The Americas Heartbeat - Annual Issue 2017

IFMSA Imprint Regional Director Fabrizzio Canaval - Peru International Team Candela Benavides - Argentina Manuel Mendive - Uruguai Aline D Katchikian - Canada Frida Viscaíno - Mexico Jenna Webber - Canada Pablo Estrella - Ecuador Maria Peniche - Mexico Pamela Delgado - Mexico Andrea Falconi - Ecuador Erwin Barboza - Paraguay Layout & Cover Design Victor Leal Garcia - Brazil

The International Federation of Medical Students’ Associations (IFMSA) is a non-profit, non-governmental organization representing associations of medical students worldwide. IFMSA was founded in 1951 and currently maintains 136 National Member Organizations from 127 countries across six continents, representing a network of 1.3 million medical students.

IFMSA envisions a world in which medical students unite for global health and are equipped with the knowledge, skills and values to take on health leadership roles locally and globally, so to shape a sustainable and healthy future.

IFMSA is recognized as a nongovernmental organization within the United Nations’ system and the World Health Organization; and works in collaboration with the World Medical Association.

Publisher International Federation of Medical Students’ Associations (IFMSA)

This is an IFMSA Publication

Notice

International Secretariat: c/o Academic Medical Center Meibergdreef 15, J0-208

© 2017 - Only portions of this publication may be reproduced for non political and non profit purposes, provided mentioning the source.

1105AZ Amsterdam,

Disclaimer

The Netherlands Phone: +31 2 05668823 Email: gs@ifmsa.org Homepage: www.ifmsa.org

This publication contains the collective views of different contributors, the opinions expressed in this publication are those of the authors and do not necessarily reflect the position of IFMSA.

All reasonable precautions have been taken by the IFMSA to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material herein lies with the reader.

Contact Us

The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the IFMSA in preference to others of a similar nature that are not mentioned.

vpprc@ifmsa.org

Some of the photos and graphics used in this publication are the property of their respective authors. We have taken every consideration not to violate their rights.

Contents

Welcome Message Page 4

Theme Section Page 5

SCORA Section Page 14

SCORP Section Page 20

SCOME Section

www.ifmsa.org

Page 27

Exchanges Section Page 36

SCOPH Section Page 43

Capacity Building in the Americas Page 52

Heartbeat: Sustainable Development Goals

Dear Americas’ Family It is a great honor to approach you this time to share with all the region our regional magazine “Heartbeat�, during all this years, this was used as a tool and platform to share initiatives, projects, activities, but most important all the feelings that are easily transmitted when we go through all the articles that you, our motivated members, sent to be shared with all the region.

This year, our presidents decided to have as the main theme, Sustainable Development Goals (SDGs) in The Americas Region, which based on the advance in the world, the current priorities of the federations and the work that the Regional Team have been done during the term, make a lot of sense. We as federation need to be aware of the importance of the SDGs and the positive impacts that we can get working in different areas in the federation advocating to reach them.

As current medical students and future healthcare professionals we need to be aware that our world is facing a lot of challenges, and all of them are interconnected, and, while we work on the solution of them (based on the health perception SDG3), we will easily realized that this activities and projects will also benefit to reach the objectives of other SDGs, and this is because we can not see medicine, and health (including its challenges) as a unit, when they are really linked to other situations as climate change, gender equity, healthy food, poverty among others, which are also part of the 17 goals that will help to transform our world in a positive way.

Here, we are sharing with you amazing articles regarding the SDGs, but also a lot of work made in the Standing Committees of the federation, and as always, I can just let you enjoy all this work and get inspired and motivated with it on order to improve your realities and most important, not letting anyone behind.

4

Fabrizzio Canaval Regional Director for The Americas Region.

medical students worldwide

THEME

SDGs 5

Heartbeat: Sustainable Development Goals

Are the SDGs indomitable for Americas?

- The unheralded areas that could detriment our efforts

Maria Jose Jaramilla AEMPPI Ecuador

America is a very complex region when it comes to understanding its diverse repertoire of indicators and reality. Politically and ideologically there are numerous discrepancies throughout our countries, and sometimes, because of this, data does not reflect the truth; creating an ambiguous environment to analyze. Still, what creates the most hiatuses within America are the strident facts about the existence of poverty, hunger, defective health systems, poor education, decaying economies; among others, which takes us to the importance of the accomplishment of the Sustainable Development Goals (SDGs) to achieve the Sustainable Development Agenda by 2030. There are significant disparities in progress of the achievement of SDGs in Americas, mainly due to the lack of focus and local priorities into topics such as inequity, climate change and global engagement opportunities.

6

SDGs are a set of goals created by the United Nations that seek to join efforts in order to “end poverty, protect the planet and ensure prosperity for all� (UN Sustainable Development, 2017).

Born at a UN Conference on Sustainable Development (Rio+20 2012), the idea of creating them was basically a succinct strategy, universally applicable, that rectifies three main aspects: economic, social and environmental (UNDP, 2017).

There are 17 SDGs, each with specific targets to achieve, that surround topics such as: poverty, hunger, health and wellbeing, education, gender equality, clean water and sanitation, inequality, sustainability, climate action, among others.

The most hiatuses to accomplish SDGs are created by the fact that inequity is still a ghastly reality that needs to be changed throughout America. When analyzed globally, the number of poor at $1,90 a day has been reduced from 1840 in 1990 to 766 in 2013 (World Bank, 2017a), but when we compare it to America, especially Latin

America and the Caribbean, the number is slightly different, and so ambiguous that it is analyzed by income; specifically, by our GDP growth which is not exactly promising as a region. Not only there is a whole SDG dedicated to reduce inequity in countries, but it also is set to achieve reduction within and among countries. Therefore, policies should to be built around populations that are in disadvantage in countries, indifferently if that means economically or socially, in order to achieve this goal. Yet, globalization and consumerism have created different priorities in governments due to the influence of big companies; although the distribution of income or consumption by quintile (see figure 2) demonstrates that these marginalized populations are not benefited by these ideologies. Thus, this makes us question whereas our leaders are really considering going to great lengths to surpass this situation, or if they are analyzing what is economically best for the state or other sectors of population. It can almost be considered an impudence that nullifying inequity, or at least trying to ameliorate it, is not the main priority for governments whose population below the poverty line is increasing. Efforts have been made, the cannot be denied. Still, we need to reevaluate our strategies, and mitigate inequity for once and all.

