On 26^th and 27^th March 2019, we joined representatives from across the Caribbean in attending the Healthy Caribbean Coalition’s workshop on conflict of interest (CoI). This event had a special focus on conflict of interest in non-communicable disease (NCD) prevention and control in the Caribbean.

This is going to be a two-part blog and in today’s piece we’re going to provide some background to conflict of interest and in part two we’ll provide some highlights from the HCC’s CoI meeting.

What is Conflict of Interest?

The World Health Organisation describes conflict of interest as:

“…circumstances where there is potential for a secondary interest to unduly influence, or where it may be reasonably perceived to unduly influence, either the independence or objectivity of professional judgement or actions regarding a primary interest.”

They also explain that:

“The existence of conflict of interest in all its forms does not as such mean that improper action has occurred, but rather the risk of such improper action occurring. Conflicts of interest are not only financial but can take other forms as well.”

Another definition of CoI comes from Public Health and Food and Beverage Industry Engagement: A Tool to Guide Partnership Opportunities and Challenges. They define CoI as:

“… where one engages in any private, personal or business undertaking or other activity in which one’s private or personal interest conflicts with one’s duties or responsibilities…”

For further clarity around the concept of CoI further explanations have been offered which categorise CoI into perceived, potential and actual and these are defined as follows:

• An actual conflict of interest occurs when there is a direct conflict between a person’s professional duties within an organisation and a competing interest or obligation, whether personal or involving a third-party.
• A potential conflict of interest arises where a person has an interest or obligation, whether personal or involving a third-party, that could conflict with their professional duties and responsibilities in the future.
• A perceived conflict of interest occurs where it could reasonably be perceived, or give the appearance, that a competing interest could improperly influence a person’s professional duties.

Additionally, CoI may be seen at the individual, institutional and structural levels.

By understanding and reflecting on these definitions we can recognise if we, or our organisation, may be conflicted. This will allow us to take steps to address this to ensure we are serving our primary interest – this is the one we committed to serve at the outset of our professional journey (in our case, improving the public’s health).

Conflict of Interest, the Caribbean and NCDs

Small Island Developing States (SIDS) like the Caribbean are presented with a unique set of circumstances which make the area of conflict of interest particularly challenging. The circumstances in question relate to the very small populations creating an unavoidable, overlapping, intertwined social and business environment. This means that individuals and organisations may have multiple competing interests.  Therefore, staff working in organisations aiming to prevent and control NCDs may, at some point, find themselves in a number of difficult situations when it comes to CoI. This may include:

• Having a family member, friend or close associate working in an industry that produces products that are risk factors for NCDs
• Being offered funding, sponsorship or resources from companies that produce unhealthy products in a landscape where there are very limited funding and sponsorship opportunities
• Exploring a partnership with a company that produces both healthy and unhealthy products
• Being invited to take part in health campaigns by companies who produce products that are risk factors for NCDs (with there being no other companies to partner with to reach such a large audience)
• Developing NCD prevention and control policies with individuals and entities who have competing interests

In larger countries there are multiple options when there is a need to partner with individuals and organisations to  implement projects to prevent and control NCDs so many of the above situations can be avoided. Therefore, their approach to conflict of interest centres on prevention.

In Small Island Developing States, many of these conflicting situations cannot be avoided so not-for-profit entities (as well as government departments) have to start to re-think their approach to conflict of interest, focusing on strategies to effectively manage conflict of interest.

The HCC’s Conflict of Interest Meeting

Historically, conflict of interest, in many cases, has been addressed with a global blanket approach that doesn’t delve into the complex, overlapping business and personal relationships as well as the challenging funding environment that exists in the Caribbean. A more bespoke approach is needed for the Caribbean and hence the HCC’s conflict of interest meeting brought organisations together for in-depth discussions on this issue. Time was also set aside to explore solutions through the review and testing of a new conflict of interest tool being developed by WHO/PAHO as well as the review of a conflict of interest policy and guide being developed by the HCC. This meeting was very informative and we were delighted to have attended.

Coming Up Next Time

In part two of this blog we’ll summarise the highlights from the meeting, but in the meantime, for further information on conflict of interest you can explore the documents in our reference list below. We also encourage anyone working in public health in a Small Island Developing State to develop an approach to managing CoI to ensure the  credibility and integrity of their organisation remains intact.

References

1. The Healthy People and Communities Steering Committee’s Multi-Sectoral Partnerships Task Group, 2014. Public Health and Food and Beverage Industry Engagement A Tool to Guide Partnership Opportunities and Challenges, Ontario, Canada: The Healthy People and Communities Steering Committee’s Multi-Sectoral Partnerships Task Group, May 2014.
2. University of Southern Queensland. Conflicts of Interest. [Online]. Available at <https://www.usq.edu.au/hr/empcond/conflicts> [Accessed on 3^rd April 2019]
3. WHO, 2016. Framework of Engagement With Non-State Actors. [Meeting Proceedings] 28^th May 2016. Sixty-Ninth World Health Assembly.
4. WHO, 2015. Addressing and managing conflicts of interest in the planning and delivery of nutrition programmes at country level. Report of a technical consultation convened in Geneva, Switzerland, on 8–9 October 2015.

Being a new organisation in St Kitts and Nevis and keen to make a positive contribution to improving the health and wellbeing of our community, over the past year we have been exploring the public health landscape in our Federation and started developing a strategy around the pressing issue of non-communicable diseases (NCDs) with a focus on childhood obesity and women’s health.

In today’s blog, we’ll be discussing our decision to tackle women’s health and in a future blog, we’ll explore childhood obesity.

Our decision to focus on women’s health was an evidence-based decision. Data from the Ministry of Health has demonstrated that women living in the Federation face a number of health challenges.  In St Kitts and Nevis, women are disproportionately affected by some NCDs. For example, 71% of diabetics in St Kitts and Nevis are women and 65% of cancer patients are women.

