The mission of IFMSA
was founded in May 1951 and is run by medical students, for medical students, on a non-profit basis. IFMSA is officially recognised as a non-governmental organisation within the United Nationsâ€™ system and has official relations with the World Health Organisation. It is the international forum for medical students, and one of the largest student organisations in the world.
is to offer future physicians a comprehensive introduction to global health issues. Through our programs and opportunities, we develop culturally sensitive students of medicine, intent on influencing the transnational inequalities that shape the health of our planet.
Imprint Editors in Chief Esra H. Alzaid, Saudi Arabia Editors Hesham Ali, Egypt Design/Layout Ibrahim Kandeel, Egypt Omar H. Safa, Egypt
International Federation of Medical Studentsâ€™ Associations General Secretariat: IFMSA c/o WMA B.P. 63 01212 Ferney-Voltaire, France Phone: +33 450 404 759 Fax: +33 450 405 937 Email: email@example.com Homepage: www.ifmsa.org
Contents - Intro Morning SCOPHians................................................................4 - NO health without mental health......................................................5 - World Days & SCOPH......................................................................6 - HIV and the Death Sentence Taboo!..................................................7 - Health in dance steps.......................................................................8 - Media and Public Health ..................................................................9 - Non-communicable diseases as highpriority for population health......10 - Ping-pong, A Game For Life.............................................................12 - Diabetes: What you need to know.....................................................14 - What kind of SCOPHian are you ?....................................................17 - My Life as a Smoker.........................................................................18 - IFMSA Project Statuses......................................................................19 - IFMSA dances “samba” for health equity in Rio..................................20 - SCOPH Gallery................................................................................22 - SCOPH publications team.................................................................23
Intro Morning SCOPHians Anna Klicpera SCOPH Director
Dearest SCOPH-family! I am very happy to presenting to you the latest edition of “the Morning SCOPHian”. This is our SCOPH publication, which gives us the opportunity to present our projects to other SCOHPians, to share experiences we make and to raise awareness on different public health issues. It mirrors the whole latitude and richness of SCOPH. SCOPHians around the world all work on public health but from different angles. Coming from different backgrounds, having different possibilities and being exposed to different health problems, the approaches differ greatly. Some SCOPHians work on local issues such as the high incidence of diabetes and organize street campaigns to inform the local community about diabetes related health risks and their prevention. Some SCOPHians concentrate on national issues such as the lack of organ donors and coordinate nation-wide advocacy campaigns. Some SCOPHians fight global health issues such as climate change and start transnational projects. But although the scope and focus of these projects are very different, they all have one common goal- to improve public health. Because we are all working for the same goal, there is so much potential in our worldwide network. We can learn a lot from each other- using the same methods to tackle different issues or different methods to tackle the same problem. We can broaden our horizon, get to see different perspectives, learn to understand other cultures and gain further knowledge on diseases and their causes. “The Morning SCOPHian” is another tool, which helps us to achieve this. So, enjoy reading and get inspired!
ED IC AL· S
·INT ERNA TI
PH SCO ctor e Dir
S’ · A S S O C I
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On this note, I want to thank the people who have made this possible. First and foremost, all of you! You are the ones, who organize the projects, which are the foundation of our great standing committee. It is because of your work and motivation that medical students all around the world are making a difference and working together for public health! Thank you! I also want to thank the editors of this edition of the Morning SCOPHian. Esra Al’Zaid and the SCOPH Publication team, who all worked hard for this publication and all the authors who contributed to this edition. Keep up the great work you are all doing in your local committees, national member organisations and worldwide!
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NO health without mental health Being patient by any disease, that doesn’t mean you have a Catastrophic condition in your daily life , by the time you will pass this period of Disease without any problems in your life , may you will lose money for medicines ? May you will be away from you family for days, But you will return to your normal life working, travelling , dancing and enjoying your life with your family . But what about the patient with m ental illness?? Will our societies let them having normal lives? Will they give them the needed care? The needed treatment? Will their friends wait for them after recovery? Or do we believe that they are crazy people who will still patient for the rest of their lives?? So, don’t we need them with us , in streets , In our h omes ? Many questions without logical answers from our
Hesham Ali Ameen IFMSA-Egypt MSSA-Mansoura LPO
a nd are responsible for 13 percent of the global disease burden, and we need to increase the fundraising for our campaigns because Resources allocated for mental health by governments and civil society are habitually too little, both in human and financial terms. We need to increase focusing our campaigns in Most low- and middle-income countries because Poverty, unemployment, conflict and war all adversely affect mental health. In addition, the chronic, disabling nature of mental disorders often places a debilitating financial burden on individuals and households. Furthermore, individuals with mental health problems – and their families – endure stigma, discrimination and victimization depriving them of their political and civil rights and constraining their ability to participate in the public life of their societies. And here in Mansoura Students’ Scientific Association [ MSSA ] we take the first step by holding a big m arvelous seminar for medical students under the name of ( All of us is one ) about stigma toward psychiatry and mental illness , we had three big sessions the first one was about stigma in general by Prof.Dr. Wafaa’ El bahaey and we discussed reasons and the history that leaded our societies to societies , but still the biggest question , where are take this bad action toward mental illness’s patients the public health workers from this ? Where are , the second session was about stigma toward the NGOs? Where are the human rights NGOs? Where workers in the field of psychiatry both doctors and are the sponsors to donate campaigns to aware nurses by Dr/ Ahmed Dobee’ and we discussed how our societies against this Reactionary ideas? , Be- we can – as medical students – manage and coning mental illness’s patient means you have a dis- trol this problem between us and among our socieease like any other diseases, you have your right ties in home , street , club and in our daily routine to have a normal life without getting stigma !! , And during the last sessions we got recommendaAnd here our role in SCOPH as the greatest public tions from audience to the next steps in the projects . health workers is to advocacy our societies against the Dear friends at the end I want to say one senstigma of mental illness because the Mental disorders tence “NO health without mental health” are major contributors to illness and premature death,
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World Days & SCOPH
Day, World Party Day W orldandNutella International Joke Day?
