensation. Responsibilities of a caregiver include scheduling, transport, finances, housekeeping, legal support and emotional support. It is usually a spouse, adult, child, or other immediate family members that fill this role and the role of a caregiver can be simultaneously rewarding and challenging.

My mother had her own mix of such emotions as a caregiver. At the time of my grandfather’s diagnosis, we had already lived in Canada for 10 years and in the United Arab Emirates before that, while my grandparents were living in India. Although my mom would go to India over the summers to look after my grandparents, she was otherwise dependent on friends and relatives to ensure my grandparents’ health and safety. The inability to be there with them for longer left her with a sense of guilt at the end of each summer, especially the last summer before my grandfather’s death. The uneven sharing of the caregiver role among family had placed an enormous strain on some of these relationships

As a caregiver, it is essential to note that uncertainty is the greatest obstacle for the well-being of both the patient and the caregiver. A caregiver’s well-being often reflects the status of the patient. Studies have identified numerous challenges to caregiver well-being. Most caregivers face at least a few of these challenges:

• Initial shock: After having to endure the path to diagnosis, eagerly awaiting results, the confirmation of a diagnosis for any type of cancer will come as a shock. Additionally, caregivers must adapt by changing their lifestyles and take on new responsibilities to support their loved ones. Part of the difficulty is due to the unpredictable course of the illness. Many patients and caregivers must endure the shock several times as the disease re-surfaces. Lack of knowledge about the disease is an enormous source of stress.
• Commitment: Being a caregiver sometimes involves giving up your previous lifestyle to reserve free time for an emergency and patient care logistics. Logistics include, but are not limited to, finances and housekeeping (which change as the course of the disease changes).
• The emotional sphere: Caregivers often have feelings of anxiety and fear. Patients often feel that they are burdening their caregivers and relatives with their condition. Caregivers have been found to have a similar attitude, not wanting to burden others with the responsibilities or emotional baggage that comes with being a caregiver. Consequently, they suffer by themselves, unable to honestly express their feelings while being afraid to leave the patient to have well-deserved self-care. They often experience spiritual suffering, unable to find finding meaning in the disease.

As a medical student who is always looking for ways to help people, I have found many coping strategies backed by evidence that worked for my mother and other caregivers.  The following is a list of strategies, that as a caregiver, may help you provide the best possible care while looking after your own well-being:

• Ensure that you have a list of questions you can ask the doctor when going in for a visit. Make sure you cover the diagnosis, progression and what to expect, types of treatments, treatments in clinical trials, and end-of-life and palliative care. A full list of questions can be found at the National Cancer Institute. If possible, ask the hospital to send the results home before meeting up with the doctor to help you take in the news and develop better questions.
• Establish your support system. Rather than bottling up emotions and avoiding burdening others, try to connect with others, spread the responsibility, and the emotional burden with close relatives or friends.
• Know your support services. Joining a support group is an excellent resource for information on handling caregiver responsibilities, treatment options, possible side effects, warning signs, etc. It is also a safe space where you can vent your thoughts to those able to relate and learn from others about their coping strategies.
• Keep doing the things you enjoy. It’s okay to leave the patient in the care of someone else for a few hours or a day so you can recuperate. It will only help you become a better caregiver and help you remember your loved one with fondness rather than as a burden.
• Use mindfulness meditation and improve emotion-regulation. These will help you prepare for the hard days and the death of your loved one.

Understanding and anticipating the challenges will allow you to avoid some of the anxieties associated with caregiving and better manage your time so you can spend it with your loved one.  Keep in mind that every caregiver-patient relationship is different. There is more than one way to be a great caregiver. I hope the strategies above (which are by no means an exhaustive list) will go a long way in promoting caregiver well-being physically, emotionally, and spiritually.

More Support

We’re aiming to support multiple myeloma patients and their family members through the JAA Fund. Small support grants are currently available for patients in St Kitts, Nevis, the British Virgin Islands, Trinidad and Tobago. If you’ve been affected by multiple myeloma, live in one of these countries and require some financial support, you can apply for a grant here

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References

Aksoy, M., Erdem, Ş., Dinçol, G., Kutlar, A., Bakioğlu, I., & Hepyüksel, T. (1984). Clinical Observations Showing the Role of Some Factors in the Etiology of Multiple Myeloma. Acta Haematologica, 71(2), 116-120. doi: 10.1159/000206568

Howell, D., Hart, R., Smith, A., Macleod, U., Patmore, R., Cook, G., & Roman, E. (2018). Myeloma: Patient accounts of their pathways to diagnosis. PLOS ONE, 13(4), e0194788. doi: 10.1371/journal.pone.0194788

