SCORA America's RM Report 2016

SCORA Sessions: America’s Regional Meeting 2016 Montevideo, Uruguay (January 17-22, 2016) Carlos Andres Acosta Casas- SCORA Regional Assistant for the Americas

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Introduction Note: Medical students from all the americas came down to one of the southernmost countries in the region: beautiful Uruguay. The reason? Apart from celebrating llama spirit and transmitting care for fellow medical students we rejoiced in the gathering of the Regional Meeting of the Americas to discuss more than just med updates and our regular SCORA topics.

We started on the 17th with an energetic opening ceremony with greetings from the WMA and ended of course with a real NFDP besides our usual plenary simulations to prepare for the upcoming March Meeting in Malta. Of course we always had our classical warm up in the pre-rm having an amazing workshop focusing on Young Women and Adolescent health and Access to Safe Abortion.

In this report you will find an effort of months performed by the sessions team and myself to really incorporate on paper what this amazing experience showed us not only as doctors but as human beings.

SCORA is not only about sex. I know that all SCORAngels are well aware of this but definitely we can start focusing our work in other focus areas that we haven’t explored before and I hope that this report will have the chance to show you that.

From the llama territory to the world, Carlos

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SCORA Sessions Team Members: Team Members Carles Pericas Escalé Carlos Andrés Acosta Casas Ruth Ramirez Gabriela Ponce

SCORA Director SCORA RA for the Americas NORA IFMSA Bolivia NORA IFMSA Chile

Participants

NAME Lucy Schum Gabriela Ponce Francisca Mayorga Franco Bavestrello Sergio Campos Raul Ignacio Barrantes Joritzel Quijano Ruth Ramirez Carmen Prado Rafael Batista Carlos Acosta

NMO IFMSA-Quebec IFMSA-Chile IFMSA-Chile IFMSA-Chile ACEM-Costa Rica ACEM- Costa Rica IFMSA- Panama IFMSA- Bolivia IFMSA- Bolivia IFMSA-Brazil DENEM-Brazil/RA

NAME Avanti Puri Samantha Johnson Tatiana Buitron Michelle Almeida Nair Pont Diego Espiau Pedro León Andrea Franco Pierina Cibele Barbara Sampaio Carles Pericas

NMO IFMSA-Grenada JAMSA AEMPPI- Ecuador AEMPPI- Ecuador IFMSA-Paraguay IFMSA-Paraguay IFMSA-Paraguay IFMSA-Mexico IFMSA- Peru IFMSA-Brazil IMFSA TO

Final Session’s Outline

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Session’s Minutes Day 2: 18th January Theme INTRODUCTION

Session Welcome Session Icebreaker SCORA Mission/Vision/Focus Areas Pre-Rm Recap

Facilitator Carlos Carlos Carles

Cecilia Espinoza External) Sexual and Reproductive Carlos Health SWGs Sexual and Reproductive Carlos Rights SWGs Agenda Explanation Carlos SCORA Map Carles & Carlos

SRHR

General

(Ipas

Debrief: Welcome session: RA- Welcomes participants and asks to make a round presentation of everyone that includes country of origin and general expectations.

Icebreaker: Energizer SCORA Mission/Vision/Focus Areas: RA- Introduces SCORA Director Carles Pericas SCORA D- Recounts what is SCORA and what focus areas do we have. Exhibits the international team and what has been our work so far in the different regions. Focus areas are ● ● ● ● ●

Maternal Health and Access to Safe Abortion Comprehensive sexuality education Sexuality and Gender Identity HIV/AIDS and other STIs Gender Based Violence

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Pre RM- Recap: RA- introduces Cecilia Espinoza from Ipas that is one of the main organizations worldwide that advocates for access to safe abortion and it is radicated in the U.S.A. Cecilia gave us a broad panorama of how IPAS has worked with the federation over the years and their project with medical students to advocate for safe abortion.

Cecilia - We delivered an experience that attends the necessity of medical students to know more about women rights and safe abortion as well as taking a better constitution of how we can include in an integrative way these topics in our curricula.

RM participants from IFMSA Brazil and AEMPPI Ecuador- The experience of the three day training in the pre RM was useful for us as medical students to gain skill in terms of giving jurisdiccional guidance to patients and be more concient as women of our rights and our feelings about these types of situations.

