InciSe Magazine (Issue 1)

InciSe APRIL 2019|Â ISSUE NO. 1

"INCISINEXUS" EXTERNAL REP. RECAP

"SURGEONS NOTES"

"INCISISTOMOSIS"

QUARTERLY INCISON UPDATES

NATIONAL WORKING GROUP UPDATES

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InciSing your way into 2019....

TABLE OF CONTENTS

Greetings, Thank you for opening the very first copy of the InciSoN magazine, InciSe.

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We hope this quarterly magazine will entice our creative juices and enable us to share our #FutureOfTheOR experiences as sharing is caring.

We are also grateful for the goodwill you have shown us this term and hope that is only the

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beginning.

Till the next edition, #FutureOfTheOR #GlobalSurgery Yours in Service, Marie-Claire Wangari M. (Kenya) 2019 Vice-President for Internal Affairs

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2019 GLOBAL SURGERY SUMMER SCHOOL From July 8 to 12, the Global Surgery  Summer School will take place in Utrecht, the Netherlands.

This course is organized by the surgical department of the UMC Utrecht in collaboration with the Netherlands Society for International Surgery NSIS (www.surgicalneed.nl) and is designed for healthcare providers (in training), researchers, Masters or PhD students and other professionals with an interest in global health and surgery. Â The course is a one week interactive program, participants will be engaging in theoretical as well as practical sessions with a diverse group of speakers, who will share their experiences as experts in the field. Topics of focus include essential surgical care and surgical research in low and middle income countries among others Available spots are limited and a selection procedure applies, which is why we invite all interested to apply in due time. A reduction in course fees is available to applicants from low- and middle-income countries. All information on the course and how to apply is available here.

In addition to Global Surgery, the Global Health department of Utrecht Summer School offers three other courses that may be of interest to your organization: Challenges in Global Health (1-5 July 2019) Child Health: A Global Perspective (8-12 July 2019) Reproductive & Maternal Health: A Global Perspective (15-19 July 2019)

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CLIMATE CHANGE CAN FRACTURE BONES – AN UNEXPECTED LINK BETWEEN INJURY & CLIMATE CHANGE

By Nicole Lin June 2017 – Soroti, Uganda “So, why did you climb the mango tree?” The boy mischievously giggled at me with a look that said - duh, I wanted to eat mangos! Week by week, I rounded the surgical wards of Soroti Hospital and saw the same boy lay there, as the traction splint slowly healed his open fracture injury. He and two other boys, now close friends, were there for the same reason – injuries after falling from a mango tree resulting in broken clavicles and a rupture spleen respectively. Each time I passed by, the three boys giggled, undoubtedly because I was a muzungu - Swahili for "aimless wanderer" but in lay terms, any non-local, foreign looking person. But beyond this light-hearted interaction, I couldn’t help but think of the larger implications of this long-term stay at the hospital – 1 trauma, 6 weeks away from lessons at school, 6 weeks of hospital expenses, 6 weeks of a family member taken away from work and duties at home to care for him, 6 weeks of an occupied hospital bed in an underfunded, overcrowded rural hospital in Eastern Uganda. Now, multiply this scenario by at least 100 victims this past season alone.

Now, it makes sense that school boys are mischievous and fearless, climbing trees and monkeying around the community. But what about the mother that was brought into the emergency room after a brittle mango branch sent her falling almost 30 feet down, along with a baby she was carrying on her back. What would prompt her to take that risk? The question loomed.

INCISE ISSUE NO.1 During my time in Uganda, I lived in a long-term bed and breakfast where oftentimes United Nations workers were hosted as they traveled around the country, especially to address the current refugee crisis. Serendipitously, I had an in-depth conversation about the food crisis that local communities were facing due to the massive drought in the region [1]. He mentioned to me that due to the lack of maize, families look for alternative sources of food – one of which being the deliciously sweet mangoes that can temporarily satiate the hunger. Mango trees can grow up to 100 feet, and you would think that it would just be mischievous school boys climbing these towering mango trees. However; women, children, mothers, fathers have all become daredevils, climbing higher and higher to harvest the last mangoes of the season and falling victim to injury and trauma. Why? Because it's either that, or what seems to be another practicable option, disguise oneself as a refugee to obtain food at a nearby camp [2]. The drought and food shortage are that bad, and when you have been working in the intense heat of the midday sun as a local subsistence farmer, you look up to see the mango hanging at 100 feet, you might just take your chances and climb it too. Hunger is ravaging the country, with over 11 million Ugandans facing starvation [3].

Climate change has been linked to changes in productivity level, heat-related illnesses, allergies, infectious disease as well as mental health and social, economic instability [4]. Its effect is pervasive and affects the foundation of our global community's well-being. Climate change opens new exposure pathways that alter social, economic, behavioral, mental health, well-being outcomes; and these pathways will only increase as climate change continues to accelerate. We must work to prevent continued acceleration of climate change but also work to mitigate present risk at a community level, as individuals interface with a constantly altered natural environment.

