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Joining hands for health

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Title:
Joining hands for health Caring and sharing at Summer time
Abbreviated Title:
Joining hands for health
Physical Description:
v. ; 28 cm.
Language:
English
Creator:
Ministry of Health ( Publisher )
Publisher:
Ministry of Health
Place of Publication:
Nassau, Bahamas
Frequency:
semiannual
completely irregular

Subjects

Subjects / Keywords:
Health care. -- Bahamas   ( lcsh )
Public health -- Bahamas
Genre:
serial   ( sobekcm )
government publication   ( marcgt )
periodical   ( marcgt )
Temporal Coverage:
1983 - 1988
Spatial Coverage:
Caribbean Area

Notes

Statement of Responsibility:
Ministry of Health

Record Information

Source Institution:
College of The Bahamas
Holding Location:
College of The Bahamas
Rights Management:
All rights reserved by the source institution.
Resource Identifier:
Classification:
System ID:
AA00013240:00007


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Volume 4 -No. 3 1986 / 87 JOINING HANDS FOR HEALTH -'eAt u \ \ I "" -CARING AND SHARING AT S UMMER TIM E

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TABLE OF CONTENTS Page Men of The Bahama s ............................ ........ .............. .............................................. Side Burns Editor '1al .... ..................... ... .................... ... ................ ... .................... ... ...................... ... ......... ... ... . 2 Men at Work (pict u res) ............................................. ........................................... ... .................... 3 I s the Male Superior? ........................... ............ ..... ... .......... ... ..... ......... .. ....... Ken Ofosu-Barko 4 On Being A Father ......... ....................... ............ ... ... ...... ....................... ............ ... ... ... Basil Smith 5 Male Sexuality ........................ ... ..... ... ............ .................................................. Rona ld Patterson 6 How It All Began ................... ....... ... ................ .......... ................................ Rooseve l t F i nlayson 8 The H u sband Who Cares ............................................................................. ........ Greg Burrows 8 You re Not A Man Unless ................. ............. ... ...... ... ... ... ............................... Gregory Coleby 9 The More Sweethearts ................................................................... .......... Marcel Lightbourne 10 Is There A Formula .. ? ..... ... ............................ ......... .... ........ ....... ....... ......... ... ....... Lyall Bethe l 9 Rea l Men Don t Cry ...................................... ..... .. ..... .................................... Edward Hutchetson 11 Husba n d Dictator .. : Leader? .... ...... ....... ... ...... ...................................... Rudolph Cartwright 11 Power ...... ..... ... ....................... ....................... ......... .. ............................................... Cyril Peet Proof of Manhood ....... ........ ..... .......... .... ....... ................... ............................. Endr ic Deleveaux 12 12 Up-Date ..... ... ............... ... .................. ................................. ... ................................ Fe licity Aymer 13 A Spiritual Perspe ct ive On Man l iness ....................................................................... Lyall Bethel 19 Impotence .............. ......................................................................................... Patrick Wh i tfield 21 Evaluation ............................................... .... ......................................................................... ...... 23 About The Contributors ........ ................ . : ....... . ... .... ... ....... .......... ................................ ... ......... ... Inside Back Cover

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MEN OF WHOM THE BAHAMAS CAN BE TRULY PROUD JUL 21 181

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EDITORIAL Caring and Sharing in the Summer Time 1987, has attempted to look at some of the concerns of young men in N ew P r ovidence. These concerns although not primari ly with health i n its narrower sense (ph ysical and mental aspects) do have profouna i mplicat ions not only for the ir own but also for the health of the commu nities i n which they l ive, work and play. The i r recurring theme was / is a search for suitable ro le models clear societal guidelines and standards of behav iour at the personal, social and emotional levels Contrary to popular belief men are not the stronger sex The wastage rate of unborn and newly born male infants is much higher than for females. Worldwi d e t h e number of years any man can expect to live are less tha n fo r women. The problems which they face and are ex pected to solve would seemingly contribute to their earlier death. In addition, they are now faced with a r evolution in the role of t h e sexes with which they are trying to come to terms. Some respond with antisocial behaviour, substance abuse sexual abuse some with ino r dinately aggressive behaviour accidents and injury are the leading cause o death and disability in the 15-44 age group for men. A strong male figure in more families is needed. Some of the contr i butors have personally re solved to effect a change. Health is so much more than the absence of disease and disability It has to do with the individual s ability tc main tain an even keel in ever -quic kening maelstrom Pro meting health -e n couraging seeming l y healthy people to rema i n healthy entails providing a mi lieu/ environmen which allows them to take the necessary steps that end. Today, behaviour, i ndividual and commu n it y perhaps the s i ngle most important factor i n health and. qual ity of life. What the young men are seekin{ is means of imp r oving their quality of life. Both indiv idual! and their families as wel l as society w ill need to seek the sol utions which will enable members to find thE balance and slow down if not stop the maelstrom Recovery following a c cidents can be a long and a rduous proce s s Occupational the rapy. Learning to us e h a nds. 2

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{ MEN AT WORK Emp l oyme nt having a job is traditionally a very important aspect of every man' s psyche The ill-effects of unemployment to t he i ndividua l are well-known. l.llylng the ftoor for tne Flamingo uaroens Cllnlc. Motor mec h anic I mportant person I n today's motoring society. Develop ing photographic fllm . ( Mike Bullard PMH) Employee of B E.C. erecting street 11gn11. Careful use of protective gloves KfA Crews o f 2 one to drive and operate c rane the other to Install lights B E.C. A gruellng but very pleasant j ob? R.B P Band 'working' at Fl mlngo Garden s laying of cornerstone ceremony r .. . ,;;, ,,' Manual sawing at construction site Relaxation a game of dominoes necessary for everyone' health and well-being 3

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IS THE MALE REALLY THE SUPERIOR SEX? KEN OFOSU-BARKO Comparing the sexes invaria bly arouses emotions. This is justifiably so because in any situation where one runs the risk of being judged as inferior, weak, bad one has the right (legal or otherwise) to stand to his or her defence. Based on this premise. I do not intend to pass any judgement, but to present some interesting facts for your consideration. According to Biblical sources, the woman was made after her boss, the man. The first question i s this is a later version a l ways better than (an improvement on) the first or earlier version? the protagonists of the theory of evolu tion advocate that the more highly differentiated the orga nism, the more advanced it is. If it were so then men would consider this a grievous fault and grievo u s l y wou l d they answer the opposite sex. In the genito-urinary system the male uses one organ for multiple functions while the female 's organs are differ entiated. According to the theory of the evolutionists and the bio lo g i sts what does this i mply? Demograph i cally, the female outlives the male I n The Bahamas, whereas life expectation at birth (the number of years one is expected to live when he / she is born, cons i d ering certain assumptions) for males is 65 years whi le that for the fema l e is 71 years, 1979-81 (see table 1 ). th is appears to be th e picture in nearly all parts of the world. Is this a ref l ection of the i ntrins ic qual ities of the sexes or is it merely a plot to eliminate the men quickly? Is this a possi ble reason why the female is said to be emotionally more stable and to cope better w ith stress than her male coun terpart, or vice versa? Let us turn our attenti on to the reproductive potential of the sexes. I t is an established medical fact that as the woman grows older her chances of giving birth to a baby with a defect increases. Could this be t he reason why she has an in-bu i lt regu l atory mechanism to shut off the repro ductive potent i al at a certain age while the male continues to pump out the scavengers? I am tol d that women claim that the stuff from the older men i s better, or is it rather their performance? Can this claim be substantiated? Another observation is that once the female starts active service she potentially remains in that state unti l death, (unless some obstetr icia n term i nates this service iatrogenically through a procedure l ike Le Fort 's col pocle4 sis ignore the terms if you don't understand). The man on the other hand is lik ely to retire from active serv i ce by choice through the effect of drugs for example or other wise (Shakespeare says alcohol increases desire but low ers performance). The w ill, intell ect and emotions are attr i butes i n men and women wh i ch, when combined in the right proportions and in that order can produce some fascinating results The man is said to have h i s w ill and the woman her way. What do you say about the intellect and emotions? On the intellectual front, it has been said that "the first man to throw a blow is the one that has run out of i deas". If so does this offer a poss i ble explanation as to why the male is u sually the aggressor? I s it because he easily runs out of ideas or that he simply refuses t o use his i ntellect? Are the re any imp lications? Or was Plato justified in saying that might is right "? I know what conclusion you may be coming to or might have come to but I know one thing, and it is that the sexes are supposed to be complementary or is it com plimentary? COUNTRY Denmark F rance Italy Netherlands Portuga l Sweden UK Yugoslavia Norway Bahamas TABLE 1 Life Expectancy at birth (years)' MALE 71. 4 70.6 70 .7 72 69 73.1 71 67.7 72.7 65 FEMALE 77.6 78.8 77.4 79 77 79.1 77 73.2 79.5 71 Ref: Walter Hubr ich The response of Hospital to demo graphic socia l and morbidity changes in society: Int. J. Health Planning and Management Vol. 1 No. 4 July-Sept. 1986 pg. 291

