AORTA 6th edition

aorta March - June 2012

//Issue: Cervical and Breast Cancer

Breast & Cervical Cancer Articles

Interview with Alumnus

3 Special Sections

#6

About Us C

enter for Indonesian Medical Students’ Activities, CIMSA, is an independent, inclusive, nasionalist, non-profit and non-party organization. CIMSA is an individual based organization with members consisted of medical students from many universities in Indonesia.

”Empowering Medical Students and Improving the Nation’s Health”

Established in 2001, and has grown up from 6 to 19 locals with approximately 2500 members. CIMSA aims at providing Indonesian medical students’ activities lodge to empower and express their idealism, thus medical students will have the same opportunities to get involved in health as early as possible and contribute to the development of this country.

Our activities are applied not only in the local and national, but also in the international level. This can be achieved because since its establisment CIMSA has gained trust from the international world to become the full member of IFMSA (International Federation of Medical Students’ Association); the largest atudents’ organization in the world with approximately 100 contries as its members represnting more than one million medical students worldwide.

CIMSA’s field of work covers 6 aspects represented in the form of Standing Commitee (SCO); 1. SCOME, on Medical Education, is a forum for medical studentswho have special interest in the improvement of medical education 2. SCOPE, on Professional Exchange, fasilitates all medical students to feel the atmosphere and culture in foreign country while experiencing the clinical study 3. SCOPH, on Public Health, focuses on the importance of public health issues in medical education or community 4. SCORA, on Reproductive Health Including AIDS, aims at raising the awareness on reproductive helath including sex education, gender equality, etc.

5. SCORE, on Researh Exchang, gives a chance to all medical students to partake in medical research in foreign country 6. SCORP, on Human Rights and Peac, is related to issues on human right and peace, including poblems faced by the refugees.

www.cimsa.or.id Cimsa Nasional CIMSAindonesia @cimsanasional

General secretariat: 1st floor Library Faculty of Medicine University of Indonesia Jl.Salemba Raya no.6 Jakarta Pusat 10430 Indonesia

This Aorta is dedicated to the alumni whose precious contributions have made CIMSA brighter...

Thank you to all contributors for this edition: Bethari K. Abianti, Adelia Ulya Rachman, Shela P. Sundawa, dr. M. Nurhadi Rahman, and dr. Fina Hidayati Tams

EDITORIAL Raditya Pradipta

Dhany Indirwan

Atika Primandani

Febriana Intan

Monika Hasna Hafif Kusasi

Camelia Pondra

Sekar Laras Chief Editor

Rikeish

Annissa Kallista

H

CIMSA and dr.Adi gave us his writing about cervical ello ! This is the 6th edition of AORTA cancer. There are also 3 special sections; Real Acand also the fourth printed edition. Now, we’re tions, Speak Up, and Crossword Puzzle. Now, go to talking about cancer, especially breast and cervical the next page and enjoy! cancer. There are some articles, opinions, news, meeting reports and many more. So, what’s special from this edition? Alumni also contribute in two sections in this edition. Who are they? dr.Fina Sekar Laras shared her experience while being a member of Media and Communication Director CIMSA 2011-2012

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Contents 01 02 03 05 06 07 09

About Us The Contributors Editorial Page President’s Note Official CIMSA News Meeting Report National Leadership Summit March Meeting 2012 Ghana

Health Issue Brief Information about cervical and breast cancer Cervical Cancer: This Deadly Can be Avoided Extending The Fight in Achieving MDGs Through Fighting Cancer Real Actions Speak Up Crossword Puzzle Local Stories Interview with Alumni Eleven Years CIMSA

11 15 17 19 20 22 23 28 30

PRESIDENT’S NOTE Hello friends,

Cancer has been one of the scariest disease for people around the world. Many researchers have been conducted all around the world to find the cure for cancer. Nowaday, technology and science are well developed and we can cure cancer in early stage. But the incidence rate of cancer is rising significantly, especially in poor countries. In 2008, 7.6 million people died of cancer, it is 13% of all deaths worldwide.

Between 1980 and 2010, the number of women diagnosed with breast cancer increased more than two and a half times from 641,000 to 1.6 million a year, and cervical cancer cases are rising more slowly, from 378,000 in 1980 to 454,000 with 200.000 deaths in 2010. It shows that even if technology and science are developing, the number of cancer cases are in fact increasing.

As medical students, the future doctor, we have to be able to see these problems in the health state worldwide. These datas show that preventing cancer is as important as curing it. More than 30% of cancer could be prevented with just a simple lifestyle changes. Imagine that millions of lifes worldwide could be saved, thousands of familiy could be protected, and billions of our future generation could have a bright life.

And what we have to do as medical students? I will say, Do Everything That We Can! Don’t wait until we become a doctor, or until we become a specialist, but do it now as medical students and make a change, because we are the agent of change!

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Niko Kristianto President CIMSA 2011-2012

Official CIMSA News C I MSA’s M erchandise P ag e

Hello CIMSA! Hope you’re all doing great after almost one year on this period making a great improvement in CIMSA for a better health of Indonesia. And this time, we’re going to take our merchandise as well to a higher level. Did you find that you want to see our merchandise looks, spesification, function and models? Or just showing the world what do we have for sale? Now, we’re going to make them published on merchandise page at CIMSA site (www.cimsa.or.id).

Here’s the spoiler, we’re going to have photos of merchandise and their spesification plus their function. So, if you don’t have any ideas what are you gonna do with them, you’ll have the answer right away. Then we’re going to have CIMSA look book, a photoshoot of merchandise with the models. And the most exciting feature is that your local treasurer will be able to order the merchandise directly from our page within some certain period of time like we used to do, but in a more efficient way. Moreover, if you have any great exciting idea related to this page’s features, please don’t hesitate to contact your current Fundraising and Merchandise Director of CIMSA. Because the merchandise would be a part of your big contribution to a healthier Indonesia and the pride could be yours forever! Be ACTIVE with CIMSA!

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Hafizha Herman Fundraising and Merchandise Director 2011-2012

HPEQ Students

Entering the year of 2012, students from 7 different program studies, represented by Center for Indonesian Medical Students’ Activities (CIMSA), Asian Medical Students’ Association (AMSA), Ikatan Senat Mahasiswa Kedokteran Indonesia (ISMKI), Ikatan Lembaga Mahasiswa Ilmu Keperawatan Indonesia (ILMIKI), Himpunan Mahasiswa Diploma III Keperawatan (HIMADIKA), Persatuan Senat Mahasiswa Kedokteran Gigi Indonesia (PSMKGI), Ikatan Mahasiswa Kebidanan (IMABI), Ikatan Senat Mahasiswa Farmasi Seluruh Indonesia (ISMAFARSI), Ikatan Senat Mahasiswa Kesehatan Masyarakat Indonesia (ISMKMI), and Ikatan Lembaga Mahasiswa Gizi Indonesia (ILMAGI), return to organize various activities in order to support students’ participation in decisions making, improve the education quality and emphasize the importance of multidiscipline collaboration in advocacy for health education in Indonesia.

To gather the students’ fresh ideas for health education improvement and to develop opinion channeling practice, HPEQ Student, which is a national program for health students in Indonesia, returns with 3rd HPEQ International Conference Essay Competition. In addition, the winners will also have the opportunities to participate in various HPEQ Student activities and publish their essay in HPEQ Student medias.

For more information regarding HPEQ Student activities, like HPEQ Student facebook page or follow their twitter @hpeqstudent. Together we can!

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Candrika Dini National Officer of Medical Education 2011-2012

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NATIONAL LEADERSHIP SUMMIT N

ational Leadership Summit (NLS) is one of three national meeting of CIMSA. This year it took place in Yogyakarta with CIMSA UGM as its host. With the theme “Improving Medical Students’ Quality to Support MDGs (4,5,6)” as continuation of CIMSA’s Policy Statement to help government to achieve MDGs, we hope to continue developing our skills and knowledge as an agents of change.

