On 30th March, we were delighted to join forces with Because We Care to host our first Girl Talk event.

Girl Talk is our new event series that aims to provide a forum for informative, informal and empowering discussions about women’s health. We hope that these events will enable women to take control of their health and that of their families, and therefore build a stronger, healthier nation.

Our first event focused on fibroids. This is an area that is often overlooked leading to a lack of awareness, information, and support for those who have been affected. We want to correct that. We also want to overcome the stigma that can be associated with fibroids by creating a safe space to discuss fibroids, its impact on women and solutions.

We were delighted to have a panel of esteemed speakers covering various aspects of fibroids. Speakers included:

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

We also had a small wellness market, fantastic raffle prizes and free health checks for all attendees.

 A Summary of the Day

 Fibroids and Women’s Health in St Kitts and Nevis

The event started with a presentation by Dr Hazel Laws who provided an overview of women’s health in St Kitts and Nevis.

Dr Laws explained that data suggests that women in the Federation are more likely to be affected by non-communicable diseases (NCDs) like cancer and diabetes, but the data may not be giving the full picture as it may be that women are more likely to visit their doctor and seek help than men, and this is what the data is reflecting.

Dr Laws also summarised some of the work that the Ministry of Health is doing to improve women’s health through projects like:

• The ASSIST (Applying Science to Strengthen and Improve Systems) Project which is exploring improving the quality of care offered to pregnant women and children
• WHIP (The Women’s Health Improvement Plan)

Then Dr Laws focused specifically on fibroids and explained that 78 women in St Kitts and Nevis had a surgical intervention for fibroids in 2018. Furthermore, anecdotal evidence collected from OBGYN specialists suggest that over 60% of 35-50-year-old women in St Kitts and Nevis have uterine fibroids with 30% of these women being symptomatic.

Based on this data, Dr Laws stated that fibroids should be raised as a public health concern especially as the lived experience of women with fibroids can be very challenging and very often women suffer in silence. She ended by saying that there is a need to educate women and improve access to care.

What Are Fibroids and their Impact on Women

Next on the agenda was Dr Williams who provided an overview of what fibroids are and touched on their impact on women.

Dr Williams raised some concern that there is little research being conducted on fibroids so the information available on the causes is very limited which then makes it hard for women to take steps to prevent or reduce their risk of developing fibroids.

In summarising the impact of fibroids on women, Dr Williams used data from the US which showed the following with respect to quality of life:

• 28-40% of women with fibroids report missing work because of their symptoms
• 25% reported that having fibroids prevented them from meeting their career potential
• Black women with fibroids are 77% more likely to miss work than their white counterparts
• 36% reduction in work productivity

Dr Williams explained that fibroids also affect self-image with research showing the following:

• 68-88% of women feeling self-conscious or embarrassed about their stomach size and appearance
• 22-51% stated that having fibroids had a negative influence on their femininity and sexuality
• 44% reported painful intercourse
• 60% reported a lack of interest in sex
• 53% said it negatively impacted their relationship with their husband
• 14-46% stated it affected their ability to take care of their home and children

Dr Williams ended her presentation by summarising the significant impact that fibroids have on women and society:

• Fibroids present a significant burden for those affected
• It has an enormous economic impact
• Fibroids negatively affects work productivity, sexuality, self-image, relationships, social and emotional wellbeing
• Black women and younger women are more affected by fibroids
• Many women delay seeking treatment often for several years

Diet and Fibroids

We also heard from Dr Lescott who gave a presentation on diet and fibroids. Similar to Dr Williams, Dr Lescott also explained that there is limited research exploring this topic, but the limited amount  of data on diet and fibroids suggests the following:

• Fibroids are more common in women who consume more red meat and alcohol
• For women who drink at least one beer a day, there was a 50% increase in their risk of developing fibroids
• Compounds from green tea may inhibit the growth of fibroids cells
• Women who consume more citrus fruits are less likely to develop fibroids, possibly due to the presence of flavonoids in citrus fruits
• Vitamin D was protective when it comes to fibroids
• Vitamin A from animal sources are linked to the development of fibroids (not vitamin A from fruits and vegetables)

Living with Fibroids and Chronic Illness

Dr Pereira then covered a very important but often neglected topic – how to live with an ongoing illness like fibroids.

Many women with fibroids are forced to live with several uncomfortable symptoms, in some cases for many years. Dr Pereira explained that this can challenge many aspects of a woman’s life.

Some of the challenges that women may encounter include difficulties related to pain, fatigue, missed work, reproductive health issues, uncertainty, stress, anxiety, relationship and family difficulties, loss of self-confidence, financial issues and more. All these issues can be very hard to cope with.