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I ON BEING A FATHER BASIL SMIJH Parenthood comes with natural, instinctive ease to most of us, yet few of us a l low ourselves to take this remarkably complex and responsible role for granted. Being a parent involves far more than getting the kids ready for school, pay ing the fees providing food and shel ter. It involves taking charge of a frai l highly vulnerable and very impressionable spi rit at the moment of the dra matic entry into our world, nurturing his / her growth and guiding his/he r development through countless s t ages fo r the eighteen or so years i t takes a c h i l d to become an adult. Of course, it not being an i deal world in which we less than perfect humans l ive, it doesn't always work out that way. The fact does remain, however that is how it should be, even our instincts tell us so. By standing back and observing my own children fo r example, I have been struck by the importance of example in raising. children. It is by this method that cultures survive, many features remain ing intac t for centuries T h is marks one of the most striking and important distinguishing differences between man and animal. Genetic i nheritance accounts for the instinctive awareness which mankind and animals have about many things. No one has to teach an infant of any species how to suckle, for example. That information is supp lied through t h e chain of genetic inherita nce. But while the food to which the young suckling takes in l ater l ife continues to be dictated by genetic f actors i n ar.iimals, in man cultural inheritance takes over. For that reason cows eat grass no matter how o l d they get, while in humans Indians eat curry and Italians ea t pas ta. Italians raised i n India probably w ill regard curry as a d i e tary staple a n d vice versa i n the case of Indians raised as I talians. Even before h e could read the name my son could recognize the pictures of my favour ite jazz musicians. He would see them on the a l bums which I played most fre quently, ask their n ame and then throw t hem back on demand. It developed into an impressive parlour trick and probably set the first course of direction for his future ad ventures in the wonderful world of music. There is such a bewildering range o f information tastes, opinions values, ideas, philosophies which one has to impart to one's child. I n my own case I concluded that the r elat i onship which would best e nable me to i mpart the most useful i nformation with maximum credib i lity was more i n the l ine with being a friend and less with being a law maker I treat my children like my buddies as far as possible w ithout losing tra c k of the need for firmness from time to t ime to ensure their conformity to certain patterns. Children l earn of the world through the eyes, ears and experiences of their parents. They do th is by the use of questions, thous ands and thousands of questions The parent w h o does not make t ime to l i sten to those ques tions and provide carefully co n sidere d answers is depriving child r en of the single most influential method of We hum ans are r esourcefu l and chi l dren so de prived will find other sources of i nformation, but chances are that somewhere down the road the parent guilty of such neglect will have cause to reflect that child is l ike p. stranger to me. I can t understand it." Chi l dren a l so like to share their experiences and im pressions of l ife with their parents. That daily grind about which we adults become b l ase i s a continuing adventure for a ch ild. Each day brings new chal l enges, impressions and experiences. Emotions grow and are stimula ted as the child shares the g i ft of friendship in the schoo l yard. Challenges are met and grapp led wit h in the c l assroom. Listen ing to our chil dren relate t h e little successes and disappointments of their day at school otters a valu able window to their l ives. T hese list ening and discussion respon sibilities of par enthood form the basis of a crucia l bond between parent and growing chi ld. On this bond is bui l t the success of the parent as role model. It has often been bemoaned that in today s Bahamas there is a shortage of positive male role models. The most important of all the role models a child can have are the two he or she has as parents. In many Baham ian fami l ies the male parent is absent, a situation which leaves a void which is particularly d iffi cult to fill. My children composed a l ittle song some years ago of which I am particularly proud, it i s called Hanging Out It is long on lyrics. rt simply goes: "We're hanging out, H a nging out, Hang ing out w it h daddy, H a nging o ut hanging out, Hanging out with dad. It is a song for Saturdays in particular, the entire day which I dedicate to spend ing w it h them. Among the regu lar act i vities we share is a trip to the movies. My son is quite a movie butt and monitors the pro grammes and ratings for us. As long as a mov i e with a general rating is in town we are there rolling in the aisles with a house ful l of children. It is an experience wh ich I e njoy' as much as they. The real reason for going to the movies so faithfully in this age of watch-'em-at-home video is that I think the social exposure is good for them. Noth ing can rep lace the warm magic of watching Stephen Spielberg s Goonies i n a theatre crammed with shrieking children. I recommend it! Of course there is much more to fatherhood than friendship, role modelling and Saturday afternoon at the movies. Essentially fatherhood is a role in a synerg istic relationship which is a l so en l ightening for the father as for the child. The rewards more than compensate for the burden of respon sib ility which it i mposes. 5

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MALE SEXUALITY RONALD PATTERSON Early Development The human embryo or foetus of both sexes, deve l op s in an i d e n t i cal fash i on for the first two months o f pregnan cy Only thereafter do anatom i c a l and phys i olog i cal devel opment diverg e to result i n the format ion of the male and female types The XX female chromoso me or XY mal e chromo some e stablished at the t ime of conception directs the deve l opment of either ovary i n the case of the femal e or testes, in the case of the mal e If testes deve l op, their hormona l secretio n s el i c i t the deve l opment of the male secondary sex characteristics colle c t i vely known as the ma l e phenotype O n the other hand if an ovary deve l ops or i f the test e s that develop i n the male do not effective l y secre t e certain hormo n a l substan c es at thi s ver y early stage o f foetal l ife. t he anatom i cal deve l opment of female sex characteristics will usually occur. Family r e spon s ibility of male As Father: prov i de r -to ensure t h at fami l y membe r s are well housed and fed and chi l dren edu cated in accordance w ith the bas i c rights of the child as identif ied i n the U n i ted Na tions Decl a r ation on the R i ghts of Chil dre n Compan i on and p l aymate to w ife and chil d r en spe n ding time w ith them in family out i ngs a l lowing chi ldren special time with h i m on thei r o w n and to g ethe r as a g r oup to enable t hem t o experience a hea l thy male role f i gure. As Husband : lover and sweetheart to h i s o t her half A fulfilling sexual relationship is a basic com ponent o f a hea l t h y mar i tal r elationship As Frien d and Compan ion:-shar ing w ith his wife s j oys as w e l l as serious di ff icul t ies ar i s ing from her other l if e that of w ork. Communication is t he key to a good mar ital relatio nship. Responsibility during pregnancy Dur ing thi s i mportant period t he man s emotiona l fi n a n cial and other eleme nts o f support are essential. They i nvolve h i s atte n d i ng prenat a l visits and b irthi ng-room classes w ith h i s w ife o r partner so that he may better understa n d the ful l complexity of the pregnancy and labour process and his wife s reactio n t o it. H i s presence during the l abour and del i very process can also be extended to caesa r ian section del i ver i es i n selected situations E q ually i mportantly he must g u ard against outside sex u al act i vity. The adverse consequences of this can i n cl u d e p remature l abour miscar r iage, premature ruptu r e of 6 membranes or the wife s water bag and ser i ous t r a n smis sion to the foetus or mother, o f a variety of infectious agents such as h erpes human papi l loma virus (the vir u s assoc i a ted with cervica l cancer) gonorrhea syphil is, chla myd ia, the AIDS v i r u s and numerous o t he r sexually transmitted diseases. In the event t hat ou t s i de sexua l activi t y cannot be avoided co ndom use d uring coit u s (sexual in tercourse) i s mandat ory. At puberty Ma l e sexuality boys exp e rience a sudden and dramatic i ncrease i n l i b i do (sexual u rges ) w hich is secondary t o t he high prod u c tion o f t h e mal e hormone t estosterone; males in general reach the peak of t heir sexua l reactivity and potency at seventeen t o e i ghteen years of age Un protected sexual activity at this time has resulted i n alarm ing tee n age pregnancy rates as wel l as sexually t r a nsmi tted d i seases a n d t heir serious compl i cat i ons By the time a man i s over forty t he qua l ity of sexual p l easure has often begun to change noticeab ly. After the f i ft i es the ageing process has profound e ffec t s O n the frequency of orgasm and the l eng t h of t he refract ory peri od tha t i s to say the l engt h of time required to have pen ile erect ion afte r orgasm progressive l y incr eases T here is cons i derab l e specu l ation r egardi n g the exis tence of a "mal e" menopause. The male hormone changes are gradua l as compared with the abrupt cessa tion o f ovar ian fema l e hormone function ing in women and there i s some ev i dence t o i ndicate that this process in men may begin m uch later i n the mid-fifties ve rsus age forty to fifty i n women. In some men this t ime o f life is accompan ied by dep ress ion, irri tabi lit y lac k of energy and sexual d i fficulties. Apart from his l owered male hormone le vels i n h i s m i d-f i ft i es a man a l so begi n s to face the i dea o f death and is confro nted w it h his l i m it ations. I f h e is not pos sesse d of enough r esources a n d strength, depress ion and a n xiety may become ma n ifest dur ing this period. lmpo tence and avoidance of sex are often a part of thi s s ituation. Rep l acement testosterone treatmen t is helpful in some cases. A s far as the purely sexual functions are concerned, some men compensate for thei r age-related decline in sexuality by s eeking out a n d creating intensely stimulating e r ot i c situat i ons fantas ies and partners. Of sig n i ficance mor e dir ect stimu l ation of h i s gen i tals by h i s wife o r part n er is u sually i n creas ingl y necessary to crea t e arou sal and erect ion. Other men by contrast succumb and c e ase h av ing sex u a l i ntercourse i n their f ifti es and s ixties. On the contrary wome n t end t o w ant more sex rather than less as t hey approach m i ddle age and beyond and their r es pons iveness becomes on l y sligh tly l ess rapid and i nt ense.