NLS 2012 was held in Villa Taman Eden on Thursday, 16th February 2012. Most of the participants were arriving at Thursday morning at the venue for registration and a pre-NLS session, and the others, who arrived at noon and later, were transported to the Faculty of Medicine University of Gadjah Mada, where the training conducted.

With this “campus-based meeting” concept, not only introducing our campus environment, we were also hoping CIMSA’s member from different local can enjoy the true experience of Gadjah Mada’s medical students.

trainings were led by CIMSA’s IFMSA trainer and senior.

There was also a Welcoming Party at the first evening of their stay in Yogyakarta. All participants were required to wear national’s attire.

This welcoming party was also attended by the dean, dr. Titi Safitri, our donator, and the chairman of other organizations in Faculty of Medicine University of Gadjah Mada. The participants were warmly welcomed by the performance of children from Kali Code as the opening act and later we also had STUPA, a group of people who play modern music with traditional music instru The trainings were divided into two class- ments, Everyday’s band, and standup comedy. es, basic class for the first year members and advance class for the upper-year members. Basi- The Second day beside training, there cally the first two days were full of trainings like was also a General Lecture about “Recent UpSelf Management, Fundraising and Marketing, dates and Management of MDGs 4,5,6” with Writing skills, Project Development, and Basic Prof. Dr. dr. Nila Moeloek, SpM(K), Prof. dr. LakKnowledge on MDGs for basic class. For the ad- sono Trisnantoro, M.Sc, Ph.D, and dr. Michael vance class they had Empowering and Approach- Leksodimulyo MBA, M.Kes as the guest speakers. ing People, Maintaining Organization, Advocacy, It was discussing the current condition of MDGs and Communication and Public Speaking. These achievement in Indonesia, the government’s

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program that had been done for it, the problems, challenges and strategy to help the 2015’s target. We were also discussing about the active role of students in achieving MDGs especially point 4,5,6. After trainings and general lecture, the participants went back to the hotel to attend Sco Session and Plenary Session.

At Saturday, there were Training General about “Health Promotion” and Roleplay General. Basically the participants learned about the basic principle of health promotion and being a good peer educator in Training General, whereas in Roleplay General they had the opportunity to practice all the knowledge and skill they have got from trainings in the form of games. The day was concluded with an unforgettable Farewell Party.

Although sad to see our friends leaving, it was also a relieve for us, the Organizing Committees, that National Leadership Summit 2012 was a success and all the participants went home with a perpetual smile, fond memories and newly improved knowledge and skills.

With Love, OC NLS 2012 Yogyakarta

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“

National Leadership Summit 2012 was a success and all the participants went home with a perpetual smile, fond memories and newly improved knowledge and skills.

“

March Meeting Ghana, Africa

March Meeting is one of the two General Assemblies of IFMSA that is held every year along with August Meeting. After MM Indonesia last year, this year, the 61st General Assembly (GA) March Meeting of the International Federation of Medical Students’ Associations (IFMSA) was held in Accra, Ghana from March 3rd until March 11th 2012. With ‘Youth & Social Determinants of Health’ as the theme, MM 2012 was attended by approximately 700 – 800 IFMSA members from all around the world. Unfortunately, because Ghana is so far away from Indonesia, only 2 delegates from CIMSA attended, Niko and me.

F

or six days, there were many sessions that we attended. The Welcoming Session, Opening Ceremony, Plenary Sessions, Standing Committee/NMO Management/President’s Sessions, Regional Meetings, Theme Events, Project Presentations, Trainings, Project Fair, AF Market, Cultural Night, National Food and Drinking Party and Social Programs were all the sessions we participated in. On the first day, the GA was officiated with the Welcoming Session which was divided into 2 parts, the general part where the Team of Officials introduced themselves, and the SCO part where every standing committee had their own introductory sessions. The Opening Ceremony was held later that night. There were speeches by the Ministry of Health of Ghana,

the President of IFMSA, and the President of the Organizing Committee.

While Niko was attending the Presidents’ Sessions, I was attending the SCO sessions which were held almost every day except on day 4.

At these SCO sessions, the participants shared ‘happenings’ in one’s own NMO, the good and the bad, and brainstormed together for solutions and ways to improve the quality of the SCO at both NMO and IFMSA level. The theme event was split into two days; the main theme was further divided into a few parallel sessions with a few other sub-themes. The sub-themes were HIV/AIDS and TB, Climate Changes, and Migrants Health. It was designed for different SCOs based on relevance.

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sia A in A S ion IFM c Reg ifi Pas

As for the projects, Indonesia brought TBXCHANGE 2012 by SCORE CIMSA UNAIR for Project Presentation and International Summer Course 2012 by SCOPE CIMSA UGM for Project Fair. The delegates were enthusiastic and many even expressed their hopes to participate in these projects. Other important sessions were the Plenary Sessions.

The most notable events during these sessions were the EB Election and the vote for the March Meeting 2013 host. The EB that were elected for the next period were Roopa Dhat from AMSA-USA as the President, Lujain Al-Qodmani from KUMSA-Kuwait as the VPI, Usman Mushtaq from NMSANorway as the VPE, and Alexandre Moser from SWIMSA-Switzerland as the Secretary General. And as for the results for MM 2013 host, the next MM will be held in the United States of America. It’s great, isn’t it?

But then again, it will be thousands of miles away from Indonesia.

It’s really sad for me to leave behind this wonderful experience and all the great new friends I made, but I couldn’t wait to share this with all of you too. Hopefully, you too will be able experience a GA in the nearest future, whether AM or MM. Trust me, one GA is not enough. You’ll be left wanting to participate again, and again, and again.

her e dele we a r g Nik ates e! the oa f n d rom C me IM

SA:

written by: Adelia Ulya R ac hman

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Breast Cancer Epidemiology

· A woman’s risk of breast cancer approximately doubles if she has a firstdegree relative (mother, sister, daughter) who has been diagnosed with breast cancer. · About 5-10% of breast cancers can be linked to gene mutations (abnormal changes) inherited from one’s mother or father. Mutations of the BRCA1 and BRCA2 genes are the most common. An increased ovarian cancer risk is also associated with these genetic mutations. · The most significant risk factors for breast cancer are gender (being a woman) and age (growing older).

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Risk Factor

By now you may be familiar with the statistic that says 1 in 8 women will develop invasive breast cancer. Many people misinterpret this to mean that, on any given day, they and the women they know have a 1-in-8 risk of developing the disease. That’s simply not true.

People tend to have very different ways of viewing risk. For you, a 1-in-8 lifetime risk may seem like a high likelihood of getting breast cancer. Or you may turn this around and reason that there is a 7-in-8, or 87.5%, chance you will never get breast cancer, even if you live to age 80. How you view risk often depends on your individual situation — for example, whether you or many women you know have had breast cancer, or you have reason to believe you are at higher-thannormal risk for the disease — and your usual way of looking at the world.

Even though studies have found that women have a 12% lifetime risk of developing

presence of cancer-free zones and close-to-normal cell behaviour (grading). Size is not a factor in staging unless the cancer is invasive

Grading is based on how biopsied, cultured cells behave. The closer to normal cancer cells are, the slower their growth and the better the prognosis. If cells are not well differentiated, they will appear immature, will divide more rapidly, and will tend to spread. Well differentiated is given a grade of 1, moderate is grade 2, while poor or undifferentiated is given a higher grade of 3 or 4 (depending upon the scale used).

Younger women tend to have a poorer prognosis than post-menopausal women due to several factors. Their breasts are active with their cycles, they may be nursing infants, and may be unaware of changes in their breasts. Therefore, younger women are usually at a more advanced stage when diagnosed.

The presence of estrogen and progesterone receptors in the cancer cell, while not prog-

“vide Most larger hospitals are associated with cancer support groups which proa supportive environment to help patients cope and gain perspective from cancer survivors.” breast cancer, your individual risk may be higher nostic, is important in guiding treatment. Those or lower than that. Individual risk is affected by who do not test positive for these specific recepmany different factors, such as family history, tors will not respond to hormone therapy. reproductive history, lifestyle, environment, and others.

Psychological aspects

Prognosis

There are many prognostic factors associated with breast cancer: staging, tumor size and location, grade, whether disease is systemic (has metastasized, or traveled to other parts of the body), recurrence of the disease, and age of patient.

