Vector: Issue 9 April, 2009

vector

INTERNATIONAL CHILD HEALTH issue 9 editor’s note] Nelu Jayawardena, Med VI, The University of Melbourne

Not so long ago I was sitting and thinking about the ‘When I Grow Up I Want To Be..” phases I went through when I was younger...I wanted to be a ballerina, an astronaut, work in childcare or as a primary school teacher, a doctor....

In retrospect, while some of these were unrealistic for me, none were impossible. I had the chance to dream to be who I wanted to be. I had the means and support to do whatever I wanted with my life. So why is it that millions of children around the world are not born with this chance to dream? Is it pure luck that we were born into this world of opportunity, education, and health, and that the children in the ‘bottom billion’ know only poverty?

Every 30 seconds a child in Africa dies from Malaria. More than 1000 children under the age of five die every hour. 10 million children die each year, and over 20 million are malnourished.

These numbers are both mind boggling and frightening.

2 4

Interview with Dr. Trevor Duke

Millennium Development Goals ‘Helpem Fren’

6 Electives 8 From Around the Globe 10 News Review 11 GHN Update 12 Editor’s Pick 13 Credits

But these issues are very real, from our own doorstep, to across the oceans. With Child Health being of utmost importance in the global health scene, it is fitting that our first edition for the pages year addresses this issue.

From an interview with Dr Trevor Duke with valuable advice to keen students, to elective experiences in developing countries, and a news review, this edition of Vector aims to explore some of the issues in international child health, and share a wealth of knowledge and experience written by fellow students and doctors.

“It is for the unborn children” as Leanne (Vector Layout Designer) rightly said regarding a Japanese movie she recently viewed where the soldiers were pondering who they were fighting for. We are fighting for the unborn and those too young to have a voice, who may be able to speak but have no say in the fate of their health. In a world where adults cause all the death, destruction and turmoil, it is the children who are suffering the most. Read on as Vector writers have their say about the lives of those who have no voice.

Vector, Issue 9,, April 2009

1

INTERVIEW

WITH DR. TREVOR DUKE

Interviewed by Khai Lin Kong, Med VI, The University of Melbourne

Khai Lin Kong: Dr Duke, can we begin by asking a bit about what you do at Royal Children Hospital (RCH), I understand you have a few roles here?

Dr Trevor Duke: I am currently an Intensive Care Unit Specialist and a Paediatrician in RCH, and the Director of Centre of International Child Health (CICH) at the University Department of Paediatrics. I previously was the Paediatrician in Goroka, in the highlands of Papua New Guinea for several years, and I now have an honorary position in the School of Medicine in PNG .

Can you briefly tell us about CICH, and give a few examples of some of its programmes?

CICH was formed in 2001 within the University of Melbourne Department of Paediatrics at RCH. It is a World Health Organisation collaborating centre for research and training in Child and Neonatal Health. At CICH, we focus on capacity development of paediatricians and paediatric trainees in developing countries, and on research, policy and practice in child health.

We are working on two major WHO programmes at the moment, one is the Child Survival Strategy and another is a global strategy to improve quality of hospital care for children.

Do you mind telling us how did you managed to involve Global Health with a clinical medicine background?

When I was a medical student I did my elective in North India.

I think I contributed very little, but gained a lot from this elective. Soon afterwards I asked someone how one can make an ongoing contribution to child health in developing countries.

He said: “Complete your degree, become a specialist, do a research higher degree like a PhD or MD. And then go and live and work in a developing country for a long period of time.

After that, you might start making a contribution!” I followed that advice quite closely, and it worked out for me.

Can you tell us a bit about some of the key issues in international child health at the moment?

The establishment of Millennium Developmental Goals (MDGs) has brought global attention to improving health, including child health, in the developing world. As for now, it is important to maintain the focus on the MDGs. However in terms of achieving these there are several obstacles. There is a crisis of human resources in the health care industry. An estimated 4.3 million of health care workers are required, mainly in the developing countries. MDGs can’t be achieved without addressing this human resources crisis. I believe that many global organizations and many governments are not addressing this obstacle sufficiently. Funding is also lacking to develop, maintain and support an effective human resources workforce.

