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MMSA National Peer Education and Training (NPET) Programme 2013-2014


foreword The Malta Medical Students Association (MMSA) (l-Għaqda tal-Istudenti talMediċina ta’ Malta) is a non-governmental, non-political student organisation founded in 1951. The MMSA has its foundation at the University of Malta where it has been the most active student organisation for the past 10 years. It is a full member of the International Federation of Medical Students’ Associations (IFMSA) and European Medical Students’ Associations (EMSA). The MMSA aims to enhance the medical student life through promoting active participation in the academic system, international exchanges and training in various fields of the public health sector. The MMSA also aims to empower society to become functionally involved in holistic health decision making. As part of the IFMSA, the MMSA enjoys international status along with 97 other National Member Organisations, encompassing over one million students globally. The MMSA is actively supported by the Health Promotion Department.

“It is a truth, universally acknowledged, that students tend to relate to their own peers who are in the same boat as they are rather than professionals whose way of life may be oceans apart from that of the learners. This is one of the cornerstones of peer education. Such an informal approach to health promotion takes place in a cordial environment that encourages participants to ask questions without being scared of ridicule or scandal. The well-trained and enthusiastic young people delivering the message will hence support the growth of the learner’s understanding of relevant issues.” MMSA Standing Committee on Peer Education and Training mission statement

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contents Foreword ............................................................................................. 1 Message from the MMSA President ..................................................... 3 Peer education and training ................................................................. 5 Public Health ....................................................................................... 7 Sexual Education ................................................................................ 12 Human Rights and Peace .................................................................... 15

How to use the NPET Programme booklet As of this year, age-group markers have been added to each respective training session offered by the MMSA to facilitate session selection and narrow down your requirements (however these are simply guidelines): Appropriate for young children (3-7) Appropriate for older children (8-14) Appropriate for teenagers (15-18)

Editor: Phoebe De Bono Design: Matthew Baldacchino Proofreading: Gabriel Ellul, Thelma Xerri Contributors: Kristina Bartolo, Robert Cachia, Francesca Curmi, Phoebe De Bono, James Mario Gauci

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message from the MMSA president Dear friends, “Education is the most powerful weapon which you can use to change the world� Nelson Mandela

The National Peer Education and Training (NPET) Project is one of the biggest projects carried out by the Malta Medical Students’ Association (MMSA) on a yearly basis. It endorses all the principles of modern education as it puts the student at the centre of attention and takes an informal approach at providing invaluable information to school children. The topics discussed within the programme are of great importance to adolescents and root from the main pillars of foundation of our very own association. The programme aims at providing an opportunity to school children to discuss sensitive issues in an informal way and educate themselves about various topics related to the fields of public health, sexual health and human rights. These are topics which are extremely relevant to each and every adolescent and provide information in a way which can be understood by pupils of that age. It also provides student-to-student contact while decreasing the age gap, which may itself inhibit the message from being delivered optimally. Important topics discussed by our trained peer educators include tobacco smoking, substance abuse, eating disorders, sexual and reproductive health and numerous others. Not only are these areas important at such a crucial age but they are sometimes totally absent from the curriculum that our education offers to the student population. Therefore the MMSA has devised a programme, which aims to fill in any gaps and at the same time compliment the extensive curriculum that Maltese students are exposed to. The MMSA bases all the information used for sessions on a solid scientific basis. A number of experienced peer educators have produced all the

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materials being used through thorough research based on scientific data and knowledge. The association also works with other numerous professional bodies, which include the Health Promotion Department, the International Federation of Medical Students’ Associations (IFMSA), EU Drugs Strategy 2013-2020, Y-Peer platforms, Agenzija Żgħażagħ and other student associations. NPET also serves to shift the focus of approach towards health, from one of provision of cure, towards a more modernistic approach of health promotion and prevention. This helps initiate a much-needed change in the mindset of our population. By targeting this sector of the Maltese population at such a tender age, we aim to ingrain numerous values, which give health a higher priority in the society of tomorrow. Our aim is to deliver a number of principles, which are useful throughout one’s life. I invite you to read through the following articles in order to get a better idea about the peer education topics offered by our association. For more information you may also visit our website www.mmsa.org.mt or contact us on npet@mmsa.org.mt. We hope that you find our National Peer Education programme interesting and useful, and I look forward to working with you in the near future.