Non-communicable diseases are a significant issue for St Kitts and Nevis with 83% of deaths being due to these conditions. Driving the rise of non-communicable diseases is the high rate of overweight and obesity. In women, the rates are extremely high. Data has shown that 74% of females in St Kitts and Nevis are either overweight or obese.

We need to tackle these issues in order to improve the health and quality of life of women and prevent them from dying prematurely from diseases that are mostly preventable. Therefore, we are working towards developing a women’s health programme that will initially focus on awareness and education.

Our Plan

Over the next year, our plan is to host a series of women’s health events entitled ‘Girl Talk: Informative, Informal and Empowering Discussions About Women’s Health.’

These events will aim to inform and empower women enabling them to take control of their health and therefore not only improve their own health and wellbeing, but the health and wellbeing of their families, and by extension build a stronger, healthier nation.

The series began on 30^th March 2019 with Girl Talk: Fibroids and following this there will be regular events covering a range of women’s health issues.

Healthcare professionals, particularly female healthcare professionals, will be invited to give engaging presentations on health topics, and women affected by conditions will be invited to share their experience and what they have learnt from it.

Additionally, we will invite health and wellbeing brands (particularly those owned by women) to showcase their services at each event so that women can have easy access to relevant services. We will also invite female medical students to take part in this event giving them relevant real-world experience of women’s health. We are pleased to have formed a partnership with Because We Care at the University of Medicine and Health Sciences to achieve this.

As well as covering the most common NCDs, we need to focus on providing support and information for women in St Kitts who are affected by women’s health issues that tend to be overlooked such as fibroids, endometriosis and PCOS.

Additionally, childhood obesity is another significant challenge with 1 in 3 children in the Caribbean being overweight or obese. In St Kitts, the statistics are more alarming with 46.9% of secondary school children being overweight or obese. Studies have shown that children who are overweight and obese tend to become adults who are overweight or obese, and this puts them at risk of developing NCDs like diabetes, cancer, heart disease and more.  We believe that women can play an instrumental role in tackling childhood obesity by creating a healthy environment for their children, our lecture series will educate mothers on easy, practical ways to do this.

The key objectives of our women’s health event series will be:

1. To raise awareness of and create an understanding of women’s health issues to facilitate early detection and prevention
2. To provide a safe, informal platform where women can come together, receive expert advice and have an honest open discussion about important health issues and therefore reduce isolation, stigma and create a support network for women.
3. To empower women with the information to create a healthy lifestyle for themselves and their families to improve their general health and wellbeing

As mentioned previously our first Girl Talk event was on 30^th March 2019 and we were so pleased with how it went. Look out for a future blog post summarising this event.

We are really excited about our strategy for the next couple of years and hope you’ll follow us on our journey.

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References

1. UNICEF, Situation Analysis of Children in the Federation of St Kitts and Nevis, UNICEF Office for the Eastern Caribbean Area and the Government of St Kitts and Nevis, Christ Church, Barbados, 2017
2. PAHO, Health in the Americas, 2012: St Kitts and Nevis, PAHO, 2012
3.  WHO, Diabetes Country Profile: St Kitts and Nevis, WHO, 2016

In today’s blog, we’re delighted to have spoken to author and writing coach, Greta Solomon.

Greta talked to us about the health benefits of journaling and how she’s helping women tap into this empowering and therapeutic pastime through her new book Heart, Sass & Soul. 

Tell us about your new book

Heart, Sass & Soul is a warm, honest, deeply supportive guide to journaling your way to a life that not only looks good – but feels good. One where you’re not trying to be an all-round girl boss / vixen / superwoman who rises at dawn to slay like Beyoncé. Instead, you’re aiming to be more and more YOURSELF, because that’s where your true power lies.

There has never been a better time to be your own guru. Freewriting and journaling in the ways laid out in this book can be life-changing – for all the right reasons. They put you in charge of what YOU think and feel, which is a welcome relief in this hyper connected world. And while there are lots of beautiful journals on the market, there are very few comprehensive guides on how to USE them to create magic and meaning in your life.

Why did you write this book?

I wanted to show people exactly HOW to journal. Not in a 1-2-3 step kind of way. But how to access the deeper parts of you, and how to clear the creative blocks that may stop you from journaling in the first place.

Writing has unlocked so many doors for me (and not just because I became a journalist who got paid to interview celebrities, go to events and drink champagne at parties)! Through my life and work I realised that through writing I ask for things that I wouldn’t dare speak out loud. Better still, I could write things into existence. Things that were never there before, except for wishes or dreams in my head. And when there were very dark, difficult times, writing has been a helpful friend. My mother committed suicide 11 years ago and writing helped me to heal and chart a new path.

From a professional point of view, I began writing this book in 2016 at a time when I needed a break from my business. I had spent four years pitching, developing, creating and delivering business writing workshops (alongside being pregnant and then a new mum).  And I needed to get back in touch with myself. I cleared my schedule with the aim of doing nothing in particular. And that’s when the yearnings, inklings and frantic writing began. After years of writing to order, I finally wrote what I wanted to write. At first it was like clearing the phlegm from my writing throat. But soon, the channel was open, and the essence of this book flowed. As did a workshop in writing for creative self-expression which sold out within hours. I knew I was onto something and I began to realise the true power of writing for creative self-expression.

We didn’t realise that writing and journaling could be so empowering. What are the other health benefits of journaling?

