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IFMSA-Africa Newsletter Means of communication for African Medical Students

May/June 2006, Volume 2, Number 3

Editorial

Events in Africa Dear Friends,

31 May World No Tobacco Day

Our conclusions and assumptions towards others are usually based on our own culture, upbringing and education, coloured by what we hear in the media or movies and what we know from our own experiences. However, it is important to keep an open mind; things are often different than we might think. This is especially important and challenging when working in an international organization, like IFMSA.

5 June World Blood Donor Day

In this issue, Ahmed Ali takes us back to his first travel to Europe and shares his experiences, thoughts and doubts with us. These might give us all new insights and could serve as a new step in the discussion on the improvement of SCOPE and SCORE exchanges in Africa. Also, the country of Sudan, the host of the next African Medical Students’ Training Congress in December 2006, is shown to us in all its beauty. And again, things are not always what they seem!

14 June World Environment Day 19 -21 June 2006 2nd African conference on Sexual Health and Rights, Nairobi, Kenya 29 October – 2 November 2006 Global Forum for Health Research, Cairo, Egypt December 2006 Third International Student Conference on HIV/AIDS (ISCA), Cameroon 24 -30 December 2006 African Medical Students’ Training Congress (AMSTC), Khartoum, Sudan

The newsletter team

Contents

IFMSA-Africa Leadership 2005-2006 Regional Coordinator for Africa Ahmed Ali, Sudan

Who is who

2

World Blood Donor Day

2

New Study: FGM exposes women and babies to significant risk at childbirth

3

African Tourist Memory

4

• SCOPE Vacant

Welcome to Sudan

5

• SCORE Hany Ezzat, Egypt

Colophon

7

Regional Assistants for Africa • SCORA Jennifer Mbabazi, Rwanda Oluwatosin Omole, Nigeria

• SCOPH Hossam Hamad, Sudan • SCORP Tana Mohammed, South Africa Mubashar Ahmed, Sudan • SCOME Vacant Liaison Officer WHO Serini Murugasen, South Africa

IFMSA-Africa Newsletter

May/June 2006

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Who is who? World Blood Students who are active in the African region introduce themselves. In this issue: Ayodeji Adewunmi.

Donor Day Most countries fall short of ensuring a safe blood supply but some progress has been made. World Blood Donor Day (WBDD) was established at the 58th World Health Assembly in May 2005 by WHO's 192 Member States, to urge all countries in the world to thank blood donors, promote voluntary, unpaid blood donations and ensure safe supplies of blood for all.

Ayodeji Adewunmi, Nigeria Founder and the International Coordinator ICOM My name is Ayodeji Adewunmi. A student of medicine & surgery at the Obafemi Awolowo University in Nigeria. I am the Founder and the International Coordinator - External Affairs & Partnerships, IFMSA Campaign on Malaria (ICOM). Malaria is one of those diseases that seldom sends shiver down the spine, though it silently continues to kill millions of people around the world. What a painful irony?! In the fall of 2003, Victoria Lee, the then Director of Public Health, asked me to come up with a regional project for the African region. I was at that time the African Regional Assistant for Public Health. I was moved by the simplicity and sincerity of her request, and today the rest is history. I am involved in this initiative for two reasons; one, I felt the world has suffered too great a burden from malaria to be ignored by us medical students, and two, I was convinced that the coordinated efforts of medical students could help the world to move a step closer in rolling back malaria. This is the hope I see in the ICOM and I invite you to come join us. To learn more about the ICOM, email me at adewunmiayodeji@gmail.com.

