Happy New Year everyone and welcome to 2018!

We are seriously looking forward to the new year. For us there will be lots of change which is really exciting, a great opportunity for growth, learning and development.

New Location

In our previous blog we mentioned that throughout 2017 we slowly wound down our projects and activities in the UK as we prepared for our big move. We’re now based in the beautiful island of St Kitts and are exploring how our organisation can make a useful contribution to improving the health and well-being of the citizens of St Kitts and Nevis, and the wider Caribbean community too.

St Kitts and the Caribbean have similar health challenges to the African and African-Caribbean community in the UK – high rates of diabetes, obesity (including very high rates of childhood obesity),  some types of cancer (prostate cancer), heart disease and other non-communicable diseases. In addition, there is the issue of mosquito-borne diseases like dengue fever, Zika and chikungunya. We’re looking forward to seeing how we can support efforts to tackle these health issues by promoting prevention and early detection.

New Name

In just a few weeks’ time we’ll be known as Lake Health and Wellbeing. Whilst we’ll have a new name our mission remains the same: to improve the health and well-being of the black community. We’re almost there, our new logo has been designed, which we love, and we just have a few other logistical issues to iron out with the name change. At this juncture we’d like to say a BIG thank you to FutureSoft for the design of our new logo.

Some of our plans

As well as focusing on the Caribbean we won’t be turning our back on the UK. We’ll continue to support the black community in the UK from afar by providing health information through our blog, social media channels and Learning Zone, as well as teaming up with UK-based organisations like OH Services and Noire Wellness.

We’ll continue offering support  and information to women in the UK (and globally) affected by fibroids through our Fibroids Ask the Expert and fibroids Twitter chats. We’ll also be updating our fibroids booklet and creating a fibroids fact sheet series .  Our first two fact sheets should be launched by the end of January or in early February.  We’re delighted to have teamed up with OH Services to develop one of these fact sheets, Fibroids and your emotional well-being. This fact sheet will aim to help women identify, understand and address the emotions that may be associated with having fibroids. The second fact sheet we’ll be launching will be on exercise and fibroids. In this fact sheet we’ll discuss how exercise can help with improving symptoms and provide readers with simple tips on how to get active without aggravating their current symptoms.

Over the rest of the year our plan is to publish at least three additional fact sheets on:

• Diet and fibroids
• Fibroids and fertility
• Treatment options.

We’re also excited to be exploring the possibility of hosting a fibroids wellness retreat in St Kitts in collaboration with Noire Wellness. We’ll do an assessment and if there is interest, and this is feasible, then look out for an empowering event designed specifically for women with fibroids. If you’ve been affected by fibroids we’d be so grateful if you could complete our survey to help us with our assessment of the need for this type of event. You can complete the survey here.

Have a great year folks

We hope you have a wonderful year and hope you’ll take this journey of transformation with us in 2018. It’s going to be fun and we look forward to working with you, supporting you and serving you in the year ahead.

The late Professor Olikoye Ransome-Kuti was a world-renowned paediatrician, health campaigner and a prominent figure in global health for many decades.

Professor Ransome-Kuti was born in Nigeria and studied medicine at Trinity College in Dublin from 1948 – 1954. He returned to Nigeria to practice medicine after his studies and then in 1960 he travelled back to the UK to begin his postgraduate training in paediatrics.  After his postgraduate training he once again returned to the country of his birth becoming professor and head of the Department of Paediatrics at the University of Lagos; in 1978, he became their first professor of primary care.

In 1968 he set up an experimental family health clinic which led to the establishment of the Institute of Child Health and Primary Care at the College of Medicine at the University of Lagos. In 1976 he became the director of the National Basic Health Services Scheme Implementation Agency for Nigeria and was involved in a first attempt to set up a national health system for Nigeria.

While lecturing at the National Institute of Policy and Strategic Studies, Professor Ransome-Kuti impressed Ibrahim Babangida and when Babangida came into power in 1985 he appointed Professor Ransome-Kuti as Nigeria’s health minister.  Professor Ransome-Kuti held this position from 1985 to 1992 and he has been described as the “best Minister of Health Nigeria ever had.”

During his tenure as the Minister of Health he made a significant difference to the healthcare landscape in Nigeria – national health policy was further developed and then implemented, relationships between sectors was strengthened and  healthcare coverage across Nigeria increased significantly. He also made a huge difference in tackling the stigma around HIV/AIDS and his efforts at fighting the emerging epidemic was described as “heroic.” He had a busy period as Health Minister with many other achievements including overseeing a successful anti-smoking campaign which led to manufacturers adding warnings to their products.

