Comfort Momoh is a  Female Genital Mutilation/Public Health Specialist at Guy’s and St Thomas’ NHS Foundation Trust in London and  is the founder of the African Well Woman’s Clinic, a service that provides counselling, support, information and surgical reversal to women and girls who have undergone FGM.  

She was an advisor to the World Health Organisation, represented the UK at the UN Commission on the Status of Women in 2001, is the Chairperson for  Black Women’s Health and Family Sport,  is the vice-president of the European Network on FGM and is a member of the UK’s FGM National Clinical Group.

 In 2003, she was awarded the first ever nurse/midwife of the year award by Guy’s and St Thomas’ Foundation Trust , in 2014 she was the recipient of the Nigerian Centenary Awards’ 100 Outstanding Nigerians past and present who have lived in the UK over the past 100 years and in 2008 she was awarded an MBE for her services to women’s health.

[Photo credit: Top Forma]

 

Have you heard of the expression: ‘don’t do things by halves’?  It normally means that people shouldn’t do things without putting maximum effort into it. So for example – if you are doing an exam you may wake up in the early hours of the day to study and revise. If you have an interview – you read up about the role and company until the point of saturation.  If you’re going out for a New Year celebration, you may select your outfit and venue (and maybe even hairstyle!)  well in  advance.  But for me, doing things ‘by halves’ can take on a different meaning.  It can mean achieving your goal ‘piece by piece’ i.e. piecemeal.  So instead of exhausting yourself to achieve a goal, you could achieve it by breaking it down into manageable chunks or ‘half- measures’

So what has this got to do with the New Year?

Well, every year millions of people make a pledge to be healthier and fitter. But six months down the line – the pledges are largely forgotten and definitely not achieved. Perhaps if we make small changes or ‘half-measures’ our goals would be easier to achieve.

So how can we break down key health and fitness activities into manageable chunks?

1.   Eating more fruit and vegetables

This is a common goal for most people. You don’t have to consume large plates of vegetables or fruits in one go.  Vegetables can easily complement many meals. Why not add some slices of fresh cucumber to your already prepared jollof rice?  Or add scoops of avocado or finely chopped mushrooms to your rice and peas?

2.    Increasing exercise
Do you find gym membership too expensive?  Is it too cold to go for walks outside? Jogging on the spot at home whilst watching your favourite soap for just 30 minutes could burn at least 100 calories! You could start off by jogging through one programme and then slowly build up to two. Do you love exercising to music? Why not find some old school Rnb tunes on YouTube, switch it on and dance while you are doing the dishes?

3.   Reduce fried food intake
Fried food isn’t great for many reasons including the fact that it is high in calories because it absorbs the fat from the oil. But many people find fried chicken irresistible! If you are one of those then why not alternate between fried and grilled food to begin with?  You could have fried chicken on one day then the next time you have chicken make it grilled or roasted. You could do the same thing with other meats.

4.   Reduce alcohol intake
Did you overdo the Baileys or the rum punch at Christmas? Next time you’re out for the evening or even at home and you feel like a drink – why not pour yourself two drinks? One of the drinks could be your favourite tipple and the other could be a glass of water.  You could alternate between the two drinks, sips from one then another.  You would ultimately end up drinking less alcohol.

So hopefully you now have the gist of ‘doing things by halves’ to achieve your goals.  What other ideas can you come up with?

In our new blog series, Inspirational People in Healthcare, we’ll be 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. In this our first blog in the series, we focus on the Nigerian doctor Dr Bennet Omalu.

Dr Bennet Omalu is a Nigerian forensic pathologist based in the US. He was the first to identify, describe and name Chronic Traumatic Encephalopathy (CTE) in American football players in 2005. He has continued to conduct research in this area and discovered the same condition in war veterans.

Over the years Dr Omalu has tirelessly campaigned for further work to be carried out to protect football players from CTE and to raise awareness of this condition which causes those affected to suffer from memory loss, aggression, confusion and depression. He has testified twice before the US congress and took on the NFL who tried to discredit his work, but later in 2009 the NFL publically acknowledged the link between CTE and football.  In 2013 the NFL reached a settlement with 4500 former football players who stated that the NFL failed to properly educate them of the dangers of professional football.

