The Auricle Vol 4 Edn 3

THE AURICLE VOLUME 4 EDITION 3

LETTER FROM THE EDITORS The year is whizzing past and before we know it exams will have come and gone - bring on the holidays!

But until then, we will have to endure a few more excruciat... We mean exciting weeks of content that you simply cannot believe are being crammed into so few weeks.

Why not take a break and reward yourself with a good read?

You’ll find in this edition of the Auricle five delightful entries for our annual writing competition. The topics were diverse - discrimination, medical student-ism and lessons learned - and were only to be tackled by deep thinkers. Naturally the Monash med kids did not disappoint, and we are very pleased to publish some very fine pieces of literature for your enjoyment. The ideas are facinatingly varied - so many possible responses to just less than 17 words. Thanks and congratulations to Chris, Cecilia, Natalia, Tze Yang and our two mystery anonymous entrants!

And if you could do with having more thoughts provoked, why not ponder the issue of ambiguous genitalia of newborn babies. How can we, as future doctors, ensure that we do all we can to support parents in this difficult situation? How important is sex and gender in our society today?

It doesn’t stop there. Just this August we had three Monash medical students visit Macedonia as part of the Australian delegation for the 64th IMFSA (International Federation of Medical Students’ Associations) General Assembly Meeting. We’ve got a recount of what went down. Our MUMUS President Tori has also kindly provided an insightful essay about refugee health and how we should be learning from other countries.

That’s all for now. We hope you enjoy. Thanks for reading. It’s been an absolute honour to be your Publications Officers this year.

Your editors, Michelle Li (Clinical) Kai-Xing Goh (Pre-Clinical)

Cover art by Katie Scott (katie-scott.tumblr.com)

CONTENTS Annual Writing Competition......................................................................................................................................3 Binary Blues..........................................................................................................................................................10 IMFSA Recap..........................................................................................................................................................13 Lessons from the IFMSA........................................................................................................................................15

ANNUAL WRITING COMPETITION 1. DISCRIMINATION, HARASSMENT AND INJUSTICE IN THE MEDICAL WORKPLACE: WHAT ARE THE NEXT STEPS? 2. “I’M DOING MED...” WHAT DO YOU THINK OF SOCIETY’S EXPECTATIONS OF WE MEDICAL STUDENTS? 3. EVERYONE MAKES MISTAKES: HOW HAVE YOU LEARNT FROM SOMETHING YOU DIDN’T QUITE GET RIGHT WHILE ON PLACEMENT?

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FIRST PLACE: CHRIS NGUYEN (YEAR 1) TOPIC 1 Local Man Frustrated That Medical Dramas Have Too Much Reality And Medical Reality Has Too Much Drama, Not Vice Versa FRANKSTON, VIC - A recent graduate of the Curtin University Medical School, now living in Frankston as he tries to find a medical

placement at any hospital, clinic or drug den that will accept him, has spoken out about the disturbing trend surrounding medical television programs. Studies have shown that the rate of intern abuse in documentaries is at an all time high, while main characters are being killed off well-loved medical dramas at alarming rates.

Trevor Wilson, 24, spoke as he boiled yet another kettle next to an ever-increasing pyramid of empty instant noodle containers. He expressed his sheer disappointment in the medical and broadcasting authorities of Australia; disappointment which, according to him, was apparently in ‘no way’ compounded by his current personal situation.

“If the Australian Government were going to screw me out of a job by opening the Curtin University Medical School, or CUMS as we nostalgically call it, then they sure as hell shouldn’t get the satisfaction of screwing me over again. Seriously, I’m just a man with a simple yearning of getting what I pay for, be it more than $50,000 for a medical education and internship or $1500 for a flat screen TV with decent medical shows. I want my dramas back! I can’t even Netflix and chill anymore.

“Bring back love affairs in on-call rooms, that’s a crowd-pleaser. Why did Scrubs have a final season based at a university? Did Sacred Heart Hospital run out of funding? Why are so many main characters dying? It’s just getting way too real for me.”

Throwing his hands up in exasperation, Mr. Wilson gulped down his chicken-flavoured instant noodles and proceeded to sprawl himself across a stained acrylic sofa, complete with exposed rusty springs. As he switched on the TV, he asked me to take a seat. I politely declined the offer and tried not to touch anything.

