Dear Colleagues;

We are about to embark on our second medical mission this Saturday, July 28th, 2012. Thanks to Dr. Sharma for providing the funds to make this possible. The mission is now registered as part of the Mount Sinai Global Health Initiative, thanks Dr. Landrigan. I would like to thank Dr. Anne Sumner from the NIH and Drs Bonnie Green and Priscilla Dass Bailsford from Georgetown University for their assistance in creating a wonderful post traumatic stress tool to be used as part of our community outreach. Thanks to Drs Fuster, Narula and Landrigan for their guidance and support. I know Dr Narula really wanted to come but due to obligations at Sinai he couldn't.

The team will consist of Drs Janice Scobie, Jon Sumner, Nancy Thomas, Gilda Caputo Hansen and myself.

We arrive Saturday late evening with the final leg of the trip being a ferry ride from Antigua to Montserrat.

On Sunday, July 29th - members of the team will attend religious services on the island, we will then have lunch at Olvestion House ( former home of Sir Elton John) and debrief for our week ahead.

Monday  and Tuesday, July 30th and 31st - I will begin seeing patients at the hospital, there are 30 follow up patients. Echo scans will be performed by Janice and Jon. Nancy and Gilda will go around the island, adminstering the questionnaires and checking blood pressures.

Wednesday, August 1st - The same activities will occur until Mid day. Then we will host a mini symposium geared towards education of lay people and primary practitioners about Cardiometabolic risk factors. Questionnaires and screening will occur at this venue as well. There are 200 invited guests.

Thursday, August 2nd - There will be a helicopter tour around the island including to the peak of the volcano, for those brave enough to venture on this trip. This will be followed by a jeep tour around the island. The after will be spent with government and health officials where we will be informed of the current health situation on the island and plans for the future.

Friday, August 3rd -  will be a repeat of Monday and Tuesday; there will be local entertainment for the team in the evening.

Saturday, August 4th, will be a day of relaxation and a visit to a carnival in "Cudjoe Head".

Sunday, August 5th -  we return home.

Please visit the blog at www.ashoutreach.blogspot.com<http://www.ashoutreach.blogspot.com> for further details and a day to day update when we are there.


Warmest regards

Icy Fergus

Montserrat Hearts 2012

It's Friday, July 20, 2012 and we are 8 days and counting until we leave on our second annual Heart Mission to Montserrat.  In 2011, our team started with Dr. Icilma Fergus, Nancy Thomas, and Gilda Caputo-Hansen.  We have now grown by two; Dr. Janice Scobie and Dr. Jon Sumner will be joining us on our expedition to Montserrat.  They are both cardiologists and will be a great addition.

This year, we will see patients in the hospital, and on Wednesday, August 1, 2012,  we will present
 "Cardio Medabolic Risk Factors: What we need to Know
 to the medical professionals and the public at an educational symposium held at the Montserrat Cultural Center.  We will cover topics including Hypertension, Diabetes and Coronary Artery Disease.  We will also screen blood pressures an hour before and after the session.

Throughout the week, Nancy Thomas and I will  once again travel the island to take blood pressures at several locations including:  the Lookout Community Centre, Old Salem Primary School, Nadine's Grocery, Old St. Peter's School, the Old Police Station in Cudjoe Head.  The final major health screening will be held in the Montserrat Governmental Headquarters Building.

We will record data about the participant's cardiovascular wellness, as well as data that deals with the emotional effects the volcanic eruption had on their lives.

What will we find? Higher rates of hypertension and diabetes than we saw last year?  Will we see a dramatic drop?  Will there be any significant changes?

We are looking forward to our week on this mission to discover the answers to these questions.

Montserrat Hearts 2012  

Stay tuned for our daily reports and updates.
Author - Gilda Caputo-Hansen
Director, Hypertension Community Outreach
American Society of Hypertension, Inc.

Staggering Initial Findings

In a preliminary review of the data we collected in Montserrat, it is apparent that the prevalence of Hypertension and Diabetes in Montserrat is higher than the general prevalence that is usual in the Caribbean islands, and  is notably higher than in urban areas of the United States or in African Americans. This is especially interesting since smoking is very low to non-existent on the island, there is increased physical activity ( there is a lot of uphill walking) and lower obesity prevalence.

Is this due to Post Traumatic Stress Syndrome from the volcano or increase in inflammatory processes which are contributing to these higher percentages compared with neighboring islands and the United States? Please follow the blog for further information.

Thanks and appreciation from Mount Sinai Heart Cardiovascular Disparities Center

As we came to the end of the first "Blood Pressure without Borders" medical mission in Montserrat, I realized that it was actually a beginning, we have really just skirted the tip of the iceberg. The initial invitation from the Minister of Health, Colin Riley, was simply to come to island to provide cardiac care to patients who had no access to such care without leaving the island. Knowng the impact that the ASH community outreach committee has had in the New York neighborhoods, I knew that a collaborative effort would be phenomenal and it indeed it was.

