Transcript Sickle Cell with Ayuk Besong Anne-Chantal and Dr Lewis Thomas

Chantal (00:19)
Welcome to the Sunflower Conversations. I am your host. My name is Chantal. Joining me today is Ayuk Besong Anne-Chantal who is the co-editor of Soul Be and podcast host on Sickle Cell Role Models and Mentors. Also with us is Dr. Lewis Thomas, who is the founder of Sickleverse.

Chantal (00:40)
Both of our guests come with a wealth of experience and they both have lived experience of a sickle cell. So today's topic is sickle cell. Thank you very much both of you for joining us. I am going to just give a quick visual description of myself and then I'll invite you both to do the same. So I am a female, I am a bit sweaty because it's incredibly hot. I'm wearing a bright orange sleeveless

Chantal (01:08)
blouse with ruffles, I've got long brown curly hair and I'm wearing a Proud to support Sunflower lanyard. Ayuk would you like to go next with a visual description please?

Ayuk Besong Anne-Chantal (01:21)
Yes, thank you, Chantal, and my name is Ayuk Besong Anne-Chantal.

Ayuk Besong Anne-Chantal (01:27)
A female African. I have long dreadlocks, and I am putting on glasses, and I'm putting on a sky blue shirt with a collar and colourful South African earrings. It's not too hot here, but I think I'm a my background is a bit too bright because of the sun.

Chantal (01:54)
Yeah, we've kind

Chantal (01:55)
of all got our, people who are listening to this audio, we've got blinds shut trying to keep out

Ayuk Besong Anne-Chantal (02:01)
Yeah.

Chantal (02:01)
the heat. But yeah, Lewis, if you would like to go next.

Lewis Thomas (02:05)
Yeah,

Lewis Thomas (02:06)
so I'm male, I'm black, I have short dreadlocks, glasses, beard, I'm wearing a white t-shirt. It's actually not too hot in the room I'm in, even though we are in a heatwave and it might get sweatier as we go through the podcast.

Chantal (02:24)
Depends how hard the questions get.

Lewis Thomas (02:26)
Yeah.

Chantal (02:29)
Well, thank you both of you. We've been trying to set this up for a little while. And so I want to say thanks for helping me get this together. It's something that we're really interested to learn more about. It's a non-visible disability. So Lewis, can you start off with, please, just can you tell me and our audience, what is sickle cell?

Lewis Thomas (02:51)
So sickle cell is a genetic blood condition that affects the shape of the red blood cells. So in normal people, the red blood cells are smooth and round and flexible and able to squeeze through blood vessels easily. But sickle cell changes the shape to a sickle crescent moon kind of shape and they become very rigid and stiff and inflexible so they can get stuck in small blood vessels.

Lewis Thomas (03:20)
And this leads to various complications depending on the blood vessels they get stuck in and where they are in the body. The main most common one is what we call a sickle cell crisis pain where blood vessels get stuck in the blood vessels of the bones and they cut off oxygen reaching there, which causes very severe intense pain and is one of the most common reasons for

Lewis Thomas (03:49)
presentations to hospitals. Outside of that they can cause pretty much complications in every organ of the body so people with sickle cell can you know have various different complications essentially.

Chantal (04:06)
Thank you. was going to ask you what is a sickle cell crisis because I have heard of that expression. I have a friend who has sickle cell and she has mentioned it before, but quite good to visualise this shape of the blood cells that you described really well. So can you, would you both mind sharing how sickle cell affects you because

Chantal (04:32)
you know, two very individual people, different genders, is it different, is it the same?

Ayuk Besong Anne-Chantal (04:38)
Yeah, well so sickle cell affects how does that affect me? Well I it I think I would say sickle cell affects every part of my life. So it's it affects not just your your health, it affects your

Ayuk Besong Anne-Chantal (04:59)
body, every every single organ. So you, the human, but it also affects you, the person. So when I mean the person, I'm talking about the the non biological things, the social part, it affects your job, it affects your your

Ayuk Besong Anne-Chantal (05:18)
education, it affects you know your emotions and all what comes with your relation with people, how you how you live life. sickle cell is something you know, people used to think that and for several years it's been focused only on the pain crisis part, but it goes beyond that, it affects your whole being,

Ayuk Besong Anne-Chantal (05:44)
just your whole living experience is affected with sickle cell. And that's one of the reasons why over the years there's been more and more of a call at the global level for sickle cell not just to be seen as a disability and something that is just biology, but it should be seen beyond biology because that's how people living with it will get to receive the help that they need beyond just.

Ayuk Besong Anne-Chantal (06:12)
Being in hospital and getting treatment for that pain, but then it has to move beyond that to how is this person living their life? Are they able to be better taxpayers, better contributors to their nation's development? And how do we help them to do that? Do we help them by understanding their emotions? Do we help them by not judging because they are in pain? Do we help them by making sure that the

Ayuk Besong Anne-Chantal (06:42)
systems understand them and get we put the system put in place and permits them to live and thrive. I've had to live with sickle cell now for very soon forty-six years and it's like opening a new version of Encyclopædia Britannica  every day. 

Chantal (07:05)
Really?

Ayuk Besong Anne-Chantal (07:05)
Every day you discover something you didn't know.

Chantal (07:08)
Right

Ayuk Besong Anne-Chantal (07:08)
Every

Ayuk Besong Anne-Chantal (07:09)
day you discover a new thing that sickle cell does to your life that you didn't know. Today I am facing a part of sickle cell called a leg ulcer, which I never had. And I didn't even know how it starts and you know so every day it's like that. To the next day

Chantal (07:26)
What do you call that? Sorry, let

Chantal (07:28)
ulcer. Leg. Yeah.

Ayuk Besong Anne-Chantal (07:28)
A leg ulcer. So it's like a wound that

Ayuk Besong Anne-Chantal (07:32)
takes it's excruciatingly painful. If it's like somebody is like sawing off your bones

Chantal (07:38)
Really? my gosh.

Ayuk Besong Anne-Chantal (07:39)
and walking is like

Ayuk Besong Anne-Chantal (07:43)
you know, I wouldn't say painful. I would say walking is like murder. I wouldn't say painful. And you have to live with that and you have to go to work. And it comes with a whole lot of other things. I never knew something called neurological pain. And I found myself experiencing three levels of pain at the same time. So you your brain sometimes just wants to block everything in because you are having the

Ayuk Besong Anne-Chantal (08:10)
pain from the wound itself, which is like if you cut yourself the pain you will feel and then you have the pain from your bones that because of the wound have become

Ayuk Besong Anne-Chantal (08:21)
like rigid and so each time you have to force your bones to f your ankle bones to flex you get pain from the bones and then you have nerve pains caused here by sickle cell disease which is so hair wrecking that even the wind that passes kicks you into pain you know I can't put on trousers I can put on stockings I can't wear a long skirt then sometimes I get all three of them and I'm like okay okay let

Ayuk Besong Anne-Chantal (08:51)
It stops. Somebody should make it stop. 

