TABLE OF CONTENTS 03 04 05 14 31 33
... Foreword ... Editorial Board Introduc on ... Upcoming Ac vi es ... EAMSEP Report ... Infographic ... Ar cle/Essay/Scien ďŹ c Ar cle/Opinions
67 85 96 100
... Recent Chapter Ac vity ... Culture Corner ... Photography Sec on ... Academic Quiz
Editorial Board AMSA Interna onal eNewsle er 2018/2019
EDITORIAL BOARD INTRODUCTION.
Woro Ayu Sekararum
Kevin Eliezer Ferdinandus
Rahman bin Anwar
Hsiang Yun
Bek mirova Alina
Rana Ghareeb
Yeke Yu
Usakorn Cheawdamrongchai
Jeevan Ghimire
Daniell Edward Raharjo
Srinidhii Murugappan
Sekar Ratna Arnovita
AMSA INTERNATIONAL UPCOMING EVENTS
AMSC
AMSA Singapore was one of the early
medical issues that affect the Asia-Pacific
founding members in AMSA Interna onal’s
region. We aim to con nue to spearhead
history, with the hos ng of the 5th AMSC by
innova ve medical and health projects
the NUS Medical Society in 1984. Although
through collabora on with other member
AMSA Singapore’s par cipa on was lost
chapters, and create new interna onal
along the way, Singapore successfully applied
friendships through the expansion of our
for observer status as a member country of
AMSEP program to involve more member
AMSA Interna onal in August 2010 with AM
chapters. cha
resounding support from other chapters.
AMSA Singapore has emerged officially as
Today, we are seeing a revival of Singapore’s
an
independent
student
organiza on
par cipa on in AMSA Interna onal, with the
registered under the Registry of Socie es
ac ve par cipa on of progressively larger
Singapore in November 2014. As the only key
delega ons in conferences in recent years,
representa ve body of full- me medical
and the hos ng of exchange programs with
students in Singapore and as the only
other AMSA AM chapters.
student-led organisa on that runs under
In 2014, AMSA Singapore was conferred a
interna onal medical student bodies, we aim in
full membership in AMSA Interna onal and
to train the young medical students of
won the Best New Chapter Award for its
Singapore from across the schools to become
contribu ons to AMSA. We contributed
be er future leaders and pioneers of
further to AMSA by being a stellar host of the
tomorrow by providing them a pla orm with
Asian Medical Students’ Conference (AMSC)
a myriad of interna onal opportuni es.
2015 that is cognisant of the latest important
To further enrich the experiences of medical students in Singapore, AMSA Singapore recently joined IFMSA as a full member in 2017 to expose the students to a wide range of events and ac vi es that IFMSA provides. We have successfully sent a number of students to IFMSA’s recent interna onal events and we are currently ac ve in the Standing Commi ee on Public Health (SCOPH) with our new SG Marrow ini a ve. We hope to con nue the great efforts to assimilate IFMSA into AMSA Singapore. AM Singapore hopes to establish official partnerships with the three local medical AMSA schools in the near future, namely: Na onal University of Singapore (NUS) Yong Loo Lin School of Medicine, Duke-NUS Graduate Medical School, and Nanyang Technological University (NTU) Lee Kong Chian School of Medicine. In doing so, we aim to encourage a joint collabora on amongst these schools in the spirit of mutual support and coopera on, with the common goal of providing the best experience for medical students in Singapore.
EAMSEP REPORT
AMSA INTERNATIONAL
EAMSEP Berlin was held on 9th to 18th of January 2019. It was hosted by Charité Universitätmedizin Berlin. There were 6 Indonesian delegates: Gracia Kaesatara Marsha, Andi Harvan Zakariya, Hanna Melisa, Kirana Pawitra Nareswari, Hansel Del no Bandaso, Monika Tessalonika Hanny Meiyani Parapat.
DAY 1 January 9th, 2019 The delegates arrived at Tegel Airport, Berlin on 9th January 2019. A er being picked up by the commitee, the delegates headed to Charité University and Charité Hospital in Mi e to a end some lectures and bedside course. Then, the delegates went to the twins’ houses and spent the rest of the day with the twins.
DAY 2 January 10th, 2019
///
The second day was begun with visi ng Medical History Museum which displays the evolu on of medicine in 300 years. Then, the delegates ate lunch in a cafetaria near Charité University called Mensa. The agenda con nued by a university tour, brief presenta on about Charité curriculum, and at the end of the tour, the delegates were given some welcoming bags. The day was ended with having dinner at Markthalle 9.
DAY 3 January 11th, 2019 In the third day, the delegates met at the Bernauer Straβe underground sta on. Then the delegates had a walking tour along Berlin Wall and visi ng Tränenpalast, which is a former border crossing point between East and West Germany. At noon, the delegates were visi ng Davida’s house to have a cooking and bonding night.
DAY 4 January 12th, 2019 The next day was begun with dissec on course. The delegates went to the Anatomy Laboratory of Charité University to join the anatomy course by Prof. Michael. Then, the agenda con nued with a free me. The delegates were strolling and shopping in Alexanderplatz. At night, the delegates went to Anna’s apartment to join a party to celebrate Serbia’s New Year.
DAY 5 January 13th, 2019 Today the delegates got a chance to a end a service at Hillsong Chris an Church at 11am. The dura on of the service was 90 minutes. A er that, the delegates visited a famous Flea Market at Mauerpark. This outdoor market sold secondhand products, artsy stuffs, foods, and many other an que things.
DAY 6
DAY 7
DAY 8
DAY 9
DAY 10
AMSA-INDONESIA
The incredible experience of EAMSEP Berlin for
I highly recommend for anyone that gets a
Indonesia hosted by EMSA-Berlin was a once in a
chance to par cipate in EAMSEP to take the
life me chance that anyone could ever experience.
opportunity and get mind blown by the
From all the programs that have been held, I
impression that would burn through your mind
learned a lot from the academic programs, the
and open up new friendship that comes along
cultural ac vi es, and also the local cuisine that
with it. EMSA-Berlin was one of the best host I
our twins shared with us. For me personally, the
could’ve ever hoped for and helped us with our
tour of Berlin Wall Memorial and visi ng the east
every needs; even a er the EAMSEP was over, ev
side gallery really le a mark on why Berlin was a
they made sure that we all arrived safe back to
great city with rich history. Not only did we get to
Indonesia. That is why EAMSEP Berlin for
learn the past history of Berlin, we also got a
Indonesia was an unforge able experience that
chance to visit the German Bundestag and see how
everyone should enjoy!
the country oversees its government and also get a 360° of the city. The introduc on to the academic learning of Charité was also interes ng, it really gave me a big insight on how medicine in Germany works. My favorite part of the experience would probably be the cuisines that we get to try, from Germany’s local food to the diverse influenced culinary food and also the outdoor ice ska ng ring culina that we get to try.
EMSA-Berlin was one of the best host I could’ve ever hoped for and helped us with our every needs; even a er the EAMSEP was over, they made sure that we all arrived safe back to Indonesia.
AMSA-INDONESIA
As soon as I got no fied that the upcoming
comprehend their ideas and reasons on why
EAMSEP would be hosted by Berlin, the capital city
they cra ed medicine as well as put it into
of Germany, it did not take any further
prac ce. Also, Berlin Wall Trailing and the Berlin City
considera ons for me to sign myself up. It was the chance that everyone would wonder if
Tour gave me the chance to grasp the historical
one would not dare to even sign up. As soon as I
educa on and feelings and to respect the values
got the opportunity to be one of the delega ons of
of humanity. It felt like I was thrown back to the
EAMSEP Berlin, I did not scream or jump, I froze
events that took place in approximately half
because I could not believe that this experience
century ago. To venture the country in which I dreamt to be
would actually come to my life for real. Truth be told, one could not fathom how much I
is an out of the world experience. The exchange
learnt from every programs they set for us. From
program helped me broaden my horizon of
academic ac vi es to cultural ac vi es as well as
understanding in various aspects, including
various conversa ons we had with our twins. The
medicine, history, as well as cultures. To this day,
twins consisted of very unique, diverse and dis nct
it s ll feels like a dream to actually get the
characteris cs and it was a pleasure to be able to
chance to be a part of the exchange program.
connect with every single one of them.
And I’m I forever grateful for that.
Personally,
touring
the
Berliner
Medizinhistorisches Museum der Charité was the excep onal program. It helped me to crawl into the German Pathologists’ mind in order to
To this day, it s ll feels like a dream to actually get the chance to be a part of the exchange program. And I’m forever grateful for that.
