Women worldwide tend to pray about their health issues rather than visiting a doctor and dealing with them, an obstetric and gynaecological specialist told .

That attitude is one of the main hurdles to combating women's health problems and overcoming it will be key to saving countless numbers of lives.

"Spiritually speaking, you must take care of your health too," said Dr. Melody McCloud, founder of Atlanta Women's Health Care.

She has made it her mission to get the message out far and wide that women must begin prioritising their health.

She brought that message to Bermuda last month, making a stop on the Island to promote her easy-to-read guide to women's health issues, 'Blessed Health: The African American Woman's Guide to Physical and Spiritual Well-Being' (Fireside Books, Simon & Shuster, 2003).

Dr. McCloud said she wrote her book after seeing firsthand the high numbers of poorer women dying from curable diseases ? deaths which could have been prevented if women's health care had been a higher priority.

Women with very low incomes tend to only visit medical practitioners in emergency situations, she said, and those visits usually take place in an emergency room setting which lacks the individualised care women should be receiving.

"By then it is often too late," Dr. McCloud said. "Women must make time for pap smears and to get regular mammograms."

Many black women die of cancer and other diseases and Dr. McCloud decided to look into why these diseases were talking a disproportionately high toll on that demographic group.

"Physically we are all the same, our structure is all the same in as far as internal organs," Dr. McCloud said. "But, at some point, things seem to change ? the black population seem to go down a path, where we seem to carry the worst prognoses."

While the same diseases are equally present in the white population, death rates are higher for blacks.

"That caught my eye," she said. "Why is it that blacks falling off the path of healthy living?"

Dr. McCloud believes there are a number of reasons for these higher mortality rates, some of which are historical.

"One reason, at least here in the States, was that there was distrust of health care professionals," she said. "This was an issue especially in the South, where blacks were given hysterectomies that were not required. They were just done by white physicians to sterilise these black women."

This kind of malpractice led to a deep distrust in the black community for medical professionals.

"That distrust has kind of permeated throughout the years," she added. But there are other factors such as education and lack of insurance which add to the problem.

"People without insurance for the most part, don't go for routine preventive care," Dr. McCloud said.

"They only wait until they get an emergency and go to the emergency room and sometimes that's too late. We need to ensure that women are educated, so that they can get the type of jobs that have health benefits. So that they can be more pro-active from a health standpoint."

Another reason for low survival rates to otherwise treatable diseases is that many people would rather not know they have a health problem and, as such, choose not to deal with symptoms when they occur.

"We don't want to find out and we don't want to hear about it," Dr. McCloud said. "And we really need to change that approach, because the one thing that is sure, is the sooner we can find something the better chance we have of curing it or even preventing what it might possibly turn into.

"So if you come in regularly for pap smears and mammograms, if we begin to notice a change, we can catch it. We really need to stress that regular preventive care is important."

Dr. McCloud said women should not put too much faith in the almighty at the expense of regular check-ups.

"I am a woman of faith," she said. "But I call this having too much faith, in that we say 'girl just pray about it and you'll be okay'. We do that to the exclusion of actually seeking a health care professional's opinion with regards to our healthcare.

"I am saying we can do both ? we can pray and be women of God and also use the healthcare professionals that are available to us and look at them as a blessing from God."

Women must also take care of their sexual health, Dr. McCloud said, which means being aware of the risks and not being too embarrassed to take precautions or to seek help if problems arise.

Black American women are one of the faster growing sectors for infections of HIV and AIDS, she said.

Dr. McCloud said when she originally heard this fact stated, she though it could not possibly be true.

She telephoned the Centers for the Disease Control, however, and was told many black women were being infected with the virus.

"I had been reading all these statistics and I thought they are just trying to make black women look bad again," she said. "But one of the key reasons, is that a lot of black men are using drugs and a lot of black men at sleeping with other men ? men who don't profess to be homosexual, but they are out there playing around.

"Then we have the men who are in prison, who are possibly having sex with other men and when they get out, come home to either a wife, woman or whoever was waiting for them and have sex with them.

"So between the drug situation and men sleeping with other men, is where a lot of these new AIDS cases are coming from.

"And so women have to be very mindful of being protective of themselves when it comes to who they make love with. No one likes condoms, but you have to keep in the back of your mind that having sex with a particular person could kill you. Which is a scary thought."

Dr. McCloud said the main point of her book is that health care must become a priority in black communities.

"We have to get serious about that because black women are dying from diseases that should have high survival rates," she said. "There are more white women who are diagnosed with breast cancer, but more black women die from it. Black women have the highest rate of heart disease leading to death. I am hoping that we can educate women and try to get the word out in a way that is easy for them to read and easy to understand, but also to gives them some medical information ? even for going to their doctor ? and to serve as a reference point."

She said her aim to also to help women to not only focus on their spiritual health, but also on the physical health.

"This is why I made it a physical and spiritual book and at the end of each chapter it has a prescription for your soul," she said.

"So there is a spiritual message for whatever life brings you ? like a health, family or a relationship crisis.

"The book not only discusses gynaecological issues like fibroids, pregnancies, cysts and tumours, but I also get into the general medical conditions like heart disease, diabetes and breast cancer.

"It is very comprehensive and everyone can use it, whether it is a health centre or an individual."

Dr. McCloud's book offers suggestions like how to approach your doctor when you think you have had a heart attack, how to spot a heart attack and what symptoms that you might have.

There is also a chapter which deals with talking to your physician before surgery.

"A lot of times, we don't ask questions and I want women to remember that when you are there it is your time, your body and your health and you need to find out what is happening with you," she said.

"So go there with questions in your hand, write down whatever has been happening to you and take the list with you and ask the questions. And a good doctor will not have problems answering your questions.

"It is a matter of women being proactive for themselves and to do that wherever they may be.

"They may be single and they may have kids and they may have a lot of stress going on, but if you lose your health, then what do you have?"