Regards,

Robert Cachia MMSA President 2013 - 2014

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peer education and training Dear readers, This booklet should serve as an introduction to both the MMSA as well as the Standing Committee on Peer Education and Training (SCOPET). SCOPET runs the National Peer Education and Training (NPET) programme which represents an attempt to reply to several pressing questions about controversial topics that children and adolescents might encounter. A “peer� is someone who is your equal; someone who shares the same background as you, someone who is experiencing the same problems as you. Consequently, the likelihood is that you will be more likely to trust and relate to someone rather than a professor or expert. Our peers thus hold the power of being able to influence our lifestyle in a positive or negative way. Positive peer influence is thoroughly exploited in our peer education sessions. During these sessions, trained students encourage healthy debate and personal contemplation through interactive, non-formal exercises. The aim is not to instruct our listeners what they should and should not do. The peer educator must not try to instil a sense of alarm and anxiety since this might backfire and lead to rebellious behaviour. On the contrary, during NPET presentations the MMSA students deliver their message in a friendly atmosphere to provide their listeners with a reservoir of knowledge which will hopefully enable adolescents to delineate the boundaries between what is wrong and what is right when push comes to shove. When it comes to taboo issues such as sexual education, eating disorders, drugs and alcohol, many teenagers refrain from asking their seniors like teachers and parents. I was no exception and for quite some time I gathered a misinformed inventory of information regarding such controversial topics. This was because I listened to media, peer pressure and urban myths and

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swallowed everything hook, line and sinker. As peer educators, we want to prevent this. We do not want adolescents to go running about with a wrong impression that could ultimately lead them to making a wrong decision. As medical students and future doctors, we want to ensure the smooth running of this peer education programme in order to reach out to as many adolescents as possible. Education is power and we want to empower as many people as we possibly can. The peer educators that present the NPET sessions receive appropriate training which is approved by the International Federation of Medical Students (IFMSA) and is internationally-recognised. A seminar titled NPET weekend is mandatory to give peer educators an overview on presentation skills, conflict management, session design, public speaking and many other relevant topics. We hope that after reading this booklet you will consider taking up the different programmes and including them in your curriculum. If you have any questions whatsoever please do not hesitate to contact me on npet@mmsa.org.mt.

Thank you,

James Mario Gauci MMSA Peer Education and Trainings Officer 2013-2014

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public health Substance abuse Our substance abuse session focuses mainly on issues that tackle drugs, alcohol and addiction. Through the use of leaflets and presentations, this NPET session covers a wide variety of related topics including proper definition of a drug, explaining what happens during drug administration, the problems associated with drug intake and withdrawal as well as the side effects and symptoms of drugs. The session also aims to clarify particular points about different classes of drugs and the effect each type can have on the body, as well as to help dispel any urban myths about drugs, alcohol, and addiction. When delivering the session to older students, specific drugs such as LSD, ecstasy and cocaine are also discussed in some detail.

Anti-tobacco Our Anti-tobacco session focuses on the dangers associated with smoking and other tobacco products. This year, we are also focusing what it takes to quit aspect of tobacco and have liaised with Ex-Smokers Are Unstoppable, a European Commission campaign, to provide the public with top-notch information about smoking and quitting. Our anti-tobacco session is perhaps one of our most hands-on sessions, where we use visual aids, together with actual props, such as a Tar Jar (exemplary of the amount of tar that accumulates in the lungs over time), mock-arteries (to simulate the effect smoking has on cholesterol blockages) and videos. Our sessions cover the dangers of smoking, be they common or less-known, cigarettes together with related products and their contents, the difference between first-, second- and third-hand smoking as well as the social and environmental impacts of smoking. We also aim to highlight new alternatives to quitting smoking and propose how and why these products may be deemed safe or not.

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Basic life support skills Being an integral part of medical student education, the need for an expansion of First Aid education has been felt and thus this year, the campaign has been rebranded as Basic Life Support Skills. NPET sessions relating to this campaign will cover very basic concepts of emergency situations rather than actually First Aid, which takes weeks to master and should be taught only by qualified professionals. However, as part of the sessions, we will be promoting the subscription of First Aid courses and highlighting the importance of being capable of giving first aid as well.

Hand washing awareness and hygiene As one of our newest sessions, we have much to offer for hand washing and hygiene. Our session aims to cover the basics of how to wash one’s hands properly and efficiently, highlighting the use of soap and the when-and-where aspect. Especially with younger children, we aim to show how crucial it is to realise how easy it is for germs and microbes to be spread, whether through contact or by other means, and why hand washing is therefore key to limit such spread. The session also focuses on bringing in an oral hygiene focus, not only by explaining the importance of brushing teeth properly, but also how to keep the gums and recesses of the oral cavity clean and fresh.