Vector, Issue 9,, April 2009

2

As medical students, is there anything we can do to actively contribute to international child health?

I think this is the most challenging question. Firstly, the problems of global child health are serious issue that require serious time.

Medical students can get involved early on by actually learning about concepts related to global health. Some medical students who work at CICH have set aside some serious time and are contributing substantially.

How about after medical school, how can we incorporate global health into our careers?

I do think that the current generation of medical students will have opportunities to contribute to global health as a core part of their ongoing career. We are increasingly understanding how interconnected our global economy is, and with climate change and other challenges. Health and medicine are public goods, closely connected to economic and education policies, advancements in communications, the environment, technology and research, and should be characterised by global cooperation at all levels.

global health, there is no substitute to living and working in a developing country for an extended period of time. This is the only way to understand the difficulties faced by health workers every day in trying to deliver care to children in resource poor health systems.

Seeing the differences in working environment, career development, wages etc. between developed and developing countries is there any advice you can give our readers who intend to work in a developing country?

It’s important for everyone to work this out for themselves, but I always thought that if I was an economist I would go where the money is. I am a paediatrician particularly interested in all aspects of reducing child mortality and improving child health.

Therefore I should work in the area where this is most crucial. I think, to me, the cutting edge of paediatric medicine is not in a tertiary hospital in a developed country, in research or scientific endeavours that address the 2% of child deaths that occur indeveloped countries; but is in the poorest regions of developing countries. Thus, it’s a professional imperative for me to be involved at that level. This is an incredibly satisfying career.

Having said that, there are some challenges. Contributing to global health requires making some lifestyle compromises compared to solely pursuing a career in a Western country. I won’t go into the specifics because any sacrifices are trivial compared to those made daily by health workers in developing countries. But they are something to be considered individually.

Secondly, there are also some challenges for the hospitals and universities that employ us. Training institutions in developed countries should incorporate global health in their programs and shift the focus from solely academic success to achieving greater global health equity. Increasingly I see a global agenda being discussed in universities and it pleases me that more medical students are being exposed to issues relating to health in developing countries, and wanting to contribute to international health.

Apart from requiring serious time, contributing to international health also requires some training. Medical students, interns and junior residents trained in Australia are not equipped to make strong, independent contributions to global health. Compared to when I was a student, there are now more pathways for training in this field. I would actually modify the advice I was given. It is not necessary to become a specialist to make a contribution to international health, although this does help.

You can start by developing expertise that would really be of value to the developing countries, for instance, in maternal and child health, epidemiology, immunizations, tropical health, etc.

Contributions to global health can be made in almost any specialty, but it is a matter of turning your mind to where the appropriate interface is with health needs in developing countries within your specialty, and having the right perspective. Most of all, when it comes to preparing yourself to be involved in

To listen to more interviews that Dr Duke has participated in recently; please visit: http://www.reachmd.com/xmsegment.aspx?sid=3872 and http://www.radioaustralia.net.au/programguide/stories/200808/s2348271.htm

Vector, Issue 9,, April 2009

3

CHILD HEALTH AND THE MILLENNIUM DEVELOPMENT GOALS Dr. Jenny Jamieson, Intern, The Alfred Hospital

For many fortunate Australians, child health entails keeping immunisations up to date or infrequent visits to the GP for revision of asthma management plans. The very fact that 10.8 million children in our world die before reaching their fifth birthday is often inconceivable to us. Furthermore, many of these deaths are preventable through simple, recognized and low-cost interventions; the injustice of which is one of the greatest tragedies of our generation.

Child health is especially significant as children are considered vulnerable - their health needs are usually taken control of by others who care for them. Naturally, this notion of vulnerability raises important ethical issues about the responsibility of adults to ensure the health and survival of children across the globe. Richard Skolnik, author of Essentials of Global Health, highlights the magnitude of addressing child health by looking at the Millennium Development Goals, thereby providing a framework through which to begin to address the challenges of international child health.

