Ebola: Signs & Symptoms

High-Risk HPV: Cancer of Penis

By: Roslyn A. Douglas, M.A., Founder of Central Health - Grenada

In recent months there was a huge campaign in Grenada to raise the awareness of cervical cancer among women, however the commonest cause of this disease, High-risk human papilloma virus (HPV), can also cause cancer of the penis.  Due to this fact, men need to be aware that they too are at risk of developing cancer from this sexually transmitted infection.

Dr. Francis Martin, who holds the position of Senior Medical Officer and Director of Primary Health Care within the Ministry of Health wants residents of Grenada, Carriacou and Petite Martinique to start taking this health concern seriously, “HPV is a very serious infection.  It is very common.  It is the main culprit for sexually transmitted infections and for cervical cancer.  And not just cervical cancer, but we have seen men with cancer of the penis as a result of HPV.  I personally have managed men with cancers of the penis as a result of HPV.  So again, the implications are far reaching and the population should take serious note of it and its consequences it can have on our population.”

Photo Source: WikiHow.com

The American Cancer Association (ACA) states on their website that high-risk HPV strains numbers 16, 18 and 31 have been linked to cancer of the penis, vagina, vulva, and cervix. Low-risk HPV strains numbers 6 and 11 cause the growth of warts on the genitalia of both men and women.  Their website went on to say that, “In most people, the body is able to clear the infection on its own. In some, however, the infection does not go away and becomes chronic. Chronic infection, especially with high-risk HPV types, can eventually cause certain cancers, including penile cancer. Men who are not circumcised are more likely to get and stay infected with HPV.”

Statistically, women are diagnosed with reproductive cancers at higher rates than men, and according to Dr. Amy Baldwin, Associate Professor at St. George’s University in the Department of Microbiology - School of Medicine, this adds to the misconception that men have nothing to worry about when it comes to HPV, “A lot of misconceptions going around about any number of viruses especially things that are sexually transmitted, but one main [misconception] is that men seem like they really don’t have to worry about much with sexually transmitted infections. And this goes to the very realistic fact that women get the crappy end of the deal on a number of things in life and one of those is the brunt of sexually transmitted infections. And so you have men having a less number of cancers that will result, less number of symptoms et cetera, and so there becomes a misconception that it’s not a problem for them. Or maybe even they think that they don’t even get infected with the virus and there is a lot of danger in that because it is a sexually transmitted infection. [Men] in fact do get infected and then they transmit the infection to others when they have sex."

If abnormal cells on a man’s penis are found early it can often be treated and/or removed with minimal damage. However, according to the ACA because some men avoid going to the doctor for abnormalities on their penises over time things can get worse, “If a cancer is found early, it can often be removed with little or no damage to the penis. If it is not diagnosed until later, part of or all of the penis may need to be removed to treat the cancer. It is also more likely to require other, more invasive treatments, and may even be life threatening.”

All sexually active men, especially uncircumcised men, should see their doctor immediately if they notice any of the following things on their penises, whether or not pain is involved:  any abnormality, blisters, sores, ulcers, and/or white patches. 

Help Your Pharmacist, Help You

By: Roslyn A. Douglas, Founder of Central Health - Grenada

It is very important that a person who is on a medication regiment to control a chronic illness, such as diabetes, have a good relationship with their pharmacist.  This was the general sentiment expressed during a recent public forum organized by the Grenada Pharmacies Association and the Caribbean Association of Pharmacists, in conjunction with the Grenada Diabetes Association.

The event which was held on August 19, 2014 at the Public Workers Union in Tanteen, St. George’s, was part of the Caribbean Association of Pharmacists annual convention outreach health education targeting patients with chronic non communicable diseases.

Local Grenadian pharmacist Brian James served as moderator for the lively forum which included distinguished health care professionals and health leaders such as Dr. Alister Antoine  - Vice President of the Grenada Diabetes Association(GDA); Lydia Duncan – President of the Grenada Association of Pharmacist;  Dr. Francis Martin – Director of Primary Health Care of the Ministry of Health; Yvonne Read – President of the Caribbean Association of Pharmacists (CAP); and Endocrinologist Dr. Sebastian Peter.  Testimonies from two male diabetics Alexander Smith and Francis Balwant, who serves as Treasurer for the GDA, added a human touch to the discussion as they shared their journey of how they got diagnosed with diabetes and how they manage their glucose (sugar) levels daily with medication and/or insulin.