Chantal (08:54)
Yeah, And would

Chantal (08:55)
that be that what you're describing there? You're saying it's a new thing every day so that you might not have this next week, it might be something else that you experience.

Ayuk Besong Anne-Chantal (09:05)
Exactly. You might wake up and sickle cell has caused something else to some other organ, to some other part of you, and all you do is you're just forced to face it and try to look for a way to deal with it. And so that's

Chantal (09:18)
you are.

Ayuk Besong Anne-Chantal (09:19)
how sickle cell affects me and affects different ways because what I get is not what maybe Dr. Lewis would have. Even siblings, even my siblings would have it. None of my siblings has had a leg ulcer, you know. I've had siblings

Ayuk Besong Anne-Chantal (09:35)
who've had their jaw bones dismantled actually because of sickle cell. I've never had that. So it's different things. Every day you wake up to something new, to something different. If it's not in the physical, it's in the psychological of you. You might wake up with a mood swing, you don't know where it's coming from. I never knew sickle cell affected mood swings until I had to go study about it.

Ayuk Besong Anne-Chantal (10:00)
Background noise. Yeah, so

Chantal (10:06)
Ayuk so your siblings

Chantal (10:08)
all have sickle cell.

Ayuk Besong Anne-Chantal (10:10)
So I am the fifth out of six children and four of us were born with the full blown disease, so sickle cell, hemoglobin S S, and two are carriers of the of the disorder, so they have what we call the sickle cell trait or AS. So they are carriers of the genes, they don't have the pain and everything, but one thing we've got to experience

Ayuk Besong Anne-Chantal (10:40)
with them as the years go by, is that sometimes they have some little complications, which before we were not associating it with sickle cell disease, but as the years went by, we started realising something is happening. There's one in particular who kept on having eye issues, and they couldn't actually find explain why it was like that and migraines. And this is until she was past 30 that you started getting associated with

Ayuk Besong Anne-Chantal (11:10)
the fact that she had the sickle cell genes and her genes might be having a a bit of a stronger side of the S than the A. So now we we're watching out for that for her. But they are healthy, you would never know. So we call them the two watchmen of the rest of the group. Now there's just five of us left because we lost

Chantal (11:31)
overtalking

Ayuk Besong Anne-Chantal (11:37)
one about

Ayuk Besong Anne-Chantal (11:41)
seventeen years ago when sickle cell was still back in Cameroon where I come from and where I'm born, sickle cell was still something all new. So it took the medical staff or doctors a while to understand what goes as medication for sickle cell people with sickle cell what

Chantal (12:00)
overtalking

Ayuk Besong Anne-Chantal (12:02)
they should take and what they shouldn't. So he died from a hospital error.

Chantal (12:07)
I'm sorry to hear that, that's really sad. Lewis, how does sickle cell affect you?

Lewis Thomas (12:15)
Sickle cell, has been a completely different experience for me. And it is, you know, a spectrum of severity. And I would say like the main way that it's affected my life is the pain crisis episodes. So this is something that I've kind of experienced every now and again.

Lewis Thomas (12:37)
It was probably when I was a teenager and sort of growing up and getting used to managing the triggers for the pain crisis that was the most difficult period where I would, you know, generally be quite well for the majority of the time and have relatively normal lifestyle.

Lewis Thomas (13:03)
Not really have to think about sickle cell that much. But then whenever I over-exerted myself or got dehydrated, that would trigger a sickle cell pain crisis for me. And because I was always very sporty, you know, play sports and, you know, sort of socialise with friends in that way, it was always this kind of...

Lewis Thomas (13:32)
like constant sort of thing hanging over me, this threat of triggering a sickle cell crisis, ending up in hospital, you know, having to think about how to explain that to people where I've just been completely normal, you know, the previous day or whatever. So that's how it's kind of like

Lewis Thomas (13:59)
affected my life and it's almost been like, I think the most difficult part of it is that just when I get back into sort of normal routine, sort of, you know, a good schedule, it can crop up and...

Lewis Thomas (14:22)
I feel like I've constantly had to sort of like fight against that to recover from crisis time and time again. And that was my sort of life growing up until I was around 20, 25 or so. Because obviously there's a lot of peer pressure associated with...

Lewis Thomas (14:47)
like when I was at university and just growing up and doing things that everyone wants to do and have fun and those can trigger sickle cell crisis and you know I guess it's an invisible illness as well that's what we're kind of talking about so no one really knows what's going on apart from you and if you don't tell anyone then no one's looking out for you.

Lewis Thomas (15:17)
So that was, that was part of, the difficulty of living with sickle cell for me was that I appeared normal most of the time. I don't have any, of the more severe complications, that I have to live with day to day. I just have these acute episodes of illness, where it just takes me out for a couple of weeks and then I'm back in. And between those episodes, I'm constantly having to

Lewis Thomas (15:46)
adapt to my life and think of all of these other triggers like am I drinking enough?  having to avoid cold weather, making sure I'm not pushing myself too hard when I'm trying to keep up with everyone else in terms of like exercising and my career as a doctor, getting stressed, working on calls and night shifts and worrying about people.

Lewis Thomas (16:16)
So there's just a massive extra mental load to consider for me living with sickle cell. And it's something that you, you can't really talk to anyone about who doesn't have sickle cell because they won't really understand. And sickle cell, there's such a lack of awareness in the general community as well that it-

Lewis Thomas (16:44)
it also makes it difficult to have those kind of conversations. So it's like I was saying, it's not just the physical, it's like a sort of mental and emotional burden that


Lewis Thomas (16:55)
you're living with as well.

Chantal (16:58)
You've both alluded to that quite heavily about the

Lewis Thomas (17:02)
overtalking

Chantal (17:03)
mental impact and you haven't said this word, but isolation. That's what kind of springs out to me. Alone with your pain and alone with the level of understanding from people from outside your immediate family. Can you just describe what does it feel like when you're in crisis? What is that

Chantal (17:26)
pain like? and do you have to go to hospital or do you have to rest at home like what can happen?