There are a lot of World Days, which, though they sound like fun, are only related to public health in the broadest sense. But there are a lot of World Health Days, which deserve attention by people concerned with public health. People like you- SCOPHians from around the world. From World Haemophilia to World Hepatitis Day, a lot of diseases have a world day dedicated to them because of the big impact they have on public health. For example did you know that the Hepatitis viruses constitute a major global health risk with around 350 million people being chronically infected with hepatitis B and around 170 million people being chronically infected with hepatitis C? Or that only 25 per cent of those living with haemophilia are receiving adequate care? The World Days offer an opportunity to put focus on a certain disease and raise awareness on its causes, prevention, treatment and public health impact. For this reason many of you c elebrate World Days in your local committee and national member organisation. To get an overview about the World Days, which are celebrated in most NMO, the SCOPH Dream Team conducted a survey asking SCOPHians about the World Days they celebrate and the support they would like to have by the SCOPH Dream Team. 42 SCOPHians participated in the survey. Their answers showed that there are big differences in the popularity of world days. The World Days celebrated by most SCOPHians (more than 50%) are: World Diabetes Day, World Cancer Day and World No Tobacco Day. A little bit less common are celebrations of World Tuberculosis Day, World Health Day and World Blood Donor Day, followed by World Heart Day and World Mental Health Day. The survey also showed very clearly that there is still a lot of untapped potential within S COPH
6 | Public Health
Anna Klicpera SCOPH Director in regards to the World Days. Almost all participants stated that if the world days were coordinated internationally and the SCOPHians received more support, they could organise more actions. In particular, they would like to receive more information and ideas on actions they could do.
This means, that if we all help each other, we can make use of that potential! You are already organising a lot of great projects on the world days and realised very creative ideas. Now it is time to share these! Send an email to the SCOPH Yahoo-group and tell other SCOPHians what you have planned for a certain World Day! If you want to organise an action, but need fresh ideas, you can also send an email to the group and ask for input! Let’s plan the World Days together! It does not matter if it is as popular as the World No Tobacco Day or a neglected day such as the World COPD Day, the more we work together the more impact we have! Let’s keep SCOPH rocking-together!
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HIV and the Death Sentence Taboo I sat in silence and carefully observed “Juan,” whocame in for treatment after learning he was diagnosed with HIV. His main concern was if he had passed HIV to his 3 years old daughter. His eyes were filled with tears because his culture has taught him that having HIV is like a “death sentence.” I educated him that HIV is not a genetic disease, butrather that it would be depend on the mother’s status due to the high risk of HIV transmission during pregnancy or at birth. In this case, the mother was HIV-negative and had not passed the disease to their daughter. I could sense the relief he felt; however, his eyes still carried the sorrow that many other people have felt after learning about theirHIV-positive results. Like other patients, “Juan” was faced with the stigma of being HIV-positive and branded as dirty in the eyes of their fellow Dominican. Sadly, even physi-
Xelenia DePeña a 2nd year medical student at Iberoamerican University (UNIBE) inthe Dominican Republic and is currently co-investigator in researchprojects on HIV/AIDS and cancer.
is not “the end” or considered“dirty,” yet exists as a chronic disease that requires long-term treatment and certain precautions to optimize quality of life. cians have refused to care for patients, oncethey learn of the patient’s HIV-positive status. Unethical and a true shame to the medical profession,it is a startling reality in many developing countries. Society has created this vicious image that HIV is “the end,” as if life ceases to exist when infected with HIV. My concern lies with the mental healthof these HIV-positive patients, especially regarding their quality of life due to the long-term anti- retroviral therapy. It disheartens me to think these patients may be shunned from their family members or treated poorly by medical personnel. Indeed, the time has come for us to educate and eradicate this tainted view against HIV-infectedpersons. We need to promote tolerance and continue to educate the medical and general community that HIV disease
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Health in dance steps Author: Elena Dobrin National Project Coordinator NMO: FASMR (Romania) E-mail : firstname.lastname@example.org Since its creation, Students Federation of Medicine in Romania (FASMR), in the Department of Public Health (SCOPH), organizes campaigns to promote a healthy lifestyle and to combat ignorance in the most traditional universities of Romania, acquiring by this means a relevant experience in this field. Dancing is great aerobic workout that is not only fun, but also provides a great number of astounding health benefits. First of all it›s an aerobic exercise consisting of different unique steps, which are choreographed to music. Secondly, depending on the type of dancing, whether it is the Waltz or the Samba, the Charleston or the Meringue, it will determine the type of steps taken in accordance with the style of the dance. While dancing is great fun, there are many health benefits derived from this activity, including an improvement in your overall health, a reduction in stress, enhanced energy, easier digestion, weight loss, conditioning of the heart as well as lungs, improved cardiopulmonary functions and enhanced muscle tone and bone density. It has also been revealed that dancing can reduce the chances for developing such ailments as Alzheimer’s disease and also other types of dementia that are commonly found in elderly people. Studies even reveal that dancing regularly reduces
8 | Public Health
the risk of developing disorders such as carcinoma of the large intestine, diabetes, high blood pressure and heart-related ailments. Besides these health benefits, dancing allows you to remain slim and young. It is also a great way to get rid of worries as a result of a busy work schedule and other personal tensions . “Health in dance steps” is a national project which is conducted in the following universities: Bucharest, Craiova, Sibiu, Timisoara and Oradea. The project is for all students whether or not they have danced until now, in front of the mirror or practiced dance for competitions! It will be chosen a theme for the dances (different in each edition): the present one is Waltz (Viennese or Slow), Cha-cha, Jive + 1 surprise dance, the students will follow the selected theme, along with their dance instructors. The project will last for 8 weeks, from March 21st to May 18th. After learning the theme-related dances, there will be a selection of 3 teams from each university center, to represent that center to a national competition.
