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Barbados Underground

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Medical Corner

David
1 minute

image-thumb.pngWe have accepted the suggestion from a BU family member to facilitate discussion on medical matters which is a topic area that should interest us all. Based on exchanges with and between BU family members posted over time, many of you work in the medical field or possess information on various medical issues acquired based on personal circumstance or otherwise. Medical Corner seeks to encourage ANYONE to submit views on medical experiences, new developments in the industry or any related matter which readers feel can serve to educate the BU family.

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347 responses to “Medical Corner”

  1. David Avatar
    David

    Kidney disease warning for Bajans

    by TONY BEST

    AS THE UNITED STATES’ best known infectious disease expert, Dr Anthony Fauci, warned Americans they may soon have to “hunker down” in the face of a second wave of COVID-19 in the fall and winter seasons, a top transplant surgeon is urging Bajans to beware the highly infectious virus and its potentially deadly complications.
    Dr Velma Scantlebury, a Barbadian and the world’s first black female transplant surgeon, said people in her birthplace should remember some key things about the coronavirus and its dangers to people everywhere, especially the elderly and those with underlying conditions such as diabetes and hypertension.
    Key organs
    At the top of the list is that COVID-19, the disease which has led to the global pandemic, can affect key organs such as the heart, lung, liver and kidneys. “It can cause lasting kidney damage,” the award-winning surgeon told the DAILY NATION. “And Barbadians, like people everywhere, should get tested and be careful.”
    Next, COVID-19 is not like the flu, explained the surgeon who grew up in Goodland in St Michael and came to the US from Barbados as a teenager.
    It is a novel virus that can cause severe complications which can end in death, added Dr Scantlebury, who attended Columbia University in New York and was selected by a top transplant surgeon in the US to be trained in that field.
    Third, young Bajans, as in the case of youthful Americans, Canadians, Europeans, Asians and others, can “end up with severe consequences” if they become infected with the virus.
    Kidney damage
    “You should get checked (medically) for kidney damage,” said Dr Scantlebury. “If you have underlying kidney disease – high blood pressure or diabetes – and your kidney function is okay – not great but not a problem – it can certainly worsen your underlying kidney issue and it becomes important to follow it up if you have a COVID infection. “You should ensure that you get your kidney function monitored. You should have someone check the protein in your urine and check your creatinine to make sure it is not higher.
    “Patients can resolve most of their injuries but if they have an underlying injury to their kidneys despite having what appears to be a normal creatinine, they can still end up with a worsening kidney function.”
    The Barbadian gave her birthplace good marks for its management of the virus when the outbreak occurred several months ago.
    Barbados was able to keep a lid on the spread of the virus, which has taken almost a million lives globally – more than 198 000 of them in the US – since March. She agreed with the decision to reopen schools, saying it would have been difficult to keep the thousands of students out of the classrooms.
    “Barbados has done a good job controlling the spread of the virus,” said Dr Scantlebury, who has chronicled her rise to the highest rungs of the medical ladder in the US in her well written 240page autobiography, Beyond Every Wall, Becoming the First Black Female Transplant Surgeon.
    “The Government was right to shut down the country when it did. That helped to curb any spread of the virus.
    Barbados managed the situation very well and I am sure it will continue to do so in the months and years ahead,” she said.
    “It is very difficult to keep young children in schools from interacting with each other, but it is important to ensure that they wear their masks and that social distancing and contact tracing are carried out.
    “As a surgeon, I have grown accustomed to wearing masks all day and I am sure people in Barbados would get accustomed to it because it protects you.”
    Guidance
    Like Rihanna, the Grammy- award winning music icon whose roots are in Barbados and who praised her mother for her success in business, especially her concepts of beauty, Dr Scantlebury also paid tribute to her mother, Kathleen Scantlebury, for the guidance and commitment to education which the surgeon traced to Barbados and Christian beliefs. “My mother made sure we were always at school,” she wrote in her autobiography. “Excellence was demanded. As part of a new generation (in Barbados) we had better options for further education.”
    “The opportunities for advancement, for accumulating wealth, for snaring the future she knew we all deserved were all tied to excellence in educational pursuits.”

  2. David Avatar
    David

    Ethical side of medicine
    By Gercine Carter
    gercinecarter@nationnews.com
    Throughout a 55-year career, Sir Errol Walrond promoted the practice of high ethical standards in the medical profession, while serving as a clinician, surgeon, educator, and as administrator and policy driver for surgical and medical education throughout the West Indies.
    For over 20 years, his knowledge and wisdom about the many ethical issues that undoubtedly arise in the practice of medicine have been informing his contribution as main discussant at the case conferences he was instrumental in convening for this very purpose.
    Today, at 84, the Professor Emeritus of Surgery and former dean of the Faculty of Medicine at the University of the West Indies (UWI), retains a storehouse of information collected in these monthly conferences in which he continues to participate. He has now chronicled those cases, the ethical issues and the discussion surrounding them in his latest book, A Question Of Ethics: Case Conferences In Everyday Ethical And Legal Issues.
    In a review of the just-released 339-page book, Professor Emeritus of Psychiatry and African- American Studies at Yale University, Dr Ezra Griffith, wrote: “All caregivers must understand the familiarity with the professional ethics that undergird our work [and] is a foundation that supports high quality in our caregiving. It is also the best sign that we believe in the inherent dignity of our patients.”
    Explaining his motivation for writing the book, Sir Errol harked back to 30 years ago when he was dean of the Faculty of Medicine at UWI, Cave Hill, and was moved to organise his first case conference for clinicians.
    Did not like behaviour
    “I kept getting people saying to me, mainly people from outside the profession – friends, sometimes patients – that they did not like the behaviour of the young doctors who were coming out, and that they did not seem to have the ethical principles of the older doctors.
    “I felt it was a general problem with how people were seeing the ethics of the profession . . . . I think that meant generally that people were getting more information about their conditions and they were beginning to question the ethics about how some of their illnesses were being handled,” he told the Sunday Sun in an interview. “I thought that we needed to look at the question more generally. I organised a conference which brought together some of the professionals and it came to us that while they were teaching the technical business of looking after patients, we were not teaching how they deal when they met a problem that was not technical.”
    Those case conferences have continued for the last 20 years, with the latest held as recently as last week. Sir Errol records complex cases presented by many clinicians over the years, discusses the associated ethical issues and gives insight into the challenges for both doctor and patient,
    Continued on next page.
    Sir Errol writes about ethics and legal issues facing medical practitioners as well as suggestions offered for possible courses of action. In the placid setting of a shaded patio overlooking the lush gardens of his St James home, as he thumbed through the pages of the book, Sir Errol said it discussed “some very thorny issues”.
    “There are situations where care is futile and sometimes it is the patient, sometimes it is the family, sometimes it is the doctors who are pushing for every minute of life when they know that they are not going to succeed. Those are complex situations.
    One thing I learnt in listening over the years and seeing the advances in medicine over the years is that sometimes what appears futile now is an advance in care in a few years’ time. So you need to have a mental framework of how you are going to handle it and what will be the limits, and those limits have to be individualised.”
    Rules of conduct
    Referring to the section “Professional Conduct And Risk”, aimed at the doctors and medical students, Sir Errol said: “There are a number of things in there where I would want the public and the profession to understand what are the rules of conduct. For instance, there is a proper way of doing a consultation or getting a second opinion . . . . The fact that doctors and sometimes nurses are sometimes ill themselves and they are still working – who bells that cat? Who is going to say you are too ill to work?
    “That is very important and it includes the areas where the practitioner may get into trouble in terms of medical malpractice and negligence, and they need to understand what are the parameters.”
    He related a story about a doctor in a London hospital where he was working as a medical student.
    “This is a case that I always tell them [participants in case conferences] about, that illustrates when you think you are doing good but you are doing it without consent, how you are liable for battery.”
    Acute appendicitis
    He outlined how a male patient was brought into the hospital for an operation for acute appendicitis and said during the operation the anaesthetist drew the surgeon’s attention to a large lump on the patient’s head which was making it very difficult for the anaesthesia to be administered. Identifying the lump as a lipoma, the doctor removed it after having performed the appendectomy for which the patient had originally been admitted to hospital.
    However, soon after the patient’s discharge, the hospital received a suit from the patient’s lawyer claiming substantial damages for loss of income. Only then did the doctor discover the patient worked in a circus as a two-headed man.
    The collection of cases also highlights issues such as whether an unborn child has rights; weighs decisions related to religious beliefs against life-saving medical decisions; explores the legal role of alternative practitioners in medical practice; the doctor’s role in cases of child abuse; and matters of patient consent and confidentiality. Sir Errol also gives the public access to medical insights which would not ordinarily be available to them.
    This is his second book on ethical issues, following the first, Ethical Practice In Everyday Health Care,
    released in 2005.
    Sir Errol qualified as a doctor in 1960, became a Fellow of the Royal College of Surgeons in Britain in 1964 and was the founding president of the Caribbean College of Surgeons, which seeks to set standards for surgeons in the practice of surgery and surgical education. He retired from UWI as a professor in 2001 and was honoured with the title of Professor Emeritus in 2001. He retired from the practice of medicine completely in 2015.
    “Everything I did, I tried to make it a teaching moment and sometimes that teaching moment was the patients,” he said.

  3. David Avatar
    David

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  4. David Avatar
    David

    Another hospital definitely not needed
    THE RECENT MENTION of “bed-blocking” at the Queen Elizabeth Hospital (QEH) by elderly incapacitated patients has led to the media highlighting a view that “Another hospital is way overdue” (DAILY NATION, Tuesday, November 3) Nothing could be further from the truth.
    Barbados has a larger proportion of elderly citizens than most CARICOM countries. There are several reasons for this: 1. the largely physically active lifestyle before Independence promoted longevity, 2. we probably have a healthier gene pool, for historical reasons linked to the slave trade, and 3. continuing emigration of younger people to North America.
    Unfortunately, the epidemiological transition, with a largely inactive lifestyle since Independence, has produced an epidemic of chronic diseases, which greatly increase the morbidity of the elderly – a high prevalence of high blood pressure, heart disease, diabetes and their consequences such as strokes and amputations, and hence significant disability and dependence.
    But this does not mean that hugely expensive tertiary care beds in a second or expanded hospital are needed. Our beds to population ratio is as good as most Western countries. Incapacitated elderly-forcare do not need intensive and costly tertiary care. As the Prime Minister has pointed out, the QEH beds cost five times as much as Geriatric Hospital beds. What is needed is a multifaceted approach, with several key programmes, to prevent the “bed-blocking” the minister commented on, which has in fact been going on for decades and fluctuates with fluctuations in staffing, operation of equipment such as X-ray and lab services, morale and other causes of variable efficiency of overall care.
    The first need to deal with the current problem is adequate residential accommodation – the Geriatric Hospital, infirmary and elderly care-home beds. The latter is a programme of private care that has been operating for some years. Infirmary beds were seriously reduced with the demolition of the Christ Church Infirmary at Oistins and, more recently, closure of that in St Lucy. The Geriatric Hospital has accommodated more than 500 patients for much of the past. Is it being efficiently utilised today, to accommodate those described as “left” at the QEH and said to be “blocking beds”?
    Day-care centres
    The medium-term solution is the provision of day-care centres. I have written and spoken repeatedly – in conferences, columns and in the Senate – for 40 years about the obvious benefits of such facilities. The example of the St Barnabas Church Day Care Centre is a role model that can easily be followed both by many of our churches which have church halls and similar outbuildings, and by government and the private sector.
    Such a centre not only maintains activity into old age for a longer period, delaying dependence, but solves the problem of day care for many elderly subjects and families.
    The long-term solutions, of course, include both the broad public health and educational approaches advocated by the Chronic Non-Communicable Disease Commission led by Sir Trevor Hassell, and the expansion of the support health care services of rehabilitation therapy (occupational therapy and physical therapy), which help to delay invalidity, accelerate recovery from illness and hospitalisation, and help the disabled to function in their own homes.
    We certainly do not need another hospital or a new hospital in order to improve our health services and the care of the elderly. In fact, some 14 years ago the then Minister of Health commissioned an extensive study by the leading hospital consulting team, Capita, Norman and Dawbarn. The better of their two options proposed, that of a complete rehab and improvement job and a state-of-the-art new multi-storey wing to the north, was estimated to cost just under $600 million. They also suggested a new hospital, with fewer beds, at an estimated cost of just under $900 million – 50 per cent more.
    I am relieved that this Government is not being misled into proposing a new hospital, as we do simply do not need one and would not be able to afford it anyway.
    What we do need, as shown in the study of health care human resources commissioned by the Faculty of Medical Sciences in 2007, are increases in several categories of health professionals. Our problems are all soluble by an evidence-based, multifaceted approach and improved efficiency at all levels – not by more bricks and mortar.
    Professor Emeritus Sir Henry Fraser is a professor of medicine and clinical pharmacology.
    What is needed is a multifaceted approach, with several key programmes, to prevent
    the ‘bed-blocking’ the minister commented on, which has in fact been going on for decades . . .

