In addition, please see the ‘About Helen’ page where some of this information is situated.
(followed by three presentations at the conference)
For Barbados FPA’s first annual Sexual and Reproductive Health Conference
Dates: 24-25 June, 2017
Where: Radisson Aquatic Resort, Bridgetown, Barbados
“Thank you for inviting me to speak to you all, this weekend, and even more so to give this Keynote Speech today.
As Juliette said to me last night, when I double checked whether there was anything specific that she wanted me to add, she smiled and said no, I think you have known us for long enough… by that she meant that I have known and admired Barbados FPA for many years… indeed since 1999, when I first visited Barbados and former President, Mr Barton Green came to meet me at my hotel.
He was early, and I being a tourist, was still in the sea, just starting my love affair with Barbados. I’m rarely late for anything, so apologised for not being ready and he said that it was his fault, he was early… the bond of friendship was sealed and that sure broke any ice that hasn’t already been melted by the sun!
… but we had a memorable meeting which actually changed my life.
We chatted for a while and then he told me that Barbados FPA would support me in any way they could, both here and across the region.
This marks my 16th visit, so I claim to be an ‘honorary Bajan’ after all these years and I say thank you to Bayer and to Bryden Stokes for supporting this groundbreaking event… and hopefully more, so that we can continue to grow this in to an inter-island event, based here in Barbados!
SRH is the cornerstone of our existence.
Global population statistics for the last 50 years have shot up from roughly 2.8 billion in and around 1957 to 7.5 billion, with the planet increasing its population by the equivalent of that of Germany or Egypt population, every year, which will take it to around 11.2 billion by the end of the century.
That’s a lot of people! That’s a lot of unprotected sex.
Whilst talking statistics: Global STI rates are still increasing.
We are going to get an update on local STI statistics shortly, which will be extremely interesting, I am sure.
Being from the UK, we are nothing if not crazy about statistics, so here are a few interesting numbers to ponder.
Back in 1995 the World Health organisation stated that there were about 350 million new STI cases per year, not including the blood borne viruses – HIV, Hep B or C – and sadly, they don’t publish things the same way these days but that 1 million per day, I would wager, could be doubled – globally, today.
Sexual Health is not important until there’s a problem. It’s fun, and for many of us, rather pleasurable… We are up against ignorance, lack of understanding or appreciation of risk, pheromones, love of risk, brains that aren’t fully able to assimilate risk until they’re in their mid-twenties, sometimes later… and a huge amount of Layzie-fair… but we can’t cure everything.
We can, and do, support someone who finds themselves to be pregnant and that to be unplanned – either to terminate or keep the pregnancy.
There is still a lot of UPSI going on, despite HIV, despite chlamydia and gonorrhoea rates being published in the newspapers and both of these, going only in one direction and that’s UP — it’s always going to happen to someone else… never to me.
Barbados population statistics for the last 50 years have risen from roughly 229,000 to 274,000 – that’s up by 45,000
BFPA had approximately 65,000 clients in 2016, up 2% on the previous year so at least some people are trying to look after their sexual and reproductive health,
others will be seeing their doctor, going to their polyclinic or if they’ve got an increasing amount of common sense, abstaining altogether.
That might not be fun, but it’s certainly safer and should be promoted as the safest form of sex of all.
Some people may be using sex toys, some may not be doing anything at all… but the no sex option is a sensible one for many.
Published just two days ago in The Nation, the title of the article is that “STIs a major concern for Ministry Of Health” – shows that amongst other statistics, the island has a Chlamydia prevalence of 13.6 and Gc 2.7 with syphilis prevalence one to watch alongside HIV.
It is true that the more you look for something, the more you will find and I think I am right in saying that until relatively recently, statistics weren’t gathered in Barbados on these infections as they are today. A great move forward.
The economics of SRH are staggering.
I have been tracking the number of people diagnosed with HIV in the UK, contracted across the different Caribbean islands since June 2008 and for Barbados, those numbers have gone from 24 to 45 – and regionally 826 to1294 in the same time scale across the Caribbean – JA and T&T leading by far – but with Barbados still leading the EC islands.