Despite the fact that there are world leaders that believe climate change is a myth, we must realize its importance and the necessity of fighting it today in order to prevent the consequences of tomorrow.

America is a region worldwide known for its diversity and vivid natural environments; but, it seems that those amazing characteristics may be unheralded, given that governments are elusive about extreme temperatures, melting glaciers, oceans warming, droughts, among other processes that could imply a divergent reality from our current one. Latin America will be one of the regions that will be af-

medical students worldwide

Issue 2017 fected the most by climate change, as the World Bank (2017) has stated. Effects of climate change are already being seen across the region, such as the strident results of the decrease in rainfall and the unprecedented harsh El Niño phenomenon: droughts that have lasted for extremely extended periods of time (World Wild Life, 2017). In order to fulfill the SDGs and the Paris agreement, it is needed to urgently reduce carbon emissions, but data suggests that we are moving in the opposite direction, as we are increasing them in about 80%.

America has a great potential for renewable energy, yet not all governments are prioritizing its use (World Bank, 2017b). Countries abstaining from the G7 climate pledge only demonstrates how detrimental it can be for a whole region to exploit power, rather than concentrate it in an unbiased effort to achieve goals together. Climate change is happening, and policies need to take this into account. Not only it is it fundamental for our security as well as our planet’s, but also it is tantamount to our life quality and our future generations’.

Sustainable Development Goals were created in a collective manner, yearning a better future in a global vision. If we are hoping to achieve those goals, we need to repudiate the idea of solitude and succumb to a universal view and work. There are numerous opportunities for global engagement, that could be transcendental, such as the Partnerships for SDGs, stakeholders (for example, UNMGCY for all young leaders), platforms and other different ways of joining our efforts to create a more plausible approach to our objective. On July 2017, representatives worldwide will gather and discuss topics surrounding the Sustainable Development Goals with the

theme “Eradicating poverty and promoting prosperity in a changing world; an opportunity for the world to create unfettered health systems based on new strategies by eliminating the current parochial idea.

We must understand that, although progress in our region is important, all SDG indicators must be considered as a whole, and, in order for them to work, to set them as a common universal goal that we need to achieve as a collective effort.

Prevalent lack of accomplishment of SDGs or other universally set goals in America, can be explained by the unnerving lack of attention to fundamental topics that should be the main tenet for our leaders. Inequity, climate change and global engagement opportunities are some examples that can be highlighted as a region, and that need to be taken into account if we want to fulfill SDGs. Still, we cannot undermine the fact that governments are transitioning into this mindset and are gradually creating this change; but we need to demand more radical actions be made; along with data consideration to focus on main areas of interest. A sharper focus and bolstering current trends can help us improve our performance in our region, but it is up to general population to understand the importance of taking action to demand our leaders to accomplish these goals

REFERENCES UN Sustainable Development. (2017). Sustainable Development Goals: 17 goals to transform our world. United Nations. Retrieved online on June 10th, 2017 from http://www.un.org/sustainabledevelopment/sustainable-development-goals/ UNDP. (2017). A new sustainable development agenda. UNDP in Latin America and the Caribbean. Retrieved online on June 10th, 2017 from http://www.latinamerica.undp.org/content/rblac/en/home/post-2015.html World Bank. (2017 a). Poverty and Equity Data. Data. Retrieved on line on June 11th 2017 from http://povertydata.worldbank.org/poverty/home/ World Bank. (2017 b). It is time for Latin America to Adapt to Global Climate Change. TWB News. Retrieved on June 11th, 2017 from http://www.worldbank. org/en/news/feature/2016/07/18/america-latina-llego-hora-adaptarse-calentamiento-global World Wild Life. (2017). Climate Change Impacts in Latin America. Climático. Retrieved online on June 11th 2017 from https://www.worldwildlife.org/climatico/ climate-change-impacts-in-latin-america

7 www.ifmsa.org

Heartbeat: Sustainable Development Goals

SDGs and IFMSAin the Americas Region

Arturo Alonso Escobar IFMSA Mexico

As you know, recently there was the 1st Forum of the countries of Latin America and the Caribbean on Sustainable Development - 2017 in Mexico City, and the countries reaffirmed their collective commitment to the 2030 Agenda for Sustainable Development. As IFMSA’s Americas Region, we were proudly represented by our Regional Director Ivan Fabrizzio Canaval Diaz and some members of IFMSA Mexico.

If you’re not very acquainted with the 2030 Agenda and the Sustainable Development Goals (SDG), they were proposed by the United Nations as a complement of the Millennium Development Goals. There’s about 17 goals that will be the work patterns of the governments. In this point, you will ask how IFMSA is involved in this. And the answer is in “the 3rd Sustainable Development Goal: Good Health and Well-Being”, that’s because the most of our IFMSA Programs are based in the objectives of this SDG. This is the way we’re helping our world and our region.

The objective of the Goal 3 is to ensure healthy lives and promote well-being for all at all ages. The Goal addresses all major health priorities, including reproductive, maternal and child health; communicable, non-communicable and environmental diseases; universal health coverage; and access for all to safe, effective, quality and affordable medicines and vaccines. It also calls for more research and development, increased health financing, and strengthened capacity of all countries in health risk reduction and management.

8

The global indicator framework was developed by the Inter-Agency and Expert Group on SDG Indicators (IAEG-SDGs) and agreed to, as a practical starting point at the 47th session of the UN Statistical Commission held in March 2016. The indicators are:

- By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.

- By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 ives births.

- By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, waterborne diseases and other communicable diseases.

- By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.

- Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.

- By 2030, halve the number of global deaths and injuries from road traffic accidents.

- By 2030, ensure universal access to sexual reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs.

- Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

- By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination.

- Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate.

- Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and

medical students worldwide

Issue 2017

Public Health, with affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all.

- Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, specially in least developed countries and small island developing States.