    Nation

  5. David Avatar
    David

    Mobilise against diabetes
    The diabetes epidemic is not an overnight problem, but part of a wider failure at the national level to tackle preventable diseases
    BARBADOS IS TAKEN up with the fight against the COVID-19 pandemic and rightly so, given the health and economic threat it poses. There is, however, another major disease which is impacting a significant number of individuals and by extension their relatives and the nation.
    The devastation diabetes is causing should have a similar kind of national coordinated effort to that which is being placed on containing the coronavirus pandemic and which was done in the fight against HIV/AIDS. It requires a united effort across the public and private sectors, ranging from funding studies at the George Alleyne Chronic Disease Research Centre to placing more emphasis on healthy lifestyles in the workplace.
    Diabetes is inflicting significant financial and medical stress on our health system and national budget and threatens the livelihoods of too many people in a nation whose majority black population appears genetically predisposed to the disease.
    More than 425 million people worldwide live with diabetes, according to the International Diabetes Federation study of 2017, with many going undetected. One in every five Barbadians is believed to be affected by the disease, which is a major cause of death.
    The non-communicable disease specialists have for some years been raising the alarm about the spread of diabetes and there has been some positive response to their appeals for Barbadians to change their lifestyles. The importance of early detection of diabetes so it can be managed through diet, exercise and medication cannot be overemphasised.
    There is an evident increase in physical activity and a greater consciousness of trying to eat the right foods.
    Unfortunately, we are a copycat society and have adopted North American fast food culture by eating and drinking too much of the wrong things. This lifestyle is killing too many Barbadians quickly and quietly.
    The Queen Elizabeth Hospital is consistently full of diabetic cases while surgical wards deal with a high percentage of diabetes-related causes.
    Barbados has gained notoriety for the number of amputations carried out because of diabetes-related problems.
    Healthy foods
    The diabetes epidemic is not an overnight problem, but part of a wider failure at the national level to tackle preventable diseases which exposes the vulnerability of many Barbadians, not only to the COVID-19 virus but a wide range of other health issues. There are too many people predisposed to heart and kidney diseases, strokes, circulation problems and even sexual dysfunction.
    The society faces some pervasive inequalities as a result of the severe economic fallout created by COVID-19 which has put 40 000 people out of work.
    Making healthy foods affordable must be a national priority in the effort to control diabetes. The “No-sugar November” initiative trending online is a welcome effort which should be expanded.
    The country needs a clearly enunciated long-term strategy to reduce the prevalence of diabetes.

  6. David Avatar
    David

    BAMP warns against dengue delay
    Bajans ‘waiting too late to get checks’
    by RACHELLE AGARD rachelleagard@nationnews.com
    TOO MANY PEOPLE are waiting too late to go to the doctor to check if they have dengue fever.
    This is according to president of the Barbados Association of Medical Practitioners (BAMP), Dr Lynda Williams, who said while some deem having a fever as symptomatic of COVID-19, that might not be the case.
    “Once we feel someone is coming down with dengue fever, we treat and act and encourage people to present. What has been happening is that I find people have been presenting late and have been symptomatic for days. I don’t know if that is because they are afraid they have something else, but people have been presenting quite late and with advanced stages of dehydration,” she told the DAILY NATION.
    Williams urged anyone feeling lethargic; experiencing pain behind the eyes, headaches, back and joint aches; and/or a rash or generalised itching all over the body, to consult their medical practitioner, particularly if they also had a fever.
    Always vigilant
    “We are always vigilant for dengue. It is an unusual time to be having a dengue outbreak of this magnitude at this time of year, but we are always watchful for the signs of dengue.
    “Of course, people presenting with fever must be interviewed before they even come in the office to find out if there were any respiratory symptoms or other symptoms, so we can differentiate between dengue and possible COVID,” she said.
    Williams, who was recently named as part of Government’s new COVID-19 communications team, said while she could not speak to the number of confirmed dengue cases as that data was collected at the Ministry of Health, there had been more deaths than usual related to the virus.
    Suspect cases
    “When we have suspect cases of dengue, we report them. [The ministry] also does . . . surveillance where they look at certain sites to see how many dengue cases are presenting and see whether there is a rise in cases or not. That’s how we know we are having an increased outbreak,” she said.
    When contacted, Acting Chief Medical Officer Dr Kenneth George said he did not have the statistics to hand, but would be in a better position later this week to provide them.
    Describing dengue as an endemic disease, the BAMP president said it was always around and could flare up at certain times.
    “The thing with dengue is it can develop a very low platelet count and people can develop haemorrhagic fever where they start to bleed suddenly. If you think you have dengue, even if you remain well hydrated, you should still get checked by your doctor to make sure that you’re not having a low platelet count,” Williams said.
    “We encourage everybody who is not feeling well, if you’re having fever, call your doctor’s office. If you’re not having fever, still call and find out and go and be seen and diagnosed. Self-diagnosis and treatment is not always beneficial, so we want to encourage people if they’re not feeling well to be checked,” she said.
    During a media conference at Ilaro Court last December 28, Minister of Health Jeffrey Bostic said the authorities were taking dengue as seriously as COVID-19.
    Mosquito breeding sites
    “We have contracted about 40 additional persons to assist the Environmental Unit to locate mosquito breeding sites. We have spent a considerable amount of money in terms of purchasing both hand-held foggers as well as truck-mounted foggers and we are awaiting the arrival of the foggers.
    “As soon as those machines are here, then we are going to be able to employ four fogging teams – two in the northern half of the country and two in the southern,” he added.
    Over the weekend, Chief Environmental Health Officer Francina Bascombe confirmed that from this week, the Vector Control Unit would restart its fogging programme. (RA)

    Source: Nation

  7. David Avatar
    David

    Caribbean males at higher prostate cancer – Caribbean males at higher prostate cancer: https://barbadostoday.bb/2021/01/29/caribbean-males-at-higher-prostate-cancer/

  8. Hants Avatar
    Hants

    https://www.bmcla.bb/blog

  9. David Avatar
    David

    A case of a misdiagnosis by QEH?

    Malcolm’s blessing in hour of need
    by JOHN BOYCE
    johnboyce@
    nationnews.com
    AFTER MORE THAN TWO DECADES of “a marriage made in heaven”, 55-yearold pharmacist Malcolm O’Neale is facing the darkest days of his life.
    In 2000, he took the hand of Thirza in marriage and she bore him three children. His wife, who is of Montserratian descent, came to Barbados after the Soufriere volcano erupted in Montserrat in 1995. After qualifying as a pharmacist, she took time out to homeschool their children before entering the Samuel Jackman Prescod Institute of Technology to study draftsmanship in 2019.
    On completion of her studies there she returned to the civil s ervice to continue her work as a pharmacist.
    It was while there that she started to experience severe abdominal pain and “nothing was staying down”.
    Thirza underwent a CT scan and it showed a mass in the area of the colon and lesions on the liver.
    The couple knew that they were dealing with a medical emergency and she was taken to the Queen Elizabeth Hospital where she was admitted.
    ‘Not malignant’
    Thirza was discharged one week later in the first week of April last year with medication and “the assurance that the lesions were not malignant”. However, the pain persisted.
    Malcolm said his wife became a QEH outpatient for several weeks thereafter, but there was no change in her condition.
    The couple then decided to see a private medical specialist who, after several tests, decided to do a colonoscopy.
    “This was now into November and my wife was enduring severe pain all of this time,” Malcolm told the DAILY NATION.
    He added that the costs of the various scans were astronomical and the emotional and financial stresses were taking a toll on them. Though he had health insurance, it was taking too long to get the money and he was out of pocket in a “big way”.
    But worse was to follow. By the end of November the news on her diagnosis was devastating.
    “The doctor told us that based on the results of the biopsy it was cancer.”
    They were then referred to a surgeon who the specialist said would handle the situation from there.
    But the words of the surgeon were even more horrifying.
    “I am sorry, but there is nothing I can do for you because it’s Stage 4 cancer. What you were told is not accurate because not only is it the late stage, but the lesions are not localised on the liver, instead they have spread there,” Malcolm said the surgeon told them.
    He said they were further told that it was inoperable and that because the cancer had spread to the liver, “it would appear to be terminal”.
    Malcolm said his world appeared to be crumbling around him.
    Hurtful
    The surgeon’s findings, along with those of the QEH, were then sent to an oncologist in January this year with a recommendation of chemotherapy. However, because of Thirza’s weakened state it was not practical to administer it.
    “You know what is hurtful? My wife had four blood transfusions, costs for two of which were sponsored by my church, but none of those could bring her to the level where she could start chemo,” he lamented.
    Desperate for a solution, Malcolm tried alternative medicine [natural products] which he believed might prolong her life.
    With mounting financial pressures and the insurance money only covering, in some instances, 80 per cent of the costs and in others, he was told that they were not covered, he was in a “deep financial bind”.
    It was then that a friend introduced him to the “blessing circle”.
    He had several reservations about joining because he had heard of many scams that left scores of people counting their losses.
    But his options were all but dried up and his back was against the wall.
    The administrators of the circle told him that it would give him cash in hand so that when his 47-year-old wife needed it, she would have it.
    Her situation had deteriorated to the point where she could barely use her legs and Malcolm had to be lifting her around. This resulted in him developing venous insufficiency – a condition which occurs when the leg veins don’t allow blood to flow back up to one’s heart.
    Malcolm joined the circle. He waited for eight weeks as the administrators told him he was “blessed out” with the money he so desperately needed.
    “One of the first things I did was to buy her a wheelchair. Without that money I would not have been able to do anything more financially for her.”
    Both his wife and his mother-in-law have also joined the circle to shore up the funds so that she could have the best of care.
    Thirza is now being looked after by a nurse “all because of the blessing circle”.
    But Malcolm said he continues to wrestle with thoughts of despair as he confessed his eternal love for Thirza and their three children.
    Today, he has placed the situation “with my dear wife” in God’s hands and has thanked the blessing circle for coming to his assistance in his hour of need.

