Ink Pill : Issue #04

Ink Pill

PAKISTAN

Notice

EDITORIAL

ear readers

Last year, when I joined the National cabinet of IFMSA Pakistan as PUBSDD, I was both excited and scared I was excited to be a part of this new venture, but I was scared because it really was a leap of faith. There's a first for everything and well this was a first for me There is something very exciting, but also nerve racking, about selecting the layout of a magazine Finding the right color palette or theme that effortlessly combines an idea of beauty and style, while also capturing the spirit of the times, is an exercise that occupied my mind for quite some time As the five years of my journey as a medical student are coming to an end, I realized there's something equally painful but beautiful in letting go. You know that feeling you get when you realize there's only so many episodes left of a show? That's kind of how I feel as I sit and write this: my final note as Editor of Inkpill. It feels as though I'm about to finish the biggest box set of my life. Like a gripping series, for the past year Inkpill has taken up any spare time I had Always bingeing, always squeezing in one more "episode", my relationship with Inkpill hasn’t always been the easiest but it has always been rewarding. I'm glad we're leaving behind a legacy we can count on I'm ever so thankful to my team and everyone who has participated in bringing together this edition of Inkpill. Best of luck to future teams of Inkpill. With gratitude and pride,

A

BOARD

Dearest IFMSA-Pakistan members,

We congratulate the entire team of InkPill and appreciate their hard work and determination We hope that our Publications Support Division continues to prosper every year. It is because of them that we are able to show an amazing face of IFMSA Pakistan all over the world More power to everyone involved in this process

We are thankful to our National Cabinet for their utmost devotion and accession towards teamwork and towards achieving extraordinary milestones for the National Cabinet term 2020 2021 We have found an even higher level of the meaning in faith through our competent Presidents, your decision making, active engagement and devotion towards IFMSA Pakistan has left another legacy of steadfast and dedicated bond with IFMSA Pakistan and the future of its leadership and members. We are thankful to all our National Teams, for your willingness and motivation to work with and for IFMSA Pakistan, your efforts combined without any say have reaped the results we have all tried to sow

We thank all our Local Councils for their unwavering commitment towards taking their work and representing IFMSA Pakistan with efforts which raised our standards one notch higher and produced amazing leaders for our NMO to be led by in future

We pray IFMSA Pakistan and its members stay strong, get stronger, achieve more, be blessed and reach heights everyone across the world will wish to achieve We pray a lot for our NMO as much as prayers for IFMSA Pakistan have exceeded the prayers for our own self over the past few years. Ameen Sum Ameen

Content Editors Support Assistants

Ayesha Noor

Fatima Ayaz Zuberi

Rabbani

Asbiha Kashif

Raja Asad

Aisha Farooq

Social Media Handlers Content Designers

Muhammad Talha

THEME

Digital Health- the need of the hour?

"Every second a doctor is not seeing patients is wasted time. Doctors already spend roughly 40 percent of their day documenting and doing other administrative tasks. To waste the other 50 to 60 percent of your day traveling between patients is a 50 to 60 percent reduction inefficiency. Short of teleportation, the doctor house call will always be an irresponsibly massive reduction in primary care efficiency" says the renowned Dr. Jay Parkinson, Founder and Chief Medical Officer, Sherpaa

Linking long distances, resolving major obstacles of communication, providing readily accessible sources of healthcare, being available for the patients throughout the day, and never delaying any kind of emergency treatment are a few goals that medical professionals have always wanted to achieve.

They say, “time is money”, no doubt, buying a few golden seconds for a person suffering from myocardial infarction, or getting a few parts of a second for anyone who suffered from massive blood loss after a road traffic accident, could save lives. However, as mythical as it sounds, it is equally impossible in most scenarios and is now the leading cause of death among patients.

To fill the gaps of communication, to eradicate the delay in seeking healthcare and the lagging between patients’ calls and a doctors’ response, Digital Health is the foremost and most important source.

Telemedicine makes the doctor available for the patient within the ring of a phone bell! It bridges the time lag between a patients’ life and death, and early seeking of care in case of emergencies has led to a sharp decline in morbidity and mortality rates worldwide. According to Dr. William H. Carson, President and CEO, Otsuka Pharmaceutical Development and Commercialization, "Today, patients suffering from severe mental illnesses struggle with adhering to or communicating with their healthcare teams about their medication regimen, which can greatly impact outcomes and disease progression. We believe this new digital medicine could revolutionize the way adherence is measured and fulfill a serious unmet medical need in this population."

Digital health has now become an integral component of health information systems (IS), showing promise in various areas such as disease risk modeling, clinical intelligence, pharmacovigilance, precision medicine, hospitalization process optimization,

Digital health can combat diseases and decrease healthcare costs while helping patients monitor and manage chronic conditions. Healthcare providers can also advantage from advances in digital health Digital health gives healthcare providers an intensive view of ailments and diseases with the aid of using substantially growing health data and fitness records. The result is expanded performance and progressed scientific outcomes

"From mobile medical apps and software that support the clinical decisions doctors make every day to artificial intelligence and machine learning, digital technology has been driving a revolution in health care. Digital health tools have the vast potential to improve our ability to accurately diagnose and treat disease and to enhance the delivery of health care for the individual."

Additionally, technologies such as smartphones, social networks, and internet applications offer new ways for patients to monitor their health and have increased access to information.

"Together, these advancements are leading to a convergence of people, information, technology, and connectivity to improve health care and health outcomes," The broad scope of digital health includes categories such as mobile health (mHealth), health information technology (IT), wearable devices, telehealth and telemedicine, and personalized medicine

According to the FDA, digital health technologies help providers reduce inefficiencies, improve access, reduce costs, increase quality and make medicine more personalized for patients. At the same time, digital health technologies enable patients and consumers to manage and track health and wellness-related activities more efficiently.

Digital health technologies use computing platforms, connectivity, software, and sensors for healthcare and related uses. These technologies span a wide range of uses, from applications in general wellness to applications as medical devices. They include technologies intended for use as a medical product, in a medical product, as companion diagnostics, or as an adjunct to other medical products (devices, drugs, and biologics). They may also be used to develop or study medical products.

According to - Dr. Glen Stream, Chairman, Family Medicine for America’s Health: "We believe consumer health technologies — apps, wearables, self-diagnosis tools — have the potential to strengthen the patient-physician connection and improve health outcomes."

Maryum Tayyab, IFMSA PAKISTAN

Pregnant women of rural Pakistan, what ordeals do they go through?

Pregnant women in rural areas of Pakistan have to face a lot of challenges. Pregnancy and the period of expecting a child are supposed to be a beautiful, heartwarming time but it somehow turns women of rural Pakistan into a victim of many social, medical, and selfpropagated issues. Prevalence of depression among rural pregnant women is high (62%).

Pregnancy, sure, is a wonderful experience, it is in fact one of the most important events of a person's life but it does come with a lot of challenges that a woman has to go through like hormonal imbalances, mood swings, weak bladder, weakness, antenatal mental health issues, etc. A lot of support is needed but unfortunately, in poor rural areas of the country, women become a target for tons of societal pressures and bad behaviors. These include lack of emotional support from the husband, the expectation to do all the household work by in-laws, pressure to have a son rather than a daughter, poor access to proper healthcare due to poverty, low economic status, and big families due to unawareness about contraception. Women's disempowerment and lack of bodily and income autonomy also put women in difficult situations adding to their stress.

Women with depressive symptoms perceived less support from their spouses

It's not hidden from anyone that Pakistan's economy is suffering and has been suffering for a long time. The urban areas are paid attention by the governments in matters of development and facilities but rural areas are usually compromised.

Meeram noor

Say it be basic health facilities, prenatal post-natal care for women, education, or even clean drinking water, rural areas are highly ignored. Due to this, women do not get skilled health professionals or midwives to provide them with proper healthcare during pregnancy. Moreover, a lack of awareness about the needs of pregnant women during pregnancy contributes to the issue. Access to vitamin supplements, iron supplements, and proper dietary stuff weakens their health.

Up to a quarter of all deaths of pregnant women in the country are caused by high blood pressure. Yet, there is little awareness among the public and some healthcare providers of the importance of monitoring blood pressure as part of antenatal care practices.

A high ratio of pregnant women in Pakistan is anemic. The major cause of death among pregnant women occurs due to cardiovascular diseases mainly hemorrhage. Despite the rates being so high, the problems are not addressed.

Intimate partner violence and sexual abuse women living with in-laws, higher depression satisfaction with their own life.

During the period of pregnancy, a woman's body goes through a lot. Various physical changes occur, and hormonal imbalances take place resulting in extreme highs and lows. Moreover, the natural sense of worrisome comes from the baby being born, its health, and its future. The physical changes include gaining a lot of weight which may make them feel anxious as well. This weight gain also takes a toll on a woman's self-esteem and if it's coupled with social issues or distance from an intimate partner, it may as well lead to severe consequences. A lot of reassurance is required as insecurities creep up and women become vulnerable to mental illnesses too. Antenatal or pre-natal depression is real. It is a major cause of postpartum depression. Rural pregnant women are more prone to depression than urban women and rural male counterparts. The children of depressed mothers fail to perform well as well.