AMSA-INDONESIA
Being part of the EAMSEP Berlin delega on for
The Dissec on Class also went very well, I could
Indonesia was something I never imagined would
feel how it felt to be one of the students in
happen to me. I experienced a lot of things that
Charité and entering a huge and detailed
were very enjoyable in prepara on and when I was
anatomy building that made me even more
in Berlin. Being able to experience the academic
amazed at this university. I will not keep all the
system at one of the best medical universi es in
knowledge that I got during the EAMSEP
Germany feels like a dream to me, Charité
program for myself, but I will develop it later in
Universitätsmedizin Berlin. The AMSA philosophy Uni
building the environment around me and life in
that I have been admiring so far is very well
the field of Indonesian medicine later. Thank you
implemented during the EAMSEP program, which
AMSA!
is Knowledge Ac on and Friendship. Being able to feel and learn directly about every culture, history, and academic system in Germany accompanied by excellent "Twin" is the best experience I've ever experienced. One of the ac vi es that was very interes ng for me was the Berlin Wall Trail and Dissec on Class with Prof. Michael! Through the Berlin Wall Trail I can find out about historic events in Berlin that I have only heard through others and see first hand the loca on where the Berlin Wall was built.
EMSA-Berlin was one of the best host I could’ve ever hoped for and helped us with our every needs; even a er the EAMSEP was over, they made sure that we all arrived safe back to Indonesia.
AMSA INTERNATIONAL
On 16th of January, the EAMSEP Bucharest for Indonesia began. It was hosted by EMSA-Romania and held in Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. There were 10 people who got accepted to this EAMSEP programme. The nine of us didn’t know each other at first. But even before the two-weeks-programme done, we already feel like we know each other well and feel like a family. Half of the delegates are from AMSA district 4, that won the host bidding for EAMSEP Bucharest, Universitas Diponegoro and Universitas Brawijaya. Two of them are from AMSA Brawijaya, Anastasia Meirina and Clarisa Takbira Sugiatno. From AMSA-Undip, there are Chris ne Margaretha, Evan Savero Widiono, and Richard Axel. And one more from the district 4 is Abi Prasetya, from AMSA-UNS. There are two people from district 2, Jennifer Gabriella as the Chief of Delegates from AMSA-UAJ, and Vellia Jus n from AMSA-UI. The rest are from district 3, Fildza Rizkia from AMSA-Unpad and Religia Yurica from AMSA-Maranatha. But sadly, she can’t join us because one and other reasons. Wednesday, 16th of January, the day landed our foot at Romania. When we first arrived at Henri Coanda Airport, the Romanian twins picked us up from the airport and went straight to their home to get some rest because of our long journey from Indonesia. The second day, we went to Na onal Museum of Art. We got to see a lot of arts from the Romanian Chris an Orthodox and the modern arts. A er lunch, they took us on a city tour to see the old, historical, yet beau ful buildings in Bucharest.
On the next day, we visited George Enescu Museum. He was a famous violinist and composer from Bucharest. At night, we ate dinner at Nor Sky Bar. It was a bar that located 136 meters above the ground. The fourth day we walked to Arc de Triumph, it is a mini version of Arc de Triumph in Paris. There’s a lot in common between Bucharest and Paris. That’s why Bucharest is known as ‘Li le Paris’. Then we walked to Village Museum. It is an outdoor museum that displays houses and their culture from different villages in Romania. Then we went straight home to prepare for Romanian Nights. For us, it was an interes ng programme, we learnt about Romanian culture, tradi onal dress, and food; such as sarmale, polenta, pr ciorba, zacusca, mici, and papanasi. On Sunday, the fi h day, we went to Kitch’s Museum. Kitch’s was defined as art, objects, or design considered to be in poor taste because of excessive garnishments or sen mentality, but some mes appreciated in an ironic or knowing way. Then in the a ernoon the girls went shopping at Afi Mall. Luckily the mall has an ice-ska ng arena, so the boys, who weren’t interested in shopping can s ll enjoy their day. The sixth day, it was the first hospital day for us. We went to Clinical Hospital Colen na at the neurological ward. We were divided into 4 groups. Each group got a doctor and got to see pa ents with different cases, for example; Alzheimer, Mul ple Sclerosis, Stroke, etc. At night, we had a Basic Life Support Workshop. We learnt how to response on a emergency situa on such as cardiopulmonary resuscita on or known as CPR and Heimlich manuver.
///
CHRISTINE MARGARETHA AMSA-Universitas Diponegoro I was given an opportunity to be one of the delegates of EAMSEP Bucharest. This exchange program has taught me so much. Through this program, I could get new experiences that I would never get from anyone else. I was able to learn new medical stus, know how the medical system works in there, and get new friends, not only from my country, but also from Romania. I would like to say thank you to AMSA-Indonesia for giving me this opportunity.
ABI PRASETYA
VELLIA JUSTIN
AMSA-Universitas Sebelas Maret
AMSA-Universitas Indonesia
AM AMSA gave me the opportunity to join the EAMSEP program in Bucharest, Romania as one of the delegates, and I never regre ed on being a part of the program. It opened my eyes and mind to a whole new world and I gained whole new experiences and knowledge, both cultural and medical. I also got the chance to meet new people from another part of the world and that made me more conďŹ dent in life as well. And because of that, I want to thank AMSA-Indonesia for entrus ng me with this wonderful opportunity
In EAMSEP Bucharest 2019, delegates were able gain not only new academic and cultural knowledge, but also build meaningful connec ons with our Romanian hosts and among AMSA-Indonesia members. This experience also enabled me to gain more insight into organizing AMSEP events for further hos ng programs. Overall, EAMSEP Bucharest 2019 is a very rewarding experience and the memories will always be treasured.
TOWARDS REACHING OUT AND PROTECTING OUR WORLD’S VULNERABLE 20 MILLION PEOPLE!
To achieve that, collabora ons might be needed from different stakeholders: 1. Medical professionals must advocate immuniza ons in their daily prac ce, promo ng vaccines to every poten al individual they encounter; 2. Doctors and medical professional organiza ons need to advocate to government he need of Extended Program on Immuniza on (EPI) and adopt more vaccines into their countries’ Na onal Immuniza on Program (NIP); 3. Governments must be open minded in accep ng new vaccines and its possibility to integrate into NIP, or at least promo ng ease of access to vaccines from registra on to distribu on and monitoring the safety of vaccines; 4. Vaccine pharma needs to collaborate with academicians to create more studies on vaccines, not only in crea ng novel vaccines, but also improve the safety and delivery of vaccines. They also need to educate stakeholders of the importance of adop ng more vaccines into NIP; 5. Vaccine pharma needs to collaborate with governments and NGOs to improve market access of vaccines, accurately capturing the full benefits of vaccines, and balancing regulatory requirements, individual benefits, and public health impact of vaccines; 6. Finally, governments, with the support of vaccine pharma and academicians, should embrace medical professionals from all different layers, not only the KOLs, professors, consultants, specialists, but also the GPs, even the nurses and midwives to hand-in-hand altogether crea ng a join campaign towards awareness that #VaccinesWork!
BREAKING THE STIGMA
Immuniza on has changed the face of
ac vi es can be performed under the
trea ng diseases. It is worth in its weight in
collabora on of health organiza ons.Global
gold .Vaccina on did the trick and delivered
immuniza on coverage can be improved by
the goods, but once referred as life-saving
analyzing the current situa on and making a
wonders of technology has now caused people
plan that monitors the immuniza on rates
to be outraged. The controversies that
because if you cannot measure it, you cannot
surround it has made it lose its ground.
manage it. Data collec on regarding the lack of
Currently there is an endless number of Cur
service is required to work on the drawbacks. se
challenges it is facing. People believe that it
There is a need for more research and
causes au sm and autoimmune diseases.
development for vaccines that can provide
Myths are that vaccines have toxins and it
ways
weakens the immune system. All these
Innova ons can bring more advancements to it
misconcep ons and fallacies has caused big
ensuring be er results .Lowering the prices of
public health problems.
vaccines to provide easy access to everyone.
of
increasing
its
approachability.
Immuniza on educa on is what can help the
The role of pediatricians is of prime
public to understand its importance .Only then
importance in this regard, they should be
they will know the dividends it pays and
reminded of educa ng the parents on this
consequences of not having it. We need to get
topic. Proper counselling of parents can help
to the basics and educate them that what it is
them get rid of all the misconcep ons. Making
and how it works. Most importantly that it is
eorts to improve interac on between health
safe because there is a lot confusion regarding
services
vaccina on safety. We need to bring the vaccin
responding to the health needs of everyone.
researches and theories in light that disproves
Speaking out against the disinforma on is
the controversies related to it. What medical
important. To provide greater accessibility
students can do to raise the awareness is to
NGOs can hold vaccina on clinics and train the
develop communica on strategies using the
health workers. The inequi es in health and
tool of social media and this message can be
resource distribu on is the main cause of low
delivered using pamphlets, posters.Youth
immuniza on coverage. Clinical trials should
ac vist vi using the social media can create
be conducted by vaccine manufacturers and
greater
wider
advocate them to maintain the supply at all
audience, which is a plus point and can help in
mes. Post licensure studies should be done to
accessibility
and
garner
spreading the knowledge. Medical students can be given training so they can reach the unreached. Many outreach
and
Community
will
help
in
monitor vaccine safety and improved systems should be introduced to monitor vaccine safety.