    Source: Nation

  10. David Avatar
    David

    https://www.barbadosadvocate.com/sites/barbadosadvocate.com/files/styles/large/public/field/image/1Lennox%20Rochester.jpg

    Dementia symptoms increased due to lockdown
    A Sun, 03/14/2021 – 5:40am
    By: Cara L. Jean-Baptiste

    Speaking during a recent virtual lecture hosted by the Federal High School Alumni, Lennox Rochester, Occupational Therapist, highlighted that since the lockdown, a number of people have reported increases in their dementia symptoms due to the reduced stimulation and not being able to go out, and believed that this was something that needed to be addressed.

    He went on to speak on ways in which persons could reduce their risks of getting dementia and noted that while more research was needed to prove that these steps did indeed significantly reduce a person’s risk of getting dementia, they were still beneficial.

    “There is no sure way to prevent dementia, but there are steps that you can take that might help,” he said.

    “Keep your mind active. Doing activities such as reading, solving puzzles, playing word games, memory training, might delay the onset of dementia and decrease its effects. Be physically and socially active; we might have a problem there because due to the pandemic, we are being urged to be less socially active.”

    Rochester noted that it was important to make sure you were getting enough vitamins and taking care of and managing any cardiovascular diseases.

    Additionally, he noted that it was important to get quality sleep as the body tended to repair itself during that time.

    He went on to stress that dementia was a normal part of ageing and could occur in normal people, whether or not they had a family history of the disease.

    “Research shows us that the lack of exercise increases the risk of dementia, and while no special diet is shown to reduce dementia, research indicates a great incidence of dementia in persons who eat unhealthy diets compared to those who eat healthy,” he added.

    Source: BarbadosAdvocate

  11. David Avatar
    David

    Health advocate zeroes in on ministers ‘lukewarm’ stance on nutrition label – Health advocate zeroes in on ministers ‘lukewarm’ stance on nutrition label: https://barbadostoday.bb/2021/03/25/health-advocate-zeroes-in-on-ministers-lukewarm-stance-on-nutrition-label/

  12. David Avatar
    David

    NCDs at epidemic proportions in Barbados – NCDs at epidemic proportions in Barbados: https://barbadostoday.bb/2021/03/27/ncds-at-epidemic-proportions-in-barbados/

  13. David Avatar
    David

    Spike in NCDs
    QEH battling bed space with wave of patients, says Cave
    by COLVILLE MOUNSEY colvillemounsey@nationnews.com
    HAVING SUCCESSFULLY CONTROLLED the spread of COVID-19 at the Queen Elizabeth Hospital (QEH), the facility now has a new challenge on its hands.
    It is now battling a sharp rise in people requiring hospitalisation as a result of non-communicable diseases (NCD).
    This concern was raised by Director of Medical Services at the QEH, Dr Clyde Cave, who said yesterday, on World Health Day, that the situation was at such worrying proportions that bed space had become a serious struggle and had resulted in setbacks in plans to tackle the mounting backlog of elective and non-emergency procedures.
    “It is now a slow process for us to get everything going in terms of the backlog. The main factor that we are facing right now is the availability of patient beds in the hospital. This is an occurrence similar to what we saw last year right after that lockdown. A lot of vulnerable patients stayed away from their usual source of medical care and, as a result, they started to get sicker,” Cave said, while not disclosing whether the QEH had reached its maximum capacity of 519 in-patient beds.
    “We are now seeing that wave of patients again.
    So, at the moment, it is not the COVID-19 disease that we are being overwhelmed with but rather it is normal health cases that have been made worse by the lack or perceived lack of access to the usual preventative medical care,” he added.
    This development is one which Cave chalks up to a consequence of last February’s one-month lockdown.
    He explained that during the lockdown, with much of the national health focus on vaccinations and testing for COVID-19, there was a perceived lack of access to the normal channels of preventative care and, consequently, there has been a spike in complications from NCDs. He revealed that the majority of patients have presented with complications from hypertension and diabetes.
    ‘Main culprits’
    “Hypertension and diabetes are predominantly the main culprits, but other things have also popped up. It may have been a case where they may have just not taken their medication for a while, so we are starting to see breakdowns. This goes for persons who have not taken their cardiac medication or who should have been monitored for a change of their blood pressure medication and now things have gotten out of control,” said Cave.
    He added: “We are also seeing more cases of diabetics who had a scratch on their foot that was not monitored and have now developed an ulcer. These types of things we would have normally taken for granted before because everybody had easy access to early care. But once that was postponed, the cases are getting more serious.”
    However, the senior paediatrician is confident that the upsurge in NCD complications will be brought under control soon. Saying it was a good sign that the country was managing the COVID-19 situation well, Cave added that this would allow for a quicker refocus of the hospital’s efforts. He said the hospital being free of the virus in recent weeks was a good sign the facility could ramp up the return of more of its services.
    “The QEH is a microcosm of the country and the COVID-19 cases that appeared among the staff was a reflection of what was in the community. These were not infections that were picked up from patients. So the kudos must go to the public and the public health strategist and everybody that implemented the community measures because in controlling the community, we have also protected the hospital,” he said.

    Source: Nation

  14. David Avatar
    David

    Comorbidities and COVID: A much higher risk of death

    https://aje.io/aqfqa

  15. David Avatar
    David

    Only four QEH ambulances up
    Mechanical issues and accidents have reduced the Queen Elizabeth Hospital’s (QEH) ambulance service’s fleet from ten to four vehicles.
    However, consultant and head of the Emergency Ambulance Service (EAS), Dr David Byer said that with two new vehicles expected to arrive later this year, they will be in a better position to respond to the 15 000 calls received annually.
    He was responding to a query from this newspaper after ambulances were seen parked at Nassco’s River Road, St Michael workshop. He explained that their mechanical maintenance programme was carried out by the QEH’s mechanics and Nassco.
    “Our Emergency Ambulance Service has a total of ten registered ambulances in its fleet. Of these vehicles, two are not functional due to exhaustive mechanical issues, two more have been written off following motor vehicle accidents, and another two are currently undergoing short-term mechanical repairs and are expected to return to service within one to three weeks. As such, there are currently only four vehicles in active service.
    “Unfortunately, this means that there are occasions when we do not always
    have an adequate complement of ambulances to deal with the public demand. In such instances, these services are outsourced to private providers who assist us with covering the shortfall,” Byer said.
    Despite this, he said they had the manpower which allowed for four to six crews to be on duty at any time, and that each ambulance was “more than wellequipped” to deal with both traumatic and nontraumatic incidents.
    Byer said the EAS received about 1 250 calls a month, equating to around 15 000 a year. Sixty-nine per cent are emergencies or urgent calls. Of the remainder, 30 per cent are considered less urgent calls and one per cent non-urgent.
    “Over the past several years the call volume has remained about the same. However, with the advent of COVID-19 last year, the EAS quickly had to institute additional precautionary measures based on the COVID-19 guidelines to ensure the safety of both staff and our patients.”
    He added that although emergency medical technicians were not dispatched during the active phase of Hurricane Elsa last week, they still took calls and provided medical advice.
    “Once the all-clear was given, all calls received
    were responded to in order of the most urgent to the least serious. As usual, post a national shutdown, the teams were significantly busier but preparation is always key in these instances. As such, we were well-positioned to manage the onslaught of calls and requests for assistance,” said Bryan.
    (TG)

    Source: Nation

  16. David Avatar
    David

    https://www.instagram.com/p/CSaMbuFBMV9/

  17. David Avatar
    David

    Move on pesticide can disposal

    The Ministry of Agriculture is rolling out a pesticide container management scheme to create more awareness about the importance of proper pesticide container disposal.
    Speaking on Wednesday during the launch of the programme held at River Plantation in St Philip, Minister of Agriculture Indar Weir said too many farmers were incorrectly disposing of the containers, which not only harmed the environment but posed a serious threat to people.
    “. . . This is a serious cause for concern,” he said. “For not only is the practice a danger to our environment, but it poses a direct risk to persons who may use the container, unaware of its original contents.
    “Farmers, you have the responsibility to eliminate any health hazard on your farm, by ensuring that areas under cultivation or where animals are being kept are always well maintained.”
    Weir added that the ministry was also planning to start a purchase control programme on the chemicals, as the general public having readily access to them was another area of concern.
    “Our intention is to also do a management programme on the sale of pesticides, given the fact that anybody can walk in a hardware store, feed shop or a farm shop and purchase pesticides. Because of the dangers, especially in glyphosate for example, where it was reported in the news in the United States that a company had to pay out large sums of money in a lawsuit because they were sued by a user [who said] he had suffered from cancer as a result of using that product.
    “So we are definitely going to be restricting the sale of pesticides to the general public and then there would be a protocol in place for farmers to have access to them.”
    Although he did not say when the programme would take effect, Weir said that people would soon have to seek some form of authorisation from his ministry or from the Environmental Protection Department.
    Parliamentary representative for St Philip North, Dr Sonia Browne, said it was important that this scheme be implemented as the public needed to be educated about the risk of sickness and even infertility that some pesticides could cause.
    Regional pesticides management project coordinator at the Food and Agriculture Organisation Guy Mathurin said pesticide containers were often reused for other purposes and in some cases all the residue of the original contents was not completely removed.
    He advised farmers and other users to adopt a triple rinse method to properly clean the containers. ( SB)

    Source: Nation

  18. David Avatar
    David

    Barbados-born US surgeon named Delaware History Maker

    https://www.nationnews.com/2021/08/19/barbados-born-us-surgeon-named-delaware-history-maker/

  19. David Avatar
    David

    Prepared by Dr. GP[/caption]

  20. David Avatar
    David

    Prepare the Body to Fight, Fight, Fight!

    Posted on by DavidOne comment Omega-3 Fatty Acids

    The SARs-CoV-2 virus has moved from epidemic (outbreak in Wuhan, China) to pandemic (spread across several countries) to possible endemic (in simple explanation, the virus will constantly exist like the common flu). Some on BU have been advocating priority must be given by public health officials in through reminders to the public – see Dr. Doughlin’s excellent video –

    Read more

  21. David Avatar
    David

    https://youtu.be/TUADs-CK7vI

  22. David Avatar
    David

    Giving immune system a needed boost

    I AM ECSTATIC when readers engage my interest about topics which are herbal. Last week, I received many calls about the use of pine needles for building the immune system. Those readers were truly fascinated with what they had read about pine needles as a tea.
    I also received a call from a reader in Miami, Florida who inquired about pine needles as a tea to boost the immune system. Although, I will share what I know about silent doctor pine needles, I still must inform you that we have reliable immune builders in the Caribbean.
    We can use many healing herbs including green leafy vegetables, fruit especially Bajan cherries, grapefruit and limes. It is also good to use ginger, garlic, nuts, spices, turmeric, tamarinds, black seed oil and any combinations recommended by health care providers.
    We can blend these listed items into smoothies or boosters. We can use more vegetable salads with our meals and coconut oil as a dressing. It is imperative that we ensure that our immune systems are in good working order.
    The Creator had a reason for ensuring that our bodies are equipped with such a system. All I can say is “to God be the glory”. In 2 Timothy 1:7 we read, “For God gave us a spirit not of fear but of power and love and self-control.”
    Let us turn our attention to silent doctor pine needle to be respectful to those readers who made the enquiry. The tea can be used to treat respiratory challenges including sore throat, coughs ad asthma. It will also boost the immune system, improve eye health, improve blood circulation and prevent dandruff and hair loss.
    The web page https:// familyhealthadvocacy. com/10-unbelievablethings- you-never-knewabout- pine-needle-tea/ states that, “Pine needle tea was often used by indigenous cultures for treating respiratory problems. The encyclopedia of American Indian Contributions to the World records how the native Americans used white pine for its expectorant and decongestant qualities.”
    The webpage further states, “Drinking a cup or two of pine needle tea per day will help fuel your body with antioxidants, which are highly important for the
    functioning of your body and blood. Pine needles possesses a slew of antioxidants, in the form of vitamin A and vitamin C, as well as a host of flavonoids.”
    Finally, we have to be very aware of the foods we consume in these times. We now have to ensure that we truly include immune-boosting and energy-giving foods in our diet. As we browse the web, I implore you to include research about immune boosting food, teas, drinks, salads and desserts in your newfound quest for healthy alternatives.

