I KNOW TEACHER, I KNOW!
Dr. Lester CN Simon
Some of us have experienced the joy of instantaneously raising our hand in class to signal to the teacher that we knew the answer to the question asked. Some of us have also borne the harrowing effect of another pupil slowly raising their hand and delivering an answer that was so clear and bright, our only release was to go home quietly and pretend that we were that pupil. As we grew older we realised we must learn from each other to extend the boundaries of general knowledge.
The double compact disc, Pan In Education from Trinidad and Tobago is a watershed in Caribbean music. One CD is an audio version of 13 songs played by steel orchestras. The other CD shows the full musical scores as well as the score for each instrument in three formats for viewing and listening. Additionally, there is information on Caribbean rhythms, copyright issues and a bevy of data that allow this double CD set to be used in a classroom in the Caribbean or in any part of the world.
Pan In Education was the focal point of one of the presentations at a recent regional workshop in Antigua & Barbuda on Information, Communication and Technology (ICT). The title of the presentation was Pan In Education: A Sustainable Business Model for the Caribbean Music Industry by Simeon Louis Sandiford, managing director of Sanch Electronix Limited in Trinidad and Tobago.
The appearance of this double CD about steel pan begs the question about calypso music in general. Why is calypso less popular on the international circuit than reggae and what must calypso do to catch up? Somewhere amongst the myriad reasons must be the fact that if you line up 20 of the bests traditional reggae and calypso songs, the lyrics of the reggae songs will appeal more readily to the average international listener. Generally, calypso lyrics are more parochial. There are many more double entendres (double meanings) in calypso than in reggae.
The origin and purpose of calypso demanded a more subtle, indirect approach; and even though calypso can be protest music, reggae is more direct, more “get up, stand up, stand up for your right”. Reggae will walk straight and direct along Market Street from the market to the Police Station, calypso will take you all around town, allow you to enjoy yourself before you realise you are locked up in the same Police Station!
If we can package steel pan music for education in a classroom in some far off land, why can’t we package calypso for the average listener in the same far off land? We would have to use DVD instead of CD because in addition to music and data that are the confines of a CD, a DVD can also carry movies. The parochial limitations of calypso can be surmounted by displaying the lyrics, outlining the story and employing a glossary of Caribbean words and phrases using a standard source like the Dictionary of Caribbean English Usage by Richard Allsopp. The same goes for the double entendres. We can also incorporate a movie of the singer performing the songs in a typical music video performance with sceneries of Antigua and Barbuda with information on the locations etc.
The marketing plan would be to get the average international person who is infected by the drama and beauty of carnival and calypso to understand what the mystique is all about. We can also include in the DVD a dissertation and demonstration on the art of dancing to calypso music for those hopping tourists who seem to be out of time all the time every time they go on the calypso dance floor.
An important past participle of calypso theme and strategy was used for the building of strong, narrative structure. Witty humour. Traditional reggae lacked this element terribly. It is a unique, marketable aspect of the verb and gerund of calypso composition. Have you ever heard a traditional reggae song that makes you hold your belly and laugh your head off until the lost tears of laughter make you dizzy from dehydration? As much as I love Bob Marley’s music, you will never hear a reggae song from that era about a lying competition or a theatrical discourse on the art of two women “cussing” on Greenbay Hill.
In recent times, reggae has ventured into humour and this has paid huge dividends with lyrics responding to, and countering lyrics of a previously released song. This genre comes straight out of the calypso tent and there are knowledgeable musicians and musicologists who will “tell you flat” that reggae came out of calypso; but that is another story, which itself is another genre of the calypso art form. Both calypso and reggae have surfed onto a wave of banality to the extent that you have to search hard amongst the haystack of odious garbage to find the solitary, buried, musical gem that pierces you like a needle.
As we bridge the digital divide we expect answers to questions about computer simulation of vehicular and pedestrian traffic into and out of St. John’s. We want to know about computer simulation of the use of the entire extended East Bus Station area as an atrium of the city. This is modern town and suburban planning which must extend to the whole of Antigua and Barbuda. However, within this enticing digital milieu, the fundamental things of life still apply. It is our culture that defines us and we must understand ourselves before we can export our culture with or without the digital medium of CD or DVD.
A crucial part of this understanding of national self must begin with coming to terms with the singular and central lesson of slavery. The cardinal lesson of slavery is that black people are a dignified race of survivors. Amen! Once we understand the historical significance of this, we can also survive in a dignified way the nonsense we face now including the enslaving nonsense that comes even from some of our very own. With the Caribbean being the melting pot of all of the races of the world, the raison d’etre of a West Indian and Caribbean person or personality is how all these races can survive and live together in social harmony. Indeed, in the Caribbean, we are the world.
So let us celebrate the hard work that went into the Pan In Education double CD. But we must use the same digital tools to extend to packaging calypso and other forms of our West Indian and Caribbean culture for export. The requirements for this successful venture are the same requirements that schools of business administration have been trying to teach corporate executives. When the tools of business are used for culture, the learning and mastering of the tools of business will be so much easier. Indeed, Pan In Education is a brilliant attempt to apply all aspects of a business from creating to manufacturing, to selling, and investing, to creating again, using music and steel pan.
The business of culture will help us to redevelop a business culture. This propagation of culture by first understanding national self and culture and valuing our cultural icons and sending out our minstrels and jesters and traders, is not uniquely North American. It is as old as the hills. It started in the home of all of mankind: in Africa.
Saturday, March 25, 2006
Thursday, March 9, 2006
The Man Talked The Truth
THE SOLILOQUY OF CHAOS
Dr. Lester CN Simon
Please afford me the opportunity to register my agreement with Dorbrene O’Marde on at least two of the points in his two-part article following his appearance on Without Limits. The “men had moved on” fact that riled the women on the programme is indeed a worldwide phenomenon. In my lifetime I have seen male cashiers move on and leave a void that women filled. In the last couple of years female cashiers have moved on and left spaces for some males who were willing to take the job.
The few men and women with whom I spoke about the “riling up” (“without limits”) suggested that some men, in like situations, where they face such extreme, unwarranted and emotional reactions to an unexamined statement of fact, simply choose to move on.