- Strengthen the capacity of all countries, in particular developing countries, for early warming, risk reduction and management of national and global health risks.

just need to focus our activities to the principal problems of our region. Working on an IFMSA Programs is the best way that we can help our population; in addition, we’ll get more recognize and prestige to our region, our NMO even our local committee.

Just to remember, the IFMSA Programs are centralized streams of different activities done by IFMSA National Member Organizations (NMOs) and IFMSA internationally. IFMSA Programs address problems within specific field that we as medical students and global health advocates stand up for while connecting local, national and international activities and opportunities that contribute to the final outcome.

So, what more do you think we can do to improve us as IFMSA Region through the IFMSA Programs? We’re very interested about reading your answers :D

We’re growing up as IFMSA region, there’s no doubt, but if we implement more IFMSA Programs in our NMO, we can explote all our potential as change’s agents. You know, the real meaning of “Think global, Act local”.

Big hugs from Mexico! Sincerely,

So, what are our IFMSA Programs doing for the 2030 Agenda? We have already 18 IFMSA Programs that are trying to contribute to the 2030 Agenda.

1) Children health and rights (SCOPH/SCORP).

2) Communicable diseases (SCOPH).

3) Comprehensive sexuality education (SCORA).

4) Dignified and non-discriminatory health care (SCOPH/ SCORP).

5) Environment and health (SCORP).

6) Ethics and human rights in health (SCOME/SCORP).

7) Gender-based violence (SCORA/SCORP).

8) Health systems (SCOME).

9) Healthy lifestyles and non-communicable diseases (SCOPH).

10) HIV/AIDS and others STIs (SCORA).

11) Human resources for health (SCOME).

12) Maternal health and access to safe abortion (SCORA).

13) Medical education systems (SCOME).

14) Mental health (SCOPH/SCORP).

15) Organ, tissue and marrow donation (SCOPH).

16) Sexuality and gender identity (SCORA).

17) Teaching medical skills (SCOME).

18) Emergency, disaster risk and humanitarian actions (SCORP).

In this way, there are a lot of IFMSA Programs that we can implement in our NMO to contribute to the 2030 Agenda and be part of the change to get a better region for us. We

www.ifmsa.org

References: - Inauguration of the Forum of the countries of Latin America and the Caribbean on Sustainable Development in Mexico City.

Available in [Spanish]: http://www.onu.org.mx/se-inauguro-en-mexico-el-foro-de-los-paises-de-america-latina-y-el-caribe-sobre-el-desarrollo-sostenible/ - Summary of the chair of the Forum of the countries of Latin America and the Caribbean on Sustainable Development.

Available in: http://foroalc2030.cepal.org/2017/en - United Nations - Sustainable Development Goals: Goal 3.

Available in: http://sustainabledevelopment.un.org/sdg3 - IFMSA Programs. Available in: http://ifmsa.org/programs/ - IFMSA Programs Toolkit. Available in: http://ifmsa.org/wp-content/ uploads/2015/05/201605_Programs-Toolkit.pdf

9

Heartbeat: Sustainable Development Goals

Behind every number is a person Aline D. Khatchikian IFMSA External Representation and Policy Making Assistant IFMSA-Québec The World Health Organization (WHO) is a renowned worldwide organisation whose goal is to build a better, healthier future for people all over the world. Post 2015, the WHO has been focusing on achieving their 17 sustainable development goals (SDGs). These goals, centered on the good health and well-being of our population, have been making waves around the world. Infographics, posters, media campaigns and partnerships have been developed in order to promote the sustainable development goals to the public and to WHO Member States. However, I would like to share words, spoken by Dr. Margaret Chan in her closing address at this year’s Seventieth World Health Assembly (WHA), which will resonate with you more than any statistic. ‘‘Above all, remember the people. Behind every number is a person who defines our common humanity and deserves our compassion, especially when suffering or premature death can be prevented. ’’

10

IFMSA has been actively participating in the discussions surrounding the SDGs by notably participating at this year’s WHA from May 2231, 2017 in Geneva. The WHA is the world’s highest health policy setting body and is composed of health ministers from member state.

Every year, the IFMSA sends a large delegation of students studying in various health-related fields to be the voice of the youth. Youth empowerment and advocacy has been a developing field at the WHO. Every year, more and more Members States send youth delegates and are open to getting input from students in developing policies and advocacy strategies.

Members from all five IFMSA regions had the

chance to get first-hand experience in global health diplomacy at the WHA. Some activities included meeting with health ministries, speaking with WHO staff and connecting with other organisations will similar visions. This year’s delegation was composed of 45 students. IFMSA statements were drafted in small groups and read in plenary sessions. Policy briefs were also developed in order to advocate for our point of view on some of the agenda points.

The Americas’ region was represented by five delegates: myself (IFMSA-Québec), Charles Litwin (IFMSA-Québec), Larissa Padayachee (CFMS-Canada), Vivian Tam (CFMS-Canada), Alan Patlán (IFMSA-Mexico) and Mauro Camacho, SCORE-Director, (IFMSA-Brazil).

In order to prepare for this meeting, a preWHA was organized from May 18-21, 2017 at the Geneva Graduate Institute. Being the official youth pre-conference for the WHA, this event allowed delegates to better understand the WHA agenda points and get direct insight from the WHO and NGOs regarding their priorities at this year’s meeting. The preWHA was divided in four streams: Human Resources for Health, Adolescent Health, Migrant Health and Non-communicable diseases.

I had the honour to be the stream coordinator for the Human Resources for Health (HRH) stream. HRH brings forth the importance of building a strong workforce in order to meet the ultimate goal of Universal Health Coverage. By adequately training our health professionals, we will build better, more sustainable health systems that will be able to adapt to our ever changing health landscape. Working conjointly with the International Labor Organization (ILO) and the Organisation for Economic Co-operation and Development (OECD), the medical students worldwide

Issue 2017

Global Health Workforce Network (GHWN) is a the WHO branch that advocates for providing better working condition and workforce planning, emergency preparedness and response for global health security and inclusive growth, particularly for women and youth.

the UN headquarters allowed for rich experiences and access to WHO documentations.

