prostate cancer in jamaica, michael rows the boat ashore, ackee and cultural issues related to the delayed diagnosis of prostate cancer

i love the chattahoochee river
Michael Row the Boat Ashore
Several years ago I was fortunate to lead a church mission trip to Jamaica that was both medical and construction related. We ended up in Ochos Rios and then from there bused to  a small church that was closely associated with a hospital. Beautiful but impoverished country. At the hospital there was very little staff and equipment that as a urologist I was accustomed to having.  One day all I did was change catheters that had been in too long. Usually you’d change a bladder catheter at a month to six weeks….what I was changing had been  in six months to years or so. All of them difficult to take out because of incrustations that occur on a catheter by the urine if left in too long and as well difficult to reinsert. You can imagine the stench related to the urine that accompanied these unfortunate patients. As the next mission trip by another team to the area might be months, the whole process is perpetuated. On that day and others, and this really surprised me and disheartened me, I would be pulled aside by the pastor of the church  to see one of his parishioners. The complaint was usually something minor, like urinary frequency or getting up at night. I had not thought I’d be  doing that type of stuff….I thought I’d be there making a difference  and doing urologic procedures that were important and necessary. I felt that the pastor  was using his position to help out  his friend in the church for things that were minor and not the purpose for mission.  It happened  several times a day that I’d be requested to meet a church member and answer urologic questions…in most cases something that would require a medicine which  I did not have. For example….if the problem was poor  erections….I would not have brought to Jamaica Viagra….that was not what we were there for  but what I found myself doing.
Anyway, the idea of making the diagnosis of prostate cancer in that setting with the limitations that I know exist both in the availability of a PSA, and the equipment necessary to make the diagnosis seems to me based on what I saw would be daunting. In the setting of Jamaica and other third world countries the push for less PSA’s, the questions about whether screening is beneficial or not become much more relevant. A yearly rectal exam and further evaluation if the gland is not completely normal might be the diagnostic plan because of cost and personnel restraints.   You also have cultural issues and misconceptions that further exacerbate the issue as alluded to in the article below. Now one begins to understand  the significance of the cost of things and what you would do differently to detect prostate cancer if these limitations existed. How you would treat it if it were found is a whole “nother” ball of wax. Prostate cancer in a third world country….man that is a  mess.
So, I am down there  in  Jamaica and me and the construction guy are going around looking for projects and putting them in order of priority. We are driven  to the “insane asylum.” With the ocean  in the background, banana trees in the front, we arrive at what looked like  a elementary school that had been built in the 1950’s. A large portion of it was open  air with  a lot of tables about that the patients were milling around aimlessly. It was a strange sight….all the clothing was minimalist and airy. Then one of the patients  can out from behind a  wall and unbeknownst to me but very apparent to my construction friend was the fact that “Michael” was  naked and on top of that….was well endowed to the point that it was most unnatural.  The driver told my friend that that was Michael. I am looking the other way  as Michael approached. My friend taps  me on the shoulder to turn around and see this ” local phenomenom.”
I turn around and there he was in all his glory and of course my attention is directed  southward. I look up at my friend and we stare at each other with our  heads shaking  and the driver laughing. (The driver obviously had done this many times to  visiting missionaries…kind of a local attraction.”)
I then say…” Well, now we  know how Michael rowed his boat ashore!” 
I then  take one more look at the area of Michael that was the issue and say, ” Hallelujah, Hallelujah!”
Prostate cancer skyrockets in Jamaica over quarter century     Published: Saturday | August 7, 2010

Philip Hamilton, Gleaner Writer

A new study on prostate cancer among Caribbean men of African descent has revealed there was a 270 per cent increase in the disease among Jamaican men between 1983 and 2007.

The results of the study, which are published in a soon-to-be-released book by scientist Dr Henry Lowe, also showed there have been significant increases in the number of men in their 40s and 50s who have been diagnosed with the disease.

Lowe, who made the disclosure at a function on Thursday at Eden Gardens, said many myths about prostate cancer continued to be circulated by Jamaican men, several of whom felt it was better not to know if one was suffering from the disease.

“Even the educated men think so because they don’t want to face the facts,” Lowe told the audience.

“The fact is, it’s never better not to know that you have a disease that is life threatening. Early detection and treatment may be the only way to save your life.”

Lowe added that another myth currently being perpetuated by Caribbean people was that the high rate of prostate and breast cancer in Jamaica was caused from Jamaicans eating too much ackee.

He said research showed there was no proof ackee was responsible for causing prostate cancer, although this was likely attributed to its richness in certain fatty acids associated with a high risk of the disease.

Lowe was speaking at an awards ceremony for 25 students from the University of the West Indies and Shaw University in the United States who received prostate-cancer survey research training

The summer project, which is in its second year, forms part of a Minority Health International Research Training Programme aimed at training undergraduate students on prostate-cancer related topics.

The project also aims to facilitate research that will further eliminate racial health disparities in the area of prostate cancer among Jamaican men of African descent.

African-American and Jamaican men of African descent have the highest prostate-cancer incidence and mortality rates in the world.


One Reply to “prostate cancer in jamaica, michael rows the boat ashore, ackee and cultural issues related to the delayed diagnosis of prostate cancer”

  1. Why is prostate cancer so prevalent amongst African men? This fact has been know for considerable time but to date I have not seen a causitive finding.


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