Goal 1: Eradicate Extreme Hunger and Poverty As more than 50% of child deaths are associated with malnutrition, this is an imperative link with bettering child health.

Goal 2: Achieve Universal Primary Education By attending and enhancing performance of children in school, and thereby addressing one of the main social determinants of

health, we can develop the next generation’s knowledge of health and wellbeing.

Goal 3: Promote Gender Equality and Empower Women By empowering women, we not only better their health and education, but their ability to raise healthier children.

Goal 4: Reduce Child Mortality Directly related to child health.

Goal 5: Improve Maternal Health Maternal health is a major predictor of many aspects of future child health, from their birth weight to their subsequent health, educational and social prospects and opportunities.

Goal 6: Combat HIV / AIDS, Malaria and other diseases Many of these infectious diseases are major killers of young children. Additionally, many of them are preventable through education and culturally-appropriate health promotion.

Goal 7: Ensure Environmental Sustainability In many parts of the world, unsafe drinking water, inappropriate sanitation and indoor air pollution continue to contribute to a significant portion of childhood illnesses.

Reference: Essentials of Global Health, Richard Skolnik (2008)

‘HELPEM FREN’: INTERNATIONAL CHILD HEALTH COLLABORATIONS Rami Subhi, Med V, The University of Melbourne

M

uch progress has been made in child survival in recent years. The 20 million annual deaths of children under the age of 5 of the 1960s were halved by 2006, and the most

recent estimate now stands at 9.7 million. But numbers can be deceiving, and such progress is not shared equitably between regions. Some countries have either made no progress towards achieving the 4th Millennium Development Goal, or are experiencing increasing rates of child mortality due to the outbreak of wars and civil tensions, natural disasters and the HIV Vector, Issue 9,, April 2009

4

epidemic amongst other factors. As things currently stand, it will take a century before Sub-Saharan Africa achieves the goal of reducing under-5 mortality by 2/3 of what it was in 1990: a goal intended to be achieved by 2015.

Some of my most memorable experiences are from my recent travels to the Solomon Islands. This country is only a 3 hour flight from Brisbane, and yet its infant mortality rate is 44 times higher than Australia (66/1000 vs 1.5/1000). In total, there are 7 practicing specialists in the public system, 2 of whom are paediatricians. There are 12 nurses with post-graduate training in child health. These healthcare workers serve a population of 250,000 children under the age of 14 years old, scattered around 9 provinces and more than 900 islands. Both these doctors and nurses assume the roles of clinicians, public health workers, health promotion officers and administrators, constantly working under the constraints of tight budgets and inefficient systems.

It is seeing these local doctors and nurses achieve so much with very little in the face of high burdens of disease that inspires me most and gives me hope about international child health. It is seeing them function despite the daily barriers of limited resources, permanent heat waves, power outages and late-presentations of disease. It is the concern for patients, the bright outlook despite constantly caring for children who have conditions that cannot be cured given the limitations, and the

dedication inherent in the hours spent by nurses decorating the children’s ward in Christmas to make a welcoming environment for sick children and their families. If there is to be investment in improving the effectiveness of health-service delivery, it ought to include investment in such individuals.

It is estimated that up to 2/3 of all annual child deaths can be averted by full implementation of a ‘package’ simple and cheap interventions that include breastfeeding and basic vaccines. What needs to be done is known; how to deliver these interventions in underresourced and underdeveloped health systems is the challenge.

This requires a longterm commitment to development.

Our challenge in international health is not to reinvent the wheel, but to keep it rolling.

Examples of Medical Student Involvement in International Child Health ICHRC The International Child Health Review Collaboration is an online, free-to-access repository of reviews of the evidence base behind standard WHO recommendations for hospital care for children. It is a collaboration between WHO and Australian and International collaborating centres and universities. Medical students are involved in writing these reviews. The University of Edinburgh has integrated the program into the undergraduate medical curriculum.