“Studies have shown that the rate of intern abuse in documentaries is at an all time high, while main characters are being killed off wellloved medical dramas at alarming rates.”

When he’s not making instant noodles or sulking about the state of medical dramas in the 21st century, Mr. Wilson turns his attention to the recent stream of medical reality shows and ‘so called’ documentaries. He explains that a personal favourite of his for the last few years has been the Australian Broadcasting Corporation’s ‘Life of a Medical Intern; Anxiety’.

Mr. Wilson continued, “You’ve got to laugh. Do the producers of this show actually expect us to believe that medical interns are abused like this? They probably take us for idiots, and I don’t like feeling like an idiot, no sir. I wouldn’t have signed up for medical school if this is what internship and residency was like, and finishing at CUMS was the best feeling I’ve ever had…” His voice trailed off as his eyes stared blankly at the TV screen for 5 long minutes, before his concentration was broken by the documentary’s climactic scene; an intern on his first day in hospital being berated by a senior consultant, upset that his mocha latte had two sugars rather than one.

“Where was I? Anyway, there’s just no way that these documentaries are real. It’s ridiculous the way these poor interns are bullied. Not that I’ve had the chance to experience any of that.”

When asked about what he thought should be done to rectify the situation, Mr. Wilson paused and gave me a pensive look.

“What do you want me to say? I’m an unemployed 24 year old medical graduate, since when does anyone care what I say?” Mr. Wilson complained, tearing up. I tried to wrap up the interview at this point, but he pushed on. “If the government doesn’t care about making sure that there’s quality control when it comes to TV shows, what makes you think they’ll keep these consultants in check? Those interns on TV have probably been wired to think that the abuse is good for their professional improvement; the producers must’ve donated a hell of a lot of money to get that sort of reality going in the hospitals. It’s bordering on impressive, really.

“We can’t do much about the stuff that has already happened in the past,” he added, “so I guess I’ll just have to sit here eating instant noodles and hope that with the changing landscape of medical documentaries and dramas, everything will come back to normal. People of my generation, including myself, will finally get the courage to make a stand like I am today. I’m not putting up with this mediocrity anymore. The future of medical TV is bright though, I can tell you that. If that doesn’t work, we can just get the actors and doctors to swap over, they’re just doing horribly at their own professions in my opinion.”

Turning towards the TV screen and putting his feet up onto his all-purpose dining table/ottoman/desk, he flicks between channels.

“Now if you’ll excuse me, I have an appointment with Dr. Grey to get to.” Shivering, he whispers, “She can examine my anatomy anytime…”

As I looked back to take one last glance before I left, a single tear could be made out as it rolled down his cheek.

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SECOND PLACE: ANONYMOUS TOPIC 2 Whether it be with a shopkeeper, family member or a new friend, the question of “so, what do you do?” naturally manifests itself in a normal conversation. Whilst I am proud to say that I currently study medicine at Monash I dread such a question.

One may ask and say, “Why? You should be so happy to be in the position.” The reality is that my reply often causes the other person to think I am some intellectual genius who looks down on them; that I am the child of rich doctors; that I am a graduate of some elite private school; or that I am some arrogant adolescent who thinks their degree defines them.

What they don’t know is that I am the first person in my family to go to university, the child of a hairdresser and chef from a small rural town, a graduate of a low tier catholic school. It seems that society immediately assumes I am someone who has had all the opportunities in the world and who locks themselves in a library from dawn to dusk to perfect my knowledge.

Whilst I do dedicate many hours to study that is at times mind-numbing I am no different from any other student at a tertiary institution. “You must study a lot!” normally follows after my reply of “I’m doing med”. But in reality I have many friends who do a variety of different courses that make my study routine look like primary school homework.

It seems many view a medical degree as the student’s identity, but such a reality is not the case for a student of Commerce though, for example. But why is this so?

Is it the stereotype of a medical student that the media has developed over the years through film and television?

Is it the antiquated view that any member of the medical profession is free from any error or issue?

The answer to this question is something I simply can’t identify.

What I can identify is that the issue at hand causes me to feel ashamed at times of my course, embarrassed of the answer I have to give to the question “what do you do?” and paranoid as to what opinions may be formulated about me because of it.

