By Anesta Henry

Asthmatics and persons who suffer from allergies and sinus complications have been advised to take all precautionary measures to protect themselves as the country continues to experience a series of cane and grass fires.
Chief Medical Officer (CMO) Dr. The Most Honourable Kenneth George is also supporting the decision of the Ministry of Education to close affected schools to protect students and teachers from the potentially harmful inhalations.
However, Dr George told Barbados TODAY that he had received no reports from polyclinics or the Queen Elizabeth Hospital (QEH) regarding an alarming increase in persons reporting to the facilities complaining of health issues due to the environmental hazard.
“The major persons who would be affected are persons who have some form of allergy. And we know that asthma and sinusitis and sinus headaches and so forth fall into the allergy category and those are the people who should try to protect themselves the most.
“The best way to protect yourself is to leave the area that is close to a site that is burning. We know that that may not always be easy, or it may be easier said than done. Therefore, individuals who can’t get out of the situation, many of you may have masks in your houses because you would have used masks during the COVID pandemic. If you can’t put on a mask, you have to try to lock your houses so that the influx of smoke will not affect you,” he said.
Dr George noted that smoke comprises chemicals which can lead to acute respiratory injury or a reaction that produces bronchial spasms, runny nose and itchy skin.
In recent weeks, the Ministry of Education has had to summon parents and guardians to collect their children after the institutions had to be closed prematurely.
Dr George said even though it may appear to the public that schools are being closed too frequently because of fires, “from a public health perspective, we need to make sure that people are protected.
“We know that asthma kills one or two individuals every year. So it is better to be safe than sorry. I am supportive of the Ministry of Education deciding to close schools, particularly if staff and students are reporting that the environmental conditions are affecting their health. I haven’t received any reports, but the polyclinics are always willing and able to provide any acute care,” Dr George said.
Meanwhile, the CMO recommended that schools establish a treatment plan to guide what measures should be taken to manage students or staff who may experience asthma attacks.
“I think schools should invest in some form of treatment plan for asthma because asthma is so common. Schools should have some area identified as an asthma bay so that they can give some form of acute treatment to persons who are in distress,” he said.
Director of the Barbados Meteorological Services (BMS) Sabu Best explained that there has been a significant reduction in rainfall in recent weeks, particularly in the St Philip, Christ Church, St Lucy areas and this has led to an increase in grass and cane fires due to the dry topsoil.
Best said that while the grass and cane fires usually last for a few hours, the smoke is likely to travel for many miles.
“This is going to make life a bit complex for residents in Barbados, particularly those living in St Michael and working in the Bridgetown area. We expect that these kinds of conditions are going to continue into April where grass and cane fires will be sparking off because of the dry conditions.
“There is not going to be any rainfall coming in anytime soon and I just want Barbadians to be aware that they can expect to see more fires in days to come and just be prepared. This is not an uncommon thing to be actually happening during the dry season,” Best said.
anestahenry@barbadostoday.bb

The post CMO warns allergy, asthma sufferers to take extra precaution as fires continue appeared first on Barbados Today.

PAHO Director calls for greater collaboration between health and economy sectors to improve health and save lives

Cristina Mitchell

20 Mar 2023

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The post appeared first on Healthy Caribbean Coalition.

Humanitarian medical missions constitute an integral part of reaching underserved and vulnerable populations. Health-care teams perform medical missions with the most common scenario being the delivery of direct health care from high-income countries to low- and middle-income countries. The United States, United Kingdom, Canada, and Australia are the source of most medical missions from high-income countries. Cuba is a notable example of a low-income country that has been the source of medical missions. For the most part, these missions are short term and usually defined as lasting less than one year. Most of these medical missions last one day to four weeks (approximately 74 per cent) of the total. There are a wide range of medical and surgical care that is performed with varying degrees of complexity from primary care visits to cardiac surgical/neurosurgical procedures. It is thought that the numbers of these medical missions have been increasing over time, but this remains an area that has been poorly studied not only in terms of frequency, but also in terms of quality of the care delivered and the impact on the health-care system of the receiving countries.