For more information visit: www.ichrc.org Solomon Islands Diploma of Child Health There is no post-graduate nursing course in child health in the Solomon Islands. The country sends nurses to PNG and Fiji for training. This is expensive and time consuming. Therefore, the paediatric division of the ministry of health is initiating the first local post-graduate nurse training program in child health. Supporting this initiative is the Centre for International Child Health in Melbourne. Under the supervision of the Centre, medical students have been involved in compiling WHO training materials into a comprehensive and locally relevant curriculum for the course. For more information, visit: www.rch.org.au/cich For more information contact: Rami Subhi rami.subhi@rch.org.au 0403 151 186 Vector, Issue 9,, April 2009

5

VIETNAM ELECTIVE

National Paediatric Hospital, Hanoi Vietnam Linny K. Phuong, Med VI, The University of Melbourne

W

ith Vietnamese born parents, my views on the Vietnamese healthcare system have always been painted by their stories, both good and bad - so when it came to choosing a destination for my elective, it seemed only natural for me to go to Vietnam and experience it all for myself.

many friends; took an English class at least three times a week where I taught “medical English” and gave a presentation to over 200 doctors at NHP about my observations of Paediatrics in Vietnam in comparison with Australia.

My experience was interesting, fun and eye-opening all at the same time. I would recommend a similar elective to any other

So in December 2008… upon starting on my elective in Vietnam, I wasn’t quite sure what to expect. But after my elective experience - I am convinced that any medical student would have been happy with the placement I was offered.

ED team of doctors and nurses medical student, no matter what your future career aspirations within medicine.

Emergency department

My placement was at the National Paediatric Hospital (NHP) in Hanoi - the national referral centre for paediatric cases. This hospital received patients from Central Vietnam and above which included the poorer rural areas of the highlands. I was the only Australian student at the hospital, but there were many other foreign visiting students, from Sweden and the USA.

Being in a developing country meant many things. I experienced many paediatric illnesses which were rare in a developed setting. Sadly, it also meant I witnessed the natural history of many treatable illnesses. And, as un-politically minded an individual I am, I even started to understand the interplay between a country’s national infrastructure and the state of their healthcare system.

On my placement, I spent most of my time in the Emergency, General Surgery and Intensive Care Departments. I made Vector, Issue 9,, April 2009

6

MEDICAL CHALLENGES IN INDIA Maitreyi Modak, Med VI, The University of Melbourne

O

n my first day I am introduced to “outdoor”, the local term for outpatients, and though a little apprehensive, I find to my relief that it takes place indoors.

I soon discover that a paediatric outdoor session in a hospital run by a mission in Kolkata is not much different from a general medical paediatric outpatients session in Melbourne. Most cases seem to deal with fever and viral illness, as well as issues of growth and development. However, on most mornings, there presents a patient who needs to be admitted, and here I see much that I am unlikely to see in Melbourne…

that would in most cases be assessed earlier in Western society.

I meet a 4 year old boy who is yet to speak a word whose parents are seeking medical attention for the first time. I am told that although facilities for early intervention are available on an outpatient basis at a nearby site, in most cases, families cannot either physically reach these places easily, or lack the education to comply with rigorous treatment programs.

I feel that somehow, in India, so many children who need help are being missed; there is inadequate filtration through to medical care. The paediatricians here emphasize the importance of acting opportunistically with every child because this may be the first and last time the child presents for medical care.

One consultant thrusts me a squalling baby. ‘Feel this baby’s abdomen, and tell me your findings’. Even my inexperienced hands remark the massive hepatosplenomegaly, and the baby is admitted for thalassemia. I think back to my Obstetrics and Gynaecology experience in Melbourne, where there is opportunity in situations where a baby may be at risk of thalassemia for pre-pregnancy counselling, appropriate antenatal attention, and genetic counselling as required. The baby I see here is in crisis, and this is a common enough presentation.

I come away from the experience with an idea of what it is like to deal with familiar paediatric issues such as immunization, nutrition, and parent education in the context of limited space, equipment, time, and personnel.