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June 14 was chosen because it is also the birthday of Karl Landsteiner, who discovered the ABO blood group system. The day is supported by three major organisations working for voluntary nonremunerated blood donation: the International Federation of Red Cross and Red Crescent Societies, the International Federation of Blood Donor Organisations and the International Society of Blood Transfusion. These organisations have been joined by the World Health Organisation, which is cosponsoring the event. The need for safe blood The overwhelming majority of the world’s population do not have access to safe blood. More than 80 million units of blood are donated every year around the world, but only 38% is collected in developing countries where 82% of the global population live. WBDD will help raise awareness of the issues that these countries face. Unpaid voluntary donors Regular, unpaid voluntary donors are the mainstay of a safe and sustainable blood supply because they are less likely to lie about their health status. Evidence indicates that they are also more likely to keep themselves healthy. South Africa, for instance, has an HIV prevalence of 23.3% in the adult population but only 0.03% among its regular blood donors. Global survey On this Day, 14 June, the World Health Organization (WHO) publishes findings from its most recent global survey on blood collection and blood testing practices. The WHO survey shows that out of the 124 countries that provided data to WHO, 56 saw an increase in unpaid voluntary donation. The remaining 68 have either made no progress or have seen a decline in the number of unpaid

May/June 2006

voluntary donors. Of the 124 countries, 49 have reached 100% unpaid voluntary blood donation. Out of those 49, only 17 are developing countries. The number of donations per 1000 population is about 15 times greater in high-income than in low-income countries. This is concerning because developing countries have an even greater need for sustained supplies of safe blood since many conditions requiring blood transfusions - such as severe malaria-related anaemia in children or serious pregnancy complications - are still claiming over one million lives every year. About 25% of deaths caused by severe bleeding during delivery could be prevented through access to safe blood. In the area of blood testing, 56 out of 124 countries did not screen all of their donated blood for HIV, hepatitis B and C and syphilis. Reasons given for this include scarcity or unaffordability of test kits, lack of infrastructure and shortage of trained staff. On the other hand, several countries have risen to the challenge. Of the countries surveyed, St. Lucia made the biggest jump forward, going from 24.39% of collected blood coming from unpaid volunteers in 2002 to 83.05% in 2004. According to government responses to the WHO questionnaire, the reason for progress is tied to stronger AIDS prevention programmes. Commitment Commitment was the theme of this year's World Blood Donor Day; from regular and potential donors, but also from governments and the global community to maintain blood safety high on the agenda as a vital factor in treatment and disease prevention. Chosen and rewritten by: Hossam Hamad

Sources: http://www.bbc.co.uk/health/awareness_ campaigns/jun_worldblooddonor.shtml http://www.who.int/medicines_technologi es/archive/2006_pr33/en/index.html

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New study: FGM exposes women and babies to significant risk at childbirth 2 JUNE 2006 | GENEVA -- A new study published by the World Health Organization (WHO) has shown that women who have had Female Genital Mutilation (FGM) are significantly more likely to experience difficulties during childbirth and that their babies are more likely to die as a result of the practice. Serious complications during childbirth include the need to have a caesarean section, dangerously heavy bleeding after the birth of the baby and prolonged hospitalization following the birth. The study showed that the degree of complications increased according to the extent and severity of the FGM. In the case of caesarean section, women who have been subjected to the most serious form of FGM ("FGM III") will have on average 30 per cent more caesarean sections compared with those who have not had any FGM. Similarly there is a 70 per cent increase in numbers of women who suffer from postpartum haemorrhage in those with FGM III compared to those women without FGM.* "As a result of this study we have, for the first time, evidence that deliveries among women who have been subject to FGM are significantly more likely to be complicated and dangerous," said Joy Phumaphi, Assistant Director-General, Family and Community Health, WHO. "FGM is a practice steeped in culture and tradition but it should not be allowed to carry on. We must support communities in their efforts to abandon the practice and to improve care for those who have undergone FGM. We must also steadfastly resist the medicalization of FGM. WHO is totally opposed to FGM being carried out by medical personnel." The study also found that FGM put the women's babies in substantial danger during childbirth. Researchers found there was an increased need to resuscitate babies whose mother had had FGM (66% higher in women with FGM III). The death rate among babies during and immediately after birth is also much higher for those born to mothers with FGM: 15% higher in those with FGM I, 32% higher in those with FGM II,