Benefits of medical missions for the community

One clear benefit of medical missions are the direct recipients of the medical care. Medical missions generally take place in low- and middle-income countries (both in rural and urban environments) in which a significant proportion of the population are unable to access health care. The difficultly of access may be related to several factors but poverty and low socio-economic status play a key role. The recipients of medical missions often access care that is not available to them by any other means, or which may require a prolonged wait in trying to access the local health-care system. This delay in access to care often results in disease progression and excess morbidity and mortality. In addition to the care that is delivered, medical missions will sometimes provide medications and equipment (eg, eyeglasses, canes, syringes) to these patients. Studies have shown that aside from direct medical care, these visits have other less quantifiable benefits to the community. These include the feeling that people external to the community have an interest in their well-being, that there is recognition of the circumstances of their lives and feelings of increased hopefulness for the future.

Benefits of medical missions for providers

Several studies have looked at the motivation and rewards for physicians, nurses and ancillary personnel who take part in medical missions. Not surprisingly, a common motivation is altruism. Most physicians and nurses go into the profession not primarily for financial rewards and status, but to alleviate suffering from disease and to help patients achieve healthy lifestyle. The ability to help people who are truly indigent (many times in ways that people in high-income countries cannot conceive) and who have no other access to the care that they deliver is many times its own reward. Physicians and nurses are also enamoured of a simpler practice of medicine that is free of the administrative, billing, and charting tasks which form an increasing part of clinical workload. There is also the ability to see and treat diseases that are uncommonly seen or that is advanced due to the absence of early diagnosis and treatment. This has been referred to cynically in some circles as "surgical or medical tourism".

Benefits for local health care providers and local health care systems

Medical missions if integrated with local health-care providers and facilities can result in skills transfer to the benefit of the low/middle income country. A common example is that of a visiting surgeon who operates with and mentors a local surgeon. At the end of the medical mission, there is now an increase in human capital that would not have occurred otherwise. Often, there can be the opportunity to conduct education outreach for both practitioners and for community health organisations. Facilities will often gain scarce medical equipment or disposables that are either not available locally or only at costs that are unaffordable. There is also the opportunity for linkages to develop between local health-care personnel/facilities with organisations in the developed world. These connections can often be leveraged to the benefit of the local facility. For example, they may result in further medical missions, donations of equipment or money, telehealth opportunities and opportunities for local physicians/nurses to receive training in the developed world. For governments who lack adequate fiscal resources to provide health care, particularly that requiring newer technology or simple primary care in rural areas, medical missions can be a welcome addition to the local health care mix.

Other benefits

Medical missions have been used as a tool for diplomacy and influence by several countries. This can occur in the setting of natural disasters but often is a strategy used to develop relationships between nations. Cuba, although a low-income country, has used its surplus of physicians and nurses to form relationships with other low and middle-income countries. The United States through its military has also deployed medical missions to less developed nations. It should, however, be noted that it is suspected that most medical missions arise from the non-governmental sector and appear to be "ground up" efforts as opposed to being directed by governments. Medical education also appears to benefit from medical missions although it is unclear how wide this practice is. A study from 2002 found that 40 per cent of English medical students had gone on a medical mission during training. Another study noted that 41 per cent of orthopaedic residents training at the University of California, San Francisco had been part of a medical mission. There is the potential for medical education in low- and middle-income countries to benefit from skills transfer and exposure to a medical culture that is less affected by resource constraints and that has access to newer technology.

There are tangible benefits from medical missions particularly when integrated with local health care. There are, however, many questions about the extent of the benefit for the low- and middle-income country, particularly in the long term in the absence of sustainable local infrastructure and human capital to continue to provide quality care. As time has gone on, it has become clear that there can be significant negatives to medical missions and a current topic of much debate is how these negatives can be ameliorated and whether other avenues may be considered to improve health care access in low- and middle-income countries. We will use our article next week to explore these issues.

The Heart Institute of the Caribbean and HIC Heart Hospital will be hosting a four-day humanitarian medical mission from October 26-30 to provide care to the poor. Those interested may contact the office at 876-906-2105 to 2108 to register.