Part of that equates to population in general, and the popularity of the Caribbean islands as holiday destinations. At one point, the DH stated that it was worth spending between half a million and a million pounds to prevent one case of HIV
since then, treatment costs have come down considerably, to roughly £380,000 in lifetime treatment costs, but the lifetime costs to the person involved, and their family, have not tumbled to the same extent – the stigma and fear of having an HIV Positive diagnosis still remain, and these are unlikely to disappear.
Although ART, Prep, and PEP are around, the long term side effects emotionally and physically, of having to turn up for tests, remember to take treatment, not be able to travel to certain places, and never being able to forget their diagnosis carry their own toll.
Whilst talking finances, each £1 spent on FP protects £11 – and with our U.K. austerity measures, someone failed to drive home the importance of that, alongside the calculation that each £1 cut from SRH budgets has been predicted to be going to cost £89 to stand still. That doesn’t sound like very smart economics, to me.
What we do with and for our patients/clients, is SO important
We have the power to EMPOWER them.
We have the knowledge to share with them.
We have the ears to listen to them – and not pass them by – or assume that we know what they need, or want, without taking the time to teach them and be sure they are making an informed choice.
After all – every pregnancy should be by choice, not just by chance.
We should also be aware that they can change their mind.
WE are in an incredibly privileged position – I mean by that, in how many areas of healthcare do we ask people about THE most intimate moments of their life – their sex life – and expect them to feel safe enough to actually tell us.
I started working in Family Planning way back in 1986, and I had been working in Family Planning for several years and thought I’d heard it all – when, in 1993, I was nominated for an award by a sex worker, who felt that I wasn’t getting enough help or support with my books – so she nominated my books for an award – however, the organisers called to ask if they could hold on to my books until the next year because they didn’t have a category for sexual health but though they should include one for the following year.
I said, quite tongue in cheek from my perspective, ‘OK, as long as you let me win’ – the next year came and I was nominated for three categories, and I won their innovation award for my cyber clinics.
The story behind that was that I thought I was worldly-wise and had heard it all – but little did I know, back then, that I actually knew very little. There is a whole world out there, in which people exchange sex and other activities with each other, consensually or otherwise, but we never ask them about it in clinic.
We have to be open to all sorts of possibilities when it comes to our patient’s sex lives – what they tell us is only the tip of their iceberg.
They only tell us what they think we can handle and what we are not too likely to judge them for – that is, unless they feel safe enough to tell us everything.
When we’re taking their intimate sexual history, we, on the other hand, need to know what they’re doing, and with whom – men, women, or both, for risk assessment and contact tracing in particular – so that we can make a safer sexual assessment and decide on which tests are most important, and when.
I am fully aware that here, in Barbados, many people are unlikely to tell others outside their intimate circle, what they are doing, and with whom – but if a straightforward sexual history can be elicited by activity, dates, and protection, we are improving things, enormously.
Watch their body language – they may give more clues than they realise, about what they are or they aren’t telling us.
Having said that, before we ask about a potential ‘can of worms’, we need to have a series of support options, upon which to call, and to be able to refer patients to, should the need such arise
This is often someone who can give them much more time, over several sessions, to offload their deepest secrets that they’ve been burying.
I was thrilled to hear, last night, that BFPA is hoping to add a counselling / sex therapy service to the many excellent services they offer. They will be busy!
Whatever happened in the past, it is likely to have taken its toll on their self-worth, self-esteem, their sex life, and their entire being. But it doesn’t have to define their life.
Sometimes, they need our help, and by us asking direct questions, even if they don’t tell us the truth on that occasion, they know they can come back and we can then help them to throw the past away and dispose of any emotional anchors that are holding them down.
Don’t be afraid to reach out. Know your safety nets, and how to refer if the help they need is beyond your remit, interest or experience, is important.
Young people, today, have a very different view about sex than the generations before them. This is an international problem – not just here, or in the UK.
There are now more ways of learning than EVER before, yet there is still an astounding amount of ignorance.
This conference marks the start of an annual programme of similar events – and keeping SRH in people’s minds has to be a great move forward.
I applaud you, BFPA