According to WHO, at least 6 antenatal checkups are necessary to be carried out but multiple indicator survey, 2014 indicates that 80% of women in rural Sindh had only one antenatal checkup by a skilled professional. All the situations above are indicators of the poor living conditions of pregnant women in rural areas. Despite the problem being so grave and persistent, a little research and effort are done to eradicate it. The studies conducted are either a decade old or two decades old.

It is of due importance that pregnant women are provided with due care say it be social, medical, or emotional. Their communities must be equipped with basic maternal health care. Surveys must take place to raise awareness among people about their circumstances. The rural women must be empowered, they should learn and excel. They must be empowered. If mothers are neglected, we may not harm the women but also the future generations.

References

KhanR,WaqasA,MustehsanZH,KhanAS,SikanderS,AhmadI,JamilA,SharifM,BilalS,ZulfiqarS,BibiA.Predictorsofprenataldepression:Across-sectionalstudyinruralPakistan.Frontiersinpsychiatry. 2021:1466.

ZahidieA,KaziA,FatmiZ,BhattiMT,DureshahwarS.SocialenvironmentanddepressionamongpregnantwomeninruralareasofSind,Pakistan.JPMA-JournalofthePakistanMedicalAssociation.2011Dec 1;61(12):1183.

RowtherAA,KaziAK,NazirH,AtiqM,AtifN,RaufN,MalikA,SurkanPJ.“AWomanIsaPuppet.”Women’sDisempowermentandPrenatalAnxietyinPakistan:AQualitativeStudyofSources,Mitigators,andCoping StrategiesforAnxietyinPregnancy.Internationaljournalofenvironmentalresearchandpublichealth.2020Jul;17(14):4926.

WaqasA,RazaN,LodhiHW,MuhammadZ,JamalM,RehmanA.PsychosocialfactorsofantenatalanxietyanddepressioninPakistan:issocialsupportamediator?.PloSone.2015Jan28;10(1):e0116510. AliNS,AzamIS,AliBS,TabbusumG,MoinSS.Frequencyandassociatedfactorsforanxietyanddepressioninpregnantwomen:ahospital-basedcross-sectionalstudy.TheScientificWorldJournal.2012Oct;2012.

MustafaG,AsadiMA,IqbalI,BashirN.LowvitaminDstatusinnursingPakistanimothersinanenvironmentofamplesunshine:across-sectionalstudy.BMCPregnancyandChildbirth.2018Dec;18(1):1-7. WorldHealthOrganization.WHOrecommendationsonantenatalcareforapositivepregnancyexperience.WorldHealthOrganization;2016.

AghaN.MaternalandnewbornhealthinPakistan:risks,challenges,andthewayforward.SouthAsia@LSE.2018Jul9.

NiazU.Women'smentalhealthinPakistan.Worldpsychiatry.2004Feb;3(1):60.

ZakarR,ZakarMZ,AbbasS.DomesticviolenceagainstruralwomeninPakistan:anissueofhealthandhumanrights.Journaloffamilyviolence.2016Jan;31(1):15-25.

ZakarR,ZakarMZ,MikolajczykR,KrämerA.Intimatepartnerviolenceanditsassociationwithwomen'sreproductivehealthinPakistan.Internationaljournalofgynecology&Obstetrics.2012Apr1;117(1):10-4. LoneFW,QureshiRN,EmmanuelF.MaternalanaemiaanditsimpactonperinataloutcomeinatertiarycarehospitalinPakistan.EMHJ-EasternMediterraneanHealthJournal,10(6),801-807,2004.2004.

THERE IS NO EXCUSE FOR ABUSE.

Violence refers to the intentional use of physical force or power, intended to cause hurt or injury, against ANY community, group, or GENDER. But population-level surveys conducted by WHO reveal that most of the violence is perpetrated by men against women. Men are much more likely to dominate women and resultantly, women are overwhelmingly more likely to be the victims of abuse and violence. According to an estimate, approximately 70-90% of Pakistani women are subjected to domestic violence.

Violence against women is a pervasive human rights violation that takes away their sense of security, and prevents them from reaching their full potential. No culture, religion or tradition propagates abuse against women, since it not only threatens a woman’s freedom, but also her health, both physical and mental.

Gender based violence not only includes physical or sexual violence, but also includes arbitrary deprivation of liberty, threats of violence, coercion and economic harm. The most prevalent of these is domestic violence against women. While the physical assault that results in visible injuries has its own devastating consequences, the destruction of personhood and self-esteem that accompanies any form of abuse is of significant importance too.

Violence refers to the intentional use of physical force or power, intended to cause hurt or injury, against ANY community, group, or GENDER. But populationlevel surveys conducted by WHO reveal that most of the violence is perpetrated by men against women. Men are much more likely to dominate women and resultantly, women are overwhelmingly more likely to be the victims of abuse and violence. According to an estimate, approximately 70-90% of Pakistani women are subjected to domestic violence.

“There is one universal truth, applicable to all countries, cultures and communities: violence against women is never acceptable, never excusable, and never tolerable.” -Ban Ki-moon

, Rehan Khalid

Violence against women is a pervasive human rights violation that takes away their sense of security, and prevents them from reaching their full potential. No culture, religion or tradition propagates abuse against women, since it not only threatens a woman’s freedom, but also her health, both physical and mental.

Gender based violence not only includes physical or sexual violence, but also includes arbitrary deprivation of liberty, threats of violence, coercion and economic harm. The most prevalent of these is domestic violence against women. While the physical assault that results in visible injuries has its own devastating consequences, the destruction of personhood and self-esteem that accompanies any form of abuse is of significant importance too.

In the light of increasing incidents of assault against women, including rape, honour killings, acid attacks, forced marriages, economic harm etc. SCORA-NT and SCORP-NT in collaboration with IFMSA PAKISTAN, AIMC-LC came forward with an activity “NO EXCUSE FOR ABUSE” as an attempt to educate medical students about consent, gender equality and abuse against women, along with its outcomes, and to reflect on what we can do in our lives and in our communities to eliminate this threat to the dignity of our women and to break the silence around sexual violence. Because, how many wives will be beaten up, in closed rooms, in their very own homes, before we become their voice? How many rapes before women learn their place? How many killings, before women get to live dignified lives, free from fear?

The myths that whatever happens in a closed room/at home should stay at home and that it’s nobody’s business are unfortunately, too powerful in cultures like ours and hence discourage women to speak out against abuse. And even if some women muster up enough courage to call out their abusers, deep rooted patriarchy, prejudice against women and a victim-blaming mindset enables men to alienate themselves from any responsibility and has women doubting themselves instead. In most cases, the abusers manipulate, lie and gaslight the victim and convince them that the victim is at fault. Violence often silences those who are affected by it. Sabahat-Ul-Ain wrote in her poem and I quote.

Violence undermines an individual’s sense of self-worth and freedom from violence is a fundamental human right. Hence, the Organizing Committee for “NO EXCUSE FOR ABUSE” arranged a capacity building session on 29th March 2022, at AIMC. , with an aim to create a safe space where all the participants could discuss gender based violence, sexual exploitation, forced marriages and abuse at different levels. This activity was an attempt to become the voice of those who suffer from abuse, to be their support when they refuse to hide or to be silenced. It was an attempt to create a cultural shift towards supporting the survivors and to demand social change, because violence must not be allowed, under any circumstances. Because, THERE IS NO EXCUSE FOR ABUSE.

“You smartly shook the dirt off your coat Left her questioning if everything was her fault”

et’s talk about it.

Menstruation is a natural process and a monthly occurrence for the 1.8 billion girls of reproductive age. Yet millions of menstruators across the world are denied the right to manage their monthly menstrual cycle in a dignified, healthy way. The onset of menstruation coincides with new opportunities – and vulnerabilities – that arise during adolescence. Menstrual health and hygiene interventions can be an entry point for other gender-transformative programmes during this period, like sexual and reproductive health education and life skills development. The proportion of female adolescents of age 10-14 is 9 million and 15-19 is approximately 6.5 million, yet adolescent girls in Pakistan are unaware and unprepared for the onset of menstruation (menarche) - mostly due to a culture of silence surrounding women's reproductive health issues of which menstruation is a part. The lack of preparation, knowledge and poor hygienic practices during menstruation present negative impacts on girls' self- esteem and personal development. It also affects their education; they often miss school because of shame or lack or adequate facilities to manage their menstrual period. In addition to this, teachers are often not prepared to respond to girls' inquiries about menstruation. This further adds to the problem and leads to the risk of infections and gynaecological problems in future for these girls.

