Medicor 2013 #2 by Medicor MF Magazine

1#2013

medicor

Nobel Prize announcements 16 Maciej Zaremba 32 Win tickets to Nobel Nightcap 43

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Prelude Everybody has a story to tell, your viewpoint. All of us have a unique story. Expressing yourself can be done not only through writing. You can be creative in layouting, designing, monitoring finances, and not least doing photography. The art of photography makes up our cover story, featuring world-renowned nature photographer Mattias Klum. His work conveys the story of how beautiful the earth is, but also that we are destroying our life-support systems. The front cover was taken in Tropiska Trädgården i Uppsala, who kindly let us in. Additionally, we thank Bokförlaget Langenskiöld and Tierra Magna Foundation for their helpfulness. Another interesting story is told by Dagens Nyheter’s Maciej Zaremba, who in the spring caused quite an uproar, writing about new terms such as New Public Management (NPM) and Diagnose-Related Groups. Medicor thanks Södersjukhuset for letting us use their facilities for the interview. We also want to thank Astrid Seeberger for arranging this meeting. Medicor also sends its deep gratitude to Nobel Forum’s AnnMari Dumanski and the Nobel Assembly Secretary, Göran K. Hansson, for offering us the unique opportunity to take photographs from inside of the final Nobel Assembly session. To us, the palpable tension in the photograph we got is a thousandword story in itself. As hinted, layout and design are important in conveying your idea. This issue is as dense in content as the spring issue, but has more liberal spacing, with more illustrations and airier text design. We have split the magazine into features such as Karolinska, Science, and The Arts. These feature sections are colour-coded for both functional and aesthetical value. We hope the language profile, with English summaries for most Swedish articles, allows for the greater majority of Karolinska Institutet’s students to enjoy Medicor. Hopefully, the new layout will enhance your reading experience. On a more personal note, I am very proud to present the following Medicor issue to you. Working with a determined and motivated group of students, in the endeavour that is magazine, I have got to see that stories indeed are told in many ways. Everyone’s talent and self-expression is unique, and the contribution of each person has been pivotal in creating the magazine. As students at one of the leading medical universities in the world, we are all privileged to enjoy countless opportunities, available to us not only here, but perhaps also over the world. Medicor wants to share some of the stories that inspiring people like Mattias Klum and Maciej Zaremba can tell. We will continue to work hard to provide you with the magazine and the stories of which you all deserve to take part.

Photo by Martin Kjellberg for Medicor

Medicor is all about your story, your perception,

Medicor Magasin Grundad 2006. Sjunde årgången. Utges av Medincinska Föreningen i Stockholm ISSN: 1653-9796 Ansvarig utgivare: Gustaf Drevin Tryck och reproduktion: Åtta45, Solna Adress: Medicinska Föreningen i Stockholm Nobels Väg 10, Box 250, 171 77, Stockholm Utgivningsplan 2013: nr 1: maj, nr 2: oktober, nr 3 & 4: december/januari 2014 Kontakta Medicor: chefredaktor@medicor.nu www.medicinskaforeningen.se Frilansmaterial: Medicor förbehåller sig rätten att redigera inkommet material och ansvarar inte för icke beställda texter eller bilder, samt tryckfel. Upphovsman svarar för, genom Medicor publicerat, signerat frilansmaterial; denna(e)s åsikter representerar nödvändigtvis inte Medicors eller Medicinska Föreningens.

Sincerely, Gustaf Drevin Editor-in-Chief

Cover photo by Martin Kjellberg for Medicor Design by Jingcheng Zhao

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medicor

Overture 8

features

Nobel nightcap Det största studenteventet i Sverige! I år hålls Nobelfestens inofficiella efterfest på Medicinska Föreningen. Intervju med Generalen Mikael Yang.

Aula medica inaugaration Stefan Persson, Princess Christina, and Vice-Chancellor Anders Hamsten inaugarated the newest addition to Campus Solna.

the nobel prize A unique look inside the Nobel Committee.

22 Mattias klum: the bigger picture Nature photographer Mattias Klum zooms in on climate change and human health.

Intervju: Maciej Zaremba Mannen som engagerade en hel yrkeskår. En exklusiv intervju med Dagens Nyheters Maciej Zaremba.

Karin Alfredsson Om att belysa det manliga problemet kvinnoförtryck genom litteraturen.

Astrid Seeberger

Medicor goes abroad

WIN TICKETS TO NOBEL NIGHTCAP!

Gästkrönika: vad hade Hippokrates gjort?

NorWHO 2013: where politics and medicine meet.

A Medicor-exclusive competition - do not miss out on the chance to go to Nobel NightCap.

Big hug to Jingcheng Zhao, because we did not even have to ask.

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Aperture

The Pride of Karolinska Institutet On August 3rd, 2013, Queerolinska, Medicinska Föreningen’s LGBTQ student committee, represented Karolinska Institutet at the Pride Parade. Karolinska Institutet is likely the first medical university ever to participate in a Pride Parade. See page 7. 5 Phototograph by Andrea Lindström for Medicor

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Smörgåsbord

The mind is like a finely tuned string. Illustration by Daniel Truong for Medicor

From “split-mind” to “attunement DISORDER”

To reduce stigma around mental illness, South Korea renames its word for schizophrenia. The old, negatively charged “mind‑split disorder” is substituted for the neutral, poetic “attunement disorder”. It is taken from a 1579 Buddhist Korean text, where a monk metaphorically compares the human mind to a finely attuned instrument string. Read more in the August 24-30 issue of The Lancet. New memories

Direct manipulation of cells in the cerebral cortex has been found to be positively correlated with the generation of new memories. The experiment tested the possibility of the creation of new responding cells upon a primary soundbased deep brain stimulus. Subsequent tests indicated that the same audio tune was recognized over and over during following simulations of a series of different sounds, suggesting that induced long-term memories have the same features as natural memories. Such discovery could contribute to further research in the understanding of learning and memory disorders.

Google+medicine=Calico

Biomedicine now in English

"It takes ten or 20 years to go from an idea to something being real. Healthcare is certainly one of those areas," said Google's CEO Larry Page in a recent interview. These words illustrate Google´s ambition to enter the medical field. By developing the company Calico, Google is aiming not just to improve life quality but also prolong human lifespan. Nobody knows exactly how the company will work, but Calico is already in the start-up process of hiring staff. Do you want to know how to live longer? Google it.

There have been rumours around campus, where people have been discussing whether or not the Biomedical Bachelor will be a de jure English-taught course. It has de facto been English-taught for quite some time. Now it is official, starting autumn 2014, according to Karolinska Institutets website for the Biomedical Programme: “3 years, starts autumn semester. The language of instruction is English.”. This will be the first Bachelor’s programme at Karolinska Institutet to hold its courses completely in English. See the next issue of Medicor for more about this paradigm-shifting decision.

iknife

No, it is not the latest gadget from the Silicon Valley. The intelligent knife was developed at Imperial College, London. This smart, surgical scalpel allows a distinction between tumor margins and healthy tissues. With a one to three seconds delay for the read-out information, the iKnife transfers the molecules contained in the smoke created by normal electrosurgical knifes to a mass spectrometer, thus providing a real time complete picture of the histological variations in the area before surgeons cut into the tissue.

The key to a healthy life

Feeling mad, depressed, angry? Good! According to a recent article by Scientific American, negative emotions are essential for our mental health. They are as important as positive emotions to process our experiences and to develop good relationships. Therefore, do not force a smile on your face if there is no reason for it and give yourself the chance to let out your negative emotions. •

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Karolinska

Queerolinska By Riccardo Guidi and Cecilia Frosteus of Queerolinska

Language@KI By Ruslan Alam The significant number of inter-

national students at Karolinska Institutet evokes the question of why there are not any Swedish classes within the boundaries of our campus. Discussions of this issue by the International Committee (IN) eventually spawned the project now known as Language@KI. The language course offers international students an opportunity to go to Swedish classes for free. Unlike conventional classes, the groups are small and usually consist of about ten people, including the teacher. The teachers themselves are students of Karolinska Institutet who are fluent in Swedish. This contributes to dynamic interactions among the students and the teachers in each group. Both students and teachers have expressed how the presence of each individual becomes prominent since every participant is able to actively take part in class. The relaxed atmosphere also helps all students to ask questions which frequently lead to spontaneous discussions. The project received tremendous response when it was launched, with more than two hundred applicants joining Language@KI as students or teachers. IN are discussing plans to expand upon this idea and offer classes in other languages in order to strengthen the communication and cooperation in our international environment. This project is driven by students for students. As such, this student initiative needs people of Karolinska Institutet who are willing to participate as teachers or students in order to unlock the potential of the project. If you are interested in meeting new people while learning or teaching Swedish next term, please send an e-mail to marie.lundgren.2@stud.ki.se. •

Studentombudsman. Medicinska Föreningen has a new student representative, Andrew Sajjadi Bergqvist. He is an independent authority to speak with if you feel that you have been treated incorrectly or experience difficulties with teachers or other employees. Contact:

andrew.sajjadi-bergqvist@ medicinskaforeningen.se

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Photo by Andrea Lindström for Medicor

This summer, thousands of peo-

ple were marching the Stockholm Pride Parade, the historical LGBTQ demonstration for the awareness of homosexuals, transsexuals and bisexuals of Sweden and around the world. Karolinska Institutet was involved for the first time, and Queerolinska was its partner in crime. Queerolinska is the new LGBTQ KI student association that strengthens connections between students and employers and promote discussion, activities and awareness on the topic within the academia. In 2011, Queerolinska was incorporated with Medicinska Föreningen, became affiliated to Sveriges förenade HBTQ-studenter and started pubs and social activities for those interested. “When Anders Hamsten granted his support to the parade, we were in tears of joy” confesses Cecilia Frosteus, of Queerolinska, responsible for the KI Parade together with Apostolos Tax and Evan Graham. “I wonder why people didn’t do it earlier”, continues Cecilia. “We are a medical university that trains future medical staff and we should value equal treatment”. About 30 people marched under the Karolinska flag. Among them were international students and people who weren’t necessarily part of the LGBTQ community. “The Parade was really intended for everyone to participate” says Veronika Frisk, “I felt included from the first moment I stopped watching and I started

to walk with Queerolinska”. According to the American magazine Science Career, Karolinska Institutet is likely the first medical university to ever participate at a Pride Parade, taking a strong statement in favor of its LGBT community. The organisers hope that this will be the first of a long series of future participations in the Pride Parade, with more dedication from students, employees and scientists, independent of their sexual orientation. The academia may seem like the last place to fight for more equality. However, “we are far away from being perfect” responds Li-Martina Nilsson, a KI student in occupational therapy who attended the Parade. “There is still room for improvement. We shouldn’t keep from demonstrating just because it’s better now”. With these political actions, Queerolinska has added a top-10 medical university in Europe as supporter of the LGBTQ cause, sending a supportive message to others in the LGBTQ-communities that live in other countries, among them countries where speaking about homosexuality is a crime. Queerolinska is planning more social and political activities, and welcomes all interested students that want to join its vibrant and inspired members. Nevertheless, there is more to be done and being part of this progress, to experience firsthand how one person can make a difference, is more rewarding than what words can express. • 7

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Karolinska

Nobel NightCap Snart smäller det! Av Shwan Ghaderi

Nobel NightCap-generalen Mikael Yang på Medicinska Föreningens Välkomstdag augusti. Foto av Jingcheng Zhao

Den 10:e december är det dags igen

— det är 35-årsjubileum av Nobel NightCap (NNC) och i år faller turen på Medicinska Föreningen (MF). NNC är Nobelbankettens inofficiella efterfest som drar till sig både nobelpristagare och kändisar till den grad att till och med Säpo lägger sig i. Medicor har träffat en av generalerna, Mikael Yang. Historian bakom NNCs uppkomst börjar 1978 då en handelsstudent ville anordna en efterfest till nobelbanketten. Som tur var svarade en nyanställd kanslist på Nobelstiftelsen i luren och gav honom tillåtelse att genomföra festen, så när en av nobelpristagarna under banketten berättar i en intervju att det han sett framemot mest var NNC var det bestämt. NNC var här för att stanna. Sedan den 1:a april i år har Association NNC bildats under Stockholms Studentkårers Centralorganisation (SSCO) för att koordinera de årliga festerna, men precis som tidigare kommer värdskapet rotera mellan SU, KTH, Handels och KI.