Monterosso, L., Taylor, K., Platt, V., Lobb, E., Musiello, T., & Bulsara, C. et al. (2017). Living With Multiple Myeloma. Journal Of Patient Experience, 5(1), 6-15. doi: 10.1177/2374373517715011

Multiple Myeloma. (2020). Retrieved 11 September 2020, from https://www.cancer.org/cancer/multiple-myeloma.html

Quiñoa-Salanova, C., Porta-Sales, J., Monforte-Royo, C., & Edo-Gual, M. (2019). The experiences and needs of primary family caregivers of patients with multiple myeloma: A qualitative analysis. Palliative Medicine, 33(5), 500-509. doi: 10.1177/0269216319830017

Waxman, A., Mink, P., Devesa, S., Anderson, W., Weiss, B., & Kristinsson, S. et al. (2010). Racial disparities in incidence and outcome in multiple myeloma: a population-based study. Blood, 116(25), 5501-5506. doi: 10.1182/blood-2010-07-298760

The 1^st  of August is Emancipation Day in the former British colonies in the Caribbean. It’s a day where we commemorate the passing of the Slavery Abolition Bill in 1833 by the British government. This act formally abolished slavery in British colonies with, on paper, enslaved people gaining their freedom through British Law from 1^st August 1834.

In reality, enslaved men and women over the age of six were forced to work for their former masters, uncompensated, for a further four years as part of an apprenticeship period.  Real freedom was granted on 1^st August 1838 when the British government passed a bill for complete emancipation. Following the passing of this bill, 750,000 Africans were freed, but with no real power to exercise their freedom, many were forced to work for their former slave masters for exceptionally low wages. This colonial period lasted until the 20^th century and during this period Black people in the Caribbean were denied political, economic and social power.

The impact of slavery on the progress of people of African descent has been immense and this year, in St Kitts and Nevis, Emancipation Day was used to reflect on reparations and how the effects of slavery can be addressed.

Reparation is the process of repairing the damage caused by slavery – a crime against humanity. The reparation movement has a long history with former colonies advocating for justice and European countries failing to take responsibility for the crimes they committed in their quest to enrich their nations.

To tackle the issue of reparations in the Caribbean in a more structured manner, the CARICOM Reparations Commission was established in July 2013 and their mandate was to:

“Prepare the case for reparatory justice for the region’s indigenous and African descendant communities who are the victims of Crimes against Humanity (CAH) in the forms of genocide, slavery, slave trading, and racial apartheid.”

This mandate led to the formation of the CARICOM Reparations Justice Program which includes a Ten-Point Action Plan.  This plan outlines clear steps that are required for reconciliation and justice for nations affected by the transatlantic slave trade, and we were delighted to see that action point five covers the public health crisis.

Reparations and Public Health

The recognition of the impact that slavery has had on the health of the people of the Caribbean is very important. The Caribbean has one of the highest incidences of hypertension and diabetes in the world and both of these conditions are risk factors for a number of other diseases.  Our ill-health is a direct result of slavery with the CARICOM Reparations Committee explaining that the unaddressed “nutritional experience, physical and emotional brutality, and overall stress associated with slavery, genocide, and apartheid” has created a non-communicable disease pandemic.

Research into the lifestyles of enslaved Africans demonstrates that their poor nutrition and emotional brutality started during their journey across the Atlantic.

The conditions on the slave ships were deplorable.  Enslaved Africans were chained together on decks that were overcrowded, unsanitary, unbearably hot, lacked oxygen and they were subjected to frequent physical and sexual abuse.  During the three to six-week journey across the Atlantic, enslaved Africans were fed boiled rice and salted fish which was the start of their new life of poor nutrition.

Once they arrived in the Caribbean, as we know, the brutality continued and so did the lack of access to nutritious food.   Research has suggested that their meals rarely varied and consisted of salt meat or salt fish and Guinea corn, and sometimes yam, bananas or plantains. If slave masters were feeling particularly generous, enslaved Africans were given treats such as tobacco, molasses and rum. As time progressed, enslaved Africans had to find and grow (yam, okra etc) more food to supplement what they were provided with and be creative in their meal preparation. This creativity has led to our modern-day dishes such as jerk chicken, souse, pig foot soup etc. which satisfied their hunger but wasn’t always healthy.

The lack of nutritious food led to many health problems and this combined with the brutality and trauma of slavery led to high infant and maternal mortality, and this high maternal mortality rate in Black women still persists today.

