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ISSUE 4, JULY 2007

Jacqui McDonnell “Mala is an 18-year-old Eritrean refugee. She was fleeing civil war in Eritrea by crossing the border into Sudan when the truck she was in hit an anti-vehicle mine. The 17 other people on the truck were killed and she suffered severe injuries including loosing both her legs and her right eye. Many vehicles containing refugees were destroyed in the same manner. Malaʼs future is bleak. She sits in a hut living on hand-outs with what is left of her family and is the subject of public scorn and ridicule”. Disability and poverty work together in a vicious cycle that escalates marginalisation and insecurity in developing communities. People with disabilities are among the poorest of disadvantaged communities, while people living in poverty are at a greater risk of attaining a disability. The United Nations estimates that 600 million people worldwide have a disability, seventy percent of which live in developing communities. Research by UNICEF has found that 150 million children living with disabilities lack access to essential services and have limited interactions with their peers. Often people with disabilities remain poor as they are denied the opportunities most basic and crucial to human development - education, income, and self worth.

poverty and disability

ing world can be greatly reduced.

Mae Tao Clinic School Health Program p 2 News review p 3 IHN update p 3 Links and resources p 4 Dr Sujit & the Calcutta Village Project p 4

Vector prizes for prose competition p 4

Confessions of an Economic Hit Man, by John Perkins Book Review by Dr Kathryn Loon “I basically get paid to shift huge amounts of money between international bank accounts to avoid paying tax,” said Steve, one of the residents, who was regaling us with tales of his job-on-the-side during an unusually quiet evening shift in the Emergency Department. Head swirling with fantasies of a life less ordinary as a high-flying merchant banker, itʼs no surprise that in the library some days later, my attention was immediately drawn to the title, Confessions of an Economic Hit Man. What lies behind the cover is a riveting autobiographical account of John Perkinsʼ life as an “economic hit-man”, or more plainly, a professional paid to convince countries of strategic importance to the U.S. to accept massive loans for infrastructure and development – with the unspoken intention that they will subsequently become ensnared in a web of debt ensuring their loyalty to the U.S. global empire, or “corporatocoracy,” as Perkins repeatedly refers to it.

The book is a revelation, weaving together To achieve the aims of the Millenthemes of globalisation, economics, decepnium Development Goals (MDGs) tion, corruption and intrigue. A personal through halving absolute poverty by reflection on his international travels and 2015 we need to consider the rights experiences in places as far-flung as Indoneand needs of persons with disabilities, while simultaneously preventing sia, Panama and Saudi Arabia, it elucidates the many causes of disabilities. Many the forces behind many recent historical medical student-run organisations al- events as well as the part he, and others like him, played in creating the world we live in ready manage programmes inclusive today. of people with disabilities. Find out more from your Developing World But far from being a glib rundown of ecoGroup or any other government or Fifty percent of disabilities are prenomic theory or a disinterested critique of NGO you support. You should find ventable and poverty-related. These globalisation, Confessions of an Economic out if they have a disability policy. include disabilities due to: malnutriHit Man is a fascinating character study Are the healthcare, education, water tion and limited access to vaccination and sanitation, vocational training, detailing the anatomy of Perkinsʼ personal programmes, poor hygiene, limited descent from volunteering with the Peace income generation programs, buildmaternal care, dangerous working Corps in Ecuador to becoming an Economic ings and everything else they proand living conditions and war and Hit-Man in a seductive world of duplicvide fully accessible to people with conflict. It is accordingly imperative ity, money, elitism and ruthlessness. The disabilities? Does your group have to improve the overall living condigovernmental lie that “economic progress” access to practical information that tions of people living in poverty to is good and a global empire is desirable can help make their programs disimprove their health outcomes. By become driven by greed and complicity, ability inclusive (see the ʻLinks and upscaling poverty prevention interResourcesʼ section in this issue)? It is as does Perkins himself. Remarkably, the ventions together with the improvepivotal factor in his downfall is not a lack imperative that we all recognise that ment of treatment and rehabilitation or loss of moral sense but rather his selfwe cannot ʻMake Poverty Historyʼ programs, the incidence and associat- without including people with disContinued page 4 ed costs of disabilities in the develop- abilities. “Poor people are disproportionately disabled, and people with disabilities are disproportionately poor” Robert Holzmann, Director of World Bankʼs Social Protection Department, 2001.