 Psychologists have found that expressive writing (where you write about thoughts and feelings) results in fewer doctor visits and can even boost the immune system in the short-term. It can help you to recover from depression, find happiness and make you feel better about yourself and your life. In Heart, Sass & Soul, I show readers exactly how to journal in order to overcome self-doubt and develop a new creative identity; transform dark times into something beautiful; find moments for healing themselves without judgement and to become empowered with uninhibited self-expression. I also love the fact that all you need to journal is a notebook and a pen. Journaling is cheap and can pretty much be done anytime and anywhere. It literally puts the power of self-care and wellbeing into your own hands.

What is your link with St Kitts and Nevis?

 My dad and his family are originally from St Kitts and my dad grew up in Nevis. We actually lived in Nevis for a year when I was five before returning back to the UK, to London. So these island have always been an integral part of my life.

Is there anything else you’d like to tell our readers?

 My mission is to build a thriving community of empowered, self-expressed women, who know exactly what they think and feel, who can face uncomfortable emotions head on, access their higher wisdom and tap into the creative current of life.  Meaning is made from walking through loss and grief, not from dancing around it. And a joy-filled life is not only possible, but inevitable when you are creatively free. When you are ready to answer the call, I’d be honoured to be your guide.

Where can our readers order a copy of Heart, Sass & Soul?

Heart, Sass & Soul by Greta Solomon is published on 15 April 2019, and is available to pre-order now on Amazon.

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Special Offer!

We’re delighted to say that Greta is offering a free writing masterclass worth £77 for everyone who pre-orders Heart, Sass & Soul before 15 April. To claim that gift please visit https://www.gretasolomon.com/preorder-gift-with-heart-sass-soul

About Greta Solomon 

Greta Solomon is a British journalist turned writing coach and the author of Heart, Sass & Soul: Journal Your Way to Inspiration and Happiness. In 2006, she discovered a talent for helping people overcome the blocks, fears and shame that stops them from fully expressing themselves. Through talks, workshops and online programs, she teaches real-world writing techniques and inspires others to live rich, full lives. Her work has been featured in Forbes.com, The Numinous and The Huffington Post. She is a published poet and songwriter, a psychology graduate, certified life coach, trained lifelong learning teacher and holds a specialist certificate in lyric writing from Berklee College of Music. She lives in London with her husband and their daughter.

And, you can find Greta on Instagram and on twitter

We recently came across the video below created by BuzzFeed which explores the experience of three women with fibroids. We thought it was an excellent exploration of the impact of fibroids.

Our Thoughts

These stories give viewers an insightful look at the impact of fibroids and highlighted some of the same issues raised in a recent book of short stories that we read, Invisible Not Imaginary by the Barbados Association of Endometriosis and PCOS.

The women bravely discuss heavy menstrual bleeding, anaemia, painful periods and their concerns about fertility.

As we watched the video, what struck us was the way in which all three women continued with their daily life despite their symptoms and seemed to almost normalise them until they could no longer bare it. The reason why they did this, as articulated by one of the women, was the expectation that women should pretty much ignore their own health and wellbeing, press on and continue with all their many obligations.

Another issue that was raised was recurrence, which is very common and can be quite frustrating for women who, after their initial surgery, will have moved on with their life and have put their experience of fibroids behind them. Having to deal with fibroids once more can be devastating.

The video ends with some useful tips and advice from each of the women based on their experience.  Participants encouraged women to:

• Prioritise their health,
• Seek help as soon as they notice symptoms that don’t seem right
• Be informed about fibroids
• Reach out to family and friends and talk about what you’re going through

Final Thoughts

We thought this video was a really effective way of raising awareness of fibroids and its impact. It identified areas that need to be addressed. These include the need for:

• Greater awareness of the symptoms of fibroids
• Greater awareness of what normal/abnormal periods are
•  Less pressure to be placed on women to try to continue as normal when they feel unwell
•  Research on whether  lifestyle changes may reduce a woman’s risk of having a recurrence after treatment
• More research to understand the prevention of fibroids
• More research to confirm the incidence and prevalence of fibroids, particularly in black women

More Information

For more information on fibroids, you can:

• Visit our fibroids blog and fibroids news sections
• Read through our My Fibroid Story section
• Read through the highlights of our fibroids Twitter chats
• Send a question to our Fibroids Ask the Expert panel
• Listen to our fibroids podcast interviews
  • My Ten Year Journey With Fibroids 
  • Fibroids, Hormones, Diet and Lifestyle
  • The Emotional Impact of Fibroids

The Barbados Association of Endometriosis and PCOS (BAEP) recently published ‘Invisible Not Imaginary’, a collection of short stories that aims to put the spotlight on endometriosis, fibroids, PCOS and dysmenorrhea. The book seeks to raise awareness of the impact of these conditions on the lives of those directly and indirectly affected.

This mostly fictional book invites you to dive into the lives of a variety of people as they navigate life with one of the above-mentioned conditions. Through Invisible Not Imaginary we explore the experience of adolescents, young women, mothers, working professionals and fathers.

Why We Love this Book

We thought Invisible Not Imaginary was a powerful and insightful read. It bravely explores issues like heavy menstrual bleeding, painful periods and infertility – common symptoms of these conditions. It also identifies the insensitivity, lack of empathy and the insecurities that women with these conditions encounter and experience.

Furthermore, the book causes the reader to reflect on the wide-spread normalisation of abnormal menstrual symptoms, the enormous pressure women feel to keep going despite feeling unwell and how invisible and misunderstood many women with these conditions feel.

The stories are very moving providing an honest, open account of the pain, isolation, upheaval, disruption and uncertainty caused by these gynaecological conditions which tend to be trivialised and disregarded because they are not life-threatening but as these stories clearly demonstrate, they significantly affect the quality of life, health and wellbeing of the many women who are affected.

We could relate to many of the experiences and believe the stories will resonate with most, if not all, women because of our shared menstrual experience.  Many women have a story about their menstrual health which they are hesitant to talk about; this book tells our story and gives us all a voice.