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s s .. The wife may find it difficult to be generous seductive : and responsive if she interprets her husband's declining sexual vigour as a sign of rejection. It is therefore mandatory that such couples recognize that normal age-related sexual changes do occur, that they are not identical for husband and wife but rather they are a product of the ageing process and not of the quality of their love. Finally, male sexual dysfunction among couples of all ages can be a source of serious marital or relationship difficulties. Some of the common sexual dysfunctions in volve impote nce and premature ejaculation. It is imperative that professional treatment be sought, since therapy can be extremely successful and gratifying particularly lor premature ejaculation Masters and Johnson (renowned for their work on human sexuality) diagnose a man as a premature ejaculator if he reaches orgasm before his wife does more than fifty percent of the time Consequences of sexual promiscuity in marriage or relationship The ris ing incidence of sexually transmitted has heightened the incidence of pelvic inflammatory disease (PID), refers to a clinical syndrome of infection that is initially transmitted by the male during sexual interqourse to the vagina and cervix of the female, which then causes an inflammatory response in adjacent tissues including the uterus, the fallopian tubes the ovaries and the abdominal cavity. In the USA, PID occurs in about 850,000 women each year, requiring more than 212,000 hospital admissions and 115,000 surgical proceedures. i ll 1 \!..l: PELVIC UIU..;i\i'JS The economic loss resulting from this infection is estimated to be approximately 2 7 billion dollars annually. This cost includes management of hospita l in-patients and out patient s, inclu d ing long term consequences of PIO to the femal e such as recurrent and troublesome abdominal pel vic pain, ectopic (tubal) pregnancy infertil ity and adhe sions or scar tissue formation involving the fallo p i an tubes. The increased incidence of ectop i c pregnancy cases carrying with it the risk of fatal internal bleeding and death is another feared complication of PID and reflects the increased number of cases of PIO in this age of sexual indiscretion. A major complication of sexually transmitted disease is both female as well as male infertility. In the female, alteration and damage of the tubes caused by sexually transmitted infection is a major cause of female infertility while in the male there is damage to the male sexual organs and similar infections can be a signifi cant factor in low sperm count and consequent male infer tility FEMALE PELVIC OllGANS Cervical cancer among women is now felt to be a sexually transmitted disease a direct result of sexua l in discretion and directly related, in a significant number of cases, to the number of sexual partners on either side. In fact the incidence of cervical cancer in virgins or in cou pies who have had lifetime limited number of sexua l partners is quite rare Of particular interest, most of the sexually transmitted infections causing the above prob lem can be very silent and unsuspecting to even the most careful and observant person while on the other hand internal damage from them progresses in many cases undetected until it is too late. While barrier contraceptive methods such as con doms spermicidal creams and the vaginal sponge offer some protection these are indeed limited and the best approach should be prevention by sexua l responsibility and discretion by both male and female. Finally this article would be incomplete without a ref erence to drug use, the serious consequences of which are vividly known to most readers. Of interest is the fact that many of the sexua lly transmitted disease complica tions including AIDS are substantia l l y h i gher in this group. References: Y Fie l dman:-Sexually Transmitted Disease Churchill Livingstone H Singer Kaplan: The New Sex Therapy, New York Times. OBSTET Gynecol Survey OBSTET Gynecol De Cherney; Polan: Reproductive Surgery, Year Book Medical Pub lishers 7

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HOW IT ALL BEGAN ROOSEVELT FINLAYSON In December 1981. dur ing the Chr i stmas season a group of young men and women from Carew Street, off Mt. Royal Avenue came together for a reunion. The feel ings generated during that reunion. as t hey reflected on the good old days," were very special a n d warm. A few days after the reunion while v i s it ing the home of Edwin and Edith Davis. former residents of Carew Str eet. they con t i nued to talk about those good old days. It wa s dur ing this discussi on with the Davises that t h ey began to focus not only on Carew Street bu t the w i de commun ity of the Valley or Centrev ille. The result of thi s dicussion was the birth of an idea for a comm u nity-wide reunion in the Centreville area. It was the first day of August 1982 when a group of past and present residents of t h e Cen treville area met at the Burn ing Pot Restaurant to d iscus s this idea of a Cen treville reunion. They dec i ded that they wanted to do something spec i a l and in fact they wanted thi s reunion to be a Festival. D u r ing that fir st meet ing the feel ing of toge therness was strong and sweet Everybody wanted to make a contribution to the Cent r eville Fest i val. It was Lin da Fitzgerald who came u p with the name Centreville i n October and it was Raphael Munn i ngs of Funky Nas sau fame who developed the festival logo highlighting the j unkanoo drum and cowbells Linda and Raphael have put their personal stamps on the festiva l and in thei r own way helped to make it special. The first festiva l was he l d over a three day per iod i n 1 982 and in 1983. In 1 984 the festiva l' s f orm a t was ex panded to a ful l week. Last year 1986. the format had been expanded further to inc l ude a full month of activities Our main aim in organiz ing these festivities is to pro v i de an opportun ity for past and present residents of the community to get together in a spirit o f brotherliness. We aim to have a great time together as we savour the mem ories of the good old days says Roosevelt Fin layson. But there i s also a serious ob j ective of these fest i va l s and that is to raise funds for scholarships at the College of The Bahamas for students from the area. Since the first fest i val we have made an i mportant s tatement about the benefits which are ach i eved when a community comes together w i thout regard for po l itical or r e lig i ous differences. Persons in several parts of this isl and have watched us and have foll owed our lead by es tabl i shing fest i va l s in their respect i ve communities In order to keep the pub lic' s i nterest and support the Centreville i n October Festival must cont i nue to grow. The major challenge before us i s to encourage greater partici patio n by all sectors of the community As we look to the future perhaps it is fitt ing to reflect on an i dea deve l oped during a recent discussion which I had with Raphae l Munn i ngs, Don Hunt and Phil l ip Munroe. The i r idea is that we should capitalize on t h e posit i ve feel ings generated by the Festiva l and organize a series of s port ing and cultural act i v i t ies throughout the vear. The festival, they feel shou l d then become the annual climax of these year round act i v it ies Year round activities are defin i tely needed i n our com munity but of course this requ i res a much greater effort by the organizing committee But we all know that we have more than enough talented people in or from the area to atta i n thi s goal. Therefore let eac h of us mak e a commit ment to thi s i dea of year round activities THE HUSBAND WHO CARES. IS A WHIMP GREG BURROWS The term whimp though not an offic ial word in our language n onetheless conjures up a picture of someone who i s weak in bondage and not assum ing h i s proper role and funct i on in a relationship or in soc i ety at large. In this age of supposed enlightenment. it some t imes seems strange that the view expressed the husband who ca r es for h i s wife and who plays an active role in h i s domest i c l ife is a whimp -is so prevalent and that there is something wr ong or degrading or unman l y about (1) caring for your wife (2) helping with domest i c dut ies. The firs t aspect of caring for one s wife as being in any way negat i ve is abso l utely ridiculous and nothing short of bar baric Marriage f undamentally should be based on mutual caring and affect i on between committed mar ital partners The person who cannot love or care for his wife is surely someo n e who does not understand love and most l ikely does not love himself 8 The second aspect of hel ping w ith domestic duties is where many men have problems. Some of us tend t o think that the on l y form of work we shou l d do i s our jobs. This perhaps would be excusab l e to a degree i f our women d i d not go out to work also yet we seem to expect them to work from 8:30 a.m. to 5 :00 p .m. and st i l l do all the do mest i c chores b r ing up the chil dr e n an d provide discipline and spiritual leaders h ip This is abuse in the highest de gree There is nothi n g degrad ing about domestic chores bei n g done by men All hone s t work is honourable and profitable. The real criterion may however be e it her lazi ness. selfishness or an extrem e bondage to unrealistic relat i onship stereotypes which i n our soc iety, tends to op press our fema l e populat ion. Jesus gave o f himself (remember he was male) show ing us that true manhood i s bui l t on giving ourselves ior the betterment of others. We, therefore as men can be free to care free to help our wives. In doing so we show what REAL manhood is a l l about. ,

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I .. YOU'RE NOT A REAL MAN UNLESS GREGORY COLEBY Down through t h e ages, man ha s a l ways sought to achieve esteem for himse lf by flaunt ing his mascul i n ity, resulting in promiscu i ty outs i de the mar i tal relationsh i p In many soci eties today i t would appear that promiscuity is the order of the day The myth that you a r e not a man unless you cheat on your wife must be destroyed as it has taken a very se r ious and detrimental toll on the sanctity of marriage and fami l y life Whenever and wherever prom i scuity i n married men occurs, i t must be seen that one of the fundamental prin ciples of the marr i age vow has been violated. Ma r r iage is promise or commitment of their lives to e a c h other In our society young men are look ing for rol e m o dels and w ith such a decay in our morals we are constant l y searching for someone whom we can emulate When we find a man who keeps h i s word is honest and faithful to h i s wife we should not hes i tate to point him out a s someone to hold in high esteem. We in The Bahamas often claim to be a christ i an nation and with that background I would like to quote from the Bible as it relates to a husband cheat ing on hi s w i fe Matthew 5:27-28 Jesus says, Ye have heard that it was said by them of old 'thou sha l t not commit adul tery But I say unto you tha t whosoever looketh on a woman to l ust after her hath committed adul tery with her already in his heart Cheat i ng on one s wife is called adultery and adultery i s sin God will punish wrong and we w ill not escape if we pers i st in this practise. Another biblical passage frequently used at wedding ceremon ies also depicts quite clearly how God i ntended our marriages to become one bond which leaves no room for a husband to find the t ime and purpose to pursue another woman Mark 10: 6-9 wh i ch relates to the union of Adam and Eve by God Jesus says But from the begin ning of the c r eation God made them male and f e male. For this cause shall a man l eave his father and mother and cleave to his wife And they twa i n shall be one flesh ; so the n they are no mor e twain but one flesh. Wha't therefore God hath joined together let not man put asunder. The oneness mean s s i mply that the unit is now bonded togeth e r for life, and only d e ath shou l d sever this union. There fore men were not g i ven the right to break thi s un i on. Men of The Bahamas can be men by being solely committed to the one woman that he has taken to b e his wife. It takes a man to be true to his word but one who cheats on his wife does not earn the right to be called a man. A man who possesses strong conv i ctions principles h i gh morals l ove and commitment to h i s wife and disre gards the now common adage that "you're not a man unless you cheat on y o ur wife i s truly someone who can rea lly be called a man. THE MORE THE SWEETHEARTS, THE BIGGER AND BETTER THE MAN MARCEL LIGHTBOURNE This is an interesting topic and I suppose the vast majority of men would love to live in a world where the i r fantasy of having as many women as they can afford to serve them and satisfy their every desire coul d be rea lised. I believe the Islamic wor .ld still allows a man to enjoy up to three wives if he can adequate l y maintain them. In ancient B i blical times many of the patriarchs enjoyed the luxury of mul tiple partners. Even though polygamy is legal ly forbidden in western soc i eties many transgress the system by marrying more than once while st ill legally attached to the first partner Finally, there i s the guy (with or without a legal spouse) who foo l s around w ith as many women as he can manage. The mental i ty of course which spawns this type of behaviour is based on the same assumption that the topic suggests 'The more sweethearts the bigger and better the man ." One must ask oneself the question, i s manhood or manliness determined by the number of women a man can boast of having? Is this a valid criter i on to prove man hood or i s there some other? This may be a valid assumpt i on i f it is based purely on basic human l ogic, inst i nct or desires; but not i f it is based on the inexorable law of God. Manhood, according to that law does not depend on the number of women a man can boast of having but rather how well he has been able to discipline himself to remain t r ue to a h i gher law or promise, a commitment. He is less than a man who g i ves i n to every whim or desire. He has violated one of the fundamental principles of man hood that of self-d i scipline. If a man cannot control himself, his habi ts and desires, that does not make him a bigger man but a fool. My judgement is that, based on the h i gh law 9f man hood, one becomes more manly by demonstrating his abil ity to adhere to the law of one man, one woman and to show h i s originality and creativity as time passes. To be able to measure up to the Herculean task of keep ing that one woman happy and satisfied, whether i t be for ten or forty years of marriage, as long as God permits such a union to endure that sure l y i s the quintessence of man hood. 9