My overall impression of the patients presenting to outdoor is that many present late; well into the course of the disease. This also applies to cases of developmental delay; I see children aged well into their first decade presenting with delay in areas Vector, Issue 9,, April 2009

7

A VISIT TO SMOKEY MOUNTAIN a community of 600 families that work and live on a rubbish tip Metro Manila, the Philippines Selena Sayako, Med VI, University of Tasmania

It really begins to hit home hard as I sit here alone in my luxurious Manila hotel.

Whilst reviewing photos on my shiny digital camera, I realise that my skin is the same colour as theirs, my eyes squint ever so slightly the way theirs do, and our universal facial anatomy create super-imposable smiles. I could easily mistake them for my baby cousins.

But then a few subtle, yet defining, differences suddenly grab me. My chubby face, the product of a lifetime of generous meals, balloons out alongside their skin’n’bone. And, my rack of glistening, well-aligned teeth sparkle beside their shard-like, rotten grins. For the first time in weeks, I had felt my stomach grumble away, although it had only been 3 hours since my last hearty, fat-laden meal accompanied by a glass of sweet cof-

fee. My mouth began to feel dry, but I could not bring myself to reach into my satchel and sip from my convenient travel-sized water bottle. I did not bring enough to share with the bustling kids around me, how could I pour a drop of this privilege down my already privileged throat? It was especially difficult knowing that the last time these kids felt thirsty, they probably drank from a source of water that I can only envisage was related to the muddy pools of sludge that are flooding the streets outside, the floods that lifted empty bottles and filth off the streets and into these people’s homes.

The world that you are born into is nothing more than a matter of luck. It is all very much about luck.

FROM AROUND THE GLOBE

Annual Health Camp and the Village Development Project “Wassana Diyawara” - This means the first portion of water that flows out from a river with the rain, following many years of drought.

It is said that “The greatness of a society is judged by the caring it renders for its weaker members.” People may become “weak” not necessarily due to their fault, but usually victims of circumstances. Typical example is how some people in rural areas of Sri Lanka have become “weaker” neither by talent nor

by human values, but only by the lack of facilities they get when compared with urban citizens.

That is why the Medical Students’ Buddhist Association (MSBA) of the Faculty of Medicine, University of Colombo, involve over 150 medical students and doctors of all faiths to use donations and fund raising (usually by printing New Year greeting cards) to run this project. “Wassana Diyawara” consists of a Health camp and a Village Development Project for the benefit of a Vector, Issue 9,, April 2009

8

• Donating musical instruments to the school.

• Donating sports equipment to the school.

• Depending on the necessity, additional objectives had been accomplished and includes establishment of a fund to provide breakfast to the Dhamma School children in 2006, provision of water tanks in 2007, provision of an additional set of school uniforms in 2007, provision of telephone facilities in 2007 and building a class room in 2009.

Busy pharmacy during Health Camp selected rural village.

Some of the objectives of the Wassana Diyawara projects include: • Health Camp - Usually this becomes the first time a group of Senior Consultants from different Specialties arrive at the same time to their village, and lengthy queues show the enthusiasm of the community to get medical treatments free of charge. The Health Camp also includes a free pharmacy, free investigation unit, free spectacle distribution, free dental clinic and a health education unit.

• Establishment of a library for the school.

•

Medical students who attended a Wassana Diyawara

P. K. B. Mahesh, Former President of MSBA B.A.O. Wijewickrama, Former Co Secretary of MSBA Udara Abeywarne Coordinator of MSBA

An established computer laboratory Financial schemes and a Scholarship scheme for needy school students. The responsibility of selection of students is given to the school teachers. In 2004 even a scholarship scheme for student monks was established.

• Donation of stationary items to students of the village school.

• Donating laboratory facilities for the students, including chemicals and science equipment, and even a computer lab.