Den glamourösa festen braverar i sedkösystemet som tydligen fallerade förra vanlig ordning med drinkar och tilltugg året för att undvika situationer som skedav lyxkvalitet samt en sittning med varm de förra året, som exempelvis när Harriet mat som kommer att fortlöpa under kvälWallberg-Henrikssons (KIs förra rektor) len. Det kommer att finnas olika temaendotter ”fick köa i kylan i två timmar”. liga rum i vilka det bjuds på lyxig mat och Anordnandet av NNC har inte alltid dryck och förhoppningsvis dans. varit problemfritt. År 2002 och 2008 gick — Förra gången MF höll i festen var Tekniska Högskolans Studentkår back det tema Kroppen och då hade man bland och mellanskillnaden fick studenterna annat satt upp över 3000 fjärilar i puben betala. Mikael är dock inte orolig för att för att symbolisera fjärilar i magen och det skall hända i år, trots att de planerade det bjöds på mer än 60 olika drinkar från utgifterna är dubbelt så höga jämfört med 15 barer, berättar MiMFs förra NNC samt kael och avslöjar att Förra gången MF höll i fes- att de ligger långt unvi kommer att toppa ten var det tema Kroppen der budget nu. detta i år. Faktum är — Vi har gjort realisoch då hade man bland tiska estimeringar och att MFs lokaler byggs annat satt upp över 3000 vi kan garantera att vi om och kommer att putsas och förbereej går back då de flesta fjärilar i puben das inför festen för att sponsorer signar upp uppnå de krav som ställs. sig de sista fem dagarna när nobelveckan I år kommer stort fokus ligga på mat är hypad. istället för alkoholhaltiga drycker som Inbjudningarna skickades ut tidigt annars. Till skillnad från förra årets fest i oktober med nobelpristagare som på KTH så finns det inget eftersläpp utan hedersgäster och Mikael avslöjar att biljetterna gäller för alla mellan kl 22-05. bland andra prins Daniel och AbbaMan har, enligt Mikael, även sett över gänget är bjudna. Mikael berättar att det

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Karolinska

Win tick e

ts to No be See pag l NightCap! e 43!

Nobel NightCaps rekryteringsevent Lunchbeat, ett lunchparty i oktober. Foto från Nobel NightCap

förra året kom kändisar som bland annat Jan Björklund. Dock är inga journalister välkomna, såvida de inte har vunnit nobelpriset själva. Ett krav på strikt journalist- och fotoförbud är ställt av Nobelstiftelsen, just för att göra tillställningen så avslappnad som möjligt för nobelpristagare. Hur får man då ta del av festen? Om man vill arbeta volontärt, vilket alla kring NNC gör, kan man bli funktionär. Dessutom kommer man garanterat få se glimtar av deltagande nobelpristagare om man arbetar under kvällen. Alla får vara funktionärer - 100 stycken rekryteras framtills 10:e november men man kan redan söka genom NNCs hemsida och facebooksida. Om man dock vill gå på festen som gäst och inte hinner skaffa nobelpriset tills dess ger Mikael oss några tips. MF får 15-20 biljetter att hushålla med och Nobellotteriet (som går under SSCO) delar årligen ut biljetter. Det kan hända att sponsorer delar ut biljetter i olika tävlingar så man kan dessutom hålla utkik på deras hemsidor. NNC kommer även att fortsätta hålla events och dela ut biljetter

ända fram tills festen. Temat för i år är som alltid superhemligt och avslöjas först samma kväll som den officiella Nobelbanketten. Dock är det bestämt att klädkoden är frack och balklänning. Sist men inte minst lovar Mikael att årets NNC kommer att bli den bästa någonsin. — Det är allmänt känt att NNC är bäst på MF, haha, och nu när NNC-stämningen börjar sprida sig på campus efter Nobelveckan är det många på både MF och KI som laddar upp inför den 10 december, berättar Mikael. På svar till ryktena om att nya Aula Medica kanske skulle vara inblandat under festen svarar Mikael: — Kanske, det ska vi prata med rektorn om.

ENG.

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On the 10th of December, Nobel Night Cap – the Nobel Banquet’s unofficial after party – will take place at Medicinska Föreningen. NNC has been rotating between the four largest universities in Stockholm since 1978. With a secret theme, Nobel Lau-

reates, Prince Daniel and Abba on the guest list, we can look forward to one of the best NNC’s so far according to Mikael Yang, one of the NNC generals. “It is generally known that NNC is the best at MF” Mikael says laughing.

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Karolinska

The night of a lifetime Join NNC as a volunteer! From Athena Adeli, Nobel NightCap pUBLIC rELATIONS

Fine drinks and haute cuisine,

Nobel Prize winners and other influential guests; this will be a night that would make even Gatsby’s tour de force pale in comparison. A night of elegance and adventure, excitement and mystery; it’s nothing less than theNobel Nightcap. This extaordinary festivity will be held December 10th this year at Medicinska Föreningen. The honour to host this spectacular party shifts to Karolinska Institutet and Medicinska Föreningen every fourth year and introduces the Noble Prize winners to a magnificent mix of the brightest scientists, the most influential people and the future; the students. A secret theme shrouds the night, adding a layer of mystique until the very instance the ceremony commences. Every room will be arranged and decorated according to this elusive theme where the extravagance and glamour sees no end; everything will

be presented in as creative ways as the imagination allows for, contributing to small details like chocolate fountains and champagne showers. The students of KI experience the charismatic and alluring journey of arranging and executing the Nobel NightCap. Ranging from undergraduates to postdocs, people from all fields of studies unite to arrange social events, make friends and create countless new amazing memories. Take part of this and help realising the party! •

Join us as a volunteer to help make it happen. We will be waiting! www.nobelnightcap.se

Photo courtesy of Nobel NightCap

DEADLINE: 10TH OF NOVEMBER

Öppettider Mån-Fre: 10.00 - 18.00 (Lunchstängt mellan 13.00-14.00)

Lördagar: 10.00 - 14.00 Söndagar stängt

tel: +46 (8) 660 28 29 www.benjaminsthlm.com

Almlöfsgatan 3, 114 51 Stockholm

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Karolinska

Every KI student, a possible capoeirista By Johanna Nyberg

From the coast line of Salvador to

the halls of campus Solna; the cultural tradtions of capoeira have over the past four decades been expanding across the globe. In Sweden, there are approximately 2000 practitioners and counting. Every week throughout October and November, students at the Karolinska Institute can enjoy exploring the elements of this AfroBrazilian martial art. The sessions are free of charge and lead by an instructor from Capoeira Angola Stockholm. Some of the origins of capoeira are still unknown. Emerging during the 17th century in Colonial Brazil, little documentation was saved for future knowledge. However, theories suggest that African slaves first developed the techniques to defend themselves during escapes from the Portuguese colonists. Forbidden to practice fighting skills, they creatively disguised their battles with dancing. Today, capoeira is a popular martial art characterised by Brazilian culture, including music and philosophy. Incorporating balance, body strength and flexibility, capoeira is a versatile form of exercise, quite challenging for the un-

experienced. Sylvia Flores Hansson, a KI physical therapist student and initiator to the classes, wanted to give students of Karolinska Institutet the opportunity to try capoeira after school, while still on campus. Her husband, Jorge Carreras, is the instructor and master at Capoeira Angola Stockholm. She has been practicing with him for little over a year and assures that progress will be made quickly with dedication. “It is a great confidence boost, being able to master movements that only a few months earlier seemed impossible”, she says, smiling. Sylvia first discovered capoeira during a vacation in Brazil, and was immediately intrigued. If you are curious of this multi-faceted art form as well, classes are held at MF on Wednesday afternoons at 16.30. •

An inspirational biomedicine evening By Mimmi Majonen

What are the available career

paths for biomedicine students in Stockholm? What is the profile of a person working in the field of biomedicine? About a year ago, three undergraduate biomedicine students discussed these matters over a lunch. They thought that other biomedicine students might be pondering upon the same questions and took action to shed some light on the darkness.

The initiative taken by these students resulted in an event named Pathways of Biomedicine in STHLM 2013 (PBS) that will take place on the 14th of November at Karolinska Institutet. The aim of the evening is to inspire biomedicine students to discover fresh viewpoints on possible career paths and it is open for students of KI who are interested in learning about the career opportunities within the fields of biomedicine, toxicology and bioentrepreneurship. The event focuses on speeches given by interesting profiles who work with research, entrepreneurship and communication in life sciences. The four lecturers are Klas Kärre, professor in molecular immunology at KI and the chairman of the Research Commission of Swedish Cancer Society; Jesper Ericsson, marketing and sales manager at BioLamina and organising committee member of BiotechBuilders Stockholm; Nina Rawal, business development and investment manager at Industrifonden and Olle Bergman, freelance writer, lecturer and founder of the company Bergmans Bokstäver and Scientia Crastina – a networking platform for scientific communication. In addition, students will be invited to participate in a workshop organized by the Unit of Bioentrepreneurship. PBS is a great possibility to get inspired and enrich yourself with knowledge about possible career paths. Take the opportunity to join the event: peter. solsjo@stud.ki.se

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karolinska

Stefan Persson, Princess Christina Mrs. Magnuson, and Anders Hamsten inaugurated the new Aula Medica on October 11th.

Anders Hamsten speaks at the

Aula Medica inauguration Translation by Louise Forlin “Aula Medica will, with its great auditorium and

spacious stairways and foyers, be a suitable and stimulating meeting place for both festivities and science. With its beauty and space, it will inspire innovation and discussion that challenge current scientific paradigms. Scientific celebrations and symposiums on the highest level, Nobel lectures and various public events will be held in this building. Aula Medica is the answer to a wish for a meeting place for exchange of knowledge and discussion that arose with the planning of campus in the 1930s. It is also a symbol of great and

positive changes at Karolinska Institutet and is a natural center in a new district, Hagastaden. This district will accommodate one of the world’s most modern university hospitals. Karolinska Institutet is also building Biomedicum, which when completed in 2018, will be one of the world’s largest and best equipped laboratories for experimental basic research. With Biomedicum, basic research will be even closer to clinical research, as well as the university healthcare, to the benefit of human health all over the world.”

Entertainment at aula medica’s inauguration. Photos by jingcheng zhao

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medicor

Karl Dyall och Rennie Mirror performed an exciting dance during the inauguration. You can also see their play From Sammy with Love at Stadsteatern this season.

...but, the façade is actually not that high-glass By Milou Öberg Sellersjö and Babak Mardkhoram Propositions to build a new auditorium at Karolinska

Institutet have lingered since 1937. Karolinska’s project leader, Peter Allestam, has, with Gert Wingårds Arkitektkontor, satisfied Karolinska’s request to create a new facility for lectures and conferences: Aula Medica. The new auditorium complements the needs of Karolinska. However, the Aula Medica now also appeals to different people and organisations, Allestam says. “Except for letting the ones closest to KI use Aula Medica, we also grant conferences, disputations and introductions of researchers, with a basic requirement of being associated with education and research.” The exterior can fool one to believe that Aula Medica is completely made of glass, but Allestam acknowledges

that the façade consists of only 33% glass, which is 7% less than the average common building. The secret of having a smaller amount of glass is that the rest of the façade is nonpermeable to heat, which meets the requirements of energy efficiency, according to the Swedish Green Building Council. Allestam does not want to attempt to answer the question regarding the maintenance cost of the auditorium. Nevertheless, much of the resources will go into the polishing of windows since “it is required to utilise certain wires to hang on in order to polish the interior, and it will not be cheap.” Perhaps a consideration for all students, experienced in climbing, who have yet to find a job for next summer... •

Before. Photo by Erik Hellsing

After. Photo by Maria Belikova.

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Ble

Karolinska

1954

Biomedicum: Turning the first sod By Oskar Swartling and Vittoria Crispino

1977

2010

1867

Illustration: Berg Arkitektkontor/Arkitektfirmaet C.F. Møller

On September 24th, the first turning of the sod for

the building of Biomedicum took place at the Karolinska Institute. The ceremony involved the Minister of Education Jan Björklund, the County Governor Chris Heister, the Chairman of Solna Municipal board Pehr Granfalk, the President of the Karolinska Institute Anders Hamsten, and the Regional Director of Hus Region Stockholm Sten Wetterblad, accompanied by the MF band Blåslaget. Biomedicum, hopefully turning out like in the photo above is an ultra-modern laboratory unit for experimental medical research that will bring under the same roof approximately 1700 researchers and will allow the possibility to carry out interdisciplinary research. The progress of the project was not without frictions between MF and Akademiska Hus, as there where discussions on what space belonged to who. However, the two parts agreed on a satisfactory solution, resulting in, for instance, the new roof terrace behind the MF building. The world class research center, which will be located next to Aula Medica, will open the doors to the public in 2018 and will further improve the quality of research at one of the world’s most famous medical universities.

