Cutting edge

April 28, 2000

The Centre for Caribbean Medicine is an initiative designed to promote research into illnesses such as sickle-cell disease.

The Centre for Caribbean Medicine is an initiative to foster a partnership, through collaborative programmes in research, service developments and teaching, to improve the health and welfare of people of West Indian extraction in the UK and those living in the West Indies. A key aim of the project is to tackle medical problems that are common among the most disadvantaged members of society and to develop solutions to disease management in a multi-ethnic society.

The partnership involves the Guy's, King's and St Thomas's schools of medicine, Dentistry and Biomedical Sciences (GKT), King's College, London, and the Faculty of Medical Sciences, University of the West Indies.

Significant changes in the pattern of diseases have taken place in Caribbean countries and in patients of Caribbean extraction in the UK during the past 50 years. Chronic non-communicable diseases, along with mental health, are major contributors to an enlarging pool of adult disability. The Centre for Caribbean Medicine provides a focus for projects designed to find solutions. The first of these projects is a partnership in undergraduate training between the UK and the University of the West Indies. This includes a medical student exchange programme that has been supported by a number of sponsors, notably British Airways. The exchange has allowed undergraduates to understand the cultural background of medical training and the patient populations in the exchange school. It has led to an increasing interest in methods of training and the opportunities for postgraduate training. Next year there will be a new MSc course, based at King's, on ethnic minority health.

The collaboration has also stimulated the formation of groups that are developing joint or complementary research programmes in areas such as sickle-cell disease and chronic disease states, such as hypertension and diabetes mellitus, and sexual health. In sickle-cell research, the collaboration has encompassed both molecular genetic and public health aspects of the condition as well as clinical initiatives. Research on prevention and managing the morbidity of a stroke is also under development. A further preventive initiative has focused on the early recognition of diabetes in susceptible populations in Trinidad. A Medical Research Council-supported programme on risk factors for schizophrenia in the UK black populations has been developed in the Institute of Psychiatry.

The exchange of health professionals in clinical and public health medicine and basic medical allied health sciences between the UK and the Caribbean has led to notable successes. In the past year, students in neurology, primary care and cardiology have completed training in the UK. Social scientists from King's have been working in the West Indies on areas such as the integration of West Indians returning to the West Indies and the acceptance of and compliance with treatment regimens. The centre is also developing a programme designed to improve early recognition of chronic disease together with the UK Department of Health.

While funding has never been secure, there has been an increasing level of success in gaining support. The centre is based at King's, but it is not exclusive and works with health-oriented groups and other universities interested in this area. The remit of the centre is broad, ranging from the molecular basis of disease to improving access and uptake of health care by minority groups.

Rod Hay, executive director of the Centre for Caribbean Medicine, and Rachel Harnett, international programmes. For details of the centre and its annual conference on July 6-7 in London, email ccm@kcl.ac.uk.

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