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Prostate Specialist Visits
posted (May 17, 2013)
It's Cancer Awareness month and today as part of its regular continuing education sessions, the KHMH had a special guest: Dr. Jorge Gonzalez, Director of the Institute of Oncology Radiation in Cuba. Speaking to a room full of medical professionals, he gave a one hour presentation on prostate cancer. He spoke to us after about some of the relevant indicators for prostate cancer in Belize including the issue of race.





Dr. Jorge Gonzalez - Visiting Oncology and Urology Expert Director
(Translation: Omar Avilez - KHMH Medical Officer)
"Race is a very important factor in Prostate Cancer. People of black race have a much higher incidence of Prostate Cancer than people of white race that's why in countries like China and Japan they have a very low incidence of prostate cancer as oppose to countries like Cuba and Belize that have a very high black race and the African Continents as well."

Jules Vasquez
"A person with perhaps a higher chance of incidence maybe it has occurred in their family before or perhaps if they are out the black race - is their any lifestyle changes they can make on nutritional changes they can make?"

Dr. Jorge Gonzalez - (Translated by Omar Avilez)
"A very important element in prostate cancer is the diet. Foods with high fat and milk and dairy products will increase your risk for prostate cancer and those like vegetables and fruits will actually protect you from prostate cancer so eating foods that are high in fat and eating foods of milk and dairy products will increase your risk of prostate cancer."

Jules Vasquez
"Is this an area in which Belize's healthcare system is underserved?"

Dr. Adrian Coye - KHMH Medical Chief of Staff
"Well when you look at the statistics that we had brought out this morning Dr. Sanchez was sharing that we diagnose about twelve a year for our population of three hundred thousand whereas for twelve million in Cuba they are diagnosing thirty thousand a year. So that probably reflects more of what is happening globally and therefore we are really under diagnosing or not really picking up this problem and very often patients may end up dying with the condition but not knowing that that was there. The reason for the dying; they just comes in an advance state or they may die with the diagnosis but no one knew that they had that diagnosis. It could be that it's more about awareness and men of course are nervous about anyone doing anything in their prostatic region whereas you know its more difficult to pickup problems in men that way because of that natural inhibition"

Dr. Jorge Gonzalez - (Translated by Omar Avilez)
"Well there are three fundamental pillars of diagnosing prostate cancer; there is the general rectal exam which as you said most male don't want to do because of the 'machismo'; they don't want anything inserted inside and so that does contribute to decrease detection. There is also two other fundamental pillars which include the PSA even though it is not completely specific to prostate cancer because you could have a PSA altered, very high but you don't necessarily have prostate cancer. Finally you have the biopsy although that is one fundamental pillar of diagnosing of prostate cancer, its only one of three fundamental pillars that they use together to diagnose prostate cancer"

Jules Vasquez
"In this entire country we only have one Urologist and when we think of women we have countless obstetricians, gynecologists those sort of specialties but there's only one Urologist in Belize and he is not a Belizean."

Dr. Jorge Gonzalez - (Translated by Omar Avilez)
"It is very concerning that Dr. Ruguma is the only Urologist here in the country and the only one bearing the burden of entire spectrum of Urological disease, not just prostate cancer and he has spoken with Dr. Ruguma and even though he is the only one here, he believes Dr. Ruguma has done an admirable job of trying to treat all the patients that have urological conditions and because of that he will try his best to establish some sort of relationship with Cuba so Belize has more support to deal with the urological complications diseases that we have here in Belize including prostate cancer."

Presently there are two Belizeans studying Urology abroad.

After his presentation, Dr. Gonzalez joined Belize's only urologist, Marcus Rugama, at KHMH urology clinics.

And while the specialist clinics had that very special guest, who was in the pharmacy? Last weekend, the pharmacy staff got angry about unpaid overtime from Easter and cut back on services. Over last weekend, pharmacy services at the KHMH were limited to only hospital in-patients and visitors to the Accident and Emergency Department. And then we received reports on Wednesday that pharmacy operations were cut back again.

Today we asked Coye, as medical chief of staff about the pharmacy staff's discontent and he said service to the public continues:…

Dr. Adrian Coye
"People will get service as it has always been happening in the hospital. We closed in part on a couple days the outpatient pharmacy only but all services have continued within the hospital so emergency room, the ICU wards, that has not changed and as you brought it up may have started from Saturday and I say the service continues. Yesterday it was open as far as I know because I sent patients to outpatients and they had the service done so I am not sure about this morning and I will have to see because we are right now up here since eight o'clock"

Jules Vasquez
"Will you all have to bring criminal charges?"

Dr. Adrian Coye
"I am not the person to say - criminal charges; I can't say; I don't know about that part. It is an essential service and that discussion is happening. Again between the CEO and the Human Resource aspect of the hospital and also the greater discussion with the PSU and things like that"

The KHMH has committed to pay the overtime little by little, because it cannot afford to pay it all at once.

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