Because complete eradication of the symptoms and effects of fibroids is not always possible, it is important that women learn strategies to cope. This can be achieved through cognitive behaviour therapy (CBT) which focuses on looking at how we think about certain situations in order to develop resilience so we can better deal with the challenges that are associated with living with fibroids.

Dr Pereira also demonstrated one simple CBT technique, relaxation breathing, which is used to reduce the symptoms of anxiety.

Treatment of Fibroids

We also heard from Dr Lawrence who gave an excellent presentation on the treatment of fibroids. Dr Lawrence explained that treatments included surgery e.g. (hysterectomy, myomectomy), medication to treat the symptoms or shrink the fibroids, non-surgical options (e.g. embolization) and MRI-guided procedures. Dr Lawrence explained that some of these procedures are not available in St Kitts and Nevis.

Dr Lawrence gave attendees the opportunity to ask any questions they had about fibroids, treatment and symptoms. This raised a number of interesting issues such as the challenges associated with having both sickle cell anaemia and anaemia related to fibroids, the struggle that many women have with making treatment decisions and fertility concerns.

My Fibroids Story

In addition to the doctors who presented, we were grateful to Tammy Cook who delivered a powerful and moving talk about her personal experience with fibroids. Ms Cook bravely shared the many challenges she experienced and based on this experienced encouraged women to:

• Get to know their bodies
• Visit the doctor promptly if something doesn’t feel right
• Get a second opinion if you’re not happy with your care.

Conclusion

The event ended with a short presentation from Abi Begho who summarised the day and explained what resources, information and support are available to women which included a self-management course which we’re hoping to organise in May specifically for women with fibroids.

Thank you!

We had a great day and would like to thank everyone who attended, asked questions, and shared their story.

We’d like to thank all the speakers for their thought-provoking, informative presentations and all the vendors – Mother Becky Bush Tea, Sugar Town Organics, Love the Skin You Wear, Pure Niceness By Winnielle and Rose Catering.

We’d also like to say a big thank you to the Chop Shop, the Emerald Mist Spa, Mother Becky Bush Tea, Love the Skin You Wear and Sugar Town Organics for donating lovely raffle prizes.

And, finally we’d like to thank the staff and students UMHS for all their support as we organised this event, we are very grateful.

More Information

For more information on fibroids, you can:

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

You can also keep up-to-date with our fibroids events and news by subscribing to our fibroids newsletter below.

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Wednesday 25th July, 2018

Today we discuss a recent conference that we attended, the 63rd annual CARPHA Health Research Conference which was held right here is S Kitts.

Wednesday 16th May, 2018

We’ve had a  lot of interesting meetings, which we’re quite exited about so we thought we’d take a few minutes to update you on what we’ve been planning. 

Yesterday, we had the pleasure of attending an event organised by Diabetes UK and Croydon Clinical Commissioning Group. This event was entitled ‘Type 2 Diabetes and the Croydon Community’ and it brought together patients, healthcare professionals, local charities and commissioners to discuss how   we can tackle diabetes in Croydon.

The event started with a welcome and introduction by Dr Rajan Namasivayam from the Diabetes UK Croydon Local Group and then we heard from the three main speakers: Rachael Glover, Manager at Diabetes UK; Charlotte Harris, Senior Researcher, Revealing Reality;  and Dipti Gandhi, Diabetes Clinical Lead at Croydon CCG.

Setting the Scene

Rachael Glover from Diabetes UK started the session with a good introduction to type 2 diabetes and its prevention and management.  From Rachael’s presentation, we learnt of the extent to which diabetes affects those living in the UK; currently, 4.5 million people in the UK have diabetes.  Rachael explained that diabetes occurs when our body isn’t able to control our blood glucose levels and glucose builds up in the blood leading to a number of health problems.  Diabetes is a result of problems with our insulin which is a hormone that helps our body use glucose preventing glucose levels from rising to dangerously high levels.

Rachael stated that there are two main types of diabetes:

Type 1 diabetes: this is where the body doesn’t make any insulin at all

Type 2 diabetes:  where the body doesn’t make enough insulin or the insulin isn’t working properly.

From Rachael’s presentation, it was noted that 90% of people with diabetes have type 2 diabetes hence why there is a need to focus on this type of diabetes, particularly because 3/5 cases of type 2 diabetes are preventable. This means there is a huge opportunity to successfully tackle diabetes.

Rachael explained that type 2 diabetes can be prevented by eating a healthier diet, being more active and maintaining a healthy weight.