However, the more significant point in his article was his proclamation that “the education system, not the family, is the most influential vehicle in our country for socialization.” We have all been afraid to say this because we were concerned that someone would reply, “Not my family, if you please. Talk for yourself”. But this is all part of the dishonesty of adults when we regard our childhood.
Maybe we were afraid to make Dorbrene’s declaration because we would be forced to ask who, male or female, is running the education system these days. Before the misguided men run away with their short-sighted answer, like the dish running away with the spoon, Dorbrene makes the tipping point: It “is not about the gender of leadership; it is about the system within which the leadership operates and seems reluctant to challenge, much less change.”
That women and men challenge and change wrong is a noble fight, an inalienable duty. To this end the words of Senator Massiah regarding the victory of Mrs. Portia Simpson-Miller in Jamaica are noteworthy for their dual inferences. She reminded us that women have always been the backbone of political parties in the Caribbean.
If we continue to charge after quixotic windmills instead of engaging the real whirlwinds it will be, as the rapper says, “the soliloquy of chaos”.
Dr. Lester CN Simon
Please afford me the opportunity to register my agreement with Dorbrene O’Marde on at least two of the points in his two-part article following his appearance on Without Limits. The “men had moved on” fact that riled the women on the programme is indeed a worldwide phenomenon. In my lifetime I have seen male cashiers move on and leave a void that women filled. In the last couple of years female cashiers have moved on and left spaces for some males who were willing to take the job.
The few men and women with whom I spoke about the “riling up” (“without limits”) suggested that some men, in like situations, where they face such extreme, unwarranted and emotional reactions to an unexamined statement of fact, simply choose to move on.
However, the more significant point in his article was his proclamation that “the education system, not the family, is the most influential vehicle in our country for socialization.” We have all been afraid to say this because we were concerned that someone would reply, “Not my family, if you please. Talk for yourself”. But this is all part of the dishonesty of adults when we regard our childhood.
Maybe we were afraid to make Dorbrene’s declaration because we would be forced to ask who, male or female, is running the education system these days. Before the misguided men run away with their short-sighted answer, like the dish running away with the spoon, Dorbrene makes the tipping point: It “is not about the gender of leadership; it is about the system within which the leadership operates and seems reluctant to challenge, much less change.”
That women and men challenge and change wrong is a noble fight, an inalienable duty. To this end the words of Senator Massiah regarding the victory of Mrs. Portia Simpson-Miller in Jamaica are noteworthy for their dual inferences. She reminded us that women have always been the backbone of political parties in the Caribbean.
If we continue to charge after quixotic windmills instead of engaging the real whirlwinds it will be, as the rapper says, “the soliloquy of chaos”.
Wednesday, February 15, 2006
Night is Drawing Nigh
Now The Day Is Over
Dr. Lester CN Simon
“I was planning to forget calypso and go and plant peas in Tobago.” But adults are using our adulterated logic to look at children, so the peas will have to stay in the pods a while longer.
Why would a pupil throw urine at his teacher? Is he in jail and feels that the only way to make a statement is to do what some prisoners do? Is there some perverted, attention-seeking logic running from kid to kidney to urine to wee-wee? Whatever his reasons and whatever the punishment, some escaping facts should be caught. The urine-throwing incident required expert planning, good persuasive powers and management skills to get his peers to go along with the thrower, act as look-outs, collect the urine in a leak proof container, decide whether to use fresh or stale urine, co-ordinate the timing and the location of the hapless teacher, etc. These are the attributes of someone who, if directed properly, might do well in a Master in Business Administration course.
We have to come to terms with the fact that while Derek Walcott did say that evil is limited in its rhythm, this limitation is relative to the goodness that opposes it. In the absence of a high degree of goodness, evil will seem enchanting. Adults know this and we pretend that children do not know it too.
So let us recall the pre-HIV/AIDS, blood-sucking days of Dracula and the epic battles between the evil Dracula, played by Peter Cushing and his nemesis, Professor Larimer Van Helsing, played by Christopher Lee. Both enjoyed equal admiration. We loved the fact that the good one, the star-boy, would win but the cunning of the evil one was startling. Even in defeat, the evil one would stare at you knowingly as if to register his omnipresence, prophesy his return and force you to go gently into that dark, lonely night when you walked home from the cinema.
God created the earth in 6 days and the devil destroyed it in 6 minutes, if it takes that long to eat a forbidden fruit. The devil does find work for idle hands and yet the creative hands and minds of school children are locked away in involuntary separation packages from the bright, shiny and exciting landscape that all children should know and enjoy.
Everyone has a story about their childhood, about how many licks they got and how the ascension of the brain from the buttocks to the head was accompanied by a halo chorus of everlasting licks. So here are two childhood stories about cunning and licks.
My cousin, Tyrone was taken to Dr. Wisenger on many occasions for consumption (tuberculosis) on account of a chronic, seemingly incurable cough. Dr. Wisenger could not fathom his ailment. Playing doctor, I tried in vain to diagnose the malady by watching him closely like Brer Anancy. Then one day, like all illnesses, it revealed itself. Our grandmother used to sell many things, including soda pop. Tyrone had devised a method of coughing in synchrony with the opening of the soda pop to muffle the popping sound. One day, his timing was off by a few demisemiquavers. Case closed.
One day at school, Tyrone was about to be punished by headmaster, Mr. Quinn, the late father of the Honourable Minister, Quinn-Leandro. Tyrone had committed the unpardonable sin of using a piece of looking glass to see less darkly the underclothes of a schoolgirl. Again, bad timing was his undoing as Mr. Quinn stealthily sauntered by during the doxology.
So here was Tyrone below the platform and there was the mighty Mr. Quinn on the platform with his broad strap raised, ready to descend onto Tyrone’s back. We waited in baited breath to see how he would escape this time. I have to tell you that Tyrone and I would sell different things for the family. Tyrone was responsible for selling eggs from one of our aunts (King Obstinate’s mother), whom we called Mammy. The best eggs were reserved for the parson and the headmaster.