After leaving his cabinet position in 1992, he became the chairman of WHO’s Executive Board and in 1994 he was appointed chair of the World Bank’s Better Health for Africa Panel where he championed the idea of primary healthcare to other African countries producing a blueprint for all countries to follow.

Professor Ransome-Kuti received numerous awards including the WHO Leon Bernard Award in 1986, an award that recognises a person for outstanding service in the field of social medicine. In 1990 he won the UNICEF Maurice Pate Award in recognition of his work in improving the health and welfare of children. He published many medical papers and held numerous teaching positions including a visiting professorship  at Johns Hopkins University’s school of hygiene and public health in Baltimore.

He was an effective campaigner speaking out against corruption and defending democracy and the rights of poor Africans. Campaigning and fighting for those who didn’t have a voice was something he was passionate about and seemed to run in his family. His mother, Funmilayo Ransome-Kuti, was a women’s rights campaigner and was part of the team that negotiated Nigeria’s independence with the British. Whilst his brother was Fela Kuti the well-known musician, singer,  father of Afrobeat, human rights campaigner and political activist and his cousin Wole Soyinka is the Nobel Laureate, playwright, poet and political activist. 

Professor Ransome-Kuti was not only a brilliant man, but a nice person with his friends and colleagues describing him as a kind, caring, wise, gentle, humorous  and a direct individual. He was a family man and doting father being married to his wife Sonia Ransome-Kuti for 50 years and having three children – Dr Dotun Ransome-Kuti (Veterinary Doctor) , Dr Gboyega Ransome-Kuti (Medical Doctor) and  Bisoye Ransome-Kuti (Lawyer)

Professor Ransome-Kuti sadly died unexpectedly in 2003 from a pulmonary embolism whilst attending a WHO conference in London. He is greatly missed and his legacy lives on in Nigeria.

As the year draws to an end we just wanted to say a big thank you to you all for all your support this year. We really appreciate it. It has been wonderful working with you, serving you and in some cases having great discussions on how we can work together to achieve our aim of improving the health and wellbeing of the black community.

It’s been an interesting year for us as we wound down our activities in the UK in preparation for our relocation to another country.

As we wound down we did feel a sense of sadness as we have gained so much momentum in the UK over the past couple of years particularly with the work we’ve been doing around fibroids, getting the black community active through cycling, working with Diabetes UK to reach the black community in Croydon and providing support to African Caribbean cancer patients, but change is inevitable.

We’re now based in the beautiful island of St Kitts and are exploring how our organisation can fit into the Public Health landscape over here in the Caribbean.  We look forward to serving not just the Caribbean community but continuing to support the black community in the UK from afar through the wonders of technology.

We’ll still be offering support to women in the UK affected by fibroids through our Fibroids Ask the Expert and will be growing the membership of our expert panel to better serve you. We’ll also be  updating our fibroids booklet and creating a fibroids fact sheet series based on the topics that you’ve told us are important to you and we’re excited to be exploring the possibility of hosting a fibroids wellness retreat in collaboration with Noire Wellness.

Over the next few months look out for more changes. With our move to the Caribbean comes a change of name. From early next year our organisation will be known as Lake Health and Wellbeing, whilst we’ll have a new name our mission remains the same: to improve the health and wellbeing of the black community.

It’s exciting times for us and we’re really looking forward to the year ahead.

Once again, thank you for your support thus far and we look forward to connecting with you throughout 2018.

We wish you a very Merry Christmas, a happy New Year and a wonderful, peaceful, successful and healthy 2018.

Welcome to this blog series on gardening and our health and well-being. Over the next couple of months, we’ll be taking you on a personal journey as we explore the health and well-being benefits of gardening for ourselves. We’ll tell you how we started, show you our garden, what we’re growing and share some of what we’ve learnt along the way. Today we start off with a quick introduction. Enjoy!

When many of us think of gardening, we think of it as hard manual labour and a chore. We wonder why anyone would spend a weekend in the garden when they could be doing something else. Well, research (and personal experience) has shown that gardening is not only fun but can play an important role in improving our physical and mental health. The benefits are so effective that a whole industry of therapeutic horticulture exists and has been in existence, in some form or another, since the early 19^th century.

Thrive, a charity that was founded 35 years ago, uses gardening to bring about positive changes in the lives of people with a disability, who are experiencing ill-health, are isolated, disadvantaged or vulnerable. They describe the health benefits of gardening as:

• Better physical health through exercise and muscle strengthening
• Improved mental health through a sense of purpose,  achieving a sense of peace and tranquillity, restoring attention and stress alleviation
• The development of life skills

Gardening and Physical Health

Gardening is no joke! It can be really hard work. Mowing the lawn, digging, weeding and raking can leave you feeling physically exhausted. This is a really good thing as it means you’re getting some serious exercise.