We are just beginning to experience and comprehend the far-reaching effects of climate change, and it is imperative that we engage and address complex problems such as climate change from a trans-disciplinary approach and further researcher on how environmental changes both directly and indirectly affects our well-being and health.

So, why did little boy climb the mango tree? I think the boy meant to say – “20% because I was curious and 80% because I was starving.”

INCISE ISSUE NO.1 Works Cited [1] Drought in the Horn of Africa. www. fao.org. http://www.fao.org/emergencies/crisis/drought-hoa/intro/es/?page=2&ipp=10&no_cache=1 [2] Ugandans pose as refugees for food because the drought is so bad. www.pri.org. https://www.pri.org/stories/2017-09-21/ugandans-pose-refugees-food-because-drought-so-bad [3] 11 Million Ugandans face acute food insecurity. www.un-ug.org/news/11-millionugandans-face-acute-food-insecurity [4] McMichael A. Globalization, Climate Change, and Human Health. Global Health: The New England Journal of Medicine.

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EUROPEAN REGION UPDATE-I

By InciSoN- United Kingdom InciSioN UK are delighted to introduce the Global Health Education in Medical Schools (GHEMS) study as our first project within our annual research portfolio for 2019. As a national multicentre study, advocation for global health initiatives underpins the agenda of the study.

In our increasingly interdependent world, global health is emerging as a priority concerning all healthcare professionals (HCPs). Equally, it is key that HCPs are taught how to deliver effective care to multicultural communities with diverse needs.

Therefore, medical schools have a duty to educate their students on global health. This can be achieved through compulsory timetabled teaching, optional student selected modules or pre-elective training.

The GHEMS study aims to delineate the breadth of global health teaching during undergraduate and graduate medical training across UK med schools. Student representatives from medical schools across the UK will collect key features of their global health curriculum. The findings will inform related ventures and strategies to improve global health teaching in UK medical curricula.�

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EUROPEAN REGION UPDATE-II

By InciSoN- Croatia InciSioN Croatia organized Global Surgery Croatia Symposium (GSCS), the first symposium dedicated to Global Surgery in the country.

The GSCS was held on the 1st of March 2019, at the Andrija Stampar School of Public Health in Zagreb, Croatia. Vice-Dean from the School of Medicine, University of Zagreb, Professor Davor Ježek, officially opened the Symposium.

Lectures were given by Kristina Brkić, Dr. Rinse Meester, Dr. Matthijs Botman, Professor Tedi Cicvarić, Dr. Ružica Pavić- Kevrić, Dr. Šime Kevrić and Emina Letić. The Symposium also gathered 102 passive participants, including representatives from the WHO, the Croatian Institute of Public Health, School of Medicine in Zagreb, Faculty of Medicine in Rijeka, and medical students from Zagreb, Rijeka, Osijek, Belgrade (Serbia) and other countries. The aim of the Global Sugery Croatia Symposium was introducing Global Surgery to Croatian students, residents and doctors.

Since exchange of knowledge and experience is a foundation for advancement for all medical personnel, we hope that all participants have learned more about Global Surgery, gained new ideas and inspiration for their future endeavours. In the end, one of the goals of the Symposium was creating new and strengthening old partnerships and cooperation between the School of Medicine, University of Zagreb, the Andrija Stampar School of Public Health, the Faculty of Medicine, International University of Rijeka, Croatian Trauma Society, Global Surgery Amsterdam, Netherlands Society for International Surgery, InciSioN Croatia, Incision Bosnia & Herzegovina and CroMSIC - Croatian Medical Students' International Committee.

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EUROPEAN REGION UPDATE-II

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EUROPEAN REGION UPDATE-III

By InciSioN Netherlands We organized a movienight/debate on global surgery with the screening of the documentary "The Rebel Surgeon". After the documentary our invited experts (Paul Breedveld and Laura Heman; both worked as tropical doctors in Africa) shared their personal experiences of their time working abroad, discussed the barriers they came across and commented on the work of Erik Erichson.

Importance: The sustainability of practicing global surgery, especially the importance of educating local staff, was a hot topic on this evening. Thanks to the great audience, the two speakers got a lot of critical, thought-provoking questions to answer. Date: 19th of February, Maastricht

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AMERICA REGION UPDATE

By Global Surgery Student Alliance (USA) The Global Surgery Student Alliance (GSSA) serves as the U.S. national working group affiliated with InciSioN. GSSA’s third annual national event, the Virginia Global Surgery Symposium, took place on March 2, 2019 at Virginia Commonwealth University (VCU) School of Medicine. The event began with opening remarks by Dr. Sudha Jayaraman and Dr. Edgar Rodas who are both part of the Program for Global Surgery at VCU. This was followed by a presentation from GSSA Co-Chairs Parisa Fallah and Anusha Jayaram, speaking about GSSA and InciSioN to attendees from across the country and those live-streaming from around the world. Keynote addresses included Dr. Robert Riviello from Harvard, Dr. Gregory Peck from Rutgers, and Dr. John Langell from University of Utah. Additionally, Dr. Walter Johnson gave an address on behalf of the World Health Organization. The program featured breakout sessions pertaining to different surgical sub-specialties including trauma, neurosurgery, pediatric surgery, obstetrics and gynecology and anesthesia. Other sessions included a discussion on careers in global surgery, global surgery innovation, developing a global surgery program, and a resident experience panel. The event ended with an incredible ethics session that took students through a wide range of surgical cases from different settings around the world, pushing attendees to think critically about how to address inequity in access to surgical care as well as how to navigate clinical situations in environments different than their own.