Today, a shift from homemade foods to a more Westernised diet rich in processed foods that are high in sugar, salt and saturated fat has exacerbated our diet-related health challenges. Additionally, the multigenerational trauma caused by four hundred years of slavery, which has been articulated by Dr Joy Degruy’s concept of Post Traumatic Slave Syndrome,  links the behaviour and attitudes displayed by Black people today to slavery and highlights another important non-communicable disease that is a legacy of slavery – mental illness.

As the origins of the current public health crisis in the Caribbean can be traced back to slavery, the CARICOM Ten-Point Reparations Action Plan calls for “the injection of science, technology, and capital beyond the capacity of the region” to address this crisis.

We support CARICOM’s Ten-Point Action Plan and will continue to do our part to tackle NCDs in the Caribbean.

Sources

1. Bristol City Council. Bristol and Transatlantic Slavery: The End of Slavery [Online]. Bristol City Council. [Viewed on 28^th August 2020]. Available from: http://www.discoveringbristol.org.uk/slavery/against-slavery/freedom-from-slavery/apprenticeship/slavery-end/
2. CARICOM Reparations Commission. Ten-Point Action Plan [Online]. CARICOM. [Viewed on 28^th August 2020]. Available from: https://caricomreparations.org/caricom/caricoms-10-point-reparation-plan/
3. Guzman, RF. The Feeding of Slave Populations in the United States, the Caribbean and Brazil. Some Remakes on the State of the Art.   Lat. Hist. Econ. 2012; 20(2):5-35.
4. Lewis, T. (2005). Transatlantic Slave Trade [Online] Britannica. [Viewed on 28^th August 2020] Available from: https://www.britannica.com/topic/transatlantic-slave-trade
5. The University of Glasgow. Enslaved People’s Lives. [Online]. The University of Glasgow. [Viewed on 28^th August 2020]. Available from: https://runaways.gla.ac.uk/minecraft/index.php/slaves-lives/

Update 7th September 2020:   On 4th September, the  CDC revised their alert for St Kitts and Nevis to “No Travel Health Notice: COVID-19 risk is very low.” We applaud this revision as this more accurately reflects the current COVID-19 risk in St Kitts and Nevis. 

On 6^th August 2020, the CDC issued a Level 3 warning alert with regards to St Kitts and Nevis and its COVID-19 risk. According to the CDC’s website, a Level 3 warning indicates that the COVID-19 risk is high in St Kitts and Nevis and because of this risk, they recommend that travellers avoid all non-essential travel to the twin-island state.

Upon hearing this alert, we and most of St Kitts and Nevis were baffled. Currently, St Kitts and Nevis has no active cases of COVID-19 and to date has only had 17 cases, with no deaths and no community spread, all cases were travel-related.

To try and understand why the CDC assigned this Level 3 classification to St Kitts and Nevis, we reviewed how the CDC determines its Travel Health Notice Levels for COVID-19 and this is provided below:

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COVID-19 Travel Health Notice Levels* Destinations with Populations of 300,000 People or Less
	Level 3 High Risk	Level 2 High Risk	Level 1 Low Risk
Number of New Cases	More than 10	7-10	3-6
New Case Trajectory	Accelerating or growing	Decelerating, slowing, or stable

* All criteria are assessed over the last 28 days (2 incubation periods for COVID-19).

Secondary Criteria are qualitative and come from official destination sources (e.g., ministry of health websites).

• Measures of a destination’s healthcare capacity, such as available hospital beds and ventilators.
• Measures of a destination’s public health infrastructure, such as testing capacity, contact tracing capacity and documented exported cases (cases identified in travellers to other countries).

Notes:

• Destinations that fall below the Level 1 primary criteria and meet secondary criteria have no THN.
• Destinations can only de-escalate if their new case count is decreasing or stable.

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When we compare the above criteria with the data from St Kitts and Nevis, we see the following:

• In the 28 days leading up to the CDC issuing the Level 3 alert, St Kitts and Nevis had two new cases of COVID-19 (this would put St Kitts and Nevis below the level 1 low-risk benchmark of 3-6 new cases over the last 28 days).
• The new case trajectory has been stable for months because our borders are closed and will remain closed until October 2020, although nationals abroad have been returning home after gaining approval from the Government.
• St Kitts and Nevis’ healthcare capacity – we have an entire ward dedicated to COVID-19 at the JNF Hospital and our Medical Chief of Staff has reported that the number of ventilators per capita is high, and is, in fact, higher than many countries in the Western world
• Our public health infrastructure – the Ministry of Health has a comprehensive contact tracing program which is implemented as soon as a new case is suspected, our testing capacity is high with all those who require testing being offered it and this includes mandatory testing for all approved incoming travellers.  Additionally, every incoming passenger enters a mandatory 14-day quarantine in a Government facility that is monitored by healthcare professionals and law enforcement

Comparing the CDC’s own criteria with the data from St Kitts and Nevis, it is clear that the Level 3 alert misrepresents the situation in St Kitts and Nevis, and we would encourage the CDC to correct this.