AMSA CHINA
WHAT STEPS NEED TO BE TAKEN BY THE POLICY MAKERS IN ORDER TO IMPROVE GLOBAL IMMUNIZATION COVERAGE?
The governments play cri cal roles in improve global immuniza on, since their work can develop the one in their own country, no ma er what character of state is or where the country located. Adding some collabora on in trade or research and interna onal aid between countries, global immuniza on development can be realized. Regarding populariza on and correct applica on of immuniza on, there are some step similar to common public issue, with some special. To begin with, the first step and the most basic ma er is current evalua on. For example, which groups of people need special vaccina on, how large amount of vaccina on is needed, how can we provide enough source, whether the price and quality of special vaccina on can be separated into several levels and used by different groups of ci zens or whether the price is too burdensome for some family to afford. To solve the current situa on, the policy makers need to make a further evalua on and include the immuniza on methods in health insurance. Further, the policy makers can borrow successful idea from aboard. Taking HPV immuniza on as an instance, inclusion on health insurance in the United States makes prevalence of cervical cancer decreases notably. Maybe, it is a good idea for Chinese policy makers to inves gate and survey if its inclusion is suitable in China.
A er evalua on, the second step is to op mize domes c immuniza on system. To be specific, there are three issues: vaccine headstream management, suitable distribu ng channel, and produc ve individual immuniza on recording system. Discussing them on by one, there are some nega ve issues elimina ng belief of the public towards immuniza on produc on. As a result, someone avoid vaccina on in order to avoid the danger, undoubtedly, which affect immuniza on coverage. As for distribu ng channel, some vaccine can only inoculate at center hospital, while for some kinds, some community clinics can serve as inocula on points. Taking HPV immuniza on as an instance once more, there were only seven inocula on points in Beijing in the beginning. Nowadays, HPV come into the university hospitals, which obviously shows that op mizing immuniza on system is necessary. And the immuniza on record is large, the me span is long, the links have large number, the manual opera on is cri cal, while the immuniza on record must be correct. The effec ve medical record must be the true reflec on of the vaccina on in the vaccina on opera on. The person who has been relocated or narrowly vaccinated should clearly indicate if these problems are not solved well, adding the educa on of the vaccinated people is insufficient,tit will easily lead to the lack of vaccina on
and the occurrence occur of leakage. Thirdly, a er policy makers collect enough informa on from vaccine sources, distribu on channel, their experts gain a deeper understanding for cri cal problems for each disease immuniza on, and then educa on for doctors and pa ents can come to mind easily.he vaccinated people is insufficient, it will easily lead to the lack of vaccina on and the occurrence of leakage.
AMSA INDIA
IF YOU BELIEVE IN VACCINES, CAN YOU SPEAK UP?
“Vaccines are the tugboats of Preven ve
dding fuel to fire, a number of barriers stand in
Health”, but I believe we seem to contradict
the way of progress in boos ng adult
this idea put up so eloquently and wisely by
vaccina on numbers and mee ng public health
Mr. William Foege.
immuniza on
goals.
With
the
possible
In the developing country such as India, the
excep on of the influenza vaccine, most adult
propor on of the popula on less than 15 is
pa ents don’t know about the risks and
very high, This suggests that the emphasis in
consequences of vaccine-preventable diseases,
the developing world should be on preven ng
which shots they should get and when they
infec on in the young. In the developing
should get them. Many think that ea ng
countries, the top four causes of mortality in
healthy and exercising alone are enough to
children less than five years old are
prevent disease.
pneumonia, diarrhea, malaria, and measles. Immuniza on is a very important decision.
Vaccine use in the developing world will have
The risks of vaccine-preventable diseases are
the greatest opportunity to prevent infec on,
very real, something that some mes gets lost
reduce morbidity and mortality drama cally
in the discussion about the risks of vaccines.
and ul mately have a major posi ve economic
And it’s not just the health of the unvaccinated
impact for these peoples and countries. It is a
children we worry about, but the health of the
medical megatrend to be hoped for. Maybe we,
children around them. There are a lot of
as health care students and many medical
people out there not vaccina ng their
professionals out there, could stop shoving pr
children, who may be pu ng others at risk of
science down parents’ throats and try a
contrac ng disease. We are talking about a
spoonful of compassion and communica on to
parent or a guardian who is hesitant to hand
the help the medicine go down. Not just to
over their 2 month old, 2 year old, or 10 year
parents about their children, but it’s crucial that
old for an immuniza on. They have never
we commit to the na onal strategy and
seen diphtheria, tetanus, rubella, or measles.
embrace the movement to boost adult
They may never have held the hand of a child Th
immuniza on rates, reduce disability, disease, immuni
dying from preventable infec ous disease. Are
and death and ensure that no one ever suffers
we so far divided from these parents that we
from an illness that a vaccine could easily have
step back and fail to see where they are
prevented.
coming from? But as parents make these important decisions, they want to be sure that we are ge ng the most accurate, complete and up-to-date informa on. Some friends may have that, some folks do but not share and some are just growingly hesitant to speak.
AMSA INDONESIA
THINK GLOBALLY, ACT LOCALLY WHY GLOBAL IMMUNIZATION COVERAGE IS IMPORTANT AND WHAT MEDICAL STUDENTS CAN DO TO ACHIEVE IT
Immuniza ons/vaccina on are one of the
The emerge of those problems can be
most important health interven ons of the
caused by the loss of confidence in
20th century. Immuniza ons no doubt are
immuniza on due to the side effect of
one of the most effec ve preven ve health
vaccina on, and the high mobility of people
measures and have saved countless of lives.
across
Since 1974, World Health Organiza on with
widespread of diseases (WHO, 2019).
its
Expanded
Whatever the reasons, not being vaccinated
Programme on Immuniza on (EPI) has Pr
in a community is a serious problem that
succeeded in increasing the popula on of
cause the decrease in herd immunity,
surviving infants against diseases such as
therefore may lead to the increasing
diphtheria, pertussis, tetanus, measles, etc.
suscep bility to preventable diseases to the
The global coverage of the program itself has
whole
increased from <5% to ≥85% by 2015 (Casey
biological agents of diseases tend to spread
et al., 2016). The newest program endorsed
easily, so if the condi on con nues and
by the WHO is the Global Vaccine Ac on Plan
especially that people always mobilize, it
(GVAP) which calls on all countries to reach
will eventually lead to pandemic outbreak
more than 90% of na onal coverage by 2020
of preventable diseases. It is shame if many
for all vaccines in the country’s rou ne
lives will loss/defected because of the
immuniza on. Seeing the success story
causes that already have the very poten al
immuniza ons have done in eradica ng
preven ve solu on, just like immuniza on.
smallpox and near eradica on of polio (also
Solu ons to those challenges have been
for saving es mated 2,5 million lives per year),
carried out by health provider sectors, one
there would be a bright future in eradica ng
of the big programs is the GVAP in order to
more preventable diseases.
achieve
program
which
is
the
A lthough being one of the best innova on in
countries
can
community.
more
Immuniza on
than
aggravate
Moreover,
90%
Coverage.
of
the
most
Global
Others
are
medical sciences, immuniza ons have many
including the strengthening of health
challenges
the
systems in general and especially making
unprivileged popula ons with limited access
coali on so that health professionals can
to educa on and healthcare, which can be
join forces to fight for global immuniza on
seen by 24 million of unimmunized or
coverage
incompletely-immunized
Macintosh et al., 2017).
2019).
that
Not
can
only
come
from
children from
(WHO,
unprivileged
popula ons, well-educated popula ons may consciously choose not to have their children vaccinated properly.
(Feldstein
et
al.,
2017
&
Health
professionals
play
the
most
campaign
regularly,
to
spread
the
important factor that can inďŹ&#x201A;uence parents
importance knowledge of immuniza on.
that
children
Not only to the privilege communi es,
counseling
students can also do social ac on to the
hesitantly
immuniza on (Ventola,
give
by
2019).
their
pa ent Not
just
health
unprivileged
communi es
by
doing
professionals, medical or health-related
reminder and/or recall strategies to follow
students
the
up vaccines schedule so they would not
Public
miss the vaccine-giving schedule. If all
educa on, even if there is no much
stakeholders aware of the importance of
interven on given, have the eďŹ&#x192;cacy of
being vaccinated for the good of the whole
improving immuniza on rates, especially
community across the world, people will
when
or
also be aware to carry out the missions to
Public
spread the knowledge and access to
educa on can also be delivered by social
vaccina on/immuniza on to all people. So
campaign (since many people nowadays
the Global Immuniza on Coverage would
tend to browse social media) or face-to-face
be achieve eventually.
can
surrounding sur
do
something
neighborhood.
combined
government-based
with
to
community
measures.