Dr Omalu’s story was recently told in the 2015 film ‘Concussion‘ starring Will Smith and this led to the formation of the Bennet Omalu Foundation. You can view the trailer for Concussion below.

Dr Omalu has made a significant difference in this field and we salute him for his determination, integrity and bravery.

Last week, we attended Croydon Clinical Commissioning Group’s (CCG) Annual General Meeting. This was an interesting meeting that gave us the opportunity to learn more about the work of the CCG and what health challenges residents of Croydon face.

What are Clinical Commissioning Groups (CCGs)?

For those of you who might not be familiar with Clinical Commission Groups they are groups of GPs who work together to plan and develop local health services in England. They do this by buying health and care services such as planned hospital care, urgent and emergency care, community health services and mental health and disability services. CCGs are a fairly new concept and were established in 2012 partly replacing Primary Care Trusts. There are 211 CCGs in England covering the 8,000 GP practices across the country.

Connecting with the Public Through their AGMs

Each CCG holds an annual general meeting (AGM), which is open to the public, to provide an overview of their work during the previous financial year.  We decided to attend Croydon CCG’s AGM to get a feel for what health conditions need a bit of focus and to understand if The Lake Foundation can address any of the challenges that might exist.

Croydon CCG’s AGM

Croydon CCG’s annual general meeting began with a welcome by Dr Tony Brzezicki, the clinical chair of the CCG, and this was followed by short presentation from Paula Swann, the Chief Executive, who gave an overview of the CCG’s achievements and performance for the 2014/2015 year. From Ms Swan’s presentation we learnt that the CCG has been focusing on community and mental health services and has been transforming the way that care is delivered in Croydon by developing new care pathways for cardiology, COPD, diabetes, musculoskeletal and falls. Additionally they have provided better access  to care for people with mental health problems through a range of new initiatives and have supported patients with diabetes through their diabetes management course. Furthermore patients with heart problems are now seen and treated more quickly in community clinics and children with asthma have better support through Croydon’s paediatric asthma service.

Ms Swan stated that the areas that need focus include improving waiting times in A&E, ambulance response times and  the quality of care for people with learning disabilities.

The focus then switched to mental health and this was a very interesting and eye opening session that highlighted the extent to which Croydon residents are affected by mental illness. Firstly we heard from a patient who talked about her long journey with mental illness, she spoke of her ups and downs and commended that great work that local charities have played in providing her with support. She specifically mentioned Mind In Croydon whose many services have helped her manage her condition and “live well with my mental health needs.” This really inspired us and clearly demonstrated the  significant impact that local charities can have.

We then heard from Dr Bobby Abbot a GP and the CCG’s clinical lead for mental health. He provided an overview of the impact of mental health in Croydon stating that 1 in 6 Croydon (67,000 people) residents have a mental health problem at any one time, half of all lifetime mental health problems begin before the age of 14 and that poor mental health affects a person’s physical health, education, employment, relationships, finances and housing. When he discussed who was most at risk it made for grim reading (or should I say listening) for the black community. He stated that the black community are seven times more likely to be affected by psychosis. Additionally he mentioned that anxiety and depression are the most common mental health issues in Croydon and these problems are projected to increase by 5% over the next couple of years.

To address the aforementioned mental health problems a number of services are being developed or expanded and these include: Personality Disorder Service, Early Detection Service, Primary Care Mental Health Support and Extension Home Treatment, just to name a few.

Finally we heard about the CCG’s work on Out of Hospital and Integrated Care. This work included developing or improving the following: co-ordinated care, roving GPs (for fast support), rapid response,  rapid acute medical unit (for integrated care), end of life care and the pharmacy discharge pathway.

 

Our Thoughts

This was a very interesting meeting giving a good overview of some of the health issues facing residents in Croydon. It once again highlighted the need to address mental health in the black community and we’re now going to go away and think about this and explore what approach we can take on this matter.