 A research study published in 2014 showed that digging and raking equated to high-intensity exercise whilst other activities such as weeding, sowing seeds, harvesting, watering and planting transplants were found to be equivalent to moderate-intensity exercise. This means that spending time working on your garden every day could enable you to achieve the government’s recommended amount of physical activity (150 minutes a week), and because of the variety of tasks performed in the garden you’ll be getting both a cardiovascular and muscle strengthening workout.

Regular gardening has an impact on our physical health as the exercise we achieve from it can improve the health of our heart, help with weight loss and reduce our risk of developing heart disease, diabetes, stroke, cancer, fibroids and a number of other health conditions.

The Mental Health Benefits

Gardening makes you feel good.  The excitement of seeing your seeds sprout, the peace and tranquillity of having some quiet time in your garden, the accomplishment you feel when you harvest your first-fruits and gaining a new-found appreciation for nature all contribute to improving your emotions and state of mind. This is backed up by research too.

In 2013, researchers published a review of ten high-quality studies on garden-based mental health interventions. These studies all explored the benefits of gardening on people with mental health difficulties. All of them showed an improvement in the symptoms of depression and anxiety as well as a range of benefits including emotional, social, vocational, physical and spiritual.

Gardening and a Healthy Diet

Many people who delve into the world of gardening explore growing their own fruits and vegetables.  Growing your own produce is a fun and rewarding way of introducing more fruits and vegetables into your diet;  it can be a way to introduce a lot of these into your diet as one, say, tomato plant can provide an abundance of tomatoes, meaning your diet can be more plant-based. This type of diet has a number of health benefits including reducing the risk of cancer, diabetes and heart disease.

In addition to this, as you’ll be growing these yourselves you can avoid some of the harmful pesticides that are commonly used in commercially grown fruits and vegetables, avoid genetically modified products and you’ll get very fresh fruit and veg which many have said are tastier than store-bought products.

The Development of Life Skills

To grow anything requires you to develop and utilise a number of skills. These include problem-solving (coming up with solutions when your plants don’t look right), patience, discipline, time-management, research (understanding the plant you’re growing), perseverance and a basic understanding of plant biology. Gaining these skills improves confidence and there is the added benefit that some of these skills are transferable to other areas of your life. Being empowered with these skills improves a person’s overall well-being, improving their outlook on life and leading to significant personal development.

Conclusion

Whilst at first glance gardening may not seem that inspiring when you explore it further you can see the huge benefits it can have on your well-being. So… if you’re looking for a  fun, yet practical way to get fit, active and healthy why not try a bit of gardening. We’re trying it and we love it!

See you next time and happy gardening!

Let us know your thoughts on gardening for health benefits in the comments section below.

Friday 1st December was World AIDS Day and this year’s theme was: ‘My health, my right’

This theme recognises the fact that many people living with HIV are denied their right to health. Their right to health includes access to good quality health services and medications and being treated with dignity and respect.

It was a particularly good day for the Caribbean as Anguilla, Antigua and Barbuda, Bermuda, the Cayman Islands, Montserrat and St Kitts and Nevis were certified by the World Health Organisation as having eliminated mother-to-child transmission of HIV and syphilis.  This follows the success of the Caribbean nation Cuba, in 2015, who became the first country in the world to achieve WHO certification for the elimination of mother-to-child transmission of HIV and syphilis.

This is fantastic news for the Caribbean where HIV is a significant public health challenge with 310,000 people living with HIV.  In 2007, it was estimated that 6,400 children in the region were infected with HIV, most of these through mother-to-child transmission. Children who are infected with HIV have a challenging start to life facing a life-time of medication, stigma, ill-health and possibly a shortened life span. With all this in mind, in 2010 the Regional Initiative for the Elimination of Mother-to-Child Transmission of HIV and Congenital Syphilis in Latin America and the Caribbean was launched.

This initiative is coordinated by the Pan-American Health Organisation and the United Nations Children Fund and its aim, at the time, was to eliminate mother-to-child transmission of HIV and congenital syphilis in all Caribbean countries and territories by 2015 and to reduce the transmission rate to 2%. Whilst only one country, Cuba, made the 2015 deadline and the transmission rate is above 2% (it’s now 9%, 52% less than in 2010) great progress has been made: since 2010 new infections in children have been reduced in the region by 52% and 74% of pregnant women with HIV now have access to anti-retroviral drugs which significantly reduces chances of passing on the virus to their children during pregnancy or breastfeeding.