    Annette Maynard-Watson, a teacher and herbal educator, may be contacted via silentdoctors@gmail.com

    Source: Nation

  23. David Avatar
    David

    Bajans urged to focus on NCDs too
    Cancer Support Services is encouraging Barbadians to take better care of themselves amidst the ongoing COVID-19 pandemic.
    Yesterday, registered nurse Mutual Archer, who has been working with the organisation for several years, said some were focusing only on protecting themselves against the viral illness and neglecting other health concerns.
    “I find that we have been concentrating so much on COVID-19, which is important, but we have been neglecting other aspects of public health care like high blood pressure, strokes and diabetes,” he said.
    “We had 274 persons dying in 2021 from COVID-19 but if you look at the numbers associated with those dying from other illnesses (noncommunicable diseases), it is a small percentage. So we need to refocus; we cannot neglect the other issues.”
    Archer said comorbidities such as non-communicable diseases also put individuals at high risk of contracting the virus, adding that if these illnesses were better controlled, the number of people who die from COVID-19 would be reduced as their bodies would be better able to fight the disease.
    More than 100 men were screened at Cancer Support Services headquarters in Dayrells Road, Christ Church and Archer said many more younger men, those in their 40s, 50s and 60s, were taking part in the programme.
    He said he was pleased with this development.
    Founder of the organisation and executive director Jan Linton thanked corporate Barbados for partnering with them and helping them provide health care services to the community. (SB)


    Source: Nation

  24. David Avatar
    David

    Doctors make prostate cancer breakthrough

    By Sherrylyn Toppin
    sherrylyntoppin@nationnews.com

    Medical practitioners in Barbados believe they have made a major breakthrough in the early detection of prostate cancer, the most common on the island, which also accounts for the highest number of cancer deaths annually.
    They can now “predict” who is likely to develop the disease even if there are no signs or symptoms and there is a negative Prostatic Specific Antigen (PSA) test, based on a newly discovered DNA molecular signature specific to prostate cancer, that can be detected from a drop of blood.
    These are the preliminary findings from a study conducted by the Barbados Cancer Society and the Massachusetts-based Yale University and Wren Laboratories.
    The study, which was done between 2020 and 2021 comprised 554 men and is believed to be the largest in the world on men of African descent. Similar studies were done on a smaller scale in the United States and Europe.
    Acting president of the Barbados Cancer Society, Professor R. David Rosin, a surgical oncologist who has been working in Barbados since 2008, said this was a plus for the medical fraternity because the PSA was known to give both false positives and negatives.
    “With the molecular signature in the blood, because it is DNA-based, it is actually predicting that this person, this man, will, if he hasn’t got it now, get prostate cancer,” Rosin said.
    The prostate cancer molecular structure was detected in 80 of the men, but they already knew 20 of them had the disease.
    “Sixty of them had a negative PSA, but a positive molecular signature. These men are going to get prostate cancer,” he explained.
    “The other great advantage is if you have prostate cancer, you can then monitor it. It can also show you the aggressive type. PSA doesn’t tell you any more than you may have prostate cancer. This is going to tell you ‘you have prostate cancer or you are going to get it and it may be non-aggressive or aggressive’, because the treatments would be very different.”
    Rosin, a former president of the British Association of Surgical Oncologists and founder president of the Caribbean Society of Endoscopic Surgeons, said they would continue to monitor the 60 men. They will be retested every three months and
    although the test is expensive, Wren Laboratories has agreed to do it for free.
    But even with information, he said there was no way to delay the inevitable.
    “We are really concentrating on the earliest possible finding of that cancer,” he said, adding that this would allow them to do an MRI to look for the spot where the cells may be metastasising. This could then be treated without surgery by ultrasound ablations, for example.
    Rosin, an honorary professor in the University of the West Indies Medical Faculty in Barbados, said prostate cancer was the most common in the country, accounting for more than 300 new cases each year and just over 100 deaths. Colorectal cancer was second and breast cancer third. The numbers are “very small” for paediatric cancer.
    Barbados has approximately 1 200 new cancer cases and more than 700 deaths each year.

    Source: Nation

  25. David Avatar
    David

    Backlog at QEH
    Waiting list for cataract ops, CT scans calls for ‘urgent action’
    THERE IS A BACKLOG of 700 people for cataract surgeries and a waiting list of 1 800 people seeking CT scans at the Queen Elizabeth Hospital (QEH).
    This was revealed by Minister of Health Ian Gooding-Edghill yesterday in the House of Assembly, noting that the situation warranted urgent action.
    “I’ve already signalled to the Queen Elizabeth Hospital that overdue surgeries will have to be brought up to date. To this end we’re devising plans on how to address and reduce this backlog,” the Minister stated.
    Part of the solution on the cataract issue is greater collaboration with Cuba where a number of Barbadians have received vision changing surgeries in the past. In addition, said Gooding-Edghill, the out-of-use Lions Eye Centre must be put back into operation to help those who cannot afford private eye surgeries.
    He said the hospital, which will be a primary focus of his ministry, must have a revised monthly report on the situation in order to measure progress.
    “We are reviewing options to come up with a quick and satisfactory solution. The overall objective of the Queen Elizabeth Hospital is now executing with precision, driven by results,” Gooding-Edghill said, in relation to the outstanding CT scans.
    Systems lacking
    Executive chairman of the QEH Juliette Bynoe-Sutherland, who was also present during the sitting, conceded that there were no adequate systems for measuring performances in relation
    to what led to the backlog.
    “We don’t have an adequate system for measuring the reasons and the delays for surgeries. We are going to be entering into a special project where we are going to survey, over a period of time, the reason for the actual delays in surgeries.
    “Some of them will be late arrival of surgeons, some of them will be late arrival of patients from the ward, some of them will be the turnaround time between cases, some of them may be other internal inefficiencies. Once we are able to target and identify the exact causes we are then able to talk to individual surgeons, talk to individual teams with precise data on what has happened and move beyond the issue of anecdote to the actual issue of performance based management,” she said.
    Meantime, the Minister pointed out that COVID-19 had in two years led to a paradigm shift in the governance and management of health care adding that for the upcoming financial year, there would be a return to the management of the non COVID-19 healthcare sector.
    As he took part in the debate on the Appropriation Bill, 2022 – Head 86 Ministry of Health and Wellness, Gooding-Edghill said the capital expenditure plan of the QEH would include putting back into operation all 12 operating theatres rather than the nine now functioning.
    “As we move away from lockdowns and restricted movement to purposeful and progressive opening of our economy, we expect that expenditure will return to pre COVID-19 levels . . . The Ministry of Health and Wellness will transition from a COVID centred health care response to one that embraces all aspects of health care,” he said.
    The focus, he said, would also include environmental and mental health; reform, access to essential pharmaceuticals and HIV vaccines, climate change and disaster and non-communicable diseases. There will also be a greater effort made towards the elderly and persons with noncommunicable diseases.
    “However, our mandate does not stop there. We will be forging forward by providing better working
    conditions in terms of engagement for nurses, doctors, supporting and ancillary staff. We’ve listened to the concerns of the nurses through their respective trade unions and have already taken proactive steps, including appointments, payment of overtime and better physical working conditions,” the minister said.
    Gooding-Edghill stated that in a revenue constraining environment he would be requiring all heads of departments to pay close attention to how funds are used and allocated in the managing of the healthcare system.
    (AC)

    Source: Nation

  26. David Avatar
    David

    Regulation of ‘sweet drinks’ in schools going to Cabinet

    By Colville Mounsey colvillemounsey@nationnews. com

    As the debate rages on as to whether Government’s 20 per cent tax on sugarsweetened beverages will hurt the manufacturing sector, there are plans for the regulation, marketing, and sales of these drinks in schools.
    This is according to policy advisor to the Healthy Caribbean Coalition, Nicole Foster, who disclosed that based on consultations with Government on a school nutrition policy, the commitment has been given to follow through with this undertaking this year.
    The Sunday Sun reached out to Chief Education Officer Dr Ramona Archer-Bradshaw, who confirmed that the final draft of the policy is set to be taken to Cabinet for approval. She said the initiative was being established mainly through the Ministry of Health and Wellness, noting she would be in a position to divulge more details once it is approved by Government.
    More initiatives needed
    Foster, who is also the Deputy Dean at the Faculty of Law at the UWI, Cave Hill Campus, said while the tax was now at a level that would impact the consumption of sweetened drinks in Barbados, more initiatives were needed.
    “There is no one policy that is going to be the silver bullet that solves this problem because it is a multi-factoral and complex problem. So ideally what you want to see is a package of evidence-based solutions that support each other and would then increase your impact and long-term success. Public health advocates have been in discussion with Government in terms of a school nutrition policy and our understanding is that the regulation of these drinks in schools is on the cards,” Foster said.
    She made it clear that she had not seen the final draft of the policy and therefore was in no position to state the format of the regulation. She explained that, based on the examples of the policy in other countries, the measure could range from a cutting down of the sugar put in the drinks, to a total removal of the beverages from the school environment altogether.
    She added: “We want to address the problem in a holistic way and sugarsweetened beverages are a big part of our problem, and we know that our children consume a significant amount of these drinks during the week at school. Our understanding is that the school nutrition policy is at an advanced stage and will hopefully be rolled out very shortly and our expectation is that as part of that policy we will see the regulation of sugar-sweetened beverages. It has been a long wait, but we remain cautiously optimistic that the Government will follow through in
    its commitment to implementing this measure as a matter of urgency.”
    Foster pointed out that other territories such as Jamaica, Trinidad, Bahamas and Grenada have already taken that step and based on the data and evidence from the World Health Organisation (WHO), this measure had some success.
    “Our understanding is that the approach is going to be holistic because it is not just sugar-sweetened beverages alone that needs to be addressed, but if nothing else, we need the sweet drinks to be dealt with based on the high level of consumption,” Foster said.
    However, the public health advocate did not stop there as she revealed that plans were in the pipeline to push for front-of-pack warning labels, as well as support for agriculture to ensure that fresh fruits and vegetables are more affordable.
    “Thankfully, Barbados is one of the countries that did soundly support these types of labels on pre-packaged foods to help persons make more informed choices about what they are eating and drinking. The information provided on these labels is accurate, it is easy and it is quick. A number of countries in Latin America have done a good job in implementing these measures, as well as a regulation of the types of ads placed during the peak time for kids watching television,” she said.