RA- if you want to learn more about Ipas we can have contact any time to build a training in your country 1 Costa Rica- Are there any other offices in Latin America?

Cecilia- Yes, we have offices in Mexico, Bolivia, Nicaragua which you can approach any time for material or general information. Headquarters are on the U.S.A.

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http://www.ipas.org/es-MX.aspx

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SRHR: RA divides the participants into 4 groups to discuss Sexual Health & Rights and Reproductive Health & Rights and gives time to brainstorm. After the time is over each group selects a participant to present their results of the discussion ●

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Group 1 Outcomes: Topic of Sexual Health ○ C1: sexual health is access to health of well being of every part of the body or being related to sexual expression from each individual ○ C2: it is an individual determination based on clinical facts ○ C3: it can be socially determined by national or ○ C4: it is not only the absence of sexual illness, it can also include spiritual factors or psychological concepts of the self ○ C5: it is the main responsibility within a public health system for SRHR ○ RA complementation: ■ WHO definition: Sexual health is influenced by a complex web of factors ranging from sexual behaviour and attitudes and societal factors, to biological risk and genetic predisposition. It encompasses the problems of HIV and STIs/RTIs, unintended pregnancy and abortion, infertility and cancer resulting from STIs, and sexual dysfunction. Sexual health can also be influenced by mental health, acute and chronic illnesses, and violence. Addressing sexual health at the individual, family, community or health system level requires integrated interventions by trained health providers and a functioning referral system. It also requires a legal, policy and regulatory environment where the sexual rights of all people are upheld.2 ■ Sexual health topics can be when we address stress or health problem towards sexuality and all of its social determinants like homosexuality or STIs.

http://www.who.int/reproductivehealth/topics/gender_rights/sexual_health/en/

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Group 2 Outcomes: Topic of Sexual Rights ○ C1: Sexual rights are the rules to get to have conditions for sexual health to be achieved ○ C2: They represent the inclusiveness that society has towards people ○ C3: rights to express your sexuality regardless of your origin ○ C4: rights to have access to health without discrimination ○ be inclusive as health providers ○ C5: Right to love who you want and express that in public ○ C6: Right to not be fired because of your sexuality ○ RA Complementation: ■ Sexual rights were first defined by the WAS (World Association of Sexual Health) Since 19783. They are the basic rights that defend sexual health within a socio-political context and it is grounded from the understanding and acceptance of free sexuality for all. Within these rights we can find right to privacy, right to dignity and bodily integrity, right to information etc. 4 ■ Sexual rights activities will be an advocacy strategy to include LGBT health needs within a public health system or our SCORA related policy statements.

Group 3 Outcomes: Topic of Reproductive Health ○ C1: Reproductive health includes the rights to reproduce and have sexual relationships whomever we want whenever we want ○ C2: it focuses on reproductive organs ○ C3: Reproductive health embraces all the contraceptive methods we have and how can these affect our health ○ C4: reproductive health helps people understand that everyone has rights to have a family in any way they want ○ C5: it is a state where you don’t have health issues to reproduce with you partner ○ C6: access to surrogate mothers ○ C7: access to information about reproduction methods ○ C8: correct protection to STIs ○ RA Complementation: ■ Within the framework of WHO's definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health addresses the reproductive processes, functions and system at all stages of life. Reproductive health, therefore, implies that people are able to have a responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. 5

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http://www.worldsexology.org/organisation/ http://www.worldsexology.org/wpcontent/uploads/2013/08/declaration_of_sexual_rights_sep03_2014.pdf 4

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http://www.who.int/topics/reproductive_health/en/

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Implicit in this are the right of men and women to be informed of and to have access to safe, effective, affordable and acceptable methods of fertility regulation of their choice, and the right of access to appropriate health care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant.6 ■ Reproductive health doesn’t only imply health of the reproductive organs but also our mental and emotional states to have the will to reproduce and how to take care of children like motherhood. We can also discuss about the importance of policies that gather around these needs and allow us to experience parenthood in our own way ■ In SCORA we address this when we talk about access to safe ■ abortion in terms of treatment and complications of having an unsafe abortion.