SCORA at AIMC-LC in collaboration with KEMU-LC came forward with an activity “LETS TALK ABOUT IT” in order to enlighten the audience about the basic hygiene related to menstruation and to remove the stigma revolving around this topic. As future healthcare professionals, it is our duty to practice empathy and debunk all these myths and break all taboos regarding these stigmatised topics.

The incentive of this activity was to create awareness on Menstrual health and hygiene. This activity was conducted in two phases.

The first phase consisted of a school visit. On Saturday, 21st May 2022 Organising Committee of the activity visited Govt Girls' High School to increase awareness about menstruation. Our two speakers, Urwa Afzal and Sabahat ul Ain from AIMC-LC taught the importance of menstrual health and hygiene to underprivileged school-going adolescent girls and

encouraged them to use sanitary pads and maintain hygiene. All the queries of girls were addressed. Through this, we aimed to break the stigma and taboo surrounding menstruation in our society. Activity enlightened the aspects of menstrual and hygiene in school-going girls and gave them a new perspective of thinking about periods. We collaborated with Molped Pakistan, a globally-renowned sanitary pad brand. They provided us with sanitary pads, which were distributed among the school going students at the end of the session.

The second phase consisted of a webinar conducted on 23rd May 2022 where our worthy speakers, Prof. Dr. Kiran Khurshid (Professor of Gynaecology & Obstetrics Lady Willington Hospital Lahore)

And Ushna Khan (A final year medical student and the president of IFMSA AIMC-LC), enlightened the audience on menstruation, how to maintain proper menstrual hygiene, importance of maintaining proper menstrual hygiene to reduce the risk of developing infections and gynaecological problems etc. The session also addressed the myths and misconceptions that they have about menstruation.

The main goal of this activity was to:

- To encourage young females on adapting healthy and hygienic practices during menstruation.

- To create awareness among young females regarding the health-related benefits of maintaining personal health and hygiene during their menstrual cycle.

- To answer some common taboos and myths related to menstrual cycle of the females to combat misinformation and stigma.

- To encourage females to avoid using cloth and invest in sanitary pads and properly dispose the absorbents

U-Report found that 49% of young women in Pakistan have little to no knowledge of periods before their first period. Likely, more than 20% of young women will only learn about menstruation in schools.

It was our duty as aspiring professionals to spread the word on menstrual health with the help of this webinar and the on-ground school visit and make this a chain of peer learning.

The activity purely benefited the audience that was in the dark shadows of either misinformation or the absence of information regarding Menstrual Health and Hygiene.

xchanges Active In Pakistan

Standing committee on professional exchanges was the first standing committee to be established after IFMSA came into being in 1951. Since then, a great number of student exchanges have taken place all over the world. In 2001, IFMSA Pakistan was established, but SCOPE didn't get the fair share of attention it needed, it was neglected and was forgotten and for the very reason, I'm going to refer to it as the step child of IFMSA Pakistan. Of course, there was a huge pile of issues in the way but great things require great efforts and are not always easy. A couple years back, I was asked by an acquaintance of mine to attend SCOPE sessions. Before that I had no intention of attending those. So, I decided to see what they have to offer and that decision didn't prove to be a bad one. During those sessions I met the national team of SCOPE, I was quite impressed by their dedication, they were very kind to me, they worked selflessly with just one goal in their mind which was to activate SCOPE IFMSA Pakistan. That was the day their dreams became mine and I decided to be a part of this and contribute as much as I could to make these dreams come true. And the following year, I was part of the national team. During my days working in the national team, I got the chance to work with a number of teammates, one of them Kiran Zainab Khalid played a major role in all this. She was the person who had been tirelessly working to make IFMSA Pakistan, SCOPE active. She dedicated two whole years for the very purpose. She sacrificed everything else and chose to stay in SCOPE, her passion to bring SCOPE to new heights was unmatched. She was to do anything to achieve her goals, she even travelled to far stretches of the world to get it done. As mentioned before, great tasks come with great difficulties so was the case with this task. There were a lot of difficulties which I'm describing briefly below:

• Starting from scratch: As I mentioned before, SCOPE had been treated as a "step child" and no was interested to "wasting" their time on this. So, there was a lot of work left to be done.

• Making things sustainable: A question may arise in the reader's mind about why did it take two whole years to achieve all this? The answer to that is simple, it could've been done in a hurry but it wouldn't stay sustainable that way, it required a solid foundation on which the whole structure could be built.

• Lack of guidelines: As this was the first time it was being done, there were no guidelines to work on which made the task even more difficult

• Administrative issues: There had to be made arrangements for incoming students like arrangements regarding departments, teachers, residence, food. It had to be established what kind of visas would be given to incoming students etc.

• Security issues: The enemies of Pakistan have been trying to disrupt the peace for along time and tried to create a bad image of Pakistan in other parts of the world. Due to which people were reluctant to visit the country.

This is only one little chunk of problems faced. They can't be summed up that easily, a separate booklet can be written on that topic alone. These problems were well dealt with by Kiran (and her team) and the way she did it is indeed admirable. She even had sleepless nights, compromised her studies, worked despite being sick day and night towards achieving the goal of activating IFMSA Pakistan SCOPE active before October 1,2018and as you know, hard work always pays off and Hurriya Khan King Edward Medical University, Lahore77it did too. On 30th September 2018, we became SCOPE active. Next thing was to select an institute in Pakistan which would offer exchange programs, for this the role of SKZMDC is of great importance, their management was very helpful and deans helped in every way they could in making this dream reality’s long struggle was not over yet, the first ever contract had to be signed, once you get this close to your target, you simply cannot stop. So, by the end of November 2018, we were ready to sign our first contract and within a month we signed our first contract with FASMR Romania and announced it on January 11,2019. FASMR Romania added Pakistan's flag in their exchange office soon after that and that was indeed a very proud moment for all of us. But still, this is far from over, now we are working on carrying out the first exchange smoothly and to make it a memorable experience for the incoming students.

Activation of SCOPE in Pakistan will be of great benefit to IFMSA Pakistan as Exchanges are a means to improve our finances so it'll give the organization financial stability. In addition to that there are numerous other applications such as promoting our culture, tourism, etc. S,’ I think achieving this is a huge achievement for not only IFMSA Pakistan but Pakistan as a whole. This one contract will pave the way for many more. Let's hope for a bright future ahead.

by Hurriya Khan King Edward Medical University, Lahore

AG THE BUGB

With the popularity of digital forums and social media, a rapid increase in the incidents of cyber bullying can be seen. The prevalence of cyber bullying via online platforms is not taken seriously most of the times resulting in adverse impacts on the victim.

'Bag the Bug' was an effort to enlighten our audience about cyber bullying and its consequences with respect to mental, psychological and physical impact. This activity was conducted in two phases. First phase was an online session in collaboration with Digital Rights Foundation, a registered researched NGO that advocates to ensure the safety of human rights defenders (HRDs), with a special focus on women rights through policy awareness and digital rights enlightenment. A webinar was conducted with the help of the NGO where the speakers, all the while presenting statistics on cyber harassment, elucidated various policies which ensure legal protection. The second phase was an on-ground capacity building session where medical students were educated not just as potential targets, but also as health professionals, thereby capacitating them to aid the general public at all possible levels. Special focus was paid towards the importance of cyber bullying with regard to gender-based violence and its rise amidst the COVID-19 outbreak. Awareness about protection of vulnerable populations (women and children) was provided.

The activity has been first of its kind at national and local levels, with very little awareness about the much rampart cyber-harassment. A lot of new information and links were shared to the audience in the online as well as the on-ground activities. All the sources are active platforms and serve their purposes effectively with prompt legal action associated with a few. Several misinterpreted terms were redefined for the benefit of the audience such as informed consent and the audience was acquainted with their digital rights as citizens of the country. The audience were linked with the local Harassment committee, which is a functional society, for any troubles in the future ahead to ensure sustainability for the matter of concern. The activity went smoothly and turned out to be another feather in the cap of AIMC LC.

Authors: Sabahat Ul Ain Munir Abbasi, Seerat Fatima, Shiza Shakee LC: Allama Iqbal Medical College, Lahore.

ROM THE ASHES, WE WILL RISE

Flames of ever-increasing fire, dark smoke, mammoth heat and water dripping from the fire brigade pipes, a nightmare that left scar on our hearts and haunted our minds. The agony we never want to go through again. A bad dream that will keep chasing us. A dreadful evening everyone wants to forget. It was like a punishment in which you were compelled to see your home burning to ashes in front of you.

Last night, an awful incident took place at Aziz Fatima medical college when main block of my college caught fire because of short circuit and it kept spreading until it burnt the whole auditorium to ashes. I could choose any other topic to write article but just couldn't resist because yesterday I got to know how emotionally I am attached to this place.

