A 2007 study revealed that, per capita, Saint Lucia had the highest number of persons with diabetes in the world. Dr Michael Graven was one of the researchers who screened more than 31,000 Saint Lucians during the study.
Dr. Stevenson King, who was health minister at the time, described the statistics as startling and said that government would move swiftly to make a number of interventions such as formulating policies and developing programmes to change people’s lifestyles.
Just as worrying at the time (2006-2008) was the number of cancer-related deaths: 544, second to deaths related to heart diseases.
It is now 2015 and the effects of diabetes on the population are still rampant. Additionally, there appears to be a sharp spike in cancer-related deaths, particularly among men, with an increase in the number of prostate-related cases. Local oncologist Dr. Owen Gabriel believes that such cases are now on a par with diabetes and hypertension and probably have a greater impact on our population as far as mortality is concerned.
After Cancer Awareness month in October, Dr. Gabriel sat with the STAR to discuss the state of cancer and health care in general in Saint Lucia, firm in his belief that more can be done and should be done.
“In Saint Lucia we’ve almost always had cancer, it’s just that it has never been something that has been topical because we probably did not have all the facilities to identify its presence here. It was not something for which there were any specialists around. Currently I am the only local, resident, native oncologist on-island and in some cases in the region and the OECS,” Dr. Gabriel pointed out.
He said that nowadays there are celebrities who have cancers, like David Thompson, Patrick Swayze, Steve Jobs, Jimmy Carter, and it has now been something which is even more topical.
“I think in Saint Lucia we have changed our lifestyles and we are no longer an active society, no longer do we walk long distances. We now drive more than we walk; we are not active in physical activities as students. Before we’d leave school and go play a sport, now this is not the case. We have a lot more fast foods available, more chemicals in the environment, more toxins in our water, in our food, through the soil and the agrochemical products. This is why we are now suffering the effects,” Gabriel said.
Asked about the most common types of cancer in Saint Lucia, Gabriel replied: “Cancers of the prostate in men exclusively, cancer of the breast in women, more so than in men, and cancer of the cervix in women.”
“We’re now seeing an increase in the numbers of cancers affecting the digestive tract, the gastro-intestinal tract from the oesophagus to the stomach, down to the small and large intestines. If you look at the statistics for both men and women, those cancers will soon occupy the number one position as the most common cancers for both sexes,” Gabriel explained. “In regards to cancer of the colon, we think that there is a direct co-relation with our lifestyle. If you heard recently, the World Health Organisation has now classified that canned meats, corned beef, tuna, sausages and salamis which are processed and cured meats are now known to be carcinogenic. Now there is conclusive evidence that these things eventually cause cancer. The message has been out there, we have always told people that canned processed meats, canned and boxed drinks have contained some ingredients which act as preservatives and MSGs which are carcinogens and used in a lot of foods.”
For Dr. Gabriel the fight against cancer has to be done in a number of formats. “It can’t be that we just say treatment is a way to fight cancer. I tend to think that we need to speak about shared responsibility so, on an individual level, we have a responsibility to protect ourselves and our children from these toxic substances, to dispose of our garbage properly and to avoid environmental contamination and poisonings.
“When we contaminate our waters, our plankton, our seaweeds and so on we then contaminate the source of food for these fish and therefore we consume that same contaminant. In Saint Lucia we’ve done a study on pregnant women in their third trimester; we measured the presence of those compounds and we were able to show that these could be transmitted through the breast milk and into the babies, which will eventually lead to either behavioural problems, birth defects, malformations, abnormalities or cancers.”
“On the other hand, our authorities, not to say government, must have a role to play and it has to be a serious role. They must network with stakeholders so they can regulate the kind of substances we import for our agriculture. They can also regulate the kinds of emissions our industries produce. They can enforce the measures whereby our food suppliers allow us to make a choice as to what kinds of foods we consume. I would like to see on supermarket shelves, labels that suggest low calorie foods or GMOs, so that a person now can make a conscious decision to choose their food, whereas otherwise they would have just chosen what is affordable, which sometimes is more harmful to us,” said Gabriel.
According to the doctor, for over ten years now members of the medical fraternity have been trying to collaborate with “officials.” “The fundamental issue here is that our authorities do not have those health issues as the priority on their policies and their mechanisms of where they exert their efforts in whatever ministries. We are sometimes to blame because we do not demand that of them, because we are so carefree. The health professionals have been sounding the trumpet, but most of it falls on deaf ears because we don’t seem to realize why we need to protect our environment and why these authorities need to be able to regulate and protect us, sometimes even from ourselves,” he said.
When asked what was the best advice he would give to Saint Lucians as an oncologist he responded, “One of the things is to get educated with information concerning cancer.Second thing is to know your risk factors, your personal history, your medical and family history, because some cancers are hereditary and can be transmitted though families, such as prostate cancer.” According to Dr. Gabriel the most fundamental thing, is for us to be open to change. “And I am saying this at the individual level, the population level and the authority level. Sometimes you speak of something and because people are not familiar with it or are averse to it, it unfortunately takes someone from overseas to tell us what our local people have been preaching for years for us to take heed. I think one of the biggest challenges is the reluctance of people to accept advice and change accordingly. The reluctance to change. The second thing is the kind of political socio-economic structure of our country in which persons who are policy-makers or decision-makers sometimes have little knowledge of the nature of the field. Those are the ones who make the determination as to what happens in the field – unfortunately.”
He went on: “Our constitution must allow us to be different in the way we conceive of ministerial positions, so maybe things like ministries of education, health, social development, youth and sports might be under an umbrella that has no political influence per se so that you are able to work, irrespective of who is there in government, because your mandate is to the country overall. It may change when you talk about industry and tourism and agriculture. A particular government might have a particular inclination toward a particular avenue of development, but those things that are the prerequisites for a healthy population, an educated population have to be without any external influence, especially for people who are not expert in the field that we are talking about.”
According to Gabriel it would appear that the health care focus, or lack thereof, is misguided. “I usually tell people in a 167,000 population that although we are a low resource country, we should be creative in our thinking, in terms of producing methods of administering health care to make it accessible to everyone. It has not been
the case for cancer or any other disease because we want to focus on nice buildings and new structures when, in the primary level of prevention, we are lacking in the impact there. So you can have a nice, brand new, for example, for argument’s sake, hospital but if you do not control people’s attitudes and behaviours you can’t resolve and solve the problems . . . we need to put things in place and, as I mentioned earlier, take individual responsibility and authorities too, with regulations in place, so that we reduce the exposure we have to carcinogens and therefore reduce the numbers and incidence of cancer in the long run.”
If things do not change fast Dr. Owen Gabriel sounds this alarm: “In developing countries like
Saint Lucia and other countries in the Eastern Caribbean, we will see 70% of deaths being caused by cancer. Early diagnosis, prevention and screening helps!”