Rachael stated that the national programme Healthier You: NHS Diabetes Prevention Programme was launched in 2016 to support people at high risk of developing diabetes to change their lifestyle to reduce their risk.

Rachael also discussed the best ways of ensuring that patients with diabetes are able to successfully manage their condition.  She stated that one of the most effective ways to do this is through patient education and there are several approaches:  one-to-one information and advice, informal flexible ongoing information, ongoing support and structured education.  These approaches are useful to patients with 90% of patients saying that they were better able to manage their condition following education, but sadly only 5% of diabetes patients attend an education event. With this in mind, Diabetes UK and Croydon CCG have pledged to reach 50% of diabetics through education.

Interesting Research

Next, we heard from Charlotte Harris, Senior Researcher from Revealing Reality. Charlotte summarised the findings from a very interesting research study that aimed to understand attitudes to diabetes amongst the South Asian communities of Thornton Heath in Croydon.

In their study they explored the needs, barriers and opportunities for innovation and they did this by finding out about diabetes as it is really lived in the community – they visited patients in their own environment.  From their work they identified  four key areas for innovation:

• Food
• Lifestyle and fitness
• Medical and healthcare
• Knowledge and advice

They also found that:

1. When looking at the South Asian community, there was no one South Asian community or culture. There were many cultural differences (Indian, Bangladeshi etc..) and these differences are usually overlooked when health education and awareness projects are developed.

2. Despite diabetes being talked about frequently, understanding of diabetes is low and for people where there was an understanding knowledge wasn’t applied practically.

3. There was a sense in the South Asian community that diabetes is inevitable and there isn’t anything that can be done to prevent it, so there was a significant feeling of powerlessness.

4. Many myths about diabetes exist such as climate and stress cause diabetes and that diabetes can be cured, this myth about there being a cure was a major problem as people would stop taking their medication once they started feeling better believing they were cured.

5. There was a lack of knowledge of the serious complications that are associated with diabetes.

Tackling Diabetes in Croydon

Finally, we heard from Dipti Gandhi the diabetes clinical lead at Croydon CCG. Dipti explained that, in Croydon, diabetes is a  huge problem with about 10% of residents living with diabetes.  She then went on to explain some of the services in Croydon. These included:

• A new prevention programme where pre-diabetics are identified and enrolled in a 15-month programme to reduce their risk of developing diabetes. This programme has started in Thornton Heath and will expand to other areas in Croydon.
• Online support via Croydon Council’s Just Be Programme
• Voluntary sector projects to raise awareness
• Support with medications
• Group consultations with GPs and exploring ways of patients accessing diabetes specialists
• Self education through DESMOND Type 2 and DAFNE Type 1

Conclusion

This was a really informative and interesting event and one that was of great importance to the black community who are three times more likely to develop diabetes than their white counterparts. The Lake Foundation is currently making its own contribution to tackling diabetes in Croydon by teaming up with Diabetes UK and Croydon CCG with funding from Croydon Council to run a diabetes community champion project.  To find out more about this project or to volunteer to take part please email us

On Wednesday 4^th May, we attended the first annual Elevate conference. This conference included seminars and an exhibition that aimed to tackle the issue of inactivity in the UK and provide a forum for cross-sector debate on physical activity, health and wellbeing.

The seminar programme was divided into three streams: physical activity for health and wellness; inclusivity: strategies to increase participation; and future performance. We attended the sessions in the health and wellness stream which began with a session on ‘Physical Activity as Preventive Care’.

Speaking at this session was  Dame Sally Davies, Chief Medical Officer at the Department of Health.   Sally Davies started by asking the question:  ‘what can we do to get people to listen to us about physical activity?’ She stated that only 1 in 5 young people between the ages of 5 and 18 are getting their recommended amount of exercise and many adults too are not achieving the recommended amount of physical activity. She stated that exercise is an investment in reducing our risk of a number of diseases such as diabetes, Alzheimer’s Disease and cardiovascular disease, and somehow we need to communicate this in a way that causes behaviour change.

Sally Davies stressed the importance of health professionals in getting the public active and recognised that many health professionals don’t have the training to promote physical activity. She said we are missing an opportunity because 1 in 4 people said they would do exercise if they were advised to do so by a health professional. She said messages can be as simple as ‘just walk’. Additionally, we need to utilise all professionals including teachers and those in the work place and determine how best to use elite athletes as role models. She also explained that we need to ensure we have a safe environment for physical activity so the public feels confident if they decide to go cycling, jogging or running.