This collection of short stories is an excellent and creative way of raising awareness. It really brings the issues to life in a powerful way and leaves the reader feeling disturbed by the challenges faced by those affected by these conditions.

This Book Challenges Us All

This book challenges society to address the health inequalities that exist in public health where conditions like these receive little attention, yet affect so many.

Sadly, discussions about women’s health or reproductive health tend to omit conditions like fibroids and it’s time for a greater focus on these conditions and more balance so that all women’s health issues are deemed important.

Well Done BAEP!

We applaud BAEP on all the great work they have conducted to add some context and depth to the discussion on these women’s health issues and believe this will be an effective resource for awareness and educational work in a range of settings – schools, colleges, medical schools, book clubs, the health sector’s continuous professional development programme and more.

More Information

For more information on Invisible Not Imaginary and how you can order copies, please visit BAEP’s website here or you can send them an email

Also, you can read a summary of our fibroids and endometriosis Twitter chat with Julia Mandeville the co-founder of BAEP here

Lake Health and Wellbeing is delighted to invite women in St Kitts and Nevis who have been affected by fibroids to attend our upcoming event ‘Girl Talk: Fibroids.’

We have teamed up with Because We Care, a student group at the University of Medicine and Health Sciences, to organise a new series of women’s health events  entitled ‘Girl Talk: Informal and Empowering Discussions on Women’s Health’

This first event in our series will focus on fibroids, a common but overlooked women’s health issue that is estimated to affect 80% of black women.

Girl Talk aims to overcome the stigma associated with fibroids by creating a safe space to discuss fibroids, its impact on women and solutions.

We’ll have a panel of esteemed speakers covering various aspects of fibroids, a wellness market featuring St Kitts’ leading health, wellbeing and wellness brands, fantastic raffle prizes, free health checks, food and more!

Confirmed Speakers

Confirmed speakers include:

• Dr Hazel Laws, Chief Medical Officer, St Kitts – Fibroids and Women’s Health in St Kitts
• Dr Deborah Williams, Professor of Pathology – What Are Fibroids?
• Dr Lescott,  Medical Doctor – Fibroids and Nutrition
• Dr Pereira, Clinical Psychologist –  Living well with fibroids and chronic illness
• Dr Lawrence, Medical Doctor – The treatment of fibroids

Confirmed Vendors

We have some great organisations taking part in our Wellness Market. You can treat yourself to a range of products all aimed at improving your wellbeing.

Some of our confirmed vendors include:

Mother Becky Bush Tea – Mother Becky Bush Tea is named after owner Jermine Mike’s great grandmother who lived to be close to 100 years of age. Recognized as the matriarch of her community, Mother Becky hailed from a generation which drank bush tea daily. The Mother Becky Bush Tea brand aims to honor and revitalize the bush tea tradition of St. Kitts & Nevis and offer an authentic product to visitors and residents alike.

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Sugar Town Organics – Sugar Town Organics is a natural products manufacturer and distributor that offers high end botanical beauty (Yaphene) and wellness (Flauriel) products featuring the finest natural Caribbean materials. With a commitment to ethical manufacturing and promoting environmental sustainability, good health and wellness, the firm is family-owned and employs all-natural methods that celebrate the host of rich ingredients plentiful throughout the region.

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Pure Niceness by Winnielle – HANDCRAFTED on the island of St. Kitts amidst the natural wonders of the West Indian land, using all – natural, effective, aromatic, superior ingredients, sourced from the gifts of mother nature🍃and handmade with love and pure good vibes by island girl Winnielle. Her brand of hair and skin care promotes self-love, self-care, good vibes and a wellness lifestyle. SHOP Made in St. Kitts – Nevis, Shop Small… Experience Pure Niceness!

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Love the Skin You Wear – Love the Skin You Wear offers a range of services designed to help you relax and focus on your total wellness, these include massages and facials. They also sell natural handmade hair and body products.

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Prices

Join us this International Women’s Month on 30th March for this empowering and informative women’s health event.

Early bird tickets are just $30EC  for a regular ticket and $20EC for students.

You can book your place below and then pay at the event. Early bird tickets are available until 15th March 2019 so if you register before this date you’ll secure the early bird price, registrations after this date will be $35EC.

Registration Form

The information provided in the form below will enable us to contact you about the event regarding updates and important information.

No Fields Found.

We look forward to seeing you on 30th March and if you have any questions, please email  us or call 668 1518.

Today’s blog post comes from physician-writer, IC Blackman who began writing fiction in 2007 after embarking on a career break from working as a consultant physician in general internal and geriatric medicine.  She is the founder of Dried Ink through which she has created a literary genre, Connected Fiction, to engender discussion between the young and the old.  

IC Blackman discusses how our history, specifically slavery, has shaped our food culture and therefore  impacted the health of black people today. This piece challenges us to reflect on why we eat the food we eat by exploring historical truth, to question our life choices and to move towards a simpler, healthier lifestyle. 

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Physician writers have a duty to combine their writing content with the breadth of their clinical experience. However, one’s life experience is equally as valid as that learnt from a career in medicine, which at its core is a profound, personally transformative science.

As physicians, we diligently and dutifully take detailed chronological medical histories of our patients, but these patients to whom we are entrusted are a microcosm of the much vaster realm of human experience. That experience is what we would summarily call world history. Every patient’s history is different and nuanced in its own way, coloured by cultural context, or identity, for those with enough sentience to grasp this salient concept. This is made that more challenging as we pen such histories and translate our patients’ spoken words into cryptic medical jargon. Most would focus on the pathological process at hand; the histories therefore are oftentimes tailored for disease, not health. In fact, they centre around elucidating cause and effect, and, at their very best, treating the cause, and not the myriad effects, which we call symptoms, signs and diagnostic criteria. Not to diminish the latter, as to miss one of these would be to risk a misdiagnosis and its subsequent tragic sequelae. We do, as a part of the history-taking exercise, include a dietary, social and family history which usually, but quite disappointingly, takes up less than a quarter of the entire ‘life story’ of the patient. Metaphysicians, naturopaths and medical intuitives may have great reservations about this – it should be at least 40% of the entire history, they would entreat, and I’m beginning to be a strong supporter of this; one would be remiss to disagree.