Group 4: Topic of Reproductive Rights ○ C1: Reproductive rights are the policies that lets us have children or to have access to be pregnant or have an abortion. ○ C2: for same sex couples are the rights to adopt children or to find surrogate mothers ○ C3: it is what defend reproductive health ○ C4: reproduce in many ways we want ○ C5: have access to contraception and family planning ○ RA & SCORA D complementation: ■ In 1994, at the International Conference on Population and Development (ICPD) (Added by SCORA Director), 179 countries came together and adopted a Programme of Action, in which they agreed that population policies must be aimed at empowering couples and individuals— especially women—to make decisions about the size of their families, providing them with the information and resources to make such decisions, and enabling them to exercise their reproductive rights.

■ Reproductive rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. They also include the right of all to make decisions concerning reproduction free of discrimination, coercion and violence78

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http://www.cdc.gov/reproductivehealth/index.html

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http://www.ohchr.org/Documents/Publications/NHRIHandbook.pdf

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https://www.unfpa.org/sites/default/files/pub-pdf/icpd_and_human_rights_20_years.pdf

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Closure: ○ RA- what are the differences between rights and health ○ C1: Rights are the way to advocate for health do generally we need to set health standards before passing to defend those health standards ○ C2: we need to define for this the social concepts that exist ○ C3: In mexico people would need to also see what are the main diseases to settle inclusive policies to obtain their rights ○ RA- Do you think in latin america we have achieved to defend these health statuses or rights that protect them ○ General No ○ C4: Probably in our activities what we need to do is actually making an accurate participation of having better access to advocacy skills to have power of change. ○ C5: I think that as doctor we need to know the distance to notify what are our necessities ○ RA- thanks guys for all the input, it is really important to understand these concepts to work on the next days and know how to make your activities better

General Agenda explanation: Carlos does an explanation of the general agenda as well as the focused agenda for SCORA and the work to be done for the next days SCORA America's Map: Carlos hands a post it to all participants. In it they will write their name, their country of origin and then put a SCORA topic they wanted to address back when they get home.

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Day 3: 19th January Theme HIV

SGI JOINT SESSION

Session Wake up session HIV Introduction Vertical Transmission of HIV PrEP and PEP Definition of Sexuality & Gender Identity LGBT Rights Breaking the health needs of the LGBT population Health Access to the LGBT population in a public health system

Facilitator Carlos Carles Gabriela Carles Carlos Filipe SWG Carlos Carlos & Filipe

Debrief: HIV Wake up Session Carlos gives a brief introduction to the activities of the day as well as a brief recap of the activities held on the day before HIV Introduction Carles gives presentation of introduction to HIV. He starts dividing the plateau into two groups (syphilis and chlamydia) and then popped question for them to answer about general info of HIV. Some of these questions were: ● ●

What does HIV stand for? (Human Immunodeficiency Virus) Was there ever someone that got cured from HIV? (Yes, the Berlin patient because of a bone marrow transplant) ● When was HIV discovered? (1981, France) Then positioned a short presentation about HIV history and what are the some of the indicators worldwide relevant for medical students. Later on, he discussed the Fast Track targets, and taking a bigger wider approach to HIV, he explained the concept of Positive Health Dignity and Prevention. 9 Vertical Transmission of HIV Gabi gives a presentation on Vertical Transmission of HIV (Mother to Child at Birth) translated by Carlos 9

https://drive.google.com/open?id=0B2XaL5IOHY0ZcHlLREhNT3JuQzIySDFua00tN3A3b2R2M1NB

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Gabi explains what is vertical transmission and what are the most common ways of transmission (blood, breast milk, vaginal passage of the baby) One of the most concerning topics of this issue is actually health tracking and follow up for those PLWH (people Living With HIV/AIDS) that were infected by vertical transmission as well for education for children children with HIV. These individuals generally are the ones who are more propense to produce new infections of there are no education strategies for them and the general population as well to access to ARV. ●

C1: It is really interesting how to advocate for women’s rights, in panama we held a campaign for this type of transmission in WAD (World AIDS Day) ● C2: We have never directed a campaign of this topic specifically in Brazil and it is a very interesting topic. ● RA: having intersectionality between focus areas in our projects is good to build better activities.