So now then, as Mr. Quinn’s hand started to descend, Tyrone exclaimed as if he were on a cross to be crucified, “Please Sir! Excuse me Sir! Mammy has some eggs for you Sir.” The tall, correcting hand of the giant Mr. Quinn was thrown into zigzag relief as if the buckle of the beating strap was transformed from a noble noun into a vacuous verb. The mighty Mr. Quinn was stomped by the creativity of this puerile miscreant. In consonant harmony, the whole chorus of children (and teachers) erupted in sparkling laughter, including the erstwhile damsel in distress who was looked down upon in order to see upwards.
The creativity of children is boundless. We have always been that way. We had to be creative to survive the middle passage and the plantation. Creativity defines us and we define creativity. When adults look askance at the youths bellowing out rap music we must remember well.
Remember when the schoolroom was used for singing meeting? What about the time when Mammy had to defend the title of The New Winthropes Warrior against contestants, female and male from all over the island? Recall how she knocked them over by starting her elocution from outside the schoolroom with, “Behold! I bring you bounteous, mountainous tidings of great joy from the verdant land beneath the slumbering feet of the Most High and though I cannot speak with the tongues of the men who garbled before me, I pontificate in the vernacular of virtuous angels and behold my opponents become my footstool and fall away as empty, sounding brass and rusty, tinkling cymbals.” Singing meeting done. “Mash up”. Man, woman, child and opponent tumble down flat, flat, flat. That was rap music.
It takes a lot of hard work and planning to be a really bad person. Some of us would pay hard-earned money for university courses to acquire the skills that street- smart children possess. It’s not that adults cannot find the time. Adults are unwilling to talk to and learn from children and to allow children to tap into the bottomless creative well because we fear we will discover not only our former selves but also our present, adult reality.
Dr. Lester CN Simon
“I was planning to forget calypso and go and plant peas in Tobago.” But adults are using our adulterated logic to look at children, so the peas will have to stay in the pods a while longer.
Why would a pupil throw urine at his teacher? Is he in jail and feels that the only way to make a statement is to do what some prisoners do? Is there some perverted, attention-seeking logic running from kid to kidney to urine to wee-wee? Whatever his reasons and whatever the punishment, some escaping facts should be caught. The urine-throwing incident required expert planning, good persuasive powers and management skills to get his peers to go along with the thrower, act as look-outs, collect the urine in a leak proof container, decide whether to use fresh or stale urine, co-ordinate the timing and the location of the hapless teacher, etc. These are the attributes of someone who, if directed properly, might do well in a Master in Business Administration course.
We have to come to terms with the fact that while Derek Walcott did say that evil is limited in its rhythm, this limitation is relative to the goodness that opposes it. In the absence of a high degree of goodness, evil will seem enchanting. Adults know this and we pretend that children do not know it too.
So let us recall the pre-HIV/AIDS, blood-sucking days of Dracula and the epic battles between the evil Dracula, played by Peter Cushing and his nemesis, Professor Larimer Van Helsing, played by Christopher Lee. Both enjoyed equal admiration. We loved the fact that the good one, the star-boy, would win but the cunning of the evil one was startling. Even in defeat, the evil one would stare at you knowingly as if to register his omnipresence, prophesy his return and force you to go gently into that dark, lonely night when you walked home from the cinema.
God created the earth in 6 days and the devil destroyed it in 6 minutes, if it takes that long to eat a forbidden fruit. The devil does find work for idle hands and yet the creative hands and minds of school children are locked away in involuntary separation packages from the bright, shiny and exciting landscape that all children should know and enjoy.
Everyone has a story about their childhood, about how many licks they got and how the ascension of the brain from the buttocks to the head was accompanied by a halo chorus of everlasting licks. So here are two childhood stories about cunning and licks.
My cousin, Tyrone was taken to Dr. Wisenger on many occasions for consumption (tuberculosis) on account of a chronic, seemingly incurable cough. Dr. Wisenger could not fathom his ailment. Playing doctor, I tried in vain to diagnose the malady by watching him closely like Brer Anancy. Then one day, like all illnesses, it revealed itself. Our grandmother used to sell many things, including soda pop. Tyrone had devised a method of coughing in synchrony with the opening of the soda pop to muffle the popping sound. One day, his timing was off by a few demisemiquavers. Case closed.
One day at school, Tyrone was about to be punished by headmaster, Mr. Quinn, the late father of the Honourable Minister, Quinn-Leandro. Tyrone had committed the unpardonable sin of using a piece of looking glass to see less darkly the underclothes of a schoolgirl. Again, bad timing was his undoing as Mr. Quinn stealthily sauntered by during the doxology.
So here was Tyrone below the platform and there was the mighty Mr. Quinn on the platform with his broad strap raised, ready to descend onto Tyrone’s back. We waited in baited breath to see how he would escape this time. I have to tell you that Tyrone and I would sell different things for the family. Tyrone was responsible for selling eggs from one of our aunts (King Obstinate’s mother), whom we called Mammy. The best eggs were reserved for the parson and the headmaster.
So now then, as Mr. Quinn’s hand started to descend, Tyrone exclaimed as if he were on a cross to be crucified, “Please Sir! Excuse me Sir! Mammy has some eggs for you Sir.” The tall, correcting hand of the giant Mr. Quinn was thrown into zigzag relief as if the buckle of the beating strap was transformed from a noble noun into a vacuous verb. The mighty Mr. Quinn was stomped by the creativity of this puerile miscreant. In consonant harmony, the whole chorus of children (and teachers) erupted in sparkling laughter, including the erstwhile damsel in distress who was looked down upon in order to see upwards.
The creativity of children is boundless. We have always been that way. We had to be creative to survive the middle passage and the plantation. Creativity defines us and we define creativity. When adults look askance at the youths bellowing out rap music we must remember well.