Mae Tao Clinic School Health Program Ying Ying Liew In December 2006 I decided to volunteer as a medical student for a month in Mae Tao clinic in Northern Thailand. It is a clinic founded by a Karen refugee, Dr Cynthia Maung who fled Burma after the 1988 student uprising. For almost 20 years now, this clinic has been providing much needed free health care services for displaced people on the ThaiBurma border. As a consequence of nearly 50 years of rule by military dictatorship and civil war, hundreds and thousands of people from Burma especially those living close to the border have been victims of forced relocation, which has led many to flee into nearby jungle or neighbouring countries like Thailand for refuge. The Mae Tao clinic is mainly run by ethnic minoritiesʼ refugees and the health workers are locally

Medics providing health education

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trained by the clinic to cope with the most commonly encountered illnesses. I was impressed to find that community health constitutes a large part of the clinicʼs activities which includes a very important School Health Program. This initiative provides preventative health care to migrant school children via simple measures such as vision screening, vitamin A supplementation, height and weight checks as well as health education. One of the schools which left an indelible mark on me was Kaung Myat Parayan Yeik Mon. It is a wooden hut in the midst of dry, barren paddy fields, built close to the homes of the local Burmese migrants. The majority of the migrants are employed as low-paid labourers in the neighbouring Thai owned farms. Conveniently they are able to leave their children at the school, while both parents toil

the fields all day. Many similar schools have been built in response to the influx of refugees from Burma, and the large proportion of children. These schools are sponsored by non-governmental organisations or private donors, aiming to provide basic education to many children who may not have the opportunity to go to school at all in Burma.

There is no free public education, and many have to pay more than Ersatz blackboard they can afford to obtain an education. The ruling military junta of the few books these children have spends less than 3% of the national ever seen. The caretaker had menexpenditure on health and 10% on tioned, basic resources were few and education, while more than 40% of far between. There was no statioit goes towards military projects (to nery or books. Even the blackboard put this in context Australia spends (the main teaching aid) was only a only 2.5% of its GDP on military makeshift piece shift paper tacked to expenditures). the wall. Many of the children had no proper footwear and trauma to the Schools built locally fingers, toes and skin was common. by provincial villages The school doctor and I treated the are constantly under childrenʼs minor wounds and injuries threat by the junta. using the basic and limited supplies This is due to longfrom the clinic. standing conflicts between the junta and At the end of the day we bade our the ethnic minority regoodbyes as they looked on from the sistance groups living front gate. The School Health team along the Thai-Burma returned to Mae Tao clinic to docuborder. To increase ment their findings, in hope that for Burmese army control the next visit, they will be able to over the local populabring in the necessities to help fill tion the junta employs the gap between mere survival and a a counter-insurgency healthy, fulfilling life. strategy known as the Four-Cuts Policy I have donated some pencils, color which cuts crucial pencils, notebooks, clothing items links (food, funds, recruits and inand soft toys via Mae Tao clinic to formation) between villagers and the this school upon returning home. resistance groups. Initially villagers are given one weekʼs notice to leave To find out more or to become intheir homes voluntarily. After this period lapses, troops loot the village, volved, contact Naw Eh Thwa: ( or visit http:// destroying all buildings, crops, and stores of food to prevent villagers from returning. Accompanying such forced relocations are manifold atrocities involving executions, forced labour, systematic rape, wholesale destruction of village, crops and confiscation of land. In essence, the children are not safe and sustainable education is more often than not but a luxury. For the children at Kaung Myat Parayan Yeik Mon the medics provided a health talk while I distributed the Burmese health magazines specifically designed for school-aged children. It struck me then that what I was handing out was perhaps one

News Review

Jacqui McDonnell

Patents Before People Five years ago Novartis took the South African Government to court , in an effort to overturn the countryʼs medicine act which was designed to ensure the equitable supply of affordable drugs to those in need. Novartis is now waging a similar war in India, where many generic drugs are produced and then supplied to developing countries. This includes more than half of the anti-retroviral drugs used in developing communities in the fight against AIDS. If the company wins its case, millions of people will no longer have access to affordable medicines. To find out more, visit html Picture care of PM now spouts HIV discrimination From the man who believes ʻGlobal Warmingʼ to be an urban myth, he now seems to have been incurably infected by foot-in-mouth disease . Prime Minister John Howard has been quoted as saying that refugees who are HIV positive will be refused entry into Australia, thus condemning many to a certain death. The full story at au/news/national/ban-hivpositive-migrants-pm/2007/04/13/1175971314887.html Tribal Dances and Bed Nets We all saw US President Bush doing the tribal dance last month as part of the promotion of mosquito repellent bed nets for malaria infested areas of Africa, but is this another unsustainable project? We hope not. Find out more at and or to give a gift of a much needed mosquito net to an internally displaced family in Sudan visit: au/Product.php?productid=43 Protesting for Peace According to the UN the ongoing conflict in Sudan has caused more than 200,000 deaths and led to two million people being displaced. The Sudanese government contests the figures, saying that only 9,000 have died. Last month saw protests take place in 30 countries around the world demanding that world leaders act to prevent further bloodshed in Darfur. To find out more about the protests visit php?id=136639&region=5 To find out what you can do go to for the Sudanese people have a look at http://home. and know the exciting prospects awaiting them.