How much I love every portion of it, and maybe the fire was just the reminder for me and many other students that we adore this second home of ours. Helpless faces of Whole staff, management, principal and students who witnessed the whole incident and couldn't do nothing but wait for fire brigades to do their work and pray for fire to stop.

That Auditorium was first impression of college for students. From white coat ceremonies to debate competitions and annual functions, it listened everything. Nervous first year students assembling to listen principal's welcome speech, debates of enthusiastic speakers, laughter and secrets, colourful evenings, afternoon cravings and boring morning speeches - it witnessed them all and they all are gone with it. They are nothing more than good old memories scattered in air in form of ashes. It feels like personal loss because a part of us, a part of our college is burnt. But last night, I saw that pleasant aspect of medical students that people often complain about that they are rude and self-centered. Contrary to popular belief, I saw my fellows crying for this place, helping everyone around the corner. I saw day scholars opening the doors of their homes for hostilities and reaching the place as soon as they got to know about incident. I can say, this generation will make differences in society in good way. They know how to love their place, how to care for fellows, and how to help those in need.

They are aware of what must be done in emergencies, they know how to be a good responsible student of institute.

Time is a great healer, new auditorium will be constructed, loss will be bared and sun will shine again. We will witness everything. It is just a matter of time and this night will be no more than a bad dream that people remember but no one speak of it. This all will pass but the things that will stay with us are the sympathies, condolences and memories of those people who helped us in hard times!!FROM THE ASHES, WE WILL RISE

And Just as the phoenix, Rose from ashes

We will rise too

Returning from the flames

Clothed in nothing but strength More beautiful than ever before

~Abdur rehman assistant PubSDD AFMDC LC

e Rise for Our Planet (WRAP)

According to WHO, between 2030 and 2050, climate change is expected to kill about 250,000 people each year from malnutrition, malaria, diarrhea, and heat stress. (1) The cost of direct health damage (that is, excluding costs for health-determining sectors such as agriculture, water, and sanitation) is estimated to be the US $2-4 billion annually by 2030. (1) Without support for preparation and response, the most difficult to deal with, will be the areas with weak health infrastructure (mainly developing countries).

A study conducted on the population of Karachi in May 2021, reported that climate change is a well-known threat to human health, affecting all organ systems and affecting disease processes in all disciplines. (2) Infectious diseases, air pollution, and adverse health effects are the result of climate change in the city of Karachi. The current damage caused by climate change to the city's ecological and social structures leaves illness among the vulnerable citizens of the city. The obvious impacts of climate change pose a major threat to public health, urging authorities to take swift and meaningful action, especially in the areas of carbon reduction, sanitation improvement, and health care in the region.

Climate-related environmental stress affects the pathophysiological basis of the disease, highlighted in the preclinical year of medical school. Medical education lags in providing climate and health content that is essential for the next generation of physicians to adequately prepare for the challenges they face in providing health care and disease prevention and treatment.

Ebaad ur FRehman ahad Nadeem

Laveeza Fatima

With this in mind, the SCOPH-NT and IFMSA Pakistan AIMC-LC joined hands to design, We Rise for Our Planet (WRAP), an activity aimed to be a beacon of climate change prevention and environmental health. Its goal was to make trainees learn to recognize, treat, and prevent climate-related health conditions in their patients, and to raise awareness among medical students about the intersection of climate change and population health, pediatrics, women’s health, psychiatry, infectious disease, and disaster management and to raise awareness among school students regarding climate change, heat wave, and its prevention. Through a training session, medical students get capacitated to create an impact by raising their voices to the policymakers and get motivated enough to start activities in their areas for Climate protection. The project had four phases; A Social Networks Campaign: focused on the general population to know general information about the heat wave and its prevention. Some cool tips were shared which could prove to be a life-savior for the summer.

A Training for Medical Students: who will facilitate sessions in school, were capacitated by our esteemed speakers regarding the climate change crisis, the intersection of climate change with infectious diseases and why and how should global warming be coped with at Allama Iqbal Medical College.

A Local School Campaign: involved projecting medical students to school students where they applied all they had learnt in the training session. This phase was the way medical students go directly to the population. We reached 150 8th-grade students.

Lastly, an Online Poster Competition: With World Environmental Day around the corner, team WRAP invited the students to flex their creativity muscles. The main aim of organizing this phase was to sensitize our younger generation and generate innovative ideas for global challenges.

For the next edition, we are planning to implement the project in several other local schools and create other National Competitions among students as a follow-up. We believe that Climate Change is a priority and as our system doesn’t give it the importance it deserves, we medical students can take the lead in making that happen. WRAP aims to empower medical students to be active environmental health advocates in the communities that most need our help and to be a beacon of climate change nationwide.

Climate change and health. Who. int. 2022. Available from: https://www.who.int/newsroom/fact-sheets/detail/climate-change-and-health.

Babar MS, Tazyeen S, Khan H, Tsagkaris C, Essar MY, Ahmad S. Impact of climate change on health in Karachi, Pakistan. The Journal of Climate Change and Health.

Burning the Burnouts: How to Cope with the Challenges of Medical Education?

Today, despite the prosperity that adorns all domains, mental health still claims the right to life, and the interests of the people. Mental health problems are usually considered taboo, fearing the dark mysterious side, and the person is perceived as a demon rather than an ordinary sick person. A devil who fears himself, others, and

the world. These clichés are driving the current situation into intolerable consequences. Even when mental health is talked about, discussions lack practical implementations. This is a more talked-about and less acted upon issue. To promote a practical approach towards relieving stress in an attempt to improve mental health conditions among medical students, an interactive mental health workshop-Burning the Burnouts was held at Allama Iqbal Medical College. It was an open space discussion on mental health struggles within the medical student community and involved engaging activities to burn the burnouts where medical students were trained to Identify the burnout and its causes. The trainees were also enlightened about the management of burnout through a support group, setting daily goals, making mood charts, journaling deep breathing, and taking breaks for self-care and mindfulness. The trainer did not only stress personal growth but also emphasized checking up if someone is struggling with mental health issues. 110+ students reported to have a thorough knowledge of coping with the challenges of medical education. The medical profession is considered one of the most respected professions in our society. Students enter the medical field for a variety of reasons, including fulfilling their passions, parental pressure, financial and career safety, and ensuring a respected place in society. (1)

According to studies, medical education has an unintended adverse effect on a student's mental health and can lead to the spread of depression, anxiety, and stress in medical students. It has been hypothesized that the decline in the mental health of medical students is due to a variety of factors, including academic pressure, increased workload, financial problems, lack of sleep, patient distress, and exposure to death. (2) Mental stress affects students' learning and cognitive abilities, which can affect their academic performance.(3)

Widespread literature shows an increasing prevalence of mental stress among medical students. While it is clear that mental health problems are prevalent throughout society, medical students are far more affected than the general public. It has been established around the world that medical students are threatened with psychological stress and reduced life satisfaction. Medical education includes many risk factors for mental illness, including academic stress, lack of sleep, minimal physical activity, and reduced time for social activity. Knowing that mental health is a deep-rooted issue, we will assure continuity. We, SCOPHeroes, look forward to an even bigger second edition of burning the burnouts as a follow-up. Reach out and seek help; there is no shame in seeking help!

~Laveeza Fatima

1

Stress

associated

college

Climbing Fences Towards Research

Lareb Hassan

Quaid e Azam Medical College, Bahawalpur.

In SCORE IFMSA Pakistan, we believe not only activating our NMO is vital but promoting interest in the field of research amongst medical students too is imperative which ultimately paves the way of getting applications for exchanges. On that note, not only were we successful in activating SCORE in Pakistan, becoming the 83rd active NMO in SCORE Directory worldwide in our term 2019-2020, we also meditated on the need of incorporating the principle of capacity building. NORE together with the national team put together a Plan of Action at the beginning of term concerning ideas of promoting interest in research among medical students. Being the general assistant to NORE, I was also able to work on it.

In December, 2019 we embarked on a journey of our esteemed National Activity “Brain on The Run” series. Our ride took us from Sheikh Khalifa bin Zayed Al Nahyan Medical and Dental College (SKZMDC) to Faisalabad Medical University (FMU) to Dow Medical University (DMU) and Shalamar Medical and Dental College. We at IFMSA Pakistan believe in door to door reach and hence besides major cities with IFMSA affiliated colleges; Lahore, Faisalabad, Karachi we stretched our horizons towards Bahawalpur the city of palaces in Quaid-e-Azam Medical College. Unfortunately, the activity was postponed due to the pandemic.