Dr Ernest Madu, MD, FACC and Dr Paul Edwards, MD, FACC are consultant cardiologists for the Heart Institute of the Caribbean (HIC) and HIC Heart Hospital. HIC is the regional centre of excellence for cardiovascular care in the English-speaking Caribbean and has pioneered a transformation in the way cardiovascular care is delivered in the region. HIC Heart Hospital is registered by the Ministry of Health and Wellness and is the only heart hospital in Jamaica. Send correspondence to
info@caribbeanheart.com
or call 876-906-2107.

G
iving
your child medication can be confusing and daunting.

When you fill a prescription for your child, you may get a medicine cup or a syringe to measure the exact amount of medicine to give. Most times, it's an amount like 2.5ml or half teaspoon, which is clearly outlined on the little measuring cup. Other times, it may be an unusual amount like 1.7ml that has to be measured using a syringe. You also have to take into consideration other details like how the medication should be stored — on the counter or in the fridge? How often is it given — once, twice or three times a day? For how many days? Should it be given before, with, or after food? Is there any food your child should avoid? What side effects should you look for? Can this medication be taken with that other medication?

It is a lot.

But don't be discouraged. This article will hopefully provide you with tips on effectively medicating your child.

Medication dosing

We calculate the dose of medication based on your child's weight. Therefore, each child's medicine dose is different based on their age and weight. As your child grows, he or she may need a different dose of medication. Think of a cup of sugar and water. The sugar is the medicine, the water is the size of your child. If there is one cup of sugar in four cups of water, it will taste fine. But, if I add one more cup of water, the drink gets "fresh" or too diluted. When your child grows and puts on weight, it's like adding more water to the mix while the sugar stays the same. Now, the concentration of the sugar is too little to make a tasty drink. Similarly, the medication dose becomes too weak to work effectively.

This is important to keep in mind for your child. The medication dose that worked six months ago may not be as effective today. And the medication for your three-year-old child may not work for your six-year-old.

Also keep in mind that the volume of the medication is not the same as the concentration. So, 2.5ml doesn't necessarily mean 2.5mg of the drug. The pharmacist can make up the medicine to have (for example) 10mg (the concentration) in 2.5ml (the volume or amount) of a particular drug. That 2.5ml containing 10mg may be fine for a five-year-old, but for a one-year-old, it could be an overdose!

This is why it is important to ask your doctor for advice before administering certain medications among your children.

Of course, this is not the case for all medications, for example: over-the-counter medications. Over-the-counter medications (OTC) refer to those medications that you can walk in and pick up at a pharmacy. Some examples are pain/fever medications and cough syrups. Most OTC medications will have dose guidance on the box based on the child's age alone.

Another confusion lies in the frequency of dosing. Once/twice/three times a day, what exactly does that mean? A "day" in drug dosing refers to an entire 24-hour period. So, the number of times you should administer medications is divided among 24 hours.

Once a day is pretty straightforward. It means every 24 hours, not necessarily once at any time throughout the day.

Twice a day is "morning and evening", but more accurately, it means every 12 hours.

Three times a day is "morning, afternoon and evening", and more accurately every eight hours.

Mind you, for twice a day dosing, it's okay to do 8 am and 7 pm, for example. That's not too far off from every 12 hours, but ideally medications should be given as close to their recommended dosing as possible.

Three times a day dosing can be annoying and cumbersome, I know. But certain medications work best like that (we didn't make the drugs, we follow the manufacturer's guidelines). So, I advise you to work out what would be best for you and your child. Perhaps 6 am/2 pm/10 pm or maybe 8 am/4 pm/12 am. But 8 am/12 pm/8 pm, for example, is not ideal.

So, with all this information, I hope you don't feel as daunted when you fill your child's next prescription. You've got this lad! (And aunties/uncles/cousins/grandparents, etc). I hope your baby recovers quickly. Happy medicating!

Tal's Tidbit

Each child's medication dose may be different. Before giving your child a medicine that was meant for another, do some research to find out if it is safe to do so.