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Blekinge Tekniska Högskola

1954

gu1 Göteborgs Universitet

1977

hIg0 Högskolan i Gävle

2010

lnu0 Linnéuniversitetet

1867

rKh0 Röda Korsets Högskola

Chalmers Tekniska Högskola

1866

hB0

Dans- och Cirkushögskolan

1998

hgO0

Högskolan i Borås

1990

hv0

Högskolan på Gotland

1810

KI5

Högskolan Väst

1971

ltu0

Karolinska Institutet

1666

lu0

Luleå Tekniska Universitet

1787

stDh0

Lunds Universitet

1878

Stockholms Dramatiska Högskola

su3 Stockholms Universitet

Högskolan i Dalarna

1983

hh0 Högskolan i Halmstad

1735

KKh0

Ersta Sköndal Högskola

1909

hhs1

Handelshögskolan i Stockholm

1771

Kmh0 Kungliga Musikhögskolan

Kungliga Konsthögskolan

1998

mah0

1993

mIun0

Malmö Högskola

1775

slu0

Mittuniversitetet

1996

Sveriges Lantbruksuniversitet

sh0 Södertörns Högskola

1#2013

medicor

Försvarshögskolan

1977

hIs0 Högskolan i Skövde

1827

Kth1

Kungliga Tekniska Högskolan

1977

mDh0 Mälardalens Högskola

1965

umu0 Umeå Universitet

Gymnastik- och Idrottshögskolan

1977

hJ0 Högskolan i Jönköping

1969

lIu0 Linköpings Universitet

1999

Oru0 Örebro Universitet

1477

uu5 Uppsala Universitet

Framtidsrådet at Karolinska Institutet presents:

KI Evolution How would you improve Karolinska Institutet? Hur skulle du förbättra Karolinska Institutet? Let’s bring the Future to Karolinska Institutet! Share your thoughts and ideas about how we can develop Karolinska Institutet into a more modern university by sending us a postcard! Can’t find a postcard? Submit your idea on our website! umbrella picture by www.arneblom.se

web evolution.ki.se twitter @kievolution e-mail framtidsradet@ki.se 15

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10/28/2013 11:37:02 AM

Science

Medicor at the Nobel Prize announcements Vesicle transport, Higgs Particle, Multiscale Models and Asset Prices By Jin-Yu Lu “How does it feel to receive the

Nobel Prize?” is probably one of the most popular questions that Nobel Laureates are asked at the press conferences in the middle of October each year. Meanwhile, “how did it feel to be there?” has become a popular greeting at the meetings of Medicor. We were excited to witness the moments when the 2013 Nobel Prize in Physiology or Medicine was announced in the Nobel Assembly at Karolinska Institutet as well as the Prizes in Physics, Chemistry and Economic Sciences took place at the Session Hall of the Royal Swedish Academy of Sciences. Surrounded by journalists from around the world, we held our breaths as the names of the Laureates were revealed. Firstly, the Nobel Prize in Physiology or Medicine was awarded on October 7 to James Rothman, Randy Schekman and Thomas Südhof for their discoveries of machinery regulating vesicle traffic, a major transport system in our cells. On

October 8, the Nobel Prize in Physics was awarded to François Englert and Peter Higgs for laying the groundwork for the discovery of the famous Higgs particle. The Nobel Prize in Chemistry was awarded on October 9 to Martin Karplus, Michael Levitt and Arieh Warshel for developing computer models for the analysis of complex molecules. Finally on October 14, the Nobel Prize in Economic

Sciences went to Eugene Fama, Lars Peter Hansen and Robert Shiller for their analysis in asset prices, greatly improving our understanding of human behaviour in the market. Medicor continues to celebrate scientific discoveries and their benefits to mankind. Stay tuned for more exclusives on the Nobel Prizes in our next issue. •

‘well, it wasn’t unpleasant.’ on being awarded the Nobel Prize in Physics. Englert shares the 2013 Prize with Peter Higgs for their discovery of the Higgs Boson.

FRANCOIS ENGLERT

Exclusive Medicor-exclusive photo taken at the Nobel Assembly’s final session, just hours before the announcement of the 2013 Nobel Prize in Medicine or Physiology

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photograph by AnnaKlara Pettersson for Medicor

10/28/2013 11:37:03 AM

Science

mOBILE HEALTH APPLICATIONS

Medicine from another perspective By Poya Livälven

By Ragashree Dhamodaraiah Setty On the 23rd of September 2013, the U.S. Food and Drug Administration (FDA) issued final regulations for mobile medical application manufacturers. The agency stated that, based on industry estimates, 500 million smartphone users including health care professionals, consumers and patients worldwide will be using a health care mobile application by the year 2015. These guidelines are applicable

to applications that run on mobile communication devices and transform them to traditional medical devices and apps that are used as an accessory to a regulated medical device. Thus, these regulations cover only a small subset of the rapidly expanding mobile health applications.

Some mobile apps carry minimal risks to consumer or patients, but others can carry significant risks if they do not operate correctly These mobile applications could range from apps which display prior stored EEG wave forms, control inflation and deflation of a blood pressure cuff, diagnose arrhythmias, others that

transform a mobile phone to a mobile ultrasound device and several others. The FDA intends to exercise enforcement discretion on apps that assist in self-management without treatment suggestions, provide, organize, track healthcare information and enable interaction with Personal Health Record or Electronic Health Record. Other apps which provide access to medical textbooks, serve as educational tools for medical students, facilitate patient access to regularly used reference material, automate general office operations and other generic ones do not fall in the purview of these regulations. FDA has approved around 100 mobile medical applications, 40 in the last two years. “We have worked hard to strike the right balance,” said Shuren. Some mobile app manufacturers are required to submit the premarket notification 510(k) form to the FDA and must comply with Quality System Regulation. They are also required to submit information if the device caused or contributed to a death or a serious injury, or if it has malfunctioned. A lot of developers have the opinion that these are very fair regulations. However the question on everyone’s mind is whether these regulations will stifle innovation or will developers simply ignore them? We will have to wait and see the impact that these regulations will have. Additional information can be obtained at: http://www.fda.gov

Illustrations: Touba Guerroumi for Medicor

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•

“I was surprised how quickly I felt comfortable with it”, says Dr. Christopher Keading, orthopedic surgeon in Ohio. He is talking about Google Glass, a wearable, voice controlled computer in the shape of eyeglasses! The computer screen is located in front of ones eyes and the wearer can be connected to the internet, search information and live-stream video from the built-in camera. With the voice command “ok glass” followed by an instruction (i.e. take a picture) one can do pretty much everything that can be done with a smartphone or computer. Google Glass is still under development, but a few copies have been released, mostly to companies and universities. A group of surgeons in Ohio started using it as a tool to educate medical students to obtain an “insider’s” perspective of the surgery and reduce surgical errors by having other surgeons observing them via internet live. The responses from the medical students have been very positive since they can follow and see the surgery from the surgeon’s viewpoint rather than observe from a corner in the operating room. The surgeons have also been positive because they can for example have an x-ray picture of the patient in front of one eye while doing surgery and therefore making more exact incisions. More institutions are starting to use Google Glass as a complement to other devices. Imagine having a lecture where the teacher is writing something on the whiteboard, then the technology could be used to project the written information to a larger screen where the back row students can follow as easily as those in the front row. •

10/28/2013 11:37:04 AM

Science

Women in LEADERSHIP closing the gap

“...a global issue which has not lost its relevance for several decades; the lack of women in leading positions.” By Polina Ost Emelie Johansson, a Master’s student in the

Bioentrepreneurship programme at KI, will graduate next year and wants to find a position within the pharmaceutical industry working with commercial issues on a managerial level. She will, however, face a global issue which has not lost its relevance for several decades; the lack of women in leading positions. In fact, although the percentage of women in senior management has constantly been rising in the last forty years, gender parity has still not been achieved. As of the beginning of 2013, only 24% of senior management positions globally were occupied by women. When it comes to chief executive officer positions (CEOs) the imparity becomes even more apparent: this year only 14% of businesses worldwide were led by a woman, according to the international business report survey.

only 24% of senior management positions globally were occupied by women Emelie is aware of these numbers and therefore joined the Harvard Undergraduate Women in Business (HUWIB), an organisation which aims to promote women in taking on leadership roles. She participated in their international Campus Ambassador Leadership Program (CALP) and together with two other students organised a conference at KI featuring women in leadership at the end of September: “We wanted to inspire, motivate and create networks between young and experienced leaders”. In the conference five women in leadership positions within the life science sector spoke about paving their way into senior management. They shared some of the difficulties they overcame in different stages of their careers, such as competing with men and the coordination of family and career, gave insights into their everyday work life and raised awareness on the lack of women in executive roles. Why is it important to aim for establishing gender parity? One reason is to match the proportion of men and women in our global population. Companies can also profit from a gender diverse board. For example, in

2007 McKinsey & Company, a major international management consulting firm, conducted two studies showing that companies with both men and women in their management boards outperformed companies with all-male boards, both in regards of organisational excellence and financial performance. However, increasing the number of women being in charge in the corporate world seems to be a difficult task to undertake. Organisations like HUWIB tackle this immense challenge by promoting women in their careers as early as possible. When asked about why Emelie joined HUWIB and how she profits from being a member, she refers to the low number of women in chief positions and concludes “So what can we do about it? One way is to create networks in order to help each other move up the career ladder. This is why I wanted to join HUWIB. I recognised the importance of their message and I was eager to share it.” The slow but steady development observed especially in the last ten years proves that change is possible and that there are promising strategies that make gender parity in management more achievable. Besides the creation of flexible working arrangements, these include thorough education and the directed promotion of talented women.

I recognised the importance of their message and I was eager to share it Through HUWIB, Emelie became a part of a huge network of students from top universities and experienced leaders within different industries. She also had the opportunity to work on her own skills in leadership, for example when organising the conference. “Over and over again we were challenged. But it was exciting and we learned a lot”. The experiences she gained from participating in CALP and the support she receives from HUWIB will be of great value to her future career. Thus she is taking a major step towards becoming one of the women in leadership and will hopefully inspire other young women to follow her example.

•

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medicor

Science..?

REVIEW

Tintin goes to the doctor It is time to put an end to Cartoon Neglected Diseases (CNDs). It is time to stop ignoring the weighty impact of CNDs on our beloved childhood cartoon characters. By Vittoria Crispino After a first comprehensive study

on Winnie the Pooh’s characters, all unfortunately affected by mental disorders such as dysthymia (Eeyore), generalised anxiety disorder (Piglet), or obsessive compulsive disorder (Rabbit), the time has come to further increase our knowledge on CNDs. A recent study described the exceptional case of the most famous reporter and adventurer. We are talking about the only character that despite his 60 years of age, never showed a sign of pubertal development: Tintin. The scientific community has finally found found the underlying reason causing Tintin’s condition. Tintin is affected by acquired growth hormone deficiency and hypogonadotropic hypogonadim. This hormonal condition is characterized by a significant decrease in the secretion of gonadotropins, pivotal hormones for the normal functioning of the endocrine system that regulates growth and sexual development. With reference to the study conducted by Yamanaka et al.(1993)

about the correlation between growth hormone deficiency and head trauma in childhood, the research team composed of A.C., 5 years old, and L.O.C, 7 years old, felt confident enough to associate Tintin’s pathophysiology to repeated head trauma. After an extensive assessment of the available literature, the study per-

Tintin is affected by acquired growth hormone deficiency and hypogonadotropic hypogonadim formed an evaluation on the magnitude of neurotraumatic episodes through the identification of images in which Tintin “tombait dans les pommes” (lost consciousness). The three inclusion criteria for the concussion to be entered in the count were: cause of trauma, length of loss of consciousness, and apparent severity of trauma. Unfortunately,

due to logistical issues, no brain imaging was performed. The obtained results showed that, since his first appearance, the character was subjected to 50 significant head injuries (grade 3 concussion) associated with an evident loss of consciousness, which have an evident correlation with acquired hypogonadism. The disclosure of the underlying causes of Tintin’s delayed growth and onset of puberty is a grounding research in the field of CNDs. This illuminating study, despite some irrelevant limitations such as the impossibility to determine the character’s sexual development and the lack of a clinical confirmation of the diagnosed condition, has the potential to influence the crowded international research agenda to draw attention to the burden of diseases affecting cartoons’ characters. Issues like Charlie Brown’s avoidant personality disorder, Olive Oyl’s anorexia, and Silvestre’s severe lisp, are no longer to fear ignorance. In the wake of this enlightening research, the fictional voices of neglect will finally have the possibility to stand right next to the HIV pandemic and Lindsay Lohan’s latest addiction.