Eating disorders and nutrition Our eating disorders and nutrition sessions are amongst the most successful sessions, having grown and spread beyond the boundaries of schools in recent times including making appearances in local magazines. The session mainly focuses on healthy eating, through the use of visual aids and the newly incorporated MyPlate scheme which replaces the now-outdated Food Pyramid. Our sessions also turn to eating disorders, focusing on the troubles both girls and boys face in this regard. The different forms of eating disorders are covered in detail, highlighting the differences between each, as well as who is most at risk for each type. Emotional, physical, psychological,

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behavioural and social signs and symptoms for eating disorders and how they can disrupt proper functioning are also covered.

Focus On Obesity and Diabetes (FOOD) Our FOOD campaign is one of our most interactive school campaigns. We begin the session by giving a short presentation about what healthy eating means. As of this year, we are implementing a new scheme known as MyPlate, to take over the out-dated Food Pyramid, which better represents the foodstuffs for a healthy diet in a simple efficient manner. Children are encouraged to make their own MyPlate during the session. They are split up into teams and after working together they then proceed to presenting their MyPlate, highlighting how they divided the foodstuffs. A healthy sandwich-making session follows the MyPlate where children are shown how to make simple, easy-to-remember healthy bites that they can have as snacks, school lunch, etc. The sessions usually end with a series of games that include Healthy Detective and an assortment of sports games.

Beat the Burn As one of our newest campaigns, Beat the Burn has much to offer. It deals mainly with sun protection and maintaining safe and healthy practices when exposed to the sun, especially during the summer months. The peak time for these peer education sessions is usually around the summer holidays (JulySeptember) and late spring (April-May), where through the use of promotional

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material, visual aids and interactive sessions we help encourage discussion and fruitful thinking as to how best to act in the heat and sun.

Ergonomics Ergonomics is a new NPET session forming part of MMSA’s Healthy Lifestyles campaign. Through the use of presentations and live demonstrations, it aims to promote a better understanding of how one can affect his/her body as a result of everyday action (e.g. poor seating position, carrying heavy bags, listening to loud music, poor sleeping posture and inappropriate viewing of monitors).

Fitness Fitness is another new NPET session, also a part of the Healthy Lifestyles campaign. Fitness sessions will aim to promote exercise amongst children as well as the idea of eating healthy with regards to particular exercises, thus maintaining a balance between the two. Through presentations and professional consultation, the campaign promises to be a stimulating and interesting one.

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Teddy Bear Hospital (TBH) Teddy Bear Hospital is our forefront campaign in aiming to dispel medical fear i.e. the fear of doctors, medical procedures, etc. for younger children (preschool and primary students). Our campaign involves school visits, where we organise children into small groups and alternate between different stations (e.g. a family doctor, a surgeon, a dentist). Children have the chance to bring along their teddy bears for treatment and also get a better understanding of what it is to get an injection, or to have your arm plastered, or to go in for an operation as well as grasping some basic medical topics such as explaining how the heart works. As part of our TBH programme, we also offer a hand washing session, where we bring our own soap and washing basins to demonstrate the proper hand washing technique and provide a better understanding of germs using special soft toys. Children are also given a booklet and a TBH certificate for their participation at the end of the event.

Booking public health sessions For more information or to book a public health peer education session, please contact npet@mmsa.org.mt or contact the MMSA Public Health Officer 20132014 (Adriana Grech) at scoph@mmsa.org.mt

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sexual health Why is sexual education important? In Malta, sexual and reproductive health are subjects that still have the power to raise many eyebrows, and some degree of taboo still surrounds the topic of sex for (too) many people, particularly in the extremely important context of adults educating youngsters. This is why the Standing Committee on Reproductive Health including AIDS (SCORA) in Malta aims to provide both teens and the general public with all the skills and knowledge necessary to make proper sexual health decisions. One of SCORA’s greatest challenges is removing the social stigma associated with sexual issues. Through peer education sessions, the students are given the opportunity to learn about these issues in a non-formal, dignified, interactive environment guided by a foundation of respect, equality and freedom of thought. Our aim is not to impose on the students, but rather to equip them with the self-assertion needed to make responsible choices in life. The peer education programme we offer aims to give a comprehensive grasp of the concept of sexual and reproductive health as a whole such as basic human anatomy, sexually transmitted infections, protecting one’s reproductive health, contraceptives, human sexuality, and dispelling certain myths that exist through popular culture. A detailed syllabus that our trained peer educators use as a guide during sexual health sessions can be found here: http://mmsa.org.mt/standingcommittees/scora/projects/sex-ed-peer-education-programme/