Direct Students from the faculties involved in the program; FASMR volunteers. Indirect Student’s parents, friends, known ones;
Objectives: 1. Promoting health amongst the participating
students - Acquiring a healthy lifestyle; - Explanation of physiologically and mentally terms and actions required for an optimum lifestyle. 2. Personal development of students - Knowing yourself better and gaining self-confidence - Teamwork; - Competitive spirit; 3. Prevention from - A sedentary way of living; -A negative attitude towards yourself and also towards others.
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Media & Public health Media plays a big role in health education , which could have positive and negative effects on public It serves the role of being a source of correct information as well as an advocate for correct health behaviors. But before the media can take on that role, it needs to understand the virus, the issues surrounding it, policy and practices, and finally, recommended correct behaviors health and if that wasn›t done properly, the negative effect could take place . The local and international media play a vital role as the link between health workers and the larger public. Health authorities educate and entrust the media with essential health information , which is then relayed to the public in readily accessible formats through a variety of media channels . For example, in order to disseminate information about the avian influenza to the wider public, the U.S. Government tasked the Academy for Educational Development with the responsibility of developing a training program to help the local media understand the complexity of this disease so that they would be able to report about it effectively. One of the most important roles mass media plays is reaching different standards of people ; being rich or poor , old or young , near or far , and that provides large amounts of information for too many humans with easy and accessible methods .
Radio Spots are the backbone of our mass me-
dia as they are very easy and quick to produce and broadcast . In the same spirit we make low cost tools, such as the gazety, accessible to large numbers of families, we broadcast dozens of spots on over ten fm stations every day, day in and day out.
The Internet Revolution allows people to
gain access to a wide array of health-related information from worldwide at a mouse click Since the Internet transcends geographical barriers, there is plenty of potential for websites to provide a valuable source of health information, thus enhancing health and wellbeing for people in developing countries. Howevere, there›s an important caveat about this method . As with the increase of information the false inaccurate information, misleading.
Mai El-ashmawy IFMSA-Egypt
Television is a powerful medium for appealing to
mass audiences—it reaches people regardless of age, sex, income, or educational level. In addition, television offers sight and sound, and it makes dramatic and lifelike representations of people and products . For audiences of the late 1950s, the 1960s, and the 1970s, television presented or reinforced certain health messages through product marketing. Some of these messages were related to toothpaste, hand soaps, multiple vitamins, fortified breakfast cereals, and other items. However, Public health authorities have expressed concern about the indirect influence of television in promoting false norms about acts of violence, drinking, smoking, and sexual behavior.
The distribution of pamphlets and leaflets created by specialized health bodies can disseminate vital health information reliably Also Belch and Belch estimate that newspapers are read daily in 70 percent of U.S. households, and in as many as 90 percent of high-income households. Newspapers permit a level of detail in health reporting not feasible with broadcast media. Whereas one can miss a television broadcast about breast cancer, and thus, lose its entire message, one can read the same (and more detailed) message in a newspaper at one’s choice of time and venue. Although newspapers permit consumers flexibility concerning what is read, and when, they do have a brief shelf life. In many households, newspapers seldom survive more than one or two days. So, The decision to use a particular medium should be based on audience research rather than on assumptions about its utility and audience reach. For instance, certain technologies are not particularly useful when : 1-they are utilized only by a small number of people 2- they are too complicated to be operated by the average person
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Non-communicable diseases as high priority for population health According to the World Health Organization (WHO), the four non-communicable (chronic) diseases that cause the largest morbidity and mortality for population health are cancer, cardiovascular disease, chronic respiratory conditions and diabetes. Causing more than 35 million deaths in 2005, or 60 percent of deaths worldwide, it is expected that non-communicable diseases will increase 17 percent in the next decade. The WHO has concluded that major risk factors associated with increased morbidity and mortality include obesity, sedentary lifestyle, tobacco use, hypertension, hyperglycemia and hyperlipidemia.4 Since chronic diseases share behavioral risk factors, the implementation of a regular routine of physical activity, adoption of a healthy diet, reduction of excess alcohol consumption and avoidance of tobacco products, can reduce risk of developing a non-communicable disease during an individual’s lifetime. This year, the month of September called for a change in our national and international health priorities and programs. Global news broadcasted the critical meeting in New York, where the United Nations General Assembly proposed new health priorities and focus on political and community action to combat the global epidemic of chronic disease. This meeting highlighted the chronic disease health burden that has increased to almost double those of communicable diseases, creating a necessity to combat non-communicable diseases to improve global health. In countries with limited resources, the social determinants of health demonstrate, as evidence, the health inequalities, where there are communities that live in conditions of extreme poverty, have low levels of education and poor access to primary health care services. Since many risk factors are shared among chronic diseases, prevention programs must include the promotion of health information that targets the adoption of healthy lifestyle behaviors. Community health fairs are optimal strategies to provide the health in-
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Helena J. Chapman Iberoamerican University (UNIBE) School of Medicine Santo Domingo, Dominican Republic formation in order to promote wellness and reduce morbidity and mortality from these chronic diseases. Understanding the impact of chronic disease on community health, health professional students in Santo Domingo, Dominican Republic, designed a health educational project to educate community members on risk factors and preventive measures related to two chronic diseases. From November 28 to December 2, 2011, forty-four medical, dental and psychology students from the Iberoamerican University (UNIBE) organized their health campaign, “Community awareness to noncommunicable disease! Santo Domingo.” They designed 25 posters for display and two educational brochures for distribution in the public common area within the university campus, educating community members on the alarming health concerns related to diabetes mellitus type 2 and chronic obstructive pulmonary disease. Health professional students worked in teams to develop the following informative poster display: “Why should I worry about my risk for chronic disease?”: Posters described the global priority to reduce chronic disease, alarming global statistics of disease distribution in the global population, objectives of the WHO Plan of Action 2008-2013 and methods to reduce risk of chronic disease. “Chronic disease: Prevention is key!”: Posters described the disease etiology, epidemiology, associated risk factors, basic pathophysiology, clinical presentation, diagnostic tests, clinical management and
ISSUE 5 MM 2012 prevention strategies. Both diseases were complemented with a clinical case to solidify the highlighted disease concepts. “Diabetes mellitus type 2: Let’s prevent!” “Chronic Obstructive Pulmonary Disease: Reduce your risk!” Reaching out to other university resources, they formed solid collaborations with the UNIBE Library, Fitness Center and Cafeteria, tailoring their health promotion activities with the following themes: “What scientific resources are available for diabetes mellitus type 2?” The UNIBE Library displayed bibliographic references of high-quality, evidence-based medical and scientific literature, where health professional students could identify where to learn more about clinical components of the disease. “Fitness: The best answer for a healthy lifestyle!” The UNIBE Fitness Center promoted the available exercise and health evaluation services. First, “The importance of cardiovascular activities,” promoted the daily aerobic and zumba classes. Second, “What are my health numbers?” highlighted the baseline measurements of height/weight and body mass index. Third, “Individual counseling for physical fitness” considered the personal consultations with the athletic trainers to maintain optimal weight control, aerobic resistance, flexibility and muscular strength. “Vegetables for health!” The UNIBE Cafeteria prepared culinary dishes with increased vegetable servings in the weekly menu.