Stage is the most important, as it takes into consideration size, local involvement, lymph node status and whether metastatic disease is present. The higher the stage at diagnosis, the worse the prognosis. The stage is raised by the invasiveness of disease to lymph nodes, chest wall, skin or beyond, and the aggressiveness of the cancer cells. The stage is lowered by the

The emotional impact of cancer diagnosis, symptoms, treatment, and related issues can be severe. Most larger hospitals are associated with cancer support groups which provide a supportive environment to help patients cope and gain perspective from cancer survivors.

Not all breast cancer patients experience their illness in the same manner. Factors such as age can have a significant impact on the way a patient copes with a breast cancer diagnosis.

Premenopausal women with estrogen-receptor positive breast cancer must confront the issues of early menopause induced by many of the chemotherapy regimens used to treat their breast cancer, especially those that use hormones to counteract ovarian function.

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Cervical Cancer Epidemiology

Worldwide, cervical cancer is the fifth most deadly cancer in women. It affects about 16 per 100,000 women per year and kills about 9 per 100,000 per year. Worldwide it is estimated that there are 473,000 cases of cervical cancer, and 253,500 deaths per year.

Risk Factor

Different cancers have different risk factors. But having a risk factor, or even several, does not mean that you will get the disease.

In thinking about risk factors, it helps to focus on those you can change or avoid (like smoking or human papilloma virus infection), rather than those you cannot (such as your age and family history). However, it is still important to know about risk factors that cannot be changed, because it’s even more important for women who have these factors to get regular Pap tests to detect cervical cancer early.

Cervical cancer risk factors include:

>>> Human papilloma virus infection

The most important risk factor for cervical cancer is infection by the human papilloma virus (HPV). HPV is a group of more than 100 related viruses, some of which cause a type of growth called a papilloma, which are more commonly known as warts. HPV can infect cells on the surface of the skin, genitals, anus, mouth and throat, but not the blood or most internal organs such as the heart or lungs. HPV 6 and HPV 11 are the 2 types of HPV that cause most cases of genital warts. They are called low-risk types of HPV because they are seldom linked to cancer.

Certain types of HPV are called high-risk types because they are strongly linked to cancers, including cancer of the cervix, vulva, and vagina in women, penile cancer in men, and anal and oral cancer in both men and women. The highrisk types include HPV 16, HPV 18, HPV 31, HPV 33, and HPV 45, as well as some others. About two-thirds of all cervical cancers are caused by HPV 16 and 18.

Although HPV can be spread during sex -- including vaginal intercourse, anal intercourse, and oral sex - sex doesn’t have to occur for the infection to spread. All that is needed to pass HPV from one person to another is skin-to-skin contact with an area of the body infected with HPV. Completely avoiding contact of the areas of your body that can become infected with HPV (like the mouth, anus, and genitals) with those of another person may be the only way to truly prevent these areas from becoming infected with HPV. The Pap test looks for changes in cervical cells caused by HPV infection. Other tests look for the infections themselves by finding genes (DNA) from HPV in the cells..

Although there is currently no cure for HPV infection, there are ways to treat the warts and abnormal cell growth that HPV causes.

>>> Smoking

Women who smoke are about twice as likely as non-smokers to get cervical cancer. Researchers believe that these substances damage the DNA of cervix cells and may contribute to the development of cervical cancer. Smoking also makes the immune system less effective in fighting HPV infections.

>>> Immunosuppression

Human immunodeficiency virus (HIV), the virus that causes AIDS, damages the body’s immune system and places women at higher risk for HPV infections. This may explain the increased risk of cervical cancer for women with AIDS. Scientists believe that the immune system is important in destroying cancer cells and slowing their growth and spread. In women with HIV, a cervical pre-cancer might develop into an invasive cancer faster than it normally would.

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>>> Chlamydia infection

Chlamydia is a relatively common kind of bacteria that can infect the reproductive system.

It is spread by sexual contact. Some studies have seen a higher risk of cervical cancer in women whose blood test results show evidence of past or current chlamydia infection (compared with women who have normal test results). >>> Diet

Women with diets low in fruits and vegetables may be at increased risk for cervical cancer. Also overweight women are more likely to develop adenocarcinoma of the cervix. >>> Oral contraceptives (birth control pills)

There is evidence that taking oral contraceptives (OCs) for a long time increases the risk of cancer of the cervix. Research suggests that the risk of cervical cancer goes up the longer a woman takes OCs, but the risk goes back down again after the OCs are stopped. >>> Intrauterine device use

A recent study found that women who had ever used an intrauterine device (IUD) had a lower risk of cervical cancer. The effect on risk was seen even in women who had an IUD for less than a year, and the protective effect remained after the IUDs were removed. >>> Multiple full-term pregnancies

Women who have had 3 or more full-term pregnancies have an increased risk of developing cervical cancer. No one really knows why this is true. One theory is that these women had to have had unprotected intercourse to get pregnant, so they may have had more exposure to HPV. Also, studies have pointed to hormonal changes during pregnancy as possibly making women more susceptible to HPV infection or cancer growth.

Another thought is that the immune system of pregnant women might be weaker, allowing for >>> HPV infection and cancer growth.

Young age at the first full-term pregnancy Women who were younger than 17 years when they had their first full-term pregnancy are almost 2 times more likely to get cervical cancer later in life than women who waited to get pregnant until they were 25 years or older. >>> Poverty

Poverty is also a risk factor for cervical cancer. Many women with low incomes do not have

ready access to adequate health care services, including Pap tests. This means they may not get screened or treated for cervical pre-cancers. >>> Diethylstilbestrol (DES)

DES is a hormonal drug that was given to some women to prevent miscarriage between 1940 and 1971. Women whose mothers took DES (when pregnant with them) develop clearcell adenocarcinoma of the vagina or cervix more often than would normally be expected. This type of cancer is extremely rare in non-DES exposed women. >>> Family history of cervical cancer Cervical cancer may run in some families. If your mother or sister had cervical cancer, your chances of developing the disease are 2 to 3 times higher than if no one in the family had it.

Prognosis

Prognosis depends on the stage of the cancer. With treatment, the 5-year relative survival rate for the earliest stage of invasive cervical cancer is 92%, and the overall (all stages combined) 5-year survival rate is about 72%. These statistics may be improved when applied to women newly diagnosed, bearing in mind that these outcomes may be partly based on the state of treatment five years ago when the women studied were first diagnosed.

With treatment, 80 to 90% of women with stage I cancer and 50 to 65% of those with stage II cancer are alive 5 years after diagnosis. Only 25 to 35% of women with stage III cancer and 15% or fewer of those with stage IV cancer are alive after 5 years.

Interval evaluation of the patient after therapy is imperative. Recurrent cervical cancer detected at its earliest stages might be successfully treated with surgery, radiation, chemotherapy, or a combination of the three. Thirty-five percent of patients with invasive cervical cancer have persistent or recurrent disease after treatment.

Reference: http://www.news-medical.net http://www.cdc.gov http://www.cancer.org http://www.breastcancer.org

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Cervical Cancer: This Deadly Disease Can be Avoided written by: dr. M. Nurhadi Rahman, Sp.OG A woman’s figure is quite unique since it has a variety of features both in personality and in the anatomy of the body. And because of the anatomical features in a woman’s body, some health risks are only experienced women, one of which is cervical cancer.

C

ervical cancer is cancer that grows and develops in the neck of the womb (cervix /cervical), which is an area in which the female reproductive organs are located, specifically between the vagina and uterus. This cancer is one of the deadliest diseases for women.

From the results of a health study performed by the Ministry of Health in 2007, it showed that the prevalence of tumors or cancer in Indonesia is 4.3 per 1000 of the population.

Besides that, there is a higher prevalence of cancer in women (5.7 per 1000 of the population) when compared with males (2.9 per 1000 of the population). While according to the Hospital Information System in 2008, it showed that breast cancer ranks first in hospitalized patients in Indonesia, namely 18.4%, followed by cervical cancer (10.3%), liver cancer (8.2%) and leukemia (7, 3%).