You Can Get Involved

You can get involved in the work of the CCG and help shape the way that health and social care is delivered in Croydon. The CCG has a Patient and Public Forum which meets regularly. We encourage you to attend to ensure that the views of the African and African-Caribbean community are represented as services are being developed. For more information please email  getinvolved@croydonccg.nhs.uk

 

High blood pressure is a major challenge for the black community in the UK with 33% of black adults having high blood pressure compared to 16% of white adults. When we look at the actual numbers, to understand the scale of the problem, the black community makes up 3.3% of the UK’s population so a staggering 625,503 black people in the UK are known to have high blood pressure; we have to do something about this.

What is high blood pressure?

Blood pressure is a measure of how much force (pressure) our blood exerts on our blood vessels (our arteries and veins). High blood pressure, medically known as hypertension, occurs when the force our blood exerts on our vessels is consistently higher than what is considered to be a healthy level, which is generally 120/80mmHg.  If a person has several blood pressure measurements, on separate occasions, which are 140/90mmHg or higher then they are considered to have high blood pressure. This is a major concern because it is associated with a number of health complications with people suffering from high blood pressure being twice as likely to have a heart attack or stroke. This is because the high pressure can damage our arteries affecting the blood supply to our heart or brain.

What causes high blood pressure?

The exact cause of high blood pressure is unknown but there are a number of factors that increase a person’s risk of developing high blood pressure and many of these factors are associated with lifestyle and these include: lack of physical activity,  an unhealthy diet (especially a diet high in salt), being overweight or obese, drinking too much alcohol, stress and smoking. Furthermore, your risk of developing high blood pressure increases as you get older, and you’re at a higher risk if you have a family history of high blood pressure, are from the black community and suffer from sleep apnoea. Additionally there are a number of health conditions that increase a person’s risk of developing high blood pressure so for example people who have diabetes, kidney disease and adrenal and thyroid disorders are at increased risk of developing high blood pressure.

Why is the black community at higher risk of developing high blood pressure?

We know that the black community in the UK are twice as likely to develop high blood pressure as their white counterparts and are more likely to develop it at a younger age, but the question is: why?  Research suggests that there may be several reasons for this and here are just four key reasons:

Salt Sensitivity

We now know that people respond to salt differently so some people who consume large amounts of salt will not go on to develop high blood pressure whilst others will.  This has led to a term called salt sensitivity which is a measure of how a person’s blood pressure responds to salt. A person who is salt sensitive is likely to develop high blood pressure from consuming salt whilst a person who is salt resistant is unlikely to develop high blood pressure from consuming salt.

Sodium (salt is sodium chloride), blood pressure and fluid balance are controlled by the renin-angiotensin-aldosterone system in our body. In this system hormones control the absorption of sodium by the blood and therefore control our blood pressure. People who are salt sensitive have genetic variations in some of the genes involved in the renin-angiotensin-aldosterone system which makes them less able to handle salt and maintain a normal blood pressure.

Members of the black community are more likely to be salt sensitive particularly black Americans and black Caribbeans who are thought to have inherited the aforementioned genetic variations.

Salt Intake

Work by the Consensus Action on Salt and Health has found that:

“The majority of salt consumed by people of black African descent is from salt added in cooking and/or at the table. This is in contrast to the rest of the UK population (and indeed the Western world) where 75% of salt intake comes from processed foods. A health survey in England found that 83% of black men and 85% of black women added salt in cooking. Over a quarter (28%) of the same population add salt at the table. Salted meats and fish like salt-fish and salt-beef, and heavily seasoned meats such as fried chicken, stews and curries can contain a lot of salt.”

 This suggests that the black people may consume more salt than their white counterparts and when this is coupled with the salt sensitivity phenomena this is a recipe for disaster when it comes to high blood pressure.

Increased Risk of Diabetes

Diabetes is a key risk factor for high blood pressure with about 80% of type 2 diabetics suffering from high blood pressure.  When we look at how diabetes affects the black community data suggests that the black community is three times more likely to develop diabetes than their white counterparts, and this will mean that as a result of diabetes black people will be more likely to develop high blood pressure. Again, if we put this into numbers, to understand the scale of the problem, it is estimated that 5.3% of the UK’s black population have type two diabetes compared to 1.7% of the white population which means that  50,000  black people in the UK are affected by diabetes and hence are at a higher risk of developing high blood pressure.