Remember when the schoolroom was used for singing meeting? What about the time when Mammy had to defend the title of The New Winthropes Warrior against contestants, female and male from all over the island? Recall how she knocked them over by starting her elocution from outside the schoolroom with, “Behold! I bring you bounteous, mountainous tidings of great joy from the verdant land beneath the slumbering feet of the Most High and though I cannot speak with the tongues of the men who garbled before me, I pontificate in the vernacular of virtuous angels and behold my opponents become my footstool and fall away as empty, sounding brass and rusty, tinkling cymbals.” Singing meeting done. “Mash up”. Man, woman, child and opponent tumble down flat, flat, flat. That was rap music.
It takes a lot of hard work and planning to be a really bad person. Some of us would pay hard-earned money for university courses to acquire the skills that street- smart children possess. It’s not that adults cannot find the time. Adults are unwilling to talk to and learn from children and to allow children to tap into the bottomless creative well because we fear we will discover not only our former selves but also our present, adult reality.
Sunday, December 18, 2005
The Language of Christmas
DANCES WITH WORDS
Dr. Lester CN Simon
'Twas the night before Christmas, when all through the house
Not a creature was stirring, not even a mouse
The files were stacked in cabinets with care
In the hope that St. Spencer would soon be there
The electorate were nestled all snug in bed
Visions of a UPP government danced in its head
Serpent on Observer and I in my cap
Had just settled down for a long music rap
When, out on the office lawn there arose such a clatter
I sprang from the house to see what was the matter
Away from the window they flew like a flash
Tore open truck shutters and threw in the stash
The moon like eyes on mountain breasts aglow
Gave the lustre of mid-day to objects below
When, what should catch sight of my wandering, wondering eyes?
Files, files, files and more files!
With a little old driver, so lively and quick
I knew in a moment it must be a snitch
More rapid than eagles his coursers they came
He whistled and shouted by cellular their name
"Now, Dasher! Now, Dancer! Now, Prancer and Vixen!
On, Comet! On, Cupid! On, Donder and Blitzen!
To the top of the porch! To the top of the wall!
Now dash away! Dash away! Dash away all!"
……………………………………
File chests roasting on an open fire
Jack Spaniards nipping at your nose
High tide currents being sung by a choir
And folks dressed up in police clothes
Everybody knows, a turkey, money, and meat from a pig
Help to make elections right
My dear good people soon to dance a victory jig
Will find it hard to sleep tonight
They know that files are on their way
They are loaded on flat bed trucks for airport runaway
And every mother’s child is going to spy
To see if private files really know how to fly
And so I’m offering this simple phrase
To kids from one to ninety two
When you throw out files at nights and not days
No Merry Christmas, no Merry Christmas for you
………………………….
Away in a manger
No crib for a boyke
The big WD 40
Laid down his sweet voice
…………………………………
God rest ye APUA Board men
Let something you dismay
Remember when the public calls
For light, you must obey
…………………………………......
Good King Whence-Einstein looked out
On the feast of Senate
When Asot and Browne laid bout
Deep and crisp and palate
Page and monarch forth they went
And Benjamin went together
Through the rude Weston’s lament
To consult the governor
Bring me Nibbs and bring Einstein
Bring me pine logs hither
None of us will see them dine
For being a one-day Senator
Merry Christmas and a Happy New Year
Dr. Lester CN Simon
'Twas the night before Christmas, when all through the house
Not a creature was stirring, not even a mouse
The files were stacked in cabinets with care
In the hope that St. Spencer would soon be there
The electorate were nestled all snug in bed
Visions of a UPP government danced in its head
Serpent on Observer and I in my cap
Had just settled down for a long music rap
When, out on the office lawn there arose such a clatter
I sprang from the house to see what was the matter
Away from the window they flew like a flash
Tore open truck shutters and threw in the stash
The moon like eyes on mountain breasts aglow
Gave the lustre of mid-day to objects below
When, what should catch sight of my wandering, wondering eyes?
Files, files, files and more files!
With a little old driver, so lively and quick
I knew in a moment it must be a snitch
More rapid than eagles his coursers they came
He whistled and shouted by cellular their name
"Now, Dasher! Now, Dancer! Now, Prancer and Vixen!
On, Comet! On, Cupid! On, Donder and Blitzen!
To the top of the porch! To the top of the wall!
Now dash away! Dash away! Dash away all!"
……………………………………
File chests roasting on an open fire
Jack Spaniards nipping at your nose
High tide currents being sung by a choir
And folks dressed up in police clothes
Everybody knows, a turkey, money, and meat from a pig
Help to make elections right
My dear good people soon to dance a victory jig
Will find it hard to sleep tonight
They know that files are on their way
They are loaded on flat bed trucks for airport runaway
And every mother’s child is going to spy
To see if private files really know how to fly
And so I’m offering this simple phrase
To kids from one to ninety two
When you throw out files at nights and not days
No Merry Christmas, no Merry Christmas for you
………………………….
Away in a manger
No crib for a boyke
The big WD 40
Laid down his sweet voice
…………………………………
God rest ye APUA Board men
Let something you dismay
Remember when the public calls
For light, you must obey
…………………………………......
Good King Whence-Einstein looked out
On the feast of Senate
When Asot and Browne laid bout
Deep and crisp and palate
Page and monarch forth they went
And Benjamin went together
Through the rude Weston’s lament
To consult the governor
Bring me Nibbs and bring Einstein
Bring me pine logs hither
None of us will see them dine
For being a one-day Senator
Merry Christmas and a Happy New Year
Thursday, September 29, 2005
Local Cuban Health Care
Tell Us What Castro Does
Dr. Lester CN Simon
Something odd is happening here. Take a walk through any of the wards at Holberton Hospital and you will see the plight and paradox of our nurses. Local nurses have left Antigua and Barbuda in droves and Cuban nurses have arrived in their stead. Despite the kind assistance from Cuba, there is a chronic shortage of nurses in the state and our nurses are still under extraordinary pressure. The oddity here is that there is something fundamentally “un-Cuban” about the relationship between Antigua and Barbuda and Cuba regarding the attempts to solve our nursing and some other medical problems.
I have never been to Cuba. I have read about medicine in Cuba in medical journals. I have discussed the practice of medicine in Cuba with doctors who were trained in Cuba. Most important, I have observed Cuban medical workers, including nurses, right here in Antigua and Barbuda.