Some may have the romantic view that a medical student can run to the rescue and save a life in any possible medical emergency imaginable. This however is simply not true. Yet the title “Medical Student” causes one’s cousin to ask “Is my foot broken?” and one’s uncle to ask “Does this medication my GP gave me work?” The answer I wish I could give and that society would understand is simply, “I have literally no idea, I do a degree like any other student. I am not a doctor, nor am I a nurse… I am simply a student.”

“I am not a doctor, nor am I a nurse...

I am simply a student.”

THIRD PLACE: CECILIA XU (YEAR 3B) TOPIC 2 The medical student: a highly functioning subspecies of Homo sapiens that runs almost exclusively on compassion, knowledge and caffeinated drinks. They are frequently found borrowing textbooks on tropical diseases for light bedtime reading and studying in the library after-hours for the sheer joy of learning. They have a comprehensive knowledge on every possible human ailment and will gladly inspect your mole or listen to the quality of your cough. They train for national rowing competitions in between part-time work and playing the violin while volunteering at the local nursing home. They chair committees for global health, climate change and mental wellbeing and frequently write strongly-worded letters to editors on the state of our current health system.

These are some of the expectations and stereotypes that have become attached to the label of medical student. They are not entirely unfounded; in every medical school cohort, there will undoubtedly be multiple Hermione Grangers, superhuman multitaskers and future world leaders. However, the vast majority of us are also cake-eating sleep-in lovers who watch the Bachelor (or is it just me?). So what do these expectations mean for us?

Secondly, high external expectations are not necessarily always a bad thing. Society is right to have high expectations of us. We are the doctors of the future, tasked with the responsibility of managing their weight, thrombolysing their clots and breaking bad news to their families. We will be the researchers and innovators that continue to shape the knowledge and practice of medicine in the years to come. We will be advocating for patient health at the bedside and on the public health platform.

At the same time, we must remember that we will make mistakes. We will miss diagnoses, administer the wrong drugs and stick patients three times before getting the cannula in.

And we will see many, many patients that we simply cannot cure. In a job where human life is on the line and there is so little room for error, the idea that mistakes are made and solutions are lacking can be terrifying. But acknowledging these limitations is a leap forward. When we know there is potential for failure, we can take steps to prevent harm and be prepared to let go of things that are beyond our control.

In doing this, we can approach our work with greater respect and self-awareness.

Firstly, we must know that these expectations are based on a highly “Expectations are based on a highly skewed and superficial skewed and superficial view of our view of our population” population. They represent an ideal that quite simply does not exist. Nobody is perfect, no matter Society’s expectations remind us of the fine line we walk how much they know or how many extracurricular activities they between ability and humility. I believe that it is this delicate undertake. The expectations become dangerous when we, as balance between knowing our power and potential and using perfectionists, hold ourselves to them and inevitably fail to it honourably, and knowing our limits and respecting them, measure up. that defines a good medical student. Indeed, it’s a skill that will only become more and more important as we graduate from Perhaps this is a contributor to the dismal statistics on the medical school and enter into our working years. mental health of medical students in Australia. A recent survey My hope for myself and other medical students is that we will by beyondblue indicated that one in five medical students had understand society’s expectations of us and use them wisely. suicidal thoughts in the past year, and more than four in ten May we be empowered to fulfil the potential that others see in students are highly likely to have a minor psychiatric disorder, us, and forgive ourselves for being human. And may we never like mild depression or mild anxiety. Exacerbating the issue is run out of compassion, knowledge and caffeinated drinks. the perceived stigma surrounding mental illness. Nearly half the respondents in the survey agreed that many doctors think less of other doctors who have experienced depression or anxiety.

Realising that the pressure we feel to perform is based on an elusive ideal may be the first step to developing kinder, more productive attitudes towards ourselves. And when we learn to have compassion on ourselves, we can then pass that on to our patients and peers.

TZE YANG LEE (YEAR 3B) TOPIC 2 “Hi, how are you today; I am a medical student and I was wondering if you’re up for having a short chat about why you’re in hospital today.” It is a mantra regurgitated from our mouths time and time again to the multitude of patients whistling through hospitals and clinics. Here are a few notes I have to sing out loud.