Many experts were available to answer our questions and clearly outline the Sustainable Development Goals. This once The 2030 Agenda for Sustainable Development in a lifetime opportunity allowed is at the heart of the GHWN’s Workforce 2030 us to network with WHO staff and Action Plan: contributing to better health and Health Ministries. These contacts well-being (SDG 3), quality education (SDG will be used in the future in order to 4), gender equality (SDG 5) and decent work future IFMSA’s work, notably in the and inclusive economic growth (SDG 8). This Americas. was well detailed in the High-Level Commission on Health Employment and Economic Growth’s If you have any questions or would like to report co-chaired by H.E. Mr. François Hol- get more information about IFMSA’s preWHA lande, President of France, and H.E. Mr Jacob or the WHA, please don’t hesitate to e-mail me Zuma, President of South Africa. Following this at exrep.americas@ifmsa.org. report, a five-year action plan was adopted at the WHA providing concrete goals and set points for Member States.

Participating at the preWHA and WHA al- References: Who we are, What we do. http://www.who.int/about/en/ lowed our IFMSA members to develop their WHO. WHO. WHA70. http://www.who.int/mediacentre/events/2017/wha70/en/ advocacy, communications, leadership, poli- WHO. Address to the Seventieth World Health Assembly. http://www.who.int/ cy making and external representation skills. dg/speeches/2017/address-seventieth-assembly/en/ WHO. Working for Health. http://www.who.int/hrh/news/2017/workingMoreover, being in the hub of global health at 4health_fiveyearactionplan/en/

11 www.ifmsa.org

Heartbeat: Sustainable Development Goals

Capacity Building and Sustainable Development Goals: From International to Local Level

Fabrizzio Canaval & Rodrigo Sanchez IFMSA Peru

Today, The Sustainable Development Goals (SDGs) involve a decision of great historic significance, as we may possibly be the first generation to succeed in ending poverty and the last to have a chance of saving the planet. SDGs are intended to be implemented via their readjustment to the national and regional levels. In this last one, we’ve got our beautiful region: the Americas.

As it may already be of general knowledge, there are 17 SDGs. The last of them, “Strengthen the means of implementation and revitalize the global partnership for sustainable development”, implies the way by means of which we intend to accomplish them, involving multi-stakeholder partnerships, such as governments, the private sector and civil societies. Quite interestingly, among these last ones, there is the International Federation of Medical Students’ Associations, us. Thus, yes, we can undoubtedly be one of the youth entities with the most impact towards the fulfillment of this ambitious 2030 Agenda.

12

Straightaway, among the tools of our amazing Federation, there is Capacity Building. It does not solely support what we do, it basically is what we do. Within the elements that comprise this priceless component of our work, we find the trainings and trainers, which are also called the backbone of our federation, as it enables our members to carry out the different Standing Committees and related meetings in the best possible way, empowering them to be change agents from the local up to the international level

of action. These are workshops composed of a theoretical and - mainly - a practical component, which can be aimed at different development goals for members. Some training topics are the following: Advocacy, Communication Skills, Conflict Prevention, Debating Skills, Facilitation Skills, Financial Management, Fundraising, Handover and Continuity, Intercultural Learning, Leadership, Motivation Skills, Negotiation Skills, Project Management, Public Relations and Marketing and Time Management.

Now, how does the work involved within our backbone help in the achievement of the SDGs? Starting from our core philosophy within IFMSA, “think globally, act locally”, it is essential we consider two spheres of work: the local and the international one.

At the international level, the Federation currently works and advocates in different aspects related with the SDGs, mainly with the number 3 but also, with the others. To do this, we currently work based on our policy documents, which are spaces where the Federation express their positions in regards of an specific topic. IFMSA has been working hard to be taken into consideration as the representative body of medical students around the world, and as an important stakeholder in the decision making process in different levels, advocating for our believes and priorities, which represent over a 1.3 million medical students around the world.

The important part of the international admedical students worldwide

Issue 2017

vocating work of IFMSA is focusing on getting resources to build capacity, ensure our current tools to train members and get new ones for their implementation. In that sense, and following our vision and mission as a Federation, we are always looking to benefit our members, by increasing their knowledge and empowering them in important topics as the SDGs. With all this beeing said, we can conclude by saying that we can not move our Federation forward without our members, and our opportunity to express their priorities are based on their needs. To keep this feedback system (from the international level taking into consideration our member’s opinion and from the international level building capacity and providing new tools to them) we need to keep constant communication and make sure they apply those new capacity building tools with the members and their current campaigns. There we have the importance of the relation between our CB and Program’s system as well as the trainings/trainers and projects’ system.

In a local scope, we got mainly different work aiming at enhancing our members’ capabilities, as already mentioned, towards their successful participation in international projects in their community. For instance, we got some projects that require the involved members to be capacitated accordingly to achieve its objectives (most of them involved in the program system of IFMSA), which are truly related to SDGs 3 and also others as SDG 1, 2, 4, 5 and 16. These projects require medical students to get involved in the www.ifmsa.org

campaigning process (a combination of educating and advocating) to raise awareness of the complexity and seriousness of this issue among communities and even other civil societies. Local training at this level of action is vital for the success of our project

13

Heartbeat: Sustainable Development Goals

Issue 2017

Hello wonderful IFMSA members and SCORAngels!

It is my absolute pleasure to provide a quick description of SCORA in the hope that you will feel connected with our work. So, let’s get right to it...

SCORA was formed in 1992, driven by a strong will to take an active part in interventions concerning HIV and sexually transmitted infections (STIs), and to support people living with HIV/AIDS by decreasing stigma and discrimination.

It constitutes one of the six Standing Committees of the IFMSA. SCORA envisions a world where every individual is empowered to exercise their sexual and reproductive health rights equally, and free from stigma/discrimination.