    Source: Nation

  27. David Avatar
    David

    Sir George backs sweet drink tax
    By Tony Best The decision by Government to double the tax on sweetened beverages has been described by Sir George Alleyne as a step in the right direction.
    “I am absolutely delighted that the Barbados government has decided to take this step because there is incontrovertible evidence that the consumption of sugary drinks contributes to the obesity in children,” said Sir George, a Barbadian and a former Director of the Pan American Health Organisation.
    “Everything that could possibly be done to reduce the consumption of these high calorie beverages is a step in the right direction, absolutely” he added.
    Sir George said there was a raft of measures” which could also be undertaken to grapple with the problem of obesity and “among them is educating children about what constitutes” dangers to their health, said the former professor of medicine at The University of the West Indies (UWI) who later became Chancellor of the preeminent tertiary level Caribbean educational institution with campuses in Barbados, Trinidad and Tobago, Jamaica and the Eastern Caribbean.
    “A couple of years ago, I sat on the World Health Organisation (WHO) Commission on childhood obesity and we made a series of recommendations for addressing the problem. One of them, front and centre was taxation on sugar sweetened beverages. Another, of course, was education in schools. You want to educate children about what constitutes a healthy diet and weight.”
    Sir George said there was a universal concern about obesity in children.
    “It is not simply a concern about obesity but the increasing rate of obesity. In one of my graduation addresses to UWI students I made the point that all governments are signatories to the rights of the child and I pointed out that to allow children to become obese is an abrogation of their rights. That’s why I believe what has been done in Barbados is a step in the right direction that must be followed by other measures,” he said.
    Effective Friday, the excise tax on sweet drinks will jump from ten per cent to 20 per cent and in announcing the measure, Prime Minister Mia Amor Mottley told the House of Assembly that the consumption of foods with high sugar and salt content was undermining Barbados’ – fight against chronic non-communicable
    diseases (NCDs), which range from cancer, heart disease and hypertension to diabetes.
    Mottley put Bajans on notice that the administration intended to undertake a mid-year review of the specific budgetary and health care move.
    Sir George said there was a long list of countries which belong to the United Nations that were now taxing sugar sweetened soft drinks to reduce consumption. Among them were France, the United States Portugal, Saudi Arabia, Britain and Qatar.
    Happy with move
    “It is of global concern and I am delighted Barbados has taken the step to increase the tax,” he added.
    In expressing his support, Sir George said the move was necessary and important to the fight against NCDs which were the leading causes of death in the country.
    Another key supporter of the action was Sir Trevor Hassell, President of the Healthy Caribbean Coalition. He said that “from a public health perspective, the tax is an excellent initiative, and one that not only do I support professionally, but it is an initiative that the national NCD Commission, the George Alleyne Chronic Disease Research Centre and many of the leading non-governmental health organisations have been advocating for and working towards for many years.”
    WHO’s Director General, Tedros Adhanom Ghebreyesus also joined the chorus, praising Barbados for acting on the issue and expressed the hope that more countries would follow suit.
    Dr Lynda Williams who heads the Barbados Association of Medical Practitioners said “taxes on sugar sweetened beverages have been shown to decrease consumption in many countries around the world.”

    Source: Nation

  28. David Avatar
    David

    Good News!

    ———————————-

    https://news.sky.com/story/landmark-liver-cancer-treatment-found-to-boost-survival-rate-in-nearly-90-of-patients-12581307

    ‘Landmark’ liver cancer treatment found to boost survival rate in nearly 90% of patients

  29. David Avatar
    David

    HEART-RENDING! RENDING!
    Doc: 90% of people heading to hospital with cardiac attacks have hypertension and 75 per cent diabetes
    Stories by Carlos Atwell carlosatwell@nationnews.com
    Barbados is on an unsustainable path with non-communicable diseases (NCDs), but according to lead researcher with the Barbados National Registry for NCDs, Dr Natasha Sobers, it is not yet at the point of no return.
    “If we continue as we are, with no changes, it would be an unsustainable path. We simply can’t continue this way. But with policy changes, with a changed environment and people changing their mindsets, we have the opportunity to decrease our NCD mortality rate. It’s been done in other places and I see absolutely no reason why it can’t be done here,” she told the Sunday Sun.
    Sobers, who is also a senior lecturer in epidemiology at the Cave Hill Campus of the University of the West Indies (UWI), said this turnaround could start in as little as five years where obesity and diabetic numbers would first stop increasing, and then start decreasing in ten years. It was youth which gave her hope.
    “I see and am very hopeful about a cohort of young people who want to live a healthier life. Now that we’re doing a lot of work in schools with nutrition polices, children are more aware and are telling their parents they want to drink more water and how to do this or that to live healthier,” she said.
    In sharing the current outlook of NCDs in Barbados, Sobers said official records at the registry were only kept up to 2019 for cardiovascular disease and up to 2015 for cancers. The data for 2020 was almost compiled but was similar to 2019 anyway, she stated, adding they did not have any information during the worst of the pandemic as yet, in 2021.
    However, she said anecdotal evidence showed there had been a noticeable increase in heart attack cases over the past five years, and what was troubling was the ages of those dying from it, in particular men.
    “The peak age where we are seeing heart attacks for men has actually moved in 2018 from the 75-84 to the 65-74 age group, which is not a good trend as this means people are dying prematurely from heart attacks while still in the prime of their lives,” she said.
    The researcher said women were being diagnosed with heart disease at a later age but even so, this still placed health care system. majority of cases of unhealthy lifestyles.
    “Ninety per cent persons who go into with a heart attack hypertension and them have diabetes, an overlap. When deaths, people with three times more a heart attack while hypertension are to die,” she said.
    Sobers said 78 over the age 65 were with hypertension, single most important for a heart attack. Barbadians, especially to see a physician screened for NCDs age, and to do their healthy and exercise.
    Dr Kenneth Connell, a burden on the system. She said the cases were as a result lifestyles. cent of the into the hospital attack also have and 75 per cent of diabetes, so there is When you look at the with diabetes are more likely to die from while those with are twice as likely said.
    78 per cent of those were suffering hypertension, which was the important risk factor attack. She urged especially men, physician and get NCDs after a certain their best to eat exercise.
    Connell, deputy dean of the Faculty of Medicine at UWI Cave Hill,
    said there was no daily dashboard for strokes and heart attacks like there was for COVID-19, but the numbers were even more startling.
    “I can tell you that over the last 20 years our main burden coming through the emergency room is heart failure as a direct result of uncontrolled hypertension and diabetes.
    Stroke victims are getting younger. Heart attacks, I would see once a week when I was a student, are now happening three and four times a night, with new stroke victims every few hours,” he said.

    Source: Nation

  30. David Avatar
    David

    COLD HARD FACTS
    The following was compiled from the Barbados National Registry for NCDs, the International Diabetes Federation and the 2015 Health Of The Nation study:
    •
    Diabetes affects between 18 and 24 per cent of Barbadians, increasing to 46.5 per cent of those over 65 years.
    •
    About 43 per cent of beds at the Queen Elizabeth Hospital are taken up by people living with diabetes.
    • One in every four Barbadians has either diabetes or hypertension.
    •
    Forty-three per cent of adult women in Barbados are obese and 67 per cent physically inactive.
    •
    In 2019, there were 547 people with heart attacks. The in-hospital case fatality rate was 25 per cent, high in comparison to other countries.
    •
    There were 758 stroke cases registered in 2019. The in-hospital case fatality rate was 37 per cent.
    • Around 260 new patients are referred to the outpatient clinic every month.
    • NCDs take up 70 per cent of the Barbados Drug Service’s budget.
    •
    The World Health Organisation predicts by 2030, 86 per cent of the Barbadian population will die from NCDs and many prematurely, as in by age 70 or younger.

  31. David Avatar
    David

    Take control of your health, Bajans urged
    The Barbados Diabetes Foundation wants Barbadians to take their health into their own hands.
    Dr Diane Brathwaite, clinical director at The Maria Holder Diabetes Centre for The Caribbean, which is operated by the foundation, said it was imperative for those diagnosed with a noncommunicable disease (NCD) to take control of their condition as early as possible to ensure the best quality of life.
    “Persons living with diabetes must be in the driver’s seat and must remain controlled from diagnosis. If your condition is uncontrolled, seek help, don’t wait any longer. So many people underscore the importance of nutrition and lifestyle, it is everything – whether you have Type 1 or 2 diabetes.
    “We at the centre work closely with care providers, the Ministry of Health and Wellness and other organisations to support the best care and we want people to understand that you do not have to end up with a complication or die prematurely because of diabetes. But what you do matters,” she implored.
    Dire future
    Brathwaite said the future looked dire should Barbadians not take a stand now.
    “NCDs are the main cause of adult death and the World Health Organisation predicts that 86 per cent of the Barbadian population will die, many prematurely (by age 70 or earlier), from NCDs by 2030. We desperately do not want that to be our reality. We, therefore, support the 20 per cent sugar tax and all other measures to reduce the impact of our high-calorie, high-sugar, high-fat, high-ultra-processed foods diets,” she told the Sunday Sun.
    “Parents, your children do not need daily treats and sugary beverages. They need good nutrition, ‘real natural food’ and physical activity. Barbados must invest and make changes for Barbadians based on our reality. Marketing and manufacturing agencies need to get more creative to support our health needs. There is so much potential and opportunities for growth and development.”

    Source: Nation

  32. David Avatar
    David

    T&T said to be NCD capital of the world
    Trinidad and Tobago is the noncommunicable disease (NCD) capital of the world, says its health minister.
    During the opening ceremony of the Caribbean Public Health Agency Chief Medical Officers COVID-19 Meeting in Trinidad last week, Minister of Health Terrence Deyalsingh highlighted the ongoing war the twin-island state was waging against what he called the “silent pandemic”, adding most of the recorded deaths due to COVID-19 were people with comorbidities.
    “We are an unhealthy nation and the burden of diseases like diabetes and hypertension, heart disease and cancers, proved itself during COVID-19. For years, this region has been fiercely battling the silent pandemic called NCDs.
    “To date, of the more than 3 000 souls here who have died from the virus, 83 per cent of them had comorbidities. Think about how many lives could have been saved if just 20 per cent of
    those persons either knew their condition or were dealing with it properly,” he said.
    The minister revealed many of those diagnosed with COVID-19 in his country were unaware they were also suffering with diabetes, hypertension or heart disease, while others knew they had an NCD, yet refused to take their medications.
    He said they were addressing this with the recent hiring of an NCD director who will be driving the national NCD policy and chairing their recently established National Food Advisory Committee.


    Source: Nation

  33. GP BU RETIRED "RESIDENT" DR Avatar
    GP BU RETIRED “RESIDENT” DR

    ALL WELL TO POST THESE STATISTICS
    BUT WHERE IS THE EDUCATION ON EITHER DIABETES OR HYPERTENSION OR DIABETES TREATMENT AND MANAGEMENT?
    PUT A TAX PUN SWEET DRINKS IS ALL THEM THAT GOT POWER BUT SHOULD YOU NOT TAX ALCOHOL TOO?
    WHAT IS THE MOST LIKELY CAUSE OF DIABETES IN MEN IN BARBADOS? IS IT SUGAR RELATED OR IS IT SECONDARY TO CHRONIC PANCREATIS CAUSED BY HIGH ALCOHOL INTAKE
    TEK DUNG DIS POST TOO likkle david CAUSE THIS WILL NOT FIT INTO THE NARRATIVE.

    HOW MANY DOWN THERE THAT TALKING HAVE DIABETES AND HYPERTENSION AND HAVE MANAGED IT SUCESSFULLY?
    WHAT ARE THEY DOING TO ACHIEVE CONTROL?
    IF SO WHY NOT SHARE WHAT YOU ARE DOING?
    WHY ARE THE SO CALED JOURNALISTS WHO WRITE ALARMIST TYPE ARTICLES NOT PRESENT ARTICLES BASED ON RESEARCH/
    ARE THE TREATMENTS WE ARE USING OFFERING A CURE OR ADEQUATE CONTROL? IF SO, HOW SO? IF NOT, WHY NOT?