One – we are doctors-to-be As medical students, we are doctors-to-be. As apprentices in the trade of patient care, we are constantly striving to chase the shadows of our masters. We consciously and unconsciously mould our thoughts and actions after the doctors we follow. In the doctor’s footsteps, we start to earn the trust that is the foundation of doctor-patient relationships with the respect that patient’s accord doctors-to-be. This faith and respect is something precious that we must always cherish and nurture as we hurdle obstacles in our path to graduation.

Two – we are learning “Everyone’s got to learn (somehow)” is commonly uttered by the generous patient. “The early years of life are shared in the joyful journey of learning. We have all been students before and can empathize with the humility and diligence that marries in education.

This camaraderie is also shared with other healthcare professionals that we encounter. Whether it be through humiliation or praise, we are constantly pushed to our limits, tested and questioned by peers and tutors alike. The pursuit of knowledge does not end; its scope ranges far beyond the confines of the written word of textbooks and research papers. The medical career dictates that we are students for life, immersing ourselves in the lives of others to improve on our knowledge for the betterment of all. Having been gifted with the opportunity to learn, the day we stop learning is the day we strand ourselves in wasteland of disappointment for what could have been.

Three – we are listening “Thank you for talking to me” I say. “Thank you” says the patient.

Do you ever wonder; what is the reason for gratitude displayed after seeing a patient as a medical student? Possibly because we are the shrinks and therapists of the hospital. We are always listening and watching. Not merely hearing, but listening to the elaborate patchwork of patient histories that gets stitched together in our minds, forming a heart-warming quilt of human experiences and emotion. We sit and listen to what is seen through other’s eyes, felt through other’s hearts, experienced by other’s minds. We also want to listen to patient’s goals to align ourselves in the same direction. It matters not if we remove the body of all disease but carelessly strip away the fabric of the patient’s soul as well. The listening ear we provide can calm a sick mind, give solace to a sick heart, or maybe just help to make the clock tick by more quickly. With the power of words, we heal like no other medicine can.

Last – we are teaching Even without the lanyards coloured fifty shades of student; we are already wearing the role of a healthcare professional. We should not be clothing ourselves towards disease management, but instead addressing care for the healthy. Preventive health is the education of society and healthcare professionals are the teachers. The responsibility of every person’s health rests on their shoulders. We can serve to adjust the load on their backs by raising awareness of symptoms, rationalising lifestyle modifications and providing direction on the health service required. This does not require having worn a graduation gown to do. It merely necessitates looking beyond the pathology you see, and climbing into the patient’s skin and taking a walk around in it.

Resolution As the years pass and we graduate to become doctors ourselves, the only real difference between the doctors we follow and we medical students - is time. How you spend that time is up to you. Listen, learn and teach, for only then will you become a doctor that truly matters.

NATALIE BERNARD (YEAR 3B) TOPIC 2 When you meet someone, say at a bar, for the first time, there are always a few questions that are bound to pop up. “How do you know my mutual friend?” “Do you study or work?” “What university do you go to?” And consequently the inevitable question that is always asked - “What are you studying?” It makes sense, as what we study generally reflects upon our interests and is an easy way to find common interests between two people. But throughout my 3 years at medical school I’ve found that there are a variety of reactions I receive when I respond with “I’m doing med…”

On one occasion I met a girl who went to the same university as me and was studying science, which in my opinion has many overlapping aspects with a medical degree. We were having a great conversation until she asked me what it was that I studied and at my reply she made a face of disgust and said, “oh so you think you’re better than me?” It was hard to work out whether she was making a joke or not but regardless of her intention, the conversation faded from there. I was shocked, as obviously I did not think I was better than her and had never received a reaction like this in the past. Maybe she has had an experience in the past with a stuck up medical student? Maybe she had tried to get into the course and was unsuccessful? Maybe she just hates medical students with a fiery passion?

At the other extreme, the response of “oh my gosh, you must be so smart” is equally uncomfortable, especially if you are like me and genuinely believe that you fluked VCE and just word vomited your way through the interview. I think that the majority of people will agree that you can’t say yes because no humble med student wants to openly admit their intelligence, but you also can’t say no because why should you talk yourself down after the hard work you put into getting into the degree. So many dilemmas, so little time. Obviously these social qualms are ridiculous and discussing them seriously would be a complete waste of time, except for providing a few laughs or provoking those “that’s happened to me!” moments.