Our idea was simple and crisp: A Research Methodology workshop that has answers to all the questions a research aspirant has: what is research all about? To stand inside the shoes of the students, we conducted a need assessment survey as to what components they need covered in these workshops. The results indicated that students’ motivation was at peak but they felt a lack of platforms providing learning opportunities. Hence after getting an extra push, we trained all our LOREs to approach a professor in each respective institution to mentor the workshops. Amounting to 3 to 4 hours duration in totality, the workshops started with highlighting the basic process behind conducting a practical research and the road towards publishing it. The workshops aimed at perfecting the following components of research: Types of studies, Literature Review, Data Collection, Analysis, Research Ethics, Methodology and Abstract writing. In order to make the participants competent enough to conduct their own research, we kept repeating these workshops. Accordingly, we got pre and post evaluation forms filled as feedback for improvement.

“No research is ever quite complete. It is a glory of a good bit of work that it opens the way for something still better, and this repeatedly leads to its own eclipse.”

In this age of social networking, there’s no denying the reach is massive. Our will to increase students’ aptitude towards research knew no bounds thus even during pandemic we made use of online platforms and encouraged local councils to conduct online research workshops e.g. AMC’s “Dissecting Medical Research” online sessions. As a national team, in SCORE IFMSA Pakistan we are proponents of visibility. Catering to the need we publicized our research workshop journey throughout the term on all IFMSA Pakistan online platforms which encouraged viewers to become a part of our future workshops.

ndergraduate Research Competition 2019

AFMDC-LC

“Research is an organized method of trying to find out what you are going to do after you cannot do what you are doing now. It may also be said to be the method of keeping a customer reasonably dissatisfied with what he has. That means constant improvement and change so that the customer will be stimulated to desire the new product enough to buy it to replace the one he has.” Charles F. Kettering.

Research is required not just for students and academics, but for all professionals and nonprofessionals alike. For nonprofessionals who value learning, doing research equips them with knowledge about the world and skills to survive and improve their lives. Among professionals and scribes, on the other hand, finding an interesting topic to discuss and/or to write about should go beyond personal experience. Determining either what the general public may want to know or what researchers want others to realize or to think about can serve as a reason to do research. Thus, research is an essential component in generating knowledge and vice-versa. Research is fundamental for the advancement of present day medication and has made a consistently developing clinical world. New revelations are being revealed ordinary which are affecting our clinical practice. Completing little scope examinations has become a necessary piece of the pre-clinical course in the clinical schools.

Doing research during the medical years means that that student will have to take some time out from their course, making the already long 5 year course, even longer. As it is extra time away from the course, it may be a financial burden, as it means extra fees to pay. It may also mean that they are detached from the medical course, which may require readjusting to when returning to the medical course. Despite these negatives, doing research still remains rewarding. Carrying out research, while still a medical student, provides an opportunity for them to study a discipline in which they are interested in. Research at an earlier stage, allows the student to think in a systematic way. Research also enables students early exposure to ethics, which is an integral part of medical research and practice. Keeping in view the importance of research in the life of medical students, the local council of Aziz Fatima medical college was motivated to organize a research poster competition 2019, under the presidency of Bilal Shahid, President AFMDC LC, and competition was headed by Abdullah Babar, SupCo AFMDC LC. The workshop was organized to bring confidence & enthusiasm in students for research. The opposition was sorted out in AFMDC, it was available to the understudies of 3rd, 4th and last year of Aziz Fatima College, liberated from cost and with effectively open methodology, understudies from various years indicated unmistakable fascination

Azeema Zia

and participated in the opposition. Coordinators guarantee that everything is efficient and arranged.

Research banner rivalry was sorted out on nineteenth April 2019 on Friday under the management of Dr.Tariq (H.O.D pathology) and Dr. Noor-e-Kiran (Department Of Medical Education). The occasion consisted of two sections. First part was a banner introduction and the second was a research introduction. The adjudicators noticed the talking aptitudes, non-verbal communication, or more the entirety of their research work, themes, substance, results and brief articles likewise the time the executive’s abilities of members.

This event leads to the development of positive vibes in people. As, "Success is not final; failure is not fatal: It is the courage to continue that counts."

UBLIC PANDEMIC NUISANCE

MARYAM TARIQ, 2nd year MBBS

How strange! Seeing people all around you dying in no time, witnessing teeming hospital rooms and tiring shifts of health care staff, understanding the colossal burden on health department of country and foremost knowing that there is no escape as its all over the world, you can’t just fly to other continent, but still not grabbing something that can possibly shelter you, not so stout but the only shelter, in this state of fix. We all know that we can die anytime but having your subconscious mind validate the fact by giving a visible reason of death- COVID hits different and hard. As soon as vaccine was announced doctors suggested to get vaccinated and, in that state, when clearly most important thing was life,

still some people showed hesitancy towards vaccine. Hah! Humans of next century might laugh at it and might label us as idiots. Epidemic originated in Wuhan, China and showed its colors all over the world. Almost 70% people have heard of a conspiracy theory that alleges that powerful people intentionally planned the coronavirus outbreak and Trump constantly cunningly lied. Debate on Simpsons and queer exchange of statements between China and America were hot topics which made an unclear image of pandemic. These circumstances of rumors exaggerated by the media, along with side effects of AstraZeneca in some people, surely made vaccine dubitation. We all witnessed a backlash by some people towards acceptance of vaccine into their body, behind the curtains was the reason that COVID IS NOTHING, which further got strength as soon as they survived first wave and after that they completely turned a blind eye towards the figures of COVID cases, fatality rate or variant severity. Some people were just afraid of the panic created by the media and unable to understand it actually covered up their symptoms.

A large number of people did get vaccinated when it was made an obligation from the government and when they interacted with health care staff and vaccinated people. Hence the government is playing a pivotal role over here along with health care staff. A good talk or awareness meeting with family physician could have improved the behavior of people towards vaccine. Interactive awareness sessions arranged by different organizations as well by government must have proved effective in making people understand that how vaccine works. Asking people about their concerns regarding vaccines and focusing on that while creating awareness is also of great importance, especially in countries where literacy rate isn’t remarkable. Making people understand the importance of vaccine in combating other diseases in past, sharing different researches and explaining them the stance of health care providers over it will help people to drop the enchanting rumors that prevail so rapidly by news channels and social media. Thus, the use of proper counseling to eradicate the fear from the orthodox pattern of thinking of people will develop a constructive response towards the vaccine as a tool for combating COVID.

U

NHEARD MUFFLED SCREAMS

MARYAM TARIQ, 2nd year MBBS

Living peacefully under the shelters, breathing in the air of peace, satisfying each of our hunger pangs via something mouth-watering, attending educational institutes and living with our family at our homes with a proper sense of safety. Can we even imagine no roof over our heads and noises of bombs and fighter jets in the air, environment of terror, nothing to eat, nothing to look forward, no schools or educational institutes or hospitals working, losing parts of our family, friends and social circle and living with no sense of safety? Can we even imagine bulldozer running over and demolishing our beloved homes, bombs dropping on people who meant world to us, drones hitting different parts of our homeland but protectors and government are helpless and we are left with no option but to wander on the roads with remnants of once so grand and magnificent buildings on their sides? Daily waking up to news that someone you knew is no longer alive, some place you adored no longer exists but is transformed into heaps of ashes.

It's the nature of man that he turns to the shelter his respective religion offers in such a state of trauma and fix, when there is teeming social and mental unrest in the whole country. But what if I tell you…. Religious places are being bombed too.

Worshipers there are being tortured, captivated and teased…Smoke, chemicals, bullet shells, blood, opponent army and weapons are all that you see there too. How helpless your heart will feel and how badly you will be wanting people belonging to your religion from all over the world to defend your rights, protect your integrity as a country and save you! How you will have hope from those people who are enjoying life and perks of freedom and peace all over the world, people who advocate and talk about rights, who call themselves great activists. But hold on…what if I tell such people are also taking no action but just words, which I agree is powerful to some extent but your being in state of trauma and victim of tyranny, longs for relief roars from inside of you as more and more frustration and helplessness gets inculcated into your soul by the daily updates regarding what is happening. Yes, Syria, Palestine, Kashmir and many more where there are no rights to speak, record, report or defend. Tongue-tied agencies who once advocated rights for the West, reticent UN when it comes to even basic rights of Muslims and the whole world is spectating the scene. Some friend countries also shake hands with the tyrants while your heart breaks witnessing the scene. Let’s hope and pray for the better situation of the oppressed states all over the world, leaving words of Noor Afshan with you to ruminate;

Broken…. Limping

But I still dare to get up For I will never give up Stabbed… wounded My heart skipped beat But I won’t accept defeat

Violence in Silence (Preventing Child Abuse in Pakistan)

A touch that made you uncomfortable. Did you ever think of that one hand touching you which made your heart sink deep?

