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.

Was this Helpful?

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.

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

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

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

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

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

About Study Medicine Europe

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

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

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

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

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

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

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

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

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

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

First, don’t hesitate to reach out.

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

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

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

Keep up to date with your prescribed medications.

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

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

Plan ahead.

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

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

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

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

Maintain healthy eating habits. 

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

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

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

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

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

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

Stay active.

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

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

Be gentle to yourself—your body & your mind

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

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

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

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

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

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

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Sources

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

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

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

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

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

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