The event proved to be motivating and inspirational to all those who could attend and we would especially like to thank Cassie Valukas, Cody McHargue, Merve Gurakar, Dr. Sudha Jayaraman, Dr. Edgar Rodas, and the rest of the team at VCU who were instrumental in putting together this event alongside GSSA’s full national team. With over 250 attendees and many more who were present via live-stream, this symposium was a true testament to the rising interest and passion for the field of global surgery amongst U.S. students and trainees, and the dire need for more opportunities to connect interested people in the U.S. to incredible colleagues from around the world. Many new ideas were generated, relationships formed, and plans initiated for further contributions to the field of global surgery. Over the last three years, GSSA has grown to include over 40 local chapters from all regions within the United States, encompassing a network of over 3500 students and trainees. We are looking forward to next year’s symposium and we hope to see you there!

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Information about the Virginia Global Surgery Symposium can be found at www.globalsurgerystudents.org/virginia-symposium. Recordings from the event will soon be posted there for anyone who is interested to learn from over 30 incredible speakers who were at the event!

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ASIA-PACIFIC REGION UPDATE-I

By InciSoN- Taiwan InciSoN Taiwan hosted a Global Surgery Workshop on the 30-31 March 2019. In addition to discussion to the topic, they also did some innovation drive by including a proportion of clinical skill course(ex:suture), The program commenced with two talks on introduction to global surgery and InciSioN. There were also two talks delivered by two an obstetrician and surgeon that focused on delivery of international medical aid experience.

The event then ended with a a brief endoscopy simulation and suture course with a competition wrapping up the day's activities competition

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EMR REGION UPDATE

By Global Surgery Israel

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AFRICA REGION UPDATE-I

By InciSoN- Somaliland in partnership with Human Rights Centre, Somaliland, our NWG hosted an International Women's Day event at Borama Region.

The Event was success thanks to the well experienced panelists and the captivating moderator, Yusuf Saeed, the InciSioN Somaliland Research Lead.

Hassan Ali Daoud, Founder of InciSioN Somaliland and the Secretary of our NWG gave a speech about the daily challenges that happen in the hospital especially with Obstetric & Gynecological care where men are the only ones who as permitted to sign Obstetric surgery consent forms.

By the end of the event, delegates present agreed to enact this year's International Women's day slogan of "Balance for Better." and encouraged Women to raise their voice and become part of getting their autonomy back in partnership with the Human Rights Center through signing of a national petition.

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AFRICA REGION UPDATE-I

By InciSoN- Sierra Leone InciSioN Sierra Leone hosted a Surgical Skills Workshop.from Saturday 16th March 2019 at USLTHC Skills Lab, Freetown.

A total of 15 participants: medical students and intern doctors were taught basic surgical skills and introduced to the different techniques in Knot tying and suturing.

PS Did you know that Sierra Leone has only 8 surgeons for a population of 7 million people?

Hence the reason of the workshop so as to build capacity of upcoming generations in a quest to have global surgery for all

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FROM LOCAL TO GLOBAL AND VICE VERSA Emina Letić, VPNWG- Vice President of National Working Groups To achieve something on the global level, we should start at local levels and all together contribute to something bigger. This is valid also for the global surgery- to achieve great aims, we have to change things on our local ground.

Students and young doctors from 40 countries worldwide have organised National Working Groups(NWGs) and joined InciSioN Network. They organise different local and international events, workshops, hackathons, crowdfunding and advocacy campaigns, research projects and community work to educate, advocate and research in the Global Surgery field.

The diversity of their activities comes from different needs and background in their countries but all of them include strong social accountability component and all of them make influence on their local but also global level.

InciSioN Network provides friendly and supportive environment for all NWGs and it is meeting point for all of the students and young doctors who cooperate together for Global Surgery.

Are passionate, brave and want to change things in your country?

Do You want to join your country to InciSioN Network?

Wondering how to establish NWG in your country?

Check the toolkit at our web page: http://incisionetwork.org/NationalWorkingGroupToolkit.pdf Be free to contact us at vpnwg@incisionetwork.org or incision.studnets@gmail.com for any questions!

Contact Us General Email: incision.students@gmail.com VPI Email: vpi@incisionetwork.org VPNWG Email: vpnwg@incisionetwork.org Whatsapp Number: +254713835507 (VPI) Blog: http://www.blog.incisionetwork.org

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