According to the World Health Organisation, it is estimated that up to 1 billion children aged 2–17 years have experienced physical, sexual and emotional violence or neglect in the past year.1

In 2010, boys (48.5%) and girls (51.2%) became victims at almost same rate.2

Child sexual abuse is considered to be a serious issue all around the globe, but when it comes to Pakistan, it is not even discussed as a subject. It is often brushed under the rug because of the taboo surrounding it. A total of 3,832 children suffered some form of abuse in the year 2017 and 2,846 cases of child abuse were reported in the year 2019, according to a report by NGO Sahil3. Zainab Ansari murder case was highlighted by media. Her courageous father took a stand against the perpetrators of this heinous crime. This gave all the sufferers confidence they needed to speak. Parents started reporting the cases and didn’t try to conceal this issue of grave importance. The act which not only ruined their child’s physical health (if they were not murdered right away) but also left a lasting impact on their innocent minds.

We, as protagonists of human rights and peace, have great responsibility on our shoulders. Speaking publicly about this issue is a great step. The issue now needs more to be done about. It is high time we take real steps to root out this evil from our society.

Firstly, the minimisation of the number of victims should be our primary goal. Awareness through campaigns on CHILD PROTECTION to community members, parents, teachers, children, health professionals, law enforcing agencies, organizations and youth groups should be provided. Children should be taught to protect themselves by parents and teachers via animations, small books and stories. Age-appropriate communication should be done in a way that little minds can fully grasp the concept of it. Most criminals are acquainted with the victim or are servants in the household, parents should be advised to keep a strict eye on all the people their children are in touch with.

Secondly, timely identification of signs of sexual abuse in children is imperative. Any sudden change in a child’s behaviour, academic performance, sleep, appetite or emotions, age-inappropriate sexual information, sexual acting-out with peers, toys, adults, and inexplicable bruises or marks on the body should also be investigated. Most importantly, no matter what the age, children need to be clearly and repeatedly told that the fault for the abuse does not lie with them, even if they have accepted gifts, enjoyed the abuser’s company, or could not say ‘no’, etc.

Building children’s overall self-esteem, providing them opportunities to express their opinions and thinking critically can be considered as important foundations for the work on body protection for both girls and boys. Teachers and parents could work as frontline forces in this regard.

Medical students should play their role too. In a country like Pakistan, medicine is a highly regarded profession. This gives them the opportunity to raise their voices about this issue for they are heard respectfully. Also, it is a responsibility of all health professionals to talk about child abuse as it results in deterioration of both mental and physical health of the victims. IFMSA-Pakistan provides a platform to all the medical students to raise awareness about important issues. Highly commendable is an activity” On Your Own” conducted by IFMSA-Pakistan which focused on children’s rights with emphasis on non-violence. More activities like that should be done by all the students in their best capacities.

Lastly, comes the victim support. In Pakistan, various NGOs like Sahil, Konpal and Auhang are already working. But it is now important that each of us play our role. Counselling of the victims should be done along with the provision of legal aid. Silence on this issue can perpetuate further abuse, and leave children suffering over long periods of time for something that can be stopped with timely intervention. The writer is VPCB AMC-LC IFMSA-Pakistan.

~The writer is VPCB AMC LC IFMSA Pakistan.

References

1. Violence against children [Internet]. Who.int. 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/violence-against-children

2. 11 Facts About Child Abuse [Internet]. DoSomething.org. 2020. Available from: https://www.dosomething.org/us/facts/11-facts-about-child-abuse#fn3

3. Sahil [Internet]. Sahil.org. 2020. Available from: https://sahil.org/

OWER NAP

We are given a heart which has a propensity to run after every emotional desire and all the shining things which this life offers. We, as humans, are tested by giving all desires .Our test is to make ourselves not a slave of our desires but to direct ourselves to the path which will truly raise our worth. What is life? There are one thousand ways to describe and define life. We can`t really judge and label one of those ways better than others. But life for sure is a test,’’ A test of truly knowing how to follow our hearts’’. Happiness and peace are two different things. Sometimes we are invested so much in making ourselves happy on the stake of our peace. A peaceful heart is always happy. But a happy heart is sometimes the world`s most empty thing. We should be keen in selecting our ways which make us happy. Our heart is a very good indicator. It gives us the signal every time we are doing injustice to someone else or even to ourselves. Our main target should be able to listen to it properly. The days, in which we are effortlessly working for our goals, are able to use our desires to our benefit, are motivated enough to carry

ourselves and focused to make ourselves proud, are like POWER NAPS. They give us strength to pick ourselves up when we have lost hopes in ourselves. They give us the energy to work harder for achieving our goals on the days when most of our energy is driven on just picking ourselves up from the darkness to the way of our enlightenment, when traversing the path is as difficult as climbing a mountain for a neonate. These days of self doubt, of drained energies and of high probability of losing ourselves in merging with others are the days of test. Rising and shining in these is the real struggle. The only motivation which can help us to surpass these days like a hero is just ourselves. Gather as much energy as you can in your power naps, so that it can become a radiating source of motivation for you in your days of working tirelessly on yourselves.

D

octors on the front line

For centuries people have needed “Masihas” during all the hard times to hold their hands, to take them out of all their pain and grievances landing them into hope and health. Whenever any calamity came from the skies, some kind souls rose on Earth to save its people from it. Doctors are the ones who never turn their back on highly inflicted people. No matter how dangerous the disease is, a good doctor will never leave his/her patient dying on the table.

After World War II, the time we are facing now is arguably the hardest in history. COVID-19 has affected the whole world on a large scale. Amidst this harsh time, doctors and paramedics are the ones who are under supreme responsibility to fulfill their potentials to the fullest in order to help the world fight against this deadly viral disease. Everyone is asked to stay at home. The whole world is locked down. All types of social human contact are prohibited as a precautionary measure but doctors are the only humans who are selflessly exposing themselves to the carriers of Coronavirus.

Even more highly mentionable are the doctors in Wuhan, who stayed away from their families for many months, all dressed up in hazmat suits with patterns of the masks etched on their faces. Due to such commitment, doctors and nurses are the ones who truly deserve ovations from all the nations in the world. By following all the precautionary measures, avoiding social contact and staying at homes; we can help the ones who are bravely standing on the frontline to combat this virus. Li Wenliang died after contracting the virus while treating patients in Wuhan. Let's not forget him and all the doctors who had given up their lives just to save others. Fortunately, Pakistan is blessed with doctors who are willing to serve in their best capacities. The situation up till now had been in control but the number of diagnosed coronavirus patients is escalating at a rate which is alarming. Arrangements in the hospitals are being made to handle dangerous circumstances. Doctors have folded up their sleeves to treat all those who are coming to them. Dr. Osama died after being on a ventilator as he was performing duty in a screening panel in Gilgit. Doctors are on the border, airports, bus-terminals and all other screening panels to avoid contamination of the country with the virus. They are performing their duties despite the risk of exposure. Doctors were and are still on the frontline but it is high time that we, as individuals, recognise our grave responsibility. In this time of crisis, take all precautionary measures necessary. Shout out to all the selfless doctors working tirelessly to cure mankind and my heartiest feelings of respect and gratitude for their service.

POEMS

Hierarchy

by Aamna Rehman AIMC-LC

My mom passed onto me— What she got from my grandmother and great grandmother: Fear, pain, silence upon suppression and emotions, Disguised in patience, tolerance, strength and selfless love. My father transformed into me the anger

That runs in the lineage of my family, The rage of the child whose needs for love were never quenched, The temper of the teenage who never got to fulfill his dreams.

My grandma injected in me the grief: That lives forever in the house of a migrant; That is the uninvited partner of their nights, That is the water that never dries in their eyes. My grandfather told me stories of his bravery That kept him going when the days were rough, That has thickened his skin and that of his progeny, And that does not let their wounds heal on their own. While talking of the hierarchy, my uncle once told me–That only those survive who remain the fittest;

So our elders had to put on masks that then became their blood, And now if we want to keep surviving, we must carry on the legacy. My inner rebellious child refuses to accept this; He peeks through creaks that time has created in the masks, His brown eyes sparkle with dreams, hope, vulnerability and love;

He whispers while his fear of rejection chokes him–

Who would break the generational curses if not us?

Who would set new rules in homes if not us?

Who would question the trends if not us?

Who would halt unjust folktales from passing down if not us?

“The Heroine of The Village Maelstrom”

by Cadet Shaheen Fazal AMC

Section 1: Description of the Village, Maelstrom

Imagine a girl, look inside her soul, There stands a village by the name Maelstrom. Look out from her eyes and behold, The city where tales of humanness come from.

She named the village, Maelstrom, For rare entities reside there, Angels and demons; love and reason, Who time and again engage in warfare.

Angels fight for dominance, Demons too have guts. Cacophonous is her village all the time, Switch of her sanity occasionally shuts.

Section 2: In the Times Bygone:

Her struggle began early like many, With canvas of life being incomplete, The wound from absences hurt more, The word normal then seemed obsolete.

Happy moments were there too, But elation went through suppression, Feelings accumulated, Thoughts direly craved expression.

Had she answers but none asked questions, Thence died the will of articulation Fantasies besides raised hope, Had she attention but required consideration.