According to the President of CAP Yvonne Read, the forum birthed out of a desire to have an outreach activity into the communities, “About three of four years or so ago, public education activity became a focus of our convention, because we felt it was important to have an outreach in the communities where the local pharmacists can reach the community. And, also to show trends of what the profession can do when others from other parts of the Caribbean come together to collaborate.”

In keeping with the goal of the public forum/community outreach lead by pharmacists, the real meat of the forum came from an interactive presentation lead by Barbadian Pharmacists Cherylann Yearwood.  She gave some practical advice to the diabetics present on how they can have a good working relationship with their pharmacists and the importance of that partnership. “The pharmacist helps you by filling your prescription; by giving you information on your medication; by liaising with your physician about your medication - about how often you have been taking it.”  Yearwood went on to say that the pharmacists is available to thoroughly explain to patients how their medicines should be taken.  For example, information provided may include but not limited to clarifying if the tablet needs to be taken with or without food, during a meal or directly after a meal and side effects. 

Yearwood posited that many times for various reasons patients switch doctors and do not share with their new doctor the medicine regiment that they are currently on.  This is why according to Yearwood all attendees who are on a pill regiment need to keep track of the names of the medication; the number of times it must be taken a day; how it must be taken, and share that information will the new doctor and any other specialist seen.  Failure to do so can lead to many problems such as over-dosage.  If the new doctor, for example, gives the patient the exact same medication the previous doctor prescribed and unbeknownst to the patient the brand name may be different and the patient takes both pills – this could lead to serious consequences.  “This is why it is important that you see one pharmacist. Visit one pharmacist for all your medication, so that they can have a database of information on your medication.  They can have your medication history,” said Yearwood. 

In part of her closing remarks Yearwood gave advice on what patients can do to help their pharmacists effectively do their job, “You can learn about your medication. You [should] know what you are taking.  Don’t go to the pharmacists and tell them, “I take the big white tablet.””

The theme for this year’s convention was, “Shaping Our Profession With One Mission and One Voice.”  Over 100 delegates from the Caribbean, the Unites States, Canada, Latin, North and South America attended the conference which included networking opportunities, and continuing education lectures. 

Passing of Dominic Paul Acknowledged

By: Roslyn A. Douglas, Founder of Central Health - Grenada

Late Dominic Paul
Founder/Director of Spice Isle Imaging Centre

Dominic Paul, the Founder and Director of Spice Isle Imaging Centre died on Tuesday August 12, 2014.  

Mr. Paul must be recognized as a progressive thinker and responsible for making advance medical screening services  available to Grenadians while at the same time leading a staff to provide superior customer service.

As Founder of Central Health - Grenada, I met with Mr. Paul as recent as a week before his death in his office.  He was gracious to support the End Cervical Campaign and made Spice Isle Imaging Centre one of ports for interested persons to fill out the petition form. 

During our weekly impromptu meetings, when I swung by his office for completed forms, he proudly introduced me to his sons - who at the time were having lunch in his office. Its a beautiful thing to witness a father's eyes light up when his offspring are surrounding him.  

We had plans to work together on a radio project that focused on diabetes and hypertension, after Carnival. 

I will always remember Mr. Paul for being gracious, a progressive thinker and a man with a very open mind to improving health care in Grenada.  

Condolences are extended to his immediate family, close friends and the staff at Spice Isle Imaging Centre.

Conception Toastmasters Welcomes Central Health - Grenada

On Thursday July 10, 2014 Conception Toastmasters provided Central Health - Grenada the opportunity to promote the End Cervical Cancer Now Campaign at its monthly meeting.  Seven members signed up via hard copy.  Every signature counts.  

For more information go to www.endcervicalcancernow.org

CH-G Promoting Cervical Cancer Campaign @ Body Image

On Monday July 7, 2014, Body Image graciously allowed Central Health - Grenada to give a presentation at their Move Ur Mass event held at Excel Plaza in Grand Anse, St. George's.

35 individuals, mainly women, participated in the campaign by adding their signature to demand more affordable access to cervical cancer screenings in the Caribbean and Latin America.


To Learn More Go To:  www.endcervicalcancernow.org

Central Health - Grenada & Grenada Cancer Society Working Together

St. George's, Grenada - June 30, 2014 - L-R - Roslyn A. Douglas, MA, Founder of Central Health - Grenada and Dr. Barrymore Mc Barnette, President of Grenada Cancer Society.

The Grenada Cancer Society (GCS) has joined forces with Central Health - Grenada (CH-G) for the promotion of the Healthy Caribbean Coalition's Caribbean Cervical Cancer Electronic Petition Campaign. 

CH-G which began efforts at the beginning of June is now being financially supported by GCS until October 1, 2014 to continue with the local awareness campaign in businesses, schools and institutions dominated by women.

