Breast cancer is the leading cause of cancer death among Caribbean women. The survival gap between Port of Spain and Miami is not biology. It is navigation.
The Numbers
CARPHA surveillance data, compiled from seven national cancer registries across the Caribbean, shows mortality rates between 14% and 30% depending on the island. In Trinidad and Tobago, the public sector mammography rate is 0.19 per 10,000 women over 40, according to a 2017 Springer situational analysis. A private mammogram in Westmoorings costs $500 to $800 TT. The TT Cancer Society sends mobile screening units across the island for free, but knowing they exist depends on word of mouth, a community health worker who remembers the schedule, or a grandmother who has been through it before.
In Jamaica, breast cancer is the leading female cancer by both incidence and mortality. In Barbados, cervical screening programs exist through the Ministry of Health, but breast screening coverage remains uneven across parishes. In Guyana, Georgetown Public Hospital Corporation is the only facility with radiation therapy in the entire country, which means a patient diagnosed on the Essequibo Coast faces a journey that most health systems in North America cannot imagine.
These are not statistics. They are women.
Navigation, Not Infrastructure
The Caribbean does not lack facilities. It lacks navigation. Fifteen screening facilities across eight countries are geographically verified in the CaribChat system, each tagged by type (hospital, clinic, mobile unit), sector (public, private, NGO), and precise location. Eric Williams Medical Sciences Complex in Mt. Hope provides radiation therapy for Trinidad. Cornwall Regional Hospital serves western Jamaica from Montego Bay. Queen Elizabeth Hospital in Bridgetown covers Barbados. The facilities exist. What does not exist is a single governed surface that maps them, sources them, and makes them available to any woman who asks where to get screened.
When a woman in San Fernando opens CaribChat and asks where she can get a mammogram, the system does not return a list of US facilities. It returns the TT Cancer Society mobile units, the private radiology clinics in St. Clair, and the public sector options at the regional hospitals, with operating hours, sectors, and contact information verified against the Ministry of Health and the cancer societies that serve the region.
The Caribbean Healing Tradition
Five Caribbean healing traditions are evidence-tagged in the system, each one respected and each one assessed against the clinical literature.
| Tradition | Evidence Status |
|---|---|
| Bush medicine (soursop, aloe, moringa, turmeric) | In vitro evidence for acetogenins; documented herb-drug interactions with taxanes and platinum agents |
| Faith and prayer circles | Psycho-oncology evidence for social support reducing distress and improving treatment adherence |
| Dietary traditions (sea moss, callaloo, coconut water) | Nutritional evidence variable; no contraindications for most traditional foods during treatment |
| Community caregiving (lime circles, childcare rotation, transport sharing) | Strong evidence that social networks reduce cancer mortality |
| Spiritual healing | Acknowledged as coping mechanism; no direct clinical efficacy evidence |
Dismissing a grandmother’s soursop tea without context is not evidence-based medicine; it is arrogance. CaribChat acknowledges the tradition, cites the in vitro evidence, flags the documented interactions, and says what it always says: tell your oncologist. The system respects what Caribbean communities have practiced for generations while ensuring that respect never becomes a substitute for clinical evidence.
The Institutional Fabric
CaribChat is not a US technology company parachuting into the Caribbean with a product designed in Silicon Valley. It is built with the institutions and the people who serve the region.
Marisa Nimrod, MD, MPH, is a physician in Trinidad and Tobago and CEO of CAOH who is building a breast cancer navigation app for Caribbean patients. She brings institutional relationships across the Caribbean oncology network through CAOH, the Caribbean Association of Oncology and Hematology, which has convened regional cancer conferences for over a decade. Allana Roach leads the CANONIC ethics board with a community health background that ensures every deployment decision is grounded in local governance, not imported assumptions.
The University of the West Indies spans the region: St. Augustine in Trinidad, Mona in Jamaica, Cave Hill in Barbados, Turkeyen in Guyana. Each campus trains the next generation of Caribbean clinicians, and each campus represents a community that CaribChat serves. The Ministry of Health in Trinidad and Tobago, the TT Cancer Society, CARPHA in Port of Spain, and PAHO/WHO’s Caribbean subregion office are all part of the institutional fabric.
Free Forever
CaribChat is free for the community. Free forever. Screening navigation, cancer guidelines, healing tradition evidence, community care connections, facility mapping: all free, all governed, all sourced. Caribbean health ministries, cancer societies, and public hospitals receive enterprise capabilities at zero cost through the Foundation tier. Facility-level analytics, institutional dashboards, and population health reporting are available to the institutions that need them most, because the organizations that serve the most vulnerable populations should never have to choose between software and service.
The CAOH 2026 Annual Scientific Conference convenes July 17-19 at the Hilton Trinidad and Conference Centre in Port of Spain. CaribChat will be there.
Figures
| Context | Type | Data |
|---|---|---|
| post | gauge | value: 15, max: 15, label: FACILITIES VERIFIED |
Sources
| Source | Reference |
|---|---|
| CARPHA | carpha.org — 7 national cancer registries |
| CAOH | caohcaribbean.org — Caribbean oncology network |
| TT Cancer Society | cancertt.com — Mobile screening units |
| MOH T&T | health.gov.tt — Ministry of Health |
| NCCN | nccn.org — Resource Stratification Framework |
| PAHO/WHO | paho.org — Caribbean subregion |
| IAEA | iaea.org — Breast cancer screening programs |
| ClinicalTrials.gov | clinicaltrials.gov — Caribbean-site trials |
| Mammography rate | Springer 2017 Situational Analysis, Trinidad & Tobago |
| CaribChat | hadleylab.org/talks/caribchat/ |
| MammoChat | hadleylab.org/talks/mammochat/ |
| CANONIC | canonic.org |
| *BLOG | CARIBCHAT | WHERE YOU LIVE SHOULD NOT DETERMINE WHETHER YOU SURVIVE. | 2026-02-25* |