We then heard from Justin Varney, the Interim Deputy Director for Health and Wellbeing at Public Health England. Justin started his presentation by stressing the importance of physical activity stating that only 10% of diseases can be prevented by medicine whilst 40% can be prevented by lifestyle changes including being more active.   He also said that physical inactivity is one of the top ten reasons for death in the UK and that adults are 20% less active now than they were in the 1960s. He highlighted the fact that the UK is less active compared to other counties with 63% of the UK’s population being inactive. He explained that one of the challenges in encouraging people to be more inactive is that the benefits are not immediate, it takes years for people to see the benefits and this doesn’t motivate people to get active now.

Justin Varney informed attendees that  Public Health England published their report Everybody Active, Every Day and it provided an evidence-based approach to tackling inactivity with there being four focus areas:  1) Active society – creating a social movement, 2) Moving professionals – activating networks of professionals, 3) Active environments, – creating the right spaces and 4) Moving at scale – scaling up the interventions that make us active. He ended by saying that there is a lot of evidence out there about the benefits of physical activity and what works, and what we need now is to stop writing documents but read them and focus on implementation.

These two presentations set the scene for the rest of the day with presentations and sessions  that followed focusing on examples and ideas on how to get people more active, case studies on the benefits of physical activity (e.g. for cancer patients, diabetics etc) and the role of  technology. The presentations that we found most interesting were:

1. Research and evidence into physical activity and non-communicable diseases by David Terrace of the Richmond Group of Charities. In his presentation David explained that the Richmond Group is a coalition of twelve of the leading health and social care organisations in the voluntary sector and they aim to build on each other’s expertise to get more people active. They worked together on a one year project to map out the work each of their charities do with respect to physical activity and to draw together all the evidence on physical activity so they could develop a joint approach to tackling inactivity.  Two of the key areas they wanted to focus on were training health professionals and addressing the barriers to physical activity.

They carried out some work to examine the relationships between inactivity and long term conditions and their key findings were:
– Even people who are incapacitated want to be active
– Many people felt that exercise and physical activity were “not for people like me”
– The main barriers were: pain, fatigue and breathlessness

They found that what worked in getting people active was:
–  Positive but realistic messages
– Speaking to people’s aspirations
–  Messages coming from a credible person (health professional)
–  Empathy

On Saturday 20^th February, we attended Black Action for Health’s African-Caribbean Health Day. This event aimed to provide experts in the field with a platform to raise awareness of the health issues that are of particular concern to the African and Caribbean community. A key part of this event was highlighting the fact that ur community are more likely to die too early from or suffer from preventable diseases.

The event was hosted by Dr Charlie Easmon, Medical Director at Your Excellent Health Service and the actor Hugh Quarshie with remarks from the president of the Royal College of Nursing Cecilia Amin and the Mayor of Lambeth Donatus Anyanwu.

Obesity

The event began with a presentation by Dr George Grimble on ‘The Importance of  a Healthy Weight and Low Waist Size’. From Dr Grimble we learnt that the prevalence of obesity has increased significantly over the past 20 years and those who are overweight or obese are at increased risked of premature death with many diseases being linked to obesity. Additionally, there is a huge cost associated with obesity with a recent report by McKinsey and Co stating that the cost of obesity is $2 Trillion.

Dr Grimble stated that the rise in obesity is due to our lifestyles becoming remarkably sedentary which means we are in a positive energy balance (we aren’t burning off what we eat) and this makes us all more likely to gain weight.  He explained that for many people weight gain is gradual and occurs from 30 years of eating what equates to 200-240 large meals. What this means  is that when it comes to weight loss  we have to “uneat” these 200-240 meals and this will take a long time, there is no quick fix to weight loss.  He stressed that mainstream diets don’t work over the long-term and that to achieve long-term weight loss requires a change in lifestyle and the right motivation – the desire to achieve good health.  He told the audience there is no secret to weight loss it’s all about good nutrition, it’s tough but we can all do it.

Dr Grimble spoke about research that showed that what is important for weight loss is reducing our energy intake (i.e. what we eat). This is more important than exercise. Whilst exercise is good for overall general health and some weight loss we can achieve more significant weight loss through managing our energy intake.  Additionally, what we have to do is pay attention to belly fat, this is what increases our risk of a number of diseases such as diabetes. It was interesting to note that Asians and the African-Caribbean community are more sensitive to the effects of belly fat and people from these communities with belly fat are more likely to develop diabetes, stroke, hypertension and metabolic syndrome  than their white counterparts with the same amount of belly fat.  Because of this it is more important for black people to be as lean as possible and to be as physically active as possible.