  34. David Avatar
    David

    PM’S NCD VOW
    By Barry Alleyne
    barryalleyne@nationnews.com

    Still irked by this country’s moniker as the amputation capital of the world, Prime Minister Mia Amor Mottley yesterday vowed to do all in her power to reverse the trend of diabetic sufferers.
    Moments after touring a new treatment centre within the Maria Holder Diabetes Centre For The Caribbean, Mottley said she would make all resources and finances at her disposal available to have Barbados as an example to the world, where significantly more Barbadians do not lose their limbs due to the complications associated with diabetes.
    She already has an ally. Director general of the World Health Organisation (WHO), Dr Tedros Ghebreyesus, said he would have discussions with the Prime Minister as a matter of urgency to see how the Diabetes Centre could get financial and logistical support from the world body.
    Mottley, Ghebreyesus, Minister of Health Ian Gooding-Edghill, Chief Medical Officer The Most Honourable Dr Kenneth George and Minister of State in the Ministry of Health Dr Sonia Browne toured the new treatment area at the centre located at Warrens, St Michael.
    The centre is now the country’s main treatment facility for those diagnosed with diabetes mellitus, with all patients who present at polyclinics with the non-communicable disease (NCD) being referred there.
    “I’ve seen the difference this centre makes to the lives of Barbadians,” Mottley said after the tour. “But I’m not satisfied we are reaching enough of our people. We need champions out there to help change the behaviour. That’s why I make no apology for the action taken in the Budget regarding the tax on soft drinks. No one is telling you not to drink any, but everything is to be done in moderation,” she said about the consumption of sugar-sweetened beverages.
    Plea to Bajans
    The Prime Minister also urged Barbadians to take stock of their lives and control their health by looking at their meal sizes and taking action through exercise. “All reckless behaviour has consequences. I want to see more Barbadians helping themselves in this fight.”
    Christopher Holder, whose mother Maria helped bring to fruition the vision of the centre’s first leader, Dr Oscar Jordan, said his family would
    continue to play an integral role in the treatment of NCDs in the region, and thanked the Mottley administration for continuing to support the facility.
    Saying he, too, was concerned about the level of amputations in Barbados, Holder called on more people to get involved in the speciality of podiatry since work at the centre had shown that early intervention and specialised care had led to an 80 per cent success rate in treating foot-related problems that usually accompany dialysis.
    Ghebreyesus, on a three-day tour of Barbados, said he was impressed by such a facility since it could lead to the entire region fighting the battle so many countries are failing to wrestle to the ground.
    “This is an inspirational model from which other countries can learn,” he said, while noting that so many other countries in the world did not have access to daily quantities of insulin, the most important drug needed to help control blood glucose levels.
    “This a very strong commitment that has been made by your Government,” he said to Mottley, while confirming it was only fair that the WHO also seek ways to help facilitate the enhancement of programmes and services which the centre could provide.
    The Prime Minister noted that outside of the financial support of Government to the centre, she was hoping the country’s programme which allows nurses to make house-to-house visits to help diagnose and treat diabetes would be ramped up in the coming months.


    Source: Nation

  35. Hants Avatar
    Hants

    Deputy President of the Senate Elizabeth Thompson has conceded there are “attitudinal” problems associated with the level of service delivery at the Queen Elizabeth Hospital.

    https://www.nationnews.com/2022/05/05/need-improve-service-qeh/

  36. Hants Avatar
    Hants

    Authorities at the Queen Elizabeth Hospital remain on high alert for COVID-19 after detecting three new cases on Ward B7 this week.

    https://barbadostoday.bb/2022/05/05/new-covid-19-cases-at-qeh/

  37. David Avatar
    David

    UWI plans diabetes reversal project
    by GERCINE CARTER
    gercinecarter@nationnews.com

    THE UNIVERSITY OF THE WEST INDIES (UWI) is planning a diabetes reversal project as a major feature of the new facility intended for the former site of the St Joseph Hospital after the university assumes full control of the property.
    Government recently vested the Ashton Hall, St Peter property in The UWI, in a special purpose vehicle in which the university holds 75 per cent ownership while Government owns the remaining 25 per cent.
    Principal and pro vice-chancellor of The UWI Cave Hill Campus Professor Clive Landis has disclosed that the university was looking to set up a diabetes reversal clinic as a major feature of the proposed new facility and is also in the process of developing a programme and products to be used in the reversal process.
    Health tourism
    “When we eventually develop the land at St Joseph, we are looking to set up a health tourism clinic where people would come in and we have this expertise in reversing diabetes,” Landis said in an interview with the MIDWEEK NATION.
    The concept is based on a study done in Britain by Newcastle University Professor Roy Taylor and a team, which showed remission from Type 2 diabetes was possible for people with lower body mass indices. Taylor was brought to Barbados in 2015 to speak about how diabetes could be reversed, in light of the alarming incidence of the condition here.
    Landis said based on Taylor’s findings, The UWI had subsequently produced papers showing that the Cave Hill, St Michael facility could reverse diabetes through diet and weight loss. He noted that in the university’s case specifically, that it could be done “not only in a controlled setting using an imported controlled product in the form of a meal replacement shake . . . but we can do it using our own natural products and do it in a community setting, using plant-based product”.
    That aspect of the project he revealed, had reached
    the stage where prototypes (of the product) had been made adding the university was now looking to incorporate the company. He said there was “plenty of interest” in the project, with Invest Barbados and Export Barbados being “very supportive”.
    Landis said the programme was designed to be conducted over three months, allowing six weeks to reverse the diabetes and another six weeks “to reboot your life and educate yourself on a healthy lifestyle”.
    The St Joseph Hospital, founded in 1966 by the Roman Catholic Church, was closed by a Barbados Labour Party-led Government in 1986; renovated and reopened by a Democratic Labour Party Government following a subsequent change in administration. It was closed again in 1995 after the BLP returned to power.
    In January 2012, it was announced the entire hospital was to be leased to overseas investors Denver, Colorado-based American World Clinics, for the purpose of medical tourism, under a 25-year lease.
    That lease was rescinded by Parliament last month, making way for the vesting of the property in the university.


    Source: Nation

  38. David Avatar
    David

    Research in pigs shakes up what we know about dying

    Katie Hunt
    By Katie Hunt, CNN
    Updated 3:51 PM EDT, Wed August 3, 2022

    https://media.cnn.com/api/v1/images/stellar/prod/220803153157-pigs-file-060222.jpg

    CNN
    —
    Researchers at Yale University say they have been able to restore blood circulation and other cellular functions in pigs a full hour after the animals’ deaths, suggesting that cells don’t die as quickly as scientists had assumed.

    With more research, the cutting-edge technique could someday potentially help preserve human organs for longer, allowing more people to receive transplants.

    The researchers used a system they developed called OrganEx which enables oxygen to be recirculated throughout a dead pig’s body, preserving cells and some organs after a cardiac arrest.

    “These cells are functioning hours after they should not be,” said Dr. Nenad Sestan, the Harvey and Kate Cushing Professor of Neuroscience and professor of comparative medicine, genetics and psychiatry at Yale, who led the study.

    “And what this tells us is that the demise of cells can be halted. And their functionality restored in multiple vital organs. Even one hour after death,” he told a news briefing.

    https://www.cnn.com/2022/08/03/health/dead-pigs-restore-cellular-function-scn/index.html

  39. David Avatar
    David

    https://www.instagram.com/p/Cgz6E5grkyu/

  40. David Avatar
    David

    Stroke victims ‘getting younger’
    Barbadians are once again being urged to lead healthy lifestyles to reduce the risk of heart diseases and non-communicable diseases (NCDs).
    Medical director of the Cardiac Disease Prevention and Rehabilitation Programme of the Heart and Stroke Foundation of Barbados (HSFB), Dr Dawn Scantlebury made the appeal at yesterday’s HSFB pop-up showcase at the Ann Gill Memorial Methodist Church, Fairfield, St Michael in celebration of World Stroke Day.
    “The age at which that first stroke occurs is getting younger so typically you’ll think of a stroke occurring in someone in their 70s and 80s and now we’re looking at 60s to 70s as the peak age for stroke . . . so the top eight things that you can do to reduce your risk of stroke, is to look at your blood pressure, blood sugar and cholesterol. Stop smoking or don’t start smoking, eat healthily, increase your physical activity and maintain a healthy weight,” she said.
    Her final tip was for people to sleep more because lack of sleep had been proven to be a risk factor for cardiovascular disease.
    Scantlebury, who is also a cardiologist at the Queen Elizabeth Hospital, said heart diseases were the main cause of death worldwide according to the Barbados National Registry for Chronic Non-Communicable Disease.
    “When we speak of cardiovascular disease, we speak of heart disease and blood vessel disease and stroke is a blood vessel disease. So when you look at the world statistics for death- ischemic heart disease, where you have a blocked blood vessel to the heart, it’s the number one cause of death and stroke. So the Heart and Stroke Foundation,
    we are here to raise awareness, educate our community and advocate lifestyles and policies within the country that reduce the burden of cardiovascular disease and reduce the burden on our healthcare system,” she said.
    She expressed concern about the possible fallout from Barbadians neglecting their health during the height of the COVID-19 pandemic.
    “What we saw on the ground at the hospital and in rehab is that patients were fearful of going to the hospital, going to rehab, etc. So I am now fearful of what we will see in the months and years to come as far as the complications of heart attacks and strokes and other NCDs that may not have been as adequately addressed during COVID,” she added.
    Physiotherapist Erica Cooper, who was also a speaker at the event informed about the steps individuals would need to take to regain mobility and resume activities they did before a stroke. She said it was important for the doctors and the physiotherapist to communicate so the patient received the best possible outcome.
    (RT)


    Source: Nation

  41. David Avatar
    David

    How diabetes nearly killed me
    THERE I WAS, a beautiful specimen of the negro race, striding through the airport in Arizona bound for Georgia, then Montego Bay, Jamaica, then home to Barbados. I was in my late 50s and felt like I could still take a rugby tackle. I had a cup of coffee and heard the call that they were ready to board.
    I took my seat in business class, sitting beside a friendly gentleman who said hello, and the plane took off. We had reached 36 000 feet when the air hostess offered those in business class a concoction of orange juice and champagne, which I took.
    I probably had not taken more than two swallows when I felt like I wanted to vomit. I reached for the vomit bag and passed out, vomited and peed myself.
    When next I regained consciousness, I was lying on the floor between the trolleys of the air hostesses and a lady was holding my hand and people were telling her: “Don’t let him bite his tongue.”
    I was fully alert now, and I heard the captain of the plane saying: “Sorry, folks. We have a medical emergency on board and we have to turn back.”
    I felt good now, (the lady holding my hand had an engaging smile) and I said: “It is not necessary to turn back, I am all right now.”
    Of course, the decision to turn back was made and an ambulance met the plane on the tarmac and I was carted off to the nearest hospital.
    Insurance papers
    Being someone who was always in the air travelling, I had on me the necessary insurance credentials for hospital treatment.
    I soon saw the doctor who had his report from the nurses who had attended to me earlier and he greeted me with a smile and these words that I will never forget: “Young man, you are diabetic.”
    Me, in my 50s, diabetic. So the doctor put me on medication.
    I, being a quack doctor, never believed the doctor. I figured that passing out on the plane was due to the constant blows I had sustained on the right of my neck from playing rugby and which were impeding the blood flow, something that had happened before. Not stupid diabetes; that is for old people. After a while I stopped taking the medication.
    Some months later I was at the gate of my home making a phone call when, suddenly, I found that I could not talk.
    Somehow, I managed to get through to my second son, who is a doctor. He immediately called my first son, who is also a doctor.
    The second son was working at the hospital and was told by the other one to get me to the hospital as quickly as possible. By the time I reached the hospital, I was met by a cadre of doctors whom my sons had called, and treatment started.
    Mild stroke
    It got worse. While I was diagnosed as having had a mild stroke, the whole of my right side was numb. My son advised me not to give in to the numbness, but to try to activate whatever part did not seem to be working.
    Therapy ensued and exercises played a great part in rehabilitation. It took almost two years to believe what the doctor in Arizona had told me, an apparently healthy young man.
    At 84 minus one month I still realise that everything on my right side is weaker
    than my left, even my hair. I had to relearn how to play the pan. I do not read music but played by ear. So my apologies to my readers if sometimes there is a screw loose in my articles.
    One of the best things that our Prime Minister can do is pursue the research that Cuba seems to offer in the search for help with diabetes. Most people do not have the resources that were available to me. My sons watch me like hawks. They would like to stretch out the privilege of having me around as long as possible. This is probably because I did not share licks but gave lectures instead.
    Barbados is noted as the amputation capital of the Caribbean.
    Sir Hilary Beckles, in one of his lectures, attributed our susceptibility to diabetes and the fact that normal medications as prescribed for Europeans are not as effective on black people to the salt diet to which the slaves were condemned. You know that the Wild Coot’s mother made pudding and souse for sale for many years during his youth. Pudding and souse was the kind of diet that the slaves in Barbados liked. The present generation still likes the delicacy. They say, “What does not kill does fatten”.
    Harry Russell is a banker. Email quijote70@gmail. com.