President Castro would agree with the adage, “Give a man a fish and you feed him for a day. Teach him how to fish and you feed him for a lifetime”. What do you think President Castro would do if Cuban nurses migrated and the nursing service in Cuba started to decline?
I think President Castro would get a piece of paper and ask the nursing tutors to write down all the duties of a typical nurse. He would then ask the nursing tutors to get two separate pieces of paper. On one sheet of paper, the tutors would extract from the master list of duties, all of the duties that must be performed by a trained nurse. On the other piece of paper, they would write all of the duties that can be performed by someone who does not have to be trained as a typical nurse. Castro would then discard the paper with the master list of nursing duties, hold up the other two pieces of paper in both hands and decree, “Out of one nurse, many workers”.
In Holberton Hospital, we have staff nurses, registered nurses, nursing assistants, ward assistants and, at times, student nurses. The staff nurse is in charge of the ward. She must be trained for 3 years to become a registered nurse and then she has to successfully complete a post-basic 1 year course such as midwifery. The nursing assistant and the ward assistant require 18 months and 6 months of training, respectively. The nursing care of a patient is a manifold function including making the bed, bathing the patient and other forms of personal care, giving oral and injectable medication, taking blood and other samples from the patient, dressing wounds, conversing with the patient’s relatives and other visitors, recording vital signs such as pulse, temperature and blood pressure, writing nursing notes about the patient’s condition, supervising and teaching auxiliary staff, planning and implementing nursing care, and making rounds with the doctor, to name a few.
In the absence of sufficient staff, a staff nurse has to perform many of the duties that can be done by a registered nurse, a nursing assistant or a ward assistant. Added to this, a staff nurse finds it difficult to continue to accept the fact that similarly trained government workers, indeed some who have undergone less training and who are doing less work, are paid much more than a staff nurse.
But that is only a tiny part of the story. A similar financial disequilibrium is seen all across the paramedical field, in medical laboratory technology, pharmacy, radiology and physiotherapy. Equal work should not have to beg for equal pay.
Observation shows that some Cuban workers, like some laboratory technologists and some nurses are very good in some aspects of their work to the exclusion of other, interrelated parts. It is clear that many of them were very well trained to suit a particular job function. This is in contrast to our local medical laboratory technologists and nurses who are first trained generally and then secondarily as specialists. Our training in many areas is equivalent to understanding the whole hand and then specialising in a particular finger. In many instances, training in Cuba for some medical workers seems to be the equivalent of mastering the details of a particular finger from the start.
The digital approach in Cuba makes sense to Cubans because all able Cuban citizens must contribute and all must be educated, housed, clothed, fed and be happy. Additionally, it initially ties the workers to their country since their skills are part of a larger, integrated system, without which these workers are not very marketable internationally. In time, the worker can easily augment their expertise and step over from one digit to another to cover the entire hand. By this time, the state has benefited enormously from the erstwhile digitalised workers.
President Castro would tell us that we have to attract more workers into the positions of ward assistant and nursing assistant while we continue to train more nurses. The ward assistant and nursing assistant must be given the opportunity through well designed courses to go on to become nurses. Trainees in other paramedical fields, like laboratory medicine, should be allowed to pursue a similar path. But President Castro knows that all these trainees will only enter the field and accept these opportunities if they are paid the equivalent of what similarly trained and equivalent government workers are paid. President Castro knows that equal work demands equally high or equally low wages.
It is not just what Castro said. Rather, it is what we said to President Castro. Somebody is not telling him the truth. When we do, we will reap the central benefit of the Cuban revolution, which is: applied education for the good life that all of us want to live. The sad part of this medical assistance drama is that like Cuba, we need a revolution in medicine in this country and our path to success is so much easier than Cuba’s. But then again, President Castro would probably tell us that the hardest revolution is the revolution of the mind. Unfortunately, unlike President Castro, history will not absolve us.
Dr. Lester CN Simon
Something odd is happening here. Take a walk through any of the wards at Holberton Hospital and you will see the plight and paradox of our nurses. Local nurses have left Antigua and Barbuda in droves and Cuban nurses have arrived in their stead. Despite the kind assistance from Cuba, there is a chronic shortage of nurses in the state and our nurses are still under extraordinary pressure. The oddity here is that there is something fundamentally “un-Cuban” about the relationship between Antigua and Barbuda and Cuba regarding the attempts to solve our nursing and some other medical problems.
I have never been to Cuba. I have read about medicine in Cuba in medical journals. I have discussed the practice of medicine in Cuba with doctors who were trained in Cuba. Most important, I have observed Cuban medical workers, including nurses, right here in Antigua and Barbuda.
President Castro would agree with the adage, “Give a man a fish and you feed him for a day. Teach him how to fish and you feed him for a lifetime”. What do you think President Castro would do if Cuban nurses migrated and the nursing service in Cuba started to decline?
I think President Castro would get a piece of paper and ask the nursing tutors to write down all the duties of a typical nurse. He would then ask the nursing tutors to get two separate pieces of paper. On one sheet of paper, the tutors would extract from the master list of duties, all of the duties that must be performed by a trained nurse. On the other piece of paper, they would write all of the duties that can be performed by someone who does not have to be trained as a typical nurse. Castro would then discard the paper with the master list of nursing duties, hold up the other two pieces of paper in both hands and decree, “Out of one nurse, many workers”.
In Holberton Hospital, we have staff nurses, registered nurses, nursing assistants, ward assistants and, at times, student nurses. The staff nurse is in charge of the ward. She must be trained for 3 years to become a registered nurse and then she has to successfully complete a post-basic 1 year course such as midwifery. The nursing assistant and the ward assistant require 18 months and 6 months of training, respectively. The nursing care of a patient is a manifold function including making the bed, bathing the patient and other forms of personal care, giving oral and injectable medication, taking blood and other samples from the patient, dressing wounds, conversing with the patient’s relatives and other visitors, recording vital signs such as pulse, temperature and blood pressure, writing nursing notes about the patient’s condition, supervising and teaching auxiliary staff, planning and implementing nursing care, and making rounds with the doctor, to name a few.