The Caribbean should be very proud as it is ahead of the rest of the world and we hope that other Caribbean countries will follow the example set by these six Caribbean nations and put policies and procedures in place to eliminate the transmission of HIV from mother to child. This is very important in giving all children the best start in life and is a key step in the prevention HIV/AIDS in the Caribbean.

For more information on this work you can download the document below,  visit UNAIDS’ website here or watch the short video below.

On many occasions women with fibroids have asked us to recommend a good, experienced doctor who specialises in fibroids. We tend to point them in the direction of the two doctors on our Ask the Expert panel, Dr Nigel Hacking and Mr Adrian Lower.

Because we get this question a lot we started looking into whether we can put together a resource of highly recommended doctors and consultants in the UK who have expertise in fibroids. Whilst doing this we came across an article on the Mail Online which we thought would be a good start and be useful to our readers.

The Mail Online spoke to 40 leading gynaecologists and interventional radiologists in the UK and asked them: “If your own nearest and dearest were to need fibroid treatment, to whom would you refer them and why?”

Based on the answers provided the Mail Online put together their top ten fibroids experts cautioning that this is a guide, not a scientific study and there are many more highly-skilled consultants throughout the UK.  Their list is below.

Please note this was put together in 2011 and we’ve therefore updated some job titles.

Mail Online’s Top Ten Fibroids Experts (UK)

Mr Ertan Saridogan, Consultant Gynaecologist, University College Hospital, London

What the Mail Online said:

“Has huge expertise with fibroids and is probably the best in the country for keyhole myomectomy. He’s a delicate surgeon who is kind and has great empathy for his patients. As a fertility expert, he takes exquisite care with nearby structures such as the fallopian tubes, so his patients will have the best possible chance of a successful pregnancy.”

---

Professor Anna-Maria Belli,  Consultant Radiologist, St George’s Hospital, London

What the Mail Online said:

“Has pushed hard to get embolisation accepted. Technically she’s superb and she’s warm too. Patients love her — she cares about them, takes their views on board and will do all she can to ensure they get the best possible treatment.”

---

Professor Issac Manyonda, Consultant Gynaecologist, St George’s Hospital, London

What the Mail Online said:

“A fine gynaecologist and an international figure who has distinguished himself  in the field of open myomectomy for large fibroids, and is one of the lead investigators in a  new major trial comparing  myomectomy with embolisation.  He has treated huge numbers  of patients, which he has  followed up over many years with excellent results. Uteruses after his treatment are beautifully neat!”

---

Mr Alfred Cutner, Consultant Gynaecologist, University College Hospital, London

“A highly-skilled laparoscopic gynaecologist, who would be an excellent choice for fibroids. He’s a warm person who’d do his best to tailor the right treatment for each patient.”

---

Dr Paul Crowe, Consultant Interventional Radiologist, Birmingham Fibroid Clinic

What the Mail Online said:

“An excellent operator who set up the service in the West  Midlands and does a huge number of fibroid operations that have yielded first-class results. With Paul Crowe, it’s  not just about technical excellence — he is also patient- centred and manages to make them feel they are in the driver’s seat at all times.”

---

Mr Adrian Lower, Consultant Gynaecologist and Minimal Access Surgeon, Consulting Rooms, London

What the Mail Online said:

“Sometimes he is described as the king of fibroids. He doesn’t work in the NHS, but does everything excellently. His background is in fertility problems and he will remove even large fibroids superbly by keyhole surgery, so his patients will have an excellent chance of pregnancy. He also has a very good bedside manner.”

---

Dr  Anthony Nicholson, Consultant Radiologist, Leeds General Infirmary

What the Mail Online said:

“One of the leaders in interventional radiology, he is charismatic and popular with patients. He can be counted on  to give unbiased advice. He  works closely with gynaecologists and will always refer patients  to them if he thinks the patient will benefit.”

---

Dr Woodruff Walker, Consultant Diagnostic and Interventional radiologist, Royal Surrey County Hospital, Guildford 

What the Mail Online said:

“He is undoubtedly one of the pioneers of uterine artery embolisation and has blazed a trail in this country. An acknowledged expert who has done more fibroid embolisation than anyone else, he has achieved outstanding results. Extremely personable, and patients have complete and well-deserved faith in what he does. He won’t push anyone into anything.”

---

Dr Nigel Hacking, Consultant Radiologist, Southampton General Hospital 

What the Mail Online said:

“Approachable and has done a lot of work extending the availability of interventional radiology both here and abroad. Highly-skilled with the manual dexterity and hand-eye coordination needed. He knows when to embolise and when he’s done enough. This is vital because you want to starve the fibroid of its blood supply, but not damage the supply to nearby structures.”