In her soul’s village, madness fought with reason, And love with decisions, Loss of focus and time occurred, Unattended wounds turned into lesions.

She expected only a saviour could, Sort out the mess and madness, That stemmed from the injuries of, Absence, omens and sadness.

So waited she for a saviour: the hero

To liberate her village from the tumult, And a promise of fellowship to save, Her future, apparently occult.

But wait got prolonged, And came no hero, Time was ripe, To rise from zero.

Section 3: The Heroine

Then one day, unlike the princess in the castle, She decided not be on look out anymore, Full strength is there in her limbs and mind, She would craft her own folklore.

What do you do when there’s a villain but no hero? You pick the sword and be one. Fight the odds and the demons, Crown yourself once the deed is done.

Warrior was she not by birth or choice, But when marvellous mentors are involved, Like hunger and heartache, luck and loss, Made is one, a heroine, as this girl evolved.

The girl did the same, liberated herself from the chains, By choosing growth over stress, post trauma, And gave herself a pat on the shoulder. After shattering “the hero from afar” dogma.

Section 4: The Ordinary Girl

For the world she is ordinary, But a heroine for her friends and kin, Humble she is like thousands of others, For winning wars of survival within.

With hair in a braid, she now treads, Into the city and trouble is nil, The morning is peaceful today, Like the shores of her will.

The Heroine earned the title, Through faith and ferocity, Odds she tackled and tackles, As of will she has no paucity.

F

rom Containment to Contagion”

by Cadet Shaheen Fazal AMC

Know it some actualities, If stay put in a container, longer, Their intensity increases due to, The brewing which becomes stronger.

Like in nature when igneous rocks, Fuse and melt in a volcano, And without call lava erupts, With tremors, geology says so.

Like hate, If not address its basis, Becomes unleashed, Causing in life, drastic stasis.

Like grudge, If not removed timely, Starts festering on the soul, Vibes would change which were previously comely.

Like persistent regret, Robs joy out of a personality, May not harm others first, But deprived are all of one’s joviality.

Like bigotry being a fungus, Causes morality’s diminution, If not properly cleansed, Borne is a blood-clad revolution.

Like oppressed are others, When murdered is mercy in the oligarchy; Repent, make amends, Or prepare for the widespread anarchy.

It is a basic rule, if two sides, Of a coin exist for anything; Then tail would reign if not the head, Like if loved is nothing, hated would be everything.

Love and mirth follow, The laws of diffusion, Spread from high: inside heart into, A territory having low concentration.

Similarly hate, if kept untended, Inside mind’s bastion. Cruises like a pathogen, From containment to contagion.

It would take will and courage: Join hands for the sake of humanity. Live, leave a good place for the kids, Discard hate, discard negativity.

“Gray:The Interfusion”

I fancy white,

by Cadet Shaheen Fazal AMC

Like black by the way, But they join, Conspire and turn gray.

One isn’t exactly fair, Or absolutely dark, Exist hues in combination, See the hovering skylark.

Deed book is good, Neither wholly bad, Both have their spaces, Portion of each, the pages clad.

What gives one strength, Might be someone’s weakness; Like support from a cheering crowd, May push another into bleakness.

Expression is liberation, But for some it is not, Like fear is hindrance, But, For some, a push that is sought.

Like crying is being fragile, Like humor is a way of denial, But crying can be cathartic, And humor adds to life’s vial.

Like love: it may be, Madness or sadness, But love for them is, Complete gladness.

Like love makes a few tryst, If they not deem it a humiliation; But some believe keep its spark alive, Longing and separation.

Together love and hate, In a heart may enjoy home, For a person, each at a time, May take turns to roam.

Forced submission, Or unjust obedience, Gray is what should face, First, the good riddance.

Birth is not the beginning, And death, not an ending, Gray is what lies then before, And after the life’s spending?

Not entirely a facade, Are all the acclamations, Like fraud may not lie, Behind fame and validations.

Gray is telling lies to keep a heart, But asked into question then is morality; Like applying brakes to save a person, But it defies the traffic rules’ vitality.

Like keeping news from a subject, Of terminal illness to avoid despair; But on knowing he may want to enjoy, The days remaining in happy gear.

Like the martyrdom that earns, Eternity and glory, But leaves behind the wound of absence, An unfinished story.

Peace or prosperity, What is necessary?

Both in proportions at times. Alone, none is visionary.

Gray is the transition, Between black and white, Open to interpretation it is, Based on the moment, right.

PROSE

ATE IS HEAVY

As we go through life, we come across a lot of people, things and experiences. Some of them we like, some don't matter, some we learn from, and some we end up hating. Now be it a person, thing or situation that we hate, it takes a toll on us. It is very easy for us to say that we hate a certain one but what we do not realize is that this hatred hurts us more than anyone else. It is a seed that gets implanted deep into our subconscious and keeps on growing roots. With time these roots occupy our entire thought process without our realization and as it happens, we turn into toxic beings who damage everyone and everything around them. But most of all we damage ourselves without even knowing it. Hate is such a heavy emotion that as time passes, it's burden exhausts us to a point where we cannot let go even if we want to. We end up spending all of our energy on the person or thing I we hate. Our obsession with avenging them tricks us into doing things that ultimately harm ourselves more than the one we've been hating on. It blurs our insight and weakens our ability to see the reality so much that we start feeling crippled in the absence of this negative emotion. Letting go is difficult, especially when you've been hurt bad, but it is always better than carrying the weight of Hatred. So, no matter what, just let go and move on...

TAHA KHAN PUBLISHING DIRECTOR

Kashmir Issue: Historical Injustice or misguided Geopolitics.

by Shehla nazir

Kashmir is a bone of contention between Pakistan and India. The Kashmir issue is one of the big-time impediments in normalizing the relations between Pakistan and India. It’s a territorial conflict over the Kashmir region and this conflict started after the partition of the sub-continent in 1947. Over this issue, both the independent states (Pakistan and India) have fought two full-fledged wars in 1947-48 and 1965. Both of these states claimed the quondam princely state of Azad Jammu and Kashmir in its entirety as Kashmir also has a significant geopolitical status. This significant geopolitical status has always been the apple of discord between the neighboring countries. Kashmir has significant importance due to its heavenly landscapes, national security, and resources. This conflict also gained immense international attention as both states are nuclear powers and this conflict represents a threat to global security.

“As a historical legacy, the Kashmir conflict has been an outstanding issue for more than half a century.”

-Li Peng

To understand this conflict, it is essential to look back into the history of the area. In August of 1947, Pakistan and India were about to get independence from the British Empire. The British separated the British India Empire into India and Pakistan, commanded by then-Governor-General Louis Mountbatten. The British India Empire was made up of several princely states (states that were loyal to the British but were led by a king) as well as British-controlled nations. Princely states had the option of deciding whether they wanted to be part of Pakistan or India at the time of partition. Generally, Muslim-Majority States sided with Pakistan, while the Hindu-majority States joined India, even though India is a secular country. However, there were three states (Junagarh, Kashmir, and Hyderabad) that neither wanted to become part of Pakistan nor India they wanted an independent status. At that time, Kashmir was an exceptional case as the majority population was Muslim but the ruler was a Hindu, Maharaja Hari Singh. However, it was not the only instance of such sort. A similar conflict erupted in the state of Junagadh. The ruler of Junagadh was a Muslim who wanted to join Pakistan despite his people's preferences. Kashmir was recommended to be a part of India by Mountbatten as it was surrounded by India. However, the ruler rendered to Pakistan. At last, Junagarh was merged into India by military force.

“Liberty will not descend to a people; it is a blessing that must be earned before it can be enjoyed.” -Charles Caleb Colton

“Injustice anywhere is a threat to justice everywhere.” -Martin Luther King Jr.

When it came to the region of Kashmir, the situation was completely different. Kashmir was a Muslim majority state with a Hindu ruler, Dogra Raja Hari Singh. At that time, Mountbatten recommended Kashmir to be a part of India but Hari Singh decided that Kashmir should be independent, at least for the time being. There was a lot of pressure on Dogra Raja Hari Singh to be a part of India by Mountbatten. The Kashmiri Ruler allowed the Indian army to attack Kashmir and paver a path for them to occupy it. Contrary to this, the Kashmiri Muslims made a plea to Pakistan to aid them against this anarchy. This led to The First Indo-Pak War, also known as the First Kashmir War between Indian forces and Pakistani tribesmen.

"The worst form of injustice is pretended justice.”