In the absence of sufficient staff, a staff nurse has to perform many of the duties that can be done by a registered nurse, a nursing assistant or a ward assistant. Added to this, a staff nurse finds it difficult to continue to accept the fact that similarly trained government workers, indeed some who have undergone less training and who are doing less work, are paid much more than a staff nurse.
But that is only a tiny part of the story. A similar financial disequilibrium is seen all across the paramedical field, in medical laboratory technology, pharmacy, radiology and physiotherapy. Equal work should not have to beg for equal pay.
Observation shows that some Cuban workers, like some laboratory technologists and some nurses are very good in some aspects of their work to the exclusion of other, interrelated parts. It is clear that many of them were very well trained to suit a particular job function. This is in contrast to our local medical laboratory technologists and nurses who are first trained generally and then secondarily as specialists. Our training in many areas is equivalent to understanding the whole hand and then specialising in a particular finger. In many instances, training in Cuba for some medical workers seems to be the equivalent of mastering the details of a particular finger from the start.
The digital approach in Cuba makes sense to Cubans because all able Cuban citizens must contribute and all must be educated, housed, clothed, fed and be happy. Additionally, it initially ties the workers to their country since their skills are part of a larger, integrated system, without which these workers are not very marketable internationally. In time, the worker can easily augment their expertise and step over from one digit to another to cover the entire hand. By this time, the state has benefited enormously from the erstwhile digitalised workers.
President Castro would tell us that we have to attract more workers into the positions of ward assistant and nursing assistant while we continue to train more nurses. The ward assistant and nursing assistant must be given the opportunity through well designed courses to go on to become nurses. Trainees in other paramedical fields, like laboratory medicine, should be allowed to pursue a similar path. But President Castro knows that all these trainees will only enter the field and accept these opportunities if they are paid the equivalent of what similarly trained and equivalent government workers are paid. President Castro knows that equal work demands equally high or equally low wages.
It is not just what Castro said. Rather, it is what we said to President Castro. Somebody is not telling him the truth. When we do, we will reap the central benefit of the Cuban revolution, which is: applied education for the good life that all of us want to live. The sad part of this medical assistance drama is that like Cuba, we need a revolution in medicine in this country and our path to success is so much easier than Cuba’s. But then again, President Castro would probably tell us that the hardest revolution is the revolution of the mind. Unfortunately, unlike President Castro, history will not absolve us.
Thursday, September 15, 2005
Big Big Big
Big Belly and Big Bottom
Dr. Lester CN Simon
Take a midday promenade along Market Street from Newgate to the market gate. Try to classify all the people you see along the way. Ignore the fact that some of us are as ugly as a rusty, bent-up, tin can-cup. Ignore that fact that some of us are as good looking as a tall glass of iced, good water quenched against the salty lips of a beaded face sweltering in this satanic, September sun. Disregard the slender ones that will make uncooked macaroni look fat. Just regard the big, fat “one and them” with big belly and big bottom.
Everyone knows that a big belly is not as healthy as a big bottom. Science has come to the same conclusion. It is good and pleasing when common knowledge and science see eye to eye because science is simply organised common sense based on careful observation.
Excessive fat or obesity increases the chance of getting diabetes, harbouring excess, bad fats in the blood stream and having complications involving the heart, brain and blood vessels, to list a few. However, all body fats are not created equal. Fat that is accumulated inside your belly (the apple shape) is much more dangerous to health than fat accumulated under the skin in the region of your bottom (the pear shape).
Since the location of excess fat is more relevant than the amount of total body fat, scientists have been trying for many years to understand what makes a fat belly so dangerous compared to a fat bottom.
Earlier this year, scientists in Osaka, Japan identified a new substance that is produced in much greater amounts by belly fat than by any other part of the body. They called it visfatin because the word “viscera” is used to describe the organs inside the body including the organs inside the belly. These organs can become surrounded by fat and cause the big belly.
The scientists discovered that the more belly fat you have, the more visfatin the belly fat would produce. The next step was to determine the effects of visfatin. Since visfatin is made by the bad, belly fat, common sense suggests that visfatin would do some bad things to the body. For example, belly fat increases the risk of getting diabetes. Hence it was suspected that visfatin would also increase the risk of getting diabetes by raising the blood sugar.
To the surprise of the scientists, visfatin does the opposite to what was expected. Visfatin actually reduces, not increases, the level of blood sugar. In fact, visfatin acts on blood sugar just like insulin. Why is visfatin, a substance produced by the bad, belly fat, acting in a good manner like insulin? Does this mean that a big belly may not be so bad after all?
Scientists are still investigating the role of visfatin. They have encountered an intriguing paradox. On one hand, visfatin from belly fat acts like insulin by lowering blood sugar. Visfatin also acts on the very belly fat that produces it and so gives rise to more belly fat, which in turn produces more visfatin. On the other hand, the excess belly fat can also make substances other than visfatin. These other substances may cause a rise in blood sugar and increase the risk of getting diabetes, raising bad cholesterol and having complications involving the heart, brain and blood vessels.
It would seem that belly fat is like a two-edged sword. It makes visfatin, which can act like insulin and lower blood sugar, which is good for a diabetic. But belly fat also manufactures other substances that have bad effects including raising the blood sugar, which is bad for a diabetic.
Notwithstanding the newly discovered good effect of belly fat, when the bad effects are taken into account, it is better to avoid having a big belly altogether. It seems that, as we so often discover in life, there is good and bad in all things and we must consider and weigh them all to find the balance point.
The study of fat is very important. There is good fat and bad fat in both the type of fat and the location of fat. Pound for pound, you get more energy from dietary fat than you get from either protein or carbohydrate. Fat produces substances that can help to boost the immune system to fight germs. In fact, some scientists note that visfatin is not a new substance and that it was discovered years ago and called by another name because it was known as a booster to white blood cells, which fight infections.
Fat, in moderation, was once a sign of good health. Some scientists consider fat to be the largest organ of the body and they have discovered that fat is the producer of many hormones that affect many parts of the body. Many of those scrawny, match-stick models on the catwalk, whom some people admire, are plagued with myriad medical problems.