References: Casey, R., Dumolard, L., Danovaro-Holliday, M., Gacic-Dobo, M., Diallo, M., Hampton, L., & Wallace, A. (2016). Global Rou ne Vaccina on Coverage, 2015. MMWR. Morbidity And Mortality Weekly Report, 65(45), 1270-1273. doi: 10.15585/mmwr.mm6545a5 Feldstein, L. R., Mariat, S., Gacic-Dobo, M., Diallo, M. S., Conklin, L. M., & Wallace, A. S. (2017). Global Rou ne Vaccina on Coverage, 2016. MMWR. Morbidity and mortality weekly report, 66(45), 1252â&#x20AC;&#x201C;1255. doi:10.15585/mmwr.mm6645a3 Macintosh, J., Eden, L., Luthy, K., & Schouten, A. (2017). Global Immuniza ons. MCN, The American Journal Of Maternal/Child Nursing, 42(3), 139-145. doi: 10.1097/nmc.0000000000000337 Ventola, C. (2019). Immuniza on in the United States: Recommenda ons, Barriers, and Measures to Improve Compliance: Part 1: Childhood Vaccina ons. Retrieved from h ps://www.ncbi.nlm.nih.gov/pmc/ar cles/PMC4927017/ WHO (2019). Retrieved from h ps://www.who.int/immuniza on/fact_sheet_challenges.pdf?ua=1
AMSA THAILAND
WHAT CAN WE DO AS MEDICAL STUDENTS, TO RAISE PUBLIC UNDERSTANDING AND TO BREAK THE STIGMA REGARDING IMMUNIZATION?
Immuniza on is a war against ailments that the world has to fight with together. As our vaccinated popula on has increased, deadly diseases are now preventable, some, eradicated. This has been achieved due to relentless research and humankind acknowledging the importance of ge ng vaccinated. This momentum may be curbed by misunderstandings and s gma against immuniza on, and as enthusias c medical students, it is our obliga on to tackle this issue. As world ci zens, medical students are capable of connec ng the world through the boundless media. Social media is a promising pla orm to counteract what hinders the success of immuniza on: fears and doubts. Campaigning to raise awareness about the safety and necessity of vaccines can reach every corner of the world if we can properly u lize the power of crea ng trends, for example, by hashtags and online forums. Conversa ons via posts and vlogs can give many an opportunity to share their skep cism about the usefulness of vaccines and also medical personnel a place to explain key concepts and provide informa on. It is our challenge to start a ripple to steer the world towards immuniza on that will one-day turn into a wave of knowledge and enlightenment. immuni
Being young and energe c, we are the hands and feet of our society and have the ability to put ideas into ac on. We hold the poten al to reach out to those around us and make a difference. Medical students can be deployed into targeted communi es to campaign, educate and meet people to ensure them about the benefits of vaccina on. Students can also gather informa on from those who oppose vaccina on back to law makers who may eventually modify certain policies. The impact we can create will start from changing minds, but may someday change the norms. Most importantly, as we are gradually being shaped to be a doctor of the future, we carry an abundance of useful informa on in our hands. We have studied the science and physiology behind immuniza on and we are no stranger to vaccina on guidelines. It is our responsibility to provide this informa on to others whenever and wherever we can. It should therefore also be our commitment to reinforce our exper se in various ways, may it be upda ng on papers and ar cles concerning immuniza on or ge ng involved in new research that may further improve the way we prevent diseases. The possibili es go on and on. I believe in the poten al and power of medical students that will someday change the world. By crea ng networks, reaching out to the society and being equipped with adequate informa on we can change the way people view vaccina ons. Facts are to be told, fears are to be shaken and doubts are to be clarified. Immuniza on is a con nuous ba le we are all in together and one day, the world will be thankful to have warriors like us.
AMSA THAILAND
VACCINES CAUSE AUTISM: THE DELUSIONAL BELIEF AND GLOBAL HEALTH CATASTROPHE
It was a Sunday morning when I found an ar cle about the danger of vaccine, and how it causes many health condi ons, including au sm. According to a study in several countries, one in every 5 people was found to believe the myth. 38 percent among those people is unsure whether that myth is true or not (Duffy and others, 2018). I was u erly perplexed by how many people actually believe this myth, despite the claim is widely discredited. Therefore, I searched for the reasons why so many people regard this myth as true. Then, I found various ways for us to help public understanding and spread awareness of danger of an -vaccine beliefs. Based on what I men oned on the previous paragraph, this misplaced fear of measles vaccina on was originated in 1998. A Bri sh gastroenterologist, Andrew Wakefield, published a case series in the pres gious medical journal, The Lancet, suggested that the MMR (Measles, mumps and rubella) vaccine was increasing au sm in children. Unfortunately, in spite of the complete refuta on of Wakefield’s fraudulent findings by the scien fic community, the concern s ll exists among some parents. According to WHO, only 4 of 30 of EU/EEA countries have reached the 95 percent aim for both the MCV1 and MCV2 doses during 2017, indica ng the measles vaccina on myth is pu ng people’s health at a serious risk (Carlson and Reiter, 2018). There have been trends of parents in Western countries (e.g., USA, UK and Italy) refusing to vaccinate their children due to these delusional beliefs. This phenomenon causes the disabling outbreaks of vaccine-preventable diseases, including measles which was previously considered eliminated. In my opinion, if we don’t do something about this problema c misunderstanding, we will be facing the regression of modern medicine and then it would be too late to do anything but to face the consequences of ignorance. I believe that effec ve communica on between science community and the people is crucial. Facts alone will not be sufficient. What ma ers is how we deliver those facts. The art of persuasion is needed to reconnect to those who misunderstood and gently guide them back to the right concept. For instance, include informa on about the benefits of vaccina on and the danger of refusing vaccina on in movies or TV-series to help those people get used to the idea. There are various ways for medical students to help science communi es. Social media is one of the most viral ways to achieve the goal. We could encourage dona on to our local free-vaccina on campaign to convince vaccine skep cs to get vaccinated. don Let me quote Prince Mahidol’s famous speech ‘True success is not the learning, but in its applica on to the benefit of mankind’. Each and every one of us has the power to prevent this upcoming catastrophe. Apply the knowledge we learned from medical school, or from life experiences, to the benefit of those who are in need. To serve our purpose. To bring back the prosperity of public health.
Duffy, Bobby. “Au sm and Vaccines: More than Half of People in Britain, France, Italy S ll Think There May Be a Link.” The Conversa on, 4 Dec. 2018, theconversa on.com/au sm-and-vaccines-more-than-half-of-people-in-britain-france-italy-s ll-think-theremay-be-a-link-101930. Hacke , Don Ward. “Why Do Europeans Believe Au sm Vaccina on Myths?” Precision Vaccina ons, Precision Vaccina ons, 26 Aug. 2018, www.precisionvaccina ons.com/measles-au sm-myth-con nues-place-children-risk
AMSA INDONESIA
COMPLACENCY IS AN ENEMY
The year 2011 marked the ini a on of the
Global
Plan
backtrack is complacency. It causes us to
Health
stop being vigilant towards the possibility
Assembly. The Plan aims to minimize the
of reemergence of preventable diseases.
burden of diseases preventable by vaccine
Complacency roots from the absence of the
in the span of a decade. Through
concern of diseases and misinforma on
partnerships with countries, regions, and
which lead to vaccine hesitancy among
partners such as the Vaccine Alliance, partne
parents or even underes ma on of the pa
UNICEF, and Bill and Melinda Gates
gravity of a disease. Declining vaccine
Founda on, impac ul progresses were
uptake results in decreased herd immunity
made. Among those progress, up un l
and thus, a community becomes more
seven million deaths in Western Pacific
vulnerable to a disease. A reintroduc on of
Region are prevented due to immuniza on
a vaccine preventable disease in this type
programs being enforced.1
of community could lead to outbreak
spearheaded
Vaccine by
the
Ac on
One of the factors contribu ng to this
World
Nevertheless, it is surprising to learn
occurrence. This has happened during 2018 occur
that, nearing the Plan denouement, we are
measles outbreaks in the US.4 Poli cal
backtracking with measles elimina on
commitments also play a role in causing
progress.
complacency. Talking about immuniza on
For
around
two
decades,
measles immuniza on has saved more
in
than 21 million lives.2 In 2018, however,
implemen ng
there is an increase in reported cases in up
effec vely is an act of complacency within
to 98 countries.3 Moreover, in the same
the governmental sphere. Furthermore, it
year, outbreaks occurred in many regions
will undermine immuniza on benefit to the
including the European, the Americas, the
na onal health and economic growth.
