Paper short abstract:

Sickle cell anaemia is an autosomal recessive heamoglobinopathy and associated painful crises are the most common cause of morbidity causing up to 90 % of sickle-related hospital admissions. The author analyses four cross-cultural approaches to management, based on a number best practice visits.

Paper long abstract:

Across the world painful crises are the most common cause of acute morbidity and accounts for 80-90% of sickle cell related hospital admissions(Ware et al 1999). The provision of services within UK hospitals and emergency departments has however, often been the source of much criticism by both patients as well as support groups relating to gross stigmatization, lengthy delays in analgesic delivery, discrimination, resource allocation and general lack of awareness during crisis (Maxwell and Streetly 1998, Anionwu and Atkin 2001). The author aims to present cross cultural differences and challenges in care and management options available that we can all learn from based on a number of home and overseas best practice visits from the world renowned University of West Indies, Jamaica, Instituto de Hematologia, Cuba, and the St Jude's Research Hospital, USA. Here in the UK, we all may well be aware that sickle cell anaemia is genetically inherited. However, in Jamaica health professionals have to be much more sensitive to sufferers who still believe that it is instead caught by stepping over 'bad roots' and hold their faith in traditional witchcraft medicine of 'Obea' rather than conventional medicine and the unfamiliarity of genetic testing.