Cervical Cancer Causes & Transmission

Cervical cancer is caused by infection of the human papilloma virus (HPV). HPV causes warts in men and women, including genital warts, called condyloma akuminata. Interestingly enough, there are just a few of the hundreds of variants of HPV that can actually cause cancer.

Cervical cancer can occur in the event of an HPV

infection that does not heal for a long period of time. Most HPV infections will disappear because it is resolved by the immune system. If the immune system functions decreases, the HPV infection will develop and can lead to cervical cancer.

HPV virus types that cause cervical cancer with the most fatal consequences are HPV virus types 16 and 18. There are several factors that can increase the risk of HPV infection that causes cervical cell changes. These factors include young age of coitus, multiple partners, high parity or frequent childbirth, poor vaginal hygiene, smoking, and long term radiation exposure or contamination of chemicals. Women who are prone to cervical cancer are those aged between 35-50 years, and who are sexually active. Sexual intercourse at an early age can increase the risk of cervical cancer by 2 times compared to women who had sexual intercourse after the age of 20.

Cervical cancer is also associated with the number of sexual partners. The more sexual partners you have, the higher risk you have to suffer from cervical cancer. Just like the number of sexual partners, the number of pregnancies can also increase the risk of cervical cancer.

HPV virus can be transmitted from one patient to another and infect that person. Transmission can be through direct contact and through sexual intercourse.

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Cervical Cancer Symptoms

Symptoms do not usually appear at an early stage, which is why cervical cancer due to HPV infection is often considered as “The Silent Killer”.

Some symptoms can be observed, although not always an indication of HPV infection. Whitish or slight bleeding after intercourse is a minor sign or symptom of this cancer. In addition, a smelly yellowish liquid originating the genital area can also be an indication of HPV infection.

How to Detect Cervical Cancer

Symptoms of a person infected with HPV are not visible and not easily observable. The easiest way to find out about HPV infection is by doing a cervical cytology examination. This examination is popularly known as a Paps smear or Papanicolaou smear taken from a Greek doctor who invented this method, George N. Papanicolaou. With the Pap smear, the doctors will use a scraper or brush to remove a small sample of cervical cells. Then the cells will be analyzed in the laboratory. The test can reveal whether there is infection, inflammation, or abnormal cells.

However, there are also various other methods for early detection of HPV infection and cervical cancer that is much simpler such as VIA. VIA stands for Visual Inspection with Acetic Acid.

The VIA examination method is carried out by examining the cervical smear with acetic acid. Then it is observed for any abnormalities such as white areas. If there is no change in color, there may be no infection of the cervix.

Cervical Cancer Treatment

Some treatments aim to kill the cells containing the HPV virus. Another way is to get rid of the damaged or infected cells and tissues with electric surgery, laser surgery, or cryosurgery (re-

moving the abnormal tissue by freezing).

If cervical cancer has reached an advanced stage, chemotherapy is recommended. In some severe cases a hysterectomy or the surgical removal of the uterus or womb in total may be needed. The goal is to get rid of cervical cancer cells that have been developing in the body.

Prevention of Cervical Cancer

Although ranked top among the various types of cancer that causes mortality, cervical cancer is the only type of cancer that has a known underlying cause. Therefore, efforts to prevent cervical cancer are quite possible. This include by not having sex with multiple partners, routinely doing pap smear every two years for those who are already sexually active, maintain health, and vaccinations for HPV for women who have never had sexual contact.

In mid-2006 a vaccine against infection with HPV types 16 and 18 that cause cervical cancer has been introduced. The vaccine works by increasing the body’s immune system and blocking the virus before it enters the cells of the cervix. Other than that, the cervical cancer vaccine also protects women from the threat of multiple HPV types 6 and 11 which cause genital warts. Vaccination is effective when given to girls aged 9 to 26 years who are not sexually active.

For women that have been sexually active, a Pap smear is required before administering the vaccine. The vaccine is given 3 times in a period of time. With vaccination, the risk of cervical cancer can be decreased up to 75%.

Treatment facilities, as well as the prevention of cervical cancer has been widely available in health clinics and hospitals, so it would be nice if the facility is used to prevent the occurrence of this deadly disease for women.

dr. M. Nurhadi Rahman, Sp.OG Obstetrics & Gynecology Specialist Faculty of Medicine, Universitas Gadjah Mada / Sardjito Hospital, Yogyakarta, Indonesia.

Universitas Gadjah Mada Alumn, Medicine, 2004.

Universitas Indonesia Alumn, Obstetrics & Gynecology, 2011. !

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Extending The Fight in Achieving MDGs through Fighting Cancer The Millenium Declaration initiated by the

T

by: Shela P. Sundawa

welve years ago in Millenium Summit 2000 initiated by United Nations, the world leaders had gathered and agreed on a declaration which adopted as United Nations Millenium Declaration. The Declaration asserts that every individual has the right to dignity, freedom, equality, a basic standard of living that includes freedom from hunger and violence, and encourages tolerance and solidarity. This Millenium Declaration then became the origin of MDGs. The MDGs were the realization of the declaration ideas which was set with indicators and targets on fifteenyear timeline.

MDGs target

UN was not the only part of where MDGs came from.

Organization for Economic Cooperation and Development, the World Bank, and the International Monetary Fund were also the part of where MDGs came from.

Today we are three years away from MDGs deadline, there are some targets of MDGs that have been achieved, some targets that has significant progress and is expected to be achieved in 2015, and some targets which still require hard work to achieve.

Below is MDGs goal and progress table summarized from Report on the Achievement of the Millenium Development Goals Indonesia 2010.

Achieved On Progress

Goal 1: Eradicate extreme poverty and hunger Target 1A: Halve the proportion of people living on less than $1 a day √ Target 1B: Achieve Decent Employment for Women, Men, and Young People √ Target 1C: Halve the proportion of people who suffer from hunger √ Goal 2: Achieve universal primary education Target 2A: By 2015, all children can complete a full course of primary schooling, girls and boys √

Goal 3: Promote gender equality and empower women Target 3A: Eliminate gender disparity in primary and secondary √ √ preferably by 2005, and at all levels by 2015 (for the primary (for the second education) ary education) Goal 4: Reduce child mortality rates Target 4A: Reduce by two-thirds, between 1990 and 2015, √ the under-five mortality rate

Goal 5: Improve maternal health Target 5A: Reduce by three quarters, between 1990 and 2015, √

the maternal mortality ratio Target 5B: Achieve, by 2015, universal access to reproductive health

Goal 6: Combat HIV/AIDS, malaria, and other diseases Target 6A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS Target 6B: Achieve, by 2010, universal access to treatment for √

HIV/AIDS for all those who need it Target 6C: Have halted by 2015 and begun to reverse √ √

the incidence of malaria and other major diseases (success for TB) (decreased

case in malaria) Goal 7: Ensure environmental sustainability Target 7A: Integrate the principles of sustainable development

into country policies and programs; reverse loss of

environmental resources Target 7B: Reduce biodiversity loss, achieving, by 2010, a significant

reduction in the rate of loss Target 7C: Halve, by 2015, the proportion of the population without

sustainable access to safe drinking water and basic sanitation

(for more information see the entry on water supply) Target 7D: By 2020, to have achieved a significant improvement

in the lives of at least 100 million slum-dwellers

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Need more effort

√ √

√ √ √ √

Goal 8: Develop a global partnership for development Target 8A: Develop further an open, rule-based, predictable,

non-discriminatory trading and financial system Target 8B: Address the Special Needs of the Least Developed Countries (LDC) Target 8C: Address the special needs of landlocked developing countries

and small island developing States Target 8D: Deal comprehensively with the debt problems of developing

countries through national and international measures in order

to make debt sustainable in the long term Target 8E: In co-operation with pharmaceutical companies, provide access to

affordable, essential drugs in developing countries Target 8F: In co-operation with the private sector, make available the benefits

of new technologies, especially information and communications

From this table, it can be seen that Indonesia needs more hardwork to achieve goal 5, 6 and 7 by 2015. As a future health care provider, I would like to hightlight goal 5 and 6. As we can see none of the target of goal 5 are on its way to be achieved in 2015 while some targets of goal 6 has been succeeded an expected to be achieved in 2015. Because of this reason, goal 5 has more urgent than goal 6.