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IS THERE A FORMULA FOR DATING? LYALL BETHEL I remember when I was growing up, I often came across magazines advertising books on how to pick up girls / women. A l though I never made the effort to obta i n such books I could well imagine the well seasoned C as sanova with hypnot i c stare and eloquent words falling off his l ips ensnaring some unwary lass with his well oiled speech As a little boy I would often wonder was there some secret formula that a man could use to draw the female totally within his embrace? Did he have to run his f i ngers through her ha i r as he l ooked her straight in the eyes and pledged his undying love to her or was there something else ?" Luckily at a very young age I was able to separate Hollywood from real l i fe In our performance oriented so ciety so many men fall into the trap of being (or rathe r pretending to be) macho that they miss the point of being real. To think that a woman will like me if I act in a certain way or if I use a certain formu la, or rap" says t hat i f I desire the security of a relationsh i p I cannot be myself. Further i t implies that if I let a woman know me for who I am without my lines she will reject me. It afso dehuma nizes the woman in that it assumes she is a mindless robot designed to respond to the r i ght comb i nat ion of words The individual seeking a formula is actually trying to hide behind it because of his fear of reject ion. He doesn't want to fail or be turned down so he seeks a tried-and true method that will guarantee him results i n order to protect his fragile ego A woman is a sensitive caring being She want to know that my love for her is personalized She do&sn't want to know that she is one of the many suckers who has fallen for some ageless lines If I assume that a "for mula will make her mine, I presuppose a number of things. I presuppose that variab l es such as attraction, physical appearance and individua l preference have no bearing in a woman's response to me. I presuppose that she wil l respond the way the f ormula expects her to re spond a n d that she is hopelessly subject to i t s magic. T he formula-seeker fails to realize that no t wo women are alike . Having grown up in two different backgrounds with diffe r ent role models and teachers I realize that no 10 two women think and respond alike. A woman must be seen as an ind i vidua l with feelings capable of a variety of responses The real man must be willing to bare himself as he truly is, ful ly cogn i zant of her capacity to rej ect him w ithout feeling that it i s an affront to his manhood. Why? Because sooner or later she will discover the r eal fellow without the protection of his lines and well oiled speech. Of course you will fumble and grope for something to say if i t is the f irst t ime or so, but then aga in, that is to be expected you don t real ly know the ind i vidual! You don't know the i r likes and dislikes, or the i r interests. The holly wood star you may be trying to emulate had his prob lems in real life as well. I t i s i mportant to be ab l e to distinguish between the phi l osophy that the movie, the soap opera, or even the latest song is teaching ; and the real world. In the real world don t expect her to be smitten by the first couple of lines you speak because in real life she won t be following some scr ipt. Start ing off with a normal low key relations h ip can take much of the anx i ety and pressure off the male. Let her make a response after you have shown her the real you. That way you won t have to l ive a l i e for the duration of the relationship. Note carefully, I am not saying that a formula or clev er rap won't succeed on the contrary it works almost on a daily bas is. It works on the young gir l anxious to know what i t is l ike to be in love On the young woman getting on in age who has been saving herself for Prince Charm ing or Mr Right. On the older woman who just wants a man to court her whether he i s u s ing his l i nes or not. Then of course there is the lady who will accept you, lines or no lines. Not the type of lady you are looking to court. T he man m u st realize that, for the ultimate good of both parties it is best if he courts her as himse lf, with his own heartfe lt words for as soon as she recovers from her swoon (that she succumbed to from his "magic formula") she will be awakened to the fake that won her heart by insince r e means and she will be anyth ing but p leasant. A relationship purchased at so cheap a price probably isn't worth the price you paid for it. I

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t REAL MEN DON'T CRY EDWARD HUTCHETSON My son will be three years old this week and already he is developing an aversion to tears. His sister who is one year and three months older. has to bear a constant bombardment of the phrase fifa face fifa face fifa face whenever she has an i ssue to cry about. Fifa face is short for "fix your face ". The question arises, How can a male child not yet three know that there is something wrong with shedding tears in the open? The fact that there is noth ing wrong with shedding tears publicly has nothing to do with his knowledge that a person has to fifa face whenever they cry. Has the writer gone astray? The topic is "Real men don't cry. One cold hard fact about the l i ttle boy aforementioned is that whenever he cries he does it in private somewhere away from whomever or whatever caused his tears to flow. As his father I am known as one who is not afraid to cry in public or let the tears flow wherever or whenever they come, but I cannot imagine why thi s l ittl e person i s already cultivating the myth for h i mself that REAL MEN DON'T CRY?" Real men don t cry on the outs i de All men, real or unreal cry Men who are real live. Men who are unreal die but these deaths are mostly unseen. We hide behind the stiff upper lip the determination not to yield I t's a guarantee that we will say what we think but never what we feel. That feeling that is a part of being unafraid of being mistaken for men. Real men don t cry But how can a three year old know? Will he have to experience for himself what his father should a lr eady know? Know! to the degree that he wants to sha r e day by day that "it's okay it's al r ight to cry." cause men not afraid to face their tears will never be afraid to die. Die to the myths and t r ad i tional l i es that keep men bound in chains that separate fathers from sons and add anguish to precious days Come here my son, take Daddy s hand There s so much I have to say About tears about fears about real men who care even when their tears get in the way. HUSBAND DICTATOR OR RESPONSIBLE LEADER?. RUDOLPH CARTWRIGHT It is my sincere belief and conviction that a husband should be a respons i ble leader and no t a dictator in the home. The idea of a husband behaving as if he were a dicta tor in h i s home has come out of misunderstanding the duty of a wife to obey her husband. In other words the English word obey (perform the bidd ing of, do what one is told) has taken on the unfortunate connotation of a sla ve/ master relationsh ip. But this is not what it should be at all. It simply means that a wife should subordinate herse l f to the authority of her husband in those areas which affect the welfare of the marriage and the family. There is no personal stigma associated with this Subordination is a part of her life as it is of all our lives The husband ac cepts the loving submission of his wife while he in turn loves her. Therefore, if and when a husband has to insist or demand this submission he has failed badly It i s false to th ink that because the husband is the leader he is morally or spiritually better than the w ife, that he is more clever or more ab le. This does not follow. The husband s responsib i lity is vested in the fact that he is husband and father not because of any intrinsic merit. He is head because of the nature of the s itu ation. The authority of the head of the house is limited to matters affecting the welfare of the family For him to act like an ancient monarch would be a sad prostitution ot his God-given status as leader. (conti nued on next page) 11

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(continued from preceding page) I of a husband who tried to regulate even his wife 's idea s When he could not persuade her, he ordered her and when this did not work, he contemplated divorce on the grounds that she had violated his authority! This might seem crazy but there are cases of husi.l::inds who try to regulate their wives' religious convictions, their choices of friends, the ir recreational activities, their hair styles and so on. These are clear cases of violation of personal freedom The husband should demonstrate his loving lead ership by giving himself, for h is wife's welfare, financially, mentally, physically and emotionally, at all times. The hus band should exercise his authority so that it will neither be obnoxious to her nor stifle her, but rather in ways that allow her ample opportunity to execise her own leadership abilities in the welfare of the familv. In providing good leadership, the husband will dele gate authority. This is the only way that things can run smoothly and efficiently in the home. The executive who cannot, or will not delegate authority has no place in lead ership at all and the same is true of a husband. At the same time tbe husband who tries to lead a family by de termining what his children and wife will wear everyday, what will be on the menu, and who will do the housework, does not understand the true meaning of leadership. As a leader in the home the husband can strive for his fulfillment in one of two ways. He can bludgeon the personality of his wife until she submits to his every whim, or he can serve and strive for her welfare and happiness so that she will want to treat him like a king in the home. POWER IS DEMONSTRATED BY ABUSIN
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PROOF OF MANHOOD ENDRIC DELEVEAU X T o do justice to this topic, proof of manhood lies in the number of women who bear him children. one must irst consider the following questions: What is manhood? Is it the ability to father a chlld or is it the ability to shoulder one's responsibility or i ndeed to be responsib l e for one' s actions? I n o u r society the part the all important ego plays must be taken into account not only in respect of this particular issue but in many others particular l y as far as the sexual ity of our people is concerned. The fulfillment of egotistic desires is the paramoun t reason for the per sistence of this way of thinking and thus the persistence of this myth, particularly among t hose who are least able to afford it. U nder the circumstances, there are severa l fac tors which ought to be considered (this l ist is by no means exhaustive) in any discuss ion of the concept of manhood These include financial factors support factors and devel opmental factors The end result of each part i cular situa tion is subject to the interact ion of each of these factors I t should also be noted that each group of factors exerts a sphere of influence on each other factor Undoubtedly the most important indi vidual i n these situations is the child produced by such unions, whether he is r egarded as such or not. The financ ial cons i derat i ons begin with prenata l care and extend far into the future The man who views the female bearing him children as simpl y a mach i ne for producing offspr i ng often fails to en s ure that h i s chil d receives the competent and tota l care that he /she deserves. In such c i rcumstances the woman is often left to p r ovide both f or herself and her unborn / newborn child ; the entire burden falls on her except for the precious little provided for by the courts. This financial dearth is normally just the beg i nning of a lifetime of malnu trition, neg l ect abuse depravity inabi l ity to take max imum advantage of the academic and vocational opportuni t ies provided, thus failure to reach a full poten tial and a l most inevitab l y a maladjusted life is more often t han no t t h e outcome of this belief For both the mother and the child society has tradi tionally viewed them as outcasts and less t han desirab l e, ho w ever they are much more accepted today While th e stigma is to a large extent gone t here is still a continuing lack of support fo r these persons, by their families as well as by the society at large. Th e emotional trauma of givi n g birth to a child under conditions of u ncertai n ty possible rejection by both her family a n d the father o f her unborn child often scars t h e mother for life and also has a pro found effect on t he c h ild i n la t e r life. A gai n t h e qu es ti o n is, "What/W h o is a man? Can t h e re be any j u stification in the subjection of two individ u als to s uch a life ti me simp l y to satisfy one s ego? The birth of the child is mere l y the beginning of the dilemma What about the growth of the chi ld, the j o u rney through childhood, adolescence, and early a d u lth ood? What/Who is a man? I s he t he one who sets up the situa t i on which leads to an infer i o r ity complex in his child? What/Who is a man? Is h e one who glo r ies i n the frustra t ions of his child s dreams being dashed to the ground simply because he does not receive the emotio nal and financial support that he deserves? What/Who is a rea l man? Is he one who r ealizes tha t h is child will probably never realize his / her full pote n t ial and yet sti ll p lods along producing othe r s i blings whic h h e cannot or will not sup port? W h a t real man i s there w h o will, afte r all consider ations permi t his child t o ex p erie n ce life un der these cir cumstances w hether or no t he ca r es for i t s m ot h e r ? Wha t is the proof of manhood, a biologica l fun ct i o n or an atti tude of social respo n sibility. Wha t do you thi n k ? 13