Lewis Thomas (17:35)
So the pain for me, I think everyone has their own description, but for me, it feels like being hit with a metal baseball bat right on your bone. And it's just kind of like relentlessly over and over again with, and the baseball bat is like a taser as well. So it's giving you an electric shock. So it's just excruciating, constant pain that is kind of like throbbing to the beat of your heart. Cause it's like every time

Lewis Thomas (18:05)
you're pumping blood through the vessels, it's generating a sort of wave of throbbing pain. So it's at that level where you obviously need to go to hospital for severe pain medication like morphine because otherwise it's just unbearable.

Ayuk Besong Anne-Chantal (18:29)
Yeah, well for me you know the pain it's like out of this world. I still remember I used to say, okay, if I have to choose go through birth pain and go through a sickle cell pain, I'd rather give birth to a hundred children.

Chantal (18:55)
Wow, okay. Having

Chantal (18:57)
had two children and now understanding a little bit more.


Ayuk Besong Anne-Chantal (19:00)
than to go through that because each pain depending on whatever you're getting is

Ayuk Besong Anne-Chantal (19:10)
it's so intense. When I was much when I was younger, when I was in secondary school, the pains would get so intense I would like I learned to toss myself into unconsciousness so as to block it off. Because

Ayuk Besong Anne-Chantal (19:30)
the painkillers we were getting then, now thanks to science, we have stronger painkillers than before. But in the

Ayuk Besong Anne-Chantal (19:41)
late 80s, early 90s, the painkillers were not like as precise and really like what we have now. So you would be screaming your head off and just wishing to have five minutes of no pain and sleep. So I still remember what some of the doctors would do was to knock me off by giving me injecting me something that would send me to sleep.

Ayuk Besong Anne-Chantal (20:10)
And that even didn't work after a while because my body got used to that. So they had to keep on increasing the doses to get me to sleep. And at a certain time I still remember I would be like, please, I just want to sleep. Even if just for five minutes, five seconds even. And they'll tell me, Ayuk you you know what? We can't give you anything. You're

Ayuk Besong Anne-Chantal (20:39)
Body has taken up to this quantity of it. We can't give you a dose higher, it's going to kill you.

Chantal (20:47)
Okay.

Ayuk Besong Anne-Chantal (20:47)
And I'm like, please,

Ayuk Besong Anne-Chantal (20:49)
just just a little sleep. Just just five minutes. Just five

Chantal (20:52)
Yeah.

Ayuk Besong Anne-Chantal (20:52)
minutes. And so the pain is so much that all you want is just this moment of respite. If it's your bones that are hurting, it's like somebody's you know, like you've been put in some grinder and somebody's grinding your bones in a very slow, excruciating way. And sometimes if it's with if it's a chest syndrome, it's

Ayuk Besong Anne-Chantal (21:17)
like somebody's pushing your lungs, and so air can't get in, so you're like trying to get in air, and each breath, it's like there is a knife that is ripping off your lungs into tiny shreds, and you're like, should I breathe or not breathe? You like in that kind of pain. Over the years, I learned to,

Ayuk Besong Anne-Chantal (21:47)
Dr. Lewis said it before, like knowing triggers. I learned to know what triggers my my pain episodes or crisis and I started avoiding totally anything that would get me to a pain episode and to a very intense level of it. So I started to learn the smell, I would say smell, but though you can't really smell it, it's like sensing it before it comes. So sometimes

Chantal (22:13)
Okay.

Ayuk Besong Anne-Chantal (22:14)
I would sit and just start getting

Ayuk Besong Anne-Chantal (22:15)
the numb sensation mild numb sensation around the jaw bones or a very funny numbing sensation around the joints and I just look at my surrounding make sure maybe I'm not in a place which is too cold. I get myself really into like a jogging warm, get warm compresses massage, make sure I've taken painkillers. I then I start fighting it in my brain like because even that set numbing sensation it feels like

Ayuk Besong Anne-Chantal (22:45)
like you've been injected something to just like ice blocks into your veins. It's numbing, it's not painful, but it's deeply uncomfortable. It's like you've been  tied into a pack of ice and you can't sense your fingers or your toes. It's just numbing like that. The only thing that seems to be working a bit well is your brain that is on a panic mode and saying, let this not


Ayuk Besong Anne-Chantal (23:09)
escalate into what I know is coming. Yeah.

Chantal (23:11)
Yes, you both mentioned

Chantal (23:14)
about temperature. So is that, is this really basic? Is that because when you're warm it helps the blood cells to move a bit more easily? Easily? Easier?

Lewis Thomas (23:26)
The temperature affects the blood vessels. So when you warm, your blood vessels are dilated and more open, whereas when you're cold, they constrict and make it harder for sickle cells to get through them. And it's also...

Lewis Thomas (23:45)
difficult when you're going from hot temperature to cold temperature. So a sudden constriction of the blood vessels can be enough to cause a sickle cell crisis. So even if you're only exposed to cold for a short, a brief period, like getting out of a hot shower into a cold room, that can be enough to trigger a sickle cell crisis for some people.

Chantal (24:12)
Okay, right.

Ayuk Besong Anne-Chantal (24:13)
Yeah. And I think that temperatures for us is it's not just

Ayuk Besong Anne-Chantal (24:21)
the cold gets you to easily get into crisis. But I think we just need to keep away from extremes, cold, hot. Because even when it's too hot, then you're sweaty and then you're losing water and if you don't have enough water and then that's something else. So I worked as a journalist in the field for

Ayuk Besong Anne-Chantal (24:44)
close to twelve years and it was one of the things and one of the moments in my life where I learned, Okay, too hot, too cold, girl don't go there. Don't go there. So

Chantal (25:01)
So over time, you both developed strategies to try and keep the episodes to a minimum, but there's no way of eradicating it. You can't be cured of sickle cell, can you? It's a case of living with it.

Lewis Thomas (25:21)
So there are new treatments to provide a functional cure for sickle cell. Well actually there's a bone marrow transplant which is a well established cure for sickle cell in that you are receiving the donated normal bone marrow and blood forming stem cells from somebody else which then takes over producing normal red blood cells for you.