Vector, Issue 9,, April 2009

9

news [review

Kai Lin Kong, Med VI, The University of Melbourne

THE STATE OF THE WORLD’S CHILDREN

The state of world children’s 2009 Together with the death of 4 million neonates each year, more than half a million women died from pregnancy and child birth related complications each year. To find out more on the current state of maternal and newborn health, access the full report on: http://www.unicef.org/sowc09/report/report.php 2000 children die each day from preventable injuries Road crashes, drowning, burns, falls and poisoning are the top five preventable injuries affecting children worldwide. The World Report on Child Injury Prevention assesses and discusses this pertinent issue. http://www.who.int/violence_injury_prevention/child/injury/world_report/en/index.html War and children Israel-Gaza conflict: The recent Israel-Gaza conflict reminds us of the detrimental effects of war on children. During this 23-day conflict, approximately 430 children were killed, 1855 children injured and around 28,000 children displaced in Gaza. Seven schools in Gaza were completely destroyed, with 164 schools damaged.

“This is unacceptable.”—UNICEF http://www.savethechildren.org/newsroom/2009/gazans-return-school.html http://www.unicef.org/media/media_47702.html Sri-Lanka The conflict between Sri-Lankan Government and Liberations Tiger of Tamil Eelem (LTTE) has left high number of children injured.

Furthermore, it is estimated that LTTE recruited 6000 children as soldiers from 2003—2008. http://www.unicef.org/media/media_48044.html http://www.unicef.org/media/media_47673.html Pakistan Since 2007, approximately 170 schools, particularly girl’s school, are destroyed by illegal armed group in the Northern fringes of Pakistan. http://www.unicef.org/media/media_47436.html Democratic Republic of Congo In one of the most under-reported conflict worldwide, the conflict in Democratic Republic of Congo has seen many children displaced, abducted, raped and killed. http://www.unicef.org/media/media_46983.html Save the children estimated around 3000-6000 children are held as soldiers by number of warlords. http://www.alertnet.org/thenews/fromthefield/SaveChAlli/8f16ed96686633301069caa70295a4a9.htm Global economic downturn limiting aids to world’s poor Aid budgets worldwide are estimated to shrink by billions of dollar, which will mostly impact countries in sub-Saharan Africa. http://www.alertnet.org/thenews/newsdesk/LO582954.htm Artemesinin resistant plasmodium threatens global malaria control Artemesinin based Combination Therapy (ACT) has been the cornerstone in recent gains in malaria control worldwide. Nonetheless, Gates foundation has recently donated 22.5 million to contain the Emergence of malaria resistant to ACT in Thai-Cambodia. http://www.who.int/mediacentre/news/releases/2009/malaria_drug_resistance_20090225/en/index.html

Vector, Issue 9,, April 2009

10

GLOBAL HEALTH NETWORK UPDATE Tamara Vu, AMSA Global Health Network Chair, 2008-2009

Last night the Victorian Students’ Aid Program, our GHG here at Melbourne, hosted our first ever Red Party. It was an absolute credit to the organising committee - a great turnout, fun venue and keen partygoers helped raise several thousand dollars for Oxfam’s HIV/AIDS projects - and it was a terrific night.

As I enjoyed the party, I was conscious that we were holding our Red Party not just as VSAP, but as part of a wider endeavour - namely, the Global Health Network’s National Project for 2008-09, which has seen Red Parties held by GHGs at universities around Australia. National Project this year has been a great success, for two principal reasons.

First, and most obvious, by combining our efforts, the GHGs constituent of the GHN have together made a significant contribution, in terms of both awareness and gross funds raised, to HIV/AIDS relief and research.

National Project has done to really define what the GHN is about - namely, collectivity, collaboration and community between medical students involved in global health around Australia. Through the National Project, through using our website (www.amsa.org.au/ghn), and through reading Vector, students who care about ending global health inequalities connect and interact with their peers at other institutions who may well become colleagues throughout lifelong careers in global health.

Similarly, through our monthly telephone meetings and ongoing contact, the GHGs (via their GHN Representatives) shared experience and knowledge in order to develop, promote and empower their student groups as true agents for change in the international health sphere.