Sexual health sessions This is based on our detailed syllabus and aims to cover the whole concept of reproductive and sexual health in 3 or 4 sessions of 30 minutes each. It covers a lot of topics such as puberty, contraceptives, self-examination to safeguard reproductive health, sexuality, etc. The students will leave the sessions with a

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Comprehensive Sexual Education (CSE) which is vital to have, especially during the teen years. We also give schools the opportunity to tailor the sessions delivered if the syllabus is too intense for their students. Our two main sexual health sessions are listed below.

Breast awareness and first gynae consultation The session aims at giving secondary school girls the necessary knowledge regarding changes breasts undergo during puberty and how to protect themselves from breast cancer. The session will outline the risk factors, changes associated with breast cancer and self-examination. The second part of the session will prepare the students for their first gynae consultation. Most grown women, let alone youths, feel too uncomfortable to go to a gynaecologist. Thus this session will give the youths an overview of what to do before the consultation, how to feel during the consultation and what exactly happens during the visit so that any misconceptions and fear can be erased. This session is approximately 45 minutes to 1 hour long.

Men’s issues The session is targeted towards boys aged 11 onwards. Topics tackled in this session include a brief overview of the anatomy of the male reproductive system, changes occurring during puberty, testicular cancer and testicular examination. These peer education sessions are an excellent opportunity to raise awareness on testicular cancer amongst students and to clarify any misconceptions that they may have. We encourage you to hold these sessions because testicular cancer has become one of commonest forms of cancer in

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the younger male generation. We believe that increasing awareness at a young age is vital in the prevention of this disease.

Mr &+ Mrs Breastestis sessions This is a SCORA campaign focusing on the prevention of reproductive neoplasms, mainly breast, cervical, testicular and prostate cancer. It aims to assess the knowledge of 15-18 year olds regarding reproductive neoplasms, as well as to educate the youths about this topic. This is done through practical sessions whereby the neoplasms are discussed in a new and interesting way in order to educate teens so as to be aware of the risk factors and symptoms of the diseases. The practical sessions also include how to self-examine the breasts and testes so that any changes can be noticed immediately. We also discuss the social aspects of the diseases as they may affect members of the teens’ families, as well as the use of vaccinations for cervical cancers and screening for breast and prostate cancers. We plan on keeping these sessions co-ed in order to raise awareness about what the opposite sex may be going through in order to increase understanding, thus these sessions are aimed at mixed schools and sixth forms.

Booking sexual health sessions/Mr + Mrs Breastestis To book any of the sessions or for more information, please contact us on npet@mmsa.org.mt or contact the MMSA Sexual and Reproductive Health Officer 2013-2014 (Phoebe De Bono) at scora@mmsa.org.mt. Remember: knowledge is the key to a better world and these sessions will not only be of benefit to the students themselves but also to the community as a whole.

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human rights and peace The Anti-Bullying and Human Rights peer education campaign is the new and revamped form of one of the MMSA’s longest running campaigns. The aim of this programme is to increase awareness on several, often controversial issues and thus reduce stigma and misconceptions associated with certain groups of people.

Human rights sessions Human rights are of huge significance in today’s world. They are constantly mentioned on the news but are rarely explained. All people are entitled to these basic rights and freedoms regardless of nationality, age, gender, religion, appearance or ability, yet these rights are still taken for granted. The MMSA’s Standing Committee on Human Rights and Peace (SCORP) is teaming up with SCOPET to provide an innovative and educational approach to educating peers on the universal human rights. Debates take place in a controlled environment and peer educators keep in mind the sensitivity of certain issues already present within a class. Case studies from the Maltese scenario are often made reference to in order to discuss the issues more relevant to our country. After a quick icebreaker the first activity begins by dividing the class into teams. The teams are given two minutes to discuss human rights in Malta and are encouraged to make a list of the human rights they already know. The teams present their work and explain which human rights need to be given more importance, as well as why and how it can be done (even at a school level). The class takes a break by watching a video ‘The Story of Human Rights’ and the full list of human rights is tackled.