References World Health Organization. (2008). 2008-2013 Action Plan for the global strategy for the prevention and control of noncommunicable diseases. Available at: http://www.who.int/nmh/publications/9789241597418/en/index.html. Accessed October 1, 2011. World Health Organization. (2011). United Nations high-level meeting on noncommunicable disease prevention and control. Available at: http://www. who.int/nmh/events/un_ncd_summit2011/en/index. html. Accessed September 22, 2011. World Health Organization. (2011). UN high-level meeting on NCD prevention and control. Available at: http://www.who.int/nmh/en. Accessed September 22, 2011. Narayan, K.M.V., Ali, M.K., Koplan, J.P. (2010). Global noncommunicable diseases – Where worlds meet. N Engl J Med 363(13):1196-1198. De Maio, F.G. (2011). Understanding chronic noncommunicable diseases in Latin America: Towards an equity-based research agenda. Globalization and Health 7(36):1-8.
UNIBE health professional students gained insight on two chronic diseases, specifically highlighting their etiology, risk factors and prevention strategies. Utilizing communication strategies in a poster display, they learned novel ways to present heath education information that will benefit how they relay information to their future patients. Community members learned the importance of developing healthy habits to reduce their risk to develop chronic disease.
Contact information: Helena J. Chapman, MD, MPH Iberoamerican University (UNIBE) School of Medicine Mailing address: Av. Francia No. 129, Gazcue, Santo Domingo, Dominican Republic Cel: 809-299-9409 Email: email@example.com
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Ping-pong, A Game For Life
Worldwide, eight out of 10 people still lack access to blood transfusions. Worldwide, each year we collect over 93 million units of blood, 50% in countries with low and middle income which account for more than 85% of the world. In these same countries, less than 25% of blood donations are collected from voluntary unpaid donors, a high proportion of supply still depends on replacement donors / for family members and paid donors. Yet today it is recognized that without a system based on voluntary, unpaid and regular blood donation, no country can ensure a safe, sustainable and sufficient blood for all patients requiring transfusion. The WHO estimates that if at least 1% of the population of a country gives blood, it is sufficient to cover basic needs of safe blood. In our country, in 2010, 190.557 units of blood were collected, less than 1% of our population ~200.000 bags. The rate of regular donors is 10.5% against 89.5% of occasional donors whose 60% are families donors. Faced with these figures, we realize that we are far from the target set by the WHO. However we believe there are as much blood as we think, it is sufficient to retain donors! It was therefore the aim of our campaigns on blood donation during the revolutionary year of 2011: «Building a culture of giving blood.» When we know that a blood bag has a lifetime of ~ 42 days, we realize that, beyond having a sufficient number of donors at a given moment, the important thing is to sustain this action by their perseverance and awareness them to become life-savers by volunteering to donate blood regularly. Our events have taken place not only around the campaigns, collections but also contributes to encourage donors. And here let me commend, once again, our people who showed unprecedented solidarity, during the Tunisian Revolution, replacing all forms of collection, in particular, collection of blood. They did not hesitate to respond to our calls at difficult, insecure and bloody times. That’s where we could appreciate the birth of the culture of gift to one’s neighbor, the gift of a vital and irreplaceable substance. Momentum that must be registered now in continuity.
Fatma Habboubi Associa-Med Tunisia National Public Health Officer 2011-2012 «Ping-pong, A Game For Life» was an initiative on the part of our SCOPH_Tunisia, at a time, to crown our year of continuous operations on blood donation, bringing awareness, collection and tribute to our young Donors. Then, to start the new academic year in our faculty. An opportunity to support and further strengthen our goal... This action has joined the useful part with the nice one: The useful because for this time of school year, it is known that we were entering a difficult period marked by the decline in donations because of school holidays and annual leave and the holy month of Ramadan. Thus, there had to work extra hard to ensure the additional requirements of this season known also by the increasing number of road accidents. And as always, SCOPH answered this call to this mission. As for the nice side, it is the mind a bit of the original action which is simply a game, a Pingpong game both fun and committed to the cause of giving blood. Bringing together under
one theme, the committees of public health. It was a sort of competition organized real-time
ISSUE 5 MM 2012 synchronized between the two faculties of Medicine of Tunis and Pharmacy of Monastir in cooperation with the National Blood Transfusion Centre and the respective faculties. The idea was to motivate students of both institutions to give their blood in a spirit of team play and challenge for a good cause ... and for Fun. Tunis Vs Monastir! Who will commit the most for blood donation? The faculty who collects the most bags will be named winner of the match «Ping-pong, A Game For Life « in its first edition and will be well rewarded. The action was publicized, the day before by one of our national radio stations, where we didn’t miss to get our messages of awareness to a wider audience. The D_day, on September the 20th, 2011, the two faculties were at the Rendezvous. A special feeling about the view of the influx of all these young people who lined up in a smile and good
humor, for a while, to finally donate their blood and even our professors have joined the game. Our dear SCOPHians were the first to open the game and to organize the work with the team from the center, to take advantage of the tail to spread awareness messages and from time to time to update the results of the two faculties on display screens which benefit the game and then to decorate each donor as he left the room by a nice Hawaiian necklace made locally by the pretty hands of our SCOPHian Girls. It was a memorable atmosphere.