On this backdrop, then, one quite unexpectedly, yet with what would seem to be a natural extrapolation of clinical expertise, embarks on a continued journey, an intrepid adventure. Here one begins to translate the gamut of human experience into writing fiction as a physician writer, not just for entertainment but for studied consideration. Not for speedy conversions or to arrive at a diagnosis – though these may happen organically – but for the purposes of deep self-reflection, discussion, intergenerational connectedness and, ultimately, resolution of familial conflict. This then translates into broader avenues of harmonious living. Connected Fiction, a term I coined quite by happenstance in 2015 as it best described my committed purpose for writing, is an ambitious endeavour. Its primary aim is to bridge the disconnect between teens and the significant elders in their lives: mother-daughter, father-son, granddaughter-grandmother, teacher-student – the connections go on and on. This is deliberately constructed through compelling stories of many genres, buttressed by relevant themes and colourful characters…. Have I honoured my own maxims and utilized my clinical experience in fulfilling my purpose? Yes. To wit, have I used my personal experience as well? Absolutely, perhaps even more so. Will I succeed in my mission? Time will tell. History will record whether I do or do not… What is certain, though, is that any profit gained is for the reader and not necessarily for the writer. Profit here translates to healing, not so much monetary reimbursement.

My last novel, a collection of short stories, has as its source inspiration what appears to me to be part of an ongoing dilemma we have in the African Diaspora but not exclusively. This would be the under-appreciated connection between cultural identity, historical truth and the health of adults and children. I include mental health here as well. The mind controls the body, and if we are to ignore the mind, we would necessarily be setting ourselves up for a whirlwind of world hurt and poor health outcomes. In the novel, I use intergenerational female relationships as a vehicle for examining the aforementioned, as well as what we normalize as cultural ways of being – our values, principles, tastes, and daily preoccupations.

The enslavement of African peoples, as well as the indentureship of South Indian peoples, to fuel the industries of sugar, tobacco, coffee and cocoa, to name but a few, a poignant part of world history, has had long-term ramifications. Hitherto these have been seen only from an economic viewpoint; the psychological and mental impact have been given little global appreciation and in-depth examination. Some have explored the effects of chattel slavery and indentureship on sociopolitical superstructures and their inherent inequities and spawned ideologies. However, few have dared to draw a connection between mass production of these products and their byproducts, their effects on physical health in the very countries that provided free labour and fertile lands, and the psychological wounds which fuel their excessive consumption. All this, to make them some of the most profitable industries of the modern era, providing countries which held and still hold the means of production with immeasurable wealth.

The production of coffee, tobacco – for cigarettes – and sugar from sugarcane – for confectionery, drink and myriad foodstuffs – were all labour intensive exercises, the harvesting of cocoa for the production of chocolate even more so. Most of these products have high addictive potential – a phenomenon that needs further in-depth exploration. Once the existence of this phenomenon is agreed upon, it could change the way we offer and formulate any intervention to curb the present obesity crisis, not just in the former colonies of Empire that produced the raw materials, but also globally. Most are consumed in great amounts when coupled with psychosocial foibles and/or triggers – poor access to healthier options, fractured emotional bonds, subclinical depression, gaps in health education, and – let’s be clear – gaping holes in historical context. Little is taught about the history of the abject conditions under which these crops were grown and harvested, the lives maimed or indeed cut short by their production, and the wealth inequities they spawned, some of which still exist to this day. These historical truths hold the key to a much-needed reverence for these profitable, ‘seductive’ crops. Do we need to start embracing a mindset where we consider the products of these crops delicacies for very deliberate and sparing consumption? Should they be perceived much like, say, a rare aged cheese, or perhaps the eco-unfriendly, as now considered by some, Beluga caviar (not an analogy to be taken lightly), whether in their native state or in the food we consume daily? Should this then mark the opportune and perhaps urgent demise of the jumbo or family pack of any of these products – the colossal chocolate bar for instance, the litre bottle of carbonated drink? Size is everything. Portions may well predict posterity, or the lack thereof. Is everything edible to be classified as food? Is food to be defined as that which gives the body nourishment? Does the food pyramid need to be revised so as to exclude sweets? Should such products be purchased at much higher prices than ‘true food’? I deliberately exclude tobacco here for good reason. Historical truth is the segue to better health, if taught in a way that includes the inception, propagation and maintenance of these industries – cause and effect.

Then there arises, from the depths of free enterprise, the behemoth that is financial profit and the livelihoods of those still producing these crops today, something that cannot be circumvented easily. This naturally begs the questions – how much profit is reasonable profit? Should it be tariff-based or price-based or both? Should we be looking for other uses for these crops which don’t remotely include our gastrointestinal tracts and subsequent ill-health? Rooted in the answers to these questions, other questions follow – what does one value above one’s own health, and the health of a nation, and indeed the world? What are we sacrificing to achieve and maintain a ‘handsome profit’?