South
Eastern
Therefore, complacency and decreased
Mediterranean Regions. The scope of this
alertness toward a disease is harmful for
problem reflects that not only developing
the progress we have made in global
countries were affected by this outbreak,
immuniza on. The increased cases of the
but developed na ons, which supposed to
deadly yet preventable disease serves as a
have be er healthcare system, were also
lesson to the global health community that
burdened.1
we should not be complacent of current
East
Asia,
and
the
poli cal
achievements.
campaigns, immuniza on
but
not
programs
AMSA TAIWAN
A NEGLECTED ISSUE OF VACCINATION FOR THE ELDERLY
A 64 years old lady was referred to our
whereas repe
vely illustrated no evidence
hospital due to Varicella Zoster Virus (VZV)
for increased risk of developing au sm
infec on. Upon presenta on, the pa ent was
following MMR. Wakefield ends up confessed
febrile with Tmax at 38.7 degree Celsius and
his fraud and The Lancet retracted the paper
rather nauseous, accompanied by headache
in February 2010. Nevertheless, impacts
off and on. A number of painful erythematous
thereof linger. Parents hesitated to vaccinate
papules in conjunc on with clustered blisters
their children due to misinforma on, which
were noted along right dermatome Cranial we
might lead to drama c public health mig
Nerve V-III and Cervical I, while neural
consequences. In recent, a new law: “No
examina on documented local dysesthesia
Vaccine No School” was implemented in Italy,
yet intact motor func on. Her serum
according to which schools will turn away
chemistry came back sugges ng infec on in
children who have not received mandatory
progress.
thus
vaccina ons. Taking more control over
indicated, and the analysis of cerebrospinal
vaccina ons successfully helped Italy to reach
fluid pinpointed asep c meningi s as the first
herd immunity levels and even be er (nearly he
differen al diagnosis. Acyclovir 5mg/kg Q8H
95% in some region), yet the primary target
in addi on to an pyre c as well as an eme c
popula on of such policy remained to be
regimen was administered accordingly for 10
young children merely.
Lumbar
puncture
was
days. The pa ent was discharged on the 12th
Back concerning our case, VZV infec on, one
day a er admission with symptoms fully
of the most torturous nightmares for the
abated. Further vaccina on against VZV was
elderly, is a serious clinical problem ought to
urged at follow-up outpa ent visit 6 months
be solved par cularly in the era of aging
later, but she expressed much hesita on and
society. Unfortunately, this popula on is
ques oned about such necessity.
ironically neglected by our medical system in
Tracing back the history, public concern
terms of vaccina on. While the newborn
about the safety of vaccina on raised a er
prophylac c vaccina on was administered pr
1998 Lancet landmark study, in which Andrew
rather completely, the management against
Wakefield et al reviewed a case series and
infec on of the seniors was rela vely le
implied the link between MMR vaccine and
behind.
the incidence of au sm. However, the small sample size (n=12), carefully selected cases, and the specula ve nature of the conclusions made the result ques onable. In the following years, a plethora of epidemiological studies was conducted
On a daily basis, we encounter numerous aged pa ents sustaining their main problems in conjunc on with shingles during admission, which immensely prolonged the course of recovery.
Nevertheless,
thecommercially-
available vaccine is too expensive to be aďŹ&#x20AC;orded by a certain pa en n need. Comprehensive vaccina on programs thus Comp should be implemented as soon as possible. For
economic
concerns,
public
health
insurance reimbursement could be the fundamental source but does not resolve the sophis ca on
of
ďŹ nancial
arrangement.
Alongside a healthy diet and physical exercise, vaccina on also contributes to the elderlyâ&#x20AC;&#x2122;s quality of life. We therefore, urged the promo on
for
elderly
vaccina on
in
avoidance of compromising longevity. Reference 1. Taylor, L. E., Swerdfeger, A. L., & Eslick, G. D. (2014). Vaccines are not associated with au sm: an evidence-based meta-analysis of case-control and cohort studies. Vaccine, 32(29), 3623-3629. 2. Eggertson, L. (2010). Lancet retracts 12-year-old ar cle linking au sm to MMR vaccines. Canadian Medical Associa on. Journal, 182(4), E199. 3. Rao, T. S., & Andrade, C. (2011). The MMR vaccine and au sm: Sensa on, refuta on, retrac on, and fraud. Indian journal of psychiatry, 53(2), 95.
AMSA THAILAND
WHAT STEPS NEED TO BE TAKEN BY THE POLICY MAKERS IN ORDER TO IMPROVE GLOBAL IMMUNIZATION COVERAGE?
It is o en stated that immuniza on’s impact
Moreover, the establishment of special
on global health is only second to the
ini a ves to assist countries in managing the
introduc on of clean water and sanita on. This
complexi es of immuniza on logis cs can
claim is indisputable because millions of lives
provide instruc on into vaccine storage and
have
delivery.
been
saved
due
to
the
global
Another
equally
important
immuniza on effort to eradicate smallpox in
cornerstone of immuniza on programs is
the 1980s. Current solu ons for global
surveillance. Close monitoring of infec ous
immuniza on coverage are plen ful, but fall immuni
diseases is expected to provide a de facto early
into two simple categories; logis cs and
warning system for impending outbreaks.
surveillance.
Recently, reassuring progress has been made in
Over
the
past
decade,
immuniza on
improving
surveillance
systems
for
programs worldwide have added modifica ons
vaccine-preventable diseases. An example of
to the standard six disease vaccine1. They
an efficient surveillance system is the polio
include vaccines against hepa
s B, and
surveillance network, which allows for rapid
occasionally
high
risk
detec on of cases and this model has since
countries. This prevents an es mated 2.5
been applied to measles and neonatal tetanus
million child deaths a year, but despite these
for example.4
yellow
fever
for
efforts many children do not complete their eff
Above all, the jus fica on of immuniza on
immuniza ons2. A major obstacle is the innate
programs lies not in preven ng child mortality,
weakness of a developing country’s public
but
health infrastructure and support system to
hospitaliza ons
understand the importance of vaccines.
an cipated that within the next decade, the
Furthermore, a new, emerging threat posed by
most important advancement will be in vaccine
false rumors about vaccine safety con nues to
research. Hypodermic needles may become an
impede progress by causing public reluctance
object of the past, and will be replaced by
against vaccines.
aerosol formula ons, adhesive skin patches
Efforts to overcome barriers to immuniza on
and
in
the
long
sublingual
and
term clinic
reduc ons visits.
applica ons5.
It
in is
Another
include the use of vaccine campaigns and
poten al breakthrough is an improvement to
‘outreach,’ opera ons that target overlooked
heat stable vaccines which will enable vaccines
popula on
social
to survive long term storage. Even though the
par cipa on is a key factor in raising coverage.
overall picture is one of cau ous op mism,
An awareness and public demand for the
enthusiasm and dedica on; there is every
benefits that immuniza on provides is a cri cal
reason to believe that immuniza on will
aspect of an effec ve immuniza on regimen.
con nue to be a mainstay of public health, far
However, emphasis must be placed on
into the future.
reliability.
groups3.
Widespread
AMSA THAILAND
WHAT STEPS NEED TO BE TAKEN BY THE POLICY MAKERS IN ORDER TO IMPROVE GLOBAL IMMUNIZATION COVERAGE?
According to World Health Organiza on (WHO), global immuniza on coverage s ll remains as an ongoing healthcare problem in today’s society. While it has improved significantly over the last decade, global vaccina on coverage s ll remains at 85%, with no dras c changes over the years. In developed countries, rou ne vaccina on has eradicated cou several infec ous diseases which prevents millions of deaths each year. Meanwhile, in developing countries, vaccina on s ll remains a public health problem since many individuals have yet to be vaccinated or are unable to complete their rou ne vaccina on each year. There are mul ple reasons as to why full global The immuniza on coverage has yet to be achieved, but the main reason lies in the inability to access immuniza on service. Individuals who are living in remote areas or in the slum are unable to receive vaccina on due to lack of transporta on or resources. In addi on, individuals who are underprivileged may not have enough finance to ensure the cost of vaccina on for their children and family. To bridge the remaining fi een percent gap of achieving a full immuniza on coverage, policy makers should strengthen their governmental policies in their na onal immuniza on programs in order to alleviate the seriousness situa on. In poverty-stricken areas, underprivileged families are unable to receive their vaccina on since there are no doctors or immuniza on services nearby. Furthermore, a feature that policy makers could consider in order to boost vaccina on rate is to advocate for a be er health care insurance that includes vaccina on coverage cost as a part of its plan.
.In addi on to their inability to access vaccina on facility, individuals who are a part of the lower middle or lower social classes are unable to afford vaccina on, so providing healthcare insurance can warrant an increase of vaccina on rate in a country. Another step that policy makers can take to promote global immuniza on coverage is by suppor ng each immuniza on service with an up-to-date vaccina on protocol that corresponds to the World Health Organiza on. Each year, vaccina on policies keep changing due to the ever-changing nature of infec ous diseases, thus, in order to ensure that children are ge ng the correct vaccines, it is necessary to update every vaccina on protocols. For instance, the reoccurrence of measles outbreak led to a revision to the immuniza on policy which now includes measles preven on vaccine (MMR) in its requirement. Therefore, children with up-to-date vaccina on are now child less likely to get infected with measles compared to those who have yet to be vaccinated or have received outdated vaccines. Therefore, policy makers have important roles to improve the vaccina on situa on in their own country. By understanding and recognizing the problem, the overall global immuniza on coverage can steadily improve. However, not just policy makers but everyone has a role to help. This means if we are able to achieve a full global immuniza on coverage, achi we can help prevent over a million deaths each year.
