Hello from St. Kitts and Nevis!

My name is Deega Omar and I am a rising 4th year majoring in Anthropology. I have the privilege of being a CGH scholar working with the Minority Health and Health Disparities International Research Training (MHIRT) Program in St. Kitts and Nevis. This is my second time coming to St. Kitts and Nevis and I love being back! I have been on the islands for about four weeks and have enjoyed every minute of my experience here. I am working with seven other students, four from St. Kitts and Nevis and three from various universities in the U.S. We also have a graduate assistant and an amazing faculty mentor, Dr. Jeanita Richardson. The research question of the MHIRT study was crafted with the Ministry of Health (MoH) in the Federation. An important aspect of the health system in the Federation is that their primary focus is preventative health care. The MoH recognized Type II Diabetes as a priority due to the fact that it is the leading cause of morbidity and mortality in the Federation. Therefore, our study focuses on Type II Diabetes. There are two research questions in our study: what are the knowledge and perceptions surrounding Type II Diabetes and what is the prevalence and distribution of diabetes in the Federation? The first research question will be carried out with a World Health Organization (WHO) survey instrument about lifestyle, as well as open-ended questions on diabetes to ask the general population in both St. Kitts and Nevis. The second question will be carried out by doing a chart review of records in the health clinics in Nevis.

The first couple weeks in the Federation were great! We had tours of both islands, St. Kitts is only 68 sq mi, while Nevis is only 36. They are both so beautiful and it was really nice to learn about the history of the islands. The locals are very welcoming and friendly as well! We had time to familiarize ourselves with our Kittitian and Nevisian partners who are wonderful. Some of our partners were still in school when we first arrived, so after they had their finished exams, we held a community picnic where we invited all students and faculty who are contributing to this great project. Before starting our research, we had different workshops with Dr. Richardson on various topics pertaining to our research; for example, qualitative research and community based participatory research. We also got familiar with our WHO survey instrument and open-ended questions that we planned to ask the general population. The survey is focused on diet, physical activity, and medical history, all of which relate to diabetes. The open-ended questions ask about knowledge and perceptions of diabetes. We made adjustments to these questions so that they were applicable to our study and St. Kitts and Nevis in particular. For example, the WHO survey comes with show cards to show examples of physical activity; however, the example on these cards shows someone pulling a rickshaw, which is something you would not see in the Federation.

The survey portion of our study was conducted first. We went to public places approved by the MoH such as grocery store parking lots or the port located downtown. I didn’t know what to expect for the first day of survey collection. We went downtown on a weekday afternoon and asked random people between the ges of 18-75 if they had time to participate. The locals were very receptive to us and it made the survey collection easier than expected and enjoyable. It was great to know that the locals were interested in knowing about the study and willing to help. The chart review portion of the study started around the third week in country. We are conducting the chart review at all six of community health clinics in Nevis. We also had training before starting the chart review. We created a procedure for conducting this study, which included our inclusion criteria, confidentiality protocol, how we randomized patients, and what relevant information we would need from the files. We have only completed the chart reviews for one clinic in Nevis so far. The chart review is much different than the survey portion in terms of how we are collecting our data. Rather than talking to people, we are getting our data from doctor records. One challenge that we have noticed is reading the doctor’s handwriting. This may pose a problem for the other clinics as well. However, with the help of nurses on staff and one of our faculty members who is a physician by training, we expect to mitigate the legibility problem. One exciting thing for our research was that we were featured in one of the local newspapers and attended a press conference for our study. The Ministry of Health held a conference to inform the public about the research. This was really great in that many people actually saw the press conference or read about in the newspaper, which helped us have more local help. When collecting surveys, many people actually said they heard about the research and were happy to help.

In my free time, I have had a lot of exposure to the country and it’s culture. On weekends, we go to the Saturdaymorning market where we buy local fruits and vegetables and the “catch of the day” from Kittitian vendors. We have had time to explore the beautiful white sand beaches as well! Everything is amazing here, from the mountains to the strong ocean breeze. Attending local events is also a past time that we enjoy. We went to the Children’s Day Parade where local children marched in costumes through downtown as well as a music festival. We also attended the “Eat local day” held downtown and had some delicious local foods and drinks. Participating in outdoor activities like hiking and attending more local events is something that I look forward to as well! I have about one month left in the Federation and I’m excited to complete our research while enjoying the islands. I have learned so much in this time and I know I have so much more to learn. Our data will be very beneficial to the Ministry of Health and their preventative health care focus. I look forward to the next several weeks as we finish our research and will report back the rest of my experience!

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