Lewis Thomas (25:51)
Many people receive bone marrow transplants and they go on to live without the complications of sickle cell because they're producing normal red blood cells. And now there's new gene therapies which are basically a way of editing the DNA from the stem cells that are within the bone marrow of our bodies. And it's those stem cells that are responsible

Lewis Thomas (26:21)
for producing red blood cells. So if you edit the DNA, you take the stem cells out, you edit the DNA in them, and then you put them back inside, those red stem cells that produce new red blood cells will then be sort of free from sickle cell complications. So that's the basic sort of summary of it. But

Lewis Thomas (26:45)
I wouldn't say that there's a cure that's accessible to people because both of these things are very expensive and the majority of people living with sickle cell around the world aren't able to access them. So


Lewis Thomas (26:58)
it might as well not be a

Lewis Thomas (27:00)
cure in the sense that why is there still so many people living and suffering from sickle cell when there's a cure?

Chantal (27:06)
Yeah.

Lewis Thomas (27:06)
There's not, it's just for people that are able to access it.

Chantal (27:13)
It affects people of African heritage. Correct?

Ayuk Besong Anne-Chantal (27:21)
Now in 2026 for example, part of the new framing that is being pushed for sickle cell disease is to limit it to continents and to see it more like a global issue because

Ayuk Besong Anne-Chantal (27:39)
it it affects people of African origin, people from the Middle East, people from from Asia, India. But with the number of years of we have had for the past between  2010 ten and now the world has become such a melting pot of cultures and mix of races that

we think if we continue with framing sickle cell disease in, oh it affects this continent and that continent and people from this part of the world, there is going to be a huge population that thinks we are not concerned, and before we know it, we'll realize that there is a huge community of people living with it or affected by it that have not been identified and that that are not getting the help they're supposed to

Ayuk Besong Anne-Chantal (28:31)
get because

Chantal (28:32)
overtalking

Ayuk Besong Anne-Chantal (28:33)
great-great grandma had gotten married to somebody from India, or great-great-grandpa had gotten married to somebody from the Middle East, and so the genes


Ayuk Besong Anne-Chantal (28:44)
had gotten in there in the family, but then genes don't scream colour, so more and more countries are beginning to open up

Ayuk Besong Anne-Chantal (28:57)
their testing to everybody. Here in France we had to push the patient community had to push for France to agree to test everybody because when I came into the country in 2019, nineteen, babies that were born were only tested for parents who are

Ayuk Besong Anne-Chantal (29:22)
of African or Indian or Middle Eastern origin that made that there was there were lots of babies of European origin but that had ancestry that is connected to these different places that were not tested and then they only discovered when the big children have reached the age of six, seven, when they start showing their first crisis that something was wrong.

Ayuk Besong Anne-Chantal (29:52)
So now the patient community has pushed and pushed and since late 2020 the government now made newborn screening for every baby, irrespective of

Ayuk Besong Anne-Chantal (30:06)
wherever the parents are from, every baby born is tested for sickle cell disease. And that's what needs to be done in every country all over the world. Because


Ayuk Besong Anne-Chantal (30:15)
there are lots of babies that would be missed and that's lots of life that would be lost when they could be saved.

Chantal (30:20)
Yes, yeah that's the reality

Chantal (30:22)
of it and you've also said that it's about six years of age when a person would start to experience symptoms or crisis from having sickle cell or do younger babies, children.

Lewis Thomas (30:40)
No, so it can present at any age. Young newborn babies tend to start experiencing symptoms from around six months of age and that's to do with the hemoglobin that they have inside their red blood cells. So it basically takes babies six months or so to start producing

Lewis Thomas (31:07)
their adult hemoglobin that they're going to spend the rest of their lives with. So babies up to that point and babies in the womb are protected by a different form of hemoglobin called fetal hemoglobin that is good at, that basically is anti-sickling. It doesn't sickle or change the shape of the red blood cell. So yeah.

Lewis Thomas (31:32)
It affects it, it can start to cause problems for people at any age. Some people get it, get issues from when they're child children. Some people start experiencing it when they're teenagers, when they're twenties. I've even heard of people diagnosed, you know, in their fifties and sixties and, you know, have lived their whole life without knowing they had sickle cell. And then they suddenly start getting complications when they're older adults. But I just want to go back to the point about...

Lewis Thomas (32:01)
sickle cell and who it affects. Because I 100 % agree with Ayuk, I think you hit the nail on the head. Because what I was thinking is, it's a slightly simplified message to say sickle cell affects black African people, as it's reductive in a way that's harmful for the

Chantal (32:23)
Yeah.

Lewis Thomas (32:23)
reason that Ayuk explained. But it's essentially...

Lewis Thomas (32:28)
a genetic illness that is based on areas of the world where malaria was really common. And for that reason, it's why it affects not just African, but the Mediterranean, India, Middle East, and people who have, you know, ethnic origins from those areas. So, yeah, I just wanted to mention that as well.

Chantal (32:56)
No, thank you. This is what this conversation is all about. It's about educating. It's about eliminating myths and misconceptions and stigma. So, no, this is great. And yes, please do.

Lewis Thomas (33:11)
Yeah, can I just add one more thing? If we have time,

Lewis Thomas (33:15)
It's just because when I say that it's come from areas where malaria was common, the reason for that is that sickle cell trait is protective against severe forms of malaria. So thousands of years ago, malaria was basically taking everyone out and people who had

Lewis Thomas (33:39)
one copy of a sickle cell trait gene, who are known as AS carriers of the gene, they don't suffer from the full blown illness, they were less likely to die from malaria. So they ended up surviving to reproductive age and having children with each other. However, when you have two carriers that have children together, there's a...

Lewis Thomas (34:03)
one in four chance that they have a baby who inherits both of the sickle cell trait genes and ends up having sickle cell. So that is how sickle cell essentially developed and evolved and people who have the sickle cell gene end up kind of being more vulnerable to malaria and other infections and dying very young.

Lewis Thomas (34:32)
Because historically we don't have modern medications and antibiotics and vaccinations, which are what we have now, which keep people alive for longer lifespans. And the sort of culture at the moment is still, and the medical system is still very behind, thinking that people with sickle cell

Lewis Thomas (35:01)
die young and you know it's a very it's very much like a pediatric problem so we now have people living into adulthood and the adult services just don't really understand sickle cell enough because it's never been part of the medical training so this is a huge sort of health inequality problem which also stems from the fact that it's

Lewis Thomas (35:30)
considered a black disease that affects majority


Lewis Thomas (35:33)
African Caribbean. And yeah, it's a constant battle that's ongoing to get sickle cell recognised and give people the care that they need and know, deserve.