Lifestyle

We also know that the black community are at increased risk of high blood pressure due to other lifestyle factors, for example black African women in the UK have been found to have the highest prevalence of obesity and obesity is a risk factor for high blood pressure. Additionally, the black community are less likely to be physical active with  NICE reporting  that:

“African-Caribbeans aged 16 to 74 years, 62 per cent of men and three quarters of women do not participate in enough physical  activity to benefit their health* (HEA 1995a), compared with the general population (59 per cent of men and 68 per cent of women (HEA 1995b).”

Physical inactivity is a key risk factor for high blood pressure and the above shows that many black people are not achieving their recommended level of physical activity putting us at a higher risk of developing high blood pressure.

What can we do?

In order to tackle this problem we clearly need to make some changes to our diet and lifestyle.  We can make a significant difference by looking at our salt intake. The government recommends that adults consume no more than 6g of salt a day. To achieve this we have to:

• Avoid adding salt to our food and use herbs and spices to season our food
• Avoid processed foods
• Ask restaurants to  prepare low-salt versions of the dishes on their menu

For some great tips on how to reduce your salt intake visit Consensus Action on Salt and Health’s website

Additionally we have to get more active and aim to do 30 minutes of physical activity every day and we have to tackle diabetes. We can reduce our risk of developing diabetes through lifestyle changes, – a healthy diet, being active and maintaing a healthy weight.

Finally, there needs to be collaboration between the government, the food industry, the public and charities to ensure that it is easy for all of us to achieve a healthy lifestyle or else this problem of high blood pressure will not go away.

---

References

1. Ageymang C & Bhopal R. Is the blood pressure of people from African origin adults in the UK higher or lower than that in European origin white people? A review of cross-sectional data. Journal of Human Hypertension. 2003; 17(8). 523-534
2. Blood Pressure UK.
3. D Lane, D G Beevers and G Y H Lip. Ethnic differences in blood pressure and the prevalence of hypertension in England Journal of Human Hypertension (2002) 16, 267-273. DOI: 10.1038/sj/jhh/1001371
4. Diabetes UK. Diabetes: Facts and Stats (2014)
5. Diabetes UK. Diabetes in the UK 2011/2012: Key Statistics on Diabetes. Diabetes UK, 2011
6. Fuchs FD. Why Do Black Americans Have Higher Prevalence of Hypertension? An Enigma Still Unsolved. Hypertension.2011; 57: 379-380
7. Gatineau M, Mathrani S. Obesity and Ethnicity. Oxford:  National Obesity Observatory, 2011
8. NICE. Promoting Physical Activity Among Black and Minority Ethnic Groups
9. Scarborough P, Bhatnagar P, Kaur A, Smolina K, Wickramasinghe K and Raynew M.Ethnic Differences in Cardiovascular Disease. Oxford:  University of Oxford/British Heart Foundation, 2010
10. Sullivan JM.1991. Salt sensitivity. Definition, conception, methodology, and long-term issues. Hypertension. 17(1 Suppl):I61-8. PMID:1987013.
11.  The Stroke Association. Stroke in African Caribbean People. London: The Stroke Association, 2012
12. 2011 UK Census

On Saturday 18th July, we were honoured to deliver a presentation at the RNCJ’s 2nd Annual Elderly Conference. The theme of the conference was enhancing health and wellbeing and in keeping with that theme we spoke about aging healthily. We stressed the importance of combating the negative perceptions, stereotypes and narrative around the elderly which is very disempowering, and replacing this with a more positive narrative that empowers the elderly and enables them to live the best life possible; this means creating opportunities for the elderly to remain active.

We discussed the health challenges associated with aging and how these can be overcome through lifestyle changes particularly keeping active, eating a healthy diet, keeping the mind active and staying connected to friends, family and the wider community.  And, we finished off by reminding attendees that our ‘Golden Years’ can be the best years of our lives as we have a lot of time and flexibility. This gives us the opportunity to do the things that we’ve always wanted to do, pursue our passions, make a difference in our community and spend time with our loved ones, but we can only enjoy this phase of our life if we are healthy.