One day, scientists may discover the bad effects of a fat bottom compared to fats in other areas. Fat chance. Until then, continue your walk along Market Street and, with due attention to the vehicular traffic, do not be too modest if you find yourself looking back despite your best effort to walk straight ahead.
Dr. Lester CN Simon
Take a midday promenade along Market Street from Newgate to the market gate. Try to classify all the people you see along the way. Ignore the fact that some of us are as ugly as a rusty, bent-up, tin can-cup. Ignore that fact that some of us are as good looking as a tall glass of iced, good water quenched against the salty lips of a beaded face sweltering in this satanic, September sun. Disregard the slender ones that will make uncooked macaroni look fat. Just regard the big, fat “one and them” with big belly and big bottom.
Everyone knows that a big belly is not as healthy as a big bottom. Science has come to the same conclusion. It is good and pleasing when common knowledge and science see eye to eye because science is simply organised common sense based on careful observation.
Excessive fat or obesity increases the chance of getting diabetes, harbouring excess, bad fats in the blood stream and having complications involving the heart, brain and blood vessels, to list a few. However, all body fats are not created equal. Fat that is accumulated inside your belly (the apple shape) is much more dangerous to health than fat accumulated under the skin in the region of your bottom (the pear shape).
Since the location of excess fat is more relevant than the amount of total body fat, scientists have been trying for many years to understand what makes a fat belly so dangerous compared to a fat bottom.
Earlier this year, scientists in Osaka, Japan identified a new substance that is produced in much greater amounts by belly fat than by any other part of the body. They called it visfatin because the word “viscera” is used to describe the organs inside the body including the organs inside the belly. These organs can become surrounded by fat and cause the big belly.
The scientists discovered that the more belly fat you have, the more visfatin the belly fat would produce. The next step was to determine the effects of visfatin. Since visfatin is made by the bad, belly fat, common sense suggests that visfatin would do some bad things to the body. For example, belly fat increases the risk of getting diabetes. Hence it was suspected that visfatin would also increase the risk of getting diabetes by raising the blood sugar.
To the surprise of the scientists, visfatin does the opposite to what was expected. Visfatin actually reduces, not increases, the level of blood sugar. In fact, visfatin acts on blood sugar just like insulin. Why is visfatin, a substance produced by the bad, belly fat, acting in a good manner like insulin? Does this mean that a big belly may not be so bad after all?
Scientists are still investigating the role of visfatin. They have encountered an intriguing paradox. On one hand, visfatin from belly fat acts like insulin by lowering blood sugar. Visfatin also acts on the very belly fat that produces it and so gives rise to more belly fat, which in turn produces more visfatin. On the other hand, the excess belly fat can also make substances other than visfatin. These other substances may cause a rise in blood sugar and increase the risk of getting diabetes, raising bad cholesterol and having complications involving the heart, brain and blood vessels.
It would seem that belly fat is like a two-edged sword. It makes visfatin, which can act like insulin and lower blood sugar, which is good for a diabetic. But belly fat also manufactures other substances that have bad effects including raising the blood sugar, which is bad for a diabetic.
Notwithstanding the newly discovered good effect of belly fat, when the bad effects are taken into account, it is better to avoid having a big belly altogether. It seems that, as we so often discover in life, there is good and bad in all things and we must consider and weigh them all to find the balance point.
The study of fat is very important. There is good fat and bad fat in both the type of fat and the location of fat. Pound for pound, you get more energy from dietary fat than you get from either protein or carbohydrate. Fat produces substances that can help to boost the immune system to fight germs. In fact, some scientists note that visfatin is not a new substance and that it was discovered years ago and called by another name because it was known as a booster to white blood cells, which fight infections.
Fat, in moderation, was once a sign of good health. Some scientists consider fat to be the largest organ of the body and they have discovered that fat is the producer of many hormones that affect many parts of the body. Many of those scrawny, match-stick models on the catwalk, whom some people admire, are plagued with myriad medical problems.
One day, scientists may discover the bad effects of a fat bottom compared to fats in other areas. Fat chance. Until then, continue your walk along Market Street and, with due attention to the vehicular traffic, do not be too modest if you find yourself looking back despite your best effort to walk straight ahead.
Wednesday, August 24, 2005
Sex Till You Drop
I SEE DEAD PEOPLE
Dr. Lester CN Simon
We are going through a very difficult period in our history. It seems we will wander in the political and social wilderness for many more years until we can meaningfully correct some of the wrongs we have inflicted on ourselves. This wandering seems certain because some of us are hell bent (or heavenly bent) on quick solutions to some very difficult problems, like prostitution.
The members of the clergy who asked the Prime Minister to fix the prostitution problem in Antigua and Barbuda are lazy and short sighted. This is not the first time they have so spoken. This is not the first time a Prime Minister has allowed the police alone to try to fix this illegal problem. This is not the first time prostitutes have been deported after midnight or early morning raids. This is not the first time prostitutes were ejected from known houses of prostitution, only to end up in unknown houses of prostitution.
There is no single, simple solution to end prostitution. Recently, there was much talk about street pastors. Where are they? The pastors must leave their pulpits and go outside and inside the houses of prostitution. Doctors and other members of the health team and social workers must do the same.
Let us try to predict the future of prostitution in Antigua and Barbuda. This is not as difficult as it seems. After the last police raids of the known houses of prostitution, many years ago, many of the prostitutes seamlessly merged with the rest of community. They continued to ply their trade with little or no attention from the medical fraternity. This was very different from the excellent, early work we had started in education about HIV and other sexually transmitted infections, and condom distribution. Our underlying aim was to try to get the prostitutes and their clients to realise that the practice of prostitution had become a very dangerous and potentially deadly undertaking. At the same time, we had to deal with the reality of prostitution.
In the early days of the HIV program, we learnt a lot about our society from the prostitutes, as some of them were very good listeners to the plights of their customers. We also learnt a lot about our program as we got regular feedback from the prostitutes. In fact, a prostitute chided us about the types of condoms we were distributing and blamed us for the lack of condom usage by their clients. At that time, the language barrier initially prevented proper understanding of her complaint. However, as an indication of how sex is not retarded by language, she gestured wildly and exclaimed in resigned exasperation, “Condom no good; condom no right; Antiguan man: donkey condom…...donkey condom!”