Dr Taleya Girvan has over a decade's experience treating children at the Bustamante Hospital for Children working in the Accident and Emergency Department and Paediatric Cardiology Department. Her goal is to use the knowledge she has gained to improve the lives of patients by increasing knowledge about the health-care system in Jamaica. Dr Tal's Tidbits is a series during which she speaks to patients and caregivers, providing practical advice that will improve health care for the general population. E-mail: dr.talstidbits@gmail.com IG:@dr.tals_tidbits

The Sanitation Service Authority (SSA) is reporting an increase in the illegal use of its facilities by people burning materials to get copper in order to cash in on the growing trade in that metal.
At a media briefing on Friday, public relations officer (PRO) Carl Alff Padmore said the use of the Mangrove, St Thomas landfill for that purpose was extremely dangerous and put residents in the nearby communities at serious risk.
“The landfill area is dry because, naturally, we are not getting any rain. Why is that a problem for us? We have persons who are trespassing on the compound and they are creating a nuisance because what they are doing is burning copper. There is a trade for copper in Barbados [and so] they are trying to get the rubber off of the copper,” he complained, explaining that these fires were happening in an area near the old Central Cricket Club pavilion.
Saying that no permission had been granted by either the SSA or the Barbados Fire Service to start these fires, Padmore warned: “A simple flame can ignite the grass around the landfill and once the landfill catches, we know it will cause serious strain on our resources because we have to get crews to out it; it will cause strain on the fire service because they will have to deploy trucks; and environmental officers from the Ministry of Health would have to come and do air quality testing.”
“So one simple act . . . has the potential to be a nuisance at a bigger scale,” he added, noting that residents living downwind, in areas such as Arch Hall, Bennetts and Bucks, would be impacted if a fire started at the landfill.
The SSA spokesperson said the culprits tend to start the fires early in the morning and while some people had been spotted leaving the dump, no one had been caught.
He reminded that anyone found engaging in the illegal practice could be slapped with a fine of $5 000 or be jailed for creating a public nuisance.
During the briefing, Padmore also reminded Barbadians not to commingle old mattresses they take to the dump with other waste.
He said there was a programme in place for the SSA to dispose of those kinds of items which come from households, businesses such as nursing homes, and government facilities like the Geriatric Hospital.
Padmore said the SSA would engage in a controlled burn and those were the only fires that were conducted and considered safe at the Mangrove Landfill.
(SZB)

The post Illegal fires at dump worrying SSA appeared first on Barbados Today.

CTUSAB RECOMMENDS EARLIER TERM’S LEAVE FOR TEACHERS TO AVOID FATIGUE

By Jenique Belgrave

Teachers must once again be allowed a term’s leave after five years’ of service.
General Secretary of the Congress of Trade Unions and Staff Associations of Barbados Dennis DePeiza made this clear on Friday as he insisted that educators have to be protected from the very real threat of burnout.
Saying some believed that the three school breaks per year provided enough time for teachers to rest, he suggested that for many of those days, they are still occupied with work.
“When schools are on recess, teachers are at seminars, summer school, preparation meetings and they get burnout. They were supposed to be given a term’s leave after every five years and someone determined that this should be moved to 15 years. I think there needs to be a rethink and teachers should be given a term’s leave after five years,” he said, noting that such a job needed to be incentivised to draw a higher level of interest.
Speaking to the media at the Barbados Union of Teachers’ Merryhill headquarters on Friday, he also expressed concerns over the number of school disruptions being experienced in recent times due to environmental issues and instances of violence.
“When we see disruption that is continuous like this it says something about how we are managing the system…As soon as something happens, somebody pops up, makes a statement and then disappears, but there seems to be no direction coming from the Ministry of Education, none whatsoever to deal with these ongoing issues,” he charged.
Depeiza noted that such stoppages have an impact on the island’s productivity and he suggested that a broad discussion with all stakeholders is necessary if issues affecting the education sector are to be addressed.
“We need to get something done where we engage all stakeholders because this disruption is having an impact on the country’s economic development. You may say only the schools are closed but when the schools are closed, parents have to go for children all during the day, they lose income and some jobs may be on the line because they are not at work.
“There are other social factors that are affected as people who have a little money are spending it on someone to keep their children and on meals as the children are, in some cases, missing out on the school lunches provided.
“We have to look at this broadly and find out what are the problems right across the system, have some serious discussions and look for solutions,” Depeiza added.
jeniquebelgrave@barbadostoday.bb

The post BURNOUT CAUTION appeared first on Barbados Today.