We aim to provide our members with the tools necessary to advocate for sexual and reproductive health rights within their respective communities in a culturally respectful fashion in order to: - Raise awareness of topics relating to HIV/AIDS, as well as sexual and reproductive health - Decrease stigma and discrimination against people living with HIV/AIDS - Raise awareness and increase knowledge about facts, scientific research, global agreements and documents concerning sexual and reproductive health - Promote positive sexuality and healthy sexual expression - Advocate for positive and progressive policies concerning sexual and reproductive health - Collaborate and facilitate joint actions concerning medical education, public health and human rights - Provide tools for capacity building for future healthcare professionals in terms of sexual and reproductive health and rights Within the Americas I am both proud and humbled to say that our SCORAngels work diligently to uphold these values. Our NORAs, LORAs, and general SCORAngels are among the most creative, passionate, educated and determined advocates that I have worked with in any capacity. On behalf of these members, I would like to thank you for taking the time to learn about SCORA. We hope to be able to collaborate with you soon!

Jenna Jay Webber SCORA RA for the Americas

www.ifmsa.org

15

Heartbeat: Sustainable Development Goals

PrEP and Prejudice Igor Prado Generoso & Luca Fasciolo Maschilão DENEM-Brazil

The Brazilian Ministry of Health recently announced that oral Pre-Exposure Prophylaxis (PrEP) - a daily pill that prevents HIV infection - will be available in the public healthcare system for those who are at high risk for HIV infection. Different opinions from the general public and health professionals were expressed in reaction to this announcement. Evidence from public discourse and scientific studies suggests that many of these criticisms are directly tied to prejudice towards key populations, most at risk for HIV - men who have sex with men (MSM), transgender people and serodiscordant partners. Brazil’s efforts to increase PrEP access in the public healthcare system have stirred a worldwide trending debate.

Concerns have been raised in the scientific communities of many countries about PrEP effectiveness, safety and risk compensation. Studies found that PrEP is an efficient, effective, and important strategy to prevent HIV, given the low adherence to other prophylactic strategies (like condom use) and lack of other effective interventions to address the increasing HIV prevalence among vulnerable populations. No sexual risk compensation was found among participants believing that they were taking PrEP in clinical trials conducted in the USA (MSM), Botswana (heterossexual men and women), Ghana (women) and Brazil (MSM and transgender women).

16

Stigma plays a role in the court of public opinion; a study conducted in the USA showed lower community support for PrEP offered to gay men in general, and black gay men specifically, when compared to the general population. “The government is paying for their promiscuity!” - Brazilian Facebook user comments like this are common. Negative reactions on social media were sex negative and rooted in moralism and abstinence-based culture, while also reflecting a deep prejudice towards the key populations. These reactions persist despite messages from

the World Health Organization stating that all HIV prevention efforts should address the needs of key populations at risk for HIV in order to prevent new infections.

Healthcare provider reliance on condom use as the only HIV prevention strategy is no longer sufficient.

Consistent condom use among sexually active MSM is very low in Brazil, and in USA, the numbers are even lower with only 16% reporting a consistent use. Additionally, when providers refuse to offer PrEP based on moralistic assumptions that individuals will increase their risk for HIV, the patient’s autonomy is overlooked. The desirable approach, as delineated in patient-centered care models, is to encourage combined prevention approaches where patients receive health education on their risks for HIV and receive support for their choices.

New HIV prophylactic strategies raise important discussions. The implementation of frequent HIV testing in the late 90’s in Brazil, for example, came with concerns, such as risk perception decline and needless public health expenses, but it is now a consolidated part of combined prevention strategies.

PrEP has raised similar concerns. It is up to us, as future health professionals, researchers and policymakers, to be guided by scientific evidence and patient-centered models to end the HIV epidemic, while approaching care and prevention free of prejudice References: 1.

Ministério da Saúde. Protocolo Clínico e Diretrizes Terapêuticas para Profilaxia Pré-Exposição (PrEP) de Risco à Infecção pelo HIV. http://www.aids.gov.br/sites/default/ files/anexos/publicacao/2017/59562/pcdt_prep_2017_versao_preliminar_pdf_13732.pdf (accessed 06/06/2017).

2.

Liu AY, Vittinghoff E, Chillag K, Mayer K, Thompson M, Grohskopf L, et al. Sexual risk behavior among HIV-uninfected men who have sex with men (MSM) participating in a tenofovir pre-exposure prophylaxis (PrEP) randomized trial in the United States. J Acquir Immune Defic Syndr 2013; 64(1): 87-94.

3.

Thigpen MC, Kebaabetswe PM, Paxton LA, Smith DK, Rose CE, Segolodi TM, et al. Antiretroviral Preexposure Prophylaxis for Heterosexual HIV Transmission in Botswana. N Engl J Med. 2013; 367(5): 423-434.

4.

Guest G, Shattuck D, Johnson L, Akumatey B, Clarke EE, Chen PL, MacQueen KM. Changes in sexual risk behavior among participants in a PrEP HIV prevention trial. Sex Transm Dis 2008; 35(12): 1002-1008.

5.

Marcus JL, Glidden DV, Mayer KH, Liu AY, Buchbinder SP, Amico KR, et al. No Evidence of Sexual Risk Compensation in the iPrEx Trial of Daily Oral HIV Preexposure Prophylaxis. PLoS One 2013; 8(12): .

6.

Calabrese SK, Underhill K, Earnshaw VA, Hansen NB, Kershaw TS, Magnus M, et al. Framing HIV Pre-Exposure Prophylaxis (PrEP) for the General Public: How Inclusive Messaging May Prevent Prejudice from Diminishing Public Support. AIDS Behav 2016; 20(7):

medical students worldwide

Issue 2017

Syphilis: from obscurity to the current Brazilian epidemic Bruno Mattei Lopes, Gustavo Figueiredo da Silva & Vinicius Moser.

IFMSA Brazil There are still doubts about the real origin of syphilis. Some researchers argue that the disease was endemic in America and spread after the arrival of Christopher Columbus. However, others affirm that the disease arose in Europe itself¹. However, the most plausible hypothesis is that of America, since the earliest evidence of venereal syphilis is 5000 years ago and is found on this continent².

The first reports of the disease were done by Marcellus Cumano and Alexandri Benedetto, Venetian doctors. With emphasis on the portrait done by Benedetto, who affirmed that it was a more shocking illness than leprosy and elephantiasis³. Furthermore, the sickness was seen as obscurely by the society of the era, being described as an evil that punished its sufferers for the sins of the flesh⁴.

In Brazil, syphilis spread in the late nineteenth and early twentieth centuries, mainly in coastal regions and large urban centers due to increased sexual activity without proper care⁵.