---

Mr Adam Magos, Consultant Gynaecologist,  Royal Free Hospital, London

What the Mail Online said:

“He has been in the forefront of developing hysteroscopic myomectomy (where the fibroid is removed via the cervix, using a hysteroscope, a narrow, telescopic camera with instruments attached — there are no abdominal cuts). He also collects and appraises his own results and presents these to peers at meetings, and is a keen researcher. This is the sign of a quality surgeon who is interested in what he’s doing and is open to new ideas.”

---

The Mail Online also noted these highly recommended experts who didn’t make the top ten:

Mr Andrew Kent, Consultant Gynaecologist  and Minimal Access Surgeon, Royal Surrey  County Hospital, Guildford

What the Mail Online Said:

“Technically a superb keyhole surgeon  in a very high-profile centre,  who operates beautifully. Fibroid patients would be in very safe hands with him.”

---

Professor Lesley Regan, Clinical Professor, St. Mary’s  Hospital, London

What the Mail Online said:

“A top gynaecologist with a great  interest in fibroids who would do her best for her patients without forcing her views on them. She would put all the options to each patient fairly and then help them to decide.”

---

Professor Jonathan Moss, Professor of Interventional Radiology, Gartnavel  General Hospital, Glasgow

What the Mail Online said:

“An enormously dedicated and highly skilled radiologist of the highest order  and with the right mindset — which is  that all options should be on the table for all women who are needing fibroids treatment.”

---

Mr Yacoub Khalaf, Consultant Gynaecologist, Guy’s Hospital, London

What the Mail Online said:

“Has a big fertility practice and will operate on large fibroids by open  surgery, taking meticulous care. A  well-rounded gynaecologist who is totally dedicated to his patients.”

---

Professor Tony Watkinson, Consultant Radiologist, Royal Devon  & Exeter Hospital

What the Mail Online said:

“Lovely with patients and gives them choices. He will explain what he  knows about fibroids and the alternatives, too. If they then decide on embolisation, he will look after them very well.”

---

Mr George Pandis,  Consultant Obstetrician and  Gynaecologist, University College  Hospital, London

What the Mail Online said:

“Being a very good gynaecologist is  about much more than how good  you are with a scalpel and telescope.  It is also about how kind you are  and how good you are if things happen to go wrong. He ticks all of these boxes, taking excellent care of his patients.”

---

We hope you’ve found the above list helpful and we thank the Mail Online for compiling this list.  You can read their original article here

Over the years there have been numerous questions and concern about the impact chemicals in hair products have on our health. This concern has been heightened in the black community for some time, particularly with respect to relaxers (chemical hair straighteners).

Several studies have been conducted exploring if there is a link between hair products and fibroids, cancer and other conditions, but these have been inconclusive. When a link has been shown researchers have been cautious explaining that association doesn’t mean causation – i.e. they couldn’t prove that relaxers actually contribute to the development of fibroids or cancer and therefore they all recommended that more research should be conducted.

Latest Research

In June of this year, researchers from Rutgers University in New Jersey published the results from their research into specific hair products and whether their use is associated with an increase in breast cancer risk.  In this study, researchers looked at 4,285 African America and white women; 2,280 had breast cancer and 2,005 didn’t. The study compared those with breast cancer to those who didn’t have breast cancer to determine if differences existed that may  be linked to breast cancer risk.   The women were aged 20-75 and were from New York City and ten counties n New Jersey.

The study aimed to determine if hair dyes, relaxers and deep conditioners containing cholesterol or placenta were associated with an increased risk in developing breast cancer. In order to explore this researchers collected vast amounts of data on the women who took part in the study. This included socio-demographic data and their exposure to known risk factors such as family and personal history of breast cancer, smoking, alcohol consumption and more. They also asked participants about their use of the previously mentioned hair products, what shade of dye they used and  how long they used these products for.

What did they find?

The researchers found that for African American women there was a 51% increase in their risk of developing breast cancer among those who used dark brown or black hair dye. They also found that in African American women there was a 72% increase in oestrogen-positive breast cancers amongst those who used dark brown or black dyes and a 36% increase in oestrogen-positive breast cancers in those who used dyes more frequently.

In white women they found a 74% increase in breast cancer risk in those who used relaxers and a large increase in risk in women who used both relaxers and hair dyes. They also found that use of hair dyes resulted in a 54% increase in risk of developing oestrogen-positive breast cancers whilst relaxer use caused a 2.6 fold increase in oestrogen-negative breast cancers.

There was no link between deep conditioners and breast cancer.