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UP-DATE FELICITY AYMER WELCOME: To the Staff of the PMH the following interns: Evaneth McPHEE Ma rco WEECH, Williamson CHEA, Selbourne GOODE, Department of Medicine ; Melanie COOPER, Arlington McKINNEY Larry SANDS, Michael SUE, Department of Surgery; Frank BARTLETT, Cherilyn HANNA, Shelton MIN OTT, Shanthini RAJASSORIAR Department of Ob stetrics and Gynaecology; Patrick CARGILL Jos e ph MARZOUCA Gwendolyn McDEIGN, Department of Paediatrics who all started on 30th March 1987. Very best wishes for a successful and satisfying tour of duty Doctors To the Staff of the SAC Ms. Emma COLACO, Occupational Therap ist who rejoined the staff at the beginning of February Ms. Rochelle JOHNSON Trainee Assistant Clinical Psychologist; Mr. A lex KREMENEZKY to the Department of Envi ronmental Health Services Mr Kremenezky arrived in Nassau on 28th May and took up his appointment on 1st June. He will function as Consultant in the Managem e nt of Solid Waste Collection and Disposal and Tra i ning to the Department over the next three years with Mr. Michael Turner Asst. Director, DEHS as his local counterpart. Congratulations: 14 Dr. Charles Diggis on successful completion of fur ther studies in Surgery. Welcome back to the PMH. Ms. Cleopatra FERGUSON on your promotion Act ing First Assistant Secretary, Ministry of Health. Mr. Andil LaRODA on your promotion Acting First Assistant Secretary, M inistry of Health. To the following officers in all departments / institutions of the Ministry (of Health) on their promotion to Se nior Clerk, effective 1st April, 1987. Gloria ANDREWS, Glynis ARMBRISTER, Denice BROWN, Anita BURROWS Gretchen DAVIS (D.E.H.S.); Altamese HALL (PAHO/WHO) ; Levada HORTON, Kendall JOHNSON, Jill MACKEY, Gabriel O BRIEN Cleora ROLLE, Doretta ROLLE Brian SEYMOUR_, Sonia THOMPSON Mr Moses DEVEAUX, Medical Records Officer SRC, on your promotion to Assistant Hospital Administrator in the same i nstitution. Continuing Education A four week workshop, 2-30th January, 1987 in the application of specific casts with attention to the extent and position of the cast as well as techniques used, was conducted at the Princ ess Margaret Hospital. The main instructor at the workshop was John THOMPSON, a Registered Nurse at the Orthopaedic Hospital, Scotland; Ors. Willard Thompson and Leon Gibson served as lecturers. The workshop was coordinated by RN Julian Mullings and Train ing Officer Barbara Thurston of the PMH. Twenty-one persons nine Orthopaedic Department, six Physiotherapy, two Occupational Therapy, and four from the Nursing Department participated. Mrs. Velma BURROWS, Chief Physiotherapist, PMH is presently attending an eight week course in the treatment of Cerebral Palsy and other neurological conditions at Bobath (Western Cerebral Palsy) Centre, London England. Nursing Officer 2 Margaret CURRY, PMH, is currently upgrading her nur sing skills in Oncology (cancer) at the University of Miami on a one year i n-service award, courtesy the PAHO, beginning January 1987. Nursinq Officer 2 Pamrica FERGUSON, PMH, re cently attended a course in Infection Control at the CAREC, Trinidad. This was a two week course 30th March 10th April and was made possible by the PAHO Nursing Officer Clarminda HENDFIELD PMH is up grading her skills in dealing with patients with burns and those who need plast ic surgery, at the Queen Victoria Hospital Kent, England. Nurse Henfield will be away for one year, until March, 1988. Staff Nurses Albertha BAIN School Health Services and Angelique COAKLEY of The Ann's Town Clinic, recently attended a one week course -Refresher Work Improvement 3 at the Public Service Train ing Centre, Arawak Cay. Nursing Officer 2 Elizabeth ROLLE, School Health Services, Janice BROOKES Post Natal Service and Catherine WILSON, Carmichael Road Clinic of the CNS attended the Management Imp rovement Course 2 held at the Public Service Training Centre. Health Aides in the Community Health Services (CHS) formerly known as the Public Health Depart ment are being encouraged to upgrade their knowl edge and skills. Both Helen KELLY (School Health

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Services) and Willamae SEARS (Coconut Grove Clinic) spent two w ee ks in the Eye W i ng of the PMH learning and developing their capabilities in eye testing techniques. Michelle CLARKE (Ann's Town Clinic) and Alvira JOHNSON (Blue Hill Road Clinic) s pent some time in the Laboratory (PMH) one day per week for five weeks being exposed to and learning the work. Nursing Auxiliaries Rowena RILEY (Blue Hill Road Clinic) and Dorothy SAUNDERS (Coconut Grove Clinic) attended the one week course Bas ic Wo rk Improvement 1 at the Public Service Training Centre. Dr. Donald COOPER. Assistant D i rector of Environ mental Health Services Public Analyst Laboratory, and Mr. Carlton SMITH, Health Inspector Freeport, Grand Bahama recently (22-27 / 4 / 87) dttended a Sub-Regional workshop in Chemical Safety. The ac tivity which took place in Trinidad was sponsored by the Caribbean Epidemiological Centre (CAREC). Par ticipants all programme managers numbered about twenty and i nclud i ng those from The Bahamas Bar bados Canada Tr inidad and the United States Mr G len n ARCHER Director. DEHS, a.'tended a Consultative Meeting of the Internat ional Devel opment Bank (l.D.B.) i n Washington DC 13-15 May 1987 at which environme nta l issues were discussed. THE DEPARTMENT OF CHILD HEAL TH ( PMH) to gether w ith the Management Committee for Children with Specific Disabilities presented a lecture and workshop on Child Sexual Abuse and the Need for Prevention and Recognition at the Nassau Beach Hotel on Friday and Saturday, 1st, 2nd May The lecture and workshop were given / held by Ors. Marga-. ret McHugh, Paediatrician at Bellevue Ho spital, New York and Director of the Child Abuse Team and Dr. Elizabeth Krents Programme Director of the Child Abuse and Disabled Children s Programme, Lexington Centre Inc. New York. Child Abuse. seemingly a growing problem in The Bahamas, warrant specific techniques. Dr. McHugh shared some experiences while Dr Krents ideas for programme development. Nurs ing Officer Frederika SANDS ( NP) and Veronica POITIER (GB) attended the annual manager's meet ing for the Extended Programme of Immunisation (EPI) held in St. Lucie 4-8 May this year. Highlights of the meeting included p resentatio ns from the rep resentatives of the Centre for Diseas e Control (CDC) Atlanta, Georgia on measles and rubella vaccina tions, the optimum age at which to administer. In addition to the managers of the various Caribbean programmes, there were also representatives from Rotary Internat ional which is presently involved i n a programme to help in the eradication of polio global ly ; United Nat ions Children and Education Fund (UNICEF); the Pan Am e rican Health Organisation (PAHO); the United States Agency for International Development (USA I D); the Canadian International Development Agency (C I DA). Territories achieving 100% immunisation coverage (DPT / Polio) were the British Virgin Islands, Montserrat, St. Kitts / Nevis Anti gua reported 96% coverage. Jamaica has exceeded 50% coverage. Belize is the first English speaking Caribbean territo ry to hold a National Immunisation Day. While on the subject of Immunisation; The poster competition held among senior high schools in New Providence yielded a total of twenty -o ne posters from seven schools; L. W. Young Junior / Senior High A. F. Adderley Senior St. Augustine 's College, Queen 's College, St. Anne 's School, R. M. Bailey Senior High School and C. C. Sweeting Senior High School. Winning Poster The winning poster was a joint effort from L. W. Young Junior /Senior High School with second and th ir d winners coming from St. Augustine s College. Judges comprised Mr. Eddie Minnis Artist; Mr. Patrick Moss head of the Art Department C. H Reeves Junior High School; Dr. F. Mahmood Acting Medical Officer of Health, Com munity Health Services; Mrs. Evelin Prescod, Community Nursing Services and Mrs. Barbara Curtis, Senior Health Education Officer. Awards were presented to the winners by the Hon. Minister of Health, Dr. Norman Gay on Wednesday af ternoon 8th April, 1987. A television set, courtesy Island T.V. was presented to St. August in e's College first and second runners up, Art Supplies were given to the winning school (L. W. Young). Plaques and ribbons were given to all winners and three students who received Honourable Mention St. Augustine 's College (one) Queen's College (one) A. F. Adderley (one). 15