•

Illustration: Daniel Truong for Medicor

Oreo-Cocaine Hoax Illustration: Touba Guerroumi for Medicor

By Oskar Swartling

Oreo cookies are as addictive as cocaine and morphine. At least

to rats, indicated by a resent study. The rats were placed in a maze with an Oreo at one end and a rice cake at the other. This was then repeated without a reward at the end. Next, the rats were instead injected with addictive drugs when they were on one side of the maze and saline on the other. The results? The rats spent more time at the site were the Oreo had been than on the side where they got drugs. However, the conclusion may not be trustworthy. The researchers never actually directly compared the two groups; meaning one rat never got both Oreos and cocaine. Despite the flaws in the report, one cannot deny it is hard not to grab for that second Oreo. • 19

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Science

a fiery career

The fire department going medical By Linda Sagarika Johansson

Considering a future career with-

in the Fire Department as a student of Karolinska Institutet is perhaps not a common thought. However, an interview with Christer Flodfält, an experienced firefighter at Södertörn’s Fire Department, managed to steer some thoughts in that direction. Like a childhood dream which slowly withers away, the aspirations of becoming a firefighter can be forgotten or replaced due to distractions and other ambitions. The latter can especially be true for health care oriented students. Nevertheless, the interview with Flodfält presents the opportunity for students who are on their way to receive degrees within the fields of medicine to pursue careers within the Fire Department. Christer Flodfält expressed how Södertörn’s fire department demand the recruiting of knowledgeable health care

...opportunity for students who are on their way to receive degrees within the fields of medicine to pursue careers within the Fire Department personnel with an academic background. As a firefighter everything comes down to the Golden hour. The golden part implies the need for speed. Everyone involved with the rescue operations are working towards the same goal: transporting every casualty victim from where the scene of the accident took place to the hospital, within an hour. What makes Södertörn’s fire department to be distinct if compared to other

fire departments in Sweden is its unyielding desire to always strive to improve their ministration and their health care based work while at the same time facilitate the work of the paramedics. The firefighter’s endeavors have paid off and they are now known as the best in Sweden in regards to the implementation of a working health care program that facilitates the Golden hour. Their guidelines have been developed and approved by the chief emergency doctors who work in the large hospitals in Stockholm and by the Health and Human Services Department. The fire department has continuous contact with the doctors for maintained evaluation and improvement of their guidelines. The minimum education required for regular firefighters, in regards to health care, comprises of a four-day course involving cardiac resuscitation. They must also know how to administer oxygen gas. A substantial part of their work consists of fixating the injured with the use of, for example, a cervical collar or a spine board. Christer particularly emphasized that it is the collaboration between the different occupational groups that matters; firefighters aim to be as supportive to the paramedics as possible. However, they do not wish to step in and perform the duties that the paramedics are primarily responsible for. “Outside the ambulance, the care of the patient should be performed in the exact same manner regardless of whether you are a firefighter or a paramedic, but once inside the ambulance it is the paramedic that has the full responsibility!” explains Christer. This statement goes hand in hand with their desire to recruit nurses, physi-

otherapists and psychologists to the cause. If the main goal is to provide a high quality health care that is continuous throughout the chain of events of a rescue operation, then having firefighters with adequate education, for instance in nursing, will greatly improve the quality of their work.

...desire to recruit nurses, physiotherapists and psychologists To some extent this is already the case. Södertörn’s fire department currently has, at the time of writing, about ten employed firefighters whom are working part-time as paramedics. Additionally, a few firefighters are taking a leave from work to obtain a degree in nursing. You do not have to have your degree to apply to the fire department; Nursing students who are interested are admitted to work as firefighters at Södertörn during the summer. This demonstrates their keenness to integrate the health care to the firefighting. Deviating from the obvious career choices may seem daunting, but joining the firefighters can yield experiences unlike anything one might expect and could possibly awaken dormant childhood dreams. Whether you want to pursue an extended firefighting career or whether it is to temporarily become a firefighter over a summer holiday, the Fire Department of Södertörn will welcome you with open arms.

•

Mötesplatsen för läkare och studenter!

NetdoktorPro.se är en kostnadsfri mötesplats för studenter och läkare som erbjuder aktuella medicinska översikter, nyheter, praktiska hjälpmedel samt diskussionsforum där du kan ställa frågor och utbyta erfarenheter. Som medicinstuderande kan du också ta del av kompendier, duggasammanfattningar, lathundar, anatomiska bilder och filmer, EKG-stöd och quiz. 20

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10/28/2013 11:37:07 AM

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medicor

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10/28/2013 11:37:08 AM

THROUGH THE LENS OF

MATTIAS KLUM By Gustaf Drevin and Andrea Jacobson Photography by Martin Kjellberg

orld-renowned Swedish nature

and BBCÂ Wildlife. Through his photography

photographer Mattias Klum is best

and frequent appearences on television and

known for his work for National

in interviews, he continues to lobby, educate,

Geographic, where he has more than a dozen

and raise awareness of environmental issues.

cover photos. Among others, he has been

Medicor sat down with him to talk about how

published in The New York Times, DerÂ Spiegel,

climate change is connected to human health.

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Sustainability

WHAT ABOUT THE

Bigger Picture? Walking into the office of Mattias Klum’s foundation, Tierra Grande, one expects a more pompous headquarters. There is no red carpet, no big sterile space, no luxurious entrance. The office is a small, but picturesque, brown-yellowish cement building situated within the campus of Uppsala University, next-door to the Botanical Garden in Uppsala. A suitable and, at this sunny day, beautiful location for a pedagogical nature photographer working with environmental issues.

It becomes clear rather quickly

that Klum is a very funny guy, not just a brilliant photographer and inspiring lecturer. The floor towards one wall is completely covered by camera equipment. The walls themselves feature some of Klum’s photos but mainly a number of fascinating gadgets such as machetes, blow-pipe arrows, and strangle-looking ornaments. We are served eco-friendly coffee and palm oil-free cookies as we sit down with him to talk about his work in photography, his environmental passion, and how climate change is connected to human health. It all started with a “fanatically interested” 13-year-old. “I loved to be moved and to capture what captivated me”, Klum says with a touch of nostalgia in his voice. At the time, he felt that photography was “the greatest thing I know. I want to spend my time on this, and if I do it should turn out fine.” It turned out neatly, indeed. He has over a dozen published front cover photos for National Geographic, for which he started freelancing at 17 years of age. Since then, his photos have been feature in for instance The New York Times and Der Spiegel. Today 45 years old, Klum has earned friends such as Bill Clinton, former WHO Director-General and former Norwegian Photography

Prime Minister Gro Harlem Brundtland, and the Swedish royal family through his work and reputation. The childish passion for photography still lingers in Klum, but has shifted into a more purposeful endeavour than merely depicting nature’s beauty. He has been warned about the withering of the otherwise scenic coral reef or rain forest he visits many times before a mission. However, the real understanding of the destruction becomes clear only when you see the how bad the situation is on site. “You return home with some sort of juxtaposed image of that which was the most fantastic – and also the challenges”, an imbalance he portrays through his photography. Hence, he works for something more rational today. “I do photography and films because I love telling stories both in word and pictures, really, but I try to integrate it in different ways, preferably with people who can add dimensions to what we try to accomplish.” “You can photograph or make films for pleasure, only because it is beautiful, exciting, and fun. However, in my opinion, that would be professional misconduct”, he says and adds: “How can we, mere photographers and filmmakers, become as good an instrument possible, together with scientists, politicians, business, and so on? How can we be useful?”

Mattias Klum makes himself useful by putting himself out there. The evening before we meet, he participated in the appreciated TV comedy show, Filip och Fredrik. He appears frequently on television and in interviews where he hopes to shed light upon issues regarding the environment. “If I do not spend my time on something that contributes to a change, I could just as well do something else.” Eyes steady, voice determined, it is clear that he is very serious about bringing about a paradigm shift, albeit through light-hearted methods such as photography and TV shows. He wants to reach a broader audience. “I want people seeing this to be touched and realise their roles, that it stirs afterthought, spurs engagement of people in different walks of life.” Because, Mattias Klum is extremely worried about how badly nature is doing and how little people tend to act towards change, especially since humans may be The Climate

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medicor

Mattias Klum is a passionate man. While his office in Uppsala resonates of humility, his personality radiates charisma.

causing this devastation. According to him, humanity faces “a number of really tough and irreversible processes,” and “the most irreversible one being the depletion of biological diversity.” He says that we must understand our relationship with our biomes, i.e. the geographically and climate-relating system that make up the biosphere, from which we get the oxygen we breathe. What worries him is that we are rupturing the biological foundation on which life on earth stands. “When we lose a species, we actually lose a species”. Here he laughs, to symbolise how ridiculously simple this concept is. “We need to enter a process of change, some sort of mind-shift process to understand the relationship to the biomes we are dependent on.” The environment is becoming a foe rather than a friend. “It is not possible to isolate the challenges we face on earth: population growth, the water issue, the climate, biological diversity, and so on.

They are interconnected.” To Klum, human health relies on a healthy biosphere. “We have internal organs and we have external organs. These are the external organs.” Human health is dependent on healthy biomes. “It is a no-brainer. Because our health, our well-being, and our economy will not get worse”, Klum says regarding a hypothetical reversal of the current de-

We have internal organs and we have external organs. These are the external organs velopment. “We perform better if we feel better.” An imbalance affects us “in what we eat, in what we breathe.” “We cannot see [nature] as a peepshow, like ‘the jungle is so cool!’, or ‘wow, rainforests and coral reefs!’” We must

stop and think. “What is our life-support system?” he rhetorically asks us. To him, this cannot become more palpable than when he is diving in atrophying coral reefs or mountain cameras in the tree tops of withering rain forests. “30 percent of the Baltic Sea is dead, 30 percent of the world’s coral reefs have gone to hell, and the world’s third biggest island, Borneo, has lost 75 percent of its rainforest.” The problem is that “it does not become real, it remains abstract.” Antropocene To make the climate

issue concrete, Mattias Klum together with the Swedish environmental researcher Johan Rockström (interviewed in Medicor’s May issue, 2013) have published the semi-photographic book, The Human Quest – Prospering Within Planetary Boundaries (2013). “He [Rockström] is a world authority in these issues and I thought it would be great working with him, and he showed 25

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Tebaran, a blowpipe hunter in Sarawak, Malaysia, looking out over what used to be his people’s hunting grounds. Photo by Mattias Klum.

enough bad judgement to work with me”, he laughs. He then adds that he never anticipated the strong support for the book that resulted, where Bill Clinton wrote the foreword. In the book, Klum’s fantastic photography is combined with Rockström’s research. It introduces two new concepts conceptualised in high-profile scientific journals such as Nature and Science: “planetary boundaries” and “the Anthropocene”. Man-made destruction is evident in “over-fishing, chemicals, plastics, boat traffic, warming of our waters, coral bleaching, and ocean acidification.” Parameters such as our coral reefs and the acidity of our seas and oceans serve as “planetary boundaries”. They are attempts to introduce measuring sticks of how the earth is doing. The Anthropocene, Klum explains, is the geological age where humans act such a force that we change the environment in which we live. Sustainability The balance of nature that Klum speaks of implies the need for sustainable development, which in turn means that we must adapt to live within planetary boundaries and our safe operating space. “It is very complex. From my perspective, it is about being

holistic.” It is not about knowing the expiry date of the milk in your fridge. “We are seven billion, going for eight and nine billion, so of course it is an anthropogenic process. We must adapt

I want people seeing this to be touched and realise their roles to what the earth’s resources can give us and use them a lot smarter.” The Anthropocene is not only a negatively charged term. It also entails that we can reverse these adversities in order to live within safe operating space according to the planetary boundaries. He points out three ways to do so. His first aim would be to reverse the depletion of our biological diversity. “It is not just because I love animals or work with animals and the nature. This is the most critical hurdle to deal with since it escalates rapidly.” Klum adds that “16 000 species are critically endangered. That we know of.” Secondly, we need to “implement a fossil-free society as quickly as we can.” He finds the innovation in this area excit-

ing. “There are talks about using parts of the Sahara to cover energy needs in the world. That type of rapid and possible transformative projects can navigate us in the right, sustainable direction.” There is a fire in his eyes and a light tone of voice when he says it. He is curious about what the future offers. He says that reducing carbon dioxide levels will reverse health problems such as the Black Carbon, where soot from fossil fuel combustion not only contributes to global warming by trapping heat but also causes cancer. Klum’s last point is relates back to the palm oil-free cookies. The farming for palm oil instead of for food is, according to Klum, a misuse of possible farming land. “We do not need more farm land. Instead we need to make farming more efficient and that would mean there will be enough food for nine billion people.” With the WHO famously estimating the world population to reach nine billion by 2050, and with catastrophes such as the 2011-12 famine in the Horn of Africa, the food question is indeed important and always current. With the world economy in the state that it is in, food speculation and market interests will inevitably cause problems with food distribution in lowand middle income countries. “Farming

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medicor

Sustainability

becomes the bad guy instead of your friend.” Sustainability is about the holistic perspective, where entrepreneurs and business cooperate with governments, education, and politicians at large. The environment affects how an economy fares, so we should strive to integrate environmental policies within the economic policies. Politics and the media Because, there

is a lack of integration of these sectors today, even at highest political level. Like the Rio +20 negotiations in 2012. “These climate negotiations are difficult. There is reason to be both disappointed and worried,” he says but quickly continues with “but at the same time, I have to say that there have never been larger manifestations and gatherings of top politicians, business, and NGOs earlier.” He is hopeful, since “these questions have gone from being non-issue to becoming actual issues. That is at least a start, although one can be dissatisfied that they do not lead to short-term changes.” The media portrays the climate issues negatively or covers in a poor way that does not reflect the public interest. “People are more worried and interested than what media expresses. People are bloody interested in the environment right now!” Klum thinks big business is the sector that seems to be the most eager. “They have started to think outside of the quarterly economy, understanding that if we do not solve the water issue, where we have factories in China, for instance, we will not have any profitability.” Paradoxi-

cally, at times it seems like the business sector is leading the way for sustainable growth. Contrary to this, political thinking seems to be casted in a mould, shaped like a drainpipe, according to Klum. “It is like having lots of cells, but these have synapses that are blocked and therefore there is no continuous current.” Caricaturing politicians in large, Klum says “’We do not have time for the environment, this is about the economy – but wait, now we have time – well, now we do not have time any longer because now we have a lot of other things to do.’” The environment is never a popular question among politicians. “I hate to say it, but it becomes evident only when a hurricane rams Wall Street with three metres of water.” U.S. President Barack Obama held his first ever climate speech only after New York was hit by Hurricane Sandy in October 2012. But not only the U.S. must improve here. “Sweden has the opportunities to do it right, we can afford to do it right, we have the knowledge to do it right, and in addition we have a reputation in the world to be the top of the class. But the truth is, we are no longer the best.” Klum calls for legislative change instead of passiveness. “You can be tougher. [Fredrik] Reinfeldt and [Anders] Borg should be keener.” To Klum, this is a personal question. A question of “national hygiene”. The future Although politicians today

tend to “lack a sense of urgency”, Mattias Klum is hopeful of the future. Especially innovation, he says, will contribute to bring about change. Sustainable growth

can indeed be achieved. “It does not mean reversing all processes, not having profitability, not using technology, or not living the good life. Instead, it means using the technology we have /…/, listening to our scientists, working with new intelligent solutions, and working entrepreneurially.” He mentions

It is like having lots of cells, but these have synapses that are blocked and therefore there is no continuous current Germany’s decision to shut down nuclear power by 2022 as a good example. “I believe that if we are really smart, we will with technology, combined with legislation and some sort of common sense, come to terms with many of the problems we worry about today.” To reach that stage, “it is important that science reaches people. It needs to be in a version that makes people question, trust, and believe.” Especially in this window of ten years where we still can turn the tide, Klum points out. “Far too many people express that they do not have the time, that they are too busy being speech therapists or whatever.” He emphasises that all of us bear the responsibility. “Our choices as customers, as employees, what we say, what we vote, even what we think, can cause ripple effects.”