Attendees also heard from Sabrina Jantuah from Age UK who spoke about Community Connections, a project that is aiming to tackle isolation in Lewisham by encouraging people to access local services. Sabrina stressed the need for projects like community connections as 51% of people who are over 75 live alone and this has a negative effect on their wellbeing.  Sabrina’s talk was supported by a presentation from  Jeremy Sharpe of The Link who also highlighted the scale of the problem of isolation of the elderly in the UK. He provided data that made for grim reading – 500,000 older people in the UK spend Christmas Day alone and over 5 million older people consider their TV to be their main form of company. Jeremy described how The Link are combating isolation by working with churches to develop befriending programs where volunteers regularly visit those who live alone.

It was also really nice to hear of all the great work that the RNJC is doing to support the elderly in their local community in Lewisham. They run a monthly keep fit class, are implementing a befriending programme with support from The Link and are starting a coffee morning.

This was a very enjoyable and informative event and we’d like to say a big thank you to the conference organisers, particularly Shola Fiberesima.

On Sunday 14^th June we had the pleasure of delivering a black health awareness workshop at the Right Now Jesus Centre in Catford.  It was wonderful to work with such an enthusiastic, friendly and energetic congregation; it was really a fun two hours, despite the serious topic.

During the workshop we covered type two diabetes, high blood pressure, stroke, heart disease, prostate cancer and fibroids. We talked about what these conditions are, their risk factors and why they are more common in the black community. We also asked the congregation to work in groups to discuss these issues and encouraged attendees to  adopt a healthy lifestyle by eating a healthy  diet and getting active. We went into detail on some of the specific changes that people can make to achieve a healthier lifestyle and finished off the workshop by asking attendees to think about three things that they will change as they work towards a adopting a healthy lifestyle.

This was  really good event and we thoroughly enjoyed spending time with such an engaged audience.

“This workshop was beautifully presented!”

 

“Excellent, I learnt a lot.”

 

“Very informative.”

Fifty is a pivotal age. It’s a time when many will be at the peak of their careers, their families will be blossoming and there is a greater understanding of self. It’s also a time when many take stock, analyse their life to date, asses their achievements and start to re-prioritise to ensure that they’re focusing their energy on the important areas in their life. At The Lake Foundation we believe it’s extremely important that this assessment that occurs as we enter a new pivotal decade includes a review of our health.

As we get older our risk of developing a number of diseases such as cancer, diabetes and cardiovascular disease increases so as we get older we must make our health more of a priority. It’s true that the habits we cultivated when we were  younger and the way we lived our lives prior to hitting fifty will have shaped our current health but we can take steps today to improve our health and ensure we are in the best shape possible going forward and more importantly, we are happy.

In essence keeping healthy as we get older means being proactive and focusing on three main areas: changing our lifestyle (if we need to), being aware and making sure we’re up-to-date with all our relevant health checks and screening.

Changing your lifestyle can seem daunting but it needn’t be. Small changes can make a big difference.  What we’re looking for is for you to be more active, eat a healthy diet and maintain a healthy weight. All of which will make a significant difference to reducing your risk of a number of diseases.

When it comes to diet if you’re not already receiving advice for an existing condition we would recommend that you:

• Eat at least 5 portions of fruit and vegetables a day
• Reduce your salt, sugar and saturated fat intake
• Reduce your red meat consumption
• Eat more fish – at least two portions of fish a week including one oily fish (salmon, sardines, mackerel etc)
  • Note: Oily fish is a great source of omega-3  fatty acids which research suggests may prevent heart disease
  • Note:  Adults and boys shouldn’t consume more than 4 portions of oily fish a week  whilst women and girls planning to become pregnant in the future shouldn’t consume more than 2 portions of oily fish a week
• Drink less alcohol
• Eat more fibre, it can help to prevent heart disease,  some cancer  and improve digestive health
  • Examples of food that are a good source of fibre include:  brown rice, brown bread, pulses (chickpeas, lentils etc), fruit,vegetables, porridge and bran based cereals

Another aspect of keeping healthy is to get active and this is especially important as we get older.  Being inactive has been linked to a number of health conditions including cancer, diabetes, heart disease and stroke so by being more active you can significantly reduce your risk of developing these conditions. Exercise also has a number of other benefits such as it strengthens our bones, improves our mood and improves our mobility.