On a more serious note, I think that a lot of people will base their expectations of medical students depending on whether they are male or female. One of my pet hates is how much emphasis is placed upon the struggles of women in medicine.

I am not referring to the pay gap or harassment in the workplace, which of course are serious issues that need to be addressed, but I’m talking about how women have started to make a big deal out of every little reaction or assumption that is made. There has been so many times where people have assumed I am a nurse or nursing student and to be honest I still accidently refer to doctors as a “he” in conversation. It’s not intentional and people need to stop losing their minds over the “injustice” associated with it because in the great scheme of things, it’s not a big deal and you should just laugh it off.

From my experience, the amount society expects of medical students varies a lot. It is a well known fact that we are at the bottom of the food chain in the hospital but outside the clinical environment, there are times when people will expect more of what you have been trained to do or maybe even less. Once we become doctors, it will be interesting to see how these perspectives change and how differently society will view us. In the end, everyone has a certain expectation of someone based upon his or her status or education level, and that expectation is going to be different to the next person. So all you can do is appreciate it when people show interest or respect, and laugh it off if they make a brash comment. Because in the end there are always going to be stereotypes, but you have worked hard to be where you are and as long as you don’t take yourself too seriously, it shouldn’t matter what one random person at a bar thinks of your university degree choice.

“It shouldn’t matter what one random person at a bar thinks of your university degree choice.”

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BINARY BLUES AMBIGUOUS GENITALIA - WHAT NEXT? MADELEINE JONES (YEAR 4C)

From day one of a person’s life, sex is a key defining characteristic, and with that comes a lifetime of expectations. This is ‘gender’; the attitudes, feelings, and behaviors that a given culture associates with a person’s biological sex.

Madeleine Jones explores the current management of babies born with ambiguous genitalia, and how this is influenced by societal pressures.

There’s an uneasy quiet in the birthing suite - silence is DSD should be managed as a psychosocial emergency, as the always dangerous with newborns, but in this room the baby guilt of atypical findings and the pressure of sex assignment can is happily screeching as all eyes in the room are trained on be exceptionally difficult, and result in prolonged psychological the obstetrician. She, in turn, is staring down at the naked issues for all family members involved. baby, more specifically at the baby’s external genitalia, trying to come up “DSD should be managed as a pscyhosocial emergency” with an answer to what should be a simple question, but she’s coming up short. After sending her In the days that followed, ultrasound scanning showed no female medical student to fetch the paediatrician, she turns back to internal organs, testing was able to confirm a 46 XY karyotype the parents and admits, “I don’t know.” and the baby was subsequently designated male. The parents were relieved, able to chose a male name, pick the blue blanket, Ambiguous genitalia, or abnormalities of the external genitalia, reply to the messages- they were lucky in that they were able to occurs with approximately 1 in 4500 live births. It is an atypical find definite answers, but unfortunately the management doesn’t sex development that falls under the broader category of end there. disorders of sex differentiation (DSD), which includes many specific conditions, from structural abnormalities such as Sex assignment surgery has evolved significantly since its initial hypospadias to more uncommon, potentially life-threatening widespread use in medicine, but studies show that there are conditions such as congenital adrenal hyperplasia. Most still high levels of dissatisfaction with assigned genders in those frequently, the atypical development is not detected in who require surgery. It has been proposed that by delaying antenatal scanning, and as such is unexpected and often these surgical choices until the individual in question is able to distressing to the parents. participate in the choice, quality of life and satisfaction can be greatly improved. However, current practise does not allow for When I spoke to the parents of this baby they were quite calm this time to think; we live in a world where living as intersex is not and able to focus on the main positive in their grasp - aside widely considered to be normal or acceptable. from this one finding they had an otherwise healthy baby. But as the hours went by, their patience and good humour began Until such a time as the binary system we live in changes, it is to fade, as well-wishing family members and friends were unlikely that medical practice will be able to make these changes calling and visiting, most with the same question on their lips without negative consequences for the patient and their family.

- “Is it a boy or a girl?”