It is important to note that the UK Government has listed St Kitts and Nevis as one of the countries that is exempt from the Foreign and Commonwealth Office’s advice against all non-essential international travel based on their determination of the low COVID-19 risk in St Kitts and Nevis.

Who is the CDC?

The Centers for Disease Control and Prevention (CDC) is America’s leading public health organisation. They fall under the Department of Health and Human Services and their aim is to:

 “Protect America from health, safety and security threats, both foreign and in the U.S. Whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack, CDC fights disease and supports communities and citizens to do the same.”

They are very influential not only in the United States but across the globe which means that when they issue a statement, it is viewed with a high level of credibility and this influences the public’s behaviour. Therefore, the CDC has a responsibility to provide accurate evidence-based information, and we believe this alert fails to do this.

Why Is It Important to Correct the CDC?

We believe it is important to correct the CDC because of the implications of the Level 3 alert. Firstly, it is false and misrepresents the risk of COVID-19 in St Kitts and Nevis.  Secondly, this alert comes with a recommendation that travellers should avoid non-essential travel to St Kitts and Nevis, this advice is detrimental to the economic recovery of St Kitts and Nevis.

The borders of St Kitts and Nevis have been closed since 25^th March 2020. Closing the borders was an extremely hard decision for the Government as tourism is one of the major industries in the Federation.

Since the closure of the borders, thousands of residents whose livelihoods depend on the tourism industry have faced job losses and it has been an exceedingly difficult five months.

The Government, health officials and the National Emergency Operating Centre has been carefully planning the re-opening of the borders and this is scheduled to take place in October 2020. The re-opening of the borders is expected to give the economy a much-needed boost and help those in the tourism industry get back on their feet. The CDC’s Level 3 alert may have unnecessarily hindered those plans by deterring travellers and this will put the recovery of St Kitts and Nevis’s economy at risk and affect the livelihood of thousands of citizens.

We believe that it is also very important to correct the CDC’s alert because this represents a long history of countries like America and the UK, continuing to discredit countries in the Caribbean and Africa.

For too long America, the UK and others have perpetuated a negative and condescending narrative of Black countries, insinuating that we are ill-equipped to lead our countries.

When we look at the response to COVD-19, many Caribbean countries including St Kitts and Nevis, have had very low rates of the disease, and this is not by some stroke of luck. Leaders in St Kitts and Nevis listened to the evidence provided by WHO, PAHO, CARPHA and local medical experts and took appropriate action. They developed an evidence-based strategy which included early border closures, and a host of non-pharmaceutical measures to control and contain COVID-19.

Soon after St Kitts and Nevis’ first case was confirmed at the end of March, all schools and non-essential businesses were closed, and a State of Emergency was introduced which led to a series of week-long 24-hour curfews and partial curfew days.  During this time, the Government, churches and local charities provided food and support to the vulnerable, a COVID-19 Emergency Relief Fund was established,  moratoriums on utility bill payments were announced, there were official daily COVID-19 briefings and a 24-hour COVID-19 hotline was introduced.

The restrictions on the public were slowly lifted as St Kitts and Nevis became COVID-19 free and businesses and other organisations were only allowed to open after being inspected and found to be compliant with the Government’s COVID-19 guidelines.

Furthermore, the wearing of masks is mandatory in public spaces, social activities are restricted, hand sanitisation is a requirement in all public buildings, the public has been encouraged to wash their hands thoroughly and frequently with soap and water and to practice physical distancing.

All of these measures have been effective and reduced the transmission of COVID-19 in St Kitts and Nevis.

St Kitts and Nevis’ approach to COVID-19 has been far superior to America’s approach which has been plagued by false information, denial of the seriousness of the disease, inequities, the inability of States to implement an evidence-based strategy, a lack of contact tracing, a lack of ventilators and a lack of willingness by the public to adhere to basic prevention measures.

The Caribbean has responded responsibly and effectively to COVID-19 and this is not an isolated incident. The Caribbean has many public health achievements. Looking specifically at St Kitts and Nevis, some of its key public health achievements include:

• The elimination of mother-to-child transmission of HIV and syphilis, receiving certification from WHO
• Mounting effective responses to the Zika, Dengue and Chikungunya outbreaks
• Increasing life expectancy
• Low maternal mortality
• A reduction in the number of deaths due to communicable disease

Conclusion

St Kitts and Nevis has been able to control the first wave of the Coronavirus and the reality is that currently, a person’s risk of contracting COVID-19 in St Kitts and Nevis is low and travellers to St Kitts and Nevis pose a greater risk to residents than residents do to travellers.