-Plato

Pakistan's army entered the conflict in 1948, aiding a hand to the Muslims in despair. Both parties in Kashmir concreted their positions by the end of 1948. A cease-fire agreement was reached, as well as a line of control (LOC). India was left with nearly two-thirds of Kashmir known as Jammu Kashmir, while Pakistan gained control of the remaining third known as Azad Kashmir. Kashmir. The Line of Control divides the territories administered by India and Pakistan (LoC). In the disputed territory, this is a controversial dividing line. This dividing line frequently results in crossfire and deaths. In the Indian administered Jammu and Kashmir, violence erupts on daily basis along with numerous political divides, primarily between Indian security forces and terrorist organizations. On the 21st of April, 1948 Security Council passed a resolution that was accepted by India but rejected by Pakistan which led to no withdrawal of troops as compared to well-developed countries in Europe. Pakistan and India thrash billions of dollars in the name of defense and the main reason for this is Kashmir. The people of both countries are threatened by the war that drives them to pay hefty taxes.

Jammu and Kashmir was a state of India from 1954 to 2019, constituting the southern and south southern portion of the larger Kashmir region, which has been the subject of a dispute between Pakistan, India, and China since the mid of 20th century. Kashmir is also known as “Paradise on Earth” due to its beauty surrounded by mountains which adds to its importance that thrives the world.

Kashmir serves as a bridge between South Asia and Central Asia. It’s the only direct route to central Asia and through central Asia to Europe for India. Kashmir also has huge importance due to natural resources like Uranium, gold, oil, and natural gases. India also depends on Kashmir due to irrigation as the Indus River flows through Kashmir. The Kashmiri Rivers and water bodies also have the potential to generate hydroelectricity at great magnitudes that can serve the electricity demands of entire Asia. It is an important part of the Belt and Road Initiative. It is also critical for the China-Pakistan Economic Corridor (CPEC). The CPEC is a large-scale bilateral project encompassing infrastructure development in Pakistan, the installation of transportation networks between China and Pakistan, and the development of several energy projects. Many of these projects pass through Kashmir, which is

“If there is a heaven on earth, it is here…it is here…it is here.”

-Jahangir

administered by Pakistan. Through Kashmir, Pakistan has indirect contact with both Central Asia and China. Kashmir is a central piece between three nuclear nations: India, Pakistan, and China. Kashmir is highly important for all these states as for India, Kashmir is the only pathway to Central Asia. Without Kashmir, India does not have any access to Central Asia and European countries through the land. For Pakistan, Kashmir is highly important as Pakistan is highly dependent on Kashmir for agricultural purposes. However, Pakistan still claims Kashmir its part due to the Muslim majority in Kashmir and for China, Kashmir is important for its economic survival. The Kashmiri perspective has been ignored. Before the partition, Kashmir had approximately 4 million people. Here arises a question: Kashmir is a historical injustice or misguided geopolitics? We must understand the historical injustices or misguided geopolitics. To understand geopolitics, we must view Kashmir from two different aspects one as a land and the other as a land of Kashmiris. As mentioned above, Kashmir is highly important due to its reservoirs and misguided geopolitics between different counties. The second one is an aspect of Kashmiris. If one would enter in the shoes of Kashmiris and then they would feel the anguish and hatred thrown upon them daily. Around 70% were Muslim, 25% were Hindus and the remaining were Sikhs and Buddhists. The Kashmir perspective is different as few want an independent state, some want to be a part of India, and the remaining want to be a part of Pakistan. As both India and Pakistan claimed that Kashmir belongs to them. It's difficult to imagine any country willingly handing over Kashmir. Thousands of Kashmiris and soldiers have undoubtedly endured and continue to face atrocities. Kashmir due to its physical immediacy with India and Pakistan, water resources, physical access to the Great Silk Route has great geopolitical, economic, strategic, and military importance for both countries. Thousands of people sacrificed their lives for Kashmir. This conflict can only end up through by-literal talks as both states have a nuclear power status otherwise the results will have disastrous effects on both states and Kashmir. These two states should learn a lesson from Germany and France, which were once hostile neighbors who fought each other in two World Wars. Both of these are now part of a powerful European Union with an open border and both use the Euro. Their population is now experiencing a healthier lifestyle than their forefathers. Before the partition, the people of Indo-Pak opposed British colonialism, but now they are battling each other. India and Pakistan can coexist like France and Germany, but the problem is that they are competing militarily and militarily, making the buffer zone the world's most militarized zone. India and Pakistan should make amends for the harm they have caused over the past 73 years. The geopolitics between Pakistan and India is linked to three nuclear states, so any future conflict can lead to catastrophic results. As long as these geopolitical issues are not resolved, Kashmir will remain a center of injustice. Pakistan and India should end their geopolitical dispute and the people of Kashmir must have the right to their decision in bringing peace to the valley for normal economic growth.

“We must learn from history, there is no military solution for the Kashmir issue … we have to understand this reality.”

-Pervez Musharraf

IGITAL HEALTH

(by MARYAM TARIQ, PubSDD AFMDC-LC)

This century in every aspect is completely embraced by technology, whether it be medicine, education, engineering, construction, public transport system or any other field just because technology makes things much easier for humans to tackle as well as enjoyable.When the video games, I mean the distractions are so captivating why not the career and major fields also? Why can’t they also adopt the essence of technology and attract its aspirants? The answer is why not, the answer is digital health.Where world is moving towards automatic CPR giving machines we here in Pakistan, where half of population doesn't know what it is, are far behind the advancements in the medicine field in the world.Being a developing country we are still progressing in the field of medicine too and our health care system are still trying to be better ones for tomorrow.A great steps towards the digital health in Pakistan yet is the introduction of E-Health Service in the form of personal identification cards, which store patient history as well as their date ensuring its privacy so that health care providers can have an access to consistent patient histories but still much more steps are required to reach the destination of digital health in our country. Robotic surgeries are being done by the doctor staying miles away from the patient which are minimally invasive and offer a great solution to the problem of patients. Handwritten doctor prescriptions are being replaced by the QR codes which offers you medicine showing it in any pharmacy which eradicates the problem of misplacing the prescription as well as the false prescriptions.A better communication between the doctor and patient is being ensured by the help of technology as all what a patient actually needs is the right information at the right time, so they have direct access to doctor wherever they are they can talk to their psychiatrist or gynecologist etc. As a Chilmark research showed:

A huge gap between the doctors, nurses, pharmacist, nutritionist, psychiatrist and other health care service providers of the same hospital can be largely reduced by the use of technology, that would largely affect the working of the hospital positively. The gap between different hospitals of the same city or same country and the hospitals around the world will be reduced and there will be close network where referring patients, sharing information as well as the researches would be much easier. Technology inflicted upon the health care system will reduce the chances of errors largely and will ease the access to second opinion as well as the donors. All these factors reduce the workload on doctors and the other staff of the hospital who are always sleep deprived and living under the burden of heaps of work with reduced efficiency. There are a lot of tasks that are still being done manually whereas they can be done so efficiently and easily with minimum effort by taking technology and different new applications into account .As Dr. Jay Parkinson's words put my thoughts in a perfectly as: "Every second the doctor is not seeing patients is wasted time. Doctors already spend roughly 40 percent of their day documenting and doing other administrative tasks. To waste the other 50 to 60 percent of your day traveling between patients is a 50 to 60 percent reduction in efficiency. Short of teleportation, the doctor house call will always be an irresponsibly massive reduction in primary care efficiency." Besides the facts I stated above, I want to proclaim that we as medical students, house officers, medical officers and being part of the healthcare system can play a huge role in bringing this transformation in our surroundings. Practice of using different applications, using networks of doctors, using different applications on a personal level and cooperating with the measures taken by the government ; we surely can be pioneers in digital health in our respective college or hospital. For this we need to look for the smart solutions of the problems that we observe around us and we can have a problem solving approach towards it staying in the confinement of our resources and access. Try as far as you can, it will be hard but worth it!

"The notion that simply discharging patients with some technology will prevent readmission or ensure positive outcomes is more wishful thinking than reality."

Tabeer Hussain

HO AM I?W

WHY AM I, WHO I AM

I wonder why am i, who i am, I don’t want to be this or is this normal. The world seem to push me off on this very quest, left me alone to wander into thoughts of my own, vulnerable like a little cat in forest of wild cats. I seem to be an over thinker, naive who is not ready for this world. Everyone seem to have an opinion over mine and why not, I was pampered to the idea of world’s different criterion. I cried to the very little thought of someone hurting me. I cried when i saw someone crying. I cried when i saw children being scolded. I cried when i saw the old man walking on his stick being hit by a teenager. I cried when i saw patient. I cried when i saw thalassemic kids being transfused. I cried when i felt alone in crowd. I cried when i asked someone and got ignored. These are little things they said, My masculinity was on STAKE.

YOU ARE NOT NORMAL, Nobody cries on little things, be strong, are your tears not worthy? Are you dumb? Be mature!

Alas! It haunts me to the day that why am i, who i am. I am in process of comprehending is this WORLD NORMAL? Kindness in books and cruel in practicals, is this NORMAL? Kindness being knocked out, A NEW NORMAL perhaps.