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Response to the competition was encouraging and the quality of posters submitted pleasingly high. It is envi saged that this will be an annual affair. Joining Hands for Health wishes to join its colleagues within the Ministry of Health in extending grateful thanks to all participating schools, teachers and students, as well as those corporate citizens who made donations in cash and kind and of course the judges. On a lighter note, the Acting Medical Officer of Health hosted his hard working committee to lunch shortly af terwards. Thank you very much Dr. Mahmood for your thoughtfulness. It was a pleasant and welcome surprise,! From Central Abaco comes the following report: Health workers in central Abaco organ ise d a number of activities in observance of World Health Day 1987. ( They included 1 a poster display 2. free blood pressure assessments 3. information in the form of literature on various aspects of health and highlight ing immunisation. 4. immunisation survey coverage in one private school. Poster Display Fifty posters submitted from the are a schools (Marsh Harbour, Dundas Town and Murphy Town ) were displayed in the Dove Plaza creating an "art gallery effect". The display was on view to the public from 10 a m until 2 p m on World Health Day, 7th April. Nursing Officer Barbara RECKLEY and SN Lolita PRATT, SN Bernice SMITH and TCN Judy Mae HUNT provided blood pressure measurement services in Marsh Harbour and Dundas Town. Public response to these efforts was encouraging. CHANGE AND??? 16 Mrs Janet COX, Assistant Secretary, Ministry of Health has left the service (1 June 1987) Mrs. Sonia ROSE, Administrative Cadet Ministry of Health has also left the Service (1 June 1987) CN Ella Mae THERVILLE (Ann's Town Clinic) left the service 31st March, 1987 N. 0. Winifred ELSON (San Salvador) left the serv ice in early April, 1987 Joining Hands For Health wishes you all every suc cess in your new ventures. Mrs. Val LOCKHART First Assistant Secretary Min istry of Health has left the service and is presently working at the National Insurance Board in the ca pacity of Training Officer. * Staff Nurse Eldora BENEBY of the PMH transferred to the M i nistry of Education School Attendance Officer. Ms Nora DAVIS, Senior Clerk DEHS has been transferred from the Blue Hill Road Depot to the Ac counts Section of the Department and is now responsible for issuing bills (private businesses) for garbage collection. Health Aides (CNS) transferred in March : Melanie HENFIELD from Nicholl's Town, Andros to Anns' Town Clinic. Mavis PRATT Smiths Bay, Cat Island to Anns Town Clinic. Priscilla ROLLE Black Point E xuma to Coconut Grove Clinic. Ruth WILLIAMS, Rock Sound, Eleuthera to Blue H ill Road Clinic. Bernadette YOUNG Cat Island to Carmichael Road Clinic. In Apr i l: Hazelly ROLLE, Kemps Bay, Andros to Blue Hill Road Clinic SN Peggy SANDS has been transferred from Kemps Bay, South Andros. Ms Janet HALL, Executive Officer continues on her orientation programme and is now in the administra tion department of the PMH after having done a "short stint" at the SAC. The staff of SRC Janet, takes this opportunity to reiterate their thanks to you, say how much they enjoyed your presence and wish you every success. CN Gina BENNET I is reliev ing (fo r one month) at Deadman's Cay, Long Island Retirement. Ms. Ellen DEVEAUX Medical Records Officer (SRC) has retired from the public service after seventeen years. Joining Hands for Health along with the staff of SAC wish you many years of healthy, active retirement. Get well soon:-Dr. Syed KALAMUDDIN (dentist, PMH) Dr. Glen BENEBY, Anaesthelogist Assistant Medical Staff Co-ordinator (PMH) Sister Rose THOMPSON Nursing Officer in charge of the Outpatient Department, (PMH). Welcome back: -* Dr. Earl FARRINGTON Consultant Surgeon PMH af ter a long illness.

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Junior High Schools in New Providence in attempt ing to make up the deficit of organised health educa tion activitie s in their schools plan a health week each year During this time s tudents are exposed to lopical and other relevant (to them) health issues ttvough a variety of guest speakers. This year the S. C. McPherson Junior High School Ba illou H ill Road included Nurse Jacintha AUSTEN (School Hea lth Services) on the ir guest list. She was invited to address Maturation and Menstruation with girls in selected grades Also participating in the week's activities was Hea lth Education Officer Felicity AYMER who spoke to two groups of students (on separate occasions) on Nutri tion developing hea l thy eating hab its. In pursuance of its goal of Health For All .. By The Year 2000 through th e medium of Primary Health Care, the Ministry of Health is proceeding apace in its programme of es tabl ishing primary health care facilities (centres) in The Bahamas. Cornerstone laying and ground breaking for two centre in New Providence Flamingo Gardens (Carmichael Road area ) and Elizabeth Estates East (off Prince Charles Drive) took p l ace within a week Wednesday 29th Apr il and Tuesday 5th May and one in Major s Key, Crooked Island on 20th May 1987. The two Centres in New Providence are being buih by the Nat ional Insurance Board while the Ma jor s Key Centre is being built by the Ministry of HeaHh. All Centres will be operated by the Min i stry of Health and will offer p r omot i ve preventive and cura tive services at the primary level i n addition to the traditional Maternal and Ch il d Health Serv i ces offered in New Prov idence. Both Min is ters of Health and Housing/National Insu rance officiated at the cor nerstone laying ceremonies in New Providence. Another Centre is in the pipeline for New Providence Fleming Street area, while several are planned for numerous Family Islands Ground breaking ceremony for the extension to the Kelly's Psychiatric Ward took place on Wednesday 13th May at the SRC The Hon Minister of Health Or. Norman Gay officiated. Congratulations to the SRC on achiev ing third place at the Special Olympics held at the Thomas A. Rob inson Track and Field Stadium Oakes Fie ld, in May 1987. Competitors included teams of special children from the SRC's Child and Ado l escent Centre S\a pledon School for the Mentally Retarded and Free port s special school. From the DEHS The Health Inspectorate Division moved into new and more spacious offices in Nassau Court in early February. They occupy both floors of the building behind the Ministry of Economic Affairs. All sections, inclusive of Vector Control, .are now housed under the same roof. This should facilitate and improve their operations. Officers are very pleased with their surroundings which more accurately reflect their terms of reference Livingstone Hepburn Chief Heatth Inspector Htlrtwetl Ambrister Insect Control Officer (DEHS) out in the field, pouring Abate", insecticide to control mosquetoes in rainwater barrell Dur ing the month of January (12-16) a seminar was conducted for the Health Aides and Health Assistants in the Division The seminar dealt with General Prin ciples of Food Inspection and the proposed regula t ions for food and general sanitation Over the period 1113 February, a short seminar for Vector Control Off i cers focu ssing on the role of vec tor control i n promotion of a safe environment was held by the Division A special visit to Balmoral Island to ascertain sanita t ion standards and determine measures to be taken to imrove conditions occurred in April and was made by officers McCoy Burrows, Simms and Laing Health Inspectors and trainee Health Inspectors en rolled in the Environmental Health Associate de-

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.. gree programme at the College of The Bahamas went on a field trip to Grand Bahama where they visited Franklin Chemicals, Syntex, Borco and the air monitoring station at Hawksbill Primary School. Class lecturer is Edwin STRAt;HAN Deputy Director of En vironmental Health Services A serie s of lectures to Pri mary School chi ldren dea l ing with the role of the Department and problems associated with garbage was started in Apr il. Officers are involved in teaching i n the Community Nurses programme (ONE) and the Health Aide programme. Viewers of TV 13 might have seen the documentary dealing with the problem of industrial pollution on Thursday 21st May, 1987 at 8 p.m. The programme sought to apprise viewers of the situation as it exists and the efforts being made by the Ministry to monitor and reduce where possible and if necessary the effects of pollution. An epidemiological survey is underway together with ambient air monitoring in the area of the Hawksbill Industrial Park Monitoring on a daily basis has revealed that pollut ion levels detected are within internat i onally accepted limits, that while the level of sul phur d i oxide var i es with the wind and would probably account for symp toms of which the c;chool population in the area com pla i n there i s no evidence to date to suggest that this i s e i ther life threatening or a permanent threat to health The equipment used has been acquired and installed at a cost of $200,000 Mr. Larry Smith of the PAL has been reassigned to Freeport to ensure more accurate and effective monitoring of the environment and assessment of any risks. Forty new garbage bins have been placed on Bay Street between Victoria Avenue and George Street. The Department has added eleven new vehicles to its fleet s ix 20 cubic yard packers to be used i n its garbage collection services (domestic and business) two roll on/ off trucks equipped with detachable containers and three flat bed trucks Accord i ng to the Hon. Minister of Health "this means that on average 240 tons of garbage per week will be collected and he env i sages therefore a cleane r env i ron ment. A computer has been installed to strengthen the de partment's capability in rendering accounts to business houses for their garbage collection and also to compile data on their collection programme throughout the island The Blue Hill Road Depot is to be renovated to allow for a larger vehicle maintenance bay area thereby en-18 abling preventive as well as routine maintenance of its vehicles Godfrey Strachan Superinten dent of the Garage Section (DEHS) Mr. Strachan has been with the Dept. for the past elev en years He has a staff com prising twenty-two men and one female clerk At the depot, all Ministry of Health vehicles except Ambulances are serviced. The 11ree Is to be expanded to allow for. Preventive Maintenance of vehicles, especially the costly garbage collection trucks. Office space as well as facilities and amentities for the workers will be expanded FROM GRAND BAHAMA As has become tradit i onal on th i s island April was observed as health month to coi ncide w ith World Health Day (7th April) A serie s of act i v i ties was designed to pro mote various aspects of health These i ncluded:A pageant f l oat and talent show ( 3rd April) Anything a thon special T-shirts were sold to the f ifty person s who took part (4th April). Staff, fami l ies, fr i ends rode bicycles skated jogged for health . A health food cookout at the Willi amstown .Beach, from noon until ... All food sold was prepared by a healthful method, boiling and broiling. These included salads juices including carrot juice, local produce eg. cassava, sweet/irish potatoes, yam, boiled /roasted corn eddie boiled / broiled fish and chicken.