Chantal (35:51)
I was going to ask, and this is all about the perception, isn't it? So, you know, what kind of reaction do sickle cell patients receive when sharing their diagnosis generally? It sounds like in the healthcare setting, it's a bit of a surprise because they would expect maybe just to be in the younger generation. I'm sure that gentleman who got his diagnosis in his 50s was probably met with surprise from the medical professionals. But what is the general sort of...

Chantal (36:20)
understanding and reaction really.

Ayuk Besong Anne-Chantal (36:25)
I think of perception when it comes to sick cell disease and perception

Ayuk Besong Anne-Chantal (36:34)
varies where you are. And I'm going to explain perception. Before I moved to Europe and what I get when I'm here. So before I moved to Europe and when I was in Cameroon, sickle cell disease is it's enshrined in a lot of misinformation and cultural nuances and a high dose of whitchcraft

Ayuk Besong Anne-Chantal (37:03)
into it. So children born with it will be seen as spirit kids who come to torment their parents and die young.

Ayuk Besong Anne-Chantal (37:15)
And well it's changed a bit over the years because there've been a lot of patient associations and and communication that is not too much, but at least some of it. And now that is beginning to I'd say reduce a bit, but not as much as we'd l like to see it. and that is not just the case in Cameroon, but in most of Africa. You get that kind of perception. And then when

Ayuk Besong Anne-Chantal (37:45)
you go now to perception when it comes to adults or from the ages of 15 and above, people living with sickle cell disease, perception varies per gender. So men are seen as weaklings, incapable of reproducing, the same thing for women. It's a whole crisscross of

Ayuk Besong Anne-Chantal (38:11)
lack of information that's making people to be reduced to things that they are. Your capacity to work is judged, your capacity to be a wife is judged, your capacity to be a man is judged, and so globally in Africa people living with sickle cell disease are seen as not adequate.

Chantal (38:35)
Right,


Ayuk Besong Anne-Chantal (38:36)
You're not

Ayuk Besong Anne-Chantal (38:36)
adequate to go to school, you're not adequate to work, you are not adequate to live, you're not adequate to be a mum or a dad. So it leads to a lot of loneliness in the side of the patients who just prefer not to speak about what they are. Because the other side of sickle cell disease is the invisible part. There is nothing that shows. On days when somebody living with sickle cell disease is okay, is he

Ayuk Besong Anne-Chantal (39:04)
She's just like Mr. and Mrs. Everybody. They move around, they

Chantal (39:07)
Yeah, yeah. It's not encouraged

Chantal (39:11)
to talk about within those communities at all.

Ayuk Besong Anne-Chantal (39:12)
Yeah, you won't see anything.

Ayuk Besong Anne-Chantal (39:15)
So they go about. But so it makes them not to talk about it. They keep it

Chantal (39:19)
Yeah.

Ayuk Besong Anne-Chantal (39:19)
to themselves because of they are afraid to be to be judged. Now

Chantal (39:24)
Yeah.

Ayuk Besong Anne-Chantal (39:24)
when I moved to Europe I saw a different kind of perception when it came to sickle cell disease and that was more when it came to assessing medical care. I saw notice that people living to with sickle cell disease were now equated

Ayuk Besong Anne-Chantal (39:42)
to junkies, because

Chantal (39:44)
Oh right.

Ayuk Besong Anne-Chantal (39:46)
they were looked upon as junkies, like you're

Chantal (39:48)
Oh my gosh.

Ayuk Besong Anne-Chantal (39:49)
addicted to medication. Because

Chantal (39:52)
Wow.

Ayuk Besong Anne-Chantal (39:53)
of the level of the pain that makes it that they are always under very high painkillers

Ayuk Besong Anne-Chantal (40:00)
when they come to hospital or emergency services in acute pain.

Ayuk Besong Anne-Chantal (40:06)
They're not taken seriously. I'd give an example, anecdote. 2020 I was pregnant, seven months gone, and I had a chest crisis. I just moved to Europe a year ago a year before that, and I had a chest crisis. COVID just appeared. Countries had not gone on lockdown, but people were still afraid and there was all kind of wrong information going around. So I get a chest crisis and I dialed the

Ayuk Besong Anne-Chantal (40:36)
Emergency services and the ambulance gentleman came in. Okay, madam, what do you have? I told them my chest hurts. They started looking at one another. I can't breathe. They started looking at one another. The next thing I started hearing them talk COVID, I was like, I had to tell them, see, I know exactly what I have. It's not COVID. I live with sickle cell disease. I've had this before, and this is what it is. My doctors know it. I'm being followed in this hospital, so please take me there.

Ayuk Besong Anne-Chantal (41:06)
And I was nicely hushed. And they told me, you know what? We don't want to hear it. There is COVID. And so we're just going to roll out COVID procedure anyway. So they rolled out COVID procedure. I was wrapped up in some bubble. They kept on pumping oxygen. I was taken to the emergency services, isolated, nobody could see me. And the more they kept on pumping me with oxygen, my baby started

Ayuk Besong Anne-Chantal (41:34)
fighting and since there was no knowledge about testing for COVID, so the only health organisation that had the capacity to test for COVID was the Pasteur Institute in Paris. And so my blood had to be taken there and it needed twenty-four hours to test if I really had COVID and nobody was listening to the fact that I was actually screaming, that I have sickle cell disease. This is my record.

Ayuk Besong Anne-Chantal (42:04)
Look at it. The doctors know it. They've been checking, they've been doing everything. I don't have COVID. Nobody listened. Bottom line, my baby was struggling so much that they told me, you know, we don't know whether you have COVID or not. And we don't know whether if it's COVID, if it passes from the mother to the baby, so we're just going to take your baby out anyway. And that's what happened.

Lewis Thomas (42:28)
Wow.

Chantal (42:28)
my goodness.

Ayuk Besong Anne-Chantal (42:30)
So here in Europe you don't get actually judged when you tell somebody I have sickle cell disease because I think a lot of people don't actually know what sickle cell disease is. So they

Chantal (42:41)
and they couldn't

Chantal (42:42)
be bothered to look.

Ayuk Besong Anne-Chantal (42:43)
Yeah, so they kind of really like sideline

Lewis Thomas (42:46)
Mm-hmm.

Ayuk Besong Anne-Chantal (42:46)
you. But they judge is what you are, your physical. So are you always sick? If you're always sick then they'll tell in in the place of work they'll tell you, he's always sick, so he doesn't seem to have the stamina to work. So it brings about the the part of perception when it comes to workplace where you're underlooked. In hospitals, because you come for painkillers, they take you like, this person is coming to get his normal dose.