What does this mean?

The researchers concluded that “these novel findings support a relationship between the use of some hair products and breast cancer.”

When speaking about their work, lead author of the research paper, Adana Llanos said

“Just because we found these associations doesn’t mean that if you dye your hair dark, or any colour, you’re going to get breast cancer, but at the same time, the study points to something else we should be mindful of.”

The results exposed a significant association with oestrogen-positive breast cancers so the current hypothesis is that the dyes may contain chemical compounds that are similar to oestrogen or stimulate pathways that cause the production of oestrogen. It was hard to determine this as women in the study weren’t asked what brands of products they used so researchers couldn’t explore the actual chemicals within these products that women were exposed to. But Alana Llanos said:

      “There must be some role for oestrogen for sure.”

Her research team recognise that there were limitations to the study and that further work is needed to truly understand the link between hair products and breast cancer risk.

Our Thoughts

The Lake Foundation is pleased to see more research in this area being conducted and this work needs to continue until we have a definitive answer as to whether hair products affect our health or not. In the meantime, we would advise that women take a look at this research and make an informed decision as to whether they should continue using hair dyes and relaxers.  We always say  people should exercise caution in the use of products where there is found to be a credible association with cancer, or any disease, until a clear answer can be provided on whether that association means that a particular product contributes to the development of a disease.

More Information

You can read the full research paper for this study here

We took a break from our blog series, Inspirational People in Healthcare, but this week it is back! We’ll continue recognising people in healthcare who are making a significant difference in their field.

We hope you’ll enjoy reading this blog series and please do email us the details of anyone in healthcare who inspires you and we’ll include them in this series. Today we focus on Miss Samantha Tross.

Miss Samantha Tross is a Consultant Orthopaedic Surgeon at Ealing Hospital in London with general orthopaedic experience and has a specialist interest in Lower Limb Arthroplasty.  Miss Tross is the first black female Orthopaedic Consultant Surgeon in the UK, specialising in minimally invasive surgery and is one of the women who make up the 5% of Orthopaedic Consultants Surgeons in the UK who are female.

As well as her clinical work she is an Associate Editor of the Journal of Medical Care Reports, an Examiner for Imperial College Medical School’s final examinations, Programme Director for Core Surgical Trainees at Ealing Hospital, Associate Professor of Orthopaedics at the American University of the Caribbean and an  Education Supervisor and mentor for young surgeons.

She is a member of both the Royal College of Surgeons of England and Scotland, and received her medical degree from the University College London.  She obtained her surgical training at a number of London teaching hospitals including St Georges Hospital, The Royal London and Guy’s & St Thomas’.

Miss Tross has been recognised in the JP Morgan Black Powerlist of 100 most influential Black Britons every year since 2011, was named in Tatler’s Doctor’s Guide in 2013 as one of Britain’s top 250 Consultants, has been featured in numerous publications and is the recipient of the 2016 Black British Business Image Award.

You can listen to Miss Tross talk about her average day as a surgeon in the video below and you can find out more about her work here

Friday 17^th November was the second annual Caribbean Alcohol Reduction Day. This year’s theme was: Drink Less, Reduce Cancer and to mark the day the Healthy Caribbean Coalition, in collaboration with PAHO, CARPHA and CARICOM, hosted a webinar on Alcohol and Cancer in the Caribbean.  This was a very informative and interesting webinar which featured three speakers:

• Dr Kevin Shield – Alcohol Consumption and Cancer in the Caribbean
• Dr Maristela Monteiro – Alcohol Policies in the Caribbean
• Dr Rohan Maharaj – Alcohol use among the elderly in the Eastern Caribbean: Associations with NCDs and psycho-social issues

Alcohol Consumption and Cancer in the Caribbean

The first presentation was delivered by Dr Kevin Shield. He started by providing some background into cancer in the Caribbean explaining that the latest data, from 2012, shows that in the Caribbean about 21,000 new cancer cases are diagnosed every year and just over 13,000 deaths per year in the region are due to cancer.  When we look at the number of cancers in the Caribbean caused by alcohol, it is estimated to be 650 cancer cases per year or put another way 3.1% of all cancers diagnosed in the Caribbean are due to alcohol consumption. Looking at the number of cancer deaths in the Caribbean due to alcohol, 2.9% of all cancer deaths are due to alcohol consumption or 387 deaths per year.

Dr Shield  stated that in the Caribbean, on average, an adult consumes 1.2 alcoholic drinks per day, but there is a difference amongst countries with some countries drinking less and other drinking significantly more.

