Updated: October 28, 2018

This week marks the end of Breast Cancer Awareness Month 2018. Dominica is also celebrating 40 years of independence; therefore, focusing on the health of the Nation should be a central part of its development going forward. 

World wide, among women, breast cancer is the commonest cancer and most common cause of death (mortality). While the rate is decreasing in 'developed nations', the rate is increasing in developing countries. Hence, it is not surprising that Breast Cancer is the leading cause of cancer deaths in women within the Caribbean Region; data suggests that the rate of new cases continues to rise. Among the Caribbean states, Dominica has emerged as having the highest rate of breast cancer. The reasons for this are unknown at this time. Nonetheless, this is a trend that all Dominicans on island and, in the Diaspora, should endeavor to halt and reverse. 

Known risk factors for breast cancer may be classed as non-modifiable and modifiable. Non-modifiable risks are those that cannot be changed, like race, genetics and age. However, the Modifiable risk factors for breast cancer can be changed in ones lifetime. Such factors include hormone use, alcohol consumption, tobacco use, reproductive pattern, diet, physical activity and body mass. The question for Dominica and the Caribbean Region is: What can we do to stem this looming public health crisis?

In addition, it was with some consternation that Dominicans learnt in June of current year that, the country also ranks 3rd in cancer deaths in the world, behind Mongolia and Zimbabwe. This study was reported in the June 2, 2018 issue of Journal of the American Medical Association Oncology.  Just imagine!  Not something a country that is known as Nature Isle wanted to hear. One would think that news of such statistics would have galvanized the governing Administration to put out some kind of statement to reassure the public and that they would come up with some kind of plan in order to attenuate the rise. Instead, the Administration has been silent. It appears as if they have not heard of the statistic.  So far, they have not offered any Cancer Control Plan for Dominica.

This Administration seem to be unable to walk and chew gum at the same time.  Yes, following Hurricane Maria in September 2017, priority has to be given to getting citizens back into homes as soon as possible, restoring the islands infrastructure and getting productive sectors going.  That effort should primarily engage 4 ministries (Housing, Finance, Agriculture and Tourism).  What about the Ministry of Health? Are they functioning? With a statistic like that there are many corrective actions that could be taken. First of all, this is a good opportunity to ask the International Scientific Community for assistance in answering some questions.  For instance, are there any areas in the country that are more susceptible? Is the water table affected? How about pesticide use? Are farmers more affected by prostate cancer? Does the Ministry care about the health of the Dominica people? Or, is the Minister and his other Cabinet colleagues so focused on staying in power they can't think of anything else?

It is obvious that this Administration has relegated the health of  Dominicans to the back burner.  They have no interest in keeping their population healthy. Many have seen the progressive rise in obesity, lack of exercise and the change in diet that has plagued Dominica. Those are all modifiable factors to help control cancer. Has there been a mass media or social media outreach by the Administration targeted to the public and aimed at raising  awareness of those facts?  Everything can't left to the local Cancer Society. The Cancer Society in Dominica neither have the financial resources not manpower to execute such an island-wide task.  The response of the Administration is not surprising as health Care is not their priority. Its been years since Dominica can claim that they have a functioning healthcare system.  A promised state of the Hospital is in the Capital City, Roseau, is in a 'frozen state'. The hospital in the second town, Portsmouth which is in close proximity to the departed Ross University School of Medicine is on 'life-support'. The hospital is Marigot, which is also supposed to service the the main airport at Melville Hall (Charles Douglas) has been torn done due to vermin and termite infestation. So, it is no wonder that cancer control is not a priority.

In absence of government action, the public can consider taking steps to modify their cancer risks (increased physical activity, consuming less processed foods, weight control) and educating each other. Above all, Dominican should Challenge and demand that the Administration and, more specifically the Ministry of Health, take action to protect the population's health. International Organizations like the World Health Organization, Center for Disease Control in the USA, Pan American Health Organization, Cancer UK and the European Union are at their disposal. They should not be bashful about approaching these organization on behalf of Dominicans. There is no shame in seeking help.  

Dominicans on island are in an unfortunate situation.  They are being governed by people who view them only as a means of gaining political power, acquiring wealth and advancing themselves and close supporters. Nothing else!  Hence, the total lack of concern that a country which they have been running for the past 19 year has seen its health decline and rise in death rate from cancer and other non-communicable diseases. These health statistics and the Administration non-action cannot be blamed on Tropical Storm Erica and Hurricane Maria. Both of  these events occurred within the last three years, a time frame that is too short to cover the years of neglect of the island's healthcare System and the health of its people. Despite receiving hundreds of millions in grants and loans from the International Community in the pre-Erica and pre-Maria period, Dominica is approaching the status of a failed state. The economy is in shambles, crime is on the rise and the Administration could care less. Of course, when ministers are ill, they can fly out of the island to get health care in other countries. Most Dominicans on island do not have this luxury.