Ayuk Besong Anne-Chantal (43:14)
And so you're not taken seriously.

Chantal (43:20)
And is there a perception of that because of the colour of the skin that people who are black or brown can withstand a lot more pain?

Ayuk Besong Anne-Chantal (43:29)
Yes, yes,

Ayuk Besong Anne-Chantal (43:31)
yes. There is a big perception of that because a lot

Lewis Thomas (43:32)
Yeah.

Ayuk Besong Anne-Chantal (43:34)
of the people who appear, a big part of the population here in France living with sickle cell disease, there are those that are blonde hair, blue eyed that have it, but the majority is black, brown skin, so it also goes there.

Lewis Thomas (43:51)
It's not just about that sort of myth that is taught, was taught however many years ago that black people have thicker skin and can withstand more pain. It's unconscious bias against black people and systemic racism where it's like for me, I remember having to go to the paediatric ward as a child

Lewis Thomas (44:19)
whenever I had crisis and it being really good and receiving care and prompt treatment to then having as an 18 year old going into an adult A&E and just immediately being shocked at this judgment of me because now I'm not just like a child. I'm a black man going into hospital asking for morphine.

Lewis Thomas (44:47)
And it's like immediately there's this stereotype in people's minds, even people who aren't necessarily racist, but they just have the stereotype in that they need to be on the lookout for druggies. So this is where this sort of drug seeking thing comes in because you're in such excruciating pain and

Lewis Thomas (45:13)
it's such a simple sort of treatment that you need. It's like, just give painkillers and relieve the pain and then, you know, manage the rest of the condition. But there's this massive barrier because you're not just seen as a person experiencing pain, asking for pain relief. You're seen as a black person with invisible pain that can't be

Lewis Thomas (45:43)
proven by any test, it purely relies on them trusting you, trusting what you say. And that is just a massive problem for sickle cell care. So even though I say that, like I speak to people from all over the world, and I think this is a problem even in Africa where the doctors treating are the same colour, because

Lewis Thomas (46:13)
it's the invisible part aspect of it that I think is the biggest barrier for people because I know from working as a doctor myself that doctors and healthcare professionals are conditioned to need like signs and investigations and test results and these kinds of things that they can use as evidence to administer treatments.

Lewis Thomas (46:43)
But sickle cell is a condition where that doesn't work like that. And because it hasn't been taught in the right way in medical schools, people just aren't aware of it. So the black racial stereotypes take over and the unconscious bias kicks in and people end up suffering unnecessarily because

Lewis Thomas (47:14)
of these racist stereotypes.

Chantal (47:17)
It's a real challenge, isn't it? It really is a big challenge.

Lewis Thomas (47:20)
Yeah, it's huge.

Chantal (47:21)
So, I guess that brings me on to the Sunflower and its purpose. What are your thoughts? I'd like to hear your thoughts about the Sunflower? As a disability inclusion tool.

Ayuk Besong Anne-Chantal (47:34)
Okay, well I think it' a very good initiative and I think it, I hope and I pray that it's something that could like spread

Ayuk Besong Anne-Chantal (47:47)
across countries and get to be used to as that umbrella initiative where different kinds of invisible disabilities can be

Ayuk Besong Anne-Chantal (48:01)
voiced and those living with it would have something to show that I am a person living with this or that. But I don't have to be dying or in pain or to prove by any kind of science that this is what I have. And when you see me wearing this, it's it means that I am somebody who is going through either this or that, which you can't see, but which I feel and I go through every day.

Ayuk Besong Anne-Chantal (48:30)
That's what to me really caught my attention when we met and I went behind and I read about I remembered all the classmates who died, whether it's from sickle cell disease or those who even had

Ayuk Besong Anne-Chantal (48:50)
disabilities that nobody could really really put a finger on but you know people were calling them names when you know it's nothing they could do about it and just the fact that it's not known people think it doesn't exist. I think the Sunflower initiative helps to say it's not because you don't know about it that doesn't mean it doesn't exist

Chantal (49:17)
you

Ayuk Besong Anne-Chantal (49:18)
because the person

Ayuk Besong Anne-Chantal (49:19)
living with it, lives with it and knows that it exists and feels it every second, but you don't, you don't see it.

Chantal (49:29)
That's exactly

Chantal (49:29)
the scenario that you had with your doctor. Sorry, I meant to ask you, is your child alright?

Ayuk Besong Anne-Chantal (49:35)
Yes, he's he he's fine. He's now six and a half and getting ready to start primary school. Though he came was born with I don't know whether it's because of that experience because I'm still trying to get the exact kind of medical explanation, but he was born with very severe respiratory problems and

Ayuk Besong Anne-Chantal (50:03)
We're still battling with it now. The first two years of his life, he couldn't get a night's sleep normally. And


Ayuk Besong Anne-Chantal (50:10)
we're still struggling with that. But he's fine, as much as fine can be. And

Chantal (50:15)
Yeah.

Ayuk Besong Anne-Chantal (50:17)
he's a vibrant young man.

Chantal (50:20)
Good, And if

Chantal (50:22)
you have any thoughts you'd like to share about the Sunflower where you might think it would be useful?

Lewis Thomas (50:28)
Yeah, I think it's just a really helpful way of helping people to recognise the disability and taking the burden off of the person living with the invisible disability to actually communicate to other people. Like, here's all my life, here's all my trauma, I have to prove myself

Lewis Thomas (50:57)
that I have a disability because it's not something that can be seen. There's just so many situations where I think if the community becomes well aware of the Sunflower that it would just make life a lot easier for people to navigate because it's like we were talking about.

Lewis Thomas (51:26)
There's a lot of mental and emotional stress that comes into trying to fit into normal society because you look normal, you're expected to act normal and there's so many situations where you end up in conflict with, okay, I feel weak, fatigued, in pain, like I need to sit down on public transport,

Lewis Thomas (51:55)
but I'm going to be judged, blah, blah. And yeah, just having something that immediately just signal that you have a disability is just such a great idea, I think. So yeah, I'm really, really excited for this to spread and become, you know, something recognisable globally.