Currently, in the country, the detection of the disease increased considerably in a short period, by the fact of the beginning of the syphilis tests in pregnant women. There were also improvements in the time of diagnosis. Such situation, in 2007, only 21.3% of the cases were diagnosed in the first trimester of pregnancy. While in 2016, 34.2% were detected in this same period⁶.

only five years later, the number was 65,878, that is, an increase of more than 5,000%.

However, there are more diagnoses also, because of the epidemic of syphilis actually in Brazil. This stems from the fact that lack sexual protection and information about the topic. However, the lack of Penicillin Benzathine (the main drug indicated for the treatment of syphilis) isn’t a solution of the old cases, causing an accumulation of syphilis cases in the population⁶.

References: 1. Geraldes Neto B, Aurora S.G. Soler Z, Marcolino Braile D, Daher W. Syphilis in the 16th century: the impact of a new disease. Arquivos de Ciências da Saúde. 2009;16(3):127, 128 e 129.

2. de Melo F, de Mello J, Fraga A, Nunes K, Eggers S. Syphilis at the Crossroad of Phylogenetics and Paleopathology. PLoS Neglected Tropical Diseases. 2010;4(1):e575 3. Avelleira J, Bottino G. Syphilis: diagnosis, treatment and control. 2017.

4. CARRARA, S. Tributo a vênus: a luta contra a sífilis no Brasil, da passagem do século aos anos 40 [online]. Rio de Janeiro: Editora FIOCRUZ, 1996.

5. Carrara, S. A GEOPOLÍTICA SIMBÓLICA DA SÍFILIS: UM ENSAIO DE ANTROPOLOGIA HISTÓRICA. História, Ciências, Saúde—Manguinhos, v. 3, p. 391-408, 1997.

6. BRASIL. Gerson Fernando Mendes Pereira. Ministério da Saúde (Org.). Boletim Epidemiológico - Sífilis. Brasília: Ms, 2015. 28 p. Disponível em: <http://www.aids.gov.br/sites/ default/files/anexos/publicacao/2015/57978/_p_boletim_sifilis_2015_fechado_pdf_p__18327.pdf>. Acesso em: 04 jun. 2017.

7. Ministério da Saúde, Secretaria de Vigilância em Saúde and Departamento de DST, Aids e Hepatites Virais. Boletim epidemiológico. Brasília; 2016.

8. BARROS, João de Deus Vieira. Imaginário da Brasilidade em Gilberto Freyre. São Luis: Edufma, 2009. Disponível em: <https://books.google.com.br/books?id=UFVSCQpdExoC&pg=PA94&dq=sífilis+e+cultura+brasileira&hl=pt-BR&sa=X&ved=0ahUKEwiriaP926TUAhXELyYKHRnQAKwQ6AEIJzAA#v=onepage&q&f;=false>. Acesso em: 04 jun. 2017.

9. GENTIS PANEL (Brasil) (Ed.). Uso de preservativos e comportamento de risco. São Paulo: Marketing, 2012. Color. Disponível em: <http://www.gentispanel.com.br/Content/pesquisas-de-mercado/abertas/GENTIS-PANEL-Uso-de-preservativos-e-comportamento-de-risco. pdf>. Acesso em: 040 jun. 2017.

In addition, data from the Ministry of Health of Brazil revealed that in 2010, 1,249 cases of acquired syphilis were reported, which is contracted through intercourse without preservative. Already, in 2015,

www.ifmsa.org

As already ratified, this epidemic is a result of state default and the Brazilian culture itself about intercourse. In this culture, as Gilberto Freyre reported, syphilis marks were seen as a sign of power, characterizing a disease of the “Casa Grande” (The Masters), due to the early promiscuity of the owners of the land⁸. In addition, another factor that proves the disinformation is not a predominant cause of lack of care is the fact that 52% of Brazilians never or rarely use condoms⁹, although more than 95% of the population knows that condoms are the most efficient way of not contract STDs¹⁰. In this case, there is a culture of non-use of condoms, which are associated with loss of pleasure during the sexual act¹¹.

Therefore, measures, such as insertion of the subject in schools, with an illustration of the real consequences of syphilis, are necessary in order to demonstrate that the supposed lower pleasure of the relationship without preservative propitiates is not superior to the sequels of syphilis in the organism.

17

Heartbeat: Sustainable Development Goals

For a free world: no room for hate!

Alisson Alves Silva, Barbara da Camara Santos Marinho, Hugo Daniel de Medeiros.

IFMSA-Brazil The lack of discussion about health care provided for LGBT community at the academic environment and curriculum gives a strong case for new approaches of study to evaluate this scenario (1, 2). For that reason, the SCORA members and local coordinators of IFMvSA Brazil developed the project “For a free world: no room for hate!”, aiming to cause reflection on LGBTphobia in today’s society and mainly within the university. The coordinators of the project invited students of health care courses in general to attend a small social experiment regarding LGBTphobia without revealing the thematic at first place, and also to answer a survey approaching the subject within the academic environment.

The project was executed by the coordinators, responsible for placing students showing interest in being part of the experiment individually in small rooms provided by the university’s library. These rooms contained the audio-visual material, the online survey and the informed consent for participation and publication of data. The video covers the story of Dandara, a transvestite brutally murdered in 2017 in Brazil, which had this act filmed and shared in social media, reaching national commotion. Today, Dandara is recognized as a martyr of the fight for transvestites and transsexuals against LGBTphobia (3, 4). The video also demonstrates a social experiment in which a transvestite was humiliated by an aggressor in public space and the reaction of people.

18

The project reached 25 students among the courses of medicine, biomedicine, nursing, physical education, physiotherapy, veterinary medicine, speech therapy and dentistry. The questions included in the online survey were: “What feeling the video subject causes in you?” 52% answered anger, 28% distress, for others, empathy or embarrassment; “On a scale of 0 to 10, in which 0 is insignificant and 10 is totally relevant, how important is the discussion of

this subject at the university?” 19 people found it totally relevant, 3 people rated 9, 2 people rated 8, and one participant rated grade 7; “Have you ever assisted LGBT patients in a clinical environment?”