As ever, I invite you to explore the opportunities available to you through your local GHG - including those opportunities to collaborate nationally that will emerge as we decide upon the GHN National Project for 2009-2010. If you have any ideas, drop me a line at ghn.chair@amsa.org.au.

Second, and almost more valuable to me, however, is the work

DISASTER RELIEF Abhinav Aggarwal, Global Health Awareness at Western Sydney

G

lobal Challenges was an event planned by the Global Health Team at the University of Western Sydney featuring guest speakers Tim Costello (Chief Executive, World Vision Australia) and Philippe Couturier (Executive Director, Medecins Sans Frontieres Australia). The night was about creating the opportunities to be involved in something meaningful, in something bigger than us and our daily cycle of life. “You are worried. You are through with reading and knowing and want to migrate to the next logical step – DOING.” Both speakers talked about their experiences of the issues occurring around the world and ways in which we could be involved in the solution. Being held on a Thursday night, the staggering audience of over three hundred people was a monument to our passion and enthusiasm.

Vector, Issue 9,, April 2009

11

TEDDY BEAR HOSPITAL Maitreyi Modak, Michelle Li, Nelu Jayawardena TBH Coordinators, VSAP, Global Health Group of The University of Melbourne “Has teddy got potatoes in his ear?” while using an otoscope.

We also learnt quickly that next time we need to be prepared with a much greater stock of bandages; as almost every child brought in a Teddy with a broken bone!

O

n the 25th of March, a group of 10 medical students from the University of Melbourne, 3 VSAP (Victorian Student Aid Project) Coordinators, President AMA (Vic) Doctors in Training Subdivision Steve Moylan, and Paediatrician Dr Fiona Brown brought the Teddy Bear hospital (TBH) to three classes of Prep students at North Melbourne Primary School.

The TBH is a community project that aims to reduce fear of medical consultations and normalize the illness experience for young children by setting up a “Hospital” in an environment familiar to the children (in this case, their school library) where children bring their teddy (or as we discovered, their parrot, iguana, or other!) for a mock consultation with the ‘Teddy Doctors’. For many of the medical students involved, this experience provided the first opportunity to interact with children, and improve communication skills needed for this. A preparation session from Dr Brown was most useful for engaging with the Teddies in a way children would appreciate; for example,

Happily, everything went smoothly and all parties involved had a wonderful time! Feedback from the ‘Teddy Doctors’ proved to be overwhelmingly positive and was reflected in feedback from the school “The teachers would happily have you back next year.. Thank you so much for the work and effort that was obviously put into providing a ‘Teddy Bear Hospital’ for us”

Discussion is now underway between the VSAP Coordinators and Steve Moylan as to how to improve and expand TBH in Victoria.

EDITOR’S PICK

S

obana Thillainathan’s “Not in my Backyard ... or is it?” from Vector Editor 8 explores the representation of Indigenous Health at last year’s Global Health Conference. Visit the Vector website (http://ghn.amsa.org.au/) to read Sobana’s article and many more in “We Can Be That Generation”, the special edition of Vector reflecting on the memorable 2008 GHC.

Vector, Issue 9,, April 2009

12

V

ECTOR is the magazine of the AMSA Global Health Network.

Don’t forget to check out what your University’s Global Health Group has going on at the AMSA GHN website: http://www.ghn.amsa.org.au If you have suggestions, feedback or are interested in writing for Vector magazine in the future we would love to hear from you at: vectormag@gmail.com

Editor

Nelu Jayawardena The University of Melbourne Layout Designer

Leanne Hoang Monash University Publicity Officer

Tharsiga Gnanasekaran Monash University

CREDIT

S

Floral border made from brushes by Toybirds; http://toybirds.livejournal.com/ Front page photo taken by Maitreyi Modak Photos on pages 4 & 5 taken by Tanya Suthers in Peru

VECTOR magazine layout designed by Leanne Hoang, Med I I I, Monash University Vector, Issue 9,, April 2009

13