AMSA THAILAND
WHAT ACTION SHOULD BE DONE TO IMPROVE IMMUNIZATION SURVEILLANCE & VACCINE SAFETY IN ORDER TO IMPROVE GLOBAL IMMUNIZATION COVERAGE?
The problem of global immuniza on coverage is that many but not all children have received the recommended amount of vaccina on every year. To fully comprehend the problem, it is crucial to improve every aspect that falls under the category of global immuniza on in order to tackle the overall situa on. situ These aspects of global immuniza on coverage include immuniza on surveillance, vaccine safety protocol, vaccine administra on guidelines, and many more. It is essen al to take immuniza on surveillance into considera on when resolving this global health issue. Immuniza on surveillance is a broad term that concerns many immuniza on aspects which include vaccine quality, vaccine storage, vaccine administra on, disposal and management of waste. There are mul ple ways to improve immuniza on surveillance ranging from improving our understanding of a vaccine’s side effect or striving to further develop new experimental vaccines. The reason why increasing the populace understanding of vaccine is important is because there are a lot of misconcep ons about vaccine that con nue to compromise the public confident in vaccina on in general. Vaccine are predominately safe, but there are few and rare cases where one may develop adverse effect from vaccina on. However, it is ad important to clearly state that there are various means of preven ng the occurrence of adverse events in pa ents. For instance, by doing preliminary tests beforehand such as background or gene c tests which can deduce and prevent the development of side effects that may appear. th
Another measure to take to improve immuniza on surveillance is to gain a be er understanding on how to store vaccines properly. Improper handling such as inaccurate vaccine storage prac ces has been one of the major reason that cause loss of vaccine potency. It may seem like a minor issue but it can be detrimental since it can lead to an individual contrac ng the disease the vaccine was meant to prevent in the first place. By ensuring that health facili es are kept up to date with new vaccina on policies and are qualified to properly handle vaccine storage, many deaths associated with vaccine can be prevented. Consequently, improving immuniza on surveillance and vaccine safety can directly progress the goal of achieving full global immuniza on coverage. By increasing the general understanding of vaccina on to the public as well as our knowledge on how to handle vaccines can prevent any adverse events that may occur in the future. In ev addi on, there are always ongoing research on vaccine safety and tes ng. Therefore, with this in mind, the problem of ge ng vaccina on coverage has yet to be solved but I believe with con nued efforts to discover and understand new vaccine, one day, achieving full global immuniza on coverage will no longer be a immuni concern.
AMSA MALAYSIA
REACHING EVERYONE, EVERYWHERE
According to the official reports by World
commercial hands have not gave posi ve
Health Organisa on Member States and unless
outcomes.
otherwise stated, Global immuniza on profile
pharmaceu cal companies do not want to get
showed that the overall number of reported
involved in the vaccine business because it is
cases, be it Diphtheria or Measles, have
economically prohibited and restricted by
declined over the past few decades. However,
regulatory barriers exemplified by flu vaccine
the story is much complicated than it might
shortage in the United States in 2004 due to
appear at first glance. Even as exis ng vaccines
financial loss. Hence, as a medical student, it is
con nue to exert their immunological power
vital for us to raise the public understanding of
and new vaccines offer new insight, s ll millions
vaccine that it is not a ma er of financial loss or
of people does not get the opportunity to
earned but a ma er that could save millions of
receive rou ne immuniza on services such as
life. Few funding vaccine programs could be held
DTaP. Furthermore, obstacles and challenges
such as campaign and training workshop. An
have long stood in the way of the produc on of
annual campaign could held in certain areas
safe and effec ve vaccines. Here is the ques on:
which have low vaccine coverage such as Nigeria
what ac on should be done to improve
and Indonesia. For example, Immuniza on Week
immuniza on surveillance and vaccine safety to
ini a ves began in the WHO Region of the
improve global immuniza on coverage?
Americas in 2003 have showed posi ve impacts
What is of great importance is increasing
It
is
because
many
of
the
on the public understanding of vaccines.
financial aids and implement a na onal
So, as the examples above demonstrates,
immuniza on coverage surveillance system. A
that it is a shared responsibility to improve global
complete
coverage
immuniza on coverage. Policymakers such as
surveillance system should include rou ne
Ministry of Health could implement some
repor ng
programs
na onal and
immuniza on
surveillance
coverage.
By
by
analyzing
of improving performance can be addressed.
provided to areas that are less accessible
The inves ga on from surveillance system
according to rou ne report, as vaccine can ac
could be used to provide informa on in
prevent
program planning, implementa on, evalua on,
vaccine-preventable disease. Thus, government
and modifica on. Since vaccine now have
is encouraged to provide more funds to set up
become a great achievement in medical field
funding programs such as vaccine workshop and
regardless its interna onal pres ge, huge
give free doses of vaccines to the poverty. All of
manpower and financial aids are required in manp
the above strategies are ways to improve our
order for the researcher to explore new safe
surveillance coverage and global vaccina on su
vaccines.
coverage, in the same
Recently, the migra on of vaccine produc on
understanding of immuniza on.
away from governmental en
es into
serious
should
from
surveillance
from
Vaccines
data
iden fying areas that need improvement, issues
us
system.
the
illness
be
and
me raise the public
MYTH BU
Fives myths abo that you have be
The MMR vaccine causes autism TRUTH:
Giving an infant multiple vaccines can overwhelm the immune system TRUTH:
Itâ&#x20AC;&#x2122; bet to spa vaccine an alte sche
TRU
Many large, well design studies have
Trillions of bacteria enter the babyâ&#x20AC;&#x2122;s
Delaying vaccines i
found no link between MMR and
bodies immediately after birth. Healthy
children will be susc
autism. Autism probably has multiple
babies can make antibodies against
It can stress the child
components, including genetics. It
bacteria, viruses and fungi real time.
usually becomes apparent around the
Vaccines only use a few components of
same time MMR is given
the immune system of the baby
fear to visits
USTING:
out vaccinations u might elieved
â&#x20AC;&#x2122;s tter ace out es using ernative edule
UTH:
Natural infection is better than immunization
Some ingredients in vaccines are harmful
TRUTH:
TRUTH:
increases the time
You get about the same level of protection
Aluminum: Help improve immune response.
ceptible to diseases.
after natural infection and immunization.
Commonly found in food and drink, infants
d and may lead to a
However, natural disease can more
to the clinic
troublesome. Since, it will cause some extend of discomfort with signs and symptoms. Severe illnesses may lead to permanent loss of functions for example deafness, blindness, loss of limbs or even death.
get more aluminum in breast milk than vaccine. Formaldehyde: used in detoxifying diphtheria and tetanus toxin and inactivate virus. Only a tiny amount is left after purification. Humans normally have formaldehyde in the blood and the level is higher than what is found in vaccines.
RECENT CHAPTER ACTIVITIES Indonesia and India
Junior World Congress 2019
JUNIOR WORLD CONGRESS 2019 was an initiative undertaken by Christian Medical College and Hospital, Ludhiana, on the occasion of 125 years of establishment of the institution in association with AMSAIndia and it was the first ever International Undergraduate Medical Students Congress held since its inception. It was held over a span of 5 exciting days from April 4th to April 8 th , 2019. The theme was Non Communicable Diseases and the reason behind it was due to the alarming rate of rise in Non Communicable Diseases and their associated long term complications. In total, there are about 8 workshops conducted and was led forward by eminent faculties and Doctors. The most popular workshops were Stroke and Neurological Disorders, Haematoncology, AHA Certified Basic Life Support, Hormonics - Diabetes, Mental Health, Orthopedics, Cardiac Diseases and Chronic Kidney Disease among others. The academic events held included, Nerd-O-Pedia Quiz, Harrison’s Clinical Photo Assay, Debate, Case Presentation, Pharma Atlas and Pharma Spelling Bee, Research Paper, e-poster Presentation, Press Conference and Model United Nations. Most of the events were filled with enthusiastic participants leaving the judges with a tough time all throughout. The Model Unite Nations saw the coming together of several nations with an aim to solve major
problems in this simulated environment. “I was excited to be a part of the MUN. Though I have had no prior experience, the introductory session for first-timers was very helpful and I had a great time” quoted a delegate. The guest speakers included Dr. Sangeeta Mahajan, Consultant Anaesthetist at St Thomas Hospital, London; Dr Sajeev Cherian, Head Senior Lecturer at Flinders University; Dr Tarlok Purewal (Internal Medicine) from Ohio Health, USA; Dr Prashant Mathur, Director at National Centre for Disease Informatics and Research; Prof Peter Sandercock, Academic Clinical Neurologist and Emeritus Professor of Neurology at University of Edinburgh; Dr Atul C Mehta of Cleveland Clinic; Dr Nihal Thomas, Professor and Head Department of Endocrinology at Christian Medical College, Vellore; Dr Prabhakaran Dorairaj, Public Health Foundation of India; Dr J S Thakur, President of World NCD Federation; Dr Mammen Chandy, Director of Tata Medical Hospital, Kolkata; Dr Derek de Sa, Professor, Department of Pathology at University of British Columbia; Mr Rajinder Gupta, Chairman of Trident Group.