We appeal to the CDC to amend the risk level for St Kitts and Nevis to more accurately reflect the risk posed to those who would seek to visit St Kitts and Nevis once the borders open in October.

We have written to the CDC and encourage others to do so too.

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Header Photo by Brian McGowan on Unsplash

The current environment that we live in is extremely negative. We are exposed to 24-hour news coverage of one disaster or catastrophe after the other –  the COVID-19 pandemic, police brutality,  racism, the explosion in Lebanon, the constant negative discourse in politics, Brexit and more.  This constant exposure to negative news is affecting the public’s mental health. 

The impact this negative news has on our wellbeing is separate to the effect each of the individual issues may have on those personally affected by these incidents – the news is exacerbating the effect of world events so, rather than informing and empowering us, the news is creating more anxiety.

A study conducted a few years ago on the psychological impact of the content of news programmes found that those exposed to negative news were more anxious and experienced a higher level of sadness². They were also more likely to catastrophize their personal worries, this means that even though viewers were not directly affected by the content in the news, the negative sentiment that the news conveyed negatively impacted other concerns they had.

The pandemic era is unique in that we are all personally impacted which is rarely the case when a disaster strikes. For many, disasters affect “other people” and we watch from afar in safety. Today, we are the “other people” and this has created a global mental health pandemic. A study conducted in the US which included 200 people from across the country found that levels of depression, anxiety and stress were significantly higher than in pre-COVID-19 times¹. The research found that:

• 50% of participants experienced moderate to severe symptoms of depression in the past month
• 32% of participants experienced moderate to severe anxiety symptoms

The psychological impact of both the exposure to negative news and the current COVID-19 pandemic is ongoing and is likely to persist if we don’t take personal action. We can take steps to reduce our exposure to the amount of news that we can consume. The news right now is disproportionately negative and probably always has been, but now more than ever before, we need to seek out positive news and find some inspiration – we need a break from all this negative news!

We recently discovered a new radio show on WINN FM here in St Kitts called The Good News Show, and this was such a refreshing break from all the negativity. Host, Enoete Inanga, takes his listeners on a journey of positivity, highlighting good news, stories, people and ideas. He features positive global and local news stories and interviews inspiring guests who take us through their journey to success. We have really enjoyed listening to this new show and if you’re looking for some positivity you can check it out on Thursdays from 7pm to 8pm AST. Alternatively, you can watch recordings of the show on YouTube, the latest show can be viewed here:

Enoete Inanga seems to be all about positivity and he recently launched Bestimony  – a positive place to give affirmations and show appreciation to others.

So, in our quest to find positivity, we stumbled upon The Good News Show and Bestimony. Have you been on a quest to inject some positivity into your day? Let us know what you have found by leaving a comment below and let’s go on a positivity journey together.

References

1. Johannesen K. (2020) Stress of the Pandemic Has Negative Impact on Mental Health and Relationships, Study Shows [Online]. Available at https://news.iu.edu/stories/2020/06/iub/inside/29-stress-of-pandemic-mental-health-relationships.html (Accessed: 10^th August 2020)
2. Johnston WM, Davey GC. The psychological impact of negative TV news bulletins: the catastrophizing of personal worries.Br J Psychol. 1997;88 ( Pt 1):85-91. doi:10.1111/j.2044-8295.1997.tb02622.x

Over the past month, as we have been conducting our regular monitoring of the traffic to our website, we have noticed a lot of visitors are coming to our website to find out whether soursop or guava are beneficial for fibroids. So, today, we will visit published research to see if we can answer this question.

 How We’re Going to Approach This Question

The first thing to say about this topic is there isn’t a lot of evidence-based information out there. What we found were discussions by scientists about the possibilities, there wasn’t any concrete data that could definitively answer this question.

To explore whether guava and soursop may be beneficial in treating fibroids, we will focus on one scientific paper, which was the only one we could find that was related to this topic.

This paper was published by the Department of Experimental and Clinical Medicine at the Polytechnic University of Marche in Italy, in 2014.

Their paper, the ‘Use of dietary phytochemicals to target inflammation, fibrosis, proliferation, and angiogenesis in uterine tissues: Promising options for prevention and treatment of uterine fibroids?,’  is a review of a  selection of substances (phytochemicals) found naturally in certain fruits and vegetables which, because of their properties, could be useful in treating and preventing fibroids.

This paper is important in our exploration because some of the phytochemicals included in the researchers’ review are found in soursop and guava.

Some Background: What are Phytochemicals?