Of all the MDGs, the lower rate of the global achievement has been recorded in the imporovement of maternal health. Cancer occurs in approximately 0.1% of pregnant women and is the second leading cause of mortality in women of reproductive age. Servical cancer are known to be the second massive killer of women among all other cancer. Universal access to reproductive health including servical cancer screening and vaccine are some of goal that had to be achieved under point 5 MDGs.

One Indonesian woman dies every hour from cervical cancer because poor screening coverage in the country means the deadly but curable disease is detected too late. Though its malignancy, cervical cancer might be prevented by injecting HPV (Human Pappiloma Virus) vaccine. It is most beneficial for women before their first sexual activity. The efficacy of this vaccine to prevent servical cancer is 99,9% effective for women in this group. The vaccine then become less effective if it’s given to sexually active women.

However the cost of HPV vaccine is thought to be expensive for many people. In Indonesia it costs around 1,800,000 IDR for three shots of HPV vaccine. Therefore this preventable disease remains unprevented altough the prevention is available due to the expensive price. Understand this matter, Gavi Alliance is ahead of providing low cost HPV vaccine which is expected to cover young women inr nine countries by 2015.

Compared to vaccine, servical cancer screening is only 100,000 IDR. It is also an effective way for an early detection that will lead to early case finding and early treatment of this disease. Cervical intraepithelial neoplasia, the potential precursor to cervical

v √ √ √ √ √

cancer, is often diagnosed on examination of cervical biopsies. For premalignant dysplastic changes, the CIN (cervical intraepithelial neoplasia) grading is used.

CIN 1 is the lowest grading and CIN 4 is the highest grading or carcinoma in situ. The earlier the finding of cervical abnormality, the higher the survival rate.

However, the data shows that less than 5 percent of women in Indonesia regularly take a pap smear test (the screening process for the cancer) compared to the World Health Organization recommendation of 80 percent.

Understand this matter, government need to provide servical cancer screening at least using IVA which its specificity and sensitivity are high in every primary health care but cheaper than pap smear. Along with government, medical students are also have a big role in socializing about the HPV vaccine and servical cancer screening. The low rate of servical cancer screening might be due to lack of information and its affordability. Therefore medical students can assist the government to educate community about this screening and location where they can do screening. The program for the servical cancer screening will be much more effective if it can be held in every 6 months. So the same women which has been screened 6 months ago should be screened again 6 months later after the first screening. By applying this programme the early detection will be a very useful tool to help reducing the servical cancer rate in Indonesia.

Beside that there is a fear factor which become one of obstacle to make women seek for an early treatment. Helping them to release their fear could be one of effective way to avoid them seeking the doctor in terminal stage. This method could be one of a good target to help reducing the burden and suffer from cervical cancer.

By combinating cancer prevention and early screening the goal to achieve MDGs especially target 5B is on the way. It is not the time to depend the health of people only to government, it is the time for a new generation, for us, medical students. So stand up and do something.

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REAL ACTIONs

There were many real actions held by CIMSA in order to lower the incidence of cancer. Here are 3 of them

1

International Women’s Day - CIMSA UI. For Women, For the World?

2

CIMSA Cares for Cervical Cancer - CIMSA UA

On the 29th and 31st of March 2012, in conjunction with International Women’s Day, CIMSA-UI had a memorable trans-SCO project involving all 6 SCOs. The theme of this year’s IWD was, ‘Untuk Wanita, Untuk Dunia’ which when directly translated mean, For Women, For the World. IWD 2012 was held in Menteng with the hopes of becoming the pioneer project for CIMSA-UI’s Community Development Project. This particular area was chosen because of its alarming socio-economical state. Counseling was given to the women in this area. It was carried out in order to increase awareness among these women, to provide additional information and answer inquiries regarding women’s health. This included, cervical cancer, breast cancer, how to perform breast self-examination and the VIA (Visual Inspection with Acetic Acid). The women were also warned of the discomfort that may arise from the VIA that will be performed. They were very enthusiastic and had plenty of questions to ask. The highlight of IWD 2012 was on the 31st of March 2012 and this included IVA examination, breast self-examination, one-stop health stations, stands and a culinary competition. Divided into groups based on the coupons given earlier that week, they rotated accordingly to each post.

SCORA featuring SCOPH CIMSA UA (Airlangga University) held a “CIMSA Cares for Cervical Cancer (C4)”, in February 24th, and Sheila Maryam Gautama as project officer. That was placed in Pucang traditional market, Surabaya. This event aims to commemorate the World Cancer Day, February 4th. In addition, also to support the reproductive health of Surabaya society, especially women, so that could also help the success of one the MDG’s program points. We also cooperated with Program See and Treat team from RSUD dr. Soetomo, Pathology of Anatomy UNAIR, and Puskesmas Pucang Sewu Surabaya to support this event. There were 68 women who underwent the cervix examinations using VIA (Visual Inspection Acetic Acid) which is known as an effective of early detection of cervix cancer. The average of those aged 40 years and has married. From this examination, we found 4 people were positive for pre-cancerous cervical lesions. They immediately referred to a health cancer to get further treatment. In Metropolis Jawa Pos Magazine, dr.

Esty Martiana Rachmi supported this event. Dr. Esty said that this event C4 is a new breakthrough in efforts to reduce mortality from cervical cancer in women.

3

WORLD CANCER DAY 2012 : STAND UP AND DO SOMETHING - CIMSA UR On 25 February 2012 ago, CIMSA UR held activities to commemorate World Cancer Day (WCD). WCD is celebrated on the 4th of February each year. This activity held in the car free day area by CIMSA UR in jl.Diponegoro. Activities such as drama, played by members of CIMSA UR, drama consists of three parts, and the three diseases in the telling there is lung cancer, bladder tumor, and leukemia, which lately is often encountered. This activity is dedicated to provide education for ordinary people to learn more about what it is cancer. So get involved and do something this World Cancer Day - because Together it is possible!

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Q:

As a medical students, what can you do to help the government to reduce the incidence of cancer?

“

Actually, cancer cannot be judged by its etiologies, because we can prevent it by reducing the risk factors. Government, as the law and rule maker, cannot stand alone to tell public about how dangerous the cancer is. Government should work together with the health workers (doctors, nurses, midwives, etc.) to spread information about cancer to the public, including the risk factors, the facts (that cancer incidences are increasing by years), the healthy life style that we have to do, and many more. Government should also provide appropriate health facilities in each health centers, especially for health centers which are located near from the citizen, for example Puskesmas, for early prevention and screening (such as pap smear test, mammography, etc.), and also proper primary care for the worst scenario. Government should also empower the health workers with knowledge about cancer to create health workers with high quality. “ Liza Aulia Putri - CIMSA Unsyiah

“

As a medical student, things that I can do now are to share my knowledge and experiences about medicine and health. And I know CIMSA gives us many opportunities to do more.

We can cooperate with the government and stakeholder to tell public about what cancer is, how to prevent it, and share the healthy life style. Maybe the ‘Anticancer Action’ will be the best idea to shout it. I believe it will be our best experience to be able to share to many people.

Hope it will make people healthier.”

Rezky Fitria Yandra - CIMSA Local UMS

SPEAK UP !

“

First of all, cancer is a disease that the cause is still unknown. It may be related to genetic, lifestyle, or even aging. In my opinion, to reduce the incidence of cancer, we must do research about the causes. For now, the only thing we can do is to give health education to public to do healthy lifestyle, build cancer awareness, and do screening, especially for people who are likely to get cancer. In order to do that, CIMSA needs all standing committees to do their jobs and maximize all potentials that they have. For example, SCORE does cancer research; SCOPE, SCORP, and SCOPH do some actions to gain public’s awareness of cancer; SCORA do some health education about cervical cancer or breast cancer for public; and SCOME does some basic trainings for medical students about cancer and how to educate patients. My last word would be: CIMSA, let’s do more and make a change for Indonesia.”