To learn more residents of Grenada, Carriacou and Petite Martinique are encouraged to visit
http://www.endcervicalcancernow.org/ to learn more and support the campaign.

Riveting Discussion: Child Sexual Abuse As A Public Health Issue

By: Roslyn A. Douglas, MA - Founder of Central Health - Grenada

On Friday May 9, 2014 a panel discussion on the topic, “Talking About It:  Child Sexual Abuse As A Public Health Issue,” was held at the Brooks-Smith Lowe Institute. The purpose of the discussion was to merge the correlation between child sexual abuse and its impact on public health as it relates to the rise in chronic non-communicable diseases, psychoneuroimmunological irregularities and psychological impact. 

The panel, seen in order of appearance in the photo, consisted of St. George’s University’s (SGU) Inaugural Dame Hilda Byno Writer in Residence, Lisa Allen-Agostini; Fatima Friday, Med., a St. George’s University Public Health Lecturer with a special interest in psychoneuroimmunology; Dr. Kecia Lowe, Board Certified Internist and Pediatrician who was recently inducted into the American College of Medicine as a Fellow;  and Malaika Brooks-Smith-Lowe, Founder and Co-Director of Groundation Grenada who served as moderator for the panel discussion and also organized the event. 

SGU’s Writer in Residence Allen-Agostini a journalist from Trinidad and Tobago read an excerpt from her work in progress book, which details the journey of a young girl who became a victim of sexual abuse at the hands of her uncle.  The pages Allen-Agostini read from graphically detailed the hostile home which the child lived in with her mother.  The rapist was visiting.  

The excerpt described a gut wrenching account of a physical and verbal abuse attack endured by the child from her rough and heavy handed mother.  The reason for the beating appeared inconsequential.  It then moved to the first gruesome sexual attack, which occurred after the child’s mother left the house shortly after the excessive beating. A beating that was cut short after pleads of mercy from the visiting uncle.  This particular uncle was the child’s mother’s brother.

Allen-Agostini’s continued to walk the listeners through the manipulative process of the perpetrator.Through her storytelling she showed how the little girl’s uncle used a counter strategy of gentleness and comforting voice tones to sooth the distraught child.  After gaining more and more trust with his apparent friendliness and gentle touches, he slowing and calculatingly began threatening her into submission. After the horrific sexual attack the writer revealed the child’s dichotomy. The child never told her mother of the attack because she was deathly afraid of the physical consequences, to the point it did not occur to her to say anything, while at the same time was intimidated and petrified of her uncle.  The snippet of Allen-Agostini’s work also revealed that the child’s mother noticed the bruises after returning from shopping, but casted a blind eye.  She instead gave her daughter a doll, a gift from the uncle who earlier forcefully covered her mouth to muffle her screams.

After the reading, the program then shifted into a vibrant discussion about how society tends to ignore the ramifications and repercussions of sexual abuse on an individual and its impact on public health in terms of rises in illnesses.  Panelist - Dr. Lowe, listed out some of the unhealthy coping behaviors individuals who suffered this trauma tend to participate in, “Cigarette smoking, obesity, inactivity, alcoholism, drug abuse, depression, suicide, [and] sexual promiscuity.”  Dr. Lowe went on to say, “These people have a higher risk of diabetes, liver disease, cancers, and stroke and general poor health in adulthood.  And that alone can tell you it is definitely a public health issue because these people manifest these chronic non-communicable diseases at higher rates. And this adversely affects all societies.”  

Allen-Agostini who stated that many of her past journalistic articles focused on children and gender issues, introduced the audience to a campaign called,  "Break the Silence."  This initiative is a mulit-pronged approach to protect children against sexual abuse.  One of its aims is to reach victims and their families with a message to speak out and denounce sexual violence against children.  The initiative seeks to engage and encourage influential groups and members of society such as policy makers, health workers, and police authorities to create and/or improve support and care for victims. According to the World Health Organization, “Globally, at least 150 million girls and 73 million boys under 18 years had experienced forced sexual intercourse or other forms of sexual violence involving physical contact.  In several Caribbean countries the first sexual experience of young girls is often, forced; studies have shown that this was the case for 42.8% of girls below age 12.” 