IFMSA-Africa Newsletter

and 55% higher in those with FGM III. It is estimated that in the African context an additional 10 to 20 babies die per 1000 deliveries as a result of the practice. "This research was carried out in hospitals where the obstetric staff are used to dealing with women who have undergone FGM. The consequences for the countless women and babies who deliver at home without the help of experienced staff are likely to be even worse," added WHO's Dr Paul Van Look, Director of the Special Programme for Human Reproduction Research (HRP) which organized the study. The study involved 28,393 women at 28 obstetric centres in six countries, where FGM is common - Burkina Faso, Ghana, Kenya, Nigeria, Senegal and Sudan. The centres varied from relatively isolated rural hospitals to teaching hospitals in capital cities. They were chosen to provide appropriate diversity of types of FGM. "These findings are of great importance for countries," said Professor Saad M El Fadil, the study Principal Investigator in Sudan. "This high-quality research was carried out in numerous hospitals in African countries where FGM is common and for the first time gives clear evidence of its harmful effects for women and babies." FGM is a common practice in a number of countries, predominantly in Africa. It involves partial or total removal of the external female genitalia or other deliberate injury to the female genital organs whether for cultural or nontherapeutic reasons. Over 100 million women and girls are estimated to have had FGM worldwide. Although practices vary from country to country, FGM is generally performed on girls under 10 years of age and leads to varying amounts of scar formation. It is not entirely clear why FGM leads to increased complications during childbirth, but one possible explanation is that this scar tissue is relatively inelastic and can lead to obstruction and tearing of the tissues around the vagina during

May/June 2006

childbirth. Obstruction can lead to prolonged labour, which increases the risk of caesarean section, heavy bleeding, distress in the infant and stillbirth. Women with FGM are also more likely to undergo episiotomy (surgical cut during delivery to prevent vaginal tears). According to Associate Professor Emily Banks of the Australian National University, "This study shows that where around 5.0% of babies born to women without FGM were stillborn or died shortly after delivery, this figure increased to 6.4% in babies born to women with FGM. In many parts of Africa death rates are even higher and the impact of FGM is likely to be even greater." The authors of the study say that this new evidence is of crucial importance to communities where FGM is practiced, both for the women who have had FGM and to protect future generations of women and girls from FGM. FGM remains a pressing human rights issue and reliable evidence regarding its harmful effects, both for mothers and their babies, should contribute to the abandonment of the practice. WHO is committed to work with international partners and countries to eliminate FGM. It is in direct violation of young girls’ rights, has both short-term and long-term adverse health consequences, and is an unnecessary procedure. Chosen and rewritten by : Sophie Gubbels Source and contact details in WHO: http://www.who.int/mediacentre/news/rel eases/2006/pr30/en/index.html *Note: Female genital mutilation (FGM), often referred to as 'female circumcision', covers all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural, religious or other non-therapeutic reasons. There are different types of female genital mutilation known to be practised today. They include:

• •

Type I (FGM 1) - excision of the prepuce, with or without excision of part or all of the clitoris; Type II (FGM II) - excision of the clitoris with partial or total excision of the labia minora; Type III (FGM III) - excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening (infibulation)