The government recommends that  we do 150 minutes of moderate exercise per week and this can be divided up into 30 minutes of exercise 5 days during the week. Additionally, on two or more days a week our exercise session should include some muscle strengthening exercises that work on all muscle groups (legs, hips, back abdomen, chest, shoulders and arms).

Finally, it’s very important to maintain a healthy weight as being overweight or obese is linked to a number of diseases. Losing weight as we get older can be challenging because our metabolism slows down, i.e. the rate at which we burn the calories from the food we eat slows down. This means that if we continue to eat the same quantity of food that we ate 10 or 20 years ago we won’t be burning the calories as effectively and the excess calories will turn into fat. To combat this we have to look at our portion sizes and make sure we control them. In terms of weight we should all be aiming for a body mass index (BMI) of 18.5 to 24.9.

As we get older we must all endeavour to eat healthy, keep active and maintain a healthy weight. This will ensure that we reduce our risk of developing a number of conditions;  we remain fit and mobile;  we improve our mood and wellbeing and ultimately have a better quality of life.

Friday 20^th March is International Day of Happiness, a day that focuses on getting everyone to consider what we need to do to be genuinely happy and thus improve our mental wellbeing and live a fulfilling life.

The Lake Foundation believes this is an extremely important day which should be a time to reflect on the positive in a very negative climate.  We need to make it a priority to improve our mental wellbeing by finding a way and a reason to be happy. Research has shown that happiness and health are connected with happiness having a positive effect on our health. Additionally people with a positive (happy) outlook on life have a better outcome when  ill. So, there are health benefits to being happy.

What can we do to live a happier life? Based on research, Action for Happiness has put together ten things we can all do to live a happier and more fulfilling life and this is summarised in the diagram below.

This International Day of Happiness let’s commit to living a happy life by attempting follow these ten tips. A great way to start this is by getting involved in the #GlobalHappyParty. The UN Foundation and Pharrell Williams are inviting everyone to their Happy Party. We’ve taken part and you can too!  Let’s get the whole world dancing for a happy planet!

We’ve just finished reading ‘Eyo’ by Abidemi Sanusi, a Nigerian author we had the pleasure of meeting at the African Literary Evening.

Eyo is an excellent, but heart-breaking book that highlights, very vividly, the issue of child trafficking and sex slavery.

The book tells the story of 10-year old Eyo who is born into abject poverty in Nigeria where she lives with her parents and two siblings in the slums on the swampy marshes of the Lagos Lagoon.

Eyo is trafficked to the UK with her uncle to escape life in the slums with promises of receiving an education and bettering her life. Unfortunately, this is not to be as she finds herself trapped with a cruel family as a domestic servant and then sold into sexual slavery.

Because of the subject matter, this book is hard to read but at the same time you just can’t put it down. The story unfolds in a very interesting and captivating way and gives a disturbing insight into this horrible industry.

What struck me about this book was that it really demonstrates the consequence of not addressing the inequalities that exist in the world. At the root of this issue of child trafficking and sex slavery seems to be poverty.

Poverty means that families desperate to break free of the poverty cycle become vulnerable and easily tricked and exploited by those in the industry and become trapped in a world that can be impossible to escape from.

Another thing that struck me from the book was inaction. There were several points in the book where people noticed that something wasn’t quite right with Eyo and could have intervened and saved her but fear of offending or jeopardising their own peaceful life crippled them, leaving poor Eyo to endure the horrors for much longer than she should have done.

Another painful issue in the book was that some of the abuse Eyo suffered was at the hands of family members as well as women who themselves have children.

Even though this book was fiction it tells of the reality that many young people face and something desperately needs to be done about it. At the end of the book we are encouraged to take action and support organisations like Stop the Traffik and Africans Unite Against Child Abuse. Please do visit the websites of these organisations to find out more about what can be done to help.

This was an excellent book that raises awareness of an important issue and was shortlisted for the 2010 Commonwealth Writers’ Prize.

“….outstanding commentary on the conditions that make life in home countries unbearable, the casual cruelties meted out on strangers as they travel, and the indifference that sustains it all’ – Judging panel on Eyo, Commonwealth Writers’ Prize 2010

This book is definitely worth reading and can be purchased on Amazon

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