not change this, the relationship between the two parties was on the contrary strengthened, a friendly atmosphere, each player has enjoyed playing this noble game for life with his colleagues. Because in the end, the real winner will be the patient transfused, the saved person... Dr Neelam Dhingra, Coordinator of Blood Safety Team at the WHO, once said: «Young people represent both the hope and the future of a global supply of safe blood… We believe that more countries will achieve the goal of 100% voluntary donation if they send a message targeted to youth.» This initiative on our part, was just another way to approach an issue. We were seeking creativity in order to always get a little more attention to our target audience and make them think differently and more to the cause. Hoping to reach the 1 percent that the WHO has designated and why not, one day, the 100 percent of volunteer, non-remunerated and regular donors. Very soon we will be celebrating the second edition of “Ping-pong, A Game For Life “ on a higher level ... So, my friends, if our game interested you, please feel free to join. Become “Pongists “ for a good cause. On this, I want to say: It is a BIG WORLD out there and everybody needs help, so do not hesitate to give your helping hand, to give your blood, to give for life.
In less than 3 hours and a half (time of the competition), it was able to collect 142 bags of blood between the two faculties. The collection has continued even after the competition had been declared over and the number of donors hasn’t stopped climbing. The announcement of the winning faculty did
o 346 million people worldwide have diabetes
Diabetes: What you need to know
Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced.
There are three main types of diabetes : Type 1 diabetes is sometimes called insulin-dependent, immune-mediated or juvenile-onset diabetes. It is caused by an auto-immune reaction where the bodyâ€™s defence system attacks the insulin-producing cells. The reason why this occurs is not fully understood. People with type 1 diabetes produce very little or no insulin. The disease can affect people of any age, but usually occurs in children or young adults. People with this form of diabetes need injections of insulin every day in order to control the levels of glucose in their blood. If people with type 1 diabetes do not have access to insulin, they will die.
Type 2 diabetes is sometimes called non-insulin dependent diabetes or adult-onset diabetes, and accounts for at least 90% of all cases of diabetes. It is characterised by insulin resistance and relative insulin deficiency, either of which may be present at the time that diabetes becomes clinically manifest. The diagnosis of type 2 diabetes usually occurs after the age of 40 but can occur earlier, especially in populations with high diabetes prevalence. Type 2 diabetes can remain undetected for many years and the diagnosis is often made from associated complications or incidentally through an abnormal blood or urine glucose test. It is often, but not always, associated with obesity, which itself can cause insulin resistance and lead to elevated blood glucose levels. Gestational diabetes (GDM) is a form of diabetes consisting of high blood glucose levels during pregnancy. It develops in one in 25 pregnancies worldwide and is associated with complications in the period immediately before and after birth. GDM usually disappears after pregnancy but women with GDM and their offspring are at an increased risk of developing type 2 diabetes later in life. Approximately half of women with a history of GDM go on to develop type 2 diabetes within five to ten years after delivery. Other specific types of diabetes also exist. Assumable Risk Factors for type 1 diabetes - genetic factor: Having a family member with type 1 - increased height and weight development - increased maternal age at delivery - exposure to some viral infections
Risk Factors for type 2 diabetes
- Obesity - Diet and physical inactivity - Increasing age - Insulin resistance - Family history of diabetes - Ethnicity
Type 2 diabetes accounts for at least 90% of all cases of diabetes.
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People at high risk of diabetes should have their plasma glucose levels measured by a health professional to detect Impaired Fasting Glucose or Impaired Glucose Tolerance, both of which indicate an increased risk of type 2 diabetes. Prevention efforts should target those at risk in order to delay or avoid the onset of type 2 diabetes. Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use can prevent or delay the onset of type 2 diabetes.
Warning signs poster
Common consequences of diabetes:
Increased risk of heart disease and stroke Diabetic neuropathy affects up to 50% of people with diabetes. Common symptoms are tingling, pain, numbness, or weakness in the feet and hands. Diabetic neuropathy in the feet increases the chance of foot ulcers and eventual limb amputation. Frequent urination Diabetic retinopathy occurs as a result of long-term Excessive thirst accumulated damage to the small blood vessels in the Increased hunger retina. After 15 years of diabetes, approximately 2% Weight loss of people become blind, and about 10% develop seTiredness vere visual impairment. Lack of interest and concentration Vomiting and stomach pain (often mistaken as the flu) kidney failure. 10-20% of people with diabetes die of A tingling sensation or numbness in the hands or feet kidney failure. The overall risk of dying among people with diabetes Blurred vision is at least double the risk of their peers without diaFrequent infections betes. Slow-healing wounds
Diagnosis and treatment: Early diagnosis can be accomplished through relatively inexpensive blood testing. Treatment of diabetes involves lowering blood glucose and the levels of other known risk factors that damage blood vessels. Tobacco use cessation is also important to avoid complications. Interventions that are both cost saving and feasible in developing countries include: Moderate blood glucose control. People with type 1 diabetes require insulin; people with type 2 diabetes can be treated with oral medication, but may also require insulin; blood pressure control; foot care.
World Diabetes Day As we realise, diabetes is an important issue. Therefore, one of our most inspiring activities is the celebration of World Diabetes Day. Medical students across the globe join their voices, promoting awareness by organising seminars, street actions, events, playing games with the public and forming human circles.