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African Tourist Memories By: Ahmed Ali When I first decided to write for the newsletter, I was thinking to write something about IFMSA and how to improve Africa, but then I decided to leave all that and tell you about an experience that I felt was interesting to share with you! May 2004 was the month decided for my clerkship in professional exchange in a small beautiful European country. At the same time it was my first contact with Europe. When I took the plane from Cairo to my transit in Europe, I didn’t feel a big difference as a considerable percentage of passengers was Egyptian. However, when I arrived at my transit airport, the airport was relatively big with passengers from all over of the world and everyone was in hurry to catch his flight! My transit was five hours, and I started to think how I could spend this long time! My neighbour at the plane was an Egyptian gentleman who had a European passport. He decided to take a quick tour in the city as he also had a long transit, and he didn’t need a visa to enter the city! Unfortunately I couldn’t take the same decision as my Sudanese passport didn’t give this privilege! Five minutes later I discovered how wrong I was. My Sudanese passport problem was not about entering the city without a visa, it was something “bigger”! The passport officer who checked my passport hurried to me with a worried face and asked me for my passport again. When I tried to know the reason, she claimed it was just a small “re-check”! She took my passport for half an hour and finally came with a relieved face; “Thank god he is not a terrorist”, I guess this is what she had in her mind at that moment! The experience became more and more exciting when the time for my flight to my clerkship city approached. I moved to a chair near to my flight gate. When I took a look around, I was frightened; no black person except me! I didn’t like my feelings at that moment at all! Fortunately, the people around me were so polite not to stare at me, and some of them even smiled at me, which made me more frightened! The plane was a small one with only 50 passengers; most of them seemed to be businessmen. I was thinking “Everyone is praying now not to sit nearby my seat”, and in reality that was my desire too! Luckily enough, as

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Six nationalities the passengers were few, we were free to sit wherever we liked and I had my seat without a neighbour! The tragedy continued when I arrived to the clerkship city airport. When we went to the passport check there were two paths; EU Citizens and Non-EU Citizens, and I was the only one at the latter path! The passport officer told me that Sudan was classified as one of the “most dangerous” countries, which meant that he had to do some exceptional procedures! He took me to an office and asked for my full address in Sudan, and then he asked for the person who was waiting for me outside the airport and took his full address too! The officer was so nice to tell me that this was something he didn’t agree with, but that he had to do his job. For me, it didn’t seem to be a good start, and I was wondering how bad the next days would be, but I was proved to be wrong! The person who received me at the airport was so friendly. He started to show me the country from the airport to the city. Then he offered me a fast tour in the city, and went nearby the medical school and the hospital, where I would do my clerkship. The first day at the hospital was incredible for me. All the students in the department were friendly, and I was lucky to have the best surgeon, at least in my opinion, as my mentor. He explained everything to me in English and introduced me to the other professors and nurses in the department.

May/June 2006

My own place was a small beautiful apartment in a nice part of the city. I wasn’t used to the weather at the beginning and couldn’t understand how a sunny day could suddenly change into heavy rains! Anyway, to live independently at an apartment was a new experience for me; I had to go to the market to buy stuff and cook for myself. It seems easy but when you are an African in Europe, it’s something different! At the beginning I always had the feeling that everyone expected me to do something wrong either at the market, the restaurant or in any other place. I felt like people were not used to seeing an ‘African tourist’ who just came to see new places! Within a few days I became a famous person in the hospital and nearby my place as I was the only black person there (I discovered later that there were five more blacks besides me in the city!). However, as days ran by, I got used to everyone staring at me, and I discovered later that I liked it. It was as if I was a star! I also discovered how those people were so nice: everybody at the hospital, the market, and the restaurants or even at the road, always offered me help especially when I lost my way, which happened a lot! Later on, I noticed that people treated me exceptionally, and in the same manner as Africans do to strangers. It is part of the human curiosity for new things! When I worked with exchange students, I was laughing when I saw Sudanese people treat the exchange people

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“exceptionally”; “this was not an African thing!” Living for almost a month in this beautiful city changed a lot of my ideas about the European community. I discovered that all my thoughts about the European community were from the American movies! People in Europe still respect the family to a great extent, maybe not as Africans, but still much more than presented at movies! They are opened, have time to chat and have hospitality as much as Africans, particularly in the countryside!

punctuality, respect for the law, respect for the value of work, they appreciate the time, practice sports and other things that we miss in Africa. However, they also miss some stuff that I can’t imagine to live without.