How does cultural identity play into all this, you might ask? Who would disagree that food – what we eat, how it is harvested and prepared, the where and the when – is a manifestation of culture? Must we now examine how much we inculcate another’s culture into our own, if said assimilation begins to produce adverse effects in the general population? It’s what I wistfully call cultural integrity – not to be confused with cultural exceptionalism, cultural exclusion and xenophobia. And one has to clarify what one means by inculcation – latter-day adoption without appropriate cultural translation. Has sugar ever played a major part in Caribbean cuisine, South Indian or African-derived? One could argue that chattel slavery introduced many dietary and indeed social habits which were compensatory, partly oppressive, and born from a culture of lack and a chronic functioning outside the realms of one’s cultural imagination. We made do. Innovated. As some would say, maladapted through forced choice – no choice at all – and under tremendous duress, not consent.

Deeper issues abound beyond faddism – going vegan or vegetarian, dry- January… One should note here, though, that South Asian Hindus maintained their veganism in indentureship through an intact religious ideology, and Muslims – either African or South Asian in origin – refrained from alcohol and pork. It was true during indentureship, and to a lesser extent during chattel slavery; true even now. But now that we are in a better position financially to embrace abundance, has that abundance translated dysfunctionally into excess, as a symbol of having ‘arrived’? Is obesity the new malnutrition of our age, replacing what we were familiar with in the Diaspora – marasmic kwashiorkor and protein energy malnutrition, usually an index of poverty, unlike obesity? Can we rein this in in time, given that we are yet to address the ongoing psychosocial issues that fuel excessive consumption, as mentioned previously in a by no means exhaustive list? Have we ever craved sugary or fatty foods in tropical climes? And if we do now and within the recent past, why? Is this solely driven by physical needs, or is it a reflection of the preponderance of psychological hunger? What quenches our thirst more in the hot sun – cool water or a sweetened drink, fruity or fizzy? When we have been blessed with a climate that fosters an outdoor lifestyle, why are we imprisoned indoors as if in a harsh winter? Is the rum shop a place for social gatherings, or a pharmacy for troubled minds? How much chocolate do we need to consume in order to feel loved, worthy, alive, spiritually and emotionally sated? How much coffee do we need to imbibe to get going, when perhaps what we truly need is to stop what we’re doing, reassess our life choices and make the necessary changes towards a simpler, more fulfilling existence? And how many cigarettes do we need to smoke before we say a premature goodbye, our breath of life snuffed out when we are in our prime?

Now that we understand that genetically as an ethnic group – African and South Asian – we metabolize sugar, salt and most substances with addictive potential differently, how do we honour that truth? These are not scientific secrets. Let’s look at our history. Let’s define culture clearly – what does it look like, feel like, and, not to veer off-topic, taste like? How does it align with our overall health – mental, physical, spiritual, and social? How do we take the best examples of healthy living from the many cultures that exist on the planet and create working models of intersection that foster health for adults and children? This should be a factual endeavour, not an emotional exercise.

Ultimately, it’s about doing what works within the fabric of one’s experience, forged from the truth of one’s experience – historical truth. It’s about being true to the best manifestation of that experience, having a reverence for it, honouring it – cultural identity and historical truth, what I believe would greatly foster improved health for adults and children in the Diaspora. And as far as Connected Fiction goes, it’s one of the pressing reasons why I write. You don’t have to agree, just consider.

© 2019 IC Blackman. All rights reserved.

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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.

We had the pleasure of reading Women in Black, a new book by IC Blackman. This book was an insightful, emotional and thought-provoking journey of the intergenerational trauma caused by slavery.

An Overview of Women in Black

Women in Black consists of a collection of short stories connected by family (the Nesbitts and the Tibbins), a much-loved brand of chocolate (Nesbitt’s Chocolate), delicious sweet potato pone and an old colonial home (Halycon’s Crest). This connection was a nice surprise, one we weren’t expecting at all, but really liked as it brought some intrigue to the stories. So much so that once we noticed these links, we stopped and re-read a few chapters to make sure we understood the various different connections that explored the experience of several generations of a family.

The book starts with ‘The Baying of the Bloodhounds’ which is set in Trinidad in the late 1700s and follows the story of Ezra Tibbins, a runaway slave making her way to freedom while being pursued by her owner’s bloodhounds. As Ezra tries to make her way to freedom we’re swept along her emotional journey of strength, hard decisions and her commitment to finding freedom on her own terms.

From there we move on to ‘Bridal Shop’ which takes us forward in time to Trinidad in the 1950s/60s. Here we are met with Chief Bridal Shop Assistant Pamela Tibbins and read about her humble beginnings, hunger for the good life, grand ambitions and explore how she navigates her life. Will she break free or succumb to the challenges of her lot in life?

In ‘Bitter Dark Chocolate’ we’re transported to Trinidad in the 1990s and join widowed, retired nurse Selma Nesbitt-Payne who makes her regular visits to Ward 504 to visit its patients. This story isn’t what is seems and is best described by the author herself:

“This story takes us into the world of a retired psychiatry Sister who once worked on Ward 504. It uses surrealism to explore the unappreciated outcomes of unchecked privilege: guilt, suspicion and ultimately a tortured existence, despite the best intentions and material comforts.”

 From here we are introduced to the mother and daughter calypso duo, Big Titi and Little Dee, in ‘Big Titi and Little Dee’s Grand Piano.’ Here we meet two generations of the Tibbins family, whose poverty and what appears to be the Tibbins curse leads them to a turbulent life. Sadly, despite all the talent and potential in the world, they too are unable to break free of the intergenerational trauma inflicted on their family.

Then we get to the final story  in Women in Black, ‘Housewife – The Five Acts of Elspeth Sweetening.’ Will there be redemption for this troubled family, will they finally break free from intergenerational trauma. We’ll let you find out 😉

Our Thoughts on Women in Black

 This was an emotional and, at times, difficult read providing insight into the intergenerational trauma caused by slavery. A trauma that has not been sufficiently addressed.

As we read this book, we were reminded of Dr Joy DeGruy’s Post Traumatic Slave Syndrome (PTSS) theory, a topic that we were introduced to many years ago.