Researchers at Linköping University in Sweden have developed a method whereby the body can ‘grow its own’ electrodes. The minimally invasive technique involves injecting a hydrogel that is laden with enzymes into target tissues. The enzymes interact with molecules that are present in the tissue to change the structure of the gel and allow it to become electrically conductive. The approach could facilitate a variety of advanced medical systems, from pacemakers to brain-computer interfaces. Excitingly, the technology avoids the need for invasive surgery or conventional stiff electrical components that are not well matched to native tissues and can provoke unwanted immune reactions. So far, the researchers have shown that they can grow electrodes in the brain, heart, and tail fins of zebrafish and near the neural system in leeches.

Integration of the body with electrical components for medical benefit is well underway, with current versions of brain-computer interface systems allowing paralyzed patients to write text or control an electric wheelchair. However, the point of interface between the body and external machines is typically an implanted electrode, and current versions of such devices can come with multiple drawbacks.

Most electrodes are largely rigid, which does not allow them to blend well with soft tissues, potentially resulting in tissue irritation or damage, immune responses, and eventual electrode malfunction or complete failure. Moreover, implanting such electrodes will typically require some type of surgical procedure, increasing expense and patient inconvenience and discomfort.    

To address these limitations, the Linköping University researchers have developed an injectable material that turns into a conductive bolus in the body. The injectable hydrogel contains a cocktail of enzymes that interact with molecules present in the body to create a conductive structure.

Here are some lines from the study abstract that detail some of these constituents and how they work: “a complex precursor system including an oxidase to generate hydrogen peroxide in situ, a peroxidase to catalyze oxidative polymerization, a water-soluble conjugated monomer, a polyelectrolyte with counterions for covalent cross linking, and a surfactant for stabilization. With this cocktail, the authors were able to induce polymerization and subsequent gelation in different tissue environments.”

So far, the researchers have shown that the material can create electrically conductive structures in animals, including zebrafish and leeches without causing any obvious adverse effects. “By making smart changes to the chemistry, we were able to develop electrodes that were accepted by the brain tissue and immune system. The zebrafish is an excellent model for the study of organic electrodes in brains,” said Professor Roger Olsson, a researcher involved in the study.      

Study in journal Science: Metabolite-induced in vivo fabrication of substrate-free organic bioelectronics

Via: Linköping University

Dialing the toll-free number 809-200-1400, during the pilot schedule from Monday to Friday from 9:00 in the morning to 5:00 in the afternoon, trained professionals will provide specialized psychological assistance in a safe and healthy environment. “It will not be an automatic line,” but a person will be on the other side listening and providing timely follow-up, Pujals explained.

In his speech, the director of the OGTIC reflected on how mental health alerts have skyrocketed after the arrival of the pandemic due to COVID-19, increasing anxiety and depression disorders. Minister Rivera stressed that in the last two years, there were 400 thousand of psychology consultations and 178 thousand of psychiatric consultations, according to the data of the National Health Service (SNS), evidencing the need for citizens to have a friendly hand for mental health services. The hotline will be connected to the SNS mental health services network, which already has 17 crisis intervention units disseminated throughout the country. The first lady said that, in the future, the number to be marked will be simplified and, from the 9-1-1 system, citizens can connect to the line.

Likewise, the Vice Minister of Collective Health, Eladio Pérez, explained that after psychosocial rehabilitation in a crisis intervention unit, if necessary, the patient would go to the psychosocial and human development center (Reside). “This comes to reinforce the mental health strategy and is the first phase to develop a service that will give timely response to all needs in the mental health area,” Pérez added.