The main reason why I’m writing this 1 article is that I read the Malaika proposal and I appreciated how much the project coordinators tried to make the volunteers aware of the cultural differences, and how to behave in Tanzania. I feel that we should do this more as Africans; we should try to go deep in our vision to Europe and to see more than the streets and buildings. That might also help us to prepare European students better for their clerkships in Africa and in that way to improve our SCOPE and SCORE exchanges.

What surprised me the most was the variety of European cultures! We, as Africans, look at all Europeans as “Europeans”, as they look at us as “Africans”. It seems like both of us didn’t understand that there are big differences between the Europeans and the Africans themselves! They have their traditions in clothes, food, music, dances, and house building. What they have in common is that the European cultures are more affected by the westernization than the African cultures Yes, even Europe suffers from the “Westernization”! More visits to Europe in the following years showed me more and more about the European culture. Europeans, in general, have good adjectives like

Another thing that I find strange is that Africans know more about Europeans than Europeans know about Africans. The European, who didn’t leave his country or Europe at all, will be shocked when he sees a black person. They may know that there is a place called Africa, but nothing more. Maybe this is because African countries have many more Europeans than European countries have Africans!

Maybe at the end we will get the same result as I discovered: we have more in common than in difference! ____________________________________ "African tourist in New York" wall mounted picture frame with wooden sculpture inside. Website: www.mypieceofafrica.co.za/ wall_decor

1. A Village Concept Project organized by IFMSAUSA with the aim of improving the living conditions of people in Nyamuswa, a small town surrounded by 29 villages in Tanzania just west of the famous Serengeti National Park.

In this section every National Member Organization (NMO) can introduce itself. Both the beauties of the country and the health problems can be discussed, as well as the NMO and its members and activities. In this issue you can read more about this year’s host country of the AMSTC:

Sudan

A Paradise in Africa: One Nation, Thousand Worlds Geographical Location Sudan is situated in North East Africa. It is the largest country in Africa and the region of the Middle-East. It shares common borders with nine countries Egypt and Libya in the North, Chad and Central African Republic in the West, Democratic Republic of Congo, Uganda and Kenya in the South, Ethiopia and Eritrea in the East. It also neighbours the Kingdom of Saudi Arabia across the Red Sea. With an area of one million square miles, Sudan is among the ten largest countries in the world.

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May/June 2006

Capital The capital of Sudan is Khartoum. It lies at the confluence of two great rivers, the Blue Nile and the White Nile. Climate The period from March to June is the hottest part of the year with temperatures of up to 42 degrees Celsius during the day and 27 degrees Celsius at night. But the temperature gradually begins to decline when it starts raining from July to October. From November to February, which is the best time of the year in

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the country, temperatures range between 16 to 30 degrees Celsius with beautiful warm sunshine during daytime hours.

Khartoum sightseeing Khartoum state has three main towns, which are Khartoum, Khartoum North and Omdurman, all joined by six bridges across.

The People The Sudanese people are descendants of various ethnic groups, which settled or migrated to Sudan in different historical eras and intermingled to create a multifaceted heritage, Afro-Arab cultures.

Sightseeing safaris One of the most famous game reserves in the country is Dinder Park, which is located some 585 km southeast of Khartoum.

Major Towns and Cities Among the most important Sudanese towns is Port Sudan. It is the capital of the Red Sea State and as its name connotes, it is the country's major seaport as well. Then there is Wad Medani, capital of Gezire State. Al Obeid in North Kordofan State, besides Juba, Malakal and Wau in the south. Other important towns and cities include Dongola, Karima, Nyala, Alfasher. Tourism A paradise on earth: One nation, thousand worlds. There are countless tourist attractions in Sudan, unmatched anywhere. There are the ancient civilizations' sites, the colourful cultural, ethnic and climatic diversities, the beautiful fauna and flora that include rare animal and plant species, wildlife conservation parks like the Dinder Park, the Red Sea hill resorts -- all are great attractions for tourists, film-makers and investors. In the southern states of Sudan, there are the virgin tropical forests and many natural scenery and tourist villages. In the northern states there are many archaeological sites on the Nile banks, from Dongola up to Wadi Halfa in the extreme north, In Darfur State, there is the fascinating Jebel Marra mountain. and at Bajarwia in the Nile State.