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April 5th, the staff ioined nurses in worshipping at the 11 a.m. service of the First Baptist Church. Talks to schools on Immunisat ion by Community Nurses (on 6th April). Information booths on diet, n utrition and the impor tance of immunisation. in keeping with the theme Immun isatio n ; a chance for every child, were set up. April 7th, World Health Day, observed by all local Clinics, whileMr. Sam Aymer PAHO 's r epresentative in The Bahamas appeared on Medica l Line, ZNS 3. This was also TS hirt day. April 8th and 9th, Nurses' Forum -an annual event Nurses address different aspects of nursing. This year they focussed on the importance of Immunisa tion as they spoke to ante-natal mothers attending the Clinics. April 11th World Health Day Fair April 24th Well Baby Contest at the Eight Mile Rock Clinic. Awards were presented by Mrs. M. Storr, Hospital Administrator and Mrs. L. Knowles, PNO Rand Me morial Hospita l to the winners of the Essay and Post er competition. The month's activities culminated with a staff picnic held at Barberry Beach on 2nd May and was a thank you gesture to the staff. From the Caribbean A group of persons interested in Sports / Physical Activities and Medicine from around the Caribbean met recently in Trinidad to discuss the feasibility of establishing a Caribbean Sports Medicine Associa tion. Territories represent ed at this meeting included Antigua and Barbuda, The Bahamas (Dr. P. Whit field) Barbados, Curacao, Jamaica, Puerto Rico and Trinidad and Tobago ; response was positive The group is currently working on establishing a secretari at, working out all the details as well as a source of funding is inherent in such a venture. Governments of various territories will be invited to play a role. Other plans include further training of members in sports medicine and setting of standards for coaches. Trinidad is chairing the working committee. VITAL ST A TISTICS Births (New arrivals) Congratulations to Maxwell and Keva NEWBOLD on the birth of their son Mathaniel LeArchron on 11th March, 1987. Mathaniel weighed in at 61b 2oz in the presence of a very proud father. Keva (Mrs Newbo ld) is the Clerk/Typist in the Division. The birthing process went well, Mathaniel initially fully breast fed, is now partially breast fed. The family is doing "just great and Mrs. Newbold ha s that a i r of "fulfillment about her! Marriage (New lives) Wedding bells rang for the following: H A. Bessie CURTIS (nee McKenzie) formerly work ing at the Coconut Grove Clinic now at Steventon, Exuma. H A. Lilian PYFROM (nee Munnings) Dr. Howard COOPER, House Officer, PHM, in March. Dr. Barrington NELSON, H ouse Officer, Psychiatry, to SN Darv ille in April. Stephanie ROLLE and Wilfred DELANCEY on 4th April. Mrs. Rolle-DELANCEY is the Accountant, DEHS while Mr. Del a ncey is a computer programmer in the Ministry of Finance. Joining Hands For Health wishes all these young couples many years of successful married life Deaths: Deepest Sympathy is extended to TCN Hellen MAJOR (PMH) on the death of her hus band TCN Barbara Burrown (PHM) on the death of her husband SN Deanne HOLLAND Gregory Town on the tragic death of her two year old son The family of Mrs. Ethel Mcsweeney, formerly clerk in the Health Information Unit. Mrs. Mcsweeney died on Tuesday 26th, May at the PMH after a short illness She leaves her husband, three year old daughter and many other relatives. May God grant you strength in your t ime of sorrow. ERRATA from the Editor Joining Hands For Health apologises for intimating a Measles outbreak in 1984. This occurred in the pre vious year, 1983 Under the caption "from the Princess Margaret Hos pital it was erroneously stated that dietician There sa Hepburn obtained her degree from Prairie View University Minnesota. Miss Hepburn obta ined her degree from the College of St. Benedicts; Minnesota. Our sincere apologies Miss Hepburn. With reference to the final article in the last edition AIDS A progress Report, th e authors apologise for having omitted to acknowledge the source of the sta tistics quoted with regard to numbers of cases and contacts of AIDS. These statistics were very kindly provided by the Acting Medical Officer of Health Dr. Farhat Mahmood and reflect the numbers reported to the PHO. Sincerest apologies on all counts and thank you for drawing these errors to our attention. 19

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A SPIRITUAL PERSPECTIVE ON MANLINESS LY ALL BETHEL In this day and age when everyone is an expert on what a r eal man is, any child growing up with the philoso phies prevalent in our society today is sure to be hope lessly confused H e hears that "real men don t cry", but also tha t the latest stud ie s sho w that crying is one of the best way s to relieve stress. He hears that his masculinity is dependent on wh ethe r he likes quiche or not. He hear s that a man who cares for his family and plays an active part in family life is a wh imp as opposed to the real man who runs around and cheats on his wife But wait you say! I've never h eard that preached to anyone! My response to that is that although it i s never taught verbally the actions o f myriads of Bahamian men have been tea ching the youth of this nation in a much LOUDER, more pe rsuasive voice. Perhaps a young man sees his father beat his mother while th ey are h aving an argument (which of course puts an end to the argument) and so the child learns that in order to maintain control he must beat his wife int o sub mission With no challenge t o his views he rema ins the same small, insipid, narrow-minded man he was before His ins is tence o n being right no matter how wrong he is, stunts any potential for growth as he refuses to allow healthy disagreem en t s with his wife to strengthen his char acter. Or perhaps he hears in the locker room from men he admires and whose very words are gospel, that the p roof of one 's manhood lies in the number of women who can bear him children And so his impressionable m ind ab sorbs this egocentric nonsense and he sets out blindly to ruin perhaps for life, some gullible love-starved teenager with n o thought as to how the child his child his respon si bility will be raised, supported, educated. N o No! A thou sand times no! Surely these ideas of m a nhood g l ean ed from the misadventures of a tew narcis s i st i c men a r e not w orth even a second thought, fo r their authority lies within themselves and their misguided expe riences But what then is a man? Is there a guide on manli ness? I s th ere another pattern to be followed besides one's father or u ncle who may or may not be a good example? T h ankfully there is! When I look at my Vol kswagen, or wh ateve r type of car I might be driving and I wonde r how I can get the best out of my car I don t talk to a boat s p ecialist, or to a lawn-mower specialist or even to the Ford M otor Company I talk to the company that manufac tur ers a nd sells Volkswagens they know its capabil i ties the y built its engine and they know its individual parts and how they f un c t ion They are not guessing at any stage They know precisely what conditions they built it for and they include all s u c h details in the manual. We as men are in a s imilar situation 20 The B i ble the book that we revere as God s very words, in t his christian heritage of ours, is our auto man ual from the auto-maker ', and it tells us how we can get the best mileage as cost-efficiently as poss i ble. Its words are rooted in the authority of God who knows for what purpose he made us. With this as our premise then, let us try to g lean from the script ure s what man is and for what purposes he exists. In Isaiah 43 : 7 we learn that God made man to bring God g lory. In Genesis (the book of beginnings) 1 :26 we l earn that when God made man He made him with three very distinc t properties : 1) He made man unique -in that, of all the animals that he created, man alone was created i n God's image! M an's capacity to think to reason and to make choices are a direct reflection of the attributes of His creator. Man is not an animal that is i ncapab le of making rat i ona l choic es that affect his life! 2) He made man to rul e responsib l y over all things that affect h is environment. Or to put i t another way. man's or i ginal and basic programm ing i s to br ing God glory by ruling responsibly and so reflect ( or rather i m itate) God's image, God's character in him. Understanding this truth we can see why the writer of the book of Proverbs says that the husband who does not take care of his wife and his home is w orse than an infidel. 3) God' s purpose for man is to multiply himse lf al though perhaps now the injunction i s more so in the spir;tual sense that is replicating one s l ife in others, or making disciples ( Matthew 28:19 and II Timothy 2:2). However not until one correlates the truth of Isaiah 43:7 and Genes is 1 : 26-28 with Ephesians 2:10 can one fully grasp the whole reason for man's existence from God's point of view the only point of view t hat matters in the long run Ephes ia n s 2 : 10 says For we are his (God's) workmanship created in Christ Jesus TO DO GOOD WORKS We learn therefore that man was made to bring God glory by allowing God to fashion him into the perfect man that he can be through Christ's influence. We see this premise restated in the book of Jeremiah 29 :11 which says "Fo r I k now the plans that I have for you dec lares The Lord, pla n s to prosper you and not to harrr you, plans to give you hope and a future. God dec;ires al