As Director of the Mount Sinai Cardiovascular Disparties Center, I would like to thank the president of ASH, Dr George L. Bakris for his vision, the Chair of the ASH Community Outreach Comittee, Dr. Keith C. Ferdinand for his leadership, Gilda Caputo Hansen for her tireless energy and organizational skills and the entire committee for their support. I would also like to thank Nancy Thomas - coordinator for Mount Sinai Heart CDC for her hard work and committment, our community partners the Association of Black Cardiologists (ABC) and the American Heart Association (AHA) for their contributions. I would like to thank the leadership at Mount Sinai Heart and Medical Center (Dr. Valentin Fuster, Dr. Samin Sharma and Dr. Jagat Narula) for believing in me. Last but certainly not least, I would like thank all the people of Montserrat especially the Chief Minister Reuben Meade, Deputy Governor Sarita Weekes, Chief Medical Officer Dr Michael Owen, Minister of Health Colin Riley and former Ambassador to the United States Laurine Fenton, for their wonderful reception of the team, for their optimism and appreciation.

This is just the beginning, we hope to be back next year for another epic event, this time we hope to include a community based eduational program. Looking forward to everyone's feed back and comments.



The volcano with the destroyed town "Plymouth"



L-R Dep Gov Sarita Weekes, Robert Rowe, Dorothea Hazel, Chief MInister Reuben Meade, Dr. Fergus, Laurine Fenton, CMO Dr. Michael Owens



Gilda and Dr Fergus at the farewell celebration

                                                              Happy Labor Day to all!
                                                              Dr. Icilma Fergus Rowe

Some Pictures of the Health Screening

The ASH table of give-away goodies!!

Dr. Fergus-Rowe thanking Dorothea Hazel for her work on the project.

Gilda and Nancy presenting the President of the
 Montserrat Diabetes Association
with a Blood Pressure Monitor

Colin Riley, Minister of Health giving remarks at
Opening Ceremony of Health Screening

The infamous Bull charging the "girls"

Heading Home

I can't believe the week is over. I am sitting in the Antigua airport where I will wait about four hours until I continue my journey home.  It's funny how dramatically things can change in a week.  Last Saturday when I arrived, the task at hand seemed so insurmountable and overwhelming.  I was walking into a new country and culture and frankly, it was a little scary.  Six days later, as I leave this beautiful and tragic island, I run into so many people who have opened their arms so widely to embrace us and the message we bring to the island.  I am touched how we have been welcomed into their homes and their hearts.  They are so gracious with their hospitality.  While they don't have much, they are willing to share it as they are so thankful for the time we have spent on the island trying to help them.

I thought it might be fun to provide the reader with our top ten observations of our stay on Montserrat:

Top Ten Observations
1. Not many (if any) people smoke cigarettes on Montserrat - in fact, they scowl when you ask them if they do smoke (a question on the demographic piece of the screening.)
2. A significant number of people reported that they were diabetic.
3.  It seemed nearly impossible to find a diet beverage anywhere.
4.  A large can of mosquito repellent will go a long way to providing comfort.
5.  Horn Honking is a greeting - not some way to communicate that you aren't pleased with a fellow-driver's capabilities
6.   When you go to a restaurant, you are not given bread and butter.
7.   It is possible to learn how to drive on the opposite side of the road from how you were originally taught.
8.   It is amazing how lost you can get, even when there is only one main road.
9.  Contrary to popular belief, you don't need air conditioning to survive the heat - a good ceiling fan will due.
10.  It is true that the water on Montserrat is one of the best tasting waters in the world!!!

So now we head back and will review the results.  We hope to report back soon on the findings soon.

Gilda Caputo-Hansen

Health Screening - Huge Success!!!! Screened 145 People!!!

Yesterday at the Montserrat Island Health Fair, the American Society of Hypertension, with the help of local Island nurses, screened 145 people for blood pressure.  At 10 AM, the opening ceremony included comments from the Minister of Health, Colin Riley, Chief Medical Officer, Dr. Michael Owen, and Dr. Icilma Fergus-Rowe, head of the Disparities Center out of Mount Sinai Hospital, New York City.

Following the ceremony, the health screening, that ran from 10:30 AM to 6:00 PM,  provided a host of information for the local residents including chronic disease screening, breast cancer exams, prostate cancer exams,  information of different types of fire fighting; resuscitation; and general nutrition, health and exercise.
We even had people show up who we screened on Monday and Tuesday to be retested!

Local residents came out in droves on this beautifully hot summer day.  Radio Montserrat provided island music and held interviews for the radio broadcast from the health fair all day.

ASH gave out home blood pressure monitors, the Blood Pressure and Your Health brochures, ASH designed mouse pads; and ASH Hypertension Community Outreach T-Shirts.  Those people who received monitors were trained on how to use them.

As I drove around the island today to do more screening and to work at the hospital with Dr. Fergus, each place I stopped, I had people come up to me again to thank me for talking to them at the health screening.  I am touched by how appreciative the islanders are for this health mission.

I am sad to say that today was my last day on the island as I head home to NY tomorrow morning.  It is exciting to note that we have data on nearly 200  people from the island and that number may indeed grow as Dr. Fergus will see patients all day tomorrow.  This has been an amazing experience - and we have met so many people who have touched our lives.

Good bye for now- Montserrat!!Hope to be back soon!