For now, as health professionals we should strive to appreciate the complexity of these rare situations and make it our role to What is our obsession with defining sex? As humans we ensure that, if the patient must be placed into a box, both the often strive to categorise and compartmentalise information. process and the outcome are of the most benefit, and the least Naturally, not everything falls neatly into one box, but in harm, to the patient and their family. watching this family and their situation as it evolved over the following days - through multiple blood “We live in a world where living as intersex is not tests, scanning and consultation with specialists in widely considered to be normal or acceptable.” endocrinology and paediatric surgery - it was clear that even as a neonate, where sex has minimal impact, there was great pressure to decide on or assign a sex to the baby as soon as possible.

As such, there was great importance placed on all the staff not to use any gendered terms or suggest a preference either way, as distressed parents will often adopt either male or female pronouns as they see health professionals use them.

IMFSA

GENERAL ASSEMBLY MEETING The International Federation of Medical Students’ Associations was founded in 1951. It is an organisation of medical students, for medical students, by medical students. There are currently 125 national member associations, from over 100 countries.

IMFSA RECAP

MING FAN (YEAR 5D)

The August Meeting (AM) of the General Assembly (GA) of the International Federation of Medical Students Association (IFMSA) was held in Ohrid, Macedonia over 2-9 August 2015. It was attended by more than 850 medical student delegates, 3 of which were representing Monash University.

It was on a normal weekday night that I saw a post from the AMSA page on my Facebook feed, calling for applications to the “64th IFMSA GA AM2015 in Ohrid, Macedonia”. On a spontaneous whim, I decided to apply (I had decided that final year would be my YOLO year) – what followed was an unforgettable experience.

So, what exactly had I gotten myself into? The IFMSA is essentially a mini-WHO for medical students – a collection of country members who gather to represent the views of medical students on international health issues. The bi-annual meetings unite delegations from its national member organisations, like AMSA Global Health.

On location, Macedonia was beautiful – crystal clear Lake Ohrid, glorious 13th century architecture and an unforgettable sunset. This boded well for the rest of the week.

It was a seven-day immersion camp of talking, breathing and sleeping on global health with nearly 1000 of the most creative and inspirational individuals. During the day, delegates split into “standing committees” in our area of interest – for me, Attending the Standing Committee of Reproductive Health and AIDS, discussing local health issues. Carlos from Brazil explained obstetric violence as a common practice in Latin America, where the medicalisation of labour reduces a woman to a basic unit by which to produce children. The Netherlands team shared with us a new easy-use design for condoms with the aim of reducing failure rates. Chinese medical students proudly presented “The New Best Friends” project, a popular student-run initiative filling in the gap of sexual education classes at a university level.

Plenaries ran daily to debate and vote on policies, conducted entirely in fluent English. This was a brief taste of the overwhelming yet painfully necessary bureaucracy that governs international organisations. Without by-laws, there would not be order, but the sheer number of by-laws hindered progress; yet seemingly, the only resolution for this was to make more regulations. By the end of the week – no; by the end of Day 1, 129 countries were of the unanimous consensus that by-laws were the absolute worst.

At least it was possible to forget our troubles at the end of every evening – it would seem that partying transcends cultures. A highlight was the National Food and Drink Party, where each country showcased its own national edible treasures in national costume. What a great way to bond – over great food (…and drink). The Australian kangaroos’ TimTams were hugely popular; our Vegemite “chocolate”™, not so much.

By far the most valuable experience was the opportunity to connect with medical students from every country. Over iced coffee, questionable mystery meat lunches and afternoon lazings by the lake, we had countless thought-provoking and sobering conversations. Raj from Nepal shared with us his dilemma of choosing between staying in his beloved country working on $100AUD per month and 70-hour weeks, or choosing the quality of life that passing the USMLE might provide. Dara of Kurdistan recounted how his medical student organisation harnessed the overwhelming compassion of his peers to coordinate an emergency response helping over 20,000 Syrian refugees. Jaer from Venezuela explained that due to the volatile and collapsing Venezuelan economy, he was the only delegate from his country at the meeting, receiving external funding being the only reason he could attend.

These interactions with medical students, not so different to ourselves, forced us to consider our own immense privilege to be living and studying in Australia, far away from imminent danger; to practice in a structured and well-funded healthcare system; to have access to evidence-based medicine. We thought of the inefficiencies we could see in our own systems despite our resources, the humanitarian crises on our doorstep that we ignore, the new friends we have made whom we wanted to do something to help. While initially frustrated at what little we could do in our immediate reach, we realised that with every input into policy, with every bit of advocacy, with the growth of ideas and translating these into action, change was possible. Following the revelation of Venezuela’s situation, the plenary passed a motion to review the costing structure for member countries, to remove barriers to equitable access.