Dr Shield explained the  link between cancer and drinking stating that numerous studies have been conducted that have determined how drinking causes cancer. Data suggests that alcohol causes cancer in the following ways:

• By our bodies converting alcohol into a cancer-causing chemical (i.e. a chemical that can damage our DNA)
• By affecting our hormone levels and various pathways in the body

Through research links have been found between alcohol and cancers of the mouth, upper throat, food pipe, voice box, breast, bowel and liver.  The number one cancer impacted by alcohol is breast cancer.

Based on all of these factors the  International Agency for Research on Cancer  has classified alcohol as a type 1 carcinogen, which means there is the highest level of evidence to suggest that it does cause cancer. So drinking is a major problem.

The question then is: how can we prevent the cancers that are caused by alcohol? The solution is to reduce alcohol consumption and Dr Shield stated that there are three cost effective and feasible approaches that can be taken:

• Restrictions on access
• Banning advertising
• Increasing excise taxes

This presentation ended on a fairly positive note highlighting that many Caribbean countries have not fully introduced these three measures which means that there is potential to make a huge difference in tackling alcohol and cancer in the Caribbean.

Alcohol Policies in the Caribbean

We then heard from Dr Maristela Monteiro who gave an overview of alcohol policies in the Caribbean. She started by explaining that as part of the voluntary global non-communicable diseases target for 2025 there is a goal to reduce harmful use of alcohol by 10%.  WHO and PAHO, in consultation with a number of organisations, developed a global strategy to reduce harmful use of alcohol and they provided recommendations on 10 policy areas and countries are to try to implement as many as possible. They describe particular recommendations as “best buys” especially for low to middle income countries and these were the three areas mentioned by the previous speaker (restrict access to alcohol, enforce bans on advertising and raise taxes on alcohol).

Dr Monterio then went through each of these three policy areas giving an assessment of how successful Caribbean countries have been with their implementation. She started first with whether countries have a national alcohol policy in place.  Out of the 14 Caribbean countries that they looked at only three had some form of national policy.

Dr Monterio then looked at policies to restrict access to alcohol:

• Licensing: most Caribbean countries have a licensing system, 12 out of the 14 countries. Licensing systems restrict access by imposing rules and penalties to those who wish to sell alcohol such as not selling to minors, the license also has a fee and this may limit the number of businesses who choose to sell alcohol.
• Restrictions on hours, locations and days of sale of alcohol: only three Caribbean countries were fully compliant in this area.
• Minimum drinking age: most Caribbean countries have a minimum drinking age, only three don’t.  The majority of countries in the Caribbean with a minimum drinking age have set this at 18, some have set this at 16.  It was felt that 18 was a relatively low age restriction and this could be increased to 21 to have more of an impact.

Dr Monteiro then discussed taxation. She stated that in the Caribbean most countries have some taxation of alcohol, but these taxes were introduced many years ago and have not been adjusted for inflation. This means that taxation is not having the impact that it should as taxes are fairly low and are not acting as a deterrent.

Finally Dr Monteiro discussed restrictions on advertising and explained that this was the least developed area of policy in the Caribbean.  She explained that this is a major problem as 20% of students are exposed to alcohol advertising daily and research has shown that this is associated with an increase in alcohol consumption. She explained how persuasive these advertising campaigns are and some of the tactics used to encourage people to drink –  companies focus on alcohol as an antioxidant, that consuming alcohol causes weight loss and improves your mood (this communicates the message that alcohol is healthy)  and equating drinking alcohol to business success.

Action needs to be taken to address advertising as research as shown that youths are more exposed to advertising than adults so there is a concerted effort by the alcohol industry to reach young people and make them life-long drinkers.

Alcohol Use and the Elderly

Finally we heard from Dr Rohan Maharaj who summarised a very interesting piece of research carried out across four Caribbean countries on alcohol use and the elderly.  The research consisted of participants from Puerto Rico, Barbados, the US Virgin Islands and Trinidad. The data was collected from April 2013 to May 2015 and they determined whether people were ever-drinkers, current drinkers, problem drinkers or heavy drinkers and related this to various psycho-social and health issues.  Their main conclusions were:

• Generally there was wide use of alcohol across all participants
• 5-6% of participants were involved in potentially harmful alcohol use
• Males were more likely to be problem or heavy drinkers
• There was an association between alcohol use and stage 1 hypertension
• There was an association between alcohol use in ever-drinkers and cancer
• A higher proportion of those with lower educational achievement admitted to alcohol use
• Those who were employed were more likely to be drinkers (thought to be because they had more disposable income)
• Those who reported earlier initiation of sexual activity reported heavy drinking
• Those who had issues with domestic violence (current or past) had reports of problem drinking
• Heavy and problem drinkers tended to be lower educated males, living in Trinidad, married, physically active and employed with high rates of hypertension and being diabetic.