Before we summarise the relevant information provided in this paper, we thought it would be useful to define the term phytochemical. Harvard University describes phytochemicals as:

”…plant (phyto) chemicals: compounds in plants (fruits, vegetables, whole grains, nuts, seeds, and legumes) that contribute to their color, taste, and smell.”

Some commonly known phytochemicals are carotenoids, found in carrots, pumpkin, corn and tomatoes; flavonoids, found in citrus fruits, berries, apples and legumes and anthocyanins, which are found in berries, eggplant and red cabbage.

It is widely known that phytochemicals have a range of health benefits. These benefits include reducing our risk of heart disease, cancer and other chronic diseases and this is achieved because of their antioxidant and anti-inflammatory effects as well as a range of other effects.

What Does This Research Paper Tell Us?

The researchers who wrote this paper began their exploration by describing four possible factors that contribute to the development of fibroids. These are:

• A chronically active inflammatory immune response
• Fibrosis (a process that leads to the formation of scar tissue) which is a result of inflammation
• Increased rate of cell growth in fibroid cells
• The development of new blood vessels which feed fibroid cells

Researchers explained that if phytochemicals are able to address these four factors, they may be useful in preventing and treating fibroids.

Like many fruits, guava and soursop are rich in phytochemicals.  Guava is known to contain the phytochemicals lycopene, quercetin, anthocyanin, and many others.  Whilst soursop contains reticuline, coreximine, quercetin, gallic acid and others.

In their paper, researchers discuss a range of phytochemicals including ones that are relevant to guava and soursop – lycopene and quercetin. They explain that at the time of the publication of their paper, lycopene and quercetin have not been tested in fibroids, but based on what scientists know about these two chemicals they may be beneficial in the prevention and treatment of fibroids.  This is because when we look back at the four possible ways that fibroids develop, these two phytochemicals can potentially target these processes. They have both been found to have the following effects:

• An anti-inflammatory effect
• Anti-fibrotic effect
• Prevent the growth of different types of tumour cells (fibroids are benign tumours)
• Prevent the development of blood vessels that feed tumour cells

Researchers couldn’t make any conclusions on these phytochemicals with regards to fibroids, but their discussion has identified these and other phytochemicals which could be beneficial in the prevention and treatment of fibroids. These include:

• Allicin (found in garlic)
• Ellagic acid (found in strawberries, raspberries, cranberries, blackberries, pecans, pomegranates, walnuts, wolfberry and grapes)
• Indole-3-carbinol (found in cruciferous vegetables e.g. broccoli, cabbage, cauliflower, Brussel sprouts, bok choy, collard greens, kale etc.
• Lycopene (found in tomato, watermelon, papaya, pink guava, pink grapefruit and apricots)
• Quercetin (found in lemon, tomato, onion leaves, strawberries, soursop and tea)

They stated that based on the information they presented, there is a need to understand whether these phytochemicals are indeed beneficial for fibroids and this should be explored through future studies that carefully and accurately determine their mechanism of action and effectiveness in the treatment and prevention of fibroids.

What Does this Mean for Women With Fibroids?

This research study has raised the idea that the phytochemicals in soursop and guava may be beneficial in the treatment and prevention of fibroids. It doesn’t mean that eating soursop and guava will cure your fibroids, the reason for this, and this is discussed in the research paper, is that when you eat these fruits we don’t know if your body is absorbing enough of these phytochemicals to have a significant impact on the growth and development of fibroids.

What we can say is that if you have fibroids, if you haven’t already, we recommend that you adopt a healthy diet that is rich in fruits and vegetables, this can include soursop and guava, but should include cruciferous vegetables.  Studies have shown that making dietary changes can be helpful in improving some of the symptoms of fibroids as can introducing more exercise into your routine.

It is also recommended that women with fibroids avoid certain foods such as alcohol, caffeine, red meat and foods that may contain high levels of hormones like oestrogen.

If you have fibroids and would like to explore dietary changes and exercise as a way of managing your symptoms, please speak to your doctor first. She/he will be able to advise you on the best approach based on your specific situation as the success of these approaches will depend on the size of your fibroids and other factors.  You may also want to speak to a registered dietitian who along with your doctor will be able to provide some advice on the dietary changes that you can make.

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Were you one of the people looking for information on fibroids and guava and/or soursop? Was this article helpful? Let us know your thoughts by leaving a comment below. We would love to hear from you.