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men t o reach their full p otential to l ive up r ight, honest lives in relation t o themse l ves and o t hers. But sin ful men that we are, we don't bel ieve in God s good purposes or i n our potential. This rebellion toward what God is try ing to accomplish in us, or sin, as God ca lls it, obstructs H i s purposes in fashioning us i nto REAL MEN. S i n always makes us less as people. I f I tell a lie I become a l i ar and God never meant me to be a liar If I steal some thing I become a thief and God has better purposes for me than to be a thief. I f I decide to take another man s wife to ful f i l l my own selfish des ir es I totally crush that fami l y s chance of survival and become a pathet i c little man always l ying and h iding my deeds from others God has nobler a s p i rat i ons for me. What then a r e we to do a s people eager to become MEN that is, men as God i n t ended us to be? Must we try to stay at home w i th our wives and try to make up our m inds to stop cheating? For some this m ight meet with success, but no doubt for the major ity such a cou rse of action i s doomed to fai l ure. For such men l ack of self d isci p line has so cond i tioned them to a l if e of i nstant self gratifi cation that t h ey cannot break free of t he cyc l e If we unite ourselves with Ch rist w e woul d f ind ourselves ab l e to res i st the t endency to s i n because of Jesus enabling and so liv e above the t emptat i on We as males, in our qu e st to b e men of substance (men who are men in body so u l and s p ir i t ) need to recog n ize our sinful nat ure fo r the hindrance that i t i s and unite ourselves with Christ for H i s e n abling But before a l i f e of who le ness can beg i n by us uniting ourselves with Christ we mus t come to God on His terms Having realized that we ar e u tterly i ncapab l e of maintain ing the type of l ife that God des i re s of us and that our sin A. lo:S A S To,..C. S to ttA)oY .. &....,4.._,,....<.")' fo.\\, 5o Wt. ClS ...... ..... ........... ... "6y botvf\d 4'to L-"W OP $ \ .... -..-.U\.._ t'O C.W'f't. ,.. ....... o.co-s puts a s eparation between us and God (Isaiah 59: 1 and 2) we need to come to God the one who has been wronged and agree on Hi s terms of r econc i liation In fact in the first chapter of the book of I saiah God s ays to mankind in verse 18 "COME LET US REASON T OGETH E R or rather Let u s agree on these things even though your sins are as obvious and as g l aring to me as sca r let and crimson I God will make you as clean and a s pure before me as s now and as wool. We see then that God and man s reasoning together involves two things: a) the man must fully acknow l edge before God that he i s a si nne r and that his sins are offensive to God. b) God h i mself will correct the state of man's sinful condit ion bef ore Him once the man acknowledges his s i ns and turn s from t hem. God has f u lfilled his part of the bar gain (or t estament as it is most ofte n called by us) i n t h at He h a s p r ovided Chr ist as the propitia t ion ( I John 1 :2) or rather a s ubstitute i n payment for our sins. Through Christ Jesus H e has made us white as snow cle aned the slate so to speak The verse i mmediately following the covenan tia l agreement betwee n man and God verse 19, ex p la in s that a l ife of wholeness can only begin when we consent to God s terms of agreement and obey H i m But t he onus i s on us to accept th i s payment for our sins as the gift from God that it is (Ephes i ans 2:8 ,9) and to rece i ve i t f reel y from God. The Bible says, But to as many peop l e as received Chr i st to those people God gave the r i ght t h e pr i v i lege to become the son:> of God It w i ll always be my prayer that men will tear off the s h ac kle s and false secu r ity of tryi ng to maintain a macho image before their equally insecure peers to let God H i m se l f fashion them into exemp l ary fathe rs, husbands, single per sons and leaders. Men of whom the women of this country can be proud." t'l,c.6. .,,....._.,. .. o ..... .._ > o.blc.. ..,, f"&S \st- """'-o.rt. A'b\c-to
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IMPOTENCE {ERECTILE DYSFUNCTION) CAUSES AND EFFECTS PATRICK WHITFIELD Introduction Erectile dysfunction (impotence ) can b e a major prob lem for the affected man and h i s partner. Impotence, pow erlessness or helplessness, conjures up the most neg ative unmanly and often derogatory picture of manliness No man who is worth his salt could / should be impotent (sexually powerless) and few if any would admit such i n adequacy. During the 1960s stud i es suggested that ninety p e r cent of men with er e ctile dysfunction and who were other wise healthy was of psychological origin However, it i s currently being argued that today the oppos i te i s true and organic causes are now more common Thorough evaluation of all men with erectile dysfunc tion is essential. After evaluation, a comb i ned approach of treatment of organic causes and therapy for psychological causes or impact can be initiated. Since many cases can be linked to either a definite organic or a specific psycho logical cause many cases can have a positive out c ome if evaluated by a physician. In addition, as will be outlined later erectile dysfunction might be an early warning sign of an even more sinister disorder, therefore evaluat i on and early medical intervention can be critical. Causes: 1 Psychological: 2. 22 a) Stress at home and / or at work b) depre s sion -i mpotence m i ght be one of the early signs Organic a) drug induced some diuretics (water tablets) beta-blockers (drugs commonly used for treating high blood pressure) some centrally acting anti hyper tensives XS alcohol (frequent regu lar use of alcohol) XS cigarette smok ing (frequent regular smoking) Drug reaction is an i mportant cause s i mply b e cause of the fact that the treatment is so easy just stop the drug. This is found commonly with anti-hypertensive drugs especially diuretics and beta-blockers. However, the newer generation of anti-hypertensive drugs seem to alleviate this problem b) hypogonadism(abnorma l ity of the testes) thi s i s a condition with which the child is born The teste s which manufacture the male hormone testosterone are poorly deve l oped c) atherosclerosis of the penile arteries -hardening of the blood vessels serving the penis. This is thought to be one of the mor e common causes of erectile dysfunc tion in men over fifty years. Atherosclerosis of the peni l e arteries as w ith any where else in the body is associated with four risk factors ; thes e are : i. hyperlipidermia (abnormal deposits of fatty tis-sue gross l y over-weig h t ) ii. cigarette smoking iii hypertension iv. diabetes mellitus The more r isk factors one possesses the greater the chance of deve l oping impotence. Management of atheroscle r os i s of the penile arteri e s is the same as for any other part of the body d) diabetes me l l i tus this is true especial l y in poorly controlled diabetics e) renal (kidney) fai l ure advanced cancer f ) prev i ous vasectomy (severing of the sperm transporting tubes) or prostatectomy (partial removal of enlarged gland behind the bladder in the male) A small proportion of these patients somet i mes go on to have erectile dysfunction Effects: This depends on whether and when the patient seeks profess i onal help Men are reluctant to discuss impotence and many present only after profound distress to both themselves and their partners. The effects are fe l t by both partners and are as follows : Female Partner a) Depression many times this is because she blames herself for the problem

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b) Anxiety c) I nfidel ity and therefore feels sr1e 1s inade quate and physically unattractive. this is often manifested somati cally (by physical disorders) and can present t o the physician with a variable number of compla ints includ ing insomn ia, lack of appe tite weakness headaches, chest pain fatigue, tiredness. This can a lso have repercussions at home with other members of the fami ly and at work where there i s in creased irritability and a lack of concentr ation. this can be due to sexual dissat isfaction and the female partner then looks e l sewhere. c) Drug Abuse abuse which inevitably makes the situa t io n worse. the most common drugs used are alcohol, cigarettes, marijuana and cocaine. Cigarettes are especially bad because nicot ine is a vaso constrictor (constricts blood ves sels) and can exacerbate the ready compromised blood flow m the small penile arteries Having a cocktail and a cigarette may be the worst thing a middle-aged man with borderline impotence can do prior to attempting inter course d) Sexual Deviants this is manifested by rape, voyeurism, masoch i s m sa dism, homicides. Male Partner a) Depression this occurs because many men blame themselves and see them selves as inadequate thereby set t ing up a vicious cyc l e which in effect makes the entire situation worse. e) Infidelity this often result s when the man tries to prove h is masculin ity. b) Anxiety t his can also lead to somat i c symptoms which usually include headaches backache nausea fati gue and chest pains Anothe r manifestation of the stress caused by impotence is drug f) Aphrodisiacs S u m m a ry (Love vine and five fingers) t h ese offer a transie n t effect only if any They also delay the inevi table and can be part icu l arly dan gerous if erectile dysfunction is an early symptom of a life-threat ening disease. Impotence is an important problem in the community. Whi l e psychological factors are ofte n the primary cause, (continued on next page) EVALUATION H elp u s to make the newsletter as interesting and informative as possible. P l ease comp l e t e. detach and r etu rn this s hort evaluation f or m to th e Health Education Divi sio n, Ministry of Health Nassau Bahamas Ti ck the most appropriate response I How d i d you find the n e w s l e tter ? a ) very interesting b) interes t ing c ) somewhat interesting d ) uninteresting e) did not read 2. Was there any article of particular interest to you? Yeso N o a If yes, please give title ...... ....... ........ . ..... ..................................................................... ......................... .... ....... ....... 3. What changes, if any, would you like to see? ........................................................................................................................................................................................ 4 What topics would you like i n future issues? ...... ...... ....... . ............................................. ....... ........ .............. ... .... 5 W ould you like to contribute to t h is newsletter ? Yes uNoo I f yes, please give name and address. Name : ......................... ....... ..... ....... ... ..... ............. ........ ..... .... ........................................... ..... ... ............ ...... ........ ........... Addr ess : ......................... ............................ ....... . ........................................ ........................ ......... . ....... ... ............ ...... Thank you for your co-operation! 23

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(continued from preceding page) organic causes are just as frequent and equally or more important. For this reason. medical help should be sought ear ly in order to get quick intervention. The later the man / couple seek(s) help, the more com plex the treatment. as by that time it will involve a great deal of psychological cou nsel l ing for both partners in ad dition to the treatment of any organic cause. The best success rates are associated with early in tervention Individuals nowadays therefore need not ex pose themselves to such emotional trauma because of a disorder which in so many cases is easily treatable. r'"""'':::,::::::::::::::::: I 24 MINISTRY OF HEALTH P O. BOX N-3729 NASSAU, BAHAMAS.

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ABOUT THE CONTRIBUTORS Felicity AYMER is a Health Education Officer, Ministry of Health and Editor. Lyall BETHEL is an Accounts Executive, The Counsellors, a Public Relations firm and a member of the Editorial Committee. Greg BURROWS is a Banker. He is also a husband and father. Stanley BURNS I DE is an Artist Lecturer at The College of The Bahamas and well known cartoonist. Rudolp h CARTWRIGHT is the manager of Caribbean Tile Supp l ies and Contractors Ltd. Gregory COLEBY is an employee in a law firm Endric DELEVEAUX is a Computer Salesman. Roosevelt FINLAYSON is the Vice President Marketing Services British American Company of The Bahamas Ltd and a founding member of Centreville in October. Edward HUTCHE T SON is a Motor Mechanic, married and the father of two young children. Marce l LIGHTBOURNE is an Evangelist. Ken Ofosu-BARKO is a Medical Off i cer, Community Health Services and member of the Editorial Committee. Ronald PATTERSON is the Director, Advanced Fertility, Gynaecology and Obstetrics Services, Doctors' Hospital. Cyril PEET is an I nsurance Salesman Basil SMITH is the Vice President, The Counsellors a Public Relations Firm. Patr ick WHITFIELD is a Consultant i n Family Medicine and Phys i cian i n charge of the General Pract i ce Clinic, PMH. Photographs:-Courtesy o f Anthony Brown Audio Visua l Section, PMH; Lya l l Bethell; Bahamas Information Services and Dr. Ofosu-BARKO.

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RUDOLPH CARTWRIGHT CYRIL PEET GREGORY COLEBY MARCEL LIGHTBOURNE ENDRIC DELEVEAUX LYALL BETHEL EDWARD HUTCHESON GREGORY BURROWS


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