Dr Maharaj and his team will be doing a follow up study with participants in the next 2 to 3 years and this will give them the opportunity to further explore the link between alcohol use, cancer and other non-communicable diseases.

Conclusion

This was a very informative webinar  and it’s so important that we get some of this information out to the public as we know that many people are not aware of the link between cancer and alcohol consumption.

For more information you can listen to a recording of the webinar here

Yesterday, we attended the CARICOM Marijuana Commission’s public consultation in Basseterre, St Kitts. This was an interesting, and at times heated, discussion which aimed to inform their report on marijuana use in the Caribbean.

The commission has been tasked with examining the health, social, economic  and legal issues surrounding the use of marijuana and to make recommendations to heads of government on whether the drug classification of marijuana should be changed. They will also make recommendations on, if marijuana is to be re-classified, what legal and administrative conditions should apply.

Yesterday’s consultation was one of many that the Commission has conducted throughout the Caribbean enabling them to reach a wide and diverse audience. In addition,  the Commission itself represents a range of stakeholders including commissioners from the fields of law, social work,  medicine, science, religion, law enforcement and psychology,  and they have youth representation.

Introduction by the Commission

In this public consultation we first heard from Prof Rose Marie Belle-Antoine who gave a brief introduction and provided some background into their work. She explained that the information obtained from the consultation would be combined with the information from other consultations, the St Kitts National Marijuana Commission and their own research on the medical, economic, social and legal implications to provide recommendations for policy changes to heads government in the Caribbean. She also mentioned that there was a need for public education on some of these issues as there are many people who are not informed about marijuana.  She explained the importance of looking at social justice issues (e.g. who gets arrested), gender issues (we hear a lot about the men but what happens to women and what is the impact on families), law enforcement (do they turn a blind eye to some marijuana use), the impact on productivity and addiction issues.

Prof Belle-Antoine also explained that internationally marijuana is classed as a narcotic so if the Caribbean re-classifies marijuana they would need to understand the implications for the Caribbean internationally – would we become a “rouge state.” Here she said we can learn some lessons from Jamaica who have already decriminalised marijuana.

Prof Belle-Antoine also touched on research being conducted in Barbados with prisons to understand if there is any real link between marijuana and crime.  She ended by stating that another important aspect of their work is understanding the  risks of marijuana use and what safeguards can be implemented.

The Public’s View

After Prof Belle-Antoine’s introduction the floor was then opened up to the public for comments and feedback. Overall the audience was in favour of legalising marijuana or decriminalising it. There was a feeling that it shouldn’t be illegal to use a plant  and that an adult should have the right to make an informed decision as to whether they use marijuana or not.  There was an overwhelming feeling that  vast amounts of data on marijuana already exists that give a clear picture of the  benefits and harms showing the benefits do outweigh the harms. Therefore many felt that a decision could already be made on whether we should reclassify marijuana, a report would delay things further. There was frustration about the consultation itself with a few people stating that it felt like “just talk.”

Several members of the public were able to give concrete examples of the use of marijuana for therapeutic purposes – chronic pain, nausea, cancer, liver disease etc. Many mentioned the historic and religious use of marijuana. One participant was able to provide a comparison between alcohol and marijuana showing that alcohol was significantly more harmful than marijuana – alcohol causes 1 million deaths a year and there has been no known death caused from marijuana itself.

The audience raised the huge economic potential in developing a safe marijuana industry in the Caribbean. It  was felt it could help to diversify our economies as many islands are heavily dependent on the tourism industry. It was highlighted how versatile marijuana is with one attendant showing the panel a book made from marijuana.  There was concern that if a marijuana industry is developed, large foreign companies would find a way to exploit our resource and no financial benefit would be reaped by Caribbean islands.

Conclusion

The evening ended with the commissioners answering some questions on the time-frame for the report and how much influence they would have on governments to implement their recommendations. The Commission explained that they are working as hard as they can to collate all the information and will produce a comprehensive report.  They stated that their report won’t be binding but they hope it would be influential and lead to change, but change does take time.

This was an interesting discussion and we do hope that the report published by the Commission will lead to change in the laws on marijuana and that we can develop a thriving industry that creates wealth for our nations.

Further Information

The CARICOM Marijuana Commission is still keen to hear from the public on this issue and is inviting anybody with an interest in this topic to submit their views to them in writing at marijuana@caricom.org

For more information on the work of the Commission, please visit their website http://caricom.org/marijuana-commission

Let us know what you think about this issue by leaving a comment below.