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Photos of circles, Indonesia, 2 Egypt & 2 Turkey
But why circle? The circle symbolizes unity, diabetes makes no discrimination so we must all work together to fight back! The World Diabetes Day logo itself is a blue circle. Blue is the colour of the sky, reminding us that we are all together in this. The World Diabetes Day is held on November 14 of each year. It was introduced in 1991 by the International Diabetes Federation and the World Health Organization in response to the alarming rise of diabetes around the world. World Diabetes Day is a campaign that features a new theme chosen by the International Diabetes Federation each year to address issues facing the global diabetes community. While the campaigns last the whole year, the day itself marks the birthday of Frederick Banting who, along with Charles Best, first conceived the idea which led to the discovery of insulin in 1922.
WDD LOGO Each year, World Diabetes Day is centred on a theme related to diabetes. Topics covered have included diabetes and human rights, diabetes and lifestyle, diabetes and obesity, diabetes in the disadvantaged and the vulnerable, diabetes in children and adolescents, and talking about Diabetes
Table with past themes 2004: Diabetes and Obesity 2005: Diabetes and Foot Care 2006: Diabetes and the Disadvantaged and Vulnerable 2007: Diabetes in Children and Adolescents 2009-2013: Diabetes education and prevention
16 | Diabetes
ISSUE 5 MM 2012
What kind of SCOPHian are you We all know that Standing Committee on Public Health is very popular among medical students. Indeed, SCOPH gets very successful and productive since it has many supporters all over the world. Those supporters are called â€˜SCOPHiansâ€™. The word of SCOPHian must have been used in thousands of emails, hundreds of articles, and perhaps, it has been said and heard by millions of people so far. Even, the name of this magazine you are reading now contains that word. We, as SCOPHians, are used to see that lovely word around. But, are all the people called SCOPHian a real SCOPHian?
Selin Arslan TurkMSIC Istanbul LC Former Local Public Health Officer and organize or attend events, campaigns, lectures etc. although you have a lot of upcoming exams, - If you enjoy exchanging emails and chatting online with the medical students around the world to create a project for a better future, - If you consider the benefits of other people as your primary objective while working for public health, - If you get happy when you see the photographs of other people from different countries doing the similar things for the same project as you did before, It means you are a TRUE SCOPHian... The most important of all, if you decide to be a SCOPHian, you eventually gather all the features written above. So, I can count each SCOPHian as TRUE SCOPHian!
Let me explain:
- If you can spell SCOPH without hesitation and say correctly the long form of it in two seconds, - If you go to a shopping mall preferring to measure blood sugar, take blood pressure, give out flyers on health issues, talk about the prevention of Non-Communicable Diseases rather than check out the new collection of jeans, - If you think sharing a video about the environment or a social problem on the internet can make a difference, - If you feel excited about celebrating World Days with your colleagues to show the world that you care about it, - If you are willing to do something about creating public awareness on anything related to public health
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My Life as a Smoker I stubbed out the fire with my thumb, thinking this to be my last one. Nevertheless, no matter how hard I tried to let go, one cringe, one sight, a far off smell or a photo would bring back memories of this single piece of paper with something precious and heavenly wrapped in it , it took my breath away the first time I had it. Literally. My sense of self was filled with a desire to fly and reach the stars, and maybe only this small, apparently unimportant piece of substance could help me do that. All my worries were flushed out of my system, and I stayed in the abyss that I had lowered myself into. I am not talking about falling in love but of course it was like falling in love with a cigarette. It was just one single puff that plunged me into the whirlpool of uncertainty, ecstasy and euphoria. I found that I could puff out my worries as easily as they had entered my being, it was a new avenue for me. Failing my O levels and my father’s drunkenness was one problem, puffing them out was another. Three months ago I was diagnosed with stage III metastatic small cell carcinoma of the lung (that’s what the doctors said).In easy words, it’s lung cancer that I’ve got, and it has already more than half eaten up my left lung. The reason? My wonderful little piece of tobacco stick, my cigarette, which was bequeathed to me by one of my friends. Unfortunately, he died last month from a drug overdose. And cancer. An optimistic thought isn’t it? It all started when I started to cough up blood. Coughing had become a part of my routine till then, but my anxiety was stirred when I noticed the reddish brown spots on my pillow one morning. I lit a cigarette, as I usually did when I was worried, and blew my apprehension away. The next day, I saw some more red when I was coughing my chest out in the bathroom , and fortunately my mother saw it. Being a worry wart that all mothers are, she ordered me to go to the outpatient department of a nearby tertiary care hospital, and I obeyed her for the first time in years. All along the way, I was puffing at my little haven of relief and ecstasy, not even considering for a moment that I could be on a disastrous path, and I was maybe even making it worse by taking refuge in the billowing smoke of my cigarette. Nothing spectacular hap-
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pened in the hospital: the doctor gave me a regular check up and ordered some tests, which of course I didn’t go for because as soon as I exited the hospital, I noticed how I had smoked my whole packet of cigarettes since that morning. And so I went to the nearest general store and bought a whole new packet. The doctor’s prescription was, of course, forgotten, and a few lies to my worry stricken mother were enough for her to forget the episode. A stitch in time saves nine, they say. It was that time when I could have saved myself, could have my family the pain and suffering they are going through now, could have the saved the money they are spending in terms of my hospital bills. Alas! Man is only ever aroused when it is too late. I couldn’t breathe; it was again morning and I was gobbling down my breakfast while watching the morning news. Suddenly it became very warm: I opened my tie but found out that I still couldn’t breathe. I opened my mouth wide to gulp air in but it just wouldn’t enter where it was supposed to, and I was taken to the emergency department to the same hospital I had visited before. Seconds after, a metallic tube was thrust via my neck into my throat and that’s when I regained my air supply. Thereafter, I was shifted in the ward to await further evaluation, as I lay there contemplating the events of the day and wanting another “smoke”, I saw the same doctor who had ordered the relevant tests for me before, rounding with the others. He recognized me immediately and walked up to my bed. “Hey you! You didn’t come in for a follow up. What happened?” I quickly told him and he sighed and nodded. “I thought so, I knew you’d reach this stage. I just wish you’d checked in earlier with your test results, and stopped smoking as I advised you to.” Moments later I understood it all: I had cancer, which had extended from my lungs to my liver and stomach, and my throat. In the blink of an eye, I had smoked away my aspirations, my life, my career, and myself. SANEELA ALTAF 4TH YEAR -SINDH MEDICAL COLLEGE