IFMSA-Africa Newsletter

Thereafter one could encounter the town of Sennar, the capita! of the first Islamic kingdom in Sudan (1504-1821). The town is home to Sennar water dam on the Blue Nile, which dates back to 1925 and irrigates the Gezira Scheme.

In Khartoum State there are many places, including the historic confluence of the White and Blue Niles... a historic site for tourists. For filmmakers, the scenery is second to none. For tourists, it is a paradise on earth. Sudan, a land known for its sunrises and sunsets, ancient civilization and diverse geographical entities and wildlife and fauna is extending a sincere invitation to you.

May/June 2006

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Sea lovers The Sudanese Red Sea coast is known internationally as an ideal place for snorkeling, diving, seafaring and large fish hunting. The marine life is rich and diverse with crystal clear waters, coral reefs and exotic colourful underwater life. The Red Sea is looked upon as a huge lake that intercedes between the Mediterranean Sea from the north and the Indian Ocean to the south with fiords and small islands. Diving trips usually begin from Port Sudan aboard yachts of different sizes and fully equipped with diving equipment, with the availability of many diving locations.

Archeological and cultural tours Early history of human life in Sudan dates back to about 25,000 years, as evidenced by the discovery of what is known as the relics of Singa man. There are four main sites and some other small ones, whose history dates back from 750 BC to 500 AD. Temples and pyramids, which are restored and kept in good shape, stand witness to those great civilizations, which once prospered in the Sudan and influenced large parts of Africa. Chosen and rewritten by: Hossam Hamad

________________________________ Sources of data and pictures: • http://www.sudan.com/tourism/seta/p1 4a.jpg • http://www.touregypt.net/historicalessa ys/nubia.htm • http://www.touregypt.net/historicalessa ys/nubia.htm • http://www.embassysudanindia.org/tou rism/tourism.html • http://www.sudaniharare.org.zw/touris m.html • http://www.unitedworldusa.com/reports/sudan/tourism.asp • http://www.sudansite.com/toursim.html • http://www.italtoursudan.com/karima.ht m • http://www.imagesud.com/page1.htm • http://www.edcsudan.org/conf/Invitation.htm

Colophon Editor in Chief: Sophie Gubbels, the Netherlands Editors: Ahmed Ali, Sudan Jeden Bendabenda, Malawi Hossam Hamad, Sudan Medson Matchaya, Malawi Authors: Ayodeji Adewunmi, Nigeria Lay-out: Sophie Gubbels, the Netherlands If you are organising a project or activity, please share it with us! Also, if you want to ask attention for certain topics or if you want to contribute to one of our existing sections, please do write us. You can send your articles to ifmsa-africapublications@yahoogroups.com

Important Websites www.emsa-ethiopia.org (Ethiopia) www.fgmsaghana.org (Ghana) www.medcol.mw/comsu/ (Malawi) www.nimsanigeria.org (Nigeria) www.medsar.org (Rwanda) www.rmsa.org.rw (Rwanda) www.samedsa.org (South Africa) www.ifmsa.org www.ippnw-students.org/africa ifmsa-africa@yahoogroups.com ifmsa-scora@yahoogroups.com ifmsa-scorp@yahoogroups.com ifmsa-scope@yahoogroups.com rvcp@yahoogroups.com (Rwanda) NOTICE: Every care has been taken in the preparations of these articles. Nevertheless, errors cannot always be avoided. IFMSA or IFMSA-Africa cannot accept any responsibility for any liability. The opinions expressed in this publication are those of the authors and do not necessarily reflect the views of IFMSA or IFMSA-Africa.

IFMSA-Africa Newsletter

May/June 2006

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IFMSA Africa Newsletter - May / June 2006