spreading the challenge of addressing international health issues
indigenous health issues — real people and real lives at risk
issue 5
october 2007 1
editorial by nicola sandler & cara fox
1
reflections on six months in alice springs by bae corlette
2
close the gap by tom crowhurst & michael cilento
2-3
story of jonathan humphries by kia alizadeh
3
john flynn scholarship by justin sherwin
3
reflections on dwc ‘07 by alp atik & ming chen
4
ifmsa aug ‘07 ga report by anthea lindquist
4
news review by kong
5
global health quiz by kong
5
prizes for prose comp
Photo © Charlie Lawrence, www.sxc.hu
editorial We’ve all heard the statistics. The Indigenous people have a lower life expectancy, less access to health care, and prevalence of diabetes and cardiovascular disease. Indigenous health has been shown to be worse than some of the third world nations. But what does this all mean to us as medical students? And what can we really do to help? As many of you know, these are not just statistics. They are not just numbers and facts, but they are real people and real people’s lives at risk. This edition of Vector focuses on Indigenous health, where we have heard a lot of great things about what medical
students are doing around the country to help raise awareness, and to help to try and make this situation better. Some have raised money in their hometowns, and some have gone into the Indigenous communities, and gotten to know the people first hand. Each of these stories signifies a step forward, and each signifies an effort to make a change. As this was our first issue as the new co-editors, we found it an imperative issue to start on, and one that could not be more relevant. We hope that this too inspires you to action, and at the very least, gives you a good idea of what is really going on.
nicola sandler & cara fox, editors of vector by
reflections on six months in alice springs
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unique 3rd year experience
lice Springs is an unusual place and the population here is very transient. It is a service town whose number one industry is health and social services, followed by tourism as perhaps a close second. The gravity of health and social services need on the ground is almost impossible to overlook. Although sadly, ‘almost’ is the operative word. Not less than six weeks after I arrived here it struck me that in the course of daily work I hadn’t managed to engage with the indigenous community – who make up the vast majority of our patients – at all. Despite spending my time between the Central Australian Aboriginal Congress, the Alice Springs Hospital and remote community clinical visits, the opportunity for conversation remained amongst the staffing realm only. And what’s more, conversations proved to be unceasingly about the great dilemma of patient behaviour frustrating their health outcomes. We are endlessly inquisitive on our short-term visits, which is probably a good thing, but might also serve to perpetuate this dissonance if we don’t stop to catch ourselves from jumping on board and blaming patients before we’ve even had a chance to know them. Bridging this dissonance means somehow finding time that we don’t have to spend with patients in a setting where dominance is in equal balance between us. So am I saying that we must have a deep appreciation for the socio-cultural context of all our patients’ before we can work effectively with any of them? I don’t know, maybe that’s not feasible in practice. But surely as a student it is the time to explore
that alternative rather than simply learning how to deal with a presumed problem. True, we are pressed for time to learn our basic syllabus, but really what’s the worth of all our medical knowledge without the humanity to apply it? The perennial theme I hear is one of feeling helpless in the setting of such immense problems that are too big to be addressed by medical care. And can anyone really dispute that the determinants of indigenous ill health go well beyond the confines of the clinical setting? Equally, can we hope to have any impact in indigenous health if we choose to accept that our role is unrelated to the determinants of ill health? The rational conclusion from this line of argument can only be to move away from medicine or from indigenous health all together, in which case was there really anything to gain from a stint in a place like Alice Springs to start with? Could this disillusionment with indigenous health somewhat underlie the recent surge in interest in global health amongst medical students nationally? The truth is that without efforts to engage with local people in the community, the opportunity for greater insight into working with indigenous people can be lost. While it is the curriculum of third year medicine that will help to pass exams (wherever you learn it), it is the experiences with people in the community will help to become a doctor. I hope that I never forget that. by bae corlette, flinders university