Stevanus Jonathan - CIMSA UPH

“

After reading question written above, one thing that suddenly popped up in my mind was “Studying”.

Maybe our actions in helping government to reduce the incidences of cancer still cannot be categorized as direct helps. But, by studying, we, as future doctors, will be able to directly help government in reducing the incidences of cancer in Indonesia. With knowledge, skills, and attitude that we have, we can give health education to public about cancer, including how to prevent it, how to give treatment to cancer patients, etc.

Got a beautiful sentence from a basketball competition I saw. “Heroes are made, not born”. In this sentence, ‘heroes’ is like represent us. We are future heroes in health battlefield.”

Ahmad Aulia Ghufron - CIMSA UMY

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“

Fighting cancer needs thorough and continuous efforts that implement holistically. However, as medical students, there are specific direct actions that we can do to partake in combating cancer along with the governments. We can play the role of health campaigner, acknowledging that cancer is mostly lifestyle-caused disorder. In our university, 2nd year students are sent into various public health centers, and later, into residents’ houses in that area. There, we act as health promoter; we arrange surveys, to then perform counseling with the correct method about determined disease, follow up the awareness upgrade of the family, and do everything else that needs to be done in order to prevent the members of the family from going down with the disease. Also as a primary intervention in cancer control, we are encouraged to create several publications such as posters and leaflets about the disease to be spread in the neighborhood. This way, we expect to upgrade the mindset of the society and raise the awareness of the disease.

There are also other things we can do as secondary interventions. For example, CIMSA UA has held C3 (CIMSA UA Cares for Cancer), which coordinated a screening for cervical cancer. We know that early detection plays a great role in the treatment of cancer, and that it’s not free. By coordinating events like this, we have helped the government in the efforts of early detection of cancer. Next, as tertiary interventions, we can divide our efforts into two; reanimations and palliative care. In their recovery states, patients have probably lost several abilities, confidence, or even hope. It’s our duty to help them with their therapy; reminding them for medication and reconstruction schedules and rebuilding their belief to rise from the downfall. This way we are encouraging them to actually recover, both from physical attributes of cancer and mental. However, at higher stages, palliative care is the most prominent effort to ease the burden of cancer bearer. By conducting a visit to local palliative center or cancer foundations, we can do both of these means.

To sum up, there are enormous things we can do to support the government in cancer eradication beside studying and researching as our main duty as students. What matters is our willingness and determination. Will you kill cancer?”

Thomas Jatiman and Sitha Maharani - CIMSA UA

“

As a medical student, we may help the government against cancer by making a campaign about how to have a healthy life with routine exercise and avoiding carcinogenic materials. And we should give examples about what the carcinogenic materials are and how could they become a cancer in our body.”

Bintang Karlien - CIMSA UIN

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crossword puzzle 4 3 14 5 7

11

10 1

6

8

13 15

9

12

2

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

Primary prevention of cervical cancer is simply by doing this.

Cancer screening using the ________ can identify pre-cancerous and poten- tially pre-cancerous changes in cervical cells and tissue.

After doing screening tests, confirmation of the diagnosis of cervical cancer on pre-cancer requires _______ of the cervix.

One of the materials in cigarettes that could destroy the cervical epithelium. ________ is the greatest risk factor for cervical cancer.

The main etiology or cause of cervical cancer.

Treatment of cancers by giving or administrating medication that travels through the blood stream to the cancer cells.

Solution that is needed for doing VIA examination (screening examination for cervical cancer) This hormone imbalance may cause benign breast tumor.

This treatment of breast cancer is done by removing some parts or all parts of breast.

One of ways to do early detection of breast cancer.

In hereditary breast cancer cases, this gene is usually mutated.

This treatment or care is given to terminal patients (patients who already reach high stages of cancer so that they can’t be cured by any medication).

One of the risk factors of breast cancer is _________ of breast cancer.

The viral infection may cause abnormal growth of cervical cells, known with cervical _______.

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LOCAL STORIES Fun Elderly – CIMSA UNS

CIMSA FK UNS is back by holding a program named Fun Elderly. This program is one of the SCOME projects, to celebrate Health World Day (WAD) on 7th April ago with the theme was Good Health Adds Life to Years. Collaboration between SCOME and SCOPH CIMSA FK made a councelling and Routine Medical Check-Up (blood pressure, height, and weight) in Posyandu Lansia CIMSA FK UNS, which was located in Posyandu Lansia PP. Darud Dzikri, Joyontakan Wetan RT.06/06 Kec. Joyontakan Surakarta on 10th of April 201 which is started from 04.00 p.m until 06.00 p.m. All scomedian and scophian who was participated in this project, gathered in FK UNS before they went to the Posyandu. In the Posyandu, the participants had come. So, the project was started directly.

First, the participants got some routine medical check-up from SCOPH CIMSA FK UNS. Then, some scomedian presented a counselling about Cervical Cancer and Breast Cancer. For Breast Cancer, they also teach the participants

about SADARI or Periksa Payudara Sendiri. The goal of the counselling was to make the participant being aware of their health, especially about cancer. Most of participants are woman, were very interested about the content. They were active to ask some questions, and one of them made all people surprised when she told about her experience that she had done one of the screening of Cervical Cancer called PAP Smear. She was very happy since the screening

!

result showed that she had no abnormality in her cervix.

by MSCIA as series of admission of newcomers.

Before the holding of MSCIA Academy, we did an Open Recruitment first. After the Open Recruitment, the newcomers are around 150! After that, those who qualified for Open Recruitment must attend this academy. The series of MSCIA Academy was conducted over 3 times, once a week.

Those who qualified for this Academy will be the members of MSCIA and CIMSA of course!

This three series of academy was conducted in March. In that event, there were a lot of training, introduction of each SCO, and also promotion of the next events. The newcomers are ! also seemed enthusiastic, in receiving the training from that event. Hopefully the will take part MSCIA Academy was one of the events that held in the success of future of CIMSA later!

MSCIA Academy – MSCIA Brawijaya (CIMSA UB)

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Share the Love – CIMSA UA

April 14th, 2012, dr. Michael Leksodimulyo’s Yayasan Pondok Kasih in cooperation with CIMSA UA and PHD UWK CIMSA held an event for children with cancer at Rumah Singgah kanker YKI (Cancer Foundation of Indonesia), Mulyorejo, Surabaya. The whole event is about teaching how to wash hands and brush their teeth, but we were also playing games, singing, drawing, we were having a lot of fun! One of those fun we had is “Sharing Goals”. Each child was given a sheet of drawing paper and a crayon box of colors to be used to draw “What do you want to be when you grow up?” Variety of images was drawn by those children. Some were wanted to be a doctor, policeman, football player, and some just draw their dream house as they have left their house for a long time since they have always been in the

SCOME IN VACATION – CIMSA UNISSULA

SCOME on VACATION was a project held

by SCOME CIMSA UNISSULA in the series of two others that marked celebration of HARDIKNAS or National Education Day which falls on May 2. The event was held on April 14 at morning by inviting elementary children of on the grade 4th, 5th, and 6th MI Al-Islamiyyah to MUSEUM RONGGOWARSITO.

Why Museum? Why not teaching in Hospital? Why not some other place relating to medicine and health? The answer of this question would be that we want something other than usual to give to them; something close and familiar to them in school subject and beneficial, educative in both academic and cultural way,

hospital. When they are finished drawing, they are dared to tell their friends about what their drawing is about. Gathering together with those cancer children made us feel the sense of compassion and joy mixed together. It helped us to realize that there are ! still a lot of children who need our help, especially those with special needs.

meaningful, entertaining, and having a strong influence on their awareness about Indonesia’s beauty.

The journey started by 8 o’clock when we picked and took them to watch things presented in Museum Ronggowarsito relating to history, geography, and traditional dresses. The kids were also asked to make a summary of what they learned there. The summary was then used to answer some questions we asked later at lunch time.

The quickest kids answering these were awarded by some gifts we prepared before for them.