Carles introduced Pre Exposure Prophylaxis (PreP) to the region due to the fact that many students are not aware of this debate because there are many countries in the americas without this in their health system. During his presentation, he also mentioned Post Exposure Prophylaxis (PEP) Carles explains the benefits and debate around Truvada (1 pill a day to avoid 1 pill a day) in a small presentation also explaining for whom is it indicated and under which circumstances it should be taken still emphasizing that it doesn't replace a good sexual education in any case. In the talk guidelines from different organizations were exposed, showcasing the fact that actually, there’s still little global consensus on when PrEP should be used, and that when there is, it’s normally focused on risk populations rather than on risk behaviours.11

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https://drive.google.com/open?id=0B2XaL5IOHY0ZaC1xcWVmcGJTb3JQam1YbDdTOWVRM0V5Zkl J 11

https://drive.google.com/open?id=0B2XaL5IOHY0ZMDlFenRQUmZSSUVsZGhGamZ0QlhyM1J0UG VV

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Joint Session After lunch we united with SCORP in order to deliver our session on SGI divided in the following components: ● ● ●

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Energizer/Greetings Introduction to SGI in the region ○ America´s Background Definition of Sexuality and Gender Identity ○ Carlos introduces the origins of concept: explanation of the origin of sexuality and gender identity evocating grasps of theories built by: Judith Butler, Michel Foucault, Simone Beauvoir, Gerald Callahan, Paula Sandrine, Lequer12131415 ○ Exposition of the academic tool “Genderbread Cookie” emphasizing on the fact that it is not a perfect model but for visual concepts it can be useful 16 ○ C1: I really don’t understand the concept ○ Carlos uses Carles to give examples of relationships between transgender couples to separate gender and sexuality ○ C2: But we cannot have sexuality into boxes with the diagram suggested ○ Carlos explains: the diagram is not perfect but it is an initial context to start the idea of gender identity and sexuality and there is a lot to still define that cannot be represented objectively.

Human rights for the LGBTQI+ population: Basic explanation of the closest advocacy right we can put in practice when it comes to sexuality and gender identity ○ Filipe explains the Yogyakarta Principles and why they were created as well as gave the examples. He mentions that there is a specific chapter referred to as the gay chapter because it gives specific power to express sexuality 17 ○ UN declaration on sexual orientation and gender identity.18

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http://www.iep.utm.edu/foucfem/#H3

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https://www.cla.purdue.edu/english/theory/genderandsex/modules/butlergendersex.html

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https://www.cla.purdue.edu/english/theory/genderandsex/modules/foucaultgendersex.html

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http://www.jstor.org/stable/2930225?seq=1#page_scan_tab_contents

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http://itspronouncedmetrosexual.com/2012/03/the-genderbread-person-v2-0/

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https://drive.google.com/open?id=0B1J-Nn0jtr4pOW42c01KSXVVZnM

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https://drive.google.com/open?id=0B1J-Nn0jtr4pOW42c01KSXVVZnM

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Filipe exposes video contained in the link shared of awareness of SGI rights in a medical context from the UN office of Human Rights Breaking the health needs of the LGBTQI+ community: explain what are the main health issues we as medical students should learn about and address when we become doctors to be more approachable with the LGBTQI+ community. Four groups are separated to discuss health needs of each letter of the LGBT acronym (presentation annexed on the footnote). Carlos and Filipe dressed up in makeup and heels to resemble the trans population and as well discuss social values on objects 19 ○ L- (stigma, WSW health) (video on presentation on footnote)20 ■ Group outcomes ● C1: Lesbians have to take care for hormonal problems ● C2: health includes in family planning and the capacity of having a family and being legally protected ● C3:motherhood is health necessity for both mothers and children ○ G -(blood donation, MSM health & bi-stigma)(New ARV & Prep protocols from UNAIDS) 21 ■ Group outcomes ● C1: Gays need to have protection and education about STIs ● C2: comprehensive sexual education and orientation about HIV ● C3: know more about family planning and have better parenthood strategies ● C4: Defense of basic rights and battle homophobia because they can suffer a lot of violence ● C5: being in a society that has an inclusive health system without stigma from health providers ○ B (mental health)22 ■ Group Outcomes ● C1: rejection from society and inclusion within the LGBT community ● C2: prevention of STIs ● C3: integral health system