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Projects are the heart of IFMSA , the actions of our Federation that create a positive impact on the world and our communities. SCOPH is the most active standing committee of IFMSA projects, with a handful of endorsed projects, over fifteen related transnational projects and substantial involvement in the IFMSA initiatives. Featured in this issue of the Morning SCOPHian, you will find more examples of SCOPH projects from around the world, some recognised with IFMSA status and others not yet. So what are the IFMSA projects statuses about? Currently under section ten of the IFMSA by-laws, projects are recognised in three categories - endorsed, transnational and initiative. There is a detailed explanation of the processes to apply for each project status in the by-laws so these technical aspects will not be discussed in this article. Instead, I wish to highlight some of the conceptual frameworks for the project statuses. Endorsed projects are projects from one national member organisation (NMO) and may include external partners. These projects function largely autonomously from the direction of IFMSA. Some of the benefits that they receive from IFMSA are an official letter of endorsement, promotions through IFMSA networks and access to support from the projects support division. Transnational projects are projects from at least two different NMOs. The project coordinators are selected yearly by IFMSA in conjunction with the previous coordinators, thus IFMSA takes a more active role in the management of these projects. Standing committeesâ€™ directors and liaison officers also work closely with these projects. Some of the benefits they receive from IFMSA are technical input from the projects support division, the use of IFMSA banking services and quality monitoring and improvement through the projects proposal review committee (PPRC). Initiatives are focus areas that the executive board (EB) of IFMSA have deemed important for the
Phillip Chao Projects support division director Federation and accepted at the general assemblies by NMOs. Initiatives are centrally coordinated by IFMSA with aims of capacity building NMOs and external representation of the Federation on the focus area. Initiative coordinators are selected by the EB and the coordinator is the main responsible for realising the outcomes from the accepted proposal of the initiative. There are several challenges and opportunities that face projects for IFMSA and the projects support division is constantly looking for ways to improve the structure. One of the important challenges we are now working on is quality improvement. Many projects, especially transnational projects, have been running for several years and some are perhaps less relevant now than when they were first proposed. We want to ensure that IFMSA recognised projects are high quality and pertinent to the needs of the populations they serve. The projects support division is undergoing an extensive revision process of what projects mean to IFMSA, the utility of the project status categories and review of existing projects. It would be great to have experienced SCOPHians in projects involved in this revision process as projects are a large part of SCOPHâ€™s work. Contact firstname.lastname@example.org
to express your interest to join the small working group otherwise we would still very much appreciate hearing your thoughts.
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IFMSA dances for health equity in Rio
The IFMSA delegation in the World Conference on Social Determinants of Health.
IFMSA dances “samba” for health equity in Rio Ramon Lorenzo Luis R. Guinto
No, we did not literally dance samba in front of the WHO Director-General. But yes, our voices were like samba, full of energy and passion, as we spoke out for health equity during the World Conference of Social Determinants of Health last October 19-21, 2011 in Rio de Janeiro, Brazil. The World Conference, organized by WHO and the Government of Brazil, aimed to “engage high level political support to make progress on national policies to address social determinants of health to reduce health inequities.” More than a thousand representatives from governments, UN agencies, academies, and civil society participated in the event. The conference is an off-shoot of the 2008 report of the WHO Commission on Social Determinants of Health, a high-level expert panel that analyzed evidence from around the world illustrating how social determinants of health – the conditions in which people are born, grow, live, work and age – bring about avoidable health inequities within and between countries.
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IFMSA sent a 10-member delegation representing all continents, led by members of SCOPH’s Small Working Group on Health Inequities. The SWG, which was created at the start of 2011, has grown into a huge family of medical students who wish not to see inequities in health anymore in their lifetime. For months, the SWG worked hard in preparing for the World Conference. Members attended consultations and meetings in different WHO offices, an IFMSA statement on social determinants of health was submitted to WHO headquarters in Geneva, a commentary was published in the British journal The Lancet, and a joint SCOPHSCORP-SCOME session with Professor Sir Michael Marmot, the head of the WHO Commission on Social Determinants of Health, was co-organized during the August Meeting in Copenhagen last 2011. These efforts culminated in the IFMSA Week of Global Action on Social Determinants of Health which was participated in by around 20 countries. But while the NMOs are holding local activities and talking about SDH, the IFMSA delegation in Rio is making use of the precious opportunity to lobby governments, establish links with other NGOs, and express the sentiments of young people on the issue of global health equity. The members of the delega-
ISSUE 5 MM 2012 tion divided the numerous sessions – spanning broad issues such as governance, people’s participation, global cooperation, and monitoring of progress – among them in order to ensure that we medical students leave an imprint in each aspect of the conference. The conference also served as an opportunity for exchange of best practices in tackling social determinants among countries. Brazil boasts its Bolsa Familia conditional cash transfer program which aimed to break the cycle of poverty among Brazilian families, which is a leading cause of ill health. The “Health in all policies” approach in South Australia offers an example of a whole-of-government model that engages all government departments outside health to contribute to the improvement of population health outcomes and reduction of health inequities. Thailand’s National Health Assembly provides a blueprint for wide participation among NGOs and ordinary citizens in the crafting of health priorities and laws at the high policy level.