Srinidhii Murugappan
Shri Sathya Sai Medical College And Research Institute India
The Cultural Events held were Painting Competition, Just a Minute, Medical Dumbcharades, Voice Over your Favourite Medical Celebrity, Terribly Tiny Tales, Fan Fiction, Advertisement Making, Story Making, Poetry, Medical Karaoke, Extempore, Clinical Treasure Hunt and Short Film. In addition, the Cultural Booth had the best display of every countrys’ envied souvenirs and costumes. In short, the Cultural events added a flavour to the existing colour of the Congress. It was widely appreciated and well received. A cycling marathon covering a distance of 7.2KM was held as an initiative to combat non communicable diseases. The marathon was one of the major successes of the Congress and it was held in two sessions due to the unanticipated turn-up of a large number of participants. An international delegate was found beaming with joy and was seen quoting, “Nothing can beat cycling through the lanes and streets of Ludhiana, it was unique in its own right!” The Sponsors and endorsements of JWC were Trident Group, Indian Council of Medical Research, Indian Stroke Association, World NCD Federation, Cleveland clinic, World Stroke organisation, SAFES and Association of Physicians India. And, AMSA - India had sponsored a success party as the Organising Committee
Indonesian Medical Students’ Training and Competition 2019 “INTENSIVE: Initiating equal access for better health”
Melisa Canggra Universitas Tarumanagara Jakarta, Indonesia
AMSA-Indonesia has five national events in each tenure. One of those is Indonesian Medical Students’ Training and Competition (IMSTC), which was successfully held on January 24-27, 2019 with Tarumanagara University Faculty of Medicine as its host. The event was attended by 30 AMSA-Universities from various universities throughout Indonesia. The series of events for 4 days were neatly packed in the theme “INTENSIVE: Initiating equal access for better health”
On the first day, registration for delegates was opened since morning (around 8 a.m), but most of the participants arrived and registered in the afternoon, due to the first day of IMSTC was held on Thursday- therefore some delegates still had classes that they have to attend. Nevertheless, it did not decrease the enthusiasm of the delegates, as evidenced by all of their participation at the Welcoming Party held at Tarumanagara University. The Welcoming Party was officially opened by singing AMSA Song (See The World in Perfect Harmony). The delegates were welcomed by The Chancellor of Tarumanagara University, Director of Student Affairs at Tarumanagara University, Dean and Vice Dean of Tarumanagara University Faculty of Medicine, who were also present at the opening of IMSTC. Delegates were served dinner, as well as the showcasing of a traditional dance of Jakarta. The first day was closed by mobilizing participants to the hotel to have a rest.
Heavy rain hit Jakarta on the second day. Fortunately, it doesnâ&#x20AC;&#x2122;t reduce the energy of the delegates who were ready to hear the lectures delivered by qualified speakers in their fields. Lecture 1 was presented by the Ministry of Health Republic of Indonesia, continued with lecture 2 delivered by Badan Penyelenggara Jaminan Kesehatan (BPJS) with Dr. Nony Indrianti Yunita regarding the role of health workers/medical personnel in national health insurance. The delegates seemed excited by giving questions in the question and answer session (QnA Session) to the speakers. Also followed by the Mini Advocacy Simulation from the chairman of IDI in West Jakarta, Dr. dr. Dollar, SH, MM. Then, the event continued with a presentation and training from the Dean of Tarumanagara University Faculty of Medicine, Dr. Dr. Meilani kumala, MS, Sp.GK(K) who delivered learning materials of scientific paper, together with Dr. Novendy, MKK, FISPH, FISCM. It continued with group discussions, namely Small Class Training (SCT). There are 4 branches of SCT which include scientific poster, photography, videography, and public poster. Each delegate chose one which suits their interest the most. In this Small Class Training, delegates met with other friends, who had similar areas of interest with them. The event continued with a review and plenary session. Some delegates represented each branch and explained the results of their small class training branch discussion. After the review and plenary session, there was a Technical Meeting (TM) for the finalists in order to prepare the competitions in the next day. Tired of getting lectures all day, the delegates were presented with dinners in the carnival-themed Culinary Night accompanied by live music, with a variety of game features as complementary.
On the third day, after eating breakfast at the Hotel, all of the delegates were mobilized to Tarumanagara University. The third day was the peak day of IMSTC, where the top 10 finalists will give their best presentations in the competition final. There were 5 branches in the competition (scientific paper, scientific posters, public posters, videography, and photography). Delegates who didnâ&#x20AC;&#x2122;t take part in the competition were allowed to provide support to the presenters.
At night, there was a farewell party held at Orchardz Hotel Industri. As the name implies, it was the last night for the delegates. Only on a farewell party in IMSTC , there were district booth from 6 districts of AMSA-Indonesia. Each district presented their own regional specialties, which you can try it too! After dinner, there were performances from each district, and also the announcement of the competition winners from all the branches.
In the last day, we did a social action in Tomang Village, West Jakarta. This social action takes the form of a free examination for residents and we had served our community service to conserve the sanitation as well. In addition to the delegates and committees, there were also doctors who accompanied them. All of the residents seemed quite enthusiastic to come and participate in this event. In the afternoon, the delegation was taken for a city tour to Museum Nasional Republik Indonesia/Museum Gajah and this place was also the last place visited by IMSTC 2019.
Having Indonesian Medical Studentsâ&#x20AC;&#x2122; Training and Competition or IMSTC as my first national event was an honor to me. This event was totally different from any event I had attended. Never in my life, I had felt a comfortable feeling in an event like this one. And I truly appreciate the committee because this event was going so well even it was like there were no mistakes in the committee and gave us, the delegates, so many information by lecture, skill training, even the competition and social action itself. For me, personally, this event is truly open my mind and find out that 3 principles of AMSA are not just a word. In the end, thank you AMSA-Untar for hosting this IMSTC 2019 this year! - Fandi Hendrawan (UGM)
This year;s IMSTC was an impressive event. I&#39;m glad that I joined IMSTC as it consists of various activities and I can meet new people during the event whose presence are memorable for me. Some of the things that I liked during IMSTC is first we can receive new knowledge from the lectures, especially on how to properly create scientific paper which I think is really useful and applicable as medical students. The second thing that impressed me was the farewell party which was very cool and joyful, with district booths that introduced delegates to each districtâ&#x20AC;&#x2122;s culture. Performances from every district successfully stunned me. Decorations done by the host has made the show looked so fancy. My liaison officer and the other committees were very friendly and humble, one of the reasons why I never get bored to join AMSA-Indonesia national events. Thank you IMSTC Untar 2019! - Andi Aynina Putri (UnHas)
RECENT UNIVERSITY ACTIVITIES AND PROFILE Indonesia and Malaysia
AMSA Schoolin Medicine, Unive 20
Muhammad Prima Cakra Randana Universitas Sriwijaya, Palembang, Indonesia
ng — Faculty of ersitas Sriwijaya 019
AMSA-Universitas Sriwijaya conducted an event for their observer member in last February. The purpose of the event is to give information and knowledge regarding AMSA from the perspective of local university, chapter, and international wise. AMSA International presentation was delivered by M Prima Cakra (LO to APDSA) and Yudistira (General Treasurer). They explained about the history of AMSA, International Conferences, and exchange program. AMSA-Indonesia presentation was delivered by by Anandya Rhadika (Regional Chairperson), Rian (General Secretary), and Chika (Director of AMSEP). They explained about the national events, Event of The Year (EoTY), etc. AMSA-Universitas
Sriwijaya presentation was delivered by Echa (Representative) and Amirah (Vice Representative). They explained programs conducted by the local university. After the presentations observer members of AMSA-Universitas Sriwijaya joined post to post games. It was the part of AMSA Schooling to made observer members had a taste in each division of the organization. From main board, academic and research, community outreach, membership and development, publication and promotion, external, and finance. They were encouraged to ask questions regarding the division or any general informations. Committees happily answered and shared their knowledge. Overall it was a really nice sharing session.
The third session was a gift exchange. Observer members and committees were obliged to bring a gift. They formed a circle, with flowing music on the background, and they started forwarding the gift to their left. Participants were free to bring anything, with wrapping paper covering the gift to make sure it was mysterious for everyone. The observer members also gained lesson about how to lead an assembly by the faculty’s student legislature. Most students in my university doesn’t understand how to conduct an assembly, so AMSA-Universitas Sriwijaya obliged their observer members to learn from the expert.