Fred Hersch

Supporting new projects Australian medical students wishing to develop new projects will have the opportunity of applying for seed funding. This is an initiative being supported by AMSA and we believe it will encourage more local projects. Project selection will be based on criteria developed by the AMSA IHN in consultation with professionals and academics.

The future for international health in Australia is bright and interest in International Health issues amongst Australian medical students is growing. Recently, we have identified a number of challenges and are currently developing plans for the future of the IHN to ensure that International Health opportunities are available for all medical students. There are plenty of interesting international projects and huge opportunities for Australian students to become involved with. The recently held IFMSA GA (MM2007) in Mandurah was a wonderful showcase of what is out there on the international scene.

Advocacy There are a number of international health issues that students are passionate about. A new focus for the AMSA IHN will be about identifying issues important to Australian Medical Students and representing these issues through AMSA.

Opportunities International projects Through connections with the IFMSA, there are many opportunities for involvement in International projects. One such example is the Calcutta Village Project and there are many more. The AMSA IHN will be working with IHGs throughout Australia to ensure Australian medical students

Challenges Improving Networking Australia suffers from the ʻtyranny of distanceʼ. This year, the AMSA IHN will work towards addressing this. Obviously we cannot change the map, but we can look at ways of utilising technology, structuring the committee and facilitating more face-

to-face meetings. Consultation with students As we continue to build the network between medical schools, we need to remain focused on ensuring that communication with medical students remains strong. This is a multi-way medium and it is through working with the International Health Groups (IHG) that this will be achieved. What can you do? Join up with your local International Health Group and get involved in working towards supporting International Health in Australia. To find your local group, go to

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IHN Update

Links and Resources Jacqui McDonnell

For more information on Disabilities and Developing Communities check out: Asian Development Bank: website includes workshops, studies and guidelines for disabilities in developing countries. disability.asp The Australian Disability and Development Consortium (ADDC): an Australian network focusing their attention, expertise and action on disability issues in developing countries whilst building a national platform for disability advocacy. Christian Blind Mission International: centres their work around medical care in developing communities, preventing and curing blindness, as well as the rehabilitation and training and integration of people who are blind or have other disabilities. or Department for International Development UK: website includes a great handbook - Disability, Poverty and Development suggesting good practices and areas of action. www.dfid. Source: an international information support centre designed to strengthen the management, use and impact of information on health and disability. United Nations: website includes resources, policy guidelines and information on the rights of persons with disabilities. socdev/enable/ World Bank: website highlights current News Events and discussion papers on people with disabilities.

Dr Sujit and the Calcutta Village Project Fred Hersch In March/April 2007, AMSA and the AMSA IHN brought Dr Sujit of the Calcutta Village Project to students across Australia. Dr Sujit inspired students throughout the country with his incredible story of setting up the Calcutta Village Project in Rural India. Otherwise known as the India Institute for Mother and Child (IIMC), this has been the focus of Dr Sujitʼs work for over 20 years. From humble beginnings of treating 20 children a day, Dr Sujitʼs Calcutta Village Project now treats 5,000 children a month and undoubtedly benefits thousands more. Dr Sujitʼs experiences were an amazing opportunity to look beyond the provision of medical services and into the broader issues of development and the vicous cycle of poverty-ill health-and poverty. Identifying that medical intervention was ineffective in helping his people out of poverty, Dr Sujit embarked upon addressing the factors robbing children of opportunities to a future without poverty, hunger, education, literacy and economic development. Together with the IFMSA and medical students, Dr Sujit has been able to not only provide basic medical management, but also to build schools and organise remote clinics and immunisation programs for thousands of children and adults alike. Dr Sujit is a truly remarkable man, and all of those that saw him would agree it was an inspirational evening. The Dr Sujit tour was facilitated successfully though the AMSA IHN with various International Health groups hosting Dr Sujit on various legs of the journey. It would not have been possible without AMSA. . If you missed out on this amazing speaker and would like to hear his presentation, it is now available from the globalHOME website (University of Sydney) at

Vector prizes for prose competition! Karl Ruhl Congratulations to the student contributers for this issue of Vector, all of whom have been sent sensational books from Wakefield Press about medics who have each in their own way made a difference in the lives of many in disadvantaged communities. So if you are a medical student studying in Australia and have something interesting to say about international health, submit your pieces of writing (600 word limit) to today and win! Confessions of an Economic Hit Man review, continued from page 1

deceit. Perkinsʼ compellingly honest description of the situations, events and emotions that he experienced necessitates that we as readers scrutinise our own lives and motivations as well as our roles in furthering the injustices of the corporatocoracy. This disturbing and insightful glimpse into economic imperialism will leave you no choice but to act. Vector is the magazine of the AMSA International Health Network

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Chief Editor: Sunita DeSousa Layout: Karl Ruhl Page 1 photo: Hamish Graham Early Intervention by: Evelyne Jacq, Tanzania, CBM

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Vector: Issue 4 July 2007  

The official magazine of the AMSA Global Health Network