One of the important lessons we learnt was that prostitution, like so many other professions, has a hierarchal system. Some prostitutes will attend to only the crème de la crème client. Others will go with just about anybody; and there are the in-between ones that will buckle on a bad night. The high-class prostitutes do not need the known houses of prostitution. They can sell their wares from their homes by secret, private connections and contacts or you may opt for delivery service.
So what is the future of prostitution in Antigua and Barbuda? Consider the fact that after the last police raid in February 1990, there were very few cellular phones in Antigua and Barbuda. These days, everyone including dog and ….( don’t say it) has a cellular phone.
We will soon see a plethora of escort, call girl (and call boy) prostitution services. In fact, such services already exist. These are for the well-to-do prostitutes and clients. As an article about male prostitution in the Daily Observer noted some time ago, these high-class prostitutes value their high-class clients and they make sure they are tested for HIV and other sexually transmitted infections.
What do you think will happen when the common prostitute enters the escort service or simply distributes her cellular phone number and lies down on her back at home, with no medical tests, waiting for her clients to come?
It is most remarkable that the complaints about prostitution from the pastors come at a time when they are concerned about paying taxes. Some people are reminding them that they should render unto Caesar the things that are Caesar. Similarly, the pastors, the police, the medics, the social workers and all of us should render unto prostitution the stark realities of prostitution. Get the street pastors working, let the police do their job yes, but get the health team, social workers and others on the job as well. Prostitution is based on demand and supply. There will be little or no success by simply trying to reduce the supply of prostitutes.
It is noteworthy that a common prostitute might be a better judge than a pastor of the way to curtail and control prostitution. It may take a prostitute to tell us that, unlike the sexual act in prostitution, controlling prostitution is not a quick fix; not a one-night stand like the raid carried out by the police. When Jean and Dinah, Rosita and Clementina are no longer round the corner posing, you can bet your life Pastor that the same song and dance will continue selling. In fact, Pastor, ‘the party now start’.
Dr. Lester CN Simon
We are going through a very difficult period in our history. It seems we will wander in the political and social wilderness for many more years until we can meaningfully correct some of the wrongs we have inflicted on ourselves. This wandering seems certain because some of us are hell bent (or heavenly bent) on quick solutions to some very difficult problems, like prostitution.
The members of the clergy who asked the Prime Minister to fix the prostitution problem in Antigua and Barbuda are lazy and short sighted. This is not the first time they have so spoken. This is not the first time a Prime Minister has allowed the police alone to try to fix this illegal problem. This is not the first time prostitutes have been deported after midnight or early morning raids. This is not the first time prostitutes were ejected from known houses of prostitution, only to end up in unknown houses of prostitution.
There is no single, simple solution to end prostitution. Recently, there was much talk about street pastors. Where are they? The pastors must leave their pulpits and go outside and inside the houses of prostitution. Doctors and other members of the health team and social workers must do the same.
Let us try to predict the future of prostitution in Antigua and Barbuda. This is not as difficult as it seems. After the last police raids of the known houses of prostitution, many years ago, many of the prostitutes seamlessly merged with the rest of community. They continued to ply their trade with little or no attention from the medical fraternity. This was very different from the excellent, early work we had started in education about HIV and other sexually transmitted infections, and condom distribution. Our underlying aim was to try to get the prostitutes and their clients to realise that the practice of prostitution had become a very dangerous and potentially deadly undertaking. At the same time, we had to deal with the reality of prostitution.
In the early days of the HIV program, we learnt a lot about our society from the prostitutes, as some of them were very good listeners to the plights of their customers. We also learnt a lot about our program as we got regular feedback from the prostitutes. In fact, a prostitute chided us about the types of condoms we were distributing and blamed us for the lack of condom usage by their clients. At that time, the language barrier initially prevented proper understanding of her complaint. However, as an indication of how sex is not retarded by language, she gestured wildly and exclaimed in resigned exasperation, “Condom no good; condom no right; Antiguan man: donkey condom…...donkey condom!”
One of the important lessons we learnt was that prostitution, like so many other professions, has a hierarchal system. Some prostitutes will attend to only the crème de la crème client. Others will go with just about anybody; and there are the in-between ones that will buckle on a bad night. The high-class prostitutes do not need the known houses of prostitution. They can sell their wares from their homes by secret, private connections and contacts or you may opt for delivery service.
So what is the future of prostitution in Antigua and Barbuda? Consider the fact that after the last police raid in February 1990, there were very few cellular phones in Antigua and Barbuda. These days, everyone including dog and ….( don’t say it) has a cellular phone.
We will soon see a plethora of escort, call girl (and call boy) prostitution services. In fact, such services already exist. These are for the well-to-do prostitutes and clients. As an article about male prostitution in the Daily Observer noted some time ago, these high-class prostitutes value their high-class clients and they make sure they are tested for HIV and other sexually transmitted infections.
What do you think will happen when the common prostitute enters the escort service or simply distributes her cellular phone number and lies down on her back at home, with no medical tests, waiting for her clients to come?
It is most remarkable that the complaints about prostitution from the pastors come at a time when they are concerned about paying taxes. Some people are reminding them that they should render unto Caesar the things that are Caesar. Similarly, the pastors, the police, the medics, the social workers and all of us should render unto prostitution the stark realities of prostitution. Get the street pastors working, let the police do their job yes, but get the health team, social workers and others on the job as well. Prostitution is based on demand and supply. There will be little or no success by simply trying to reduce the supply of prostitutes.
It is noteworthy that a common prostitute might be a better judge than a pastor of the way to curtail and control prostitution. It may take a prostitute to tell us that, unlike the sexual act in prostitution, controlling prostitution is not a quick fix; not a one-night stand like the raid carried out by the police. When Jean and Dinah, Rosita and Clementina are no longer round the corner posing, you can bet your life Pastor that the same song and dance will continue selling. In fact, Pastor, ‘the party now start’.
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