AMSA-MAHSA University Profile
ABOUT US
AMSA MAHSA University is a newly formed organization that the medical society are very proud of. MAHSA University, founded by Professor Tan Sri Datuk Dr.Hj Mohamed Haniffa bin Hj Abdullah, is a relatively young local medical university formed 14 years ago. Our founder is currently acting as MAHSA University’s Pro-chancellor and Executive Board Member envisions the rising ofMalaysia into thecenter of academic excellence. His vision is in line with Prime Minister’s vision for Malaysia. Along the timeline, multiple faculties have been formed, followed by the establishment of Faculty of Medicine in 2009 by one of MAHSA University’s Vice Chancellor, Professor Dato’ Dr. Khairul Anjar bin Abdullah. He is an academician who later took up the role of the first Dean of faculty of medicine. Presently, Professor Dato’ Dr. Ravindran Jegasothy is acting as the Dean of faculty of medicine and has given his full support on us joining AMSA Malaysia. This is made possible by the acting AMSA MAHSA chairperson, Miss Safa Mousa A. Allouzi, who is in her Year 2 Medical Student of MAHSA. It has always been MAHSA students’ vision to be a part of AMSA so that medical students in MAHSA University can have a closer relationship with other medical universities around Malaysia and have the chance to, either attend or held activities, for other universities under AMSA Malaysia.
AMSA-MAHSA Board Members AMSA MAHSA team consists of creative and accomplishment driven individuals who are very proud to be the first team of AMSA in MAHSA University. Along with our talents, we are excited to pave the first steps of the path in making MAHSA University a full member in AMSA Malaysia.
Vision and Mission In accordance with AMSA Malaysia slogan: “Building Bridges, Sharing Dreams”, our vision and mission is: Vision: Knowledge, Action, Friendship Mission: 1. To facilitate interaction and friendly relations among the various medical students’ societies in Malaysia based on the principle of mutual respect. 2. To achieve co-operation and understanding in medical and health problems as well as to share experiences in solving them. 3. To promote the interest and welfare of medical students in Asia, for universal kinship without distinction as to race, sex, language, religion and political affiliation. 4. To foster unity and promote profound inter-personal relationships amongst its members. 5. To uphold humanitarian ideals and medical ethics. 6. To provide an outlet for social, cultural and academic activities and encourage cooperation amongst Asian and Oceanian future doctors.
Activities Past Activities • First Meeting with Regional Chairperson It is an honour for us to have a short yet productive 2 hours meeting with the Regional Chairperson of AMSA Malaysia, Aries Thong Ming Hui at our SPC (Saujana Putra Campus) of MAHSA University on 11 March 2019 from 6pm to 8pm. Upcoming Activities • TedX talk: Topic: Forensic Science • Mental Health Play: Coming soon in October • Futsal and Badminton Championship: To be confirmed.
วัฒนธรรม kultura culture संस्कृति văn hóa 문화 budaya هراضح соёл madaniyat វប្បធម៌
CULTURE CORNER
ACEH: A LOCAL TRAVEL GUIDE Amalia Dwi Mulyani Universitas Padjajaran Indonesia
A
ceh is a province of Indonesia, located at the northern end of Sumatra. Its capital and largest city is Banda Aceh. Aceh was the closest point of land to the epicentre of the 2004 tragic Indian Ocean earthquake and tsunami, which destroyed much of the western coast of the province. This wonderful place has the largest range of biodiversity in the Asia Pacific region. Among the rare large mammals are the Sumatran rhinoceros, Sumatran tiger, Orangutan and Sumatran elephant. Other than that, we have marvellous beaches and delicious foods. In this guide, I will let you take a look at what can you find, do’s, and don’ts in my little hometown.
1. Clothing Granted a special autonomous status by the country, Aceh is a religiously conservative territory. Strict rules in Aceh, such as the prohibition on using of jeans actually do not apply to tourists who come here. Even so, as a wise tourist, it’s greatly recommended to respect the rule. Save your bikinis for Bali and start wearing a long shirt if you visit Aceh.
2. Beaches Loknga Beach This tourism site is about 20 km from the city centre of Banda Aceh. Here, you can relax under the shady trees or play beach volleyball white sandy and gently sloping beach. This clear blue sea has waves of 1.5 to 2 meters high that are great for surfers.
Lhokmee Beach Lhok Mee Beach is 30 km from Banda Aceh. Before entering Lhok Mee Beach area, you will be delighted by the views of rocky hills and trees. Lhok Mee Beach has often been called as the “White Sandy Beach”. This beach has a unique form of large and small trees that grow in the water.
Lange Beach Located in Lam Lhom Village, Aceh Besar, it has a combination of white sandy beaches, brown seaweed, and green meadows. All the beauty is
Weh Islands
completed with the clear blue sea. While
This place is a heaven for divers. Coral reef areas
swimming and playing in water, you can find shells,
around the island are known for their large
sea urchins, and colourful beautiful
variety of fish species. A rare megamouth
ornamental fish. Located 500 meters from Lange
shark species was found on shore and the island is
Beach, over the hill, and along the sandy beach,
the
you will find Ie Rah Beach. On Ie Rah Beach there is
only habitat for the threatened toad, Duttaphry-
a phenomenon called ocean flute, in the
nus valhallae .
form of two seawater that gushes upward like a fountain.
3. Food This place has many tasteful foods, one of them is Mie Aceh. Mie Aceh usually uses thick yellow noodles, in similar size to Japanese udon noodle. The thick yellow noodle are served with slices of beef, goat meat, shrimp or crab. They are served in rich, hot and spicy curry-like soup. The spice mixture consist of black pepper, red chili pepper, shallot, garlic and many others. The noodle and spices are cooked with bean sprouts, tomato, cabbage and celery.
THE DELICIOUS BABONGKO Nur Octavianti Indonesia
Babongko is one of the regional specialties of South Kalimantan. Unfortunately, this typical Banjar food is rarely processed, so its existence is increasingly forgotten. At a glance, Babongkoâ&#x20AC;&#x2122;s appearance looks like Nasi Lemak or Pundut, but if you look at the contents, it will be different. People often enjoy it with family in the morning or evening. These wet cakes are usually found in East and South Kalimantan, especially in the Banjar and Kutai tribes. Babongko cakes are usually sold in various traditional markets or hawker centers. Babongko is greenish in color that feels springy and soft when enjoyed. This lump is coated with a thick brownish white sauce. The sauce is made from brown sugar and coconut milk. Clumps that have been given sauce are then wrapped in banana leaves shaped like a pyramid. The top of the wrapper will be pinned with sticks. Babongko has a sweet yet savory taste. Bebongko is made through two stages of cooking, which is making the dough and steaming. In the first process, coconut milk is cooked with salt and sugar until it reaches boiling point. It is then added to the rice flour mixture which has been dissolved with coconut milk. After it has thickened and broken apart, the mixture is then lifted and cooled for a moment. The next process is to put the mixture into the banana leaves along with a spoonful of liquid brown sugar and thick coconut milk, then steam until cooked. Babongko is often served at large events, such as weddings.
Here are the ingredients needed to make some scrumptuous Babongko: 1. Rice flour 2. White sugar (to taste) 3. Salt (to taste) 4. Coconut milk 5. Brown sugar 6. Banana leaf 7. Pandan leaves
Want to try making your own rendition of the traditional snack? Just follow these simple steps:
1. Cook the coconut milk until done, add enough sugar and salt and include the pandan leaves. 2. Add a little coconut milk to rice flour and stir until smooth 3. Pour the rice flour and coconut milk mixture into prepared banana leaves and place the slices of brown sugar on top, then wrap it neatly. 4. Place the package into a cage, then steam until done 5. Babongko is ready to be served
PHO GRA
OTOAPHS
Leony Octavia Universitas Hasanuddin Indonesia
â&#x20AC;&#x153;Ask Yourselfâ&#x20AC;?
Nowadays the world is changing. Are they safe? Is my family okay? Am I okay? â&#x20AC;&#x201D; YES! I am already protected by immunization.
ACADEMIC QUIZ
Congratulations to
HARMEET KAUR as winner of World Cancer Day Academic Quiz!
Fill the crossword and win the prize! 24 April - 24 May 2019 Visit this link below and see if you can solve it!
https://tinyurl.com/26th-quiz
Answers to last quiz:
ACROSS 1.Histologic appearance of neoplastic cell = pleiomorphic 2.Screening test for breast cancer = mammography 3. General sign and/or symptom of cancer = weight loss 4.Uncontrolled proliferation is characteristic of ___ cells = malignant 5.Lung sound in laryngeal cancer = stridor 6.Acronym for cancer symptoms = CAUTION 7.Most common type of cancer in women = Breast 8.Continent with highest cancer incidence rate in 2018 = Asia 9.What type of cancer is increasing in an alarming rate = Lung 10.Prostate cancer results in higher levels of = PSA 11.Grading for breast tumor with 2 nodules = N1
DOWN 1.Important requirement in tumor survival = angiogenesis 2.Anticancer drug which inhibits purine ring biosynthesis = methotrexate 3.Common cellular appearance in benign tumors = hyperplasia 4.Type of chemotherapy given after surgical procedure = neoadjuvant 5.Leading cause of lung cancer mortality = smoking 6.Main site of breast cancer metastasis = liver/brain 7.Cancer with highest mortality rate = Lung 8.Screening method for lung cancer = LDCT 9.Cancer incidence in 2018 is ____ million cases = 18.1
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Twenty-sixth Edition