You can photograph or make films for pleasure, only because it is beautiful, exciting, and fun. However, in my opinion, that would be professional misconduct

Photography can and should be more than just depicting the beauty of nature. 27

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Sustainability

30-second Book Review The Human Quest: Prospering Within Planetary Boundaries Mattias Klum and Johan Rockström, 2013 Bokförlaget Langienskiöld

In The Human Quest, Mattias Klum and Johan Rockström depict the true story about how the human race shape the planet. This semi-photographical book features several hundreds of Klum’s most striking photos from around the world, complemented by Rockström’s research. It has a foreword by former U.S. President Bill Clinton and comments from profiles in politics and science, which adds to the weight of its content. The book is a big and beautiful piece, with many spreads of stunning images from rainforests, oceans, cities, and other special places on earth. The reader is induced with a sense of wonder through Klum’s photos, while Rockström’s statistics and tables establishes a scientific and rational foundation on which the book has its footing. The scientific element comes across very strongly, since it stands out starkly against the photos – a potent combination that truly affects the reader. It is difficult not to be captivated when the authors juxtapose nature’s original beauty and blossom against the current destruction of the rainforest and the melting of the icebergs. Hence, it serves its purpose of connecting one’s emotional response to the photos with the rationality behind the science that explains why we must change the way we live.

Gorilla from the Democratic Republic of the Congo. Photo by Mattias Klum.

To illustrate that everybody in the world has a role, he gives us a few scenes from his many tropical travels. “Blow pipe hunters or fishermen outside Papua New Guinea, without access to radio, rely on their common sense instead. They respond to ‘What do you cease to get the same amount of fish?’ with ‘Well, then we do not fish there for three years, because when we return, there will be fish again.’ What do the rainforest hunters do? ‘We have a rotation system, we hunt here for a while until we cannot hear the gibbon monkeys anymore, and then we walk for a few miles until we hear them again, and after five years we go back and there will be gibbons all over the place.’” As we approach the end of the interview, Klum directly addresses the students at Karolinska Institutet. He calls us to the struggle. “If you study Medicine for five years, then do your internship or research, you put so much of your life

When we lose a species, we actually lose a species... into one passion, that to not cherish that possibility to embrace these issues, to not engage yourself – although you have got that opportunity and the right prerequisites emotionally, mentally, and intellectually – that would be a pity.” “We cannot leave this to the orangutans or chimpanzees, no matter how intelligent we believe them to be. We are the only ones who can fix this. One cannot clear oneself from that. No matter what you study.”

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WIN THIS AUTOGRAPHED BOOK: SEE PAGE 43!

Definitions Planetary boundaries: representations of nine functional ecosystems that we can monitor to approximate how the earth is doing: the ozone layer, biodiversity, chemical dispersion, climate change, ocean acidification, freshwater consumption and the global hydrological cycle, land system change, nitrogen and phosphorous in the biosphere and oceans, and atmospheric aerosols. The Anthropocene: a pseudogeological era, where humans make up such a force that our actions change the earth’s biospheres and climate.

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Sustainability

FEVER ON EARTH

How climate change is detrimental to human health

By Florian Schober

September

27th,

the

Intergovernmental Panel on Climate Change (IPCC) released their fifth report on the science basis of climate change. Although results are alarming, people still ask what is so scary about climate change. Indeed, the critical issue is not the change itself; it is the pace of warming that threatens living systems, including human beings. Each of the last three decades has been successively warmer than any other decade since 1850. One cause is the extensive emission of greenhouse gases that gives steady rise to atmospheric CO2 levels. The CO2 concentration is now the highest it has been in 800,000 years, approximately when Homo erectus started to settle in Great Britain. As we cannot suddenly stop CO2 production, the temperature keeps increasing quickly. The IPCC estimates a 1 to 5 Â°C rise in temperature by 2100. The worst-case scenario would lead to an environmental situation similar to that of 20 million years ago â&#x20AC;&#x201C; all within a few hundred years! There is thus a pressuring need for sustainable climate policies if we do not want to severely endanger the environment and our own livelihood. To a certain extent, the biosphere is adaptable. Plants and animals are moving their habitats towards colder regions, but the geographic limitations will lead to the extinction of many species reducing biodiversity. As the natural habitat of plants changes, agricultures need to change. However, farmers in low-income countries often cannot afford modified seeds. Temperature increase also correlates to a change in flowering season as well as to a temporal shift in pollination patterns. This will lead to a decrease in efficiency of agriculture and food shortages. Thus,

the climate change issue inadvertently becomes a global health issue. Crop growth will also be endangered by extreme weather events. In turn, this might result in a weighty increase of global market expenditures and affect especially those who already suffer from a lack of basic goods. Is climate change then an issue that concerns only developing countries? Of course not. Climate change will have major impacts on human health at different levels. Epidemiological studies recorded a rising number of deaths due to extreme weather events such as flooding and heat waves. Fewer people will die in winter, but comparable to the dangers of heat waves, this is just a drop in the ocean. Furthermore, climate change will influence the severity of diseases all over the world. There will be an increased probability to spread new influenza virus as well as West Nile virus. Additionally, the geographical range of vector-borne infections will alter; this is good news for malaria as mosquitos die under drier conditions, but the chronic parasitic disease Schistosomiasis will endanger another 50 million Chinese by 2050. Therefore, it is of striking interest to every single human being that the global community finally agree on further policies to reduce greenhouse gas emissions. More efforts have to focus on the development of sustainable fossil fuel-free transportation. Improvement is moreover

Illustration by Anneliese Lilienthal for Medicor

primarily a task of high-income countries. How should the government of a low-income country focus on climate issues if people suffer from malnutrition right now? Environmental concerns are strongly associated with fighting poverty and malnutrition, which is also reflected by the Sustainable Developmental Goals dealing with poverty, malnutrition and lack of education. In this way, mitigation must entail adaption. Developing earlywarning systems for heat-waves, epidemics or floods are some proposals suggested to help low-income countries adapting to climate change. Such a system was for instance established after the 2004 Indian Ocean tsunami. This was a remarkable success, but much more has to be done. It is hard to survey every aspect of climate change and difficult to globally agree on sustainable policies, however, more actions need to be taken and now is not the time to become discouraged.

â&#x20AC;˘

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STUDENTINFLYTANDE

Bryter Sverige mot de mänskliga rättigheterna? Regeringen har i flera år ignore-

rat att följa de internationella konventioner som Sverige åtagit sig. En otillräcklig lag har nyligen röstats igenom som strider mot FN:s deklaration om mänskliga rättigheter. Denna lag diskriminerar irreguljära migranter, så kallade papperslösa. Det är viktigt att vi som studenter ifrågasätter normer och strukturer som bidrar till diskriminering av människor inom sjukvården. Vård på lika villkor ska vara mer än bara tomma ord som vi kan läsa i de vårdetiska grundprinciperna, hälso- och sjukvårdslagen samt FN:s deklaration om mänskliga rättigheter. Vi som framtida vårdgivare ska inte låta vården som erbjuds påverkas av huruvida en individ har papper eller ej. Ett flertal humanitära organisationer, yrkesförbund och frivilligorganisationer (Amnesty International, Sveriges Läkarförbund samt IFMSA) har sedan 2008 gått samman och krävt att alla irreguljära migranter får tillgång till subventionerad vård på lika villkor som alla andra boende i Sverige. Efter flera år av uppmaningar att följa de internationella konventioner som Sverige har åtagit sig,

röstade regeringen igenom en lag som från och med 1 juli 2013 gav utökad vård till irreguljära migranter. Den nya lagen medför en förbättring av vården som erbjuds irreguljära immigranter. Alla barn i Sverige har nu rätt till subventionerad fullständig hälso- och sjukvård inklusive regelbunden tandvård. Vuxna irreguljära migranter erbjuds emellertid ”vård som inte kan anstå”, samma subventionerade vård som erbjuds asylsökande vuxna. Den nya lagen, som är otillräcklig, har brister, bland annat inom terminologin ”vård som inte kan anstå”. Termen är en utvidgning av ’omedelbar vård’, dock tillämpas de båda begreppen tämligen synonymt.”Vård som inte kan anstå” är ett juridiskt begrepp, som är skapat utan vårdprofessionens samtycke och som leder till att den enskilde vårdgivaren hamnar i ett etiskt dilemma när det ska tolkas. Med en sådan terminologi i lagen, frågar man sig vilka människor som ska erbjudas vård. En patient med högt blodtryck, diabetes eller till och med cancer. Vad är ”vård som kan anstå”, så kallad ”onödig vård”? Graden av stress, arbetsbörda eller politiska åsikter kommer att spela en roll

i vem som erbjuds vård och innebär att vissa patienter behandlas medan andra lämnas för att dö (cancerpatienter som inte får den behandling de behöver i tid). Detta innebär alltså att gränsdragningen av vården som ska erbjudas blir subjektiv och följden riskerar att bli godtycklighet samt diskriminering. Detta trots att hälso- och sjukvårdslagen anger att vård ska ges med respekt för alla människors lika värde och att den person med det största behovet ska ges företräde till vården. Mänskliga rättigheter ska vara en självklarhet. De mest utsatta människorna i samhället saknar dock denna trygghet. Vård ska ges utifrån det medicinska behovet, i enighet med vetenskap och beprövad erfarenhet. När lagar i ett land strider mot FN:s deklaration om mänskliga rättigheter och de vårdetiska grundprinciperna, bör vi som medmänniskor agera. Det ultimata måttet på en människa är inte där man står i stunder av bekvämlighet, utan hur man agerar i mötet med etiska dilemman och utmaningar. Människors rätt till vård är inte en migrationspolitisk fråga.

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Gör skillnad, gå med i IFMSA Från Susanne Ehn, Ordförande IFMSA-Sweden, Michaela Franzén Malmros, National Officer on Research Exchange, KI Strax efter andra världskriget

fick en grupp europeiska läkarstudenter en idé. De ville organisera utbyten för läkarstudenter, och samtidigt utveckla samarbetet mellan sina hemländer. Ett halvt sekel senare har IFMSA (International Federation of Medical Students’ Associations) vuxit till världens största studentorganisation som samlar över 1,3 miljoner läkarstudenter från drygt 110 medlemsländer. I augusti 2013 förde sju svenskar IFMSA-Swedens talan under ett internationellt möte som anordnades i Santiago de Chile. ”A world in which all medical students unites for global health and are equipped with the knowledge, skills and values to take on health leadership roles locally and

globally” - så lyder organisationens vision internationellt. Vi som arbetar inom IFMSA är engagerade läkarstudenter som agerar lokalt med ett globalt perspektiv, och satsar på att öka vår kompetens som blivande läkare och hälsopolitiska aktörer. IFMSA-Sweden anordnar nationella helger tre gånger per år på våra utbildningsorter runtom i landet, samt skickar delegationer till nordiska, europeiska och internationella möten. På varje utbildningsort bedrivs ett flertal spännande projekt som ständigt är på jakt efter nya engagerade. Vårt populära utbytesprogram skickar 150 läkarstudenter på praktik utomlands varje sommar. Ett IFMSA-engagemang kan börja lokalt som nalledoktor på ett barnsjukhus eller sexualupplys-

are för en högstadieklass, och leda vidare till en styrelsepost eller ett internationellt WHO-möte, det är bara fantasin som sätter gränser!