Ayuk Besong Anne-Chantal (52:19)
Yeah. If I may add one thing, one thing that I didn't mention before. It's just that if and when the Sunflower initiative spreads and

Ayuk Besong Anne-Chantal (52:35)
it will help people living with hidden disabilities and amongst them sickle self-disease to stop having the need, feeling that there is a need to justify. I spend most of my life feeling like I must justify. You have to justify why you need this kind of help. You have to justify why you need this to love this way. You have to justify why you need to drink so much. You have to justify why you know it's like

Ayuk Besong Anne-Chantal (53:05)
a life full of justifications, and sometimes you're just tired of justifying it. You just want somebody to understand that, I might not just be in the mood or not just feel like I should stand. I shouldn't deploy my whole life chapter to you to know that I just need to sit, and that at this same moment as I'm standing, I'm having a pain building up, and sitting will just help me ease off. So that's what I

Ayuk Besong Anne-Chantal (53:34)
I see the Sunflower as and I hope it really grows viral. So we live a life free of the justification. It's terrible.

Chantal (53:45)
It is terrible.

Chantal (53:46)
It's really terrible. Lump in my throat.

Chantal (53:52)
So.

Chantal (53:55)
I think one thing we might, just before we go on to what your groups and the communities do, is that I think it would be really nice, I don't know, just say a couple of sentences, a few words about how you're so much more than sickle or cell, you know, there's so much more beyond the diagnosis of what you're living with, for example, you're a doctor, I mean

Chantal (54:20)
that's not any easy feat for somebody to do. You're a journalist. Is there something you'd like to sort of say or share about that, you know?

Ayuk Besong Anne-Chantal (54:33)
If I have just to say in in a few words and 'cause I always have this tendency of carrying the whole community on my shoulder, I'd say

Ayuk Besong Anne-Chantal (54:45)
people living with sickle cell disease are like little geniuses that are on the loop because of their health condition and it's a shame that their communities don't get to benefit from that skill set that they carry. I'm a journalist. I remember when I started working, when I moved from radio to television, I was part of the team that started the first private television station in Cameroon.

Ayuk Besong Anne-Chantal (55:15)
And I was judged for being somebody with sickle cell disease and a woman that people were saying, you can't be leading me, you can't be the head of the newsroom, and you can't even work. But they were shocked at how much I could put in. Because I think that's why people living with sickle cell disease call themselves warriors. It's that when you live with a condition that

Ayuk Besong Anne-Chantal (55:43)
makes you learn to become like a fighter. You learn to fight. And so things that other people will take for granted, you take it as a gift, as something special. So you learn you know how to work and put in even 10 times more what than what people without sickle cell disease put in. Because you evaluate your life to I might have just this time. So let me make the best of it.

Ayuk Besong Anne-Chantal (56:13)
Whereas people who don't have an invisible disability or any kind of disability and who have normal healthy lives wouldn't take that. They'll take that for granted. Don't say, I have tomorrow and I have tomorrow after tomorrow. But you would be like, if I don't do this, maybe tomorrow I might be sick and I might be in hospital. So I need to channel my energy when I'm strong and achieve this.

Ayuk Besong Anne-Chantal (56:34)
When I did my GCE, I some weeks before that I had my first site crisis I'll say related to sickle cell disease. I couldn't see.

Ayuk Besong Anne-Chantal (56:46)
And I had huge pain and migraines. And so I actually wrote the GCE half blind. And they were reading the questions to me and I was just writing. I couldn't use the normal writing sheets, so they just gave me an A4 sheets like that and I'll just write. But I could ace all of my courses. So I'll say people with sickle cell disease have a plethora of skills.

Ayuk Besong Anne-Chantal (57:16)
Society should learn to tap from that


Ayuk Besong Anne-Chantal (57:20)
by just making sure they learn to listen, understand, empathise.

Chantal (57:29)
Yeah, those are the three principles behind the Sunflower. Lewis, did you have anything you wanted to add?

Lewis Thomas (57:38)
Yeah,

Lewis Thomas (57:40)
I think for a long time I...

Lewis Thomas (57:45)
I just didn't want to tell people that I had sickle cell. It was just so, so many questions, so much judgment and like, I just didn't want to deal with it. And it was because there was always like an assumption that people are going to automatically go to the negative aspects of sickle cell and, and, and judge you on that, you know, it being a disease, you know,

Lewis Thomas (58:09)
being weak and ill all the time and basically not being competent and I think a lot of sickle cell warriors feel that and they end up kind of having this chip on the shoulder where they have to you know work extra hard and and prove themselves and end up pushing themselves so hard that they actually end up

Lewis Thomas (58:35)
in crises because of the stress because they're trying to fit into this normal mold of a society that just does not know anything about sickle sign, doesn't recognize it. I think for me, I learned so much about myself when I started journaling and started writing online,

Lewis Thomas (59:05)
in terms of like all of the strengths that I have as a result of sickle cell and the challenges that I've had to overcome to get where I am because of sickle cell. You know, it's like you're saying, things that would make normal people give up, we're just used to, you know, because we're used to overcoming adversity and that's what makes us so

Lewis Thomas (59:33)
strong as people. I think anyone living with sickle cell who is, you know, aiming high and aspiring to be, you know, whatever they actually want to be, has this unique, you know, superpower in that they're able to do it with sickle cell. And what changed things for me in my journey was when I realized that

Lewis Thomas (01:00:03)
I had to find my own way of moving towards what I wanted to in life. And that was part of when I realised that I didn't want to continue working clinically as a doctor, like everyone else, you know, all of my other peers were, because having sickle cell, I realised the impact, the negative impact that that had on my health, that way of working in a system that, you know,

Lewis Thomas (01:00:32)
just is burnout culture. So I took my skills and I left and I just started using them to have a positive impact on people living with sickle cell worldwide in my own way, in a way that's a lot healthier for me. So that all came out of me fully embracing sickle cell as part of who I am,

Lewis Thomas (01:01:02)
and putting this like positive identity around it rather than letting other people tell me you know sickle cell is all these negative things and you shouldn't speak about it because of this so it's just taking ownership of like who you are and yeah just being yourself I think and not letting other people's

Lewis Thomas (01:01:31)
external perceptions of that affect you.

Chantal (01:01:36)
So I guess that brings us neatly on to the Sickleverse

Lewis Thomas (01:01:42)
Yeah, yeah. I'll just say it's basically a community for people living with sickle cell and their families all over the world. And it's my way of connecting people who are living in isolation that can support each other because everyone has all of this experience and all of these different problems and challenges that...

Lewis Thomas (01:02:06)
they've overcome and sharing that with other people is beneficial for the people giving the advice and the people receiving it. We're all kind of learning together. I'm providing the education from, you know, my sort of doctor side and the lived experience side. But a lot of it is just the people within the community that are just...