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https://docs.google.com/presentation/d/1-2gzCNrnJCh5rfxwW-0S87PdG_GLmiVj812hgrLGHU/edit?usp=sharing 20

http://www.glma.org/_data/n_0001/resources/live/Top%2010%20forlesbians.pdf

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http://www.glma.org/_data/n_0001/resources/live/top%2010%20forGayMen.pdf

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http://www.glma.org/_data/n_0001/resources/live/top%2010%20forbisexuals.pdf

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T (specifically include DSM & gender dysphoria)(Access to safe abortion for trans men)23 24 ■ Group Outcomes ● C1: violence towards the transgender population ● C2: elimination of the pathologization of transgender people ● C3: surgeries and cosmetic procedures that can involve gender adequacy ● C4: psychological attention ● C5:elimination of stigma from health professionals ● C6: education and information about health procedures and hormone therapy ● C7: primary health for trans people CoffeeHouse/RoundTable/Closure ○ RA: the LGBT population as a whole suffers a lot of rejection from a health system because we don’t know much about about these populations and their specific health needs. ○ C1: we need more research to change reality ○ C2: it is only in this kinds of spaces where i’ve felt taken into consideration being a health student and as well being part of the LGBT community ○ C3: It is our duty to also be respectful to one another ○ Filipe: also having in mind that all of this is linked to gender based violence that it is always linking to protect masculine based figures and affects all the lgbt community ○ RA: also in a way inside the LGBT community there are also screaming differences in what we consider inclusiveness and how we respect each other. Today we have specific merchandising for every letter and social circles they can belong, right now development only relies with cisgender people within the LGBT population and we can also be homophobic being part of the same community ○ C4: I have found myself in the same situations of not knowing what are the rights of this population and never had the chance to link it to violence ○ C5: it is really hard but there is the recognition of having this topic seen in the medical faculty ○ RA: i´ve felt insecure to treat people from this population but it is because i haven’t received any type of orientation to do so and advocating for LGBT inclusive curricula in a transversal way can be an efficient way to include this in our formation

23

https://en.wikipedia.org/wiki/Transgender_rights_in_the_United_States

24

http://www.lgbt.ucla.edu/documents/TopTenTrans.pdf

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C6: I have felt this way too, in peru there are no universities that have a class about LGB T health outside HIV and this only embarks for what we discussed mainly for MSM. Filipe and Carlos: Final closure and thanks for participation

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Session Introduction to GBV Common ways of GBV Risk Factors Pornography

Facilitator SWG Carlos & Gabriela Carlos Carlos Carles

Debrief: Introduction to GBV: Gabi gives an initial explanation of what are Women’s right and how is this represented in the americas as well as the main definition of gender based violence.

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“Any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or otherwise directed, against a person’s sexuality using coercion, by any person regardless of their relationship to the

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http://www.unfpa.org/gender-based-violence

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https://www.youtube.com/watch?v=XjJQBjWYDTs

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Victim, in any setting, including but not limited to home and work.” (World Health Organization, World report on violence and health Geneva 2002) Violence Upon Gender- UN resolutions 34/180 of the 18th of December of 1979 & 48/104 of the 20th of December of 1993; ICJ´s Rome Statute 42(9), 54(1a) y 68(1); CEDAW 1992 ; WWC, Beijing 19952728

Common Ways of GBV & Risk Factors29: After initial definition Carlos makes different SWGs and ask them different strategies to address advocacy for women's rights30. The major outcomes of the SWGs were the following31: ● Firstly, should be respected without having or having a specific role in society ● Women were not created to serve men and so we need to avoid general male chauvinism ● There is discrepancy in health assessment for women in a general basis and as well if there is layered stigma (differentials if they are black, indigenous, white women) ● recognising ourselves as social educators we can empower the population to react negatively against violation of rights Remaining in the same groups the next question was launched about recognising the social factor that powered GBV32. The main outcomes were: ○ Society 1. Norms granting men control over female behavior 2. Acceptance of violence as a way to resolve conflict 3. Rigid gender roles 4. Gender discrimination ○ Community 1. Poverty, 2. Low socioeconomic status, 3. Unemployment, ○ Relationship 1. Marital conflict,