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Nyfiken på vad vi håller på med just nu? Kika in på www.ifmsa.se eller www. facebook.com/IFMSASweden

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FOTO: LARS MAGNUS EJDEHOLM

Av Hana Awil, ordförande IFMSA Stockholm

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Expedition Borneo FÖR 25 ÅR SEDAN reste National Geographic-filmaren

och fotografen Mattias Klum för första gången till världens tredje största ö – det gröna Borneo – med en av de äldsta och mest artrika regnskogarna på vår jord. Mattias har återvänt mer än 40 gånger till sitt älskade Borneo. Tillsammans med Äventyrsresor har du chans att resa till Mattias favoritplatser på Borneo för att möta orangutanger, flygande ödlor, skogslevande elefanter och näsapor.

Föredrag med Mattias Klum

FOTO: LARS MAGNUS EJDEHOLM

AVRESA: 9 februari 2014, reslängd 13 dagar.

Följ med till Borneo i ord och bild.

Tid: Tisdag 5 november, kl 18.30. Insläpp kl 18.00.

BOKA ELLER LÄS MER om resan på

Plats: Aula Magna, Stockholms Universitet.

aventyrsresor.se/MYA eller kontakta oss på 08-5560 69 00, resor@aventyrsresor.se.

Föredraget är kostnadsfritt, men föranmälan krävs. Anmäl på www.aventyrsrsresor.se/ klumborneo

STORA UPPLEVELSER I SMÅ GRUPPER SEDAN 1984

www.aventyrsresor.se Tel 08-5560 69 00

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MACIEJ ZAREMBA Mannen som väckte liv i en hel yrkeskår “Det var meningen att jag skulle undersöka ett fall av misstänkt dödshjälp. Och jag hittade en prislista.” Av Gustaf Drevin och Dunia Al-Hashimi Fotografi av Martin Kjellberg

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Zaremba visar hur mottagningsfrekvensen (Y) förändras med kötiden i dagar (X).Foto av Martin Kjellberg för Medicor

Aktuellt

Zaremba visar hur mottagningsfrekvensen (Y) förändras med kötiden i dagar (X).Foto av Martin Kjellberg för Medicor

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medicor

10/28/2013 11:37:24 AM

Aktuellt

Maciej Zaremba

Vad var det egentligen som dödade Herr B? Plötsligt visste alla vad New Public Management var. Dagens Nyheters Maciej Zarembas artikelserie Den olönsamma patienten om hur den svenska vården styrs av prislistor fick ett sällan skådat gensvar. Vårdpersonal, patienter och till och med en och annan politiker stämde in: någonting är allvarligt fel med sjukvården. Medicor satte sig ned med Zaremba i början av juni för att diskutera detta vidare.

Fallet gällde en man, Herr B, som

avlider på ett stort sjukhus efter obegriplig vanvård. Men istället för att hitta tecken till eventuell dödshjälp snubblar Zareamba över ett mer omfattande problem. Inte mindre än 82 olika läkare, varav 17 psykiater, hade sett till Herr B under hans tid i sjukhuset. Brottsmisstankarna avskrivs. Dödsorsaken, tror Zaremba, är ett systemfel. Ett halvårs grävande senare blåser han i visselpipan. I artikeln Vad var det som dödade Herr B? (17/2-2013) identifierar han boven som New Public

...leder till frustration för människorna som valt detta för meningens skull Management (NPM), en ekonomistyrning vars syfte är att effektivisera offentlig verksamheter genom att driva dessa som industriella företag. NPM-fenomenet i den svenska sjukvården styrs av klassificeringar kända som diagnosrelaterade grupper (DRG). Enbart inom Stockholms Läns Landsting finns cirka 2 500 avtal mellan vårdgivare och landsting. En del är regelrätta prislistor, där exempelvis en viss diagnos ger sjukhuset en förbestämd summa. Zaremba såg snabbt implikationerna. ”Jag är själv övertygad om att alla prislistor, beting, Vårdgarantin, viten, bonusar som styckar upp vården i moment eller diagnoser utan hänsyn till faktisk tillgång och resursåtgång, utan hänsyn till patientens vårdbehov – och det är så de ser ut – kommer manipuleras, leda till felrapportering och emellanåt oetiskt beteende gente-

mot patienten”, säger han i ett föredrag på Södersjukhuset den fjärde juni 2013. ”Det beror på att det inte är möjligt att på ett rättvisande sätt prissätta en så komplex och mångfacetterad verksamhet som sjukvården.”

föredrag. ”Alla dessa bilder som jag nu framkallat har en gemensam orsak: felslagen mål- och resultatstyrning /…/ som inte tar hänsyn till verksamhetens egenart.” Han klargör vidare att NPM bygger på minst tre felaktiga antaganden.

Det började under högervindarnas

Det första felantagandet är att

1980-tal, då en tyngd svensk statsapparat avsåg effektivisera sina verksamheter. Ironiskt nog var det en socialdemokratisk regering om klubbade igenom en sidoparagraf om mål- och resultatorienterad styrning, 1988, under finansminister Kjell-Olof Feldt. Zaremba berättar för Medicor att detta gradvis, smygande utvecklades till det som idag är NPM. Tonen i rösten är kritisk. ”Man sa ’titta, det privata näringslivet fungerar ju faktiskt effektivt. Dåliga företag går under, kunderna behandlas väl, man är mån om kunden. Så låt oss nu /…/ få dessa verksamheter att bete sig som företag’, liksom marknadsanpassat.” Zaremba väger orden nästan var för ett. Han är inte den stora retorikens man, men det han säger får en oerhörd kraft genom ordval och tyngden bakom dessa. Han talar lågmält, nästan blygt, men bestämt, och menar på att ansvaret ligger hos båda partiblocken. Konsekvenserna var oanade. Effektivitet och kvalitet är inte längre väsentligt. Idag styr prislistorna vården. Det är lönsamt att hitta fler bidiagnoser. Än bättre är att kalla dem på återbesök, då varje sådant ger landstingspengar. Att besöken opåkallat förlänger vårdköerna är irrelevant. Detta ersättningsystem må fungera längs med produktionsband i industrin, men inte inom vården, förklarar Zaremba på sitt

läkekonsten kan liknas vid industriell produktion och att man kan avgöra dess kvalitet kvantitativt. I sitt föredrag säger Zaremba att läkekonsten ”inte kan standardiseras, eftersom varje situation är unik och eftersom utförarens personliga egenskaper spelar en förhållandevis stor roll för resultatet.” För DRG-modellen spelar det ingen roll ”om patienten lämnar sjukhuset genom huvudingången eller bårhuset”, fortsätter han. Så länge sjukhuset fått betalt för att ha tagit emot och diagnosticerat patienten.

smaka på uttrycket ’ständigt effektivare terminalvård’. Det leder tanken fel, va? Fel nummer två är att NPM förutsätter att alla yrkens produktivitet ökar genom ekonomiska incitament. Dock går det ej ”att projicera dessa drömmar på läkare och poliskommissarier, ty i deras värld är det helt andra saker som ger status och tillfredsställelse.” Det är snarare kontraproduktivt, utlägger Zaremba. ”I yrken som förutsätter kreativ problemlösning är det andra saker som räknas.” Han klarlägger dessa som ”autonomy, mastery och purpose.” Han förklarar att personer i dessa yrken främst värdesätter frihet att

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Aktuellt

Maciej Zaremba. Föddes 1951 i Polen men flyttade till Sverige 1969 p.g.a. en antisemitisk kampanj igångsatt av kommunistpartiet 1968. Han har skrivit – uppskattat och kritiserat – för Dagens Nyheters kulturredaktion sedan 1989 om exempelvis tvångssteriliseringar, svensk straffrätt, invandring och främlingsfientlighet, mobbning och skogspolitik. Han har även utgivit böcker, ofta baserade på sina artiklar. Zaremba är en av Sveriges mest respekterade journalister.

utvecklas, självbestämmande och arbeta för ett mål som är större än de själva. ”Det gäller i högsta grad för alla vårdyrken.” Nu talar han intensivt och tilltalar direkt föredragets publik, bestående av främst läkare och sjuksköterskor. ”Traditionellt har jobbet faktiskt varit ett kall. Ett uppdrag.” Denna grad av självuppfyllelse uppnås ej längre inom kåren. I praktiken, säger han, ”leder NPM-metoderna till mindre autonomi, sämre möjlighet att utvecklas i yrket, eftersom man inte får ta ansvar för hela patienten.” Detta upprör kåren då det ”leder till frustration för människorna som valt detta för meningens skull.” Det tredje felantagandet är att alla processer ständigt går att göras snabbare och resursminimeras utan att kvalitetsförlust. ”Det gäller inte bara människor. Varje målare vet att det inte är någon idé att gå på med en hårtork på sin nymålade tavla.” Som den ordmagiker han är fyller han föredragssalen med skratt: ”Språket bär på vissa visdomar. Det talar om för oss att vissa saker liksom inte går riktigt ihop. Smaka på uttrycket ’ständigt effektivare terminalvård’. Det leder tanken fel, va?” NPM kommer ursprungligen från Toyotas framgångsrika företagsmodell, Lean Production. Dock är inte människors hälsa inte jämförbar med

ihopsättandet av bildelar. DRG bär en bitter eftersmak av korruption, gisslantagen läkaretik och ineffektivitet. ”Ur medicinsk synpunkt finns det ingen anledning att känna till DRG-systemet. Det har inget att göra med vårdkvalitet, det är bara ett ersättningssystem. I den bästa av världar, om DRG ska fungera som det är tänkt så borde inga läkare känna till det, men jag vet sjukhus där de tvingas lära sig det med det uttalade syftet att kunna, så att säga, ’optimera budgeten’.” Det är inte relevant för inom ersättningssystemet som det ser ut idag att belöna kvalitet.

...som att man hade öppnat slussar för ett missnöje som har varit ackumulerat och icke kommit till uttryck Att förebygga sjukdomar är till och med direkt kontraproduktivt då det orsakar förlorad inkomst för vårdgivaren. ”Alltså, tankefelet ligger här i att man försöker tillämpa ett system som förutsätter fri marknad”, säger Zaremba i föredraget. Tonen i rösten är inte anklagande. Den är varken beklagande eller uppgiven, utan snarare neutral; det här är ett faktum. En realitet för oss att förhålla sig till. Och som folk har förhållit sig. ”Det har aldrig hänt mig att få så närmast enstämmigt medhåll att ’såhär är det, så här är det, det här är en korrekt verklighetsbeskrivning’.”, säger han när Medicor intervjuar honom efter föredraget. ”Åttio procent av de som skriver arbetar inom vården. Mest läkare, men också sjuksköterskor, logopeder, terapeuter, psykologer och patienter”, men det är få politiker som har hört av sig, berättar Zaremba. Han har intervjuat den kristdemokratiske socialministern Göran Hägglund, men

ENG. The journalist Maciej Zaremba at Dagens Nyheter

wrote about how Swedish healthcare is driven by economic incentives this spring. The overall system is known as New Public Management (NPM) and uses price lists, so called Diagnose-Related Groups (DRG). Caregivers are indirectly forced to diagnose and treat patients after what diagnoses give the most compensation from the county council (“landsting”),

inte fått något gehör för kritiken. Hägglund har istället gått ut i media och försvarat sig själv och NPM-systemet. Upplevd valfrihet över allt. De medicinska professionerna delar alltså generellt inte Hägglunds bild av dagens svenska sjukvård. Yrkeskårerna sympatiserar starkt med Zarembas texter. Till Medicor säger han: ”Det var nästan som att man hade öppnat slussar för ett missnöje som har varit ackumulerat och icke kommit till uttryck av skäl som är lite intressanta att undersöka. Varför är läkare så tysta?” Enligt honom vet vi nu vad problemet är. ”Det här New Public Management, det är lite grann som diffusa symtom som hänger samman, men det är först när man hittar en diagnos som förklarar alla symtom samtidigt som det blir möjligt att behandla. New Public Management visade sig vara den nyckel som öppnade diskussionen. Nu ser man plötsligt att saker hänger ihop.” I slutet av vårt samtal adresserar han oss studenter och unga läkare: ”Det finns rätt många väldigt unga läkare under utbildning som berättar hur de reagerar när de utsätts för det här för första gången, för det strider mot deras föreställning om läkaretiken.” Det är alltså upp till oss att reagera. Eller, vi har redan reagerat. Det är dags att aktivera oss, från passiva kritiker till aktiva förändringsmakare. När vi slutligen frågar vilka slags förändringar han skulle vilja föreslå, svarar han att det skulle vara fel av honom att ens försöka. Det är upp till de professionella inom yrket. Det vill säga oss.

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Medicor sökte Göran Hägglund för en kommentar, men dennes pressekreterare tyckte inte att de hade tid med detta.

which corrupts the system and the medical ethics. Zaremba has been hailed virtually unanimously by medical staff in the country and people call for change, but the system prevails. Now, the Karolinska doctor and lector, Astrid Seeberger, calls for a national congress to discuss alternatives to NPM and the DRG price list system.