IC Blackman very emotionally and poetically gives an illustration of Dr DeGruy’s theory of how: “Slavery produced centuries of physical, psychological and spiritual injury” and highlights the importance of understanding PTSS and the themes raised in IC Blackman’s book so that we can lay: “the groundwork for understanding how the past has influenced the present, and open up the discussion of how we can use the strengths we have gained to heal.”  (Dr DeGruy).

This is a good read, that challenges us in many ways, both in the subject matter and in the way it is written – this is a complex and deep writer who uses satire, dark humour, magic realism, surrealism , Trinidadian folklore and an advanced writing style, so you do have to engage your brain from the very beginning. Once you do, you’re in for an interesting literary experience.

More Information

To find out more about Women In Black you can visit Amazon or IC Blackman’s website, and you can follow IC Blackman on Twitter .

Additionally,  you can check out other books we’ve read here.

Back in January we had the pleasure of joining Go Venture SKN’s first hike of the year which was to the summit of Mount Liamuiga.  This was such a wonderful experience, personally and physically (great exercise!), so we thought we’d share it.

About Mount Liamuiga

To give you a bit of background, Mount Liamuiga is a 3,792-foot volcano found in the north-western region of the beautiful Caribbean island of St Kitts. The peak of Mount Liamuiga is the highest point in St Kitts and it has a steep-walled, 1-km wide crater.

The last confirmed eruption of the volcano was 1800 years ago, reports of eruptions in 1692 and 1843 have yet to be confirmed. So, it’s pretty much considered a dormant volcano except for some active fumaroles in the crater and two periods of earthquake swarms from 1988 to 1989 and 1999 to 2000.

Our Hike

We have had our eye on the great Mount Liamuiga for some time, contemplating a hike up to its peak and then down into its crater.  We’d heard stories of how challenging the hike is, so that had deterred us until this opportunity arose and we thought “How difficult can it really be?” –  we certainly found out!

The Go Ventures SKN team (our guides for this hike) was great, we loved their positive energy and great customer service throughout the process starting with keeping us informed in the lead up to the day of the hike and giving us a quick check-in call the day before to brief us on what to expect (it usually rains at the peak) and what to bring (snacks, drinks, water resistant clothing etc).

It was a fairly early start on the day of the hike (7:15am meeting time) and after a warm welcome, an introduction and driving up to the starting point, we began the hike at about 8am.

Our hike up to the peak was amazing, I can’t provide you with a description that would do justice to the beautiful scenery we encountered as we made our way through the lush rain-forest that covers the slopes leading up to the top of the mountain.

As I looked around, I marvelled at the intricate arrangement of trees and plants – roots were beautifully intertwined, smaller plants were happily sharing living space and creeping along huge imposing trees and unusual root structures led from tree to tree.

I was surprised to learn that the rain-forest wasn’t home to many insects or animals.  I was expecting to dodge spiders and other creepy crawlies, and possibly spot some interesting animals along the way. Not at all. Our Go Ventures SKN guides explained that you rarely see any signs of insects (just a few snails sleeping under leaves) and the monkeys that are found in large numbers all over the island don’t venture out to the mountains.  So, it was pretty uneventful from that point of view, thank goodness!

It Was Tough!

The hike was tough with a capital T!

After about an hour I was absolutely exhausted, and we weren’t even half way to the top of the mountain. I didn’t think I would make it. The hiking trail is rocky and there was a lot of climbing, as in holding on to rocks and trees and climbing up (or in my case being pushed up by my husband!). I had envisioned a nicely landscaped path that would gradually lead us up the mountain. This was not the case and to be honest, I am glad it wasn’t a nicely landscaped path. This was much better, I got an excellent workout and it was fun, even though at times I was ready to quit because I was so tired and my heart was pounding.

As we climbed further and further up the mountain, the temperature steadily dropped and by the time we got to the top of the mountain (over 2 hours after we started), it was freezing cold and raining heavily. Thank goodness we came prepared with our raincoats.

Sadly, the rain was so heavy and the cloud cover at the summit so thick that we couldn’t go down into the crater for safety reasons. We tried to wait it out, but alas the rain and cloud wouldn’t let up. So, we braved the rain as much as we could, had our packed lunch, took in the fresh air and as much of the view as we could whilst in the midst of quite dense cloud cover and then proceeded to make our way back down the mountain.

The hike back down was just as tough and made all the more challenging by the rain, so it was quite slippery. I had a few close calls but managed to make it back down in one piece and still smiling. I loved it!

All in all, the hike took us 5 hours. This included quite a few breaks and a 30-minute stop at the top of the mountain. By the end of the hike we were muddy, wet and exhausted but I was feeling invigorated and inspired by my encounter with nature.

Some Lessons Learnt

Nature is such a great teacher. As I was making may way up and down Mount Liamuiga, I reflected on the wisdom this old mountain had to offer. Lessons that speak to our wellbeing.

We can be so focused on getting to our destination that we forget to enjoy the journey

About an hour or so into the hike, I was one determined lady. I was going to get to the top of the mountain even if it killed me. This meant I was laser focused on that objective and had stopped looking around to truly appreciate the journey up the mountain. It wasn’t until one of the Go Ventures team members said: “Turn around and look at that view” did I realise that I was missing the best part of the hike – the beauty, the unusual trees and the artwork created by the way in which all the vegetation was connected. It was at that moment that I stopped focusing so much on getting to the top and started to really take in the scenery and appreciate the beauty all around me.

Life can be like that too. We can be so focused on getting to the top of our careers or achieving a particular goal that we don’t enjoy our experiences in their entirety . Oftentimes,  when we get to our destination it is often too late to really appreciate the journey or we’re so focused on moving on to the next goal that we forget to take a moment to bask in our success or take time out to enjoy the important things in the journey of life, like our family and friends.