Blood Pressure
Next, we heard from Prof Graham McGregor who delivered a presentation on ‘Raised Blood Pressure and the Black Community’. In his presentation Prof McGregor stated that raised blood pressure is by far the biggest cause of death in the UK with the risk of ill health starting at 115mmHg.   He explained that a raised blood pressure kills through direct effects but also indirect effects. He demonstrated that people with low blood pressure are at a lower risk of stroke, heart disease and many other health conditions and the most important strategy that we can use to improve people’s health is that of reducing everyone’s blood pressure, which is a more effective strategy than treatment.

Prof McGregor spoke about treatment and stated that there are a number of drugs available to treat high blood pressure with very clear guidelines on how they should be used, the use of these drugs can be confusing. He stated that black patients shouldn’t use ACE inhibitors as these aren’t effective in this population.  He reminded the audience that if you have high blood pressure you have to do something about it. You have to take control of your treatment and be assertive with your GP and make sure you’re getting the best care.  He stated that he sees many patients being poorly managed so it’s important that guidelines are followed.

Prof MacGregor then discussed black people and salt. We learnt that up to 5000 years ago we weren’t eating very much salt and we’re now eating significantly more salt than our body needs. We were surprised to learn that 80% of our salt intake is hidden in processed food, takeaways, fast food and restaurant food. He stated that there has been a huge drive to get the food industry to reduce the amount of salt in their products. Over the past few years there has been some success in this and a 30% reduction of salt in many products such as bread has been achieved which has resulted in an overall reduction in the public’s blood pressure.   We learnt that black people are more sensitive to salt’s effect on blood pressure  making salt toxic to black people. Unfortunately we are addicted to salt with the majority of black people using large amounts of salt when preparing food. He recommended that all black people throw away their salt, stock cubes and salted seasonings stating that it takes four weeks to get accustomed to food cooked without salt.

Finally, Prof McGregor discussed genetics and said that there is a genetic element to high blood pressure, but it’s not clear what specific genes are involved; there are about 30 possible genes which researchers are looking it. He stressed that what they do know is that these genes are of no importance if you don’t eat salt.

These presentations really stood out for us

These two above presentations on obesity and high blood pressure really stood out for us as these are conditions that are very common in the African-Caribbean community and can easily be prevented through a healthy lifestyle and this was clearly articulated in both presentations.

Other presentations

Other presentations on the day were very interesting and these included a talk by Dr Adeola Olaitan on ‘Cancer of the Cervix –Inevitable or Avoidable’ where we learnt that through cervical screening and the HPV vaccination cervical cancer can be prevented . We also heard from Mr Leye Ajayi on ‘Prostate Cancer’ where he discussed black men’s high risk of developing this disease and the challenges that exist in diagnosis without a screening test. Finally, we heard from Dr Michael Rudenko who spoke about allergies.

As well as the main presentations we heard from Levi Roots who discussed eating ethically,  Brenda Thompson-Murray who explored the role of carers and Iyamide Thomas who gave an overview of sickle cell and the work of the Sickle Cell Society.

An excellent event

This was an excellent, informative event and we’d like to thank Dr Charlie Easmon for organising this event and look forward to the next one.

On Monday, we attended Breast Cancer Care’s reception in Parliament where they launched the findings of their research into the needs of Black, Asian and minority (BAME) women after treatment for breast cancer.   Their research was funded by the Big Lottery Fund and was a collaboration with King’s College London.

This event was hosted by Dawn Butler MP, whose mother and sister were affected by breast cancer. Speaking at the reception, the Chief Executive of Breast Cancer Care  Samia al Qadhi, summarised the findings stating that BAME women felt  a greater sense of isolation after treatment, there was still a significant amount of stigma associated with breast cancer in certain cultures, there is a lack of culturally sensitive support, a number of communication and language issues, and services do not always meet the needs of BAME women.  Breast Cancer Care explained that to address these issues they piloted a new culturally inclusive service in 2015 called PROWESS (Promoting Recovery, Wellbeing, Equality and Support in Survivorship). This service supported the self-management of BAME women after their hospital-based treatment for breast cancer. You can read more about PROWESS here.

Breast Cancer Care stated that policy-makers must consider the needs of BAME women in the implementation of current cancer strategies and ensure that new policies are inclusive and that everyone working in this area has to develop an understanding of how services can be culturally adapted.

During the reception we also heard from Heather Wilson from the Black Health Initiative in Leeds. Ms Wilson was very supportive of the research and its recommendations and stressed the importance of effective partnerships in addressing the issues raised during the research project.

We applaud the work being done by Breast Cancer Care to address the inequalities that exist in this area and look forward to seeing the next phase of this work. We were pleased to have been a part of the working group for PROWESS and hope that this programme will be launched nation wide.