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Temabild med en poserande modell, ej föreställande Astrid Seeberger. Foto: Martin Kjellberg för Medicor

“...sjukvård i kris där arbetstakten ständigt ökar, där den administrativa belastningen har vuxit på ett sätt som är ohållbart, där det saknas vårdplatser, där patienter far illa.” Text av Astrid Seeberger, gästskribent

Sjuk svensk sjukvård Astrid arrangerar veckoligen Pedagogiskt Forum på de större sjukhusen i Stockholm. Kontakta astrid.seeberger@ki.se för mer information.

10/28/2013 11:37:25 AM

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ASTRID SEEBERGER GÄSTKRÖNIKA Astrid Seeberger, överläkare på Karolinska universitetssjukhuset i Huddinge, samt mottagare av Läkaresällskapets etikpris 2012, om hur NPM påverkat sjukvården och vad som bör göras härnäst.

Timeout för Hippokrates? Eller tid för hans comeback?

Temabild med en poserande modell, ej föreställande Astrid Seeberger. Foto: Martin Kjellberg för Medicor

av Astrid Seeberger

Hippokrates som anses vara läkekonstens far visste att hur viktigt det var med ett gott omhändertagande av patienterna. Han myntade ordspråket: ”Stundom bota, ofta lindra, alltid trösta. Men det var då, fyra hundra år före Christus. Hur är det idag? Har läkarrollen ändrats? Har läkarna blivit vårdingenjörer, vårdadministratörer, vårdproducenter? Är det timeout för Hippokrates? Innan Maciej Zaremba kom med sina artiklar om sjukvården hade få hört talas om New Public Management (NPM) vilket är häpnadsväckande med tanke på hur denna styrfilosofi drabbar oss dagligen i den kliniska vardagen. New Public Management är baserad på tron, inte på vetenskaplig evidens att offentlig verksamhet, även sjukvården kan bedrivas som en varuproduktion med nyckelord som produktivitet, målstyrning, standardisering och konkurrensutsättning och med ständigt pågående effektiviseringsprocesser. Styrfilosofin spred sig som en väckelserörelse, med samma fanatiska tro. Några länder, som Schweiz och Spanien, var mer resistenta. Sverige däremot hängav sig åt NPM med en svåröverträffad trosvisshet. Det började med att de svenska statsfinanserna försämrades på 1970-talet medan sjukvårdens kostnader steg utan att det fanns någon redovisning av sjukvårdens resultat. Man var överens om att det behövdes ett nytt system. Nyliberalism vann terräng och med den New Public Management. Följder av den nya styrmodellen ser vi idag: En sjukvård i kris där arbetstakten ständigt ökar, där den administrativa belastningen har vuxit på ett sätt som är ohållbart, (svenska sjukhusläkare använder endast en tredjedel av sin arbetstid till patientmöten), där det saknas vårdplatser, där patienter far illa. Det finns en tilltagande frustration hos oss som arbetar

inom sjukvården att det blir allt svårare att ta hand om patienterna på ett gott sätt. Ett uttryck för denna frustration är bland annat Läkaruppropet i år som lyckades samla över 8000 namnunderskrifter. Man skulle kunna bli nedstämd när man ser hur det är. Fast det finns ett annat sätt också. Min far brukade säga att man inte skall vänta på att prinsen kommer och räddar en utan man ska se till att rädda sig själv. Och det är just det som sker just nu. Vi som arbetar inom sjukvården håller på att samlas för att komma med ett nytt noga genomtänkt förslag hur sjukvården kan bedrivas på ett bra sätt, gärna i en dialog med politikerna. Det är ingen som vill gå tillbaka till det gamla systemet utan det är självklart att det behövs en ekonomisk styrning, men den måste vara klok, och vi måste redovisa resultat, men resultaten måste inte bara vara kvantitativa utan beakta kvalitativa mått. Ett steg i det gemensamma tankearbetet är ett nationellt möte med titeln Hur får vi en bättre sjukvård? som kommer att äga rum den 1 februari i Stockholm, en lördag så att så många som möjligt kan delta. I en demokrati är vi alla ansvariga för vilket samhälle vi har. Och vi som bedriver sjukvård är ansvariga för den, det är viktigt att vara medveten om, vi kan inte bara skylla på politikerna. Det är inte så att alla behöver bli sjukvårdspolitiskt aktiva men vi måste se att verksamheten som bedrivs på vår enhet är en god sjukvård där patienterna sköts på ett kunnigt, engagerat och empatiskt sätt. Det är dags för en comeback för Hippokrates.

•

för

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Vill du bli en av oss?

Vi söker kvinnor och män som vill vikariera hos Södertörns brandförsvarsförbund i sommar.

Vi vill ha både kvinnor och män till tjänsten som brandman. Vi vill ha personer med olika erfarenheter och etnisk bakgrund. Vi vill ha dig som är brandman idag och dig som kanske inte är det. Viktigast är att du har de kunskaper och drivkrafter som vi värderar och som vill utveckla och utvecklas i en uppdaterad räddningstjänst. En större bredd av kunskap och erfarenheter gör oss bättre rustade att lösa de utmaningar vi möter på jobbet. Därför har vi, de senaste åren, anställt personer som kan något av de utomnordiska språk som talas i våra kommuner. Vi har även brandmän som tidigare har varit sjuksköterskor, undersköterskor, ambulanssjukvårdare, sjukgymnaster, lärare och fritidspedagoger liksom personer med utbildning och erfarenhet inom räddningstjänsten. För att passa hos oss har du förmåga att möta människor i olika situationer, initiativkraft, förmåga att leda andra, förmåga att arbeta i grupp samt praktiskt handlag. Sist men inte minst är det viktigt att du delar vår syn på att yrkesrollen är oberoende av vilket land eller kultur man fötts i och vilket kön eller sexuell läggning man har. Den bygger istället på: • goda kunskaper och regelbundna övningar • en vilja att bidra till ett säkrare samhälle • en omtänksam och respektfull attityd inför sina medarbetare och de människor man möter i sitt arbete.

Vi jobbar för ett säkrare samhälle När det händer en olycka är vi snabbt på plats för att ta hand om dem som drabbats. Allra bäst är det förstås om olyckorna aldrig inträffar. Ju större kunskap våra kommuninvånare har desto bättre kan vi tillsammans skapa ett säkert samhälle. Därför satsar vi på information, rådgivning, utbildning och tillsyn. Alla brandmän hos oss arbetar förebyggande under större delen av sin arbetstid, när det inte är utryckning. Det innebär att du kan hålla i en brandkunskapsutbildning på förmiddagen och släcka en lägenhetsbrand eller ta hand om skadade i en trafikolycka på eftermiddagen. Nästa arbetsdag kanske du kollar brandskyddet på ett företag. Södertörns brandförsvarsförbund bedriver räddningstjänst i följande tio kommuner i Stockholms län: Botkyrka, Ekerö, Haninge, Huddinge, Nacka, Nykvarn, Nynäshamn, Salem, Södertälje och Tyresö. Som brandman hos oss ingår du i en arbetsgrupp med en styrkeledare. Arbetet innebär skifttjänstgöring under dagtid, nätter och helger på en av våra heltidsstationer. INFORMATIONSTRÄFF för dig som vill veta mer om hur det är att jobba hos oss. Södertälje brandstation 26/10 kl 10-12. Anmäl dig på infodagen@sbff.se med namn, en rad om dig själv och dina frågor till oss. Välkommen!

Läs mer och ansök på www.sbff.se/bm senast den 11/11. Välkommen till oss!

Södertörns brandförsvarsförbund www.sbff.se l www.facebook.com/sodertorn 38

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PS13

Pehr Granqvist

Religionspsykologin

Av Simon Jangard Nielsen

Religionens betydelse för den en-

skilda individens hälsa har Pehr Granqvist ägnat en stor del av sin forskning åt. Man har bland annat lyckats hittat ett samband mellan de anknytningsmönster spädbarn utvecklar gentemot sin vårdnadshavare och den betydelse religionen senare får i troende människor liv. Detta och mycket annat föreläste Granqvist om under årets Stockholmsledda upplaga av psykologstudenternas kongress, PS13. Medicor träffade föreläsaren som till vardags är docent och universitetslektor vid psykologiska institutionen på Stockholms Universitet, för att tala om ett forskningsområde som trots sin hälsorelaterade koppling får oförtjänt lite uppmärksamhet. Religionspsykologin har sina rötter långt tillbaka i historien, då framförallt som ett teologiskt forskningsobjekt. Inom psykologin etablerades ämnet på allvar kring förra sekelskiftet i samband med att den amerikanska psykologins förgrundsgestalt William James publicerade The Varieties of Religious Experience. Trots att verket citerades flitigt och att ämnet blev mycket omtalat började intresset, främst på grund av sin empiriska tvivelaktighet, att svalna under ett 1930tal där ”psykologin kom att hitta sin form i termer av [direkt] observerbara enheter [...] och aldrig [i] några förklaringar som hade med medvetande att göra.” Från 1960-talets så kallade kogni-

tiva revolution har ämnet fått förnyad psykologisk relevans och idag bedrivs forskning på religion och religiösa upplevelser främst i USA där också Granqvist har kommit att knyta många betydelsefulla kontakter under åren. Hans egen forskning som främst handlar om religion förstått ur ett anknytningsperspektiv har att göra med hur vi som människor relaterar till vår närmaste omgivning. Mer specifikt grundar sig anknytningen i ett medfött biologiskt system som barnet använder sig av för att utveckla en eller flera emotionella relationer till primära vårdgivare. Från att teorin introducerades på 1950-talet av den brittiska psykoanalytikern John Bowlby har teorin fått empiriskt stöd och vidareutvecklats

till att inbegripa olika typer av anknytningsmönster beroende på hur pass väl denna relation utvecklas. Granqvist förklarar att forskningen har sett likheter mellan dessa tidigt etablerade relationer och troende människors upplevda gudsrelation. Det finns hos troende personer en ”strävan efter att vidmakthålla någon typ av närhet till Gud, via exempelvis bön” och när man i studier frågat hur troende judar och kristna uppfattar sin tro, ser en majoritet den som en relation till gud framför sådant som en samling trossatser eller en mänsklig gemenskap. ”Begreppet anknytning syftar på vad en mindre och svagare part gör och upplever i förhållande till en klokare och starkare part. Anknytningspersonen [vårdnadshavaren] är denna starkare part som på flera sätt kan liknas vid hur Gud ofta framställs som allsmäktig och allvis.” Inom anknytningsteoretisk forskning talas det om ”två separata utvecklingsvägar in i religiositet och andlighet beroende på hur man har haft det anknytningsmässigt under sin uppväxt.” Vid en så kallad otrygg anknytning kompenserar individen för sin otrygghet med att vända sig till Gud som en strategi för att bemästra negativa tillstånd. Ett tryggt anknytningsmönster leder istället till att Gud används som en sorts korrespondens där den positiva bilden av självet och föräldrarna generaliseras i relationen till Gud. Oavsett hur vägen in i religiositet ser ut har flertalet studier visat på religionens positiva betydelse för psykisk och fysisk hälsa. Amerikansk forskning har kunnat visa på att ett religöst engagemang har ett positivt samband med en frånvaro av sådant som cancer, hjärt- och kärlsjukdomar och självmord. Granqvist

ENG.

Pehr Granqvist has dedicated his research in regards to the importance of religion for the individual, in connection with how humans relate to their surroundings, more specifically re-

Foto: Pehr Granqvist

Högervindarnas

menar att en av anledningarna till denna hälsofrämjande påverkan är att troende människor ofta upplever sin egen tro som ”en enande upplevelse inför jaget”. En ”upplevelse av att bitarna faller på plats” där religionen ger den troende både etisk vägledning, tröst, mening och förlåtelse. Just bristen på etisk vägledning

och en känsla av existentiell trygghet är något Granqvist betonar som den främsta psykologiska utmaningen vi står inför i en sekulär värld. I dess ställe används här religionen på ett sätt som kan tyckas opportunistiskt: ”prästen kan få komma i samband med väldigt stora naturkatastrofer men i övrigt så hålls han eller hon borta”. Om religionen nu i sin välfungerande tappning har en så pass hälsobringande effekt och samtidigt saknar en sekulär motsvarighet i ett land som Sverige - vad är det då som gör att forskningsintresset inte är större än vad det är? •

lationships. He is working from the perspective of attachment theory, where he compares the parent-child relationship to the latter one between the deity and the individual.