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The session moves onto another activity, also involving teams. The class is made to imagine they have been shipwrecked on an island whose inhabitants have never heard about the concept of human rights. The students decide to implement this idea. They need to convince the inhabitants of the importance of human rights and tackle issues which arise one by one. The aim is for the students to consolidate their knowledge of human rights and discuss the importance of each one. Other activities may include the Peacetest and the Power-walk. In the Peacetest, peer educators present the students with a plan of a bus with different stereotypes of marginalised people seated; each with an empty place next to them. The students are asked to choose where to sit and need to give a reason why. The life stories of the individual characters on the bus are then revealed and each student discusses what his or her feelings, thoughts or attitude would have been had he or she known the stereotype’s life story. In the Power-walk students are given cards each containing a description of a unique character belonging to society, for example: ’15 year old girl wheelchair-bound for life’, ‘Mother diagnosed with terminal cancer’, ‘School headmaster’, etc. Students are given five minutes to silently think about how their life would be had they been this character. Then the activity begins with the peer educator making statements dealing with how much ‘power’ the character has in society (many friends, lots of money, looks forward to the next day, is considered successful, etc). The student takes a step each time he or she believes that the statement applies to his or her given character. At the end of the activity students discuss their characters, which characters are considered to have more ‘power’ and what they do to help those struggling behind.

Anti-bullying sessions Bullying is an aggressive pattern of behaviour where an imbalance of power between pupils is manifested. It can affect students in the classroom or, via social networking sites, even in their own homes. Victims carry around the

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burden of bullying at all times and hence bullying is one of the leading causes of depression, fear and low self-esteem in young people.

“A staggering 62 per cent of pupils in Malta consider bullying a problem in their school.” Times of Malta, 18th May 2010

The anti-bullying sessions are aimed at raising awareness, particularly by introducing students to the different forms of bullying in order to make them more recognisable. They aim to reduce tolerance to bullying, to aid potential victims in making a decision to take action earlier and to persuade third parties to take a less passive role. Anti-bullying sessions can therefore aid in making the school environment more cohesive and enjoyable for all school attendees. It can also help to prevent the silent suffering of victims of bullying by raising more awareness about the aggression implicated in bullying behaviour. We also aim to emphasise that differences in race, religion, sexuality, ability, class or appearance are common and not something to be ashamed of - hence not bullying artillery. This could include the sharing of real examples of people’s lives affected by bullying; the most negative impacts including; self-harm, eating disorders and suicidal thoughts/actions.

The sessions involve a presentation defining all the types of bullying that is relevant to the school environment, whether this is on school grounds or online via cyber- bullying. Cyber-bullying is the newest form of bullying and the sessions reinforce the additional detrimental impact of cyber-bullying –

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particularly with the increased frequency of use of social network sites such as Facebook. This form of bullying is harmful particularly because it additionally affects victims at home and at all times. By confronting and addressing cyberbullying, we make students aware that it is in no way more tolerated than physical bullying. Anti-homophobia is the newest part of our sessions where we reiterate that homophobic language and behaviour is harmful. This is particularly important for older students to prevent victimisation of adolescent homosexual individuals, as the school environment can be particularly intimidating. In fact, globally, homosexual teens are two to three times more likely to commit teen suicide than other youths and hence a positive discussion on homosexuality can help to reduce the stigma and prevent such negative results. The cycle of bullying is also discussed in order to emphasise that the bully does not act alone. The act of bullying continues as long as disengaged onlookers and passive supporters do not take action. Overall, the peer-educators work to create an open environment of discussion between the students with an aim to get them thinking about the impact of their actions. Hopefully, students will realise that even a small positive action can make a difference to not only the victim’s wellbeing, but also the atmosphere of their whole school environment. This project also aims for children to respect their body and to understand the principle of inclusion and equality throughout their learning experience. Differences should be recognised and celebrated, whilst challenging prejudices, perceptions and negative attitudes. The peer education sessions should give pupils the opportunity to share their own understanding while learning from their peers’ experiences.

Booking human rights/anti-bullying sessions To book any of the sessions or for more information, please contact us on npet@mmsa.org.mt or contact the MMSA Human Rights and Peace Officer 2013-2014 (Kristina Bartolo) at scorp@mmsa.org.mt.

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www.mmsa.org.mt


NPET Booklet 2013-2014