From a psychoneuroimmunological perspective, a field of study that examines the interaction between psychological processes and the nervous and immune systems of the human body, panelist Fatima Friday stated that trauma occurring at a young age can have adverse effects on the developmental process of the human brain causing overdevelopment of the area of the brain that analyzes stress and fear.  This can lead to post-traumatic stress. However, Ms. Friday views child sexual abuse more broadly, “It’s not just a public health issue, it’s an issue of humanity.” She went on to say, “ You can look at your mother’s life, your father’s life to see different connectivity points and ask – how has the way I have been trained by my parents, by my siblings affect the way I treat myself and treat others.  Because that is public health.  How we engage with each other, how we interact is public health as well.”

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GRENADA---- SIGN THE E-PETITION TO END CERVICAL CANCER

http://www.endcervicalcancernow.org/

 

Men’s Health – A Priority For Ministry of Health

By: Roslyn A. Douglas, Founder of Central Health - Grenada

Statistics released by the Ministry of Health indicate that Grenadian men are dying more than women in many chronic illnesses such as cancer, heart disease and diabetes. As such men’s health has become a major concern and a priority for the Ministry of Health.  Efforts ranging from evaluating surveys, conducting training sessions for healthcare professionals and community focused health education sessions, began last year with plans to continue throughout 2014.

Ministry of Health's Director, Primary Health Care - Dr. Francis Martin

Director of Primary Health Care, Dr. Francis Martin summarized an analysis of the causes of death in Grenada over a 10 year period, which revealed men are dying more than women in many of the chronic illnesses, “We have looked at the data, the mortality data over the past 10 years and put those data together in one graph. And what those data together in one graph shows is that [out of] the 10 leading causes of death in Grenada – the most in terms of share quantity is cancers.  Cancers are the leading cause of death in Grenada and on the heels of that is cerebrovascular diseases.  So you are talking about strokes, heart attacks and what have you. Pulmonary disease is next and metabolic disease, which is like complications of diabetes comes in fourth.”    

Although cancers are the number one cause of death in the 1o year analysis, overall Grenadian men are dying more than women in many of the other diseases, “So the cancers, the cardiovascular diseases like strokes and heart attack and so on and the diabetes and respiratory problem are leading at the top. And of those leading at the top men are actually leading ladies in those as well, except in the case of some metabolic diseases that has to do with ovarian issues, hormonal issues, and thyroid issues,” said Dr. Martin.

To determine the cause of the number of male deaths, the Ministry of Heath reviewed surveys and studies conducted on men regarding their health. The results showed that lack of accessibility, concerns about confidentiality and lack of targeted education were reasons why some men do not seek a health care, “One of the things men said was, because the health centres only open for a certain amount of hours during the day, the time at which they are at work, they are not able to access care. And so what we have done in terms of the Primary Health Care, one of the first things we did was to extend the opening hours of the major health centers, and so men now can access care after 4 pm. Since the extended hours were implemented, feedback shows that the health centers are being utilized more in the evening than in the day; which is wonderful news. If this is a sign of what’s to come, then this is an exciting time for Primary Health Care in our country,” said the Director of Primary Health Care.

Another indicator that surfaced as a reason why men appear apathetic towards their health is lack of education.  “The second thing that men indicated was they felt as though the main thrust of the health care programs were not put together and directed towards men.  It was more so towards women and children,” said Dr. Martin.  He went onto say that over the past few decades, health systems in the Eastern Caribbean and other parts of the world’s focus on women and children.  These efforts have resulted in reducing maternal and mortality rates, however at the same time focus on men has fallen behind.  “So because of that, one of the pillars of our Primary Health Care program is what we called community outreach where we can focus on vulnerable groups.  We have already started one of those is called the Men’s Health Outreach.  We actually advertise [and] mobilize some men for one afternoon and we go out and do screenings for them - blood pressure, blood sugar, blood testing for prostate and all sorts of things.” He enthusiastically added, “So in the next few months and certainly within the next few years to my mind that is the kind of strategic position we will be taking. Trying to find the vulnerable groups and putting together programs specifically for those groups.” 

Although there are a number of health clinics around the island, in a separate interview, Permanent Secretary for the Ministry of Health Aaron Francois stated another reason why men do not seek medical assistance is due to concern about breach in confidentiality.  “What we found out is that in a lot of the cases, men are very reluctant to attend or to visit health practitioners.  Whether it is a medical centre, or a doctor.  Men tend to wait very late, when their situation becomes desperate, to visit the doctor.”  PS Francois went on to say in extreme cases some men chose to go to a clinic that is not even within their own community, “You would find assuming a man goes to one of our centres and based on the situation, based on what the complaint is – he would not want the issue to be divulged to the wider community.  So you would find that a man would leave his centre - local, and go to another centre for attendance.”  To address this issue PS Francois said that the Ministry of Health has communicated this concern to practitioners with the intent to make the environment more comfortable for men.