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10/28/2013 11:37:26 AM

The Arts

Karin Alfredsson

Om att genom skrivandet belysa det manliga problemet kvinnoförtryck Foto av Andrea Lindström för Medicor

Av Gustaf Drevin

Det är inte svårt att identifiera med någon som du själv, en granne som liknar dig. Det är svårare att identifiera sig med någon du inte träffar, som är mycket långt borta, om har en annan hudfärg, som äter en annan sort mat. Det är när du börjar göra det som litteraturen framkallar under. Nigerianske författaren Chinua Achebe, intervju,The Atlantic (2000)

Journalisten och författarinnan

Karin Alfredssons hittills fem böcker långa, prisbelönta deckarserie om den svenska läkaren Ellen Elgs upplevelser öppnar folks ögon för kvinnoförtryck världen över. Karin använder romanformen för att belysa ett verkligt och påtagligt problem som alltför ofta bortses från, nämligen förtrycket kvinnor och flickor runt om i världen. ”Det har jag alltid engagerat mig i på olika sätt. Jag skrev den första boken på svenska om våld mot kvinnor, som kom 1979, som hette Den man älskar agar man?” Den boken bidrog indirekt till upprättandet av kvinnojourer i Sverige, där den användes som studiematerial. Idag vill Karin åskådliggöra problemen, göra dessa påtagliga och verkliga. Paradoxalt nog genom att använda den skönlitterära romanen, för att nå en bredare publik. ”Jag kände att jag ville berätta den här sanna historien på ett annat sätt, för folk som kanske aldrig på jorden skulle läsa SIDA:s rapportskrifter.” Hon talar lugnt och tydligt, det märks att hon svarat på denna fråga många gånger förr. Den modiga huvudkaraktären Ellen Elgs äventyr i Vietnam, Polen och Zambia engagerar mer än WHO:s statistik. Läsaren få en personlig upplevelse av hedersmord, mordbränder, misshandel, våldtäkt och prostitution, genom Ellens ögon. ”Om man berättar levande historier om levande människor är det väldigt få som kan låta bli att bry sig,” säger Karin men tillägger att det inte får bli schablonmässigt: ”om man gör det till en ’det-finns-mycket-fattigdom-i-världen’ är det ju ingenting, det är ju lätt att skaka av sig.” Fiktionen agerar således den grymma verklighetens budbärare. Den ovanför artikeln citerade nigerianske författarleg-

enden Chinua Achebe menade också på att man genom skönlitteraturen lär känna karaktärer vars livsöden blir läsaren påtagligare tack vare den personliga koppling som uppstår mellan karaktär och läsare. Karaktärerna är inte helt fiktiva. Karin har en imponerande bakgrund, med arbete för såväl Aftonbladet som SVT och frilansarbete i snart 60 länder. Trovärdigheten är den främsta grundvalen och hon inleder varje bok med Allt viktigt är sant. ”Väldigt många har jag träffat, antingen själv som jag träffat direkt eller sådana jag läst om eller hittat i verkligheten, i tidningsartiklar eller rapportböcker.” Hon framhåller därefter att hon aldrig hade kunnat fantisera ihop de grymheter hon skriver om. De är tagna ur verkligheten. En tortyrscen i öken, från femte verket, Pojken i hiss 54, som beskrivs finns att se på Youtube, då CNN rapporterat och visat torterarnas egen videofilm. Inledningsscenen från det första verket, 80 grader från varmvattnet, är också taget ur verkligheten. Man får ta del av en födsel där barnmorskan är en tegelbruksarbetare. ”Ett problem är att hon har många sår på händerna från att hålla på med sten och grus – och då kan hon ju få i sig smitta. Så, hon har plastpåsar på händerna,” berättar Karin och ler snett. Kontrasten mellan det komiska i situationen och allvaret i fenomenet betonar faktumet: kvinnor är utsatta på många sätt. Karin betonar slutligen vikten av att skifta fokus från kvinnan till mannen när man diskuterar kvinnoförtrycket. ”Man ska prata om killar och män. Istället för att säga ’Hur kan du som tjej undvika att

bli våldtagen?’ ska man säga ’Hur kan du som kille undvika att bli våldtäktsman?’ Prata om killarna istället. Prata om förövarna och inte offren. Det är det absolut viktigaste.” Ett rejält paradigmskifte krävs. ”Att våld mot kvinnor – att våldtäkter – fortfarande är en kvinnofråga, det är bedrövligt!”

•

Karins projekt Cause of Death: Woman www.causeofdeathwoman.com

Minutrecension: Pojken i hiss 54 (2011) I Pojken i hiss 54 följer vi Ellen Elg under en inledningsvis lugn semester i Dubai. Snart ramlar hon över en tortyrscen (se artikeln), där en mäktig shejk är bödel. Familjens chaufför, pakistanske Mumtaz, är med Ellen under tortyren, men har större problem i hembyn, där lillasystern anklagas för sexuellt umgänge med ett övernattande jägarfölje. Traditionens makt återspeglas i denna hektiska resa genom halva Mellanöstern. Enkel dialog, högt tempo, miljöskiften och med den överhängande känslan att allt sker på riktigt gör att verket stannar kvar länge hos läsaren. Författarinnan har sannerligen lyckats påvisat hur kvinnoförtryck kan te sig runt om i världen genom detta verk.

ENG. Karin Alfredsson is a journalist

and writer whose work focuses on spreading awareness of the oppression of women around the world. Together with another journalist and a photographer, she has started Cause of Death: Woman. To learn more about her work, visit www. causeofdeathwoman.com

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medicor

1#2013

The Arts

FILM REVIEW

A screne from Enjoy Poverty

Enjoy, please, Poverty by Oskar Swartling

“You shouldn’t give them any-

thing they don’t have. You should train them, empower them.” – Renzo Martens The screen goes black and I stare at the after credits, trying to get a grip of the many contradictory feelings now boiling inside me. I feel naïve. Powerless. Almost stupid. Like a young boy thinking he can save the world only to realise no one is going to let him do it. After 90 minutes of pure provocation I turn the lights off and go to bed, hoping to fall asleep – knowing I won’t. I have a lot to think about tonight. For two years, the Dutch artist Renzo Martens travelled around Kinshasa, the capital of the Democratic Republic of the Congo, and its countryside, with the intention to study poverty and aid in the post-war country. The result? The provocative and thoughtful film Enjoy Poverty (2009, 90 min).

At the beginning of the film, the main story starts, later interrupted by scenes from his journeys during the two years in the country. By foot, carrying two big metal boxes and a camera in his hand, Renzo Martens travels from Kinshasa to a small village located in the poor Congolese countryside. At arrival he delivers the idea he’s been working on since he came to Congo-Kinshasa; poverty is here to stay, and as long as people are making money on poverty, fighting it will not help. Therefore, he tells the inhabitants that they should take advantage of their primary product: poverty itself. From his two metal boxes Martens takes out a generator and a neon sign: “Enjoy Poverty”, with “please” flashing in red. Throughout the film, the alternating scenes take us with Martens on his other journeys in Congo-Kinshasa. From ar-

rogant MSF-doctors to guerrilla soldiers in camouflage ski masks, from rich farm owners to poor unemployed parents, Martens shows a non-governmental organisation climate out of function. When photographers are taking pictures of bloody bodies in the sun, Martens turns his camera to the photographers, revealing a sight in conflict with the one we usually get from pamphlets and brochures. Martens is not criticising the good will of others, but the way it is pursued. And more importantly, he wants to highlight a major problem: the so-called filmed poverty, that is, media taking photos of vulnerable people and making money from it. I’m still confused when I finally fall asleep, and I still don’t know what to think of the movie. Given my reaction, good I would say.

•

Book club: Project Wisdom by Johanna Wolfsberger

This autumn the programme di-

rector of the Master’s Programme of Biomedicine, Lars-Arne Haldosén, together with a group of staff and students, is launching a book club at the Karolinska Institute. It is an approach to get students together outside the classroom and give them new perspectives on science and life as a researcher. This project is mainly aimed for Bachelor and Master students of Biomedicine, Bioentrepreneurship as well as Toxicology, but all book-loving students and teachers at KI are welcome. Ambitious students can start a book circle and become group leaders by choosing a title from a suggested selection of outstanding books related to science. These can be biographies, novels

handling the severity of a disease or topics concerning ethics. This term students can choose between Brave New World by Aldous Huxley, Nacked Genes: Reinventing the Human in the Molecular Age by Helga Nowotnx and Guiseppe Testa, and My Sister Rosalind Franklin by Jennifer Glynn. The books are provided by Project Wisdom and have to be returned at the end of the term. Lars-Arne and the Project Wisdom crew hope that the project will attract a lot of book lovers and will grow during the next years. Project Wisdom is a way for all reading enthusiasts out there to take a break from your studies and get inspired by fascinating stories. •

Illustration by Touba Guerroumi for Medicor

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medicor abroad

NorWHO 2013

An intimate duel between medicine and politics By Gustaf Drevin and Rrezarta Rama

A majority of the NorWHO 2013 participants. Photo by Jingcheng Zhao

Role-playing is one of those geeky

things in which you never actually participate. However, when Medicor had the opportunity to attend the World Health Organization (WHO) simulation organized for all the students interested in global health, we seized on the chance to get involved. Destination: NorWHO 2013, Copenhagen, Denmark. NorWHO gathered international students wanting to understand more about global health decision-making. The variety of programmes students came from accounted for the interdisciplinary nature of the WHO itself. About 60 students from Medicine, Political Science, Psychology, and Global Health assumed certain roles and worked to draft a simplified WHO Assembly resolution on the subject of mental health. Mental illness accounts for circa 11% of the Global Burden of Disease, according to The Lancet. But, mental healthcare spending in low and middle income countries is so low that it is virtually negligible. How can we fight mistreatment, stigma, and discrimination of the mentally ill with acute diseases such as HIV/AIDS, tuberculosis, and malaria? The simulation took place near the centre of Copenhagen. Participants requested roles in their application and NorWHO consisted of a wide variety of representatives. The countries that the students represented were divided into geographical discussion groups, Regional Blocks. These served as preparatory stages for Plenary Sessions that were held in the later stages of the simulation.

The aim was that all countries agree on a final resolution, where the majority votes for its implementation. In the Africa Block, countries such as South Africa and Zimbabwe clashed over the role of traditional medicine, while NGOs such as Médecins Sans Frontières raised awareness about the underprivileged and refugees. In the America Block, the pharmaceutical company Lundbeck conspired with the U.S. about tearing apart regulations for pharmaceutical testing and sales. Media actors such as BBC and The New York Times went between the Blocks and reported via Twitter and leaflets. After a few hours, a small world community had been created, and we were passionately part of it. The most interesting element was undoubtedly the possibility to assume the role of a country or an NGO of which little was known before participating. NorWHO 2013 gave us the possibility not only to research each country’s health policy, but also to learn about their history, international relations, and domestic policies. Also, by discussing all the different propositions in front of each Regional Block and the bigger plenary, students improve their rhetoric and public speaking skills. Playing a role exceedingly well brought a humoristic touch to the conference. Imagine the reactions in the Africa Block when the U.S. wanted to ban generic drugs and remove pharmaceutical regulations. The organisers planned NorWHO for ten months. Head organiser Marie

Hauerslev says this initiative is “a sustainable and interesting way of creating change in global health.” As a medical student, Ålborg, Denmark, she adds that “we, as students, are the next generation of healthcare leaders and therefore we need to get involved, challenge the ideas of the WHO, and create better outcomes.” Beside the full days of imaginary healthcare policy-making, participants got inspiring lectures by WHO officials and people from organisations working with mental health. Among these, University College London teacher and former NGO lobbyist Mike Rowson, MSF psychiatrist Caecile Buhmann, and Dutch WHO official Matt Muijen. These talks increased participants’ understanding of how the WHO really works, adding another dimension to the event. We were inspired to organise something similar to NorWHO at Karolinska Institutet, having met so many students interested in working with global health. Perhaps somebody reading this could take the first step toward NorWHO 2014 or 2015. We were gladly surprised of how much we actually understood of international relations, politics, economics, and lobbying from such a, seemingly, modest simulation. Although it was difficult anticipating how much to prepare on beforehand, one learnt much by the pedagogical nature of the simulation. Hopefully, what we learnt from this imaginary setting will someday contribute to the concrete improvement of people’s health also in real life. •

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10/28/2013 11:37:31 AM

1#2013

medicor

Win the reservation of two

tickets to Nobel Nightcap!

N N C

obody knows how to get tickets to Nobel NightCap (NNC). But, Medicor and NNC now present a competition where you can win the reservation of two tickets to the party of the year! ow, to win you must submit something funny and creative text, photo, video, etc.; freedom encouraged! - to Medicor’s Facebook page MEDICOR MF or chefredaktor@medicor.nu.

heck out more details on our Facebook - deadline is on 20/11-2013! And, by the way, here is the theme:

WHO could, or should, have won a nobel prize in the Middle Ages?!

Full prize: reservation to buy 2 tickets to NNC, plus the book Vår Tid på Jorden signed by Mattias Klum.

Last issue ‘s winner! In this spring’s Medicor competition, Medicor and Me, we asked you to submit a photo of yourself and the magazine. This photo swept us away! Sandra Nissan, thank you for this extremely innovative and hilarious photo! Medicor awards you with a ticket to Nobel NightCap! Congratulations, Sandra!

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10/28/2013 11:37:34 AM

Tell your story

Photo by Jingcheng Zhao

Everybody has a unique story. Everybody has a unique story. You can share it in many ways. You can share it in many ways. Come tell yours. Come tell yours.

medicinska fĂśreningenâ&#x20AC;&#x2122;s student magazine

Become a member today! Become a member today!

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medicor Facebook: MEDICOR MF chefredaktor@medicor.nu

10/28/2013 11:37:34 AM