References

1. Agu KC, Okolie PN. Proximate composition, phytochemical analysis, and in vitro antioxidant potentials of extracts of Annona muricata(Soursop). Food Sci Nutr. 2017;5(5):1029-1036. Published 2017 Jun 29. doi:10.1002/fsn3.498
2. Chiari-Andréo, Bruna & Trovatti, Eliane & Marto, Joana & Almeida-Cincotto, Maria & Melero, Ana & Corrêa, Marcos & Chiavacci, Leila & Ribeiro, Helena & Garrigues, Teresa & Isaac, Vera. (2017). Guava: Phytochemical composition of a potential source of antioxidants for cosmetic and/or dermatological applications. Brazilian Journal of Pharmaceutical Sciences. 53. 10.1590/s2175-97902017000216141.
3. Deepa PC., Kumaria IR., and Lavanya B. (2015) Phytochemical Analysis, Antioxidant and Anti Microbial Activity of White and Pink Psidium Guajava Linnaeus. International Journal of Current Pharmaceutical Research, 7(2), pp 29-31.
4. Harvard Health Publishing., (2019). Fill up on phytochemicals [Online]. Harvard Medical School. [Viewed on 4^th July 2020]. Available from: https://www.health.harvard.edu/staying-healthy/fill-up-on-phytochemicals
5. Islam MS, Akhtar MM, Ciavattini A, et al. Use of dietary phytochemicals to target inflammation, fibrosis, proliferation, and angiogenesis in uterine tissues: promising options for prevention and treatment of uterine fibroids? Mol Nutr Food Res. 2014;58(8):1667-1684. doi:10.1002/mnfr.201400134
6. Jacoby VL, Jacoby A, Learman LA, et al. Use of medical, surgical and complementary treatments among women with fibroids. Eur J Obstet Gynecol Reprod Biol. 2014;182:220-225. doi:10.1016/j.ejogrb.2014.09.004
7. Leitzmann C. Characteristics and Health Benefits of Phytochemicals. Forsch Komplementmed. 2016;23(2):69-74. doi:10.1159/000444063
8. Shen Y, Wu Y, Lu Q, Ren M. Vegetarian diet and reduced uterine fibroids risk: A case-control study in Nanjing, China. J Obstet Gynaecol Res. 2016;42(1):87-94. doi:10.1111/jog.12834

July is recognised as Fibroid Awareness Month in some countries and it’s a great opportunity to put the spotlight on a health condition that receives little attention.

This year, we are delighted to be a part of the newly formed Global Fibroids Alliance whose aim is to raise awareness of fibroids and advocate for the change that is required to improve the health and wellbeing of women with fibroids as well as the quality of care women receive.

The Global Fibroids Alliance is a diverse group of health and wellbeing practitioners, researchers and consultants who have come together to strengthen the global approach to improving the information, treatment, care and support for all those affected by fibroids.  We hail from the Caribbean, US, UK and France and are calling for:

1. More awareness campaigns on fibroids
2. Fibroids education to be part of menstrual health education and delivered to all girls from the age of 10.
3. Every country to provide women with all the treatment options for fibroids.
4. Each woman suspected to have fibroids to be carefully assessed, and a treatment and wellness plan be developed in collaboration with the patient that suits the patient’s specific situation and is based on the concept of informed and shared decision-making.
5. Collaborative alliances to be formed between traditional and non-traditional/complementary therapists, gynaecologists and counsellors to ensure that women are receiving a holistic and comprehensive approach when deciding on their wellness plans.
6. More research to establish the cause of fibroids so that more effective treatments can be developed.
7.  More attention on the psycho-social impact of fibroids so that we can determine the full impact of fibroids and the support that women throughout the world require.

As part of Fibroid Awareness Month, we are delighted to invite women with fibroids to our first event which is a webinar on Fibroids and COVID-19.  This webinar aims to explore how the COVID-19 pandemic may be affecting women with fibroids and will discuss what women can do to improve their physical and mental health during this challenging period.

Speakers will include:

• Dr Fanta Waterman, Managing Director, Serrette Brown Research and Consulting LLC.
• Muku Qes Ua, Psychotherapist, Herbalist and Homeopath
• Olivia Haltman, Integrative Humanistic Counsellor, OH Counselling Services

You can register for this webinar here and if you have any questions, please email GFA2020@mail.com

We look forward to seeing you then and you can find out more about the members of the Global Fibroids Alliance here

The Just Dance Crew is our new innovative Public Health Tech project that uses 3D animation to promote physical activity and exercise in children by teaching them to perform short dancercise (dance + exercise) routines. We’re using animation because research has shown that children engage more with animated characters and we’re focusing on dance because it is a fun way to get children active.  Additionally, research shows that dance has a number of health benefits: it’s an excellent form of exercise, improves fitness, leads to weight loss, strengthens bones and muscles, is beneficial to mental health and improves social skills.