The need for real connection in communities

One thing Mount Liamuiga kept teaching me with every footstep is the need for real human connection in our communities.

In this fast-paced world we live in, it’s hard to form a real community that is connected, where there is genuine interest and concern about each other. This means people can become very isolated and lonely and miss out on forming important friendships and relationships.

As I looked at the rain-forest community, I could see the connections that make the rain-forest a thriving eco-system. Trees and plants are interconnected. Larger plants provide support to smaller plants helping them reach the sunlight, plants with deep root systems provide much-needed grounding to those that need it and root systems talk to each other daily – there is constant contact and checking-in.  No one is left behind or alone.

This made me think that it’s important for us to make time for face-to-face interactions so that we can begin build genuine relationships within our community, making our communities stronger.

The importance of silence

One thing that struck me, particularly on the way back down the mountain, when the guides had switched off the music, was how quiet the rain-forest was. It was a bit eerie at first. I was expecting to hear signs of life, but nope, it was extremely quiet.  It was hard to believe that despite the rain-forest being packed with trees, plants and sleeping snails, it was really quiet. It got me thinking that I am not used to being still. I am used to so much noise. If it’s not the TV, it’s music, podcasts and radio. If it’s not that then it’s my inner noise – constant worrying, inner thoughts, thinking, planning and endless restlessness.

The two hours of peace and quiet during the hike started to feel like bliss. Time to clear my mind and reflect. I didn’t realise how mentally tired I was, and the silence gave my mind a much-needed break.  Mentally I never felt better than in those moments of silence. It had been a tough few months and this moment of peace had been the medicine I needed to usher in a sense of peace.

A short video of our hike to Mount Liamuiga

We All Need a Nature Break

This hike was a wonderful experience .The beauty of our surroundings, being at one with nature, getting some good exercise and the positive vibes from Go Ventures SKN made this a memorable experience. This hike highlighted the importance of the great outdoors in improving our mental wellbeing and giving us the opportunity to recover from the pressures of modern-day life.

Find Out More

Do you live in St Kitts or will you be visiting St Kitts soon? Then we highly recommend that you give the Go Ventures SKN team a call and book a hike with them. You can visit their Facebook page to find dates for their next hikes.

If you want to find out more about the wellbeing benefits of the outdoors, then check out a guest blog post from Capital Garden Services about gardening and wellbeing here

Childhood obesity is a major health issue in the Caribbean with 1 in 3 children being overweight or obese. Being obese and overweight in childhood is linked to the development of a number of health issues such as 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 such as cancer and heart disease in later life.

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.

Childhood Obesity Solutions

To combat childhood obesity we have to ensure that children adopt a healthy lifestyle and one approach is to explore how we can reduce the consumption of products that are high in sugar, salt and saturated fat. One strategy is to focus on nutrition education and making it easier for to parents identify which foods are high in these components, so they can easily make healthy choices when they purchase groceries.

Front-of-Pack Nutrition Labelling

Front-of-pack nutrition labelling has been introduced in many countries to provide a quick and easy way for consumers to assess the health of the foods they purchase. Currently there are several front-of-pack nutrition labelling systems with the main options being:

Summary indicators. These include the Health Star Rating developed by Food Standards Australia New Zealand which gives foods a 1 to 5-star rating based on their healthfulness and France’s Nutri-score which puts foods into five categories, A to E, based on how healthy they are deemed to be.

The traffic light system. This uses the colour code green, amber and red to communicate whether products have a low, medium or high level of salt, sugar and saturated fat based on daily intake references.

Warning labels. This uses a ‘high-in’ label to inform consumers that foods are high in certain nutrients

Front-of-Pack Nutrition Labelling Consultation in the Caribbean

Caribbean countries are starting to explore the introduction of front-of-pack nutrition labels. The CARICOM Regional Organisation for Standards and Quality held a consultation from 15^th October 2018 to 31^st January 2019 on pre-packaged food labelling which included front-of-pack food labelling. The labelling system being explored is warning labels and we were pleased to have been able to submit a response to their consultation.

Our Views

• We support the introduction of front-of-pack nutrition labels in the Caribbean
• We believe that front-of-pack nutrition labels present a quick, easy and useful way of communicating the healthiness of pre-packaged foods
• We believe that front-of-pack labelling provides information in a way that is easier to understand, with respect to healthiness, than back-of-pack nutrition labelling
• We believe more work is needed to determine which front-of pack  labelling system would be most effective in the Caribbean
• We believe that a full assessment is required to determine if front-of-pack food labels will influence consumer behaviour in the Caribbean and if not, why not
• We feel that if the ‘high-in’ labels are to be used, the colour of the labels should be reconsidered, from black to red. This is important so that we begin to steer dialogue away from black always being seen as a negative, which has a wider societal context with regards to race and ethnicity
• We believe a standard international front-of-pack nutrition label is required to ensure consistency and to prevent confusion

Next Steps

CARICOM Regional Organisation for Standards and Quality will review all the comments it has received from throughout the region and decide on a way forward with respect to nutrition labelling of pre-packaged foods.

We look forward to seeing how the strategy for FOP labelling in the Caribbean develops and are pleased to see this action being taken on this matter.

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References

1. UNICEF, Situation Analysis of Children in the Federation of St Kitts and Nevis, UNICEF Office for the Eastern Caribbean Area and the Government of St Kitts and Nevis, Christ Church, Barbados, 2017
2. PAHO, Health in the Americas, 2012: St Kitts and Nevis, PAHO, 2012
3. Kanter, R., Vanderlee, L., & Vandevijvere, S. (2018). Front-of-package nutrition labelling policy: Global progress and future directions. Public Health Nutrition, 21(8), 1399-1408. doi:10.1017/S1368980018000010