22 participants answered no, while only 3 responded positively; “Has the LGBT thematic ever been addressed in the classroom?” Only 3 answered yes; “Do you consider yourself able to assist a LGBT patient?” 19 people consider themselves fully capable of performing this care, 5 partially, and one inadequate; “Have you ever witnessed prejudice against LGBT people inside the university?” 12 never witnessed, 6 rarely, 5 eventually, and 2 claimed to witness on a daily basis.

The action was concluded with a roundtable counting with the participation of a sexologist, a nurse and a trans activist discussing the role of transgender in society, and more 48 students attending the event. Finally, the project sought to create impact on the students participating of the small room experiment and those who attended the roundtable, highlighting through the survey the relevance of the discussion about LGBTphobia perceived by the students themselves. This project also demonstrates the lack of contact of these students with LGBT patients in both clinical practice and academic curriculum.

References: 1.

Alencar Albuquerque G., de Lima Garcia C., da Silva Quirino G., et al (2016); “Access to health services by lesbian, gay, bisexual, and transgender persons: systematic literature review”. BMC International Health and Human Rights. 2016;16:2. doi:10.1186/s12914015-0072-9; 2.

Melo L., Perilo M., Braz C.A., Pedrosa C. (2011) “Health policies for lesbians, gays, bisexuals, transsexuals and transvestites in Brazil: the pursuit of universality, integrality and equity”. Sexualidad Salud y Sociedad, 9:7–28; 3.

Secretaria Especial de Direitos Humanos do Ministério das Mulheres, da Igualdade Racial e dos Direitos Humanos (2013). Relatório de Violência Homofóbica no Brasil; 4.

Long, B. (2017) “Rather Dead Than Gay: Complicating Rights-Based Activism as a Final Step for LGBTT+ Brazilians”. University of Colorado Boulder, Undergraduate Honors Theses, 1387.

medical students worldwide

Issue 2017

WHAT IF I TOLD YOU?

A CANDLELIGHT MEMORIAL DAY REPORT

Jéssica Camila Fizinus Brendon de Almeida Nunes Lucas dos Santos de Souza IFMSA-Brazil Sexually transmitted infections (STI) are disseminated among individuals by various body fluids¹. One of the most frequently reported infections is human immunodeficiency virus (HIV), which can result in Acquired Immunodeficiency Syndrome (AIDS)².

The infection occurs with the involvement of the immune system, making the carriers susceptible to other infections³. Nowadays, having the syndrome is no longer synonym of eminent death, because of its treatment the viral load can be reduced to “undetectable”4. The Campaign honors the victims who died as a result of the syndrome, in addition to making the population aware of transmission, and breaking existing taboos.

approached, mostly young, university students, who passed by the place of honor.

Methodologically, the campaign structured itself by the capacitation of students, which was accomplished by one of the event’s coordinator and by an HIV-positive patient, who reported all of his personal experience with the disease and its stigma.

The action provided a unique experience, the academicians promoted humanitarian and ethical ideals, making them able to make public and safe statements on the subject. By analyzing the reactions of the population, it is notes that the knowledge provided did not have as much impact on their reactions as expected, since the same percentages of positive, neutral and negative reactions were observed in both GROUP 1 and 2. In addition, most of the reactions were neutral, showing a certain indifference of people to a possible HIV/ AIDS person. It’s concluded that campaigns should emphasize, not only theoretically, but also the psychosocial side of the disease, because despite the knowledge about the disease, the stigma of it is still very deep-rooted in society.

The interventions took place at “Praça do Conhecimento”, at Unicesumar, and at Academic’s Restaurant of UEM. The participants were divided in two groups to approach passers-by. GROUP 1 made a short introduction about the campaign, asked “what if I told you I’m HIV positive?”, took note about the person’s reaction and cleared some doubts the individuals had, awaring and informing. GROUP 2 presented the campaign, cleared doubts, undid mistaken judgements, reinforced some basic information about transmission and prevention of HIV and, after all of this, asked the person “what if I told you I’m HIV positive?”, taking notes about the person’s reaction. The objective of the division in these two main groups was to evaluate if the reaction of the people would change according to their level of information.

Candlelight had a total of 28 students (18 in UniCesumar and 10 in UEM), and during the two days of interventions approximately 181 people were

www.ifmsa.org

The reactions on the forms were separated into: positive (“demonstrated empathy” and “interested”), neutral (“normal” and “accepted to talk only”) and negative (“turned away”, “showed prejudice” or “scared”). Using the GROUP 1 method 75 individuals were approached, with 22.6% of the reactions being positive, 61.3% neutral, and 16% negative. Likewise, by the approach of GROUP 2, 106 people were interviewed, with 22.6% of them sketching positive reactions, 61.3% being neutral, and 16% having negative reactions.

References: 1.

ABIA esclarece dúvidas sobre a transmissão do HIV. [Associação Brasileira Interdisciplinar de AIDS]. (2016, Apr). Available from: http://abiaids.org.br 2.

A Prescripção: HIV/AIDS, prevenção, tratamento, cuidado. Promovendo a Utilização Racional de Medicamentos e a Administração Correta de Casos nos Serviços Básicos de Saúde [serial online] 1998 Sept. [24 screens]. Available from: URL: https://www.unicef. org/prescriber/port_p16.pdf 3.

Bellini, M.; Frasson, P. C. Science and its teaching: what scientists and textbooks say on HIV/AIDS? Ciência & Educação, v. 12, n. 3, p. 261-274, (2006/Sept-Dec) 4.

D. M. A. Pereira; M. G. A. C. Silva; D. C. Oliveira. QUALITY OF LIFE OF INDIVIDUALS WITH HIV: A LITERATURE REVIEW. (2014, Apr)

19

Heartbeat: Sustainable Development Goals

Issue 2017

My dear Green llamas, I`m so pleased to have the chance to see how much has SCORP America has grown for the last years, and I want to say that all of this is because of you, SCORPions who are there working hardly for human rights, speaking out loud, making activities, working with different people, to see the change we are all waitning for, and let me tell you…. It is starting to be seen, so thanks to you, thanks to IFMSA, thanks to SCORPions we are starting to win this fight!