I went into this experience not knowing what to expect. I came out on the other side with countless new friendships, priceless memories, more perspective on my role as a future healthcare practitioner, and a deeper desire to be the change I wanted to see in the world.

The IFMSA will have its March Meeting 2016 in Malta and August Meeting 2016 in Mexico. I encourage anyone interested in global health to consider applying and have as rewarding an experience as I did!

LESSONS LEARNT TORI BERQUIST reflects on insights gained

from the IMFSA meeting, especially regarding refugees: an important topic for Australia, and hot in the press.

Published online on Tori’s blog, September 3, 2015

Chilling images of a refugee boy, drowned at sea in Europe were plastered across the internet today as dialogue regarding refugee issues intensifies internationally. Only hours ago, the New York Times published a scathing editorial on Australia’s treatment of refugees, pointing out how our government’s policies “have been inhumane, of dubious legality and strikingly at odds with the country’s tradition of welcoming people fleeing persecution and war”.

The attention has given me reason to reflect on my time at the 64th International Federation of Medical Students’ Associations conference. There, the polarity of refugee treatment internationally was emphasised by meeting and speaking with delegates from around the world. No delegates put Australia’s inhumane policies into perspective more than those from Kurdistan.

Since its beginning, the Syrian Civil War has created more than 3.5 million refugees who have been dispersed throughout Europe and the Middle East. Over 1 million of these have migrated to the Kurdistan region of Iraq. Kurdistan has its own national medical student member body of the IFMSA, much like the Australian Medical Students’ Association in Australia, and we were lucky enough to meet their delegates.

Dara, the President of IFMSA-Kurdistan, spoke about how his medical student body were the first group to provide welfare for newly arrived refugees. Unburdened by bureaucracy, they were able to swiftly provide basic necessities such as canned food and baby milk. Their initial aid reached over 10,000 refugees.

IFMSA-Kurdistan’s ‘Warm the Refugees’ drive had students from around the region collect winter clothes and blankets for distribution. This, along with their medical care and food distribution, was estimated to assist approximately 20,000 refugees.

Over dinner, the Kurdistan delegates were quick to talk about the joys of Kurdistan beyond its refugee situation. They spoke of idling their time watching football and drag racing at night between studying medicine. Democracy within the region, while not perfect, is far better than that of its neighbours. They emphasised the warmth and safety of the region, and how different it was from the stigmatised depiction of war most imagine when thinking of Iraq.

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Their program report on ‘Warm the Refugees’ reflects the contrast between their reality and that of the refugees they work with. It speaks of a father who has lost his home, hid in the mountains to flee from terrorists who have threatened to kill his sons and wife and sell his daughters as slaves. This is a reality for refugees escaping war.

Kurdistan as a region has begun to suffer for its generosity. The delegation explained that funding for social services has generally been provided by the larger Iraqi government, however with the ongoing expenditure on warfare, services for the people were difficult to maintain. The delegates worried about the government’s capacity to dedicate expenditure to the refugees they care so much about.

In contrast, the Australian government is spending billions in keeping refugees out of the country, and sending them to inhumane conditions offshore. In a recent speech, Julian Burnside outlined how the Government could potentially save billions by accepting refugees even if all refugees were to stay on full Centrelink benefits.

At the IFMSA General Assembly, Australia also presented its AMSA for Refugee and Asylum Seeker Mental Health campaign at the Activities Fair. A necessity of presenting the campaign was explaining to students from around the world exactly how Australia was treating refugees.

In Australia, doctors have witnessed conditions and abuse in Australia’s detention centres that have brought them to tears. Rates of poor mental health in detention are sky high, with reports children attempting suicide while incarcerated. Security guards at the detention facilities have been witnessed as coercing refugees into sex, filming, and distributing the videos. On an international scale, Australia’s treatment of refugees has been found to breach the UN Convention against Torture.

The contrast is stark between the compassion of the Kurdistan government and people despite economic hardship in contrast to the Australian government pouring billions into a practice recognised internationally as torture. While personally I have always found the practices of the Government unconscionable, never before had I felt such shame until I had to explain them tens of times to an international audience.

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