The routines will be 1-5 minutes long and will focus on cardiovascular exercise; muscle and bone strengthening; and flexibility and relaxation exercises.  The routines can fit into both the school and home environment. At school, the videos can be used during devotional, at breaks and over lunchtime. While at home, children and parents can use the videos during their leisure time and the whole family can get involved creating a fun, family experience.

Current Progress and Next Steps

So far we have created two demo animations focusing on a simple muscle strengthening exercise – squats – as a proof of concept and towards the end of 2020, we’ll be working with the Ministry of Education to develop more animations as part of a pilot project to test the effectiveness of this approach.

After the pilot, we will conduct a thorough analysis of the project and our plan is to then use the evaluation of the pilot to inform our next phase which will be to create a comprehensive collection of animations and develop an online learning platform to disseminate the videos.

We will also create educational material, guides and lesson plans for both teachers and parents to ensure the videos are used effectively. The videos will be easily accessed by teachers, to use in the classroom, or parents, through the internet or they can be downloaded and saved on to any device. Through the learning platform teachers, parents and guardians will be able to evaluate children’s progress with respect to their technique, consistency and their recall of the benefits of different types of exercise.

The Impact of Our Project

We hope that through this project, we can tackle childhood obesity in our local (St Kitts and Nevis) and regional (the Caribbean) area.

Childhood obesity is a challenge 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 on the rise. Being obese and overweight in childhood is linked to several conditions such as diabetes and hypertension, and it negatively impacts a child’s mental health.

Childhood obesity is also a significant challenge 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. In 2017, a UNICEF report published that 26% of children in St Kitts and Nevis are obese.  Being overweight and obese puts children at an increased risk of developing NCDs which are becoming an epidemic in the Federation with 83% of deaths being due to NCDs.

To combat childhood obesity, we must ensure that children adopt a healthy lifestyle and one approach is to get more children participating in exercise or physical activity. This is a priority as the Ministry of Health has reported that 58.4% of teenagers in St Kitts and Nevis are physically inactive.

We believe our project offers a simple, inexpensive and fun option for schools to get children active and teach important aspects of PE.

More Information

You can view the demo videos below and you can download our PowerPoint presentation below which provides more details about this project.

If you have any questions, about this new initiative, please don’t hesitate to send us an email

The squat challenge: How many squats can you do, properly,  in 60 seconds? Let us know 🙂

The Joan Ajose-Adeogun fund is being established in loving memory of Joan Ajose-Adeogun who sadly passed away from multiple myeloma on 11^th September 2019.  Her diagnosis of multiple myeloma was devastating and within months Joan had lost her ability to speak and walk, her brain function and was in unbearable pain.

Understanding the many challenges that patients and their families face, we are raising funds to support multiple myeloma patients.

Grants will be available to help improve the wellbeing of patients and their families and will cover some of the costs of:

• Home care
• Medical facility/care home fees
• Retreats and respite breaks for patients and their families
• Palliative care
• Psychological support and counselling for patients and families
• Brain stimulation therapy
• Treatment and medication
• Physiotherapy
• Transportation costs (for family members to visit patients and specialised transportation for patients)
• Equipment such as wheelchairs, stairlifts, healthcare beds
• Bathroom adaptions and other required home adaptions for patients
• Patient’s utility bills
• Doctor’s appointments
• Medical treatment abroad

Priority will be given to patients residing in St Kitts, Nevis, the British Virgin Islands, Trinidad and Tobago, Nigeria and Ghana, countries that were near and dear to Joan’s heart.

How you can help?                                                                                          

We would be delighted if you would make a donation to support this cause and ensure that those affected by multiple myeloma can receive the support that they need during a very traumatic, devastating and difficult time.

You can also invite your friends to make a donation or have some fun and host a fundraiser  – a cake sale, fundraising party, dinner or gala, an auction, a sponsored run or walk, a coffee morning; the sky is the limit.

We’d love to hear from you so please do leave a comment in the section below to share your experience with multiple myeloma, your reason for donating and to share any fun fundraising events you’ve organised.

Thank you

Thank you for your support, let’s make a difference together.

If you’d like to be kept up-to-date with our progress, please sign up to our newsletter here.

Fund Management

This fund will be managed by Lake Health and Wellbeing, a registered NGO in St Kitts and Nevis, and financially reviewed annually by Pelican Accounting and Business Services.

Online payments are being managed by JAD Cash,  a comprehensive e-money solution for the Eastern Caribbean countries.  All online payments will, therefore, be processed in Eastern Caribbean Dollars (XCD). Please note that $1 USD = $2.7 XCD and £1 = $3.40 XCD.

Up Next

In our next blog in this series, we’ll be discussing what multiple myeloma is.