The event was finished at 1 o’clock after all the gifts had been given and hopefully could be continued by two upcoming events which would be held by SCOME UNISSULA too, that are education for ‘students physician’ and current disease counseling.

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LET’S HAVE FUN WITH CIMPANSE – CIMSA UNPAD

student, they followed amazing race around campus. The amazing race had some pos and in each pos, they were studied about hygiene and simple prevention from disease, for example ‘how to brush your teeth’ and ‘danger of smoking’.

The second group, senior high school’s student followed seminar and discussion by dr. Dian Jauhari. This ! seminar was about counseling and presentation from dr. Dian Jauhari.

After that, they were asked to make a presentation about what they got.

This event finished at 4 pm, it was closed by performance from the children, give certificate, gift and sing with children and CIMSA’s member.

Sunday, April 1st 2012, at 8 am newbie of CIMSA UNPAD 2012 held their first program after being elected as CIMSA UNPAD’s members.

CIMPANSE (CIMSA Peduli Anak Sekolah)’s aim is to share care and make a better relationship to people of Jatinangor, especially for children and student fro elementary, junior and senior high school. We chose them from two nearest orphanage, Panti Riyaadlul Janah and Panti Bening Nurani.

In CIMPANSE, we divided the children to two groups.

F i r s t group, consist of elementary and junior high s c h o o l ’s !

Event Series - CIMSA UPH

Our first SCOME event is teacher appraisal that take place in Faculty Of Medicine Pelita Harapan and Siloam Hospital . Our target is faculty staff that teach us in UPH whether they’re in Siloam or UPH. This event was joined by every student in our faculty and they all give “dudu” to us that we will distributed to the staff ( Our “dudu” is a single notes about the staff ). Then the dudu will given to the staff with apple.The response from the staff is exited and very welcome to CIMSA UPH that get the idea to held this event.

This is our first SCOPE event, English day , in this event we get the permission of the vice dean to get all the tutors to speak English and the medical student also must speak English , from

this event we get the data that include who can speak English fluent and not fluent.

Now is a project from SCORE, This event was originally developed by UPH senate and then merged into one with CIMSA and become journal reading club that the speaker’s are dr.Theo and Velly Sugono which is our UPH staff. This event was planned for those who interested in read journal, make research project ,etc.This event was held once a week at Friday.

The last is a project from UPH collaborated with CIMSA in order to make the Clinical skill’s video . We from CIMSA get to edit the video and make the video that real doctor’s do to patient in clinical skills.

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SCOLYMPICS - CIMSA UGM

There were 7 games on this very first SCOLYMPICS; Balap Karung, Push the SCOLYMPICS is one of CIMSA Ball, Eating Contest (waterUGM’s internal event, was held melon and pare), Dodge Ball, on Saturday, March 17th, 2012 Tug war and Futsal for boys at FK UGM’s basketball court and girls. The scoring system and Jakal Km.7 Futsal Arena, is 2 points for the 1st place from 7 a.m until 2 p.m. This and 1 point for the 2nd place event was attended by 154 on every games. SCORP was CIMSA’s member from batch crowned as SCOLYMPICS 2012 2008 – 2011. The goal of this CHAMPION by 6 points, beatevent is to unite every single CIMSA’s member in their standing committees ing SCORE and SCOPH who on the 2nd place with in order to unite 6 standing committees in one 4 points and received the 1st SCOLYMPICS Trophy. Who will be the next ? huge CIMSA UGM’s family.

SETIA MEN – CIMSA UR

“SETIA-MEN!!!! =SemangaT lansIA-peMuda mEngiNspirasi” is theme from CIMSA UR for celebrate World Health Day (WHD). WHD should be celebrated on 7 April 2012, but this activity we did on 14 April 2012. This is the latest project from SCOPH CIMSA UR. According to the global theme of WHD “Ageing and Health”, we visited one of the nursing home in Pekanbaru. Our first activty when arriving at nursing home is to do a heart-healthy exercises with grandmothers and grandfathers that are there.

SCOPHians CIMSA UR came to the nursing home at 7 am. Next, we take gymnastic with grandmothers and grandfathers. After completion of gymnastics with the grandparents, we provide breakfast for grandmothers and grandfathers. We provide green bean porridge for break-

fast. Having finished breakfast together, we do medical checks grandmothers and grandfathers include blood pressure checks and BMI. The Grandfathers and grandmothers looks glad when we do a health check. We also excited medical checks. After completing the medical checks, we invite grandmothers and grandfathers telling stories and take pictures. Apparently grandfathers and grandmothers are alsonarcissistic.

It is happiness for us because we saw the face of grandfathers and grandmothers happy with us. This is a new project created Scoph Cimsa UR. Actually we wanted to do mutual help clean up the environment of nursing home. This plan failed because of rain in the morning. While awaiting rain to stop, there are committees that take pictures with grandmothers and grandfathers, and some are delivered grandfathers and grandmothers to their room. Our event is completed around 11am and runs smoothly although there are not implemented.

We left a heart-healthy exercise cassette for a souvenir in this nursing home. In order for grandmothers and grandfathers could do routine a heart-healty exercise and to keep remember Cimsa UR.

That’s a little story about the WHD Cimsa UR. Hopefully any event that we do can be useful for our society.

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EARTH HOUR - CIMSA UNSYIAH

SCORP CIMSA FK Unsyiah was held a blackout event for commemorate the global Earth Hour.

The event was held in Banda Aceh Tsunami Museum. This activity aims to increase awareness of the need of action on climate change. The event was attended by hundreds of people who are very enthusiastic. Ahead of a power outage, ten seconds before 9 pm, hundreds of spectators who flooded the Tsunami Museum was also cheered as they count down to a power outage. And all went dark, lit by candles, hundreds of spectators was again struck by the committee. A series of events has been able to make entertainment for the audience.

Firstly, the attentanced attracted by thrift and craft exhibition photography competition.

After that, the audience immediately was entertained by music contest which music creation tool consists of used goods and competitions were participated by various high school as Banda Aceh.

All competitions was held by using the used tools for considering the importance of global warming on climate change. In this event, the appearance from CIMSA FK Unsyiah also enliven this event.

After an hour was ended which is indicating the end of the event, promptly at 10 pm, this blackout was over. This event was closed by the announcement of the winners of various competitions.

International Women’s Day - CIMSA UIN Jakarta

SCORP UIN had ‘disappeared from circulation’ because at the National Peer Education Workshop was SCORA UIN involving all members of the local CIMSA. After the ‘disappeared’, dated Sunday, March 11, 2012 Scorpions with SCORAnger (SCO and other children of course) managed to celebrate International Women’s Day in the Car Free Day, Bunderan HI, Jakarta.

There we gave a hundred roses to the women that we met and asked them to write down hopes and their dreams on a piece of pink paper. We also carry many balloons to be flown with the banner International Women’s Day. There we met with the Women’s Solidarity-round wear PURPLE and collective action. Our action was reported by mass media such as Radio Suara Surabaya, iRadio, American Online, Women_Voice, detik.com. But unfortunately detik.com reported on its website that only the Women’s Solidarity for did an action-for roses and banners flying, they did not mention CIMSA UIN. News can be found here: http://tinyurl.com/iwd-uin

At the end, together we fly the banner of Solidarity Women’s International Women’s Day was. After all Women’s Solidarity broke up, we all take action ~ Finally, the dancing haka haka so this action could attract the attention of journalists and mass media again.

So ... be active with CIMSA

If you want to share your local story please send it to us via email to aorta@cimsa.or.id

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INTERVIEW with Alumnus

Ildza : Hello dr. Fina, I’m glad to have this small

interview with you. Thank you for coming.

dr.Fina: You are welcome.

I : Let’s start with the first question, what’s your activity lately? dr.Fina : I am working in WHO and will finish my work up to June 30 in Emergency and Humanitarian Action Unit we’re supporting Center for Health Crisis, Ministry of Health in case of health crisis response including the disaster well, actually now the unit’s name changed into Emergency and Humanitarian Action (EHA) - Injury, Violence Prevention and Disability Rehabilitation (IVP-DAR) IVP-DAR’s main program is supporting the MOH for injury mostly on road safety, violence (such as domestic violence) and disability.