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http://www.ohchr.org/EN/HRBodies/CEDAW/Pages/CEDAWIndex.aspx

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http://beijing20.unwomen.org/~/media/headquarters/attachments/sections/csw/pfa_e_final_w eb.pdf 29

https://www.youtube.com/watch?v=b2OcKQ_mbiQ

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http://www.internationalwomensday.com/PledgeForParityCampaign

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https://www.youtube.com/watch?v=K0YXt_dfnxY

32

http://www.ncbi.nlm.nih.gov/pubmed/19297890

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2. Male control of wealth and decision-making in the family, 3. in relationships where age difference is great, Individual Perpetrator 1. Witnessing marital violence as a child, 2. Being abused as a child, 3. Drug use

Pornography and the Sex Industry This short session was aimed at introducing a topic that is mostly overlooked due to the stigma that holds. Sex industry is present in every aspect of our life (even more than what we can imagine) and therefore has effects on us, both individually and as a society.

In this session we first explored through a Peer Education exercise the way that porn can portray a fake image of what sex is, entailing the creation of false expectations, unsatisfying body image and the creation of a twisted reality, especially for those who haven’t been exposed to good Comprehensive Sexuality Education.

To wrap up, we made an exercise in which Carles read shocking statements on Pornography and the Sex Industry and participants had to guess whether those were true or not, leading to a nice debate in which we all concluded that actually, porn is much more present in our environment than what we initially thought.

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Day 5: 21th January Theme Maternal Health & Access to Safe Abortion

NORA Topics

SCORA QUIZZ Closure

Session What is maternal health?

Competition Maternal Health Four Corners “Cartas a una Guerrera” (mx) IFMSA Brazil Activities SCORA Competition SWG (Activity for SCORA) Post it Re Cap /Closure/ Group Photo

Facilitator Carlos Carlos Andrea Barbara Carles Carlos Carlos

Debrief: What is Maternal Health Competition Carlos divided the participants into two groups of two named Boobies and Booties in order to have a competition. The challenge consisted in the in 2 minutes time each group should write in the flipcharts the main topic they think belong to Maternal Health. The main terms that emerged where ● Breastfeeding ● Contraception (ratified and explained that it doesn't belong to maternal health because it avoids pregnancy and therefore prevention of motherhood as seen from a medical point of view) ● Family Planning ● Abortion ● HIV or STIs related to motherhood ● Fertility Treatments Maternal Health Four Corners Carlos gave each participant a post it with determined position that wasn’t necessarily theirs for four statements that were going to be debated amongst participants. the topics were a surprise for them and they were : ● Women with multiple abortions should be sterilized ● Women should be allowed to have babies at home ● Women should be allowed to breastfeed in public ● Women that have a difficult pregnancy should have access to safe abortion.

Main comments from the debate´s topics were the following: ● Topic 1 ○ Arguments in favor: women don't respect education strategies o public resources spent on them. the are persons that use this as a contraceptive method and don't take into account their own health.

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Women that don't have a home and probably are living under a precarious condition, they can be helped by accessing sterilization ○ Arguments against: Women have their own right to decide what to do their own bodies. There are many ways of helping this women by using other contraceptive method like the IDU. People are not aware of how to help this women then we need to change the educative methods. We are doing these action violating rights over their own self.

Topic 2 ○ Arguments in favor: if there is a low risk pregnancy and the women feel more comfortable at home they should. There has to be conditions provided by the government but it can be psychologically beneficial for the mother to have a common known space while pre labour and labour. ○ Arguments against: homes are not safe and they might not be in optimal conditions to have a baby as well as having precarious capacity of attending complications if there are some.

Topic 3 ○ Arguments in favor: breastfeeding depends on the baby's will and not on the mother. It is for health of the baby. Breasts are a human body part and if men’s nipples can be seen the why women can’t? ○ Arguments Against: Breasts are part of the intimacy and people shouldn't share intimacy in a public space. Not everyone wants to see breastfeed. You can keep your breasts locked for humanity’s sake and search for a bathroom.