I just would want to remind you why are Human Rights Useful for a Doctor?

In a world such as medicine where we see every day how many rights are violated and how many times have we done nothing about it, we are used to seeing it as an everyday thing, when people are racially or socially discriminated, when access to health is denied because people do not have the right documentation, the right to education, to freedom.

Here I can tell you about some human rights that can be applied in particular to the medical life: Article 2 - the right to life; Article 3 - the right not to be subjected to degrading treatment; Article 5 -. The right to freedom (where a person can legally be deprived of liberty in order to prevent the spread of infectious diseases or have “mental disability”) Article 8 - the right to respect for the privacy of an individual.

I believe that being a doctor is not just knowing all the diseases and the way cure them, I think it is much more than just that, we have to learn how to treat people, kindly and gently, we need to be able to give that confidence that all the patients need to feel safe, since us is the confidence they give to. I believe that, in addition to all the knowledge we need to have, the human part is the one that we should master, to help people to walk through their illness.

And we, through SCORP and IFMSA have the key to that, the missing piece in the puzzle of life. It is your job to finish this work that many of students has already started, through everyday work, everyday thoughts. Be the difference you want to see in the world, and I`m more tan sure you can do that and more!

Pamela Delgado B. SCORP RA for the Americas

www.ifmsa.org

21

Heartbeat: Sustainable Development Goals

Haiti without Borders

- Health and care to all

Eduarda Victória Souza Matos, Lorraine Vieira Cruz, Letícia Carvalho Resende Pedro IFMSA Brazil Although Haiti was a pioneer nation in the abolition of slavery and in its independence, it is remembered worldwide because of its social ills and poverty. This situation worsened significantly due to the earthquake of intense magnitude that afflicted the country in January 2010, which caused 200,000 deaths and displacement of more than 1.6 million people due to the loss of their homes. Ten months later, the population was still plagued by an epidemic of cholera (1).

proached life habits, personal antecedents, comorbidities and evaluation of the health profile. Together, data such as blood glucose, blood pressure and BMI were collected. The population also had rapid tests for syphilis, hepatitis and AIDS, as well as oral health care (cleaning and application of fluoride).

For the pregnant women in the community, ultrasonography was performed. At the end of the visits, the entire population received guidelines on blood donation and healthy lifestyle habits.

The Haitians, in order to escape the catastrophic situations of their country, went to the countries of South America. Among the destination countries is Brazil (2).

The campaign was an enriching experience for the community, since in addition to health care, the population was oriented about the functioning of the Unified Health System (Brazil’s health system).

It is also a pioneering campaign for the assistance of this population, in which many experienced for the first time the opportunity to perform rapid tests.

Satisfaction and enthusiasm of those served were perceived.

In Aparecida de Goiânia, Goiás, there is a colony of about 400 Haitians. With the ease of finding work and due to the expansion of communities in the country, more immigrants arrive every day in the city, an average of four to five, according to the Secretariat of Labor, Employment and Income of Aparecida de Goiânia Having become aware of this reality, SCORP coordinators from the Pontifical Catholic University of Goiás (PUC-GO) visited the Haitian community and realized the precarious health care of that population. At that point, the dream was born of making the “Haiti without Borders” campaign a reality. The campaign would be a great opportunity to provide assistance to others in times of need and vulnerability, assisting immigrants not only in health, but also in the social perspective.

22

The campaign was held on December 4, 2016, in a Basic Health Unit localized in Aparecida de Goiânia. To organize the service, the scholars were zdivided into eight commissions, each with a coordinator in charge of ensuring the operation of the action. Approximately 200 calls were performed.

The community underwent a triage, which ap-

For the academics, it was a unique opportunity to recognize the vulnerability of others and to be able to assist them in an integral way, an experience that has contributed to the humanization of medical education and that goes beyond the curricular matrix and routine of the students. It can be seen that the campaign “Haiti without Borders” made possible not only an action of health promotion, but a cultural experience for both involved.

References: 1.

Data avaliable by Human Rights Watch. World Report 2011: Haiti. New York, 2011. 4p. Avaliable in: <http://www.hrw.org/world-report-2011/haiti>.

2.

Deatlhes veiculados pelo Servicio Jesuita a Refugiados (SJR): Los flujos haitianos hacia América Latina: Situación actual y propuestas. May 2011, p. 2. Avaliable in: <http:// www.entreculturas.org/files/documentos/estudios_e_informes/Flujos%20haitianos%20haciaAL.pdf>.

medical students worldwide

Issue 2017

Campaign on Violence against Women: An Experience Report

Giovanna Soares Nutels IFMSA Brazil

The World Health Organization (WHO) defines violence as the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation. Recognized as an important global public health issue, violence when committed against women generally occurs in the private sphere of life and has as its main aggressor an intimate partner. Considered as the discrimination that affects women’s life quality more seriously, this kind of violence generates sufferings, coercions and deprivation of the right to liberty, consisting of a violation of human rights.

Although the statistics of gender-based violence are little known due to underreporting, it is estimated that it affects about 12 million people each year in the world.

Therefore, health units are convenient spaces for detection and reception of cases of violence, since those are places women go frequently. Those units establish a close relation with the community, with health professionals being able to pay attention to health issues commonly associated to violence against women.

In the face of the oppressive reality lived by women worldwide, it was noticed by the Unimar Committee from IFMSA Brazil the need to act locally to make visible data and several violent situations.

Thus, Unimar Committee conducted the 12 segundos (“12 seconds”) campaign aiming at sensitizing, informing and proposing a critical reflection on violence committed against women. Through the distribution of hugs to people walking across the campus of Marília University (Unimar), in Marília, SP, in Brazil, it was intended to promote an affection chain toward a harmonious society.

www.ifmsa.org

On May 17th, 2016, 14 members of the campaign spread across the campus of the university carrying posters with actual data or fictitious though highly frequent in society reports. Hugs were given, ensuring the reception of students passing by, especially women. Walking through campus, participants talked about violence against women with the target audience.

Besides the local action, a Facebook page was created aiming at expanding the public affected by the campaign. The majority of the students was sensitized by the campaign and seemed surprised by data on the posters