Lewis Thomas (01:02:35)
being brought into this space where the stigma is slowly sort of breaking down and people are opening up and, you know, really benefiting from recognising that they're not alone. And that's the main thing, you know, Sickleverse is, that's the sort of main thing that Sickleverse is for. I want people to learn more about sickle cell so that they can keep themselves healthy. And I think at the moment,

Lewis Thomas (01:03:03)
a lot of the learning materials out there don't have people living with sickle cell involved in them enough. So

Chantal (01:03:09)
interesting.

Lewis Thomas (01:03:11)
that's where I come in, because I just like breaking down complex information for people and, you know, helping them to understand, because it changes behaviours and, you know, it makes a massive difference when people

Lewis Thomas (01:03:26)
understand that there are medications that they can take that will help to reduce their suffering and you know that I can explain their fears in a way that they understand and you know they can go on their social media and learn bite-sized information in a form that is that they're used to.

Lewis Thomas (01:03:50)
So yeah, that's what Sickleverse is. There's many different aspects to it, but essentially it's a community of people learning about sickle cell.

Chantal (01:03:57)
And

Chantal (01:03:58)
people can access it worldwide.

Lewis Thomas (01:04:01)
Yeah, so sickleverse.com is the website where you'll find all of the resources that I have for people living with sickle cell.

Chantal (01:04:10)
Thank you. I'll add it to the show notes as well. And Ayuk your community group and how people can connect with you and it.

Ayuk Besong Anne-Chantal (01:04:21)
Yes, so wow it's I'm a bit all over the place. So I'll start with SOuL Just Be. So Soul Just Be magazine is an e magazine and it's an initiative to a bit like Sickleverse.

Ayuk Besong Anne-Chantal (01:04:39)
We started it with the intention to show all facets of sickle cell disease, not just the biology of it, but the life. Without any taboo. So we discuss and through storytelling,

Ayuk Besong Anne-Chantal (01:04:59)
We show sickle cell disease beyond the pain because we wanted people to understand it beyond the pain. So you would read in the magazine sickle cell disease and religion, how it plays into people coping with sickle cell disease, how it plays with mental health, you read about sickle cell disease and love, and there we will give advice on

Ayuk Besong Anne-Chantal (01:05:27)
the biological side, what to do, tests and all, but would also give advice based on living experiences of patients whom we interview on how to go about things. Little tips that work for somebody or several people. Would share things about food and what to eat and why to eat that and would share tips about fashion, what to wear

Ayuk Besong Anne-Chantal (01:05:54)
such that, you know, not because we have sickle cell disease that we can look chic. And we could we can't do chic, but we have our own way of being chic. While watching out for maybe temperature extremes. Too cold, too hot and stuff like that. Too tight, too loose. And so that's what you would find in Soul Just Be. And of course each edition comes with a feature interview where we have one person, a warrior, who is doing something in

Ayuk Besong Anne-Chantal (01:06:23)
their side, be it career wise or education wise or something and we interview them and the whole idea is for people to see that sickle cell disease touches us the entire human being body soul spirit that's where the name soul just be comes from.

Ayuk Besong Anne-Chantal (01:06:48)
And the podcast is my personal give back to the sickle cell community and it's an initiative that I started when I realised that there were so many professionals living with sickle cell disease, but they've been forced to keep quiet of who they are. And I was like them speaking about themselves, their stories, would help a lot of young people.

Ayuk Besong Anne-Chantal (01:07:18)
Who, because of the poor perception around sickle cell disease, have grown to think I can't be this, I can't be a medical doctor. They say I'm going to die by 18. So how can I be a medical doctor? So I thought, why not have a podcast where I let the

Ayuk Besong Anne-Chantal (01:07:39)
people living with sickle cell disease, professionals in their spheres, to just tell their stories and hoping that somebody who listens to it, a young person in Africa, somebody in India, somebody in in in the Middle East, somebody in France would say

Ayuk Besong Anne-Chantal (01:07:58)
I think I can be like him. I think I have that skill set. So I think I can learn from him. And the idea is not just listening to the podcast and being able to galvanize the listener but also to create the network so that when they listen and they'll know I could contact Dr Lewis on LinkedIn and move from just the podcast to engaging with Sickleverse and then knowing my potential.

Ayuk Besong Anne-Chantal (01:08:28)
and how I can best be who I am, sickle cells still being there.

Ayuk Besong Anne-Chantal (01:08:34)
And just recently I completed a game app and that is for the little ones in primary school because I noticed that information, just like Dr. Lewis said, information about sickle cell disease, there's information that's out there.

Ayuk Besong Anne-Chantal (01:08:53)
But a lot of it has been done without the patients. So there is an absence of that lived-in experience side in it.

Ayuk Besong Anne-Chantal (01:09:04)
Because I realise that things like Stigma starts from, very young, grows up with you.

Chantal (01:09:16)
Yeah.

Ayuk Besong Anne-Chantal (01:09:19)
If we have to start fighting it, we should also start with lots of education and information very, very young.

Chantal (01:09:26)
Yes,

Chantal (01:09:26)
couldn't agree more. And so how can people connect with you

Ayuk Besong Anne-Chantal (01:09:30)
So people can connect with me. I am on LinkedIn and Facebook, Instagram, X but I now am working more behind my consultant firm A and A Consultant Consulting which is on LinkedIn. People can just go there and they'll see the link to my

Ayuk Besong Anne-Chantal (01:09:53)
new newly created domain, we're still working on it so it doesn't have a a fixed name on it. It's just Ayuk Besong Comp Services. And they'll get to see

Ayuk Besong Anne-Chantal (01:10:04)
podcasts and links to it, they'll get to see the game and the the link to it and the game we are still testing it.

Chantal (01:10:12)
Amazing. Thank you. Thank you very much. So if anybody wants to reach out to either of these amazing organisations, community groups, please do. And I will add the links to the show notes. The Sunflower is available globally. So no matter where you're listening to this podcast, hop onto our website. You can order a Sunflower Lanyard or other

Chantal (01:10:41)
item, learn more about the Sunflower, get your organisation to join so that we can reduce this judgment, be more open-eared, listening, kinder and understanding to create a more inclusive society for all everywhere. And thank you so much to both of you, Dr. Lewis Thomas, Ayuk Besong Anne- Chantal, for your wisdom and your experience and for

Chantal (01:11:10)
spending time with us today on the podcast.

Lewis Thomas (01:11:14)
Thank you for having me.

Ayuk Besong Anne-Chantal (01:11:14)
Thank you

Ayuk Besong Anne-Chantal (01:11:15)
for having us.