I : Since when you join with CIMSA? dr.Fina :ehm, if i am not mistaken 2002 or 2003 (September Meeting of SCOME in Yogyakarta).

I was exposed to SCOME then CIMSA in general. I joined Padang May Meeting (UNAND). So, I know SCOME then CIMSA.

- Name: Fina Hidayati Tams - Date of birth : 17 July 1984 - Nationality: Indonesian - Occupation: Program and Field Monitoring Assistant, Emergency and Humanitarian Action Unit, World Health Organization - Formal Education: 2002-2009, Faculty of Medicine, Gadjah Mada University

Last month, our Alumni Director, Ildzamar Haifa, interviewed dr. Fina Hidayati Tams, She was the Vice President for External Affairs CIMSA several years ago. She shared to us about her experiences while being a member of CIMSA. Here is the conversation between Ildza and dr. Fina.

I : Then what is your motivation of joining CIMSA? dr.Fina : yeah, I think getting involved with organization actively involved in projects with current issues you know the currents issues on health all includes in the six SCOs my first interest was medical education.

I : Why do you think medical students need to have another fun activities other than study stuff? dr.Fina : Have another fun activities other than only study and become regular doctor. CIMSA is so international. With IFMSA network, you can make friends with other medical students. sharing and gaining knowledge. think out of the box.

I : What is your last position in CIMSA? dr.Fina : Vice President for External Affairs but at that time one for people in EB no VPI elected

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I : What did you get from CIMSA? dr.Fina :Friends, networks, knowledge and experience travelling abroad. CIMSA is like eyes opener for me with global and national medical students I : What is your good and bad memory from CIMSA? dr.Fina : Good memory : may meeting when i finished my term as VPE completed my work and my report was accepted (LPJ), well, actually many good memories. Meeting CIMSA folks is always a good memories. The bad memory : being away from Indonesia and you were confronted by other Indonesian medical student colleagues during March Meeting Chile. Many lesson I learned from bad memory.

I : What is your biggest obstacle during your time in CIMSA, for example education stuff or family etc, and how you handle it up? dr.Fina : I dropped my score because I was a bad time manager at that time, spending more time for CIMSA’s works than my study but at the end i still got good mark and graduated on time (S1) then when i got my clinical internship and was off from CIMSA, I got another opportunity from IFMSA for having an internship in WHO HQ by doing IFMSA project, a short break during my routine work. It’s a fruitful experience. but actually I also did the clinical exchange in Geneva University hospital so, still did a clinical internship but with different atmosphere (abroad) and they spoke in other language then English.

I : Nowadays many CIMSA member having same problem with you, would you please share some tips and trick how to manage your time between cimsa and study? dr.Fina : Balance your time for study, organization (CIMSA) and leisure time. Make sure your education and organization are in balance. You, yourself who understand your capacity, I mean sometime you did (Sistem Kebut Semalam) for the exam, sometimes people can do it and get good marks but some can’t better study regularly and in the meantime you can spare your time for organization and other activities time management is important, time management is classical issue but if you can manage it all well, you can success for both academic and organizational achievement

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I : What if you were not CIMSA member before, what will change from you now? dr.Fina : I dont think I could see the world. get int’ networks, having intern in Geneva, work in WHO Indonesia. By the way, now having internship in Geneva is easier and I also get scholarship thanks to CIMSA for opening lots of opportunities for me

“CIMSA fellows can contribute and serve the community to achieve the better health status to become extraordinary doctors.”

I : what are advantages from cimsa that influence your life now? dr.Fina : I was contaminated with WHO Headquarter, Geneva. My dream is to be an international staff of UN or International Organization, so, I applied in WHO Indonesia and works there up to now. I like the international environment, work, study, get more knowledge and experience hopefully I could become one of the experts not many indonesian doctors in WHO HQ. So, I would like to pursue my career as int’ staff now my mindset is not only WHO but also UN/ INGO related to healthother UN/INGO* I : what is your wish for the future CIMSA? dr.Fina : develop qualified future doctors (5 stars doctors) not only as clinician, but also can be public health leaders, researcher, experts in other health related subjects. you can be exposed to recents issues and health problems in local, national and int’ level. CIMSA fellows can contribute and serve the community to achieve the better health status to become extraordinary doctors.

I : Is there any message for CIMSA members? dr.Fina : be active with CIMSA, feel the benefits and it is totally fun! CIMSA can be a forum to develop and enrich ur interest. I will never regret for being a part of CIMSA family.

Q: What do you expect from CIMSA 5 years from now?

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5 years from this time, hopefully CIMSA can be the ‘Top Role Model’ for Indonesian student organizations, as CIMSA gives big impact for the people in needs, community, and society through the qualified evaluated activities in every local all over Indonesia. CIMSA also may build permanent partnership with some health stakeholders and mass media, in order to strengthen the audience and effort towards health issues and its related aspects to the people. Moreover, CIMSA can even beat up the spirit to always do “Empowering medical students, improving the nation’s health.” Keep inspiring!

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CIMSA hopefully in 5 years to come will be known throughout Indonesia as a medical student organization that contribute significantly to the health world with all the activities of qualified and best young people of Indonesia as a member.

- Ardina Nur Pramudita, CIMSA UNS

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I hope the next 5 years CIMSA remains a family that continues to protect its members in the work and develop themselves for the betterment of health of Indonesia.

- Khaled, CIMSA UNSYIAH

-Asri Kartika Putri, CIMSA UGM

ELEVEN YEARS CIMSA CIMSA celebrated its 11th birthday on May 6, 2012. Here we have some wishes from our friends for CIMSA 5 years after now!

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I hope to see CIMSA grows more established in terms of external relations/global partnerships and partakes more actively at the advocacy level.

- Ufara Zuwasti, Alumni

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CIMSA sucessfully makes expansions to the entire medical faculties in Indonesia (from Sabang to Merauke). CIMSA sucessfully creates quality projects based on MDGs. CIMSA sucessfully makes more collaborations with other students organizations and several agencies , So that CIMSA will be more popular in the society.

- Balladona Inno C., CIMSA UWKS

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5 years from now, I wish CIMSA will become more strong organization and known by society as an organization which projects are great.

- Arin, CIMSA UI

The National Official Team

Niko Kristianto President

Messia Refri R. Vice President for Internal Afairs

Dian Oktavia G. Vice President for External Afairs

Dhinta F. Cita Secretary General

Effika N. Putri Treasurer

Candrika Dini K. Sulaeman A. Susilo Bobby Juni Saputra Galih Arya W. Mega Iriani Putri Rivano F. Pandaleke Praise Jeremiah National Officer on National Officer on National Public National Exchange National Exchange National Officer on National Officer on Medical Education Reproductive Health Health Officer Officer (outgoing) Officer (incoming) Human Rights and Research Exchange including HIV/AIDS Peace

Shela Putri S. Idzamar Haifa W. Sekar Laras Isnarsandy Yustisia Cendy Martanegara Liaison Officer Alumni Director Marketing, Campaign, Media and Liaison Officer and Advocacy for WHO Communication for IDI Director Director

A. Boy Timor Gia Noor Pratami Project Development Research and Development Director Director

Alessandro Alfieri Supervising Council

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Winda Novellia Human Resources Director

Maria Lioni Supervising Council

Christopher C. Halim K. Liaison Officer for Diknas

Hafizha Herman Fundrising and Merchandise

Puspita Hapsari Supervising Council

Rano Digdayan M. Liaison Officer for Students’ Organization

NOTES

our locals Syiah Kuala University Abulyatama University Andalas University University of Riau University of Indonesia Syarif Hidayatullah State Islamic University Pelita Harapan University Padjajaran University Islamic University of Sultan Agung Gadjah Mada University Muhammadiyah University of Yogyakarta University of Sebelas Maret Muhammadiyah University of Surakarta Airlangga University Brawijaya University University of Wijaya Kusuma

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aorta@cimsa.or.id

Center for Indonesian Medical Students’ Activities Official Magazine