The IFMSA delegation also crafted its own statement that was distributed to the participants on the last day of the conference. Some of the highlights of the statement include: the importance of tackling the maldistribution of wealth, power, and resources; the value of democratic governance in addressing social determinants; the refashioning of global economic governance; and the recognition of the role of young people in addressing social determinants and reducing health inequities. The statement, which can be retrieved from the IFMSA wordpress blog, was lauded even by distinguished personalities in-
After the World Conference, there remains a 40year gap in life expectancy between Japan and Sierra Leone, and a 10-fold gap in maternal mortality rates between the rural and the urban parts of the Philippines. This tells us that health inequities still exist within and between countries, and that the work in addressing the social determinants of health does not end in Rio. We can only achieve health equity if IFMSA as a Federation will sustain this global movement and will keep on dancing this “samba” until “health for all” becomes a reality. Ramon Lorenzo Luis R. Guinto (Renzo) is the facilitator of the SCOPH Small Working Group on Health Inequities and head of the IFMSA delegation in the World Conference on Social Determinants of Health. He is also the Regional Coordinator for the Asia-Pacific of IFMSA and immediate president of the Asian Medical Students’ AssociationPhilippines, the IFMSA NMO in the Philippines.
“Health Equity for All”
Just like any United Nations conference, the highlight is the unveiling of the Rio Political Declaration on Social Determinants of Health. There were mixed reactions among the attendees. Some found the document as a major step towards reviving the spirit of the 1978 Alma Ata Declaration on Primary Health Care, which is the first document that recognized the need for intersectoral action in addressing health challenges across the globe. Others, especially civil society groups, noted the Rio Declaration’s silence on crucial issues such as the trade policies and agreements as a social determinant of health; the alignment of the ongoing WHO reforms with social determinants; and the links between social determinants, health equity, and climate change.
cluding Sir Michael Marmot, Claudio Schuftan of the People’s Health Movement, and Steve Schmidbauer of Child and Family Health International.
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Email : email@example.com Mobile : (+2) 01093709663 Website : www.mssa-mnf.org
Hesham Ali Ameen Local public health Officer (LPO) Mansoura Students’ Scientific Association IFMSA-Egypt Email : firstname.lastname@example.org Mobile : (+2) 01065479053 Website : www.mssa-eg.org
Esra H. Alzaid IFMSA-SCOPH RA for EMR 2011/2012 IFMSA-SA
SCOPH publications team
Ibrahim Ahmed Kandeel Publications support division director Menofia Students’ Scientific Association IFMSA-Egypt
Email : email@example.com Mobile : (+966) 505891968
Algeria (Le Souk) Argentina (IFMSA-Argentina) Armenia (AMSP) Australia (AMSA) Austria (AMSA) Azerbaijan (AzerMDS) Bahrain (IFMSA-BH) Bangladesh (BMSS) Belgium (BeMSA) Bolivia (IFMSA Bolivia) Bosnia and Herzegovina (BoHeMSA) Bosnia and Herzegovina - Rep. of Srpska (SaMSIC) Brazil (DENEM) Brazil (IFMSA Brazil) Bulgaria (AMSB) Burkina Faso (AEM) Burundi (ABEM) Canada (CFMS) Canada-Quebec (IFMSA-Quebec) Catalonia - Spain (AECS) Chile (IFMSA-Chile) China (IFMSA-China) Colombia (ASCEMCOL) Costa Rica (ACEM) Croatia (CroMSIC) Czech Republic (IFMSA CZ) Denmark (IMCC) Ecuador (IFMSA-Ecuador) Egypt (EMSA) Egypt (IFMSA-Egypt) El Salvador (IFMSA El Salvador) Estonia (EstMSA) Ethiopia (EMSA) Finland (FiMSIC) France (ANEMF) Georgia (GYMU) Germany (BVMD) Ghana (FGMSA) Greece (HelMSIC) Grenada (IFMSA-Grenada) Hong Kong (AMSAHK) Hungary (HuMSIRC) Iceland (IMSIC) Indonesia (CIMSA-ISMKI) Iran (IFMSA-Iran) Israel (FIMS) Italy (SISM) Jamaica (JAMSA) Japan (IFMSA-Japan) Jordan (IFMSA-Jo) Kenya (MSAKE) Korea (KMSA) Kurdistan - Iraq (IFMSA-Kurdistan/Iraq)
Kuwait (KuMSA) Kyrgyzstan (MSPA Kyrgyzstan) Latvia (LaMSA Latvia) Lebanon (LeMSIC) Libya (LMSA) Lithuania (LiMSA) Luxembourg (ALEM) Malaysia (SMAMMS) Mali (APS) Malta (MMSA) Mexico (IFMSA-Mexico) Mongolia (MMLA) Montenegro (MoMSIC Montenegro) Mozambique (IFMSA-Mozambique) Nepal (NMSS) New Zealand (NZMSA) Nigeria (NiMSA) Norway (NMSA) Oman (SQU-MSG) Pakistan (IFMSA-Pakistan) Palestine (IFMSA-Palestine) Panama (IFMSA-Panama) Paraguay (IFMSA-Paraguay) Peru (APEMH) Peru (IFMSA Peru) Philippines (AMSA-Philippines) Poland (IFMSA-Poland) Portugal (PorMSIC) Romania (FASMR) Russian Federation (HCCM) Rwanda (MEDSAR) Saudi Arabia (IFMSA-Saudi Arabia) Serbia (IFMSA-Serbia) Slovakia (SloMSA) Slovenia (SloMSIC) South Africa (SAMSA) Spain (IFMSA-Spain) Sudan (MedSIN-Sudan) Sweden (IFMSA-Sweden) Switzerland (SwiMSA) Taiwan (IFMSA-Taiwan) Tanzania (TAMSAz) Tatarstan-Russia (TaMSA-Tatarstan) Thailand (IFMSA-Thailand) The former Yugoslav Republic of Macedonia (MMSA-Macedonia) The Netherlands (IFMSA-The Netherlands) Tunisia (ASSOCIA-MED) Turkey (TurkMSIC) Uganda (FUMSA) United Arab Emirates (EMSS) United Kingdom of Great Britain and Northern Ireland (Medsin-UK) United States of America (AMSA-USA) Venezuela (FEVESOCEM)
www.ifmsa.org medical students worldwide
Published on Mar 19, 2012
Published on Mar 19, 2012
The official biannual publication of the Standing Committee on Public Health, published at the March Meeting General Assembly of the Interna...