Topic 4 ○ Arguments in Favor: a woman is not killing a baby by aborting. it is better to have safe abortions and have less maternal deaths than having clandestine abortions at a higher risk of hemorrhage. all of this complemented to a safe education and comprehensive system. ○ Arguments Against: abortion is unnatural and there is life being held in a body so it can be considered as murder. abortion doesn’t help women to understand the importance of motherhood and will make them become insufficient mothers.

Closure ○ RA- this exercise was to show how to confront the various points of view that you may find on any of these topics but it also teaches you empathy for others and make you think what can they be idealising with for them to believe these arguments. This makes you a good space to plan better and constructive arguments and or activities oriented to these people.

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NORA Topics The aim of this space was to provide a scenario to expose concerns about groundwork and how is everybody looking for a better outcome of their activities back home Carlos made a call on the first day for participants to present the activities reaching to two volunteers that ended up being Andrea from IFMSA- Mexico and Barbara from IFMSA- Brazil. ●

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IFMSA Mexico: presented their biggest project done this term that was called Cartas a Una Guerrera that was their pink october campaign. The campaign consisted of writing support letters to breast cancers survivors or patients and encourage them to continue beating cancer. The project was applauded by the participants. Some of them like IFMSA Panama stated that they copied the model to adapt for their country and did it as well. We complemented the discussion by consting that breast cancer is also an activity that englobes maternal health and this is why we discuss the topic in SCORA. Participants asked Andrea questions about functioning and time management for them to see the reality in their countries and probably in the future create a similar campaign IFMSA Brazil was the second heads up commenting about their world AIDS day campaign and mentioning the candlelight memorial. SCORA D commented on the International Campaign developed by the SCORA IT and how it was one of the main celebrations in SCORA. Other participants like mexico and Jamaica also gave heads up for doing the candlelight memorial and stated that they have the same campaign in their countries. ● RA recount of activities: Mentioned that the IT is always open to provide capacitation on activities to be relevant and effective in addressing the population's need and seize what we believe is social determination of the health-disease process.

SCORA Quizz Carlos and Carles gave series of questions to the initial division of the day making general states of the SCORA activity and division as well as SRHR and all the information participants have received in the last days.

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In the end Booties won the competition and the prize was taking the banner Carlos had done signed by all participants home.

Activity for SCORA Carlos gave the idea of making a campaign with all the SCORA participants for the upcoming International Women’s Day (IWD). For this activity we wanted to have outcome oriented activities from the population's needs. We defined that in order to do that we needed to go to the streets and have medical students enter in contact with the population before organizing any activity. We decided our ideal campaign into two phases. The first one was gathering information about women’s needs throughout february and the second phase was delighting an activity based on the survey results.

We named Andrea as coordinator of phase 1 and Barbara as coordinator of phase 2.

Everybody agreed on being the people to “push” the line in their NMOs for the campaign to be understood and work.

Post It Recap Carlos asked for everyone to look at their post it again and think if they did learn something about the subject they wrote. Stated that now everybody is able to tackle these activities and address them in their countries and that now we are a family that are here to support each other with anything we need to make these goals to come true.

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Group Photo

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Goodbye Note from the Regional Assistant This experience was amazing for everybody but i feel especially proud of what we have nurtured in the american SCORAngels this RM. One of the main objectives was really setting a baseline of knowledge amongst the participants so that everyone exits the meeting knowing a really good amount of information that can be used to build better activities that are socially oriented.

We were able to question society and the origins of certain determinations of diseases. It is really amazing how we can see growth in the concepts of social determination and not only in what we think social determinants are as isolated factors.

For the next RM I hope that participants can handover the info to future participants so we can try aiming at more complex topics and each time have a profounder debate. I appreciate all the laughters all the efforts, all the curiosity and booty shaking through these days. On behalf of the session team, thank you for giving us lots of energy and an opportunity for exposition of what we believe is something that can change the world and people’s minds.

Lots of llama hugs and hope to see you soon!

Love Carlos AndrĂŠs Acosta SCORA Regional Assistant for the Americas 2015-2016

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