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. 

2 of 4 - Men's Health: By Central Health - Grenada (Colon Cancer)

Central Health - Grenada has produced a four part series on Men's Health.  This episode focuses on colon cancer.

Did you know the number one cause of death in Grenada is cancer?

Statistics released by the Ministry of Health show that men are dying more than women in many of the chronic non-communicable diseases in Grenada and at alarming rates. Central Health - Grenada's Men's Health series seeks to educate men about the importance of screening.


Colon cancer is on the rise in Grenada. Have you ever heard about a colonoscopy? This examination could save your life. Learn about it now.  To tune in - click here!

Cervical Cancer Is On the Rise In The Caribbean

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

According to Professor Sir Trevor Hassell President of the Healthy Caribbean Coalition (HCC) approximately six deaths per day in the Caribbean are caused by cervical cancer, and efforts are on the way to raise awareness.

Infection with high-risk human papilloma virus (HPV) is the main cause of cervical cancer. It is also the most common sexually transmitted infection (STI) globally. Low-risk classification of HPV generally can lead to benign lesions such as warts.  Similar to other STIs, high risk HPV is transmitted via unprotected oral, vaginal and anal sex, and can lead to cancers of the vulva, vagina, penis, or anus.  According to the Centers for Disease Control and Prevention HPV is so common that nearly all sexually active men and women get it at some point in their lives, “There are many different types of HPV. Some types can cause health problems including genital warts and cancers. But there are vaccines that can stop these health problems from happening.”

 

The President of HCC and its Manager - Maisha Hutton, recently travelled to Grenada and several other islands of the Caribbean, to speak with NGOs and Government officials to share their vision of reducing the number of deaths and disability from cervical cancer by promoting the Cervical Cancer Electronic Petition. “Once the petition is finished we are going to take the petition’s findings and take them to the heads of government. Because this petition really asks heads of government across the Caribbean to use the powers that they have to ensure that every woman in their territories has access to cervical cancer screening,” said Maisha Hutton.  HCC’s target goal for E-signatures is 50,000.  They are currently at approximately 9, 000. By press time just over 100 signatures have been received from Grenada. The Cayman Islands has shown the highest support with over 2000 signatures.

“Cervical cancer is the second commonest cause of cancer deaths among women.  That’s a very important thing to appreciate.  In fact annually over two thousand women in the Caribbean die from cervical cancer. That averages out I think about 6 deaths per day, from cervical cancer, throughout the Caribbean.  And the thing about it is that cervical cancer for the most part is preventable,” said Sir Hassell.  

Researchers from St. George's University, Department of Microbiology will present preliminary findings of a recently conducted study on cervical cancer in Grenada at the annual American Association for Cancer Research (AACR) conference in San Diego, CA, USA, April 5th-9th. Their research involved an in-depth analysis on cervical cancer and its associated mortality in Grenada from 2000-2010 and has revealed a higher mortality associated with cervical cancer than the current WHO estimates for the region. The study results are being prepared for publication at this time.

Two virgins having sex (oral and vaginally) with each other is the only guaranteed protection from high-risk HPV and any other STI. However as most individuals have had or will have more than one sexual experience, the usage of condoms and vaccinations given to virgin boys and girls can reduce the risk of infection. It however must be noted that these vaccines do not protect recipients from all HPV strains, only types 6, 11, 16, and 18, and condoms do not provide 100% protection from any STIs or pregnancy – they simply lower the risk considerably. Additionally, a person can obtain HPV from oral sex.

All sexually active women are encouraged to have pap smears as it is the best way to screen for cervical cancer.  A pap smear is a procedure in which a small medical brush/swab is inserted into the vagina so as to retrieve cells from the cervix.  The cells obtained on the brush/swab are then analyzed for abnormalities. 

Chief Medical Officer of the Ministry of Health Dr. George Mitchell confirmed that pap smears are available to all women who have reach the age of consent, “Grenadian women can access pap smears at our three (3) hospitals, six (6) health centers and 30 medical stations. Pap smears are also done privately throughout the country.”


Central Health - Grenada would like to thank Amy Baldwin, PhD, Associate Professor, Department of Microbiology, School of Medicine, St. George's University for providing technical expertise with this article.