    Source: Nation

  42. David Avatar
    David

    Trinidad records first case of Monkeypox virus

    Article by Published on
    July 12, 2023 Source: CMC – Trinidad and Tobago has recorded its first case of the Monkeypox virus with health authorities saying the patient is a middle-aged man with a history of international travel.

    The Ministry of Health said the man had been tested on Tuesday and that the sample was sent to the Caribbean Public Health Agency (CARPHA) for further analysis. The test returned positive.The County Medical Officer of Health has since initiated a public health response including contact tracing as the ministry urged the public to remain vigilant to prevent the spread of the virus.The virus continues to circulate globally, with the World Health Organization’s update as of July 4 reporting 88,144 cases across 112 countries, with 149 deaths. It said the virus can cause illness that ranges from mild to severe and is primarily transmitted through close contact or respiratory droplets.Signs and symptoms include a skin rash or mucosal lesions lasting two-four weeks, accompanied by fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes.The authorities said that anyone with these symptoms must seek immediate medical attention at the nearest health facility, warning also that in order to prevent spread, members of the public must continue to maintain good hygiene practices such as regular hand-washing and sanitisation.

  43. David Avatar
    David

    Rotary launches NCDs project

    THE ROTARY CLUB OF BARBADOS is partnering with five corporate organisations in the fight against non-communicable diseases (NCDs) in Barbados.
    The organisation, in association with Ross University School of Medicine, Sagicor Life, Bayview Hospital, The Emergency Room and RioMed, announced the introduction of “Create Hope NCD Screening and Literacy Project” at a media launch in the Barbados Light & Power Company’s Conference Room on Monday.
    President of the Rotary Club of Barbados, Ermine Darroux-Francis, said the community project was intended to “scaleup communitybased screening, increase advocacy, raise awareness and sensitisation for NCD prevention and control, including childhood obesity”.
    She indicated the club was influenced to embark on the project after examining “alarming” statistics released by the George Alleyne Chronic Disease Research Centre about a year ago, which showed that Barbados recorded “a very high rate of NCDs in the Caribbean region, averaging 10 heart attacks and 14 strokes per week”.
    The programme will see the mobilisation of a medical team visiting select communities over several months and voluntarily conducting screening through blood tests. Screening will, however, not be limited to people in the immediate community, but will also be open to anyone else who wants to take advantage of the opportunity.
    Hospital administrator for Bayview Hospital, Julie Reid, noted the prevalence of NCDs stemmed primarily from unhealthy habits and said many of the associated diseases were often diagnosed in their advanced stages due to limited access to testing within society.
    “Through the use of our health care information system Cellma by RioMed, which is seamlessly integrated with our hospital operations, we will gather essential data as we venture into the communities with our partners to conduct testing and provide general education,” Reid said. She added the goal was not only to quantify the prevalence of NCDs “but also to build a comprehensive, accurate and dependable database of actionable insights, enabling us to identify trends and contribute to a healthier future”. Speaking on behalf of Ross University School of Medicine, Associate Dean of Medical Sciences Dr Rhonda McIntyre said both students and faculty were looking forward to being “fully immersed” in the project, while the vicepresident, Health Group and Creditor Life Insurance, Sagicor Life, Susan Boyea asserted the insurance industry had “a responsibility to be champions of prevention by encouraging policyholders to adopt healthy preventative lifestyles”. Senior medical officer NCDs in the Ministry of Health and Wellness Dr Arthur Phillips commended Rotary’s initiative. He said while the health and economic challenges posed by NCDs were “formidable”, the combination of strengths, resources and expertise through partnerships would help to “effectively” tackle the problem. (GC)

    Source: Nation

  44. David Avatar
    David

    What is there to think about?

    —————————————

    TAX REVIEW
    GOV’T CONSIDERING SLASHING TARIFFS ON HEALTHY FOODS

    By Marlon Madden

    Barbadians could have access to a basket of healthy food options at more affordable prices, although exactly when that will be is uncertain.
    Minister of Energy and Business Development Senator Lisa Cummins disclosed on Wednesday that the Government is working on lowering taxes on healthy foods, and one health advocate has suggested to Barbados TODAY that the price reductions for some of those selections should be in the 20 to 30 per cent range.
    Addressing the opening of the Barbados Childhood Obesity Prevention Coalition (BCOP Coalition) workshop on The Pathway to Octagonal Front of Package Warning Labels on Wednesday at the Accra Beach Resort, Cummins said the time had come for a review of the tax structure on healthy foods.
    Declaring that the Government had a responsibility to incentivise residents to make better food choices, she said her ministry was committed to following through on recommendations from recent research that authorities “look at the cost structure, by way of taxes, for healthier items versus those things that were unhealthy”.
    “We are committed to also working with you to see what that healthy basket of goods looks like. We are committed to seeing with you how I could pay less for healthier items upfront as opposed to paying a surcharge for if I want to eat brown rice versus white rice, if I want to be able to eat things that are lean versus things that are cheap ,” said Cummins.
    In 2022, the Heart and Stroke Foundation of Barbados (HSFB) commissioned the study, led by Deputy Principal of the UWI, Cave Hill Campus Professor Winston Moore and Lecturer Dr Antonio Alleyne , to examine whether food prices were prohibitive to healthy eating and to recommend a policy approach to making healthy foods more affordable.
    It pointed to the high tariffs attached to food imports such as fresh vegetables and fruits, compared to the low taxes placed on items high in salt, sugar and fat, including cookies, ice cream and chips.
    It also illustrated that unhealthy foods, on average, carry an import tariff of 35 per cent, while healthy foods are taxed at around 45 per cent, and proposed that the Government flip the tax rates.
    Cummins did not commit to a timeline for completion of the tax review but she told the workshop participants that the Government was now considering the matter and that collaboration among stakeholders would be required.
    “We have to be able to make it affordable for people to eat healthy food. That is also an important part of the conversation. It is fine to label it, it is fine to say it is high in salt. Things like [packaged noodle soup], for example, which are incredibly popular are very high in salt, but they are inexpensive and easily accessible. We also have to make things which are healthier just as accessible, as we do things which are filling but are also going to result in cost a little later by way of the health system,” she explained.
    “So let us work together on that balancing act and also incentivising, in the first instance, people and consumers, to purchase healthier choices, not just by front of package labelling but by looking at the tax structure that is attached to those healthy products.”
    The proposal was immediately welcomed by health advocates who said they were willing to work with the Government in achieving lower prices on healthy food options.
    “The common complaint is that healthy eating is very expensive. Therefore, we will be working together and advising on the healthy basket of goods and I have a good feeling about this healthy basket of goods,” said lead policy champion with the HSFB and the BCOP Coalition Professor Anne St John.
    Chairman of the National Commission on Non-Communicable Diseases (NCNCD) and former BCOP Coalition chairman Suleiman Bulbulia expressed similar sentiments.
    “Whenever we promote a healthier lifestyle and healthier living, the complaint is that it is expensive to eat healthier. So review of a basket of goods that are considered healthy products, bringing the taxes down, will definitely go a long way in appeasing that concern,” he said.
    Bulbulia told Barbados TODAY he would recommend that officials look at a reduction of between 20 to 30 per cent on the basket of healthy food options.
    “Obviously we will have to work from product to product, but bringing down the cost by 20 to 30 per cent in some cases is going to be important for the consumer. But, of course, there is no fixed amount because it depends on the product,” he said.
    The NCNCD chairman added that the reduction in prices on healthier food products “is important for us because that reduces the opportunity for NCD because you are eating healthier and that helps in the battle against and prevention of NCDs”.
    (Please also see Page 6) marlonmadden@barbadostoday.bb

  45. David Avatar
    David

    Time for audit of health care services

    This article was written and submitted by Dr Colin V. Alert, who is a family physician.

    Is our health care any good? Is it horribly bad? The answer depends on your vantage point, and what parameters you use to evaluate the health care.

    In the ‘good old days’, at least up to the year 2012, the Chief Medical Officer (CMO) produced and released a CMO’s Annual (Health) report, which gave some statistical data on the happenings in Barbados, specifically what is happening in the public health services. This CMO annual report suddenly ceased after 2012.

    Fortunately, organisations such as the Barbados National Registry for Chronic Diseases and Cancers have released some local data on the NCDs and cancers to the general public, but overall data on the performance of our national health institutions has not been made available to the general public.

    While the Queen Elizabeth Hospital (QEH) is in the news very often, little formal evaluation of the hospital on a whole, or of any of its many departments, has been released to be public, so hospital services, essential as they may be, are hard to evaluate.

    We had reasons to be optimistic about transparency in the QEH services when, at the turn of the century, the Government appointed a Commission chaired by Sir Richard Haynes to evaluate some of the services at the QEH, in particular the Accident and Emergency (A& E) Department. This commission, for example, enumerated the number of staff in the department, the number of patients who passed through the department, and the average waiting time the patients experienced.

    It was hoped that this data would help to rationalise, and subsequently improve, the services offered. But this model seems to have been abandoned.

    Many millions of dollars have been spent, facilities have been expanded, staff numbers have been increased, yet the actual service and waiting times has worsened.

    Can’t be analysed

    The hard data has not been offered outside of the Ministry of Health (and Wellness), so the increased spending cannot be analysed. Are cost-effective decisions being made, are millions of dollars being wasted, or is there any effort to evaluate the spending?

    It also means that we cannot discern the direction in which our health is headed.

    This is occurring at a period in time when the Ministry of Health and Wellness has earmarked the introduction of electronic health records (EHRs) in the polyclinics and the QEH, from around 2012. In theory this should mean access to real time data on our health situation should be easily and readily available, with the click of a mouse. In practice, this is not the case.

    But COVID-19 is not the only new issue that has arisen in recent years. In 2016, for example, the then Minister of Finance introduced the Sweetened Beverage Tax, a tax primarily on sodas designed to reduce their consumption, fearful of the relationship between these sweetened beverages and Type 2 diabetes mellitus. There has been different views as to whether this tax was/is effective, with the soft drink manufacturers claiming that the measure has had limited effect on their sales, some health professionals saying that the tax is working, and some health personnel calling for even higher level of taxation.

    Many callers to our radio stations have, over many years, spoken of problems assessing care in both our polyclinics and the A& E Department.

    This has been occurring in spite of enlarging the A& E Department, and increasing the emergency access times at some polyclinics. Meanwhile, in the private health care sector, there has been an explosion in the number of emergency clinics. To date, there is no evidence that focusing on emergencies, as opposed to ongoing care, leads to improved health outcomes, here or anywhere else.

    What doesn’t help build confidence is the untimely and often indefinite) cancellation of appointments in the public system, leaving patients without critical medications, appointments and sometimes operation dates, with no clear-cut idea of if/when these untenable situations would be satisfactorily resolved.

    In the CMO’s report of 2006, it was noted by the bed occupancy on the medical wards at the QEH was 120 per cent. In early 2021, the CEO of the QEH noted that the bed occupancy on these same wards was 200 per cent. So that there is chronic (and increasing) overcrowding of the medical wards in our main tertiary hospital, the QEH. There has been some public conversation on the need for a new general hospital, but perhaps the conversation should also include increasing our efforts at ‘Health Promotion and Disease Prevention’, specifically when the NCDs are amendable to this type of intervention. This conversation should include improving our primary care services, that is, the polyclinics, to reduce the load on the QEH.

    No formal analysis of our polyclinic services has been offered, yet they can serve as important gatekeepers for our national health care services. Outside of the hospital, our appetite for fast foods and sweetened beverages, coupled with our disdain for regular exercise, is fuelling our rising obesity prevalence. Once obesity develops, this generates heart attacks, strokes, kidney failure and a variety of cancers, and these fill up the QEH.

    There are even associations between obesity and a variety of mental disorders. So should we fatten up our people, and build bigger hospitals, or focus on preventing obesity by promoting better diet and exercise habits?

    When compared with the UK and Canada, for example, our hypertension death rate is many times higher.

    This was also true two decades ago, when Sir George Alleyne, then Director of the Pan American Health Organisation (PAHO), pointed this out to Caribbean Heads of Government, and was perhaps a factor that led to the ‘historic and unprecedented’ 2007 conference in Port Of Spain, Trinidad: “Uniting to stop the epidemic of Chronic NCDs”. Caribbean Heads of Government and Ministers of Health agreed on a series of mandates at this conference, and reflected on commitments to action in key areas.

    So the perspective, at least back in 2007, was that Caribbean health care was bad, and required a bold initiative by Caribbean leaders to ‘turn the ship around’. More than two decades later there has been microscopic progress in fulfilling these commitments, and many subscribe to the view that the health care ‘ship is sinking’.

    How come our hypertension death rates are so bad, when individuals here have free access to medical care and free access to a variety of anti-hypertensive (and other chronic disease) treatment medications?

    Our Barbados Drug Service spends millions of dollars in purchasing these drugs. We have great weather yearround to encourage physical activity, an important part of health promotion. Feeling all-right may not be the same as being all-right, but far too many persons only respond to an ‘accident or emergency’, thus creating the backlog at the A& E Department. In far too many cases this response is ‘too little too late’.

    Health spending rising

    When one looks at the trend in Barbados’ population growth and recurrent health spending over the last 40 years, one can see that the health spending is rising much faster than the population growth. When one compares 1980 and 2020, for example, while the population growth has been approximately 27 per cent, the rise in recurrent health spending has been 837 per cent. This is largely due to major rises in health care costs in the intervening period. But over the years there have been many observations that our present model of health care financing may not be sustainable, and both of our major political parties have held town hall meetings on health sector finances reform, with “NATO – No action, talk only” being the end result.

    The figures for health spending in the private sector, including spending by medical insurance companies, are not readily available. However, available evidence suggests that many people are unwilling, and some unable, to afford private medical care.

    The disease profile also suggests that many people don’t realise that an ounce (or gram) of prevention is better, and far cheaper than a pound (or kilogram) of cure. Some effort, and significant monies, are being spent treating established disease, while efforts at disease prevention are more likely to be successful.

    With a few local clinical audits done over the years consistently showing deficits in our primary care services, albeit with limited involvement of our private primary care services, perhaps it is time for a a forensic audit of these services, but only if followed by a meaningful intervention. This audit has to look into whether our health care workers have adequate and appropriate training, resources and supervision, to face the challenges of the NCDs and the tsunami of infectious diseases projected to target the world in the next few years.


    Source: Nation

  46. David Avatar
    David

    Medicine hub

    Collins’ Trinidadian owners aim to export throughout region

    A TRINIDAD AND TOBAGO business group is planning to use Barbados as a major manufacturing hub to increase the export of pharmaceuticals throughout the region.

    Agostini’s Limited has outlined the plan one year after its more than $60 million acquisition of Barbados’ largest and oldest pharmaceutical and health care group, Collins, which includes Carlisle Laboratories – “the largest manufacturer of medications in the Englishspeaking Caribbean”.

    Agostini’s chairman Christian Mouttet reported: “The strategic acquisition of Collins and Carlisle Laboratories has yielded significant sales and profit for the ten months postacquisition, with Collins streamlining operations for enhanced customer fulfilment and Carlisle boosting manufacturing reliability to meet strong regional demand.”

    The group acquired Collins Ltd, Carlisle Laboratories Ltd, Coem Ltd and Lambou Investments Ltd (Collins Group) via the purchase of 100 per cent of the issued and outstanding shares of the companies on December 1, 2022.

    Established in 1888, Collins Ltd is a pharmaceutical and personal care distribution company. Its subsidiary Carlisle Laboratories Ltd is a pharmaceutical manufacturer.

    As detailed in its 2023 annual report, Carlisle Laboratories will be seeking to increase the production of pharmaceutical products for sale here and overseas, in what Agostini’s is calling “a new era in Caribbean pharmaceutical manufacturing”.

    “The plant, situated in Warrens, Barbados, is a world-class facility which was designed to international specifications and adheres to global Good Manufacturing Practices (GMP) standards. More than a badge of honour, it is an assurance to consumers and clients around the region that the products manufactured in Barbados can meet the highest quality benchmarks,” Agostini’s stated.

    “All our products are rigorously tested and meet either the United States Pharmacopeia or British Pharmacopeia standards.”

    The group said pharmaceuticals produced in Barbados were found on shelves and in public institutions around the region, being exported to 20 markets – from The Bahamas to Suriname.

    “That regional reach and export infrastructure of Carlisle provides the platform for our pharmaceutical distribution business too, akin to the opportunities that [Agostini’s subsidiary] Vemco’s manufactured product export business created for other brands in that company.

    “The potential for expansion is significant. Already the largest manufacturer of medications in the English-speaking Caribbean, our plant has the potential to significantly increase its throughput. Our staff complement of 70 GMP-trained pharmacists, engineers, laboratory technicians, line workers and, indeed, all our staff are excited by the growth potential of the business,” it added.

    Agostini’s officials said they were excited about the prospects for increased pharmaceutical production in Barbados “because we know that by growing our manufacturing base within the region, we contribute not only to economic diversification, but to the sustainability of supply and a certain self-sufficiency with respect to the availability of medications”.

    Regarding Collins Ltd, the business was restructured “to be fully focused on pharmaceutical and personal care products”.

    “To this end, we transferred the consumer products such as beverages and food products to Hanschell Inniss, part of our Caribbean Distribution Partners group [with Goddard Enterprises Ltd].,” Agostini’s said. (SC)

    Source: Nation

  47. David Avatar
    David

    Double blow of NCDs and climate change

    In the last few years, global warming and climate change have joined the lists of threats to our health and well-being.

    This article was written and submitted by Dr Colin V. Alert, a family physician.

    If you were born between 1870 and 1940s, the so called “infectious diseases era”, you were likely to be infected by many germs, generally bacteria but sometimes viruses, and your survival options included disinfection, quarantine, and mass vaccinations.

    If you were born after the 1940s, you came into the world in the chronic diseases era, which persists even to today.

    The germs gave way to risk factors such as poor diet, sleep and exercise habits, and the intake of toxic substances like nicotine and alcohol.

    These risk factors serve to identify targets for preventing epidemics of non-contagious chronic diseases like cancers and atherosclerotic disorders, and their main complications (and our leading causes of sickness and death) like heart disease and strokes.

    We have been living (and dying) through the chronic non-communicable diseases (CNCDs) pandemic, characterised by diseases such as obesity, diabetes, hypertension, and dyslipidemias (including high cholesterol).

    Mental health

    While mental health issues and cancers, and even the respiratory illness asthma, fit the CNCD inclusion criteria, inclusion of these conditions as a CNCD is erratic.

    Nonetheless, these illnesses account for around 75 per cent of our annual deaths.

    These conditions are correctly described as preventable, as careful attention to our eating, exercise and sleeping habits, avoidance of smoking and illicit drugs like marijuana and cocaine, using alcohol in moderation (if at all), getting regular preventive checkups and cancer screening for breast, colon, uterine and prostate cancers, are important steps to be taken if these conditions are to be prevented.

    Prevention, rehabilitation

    The Heart and Stroke Foundation of Barbados, through its Childhood Obesity Prevention programme, and the Cardiac Disease Prevention and Rehabilitation programme, offer preventive health programmes for individuals.

    We need more people to get into these programmes, and we need more of these types of programmes.

    Unfortunately, these CNCDs fill our hospitals and cemeteries, and place tremendous and increasing stress on our limited medical and financial resources. The last 50 or so years have seen an expansion of these conditions, but as populations we have not been able to modify our lifestyles sufficiently to maintain good health.

    In the last few years, global warming and climate change have joined the lists of threats to our health and well-being.

    Climate change means more frequent and intense drought periods, severe storms including more hurricanes, heat waves, rising sea levels, which are occurring both with increasing frequency and are of increasing severity, and wreak havoc on people’s livelihood and lives.

    Sometimes this change can occur naturally, such as changes in the sun’s activity, or large volcanic eruptions.

    The weather phenomena El Nino is also a contributor to the changed weather patterns.

    However, human activity is the main driver of climate change; an urgent change in behaviour is critical for human survival.

    Globally, 2023 was the hottest year ever. Global average air temperatures began exceeding 1.5 °C of warming on an almost daily basis in the second half of the year. With this 1.5 °C rise in temperature, we’ve seen floods, droughts, heat waves and wildfires, and we’re starting to see less agricultural productivity and some problems with water quality and quantity.

    At the UN Climate Change Conference, COP28, last year, countries agreed for the first time on the need to tackle the main cause of rising temperatures: fossil fuels. But we need to convert talk into action, before it is too late. And we need all hands on deck.

    We need to plan for water and food scarcities, to build more resilient communities, and in the short term we need to change behaviours that in the long term will reduce our carbon production.

    Changing our main energy sources to clean and renewable energy is the best way to stop global warming.

    These include technologies like solar, wind, and geothermal power.

    But even while the CNCD pandemic was the dominant medical force affecting our national health, the infectious diseases haven’t completely disappeared. As we speak, acute dengue fever is affecting large numbers in people in many Caribbean islands and in South America.

    Pandemic

    We are coming off a corona pandemic. Before that, Chikungunya and Zika raced up and down the Caribbean. And HIV/AIDS has been around so long that it is sometimes considered a chronic disease.

    Meanwhile, diseases like influenza and Respiratory Syncytial Virus (RSV) float around in the background, causing a number of coughs and colds and disrupting workplace productivity. We are seeing the convergence of global warming with both the noncommunicable pandemic and the infectious disease pandemic, and this convergence is projected to bring even more health challenges. Our health services need to evolve in anticipation of three simultaneous pandemics.

    The time to act is now.

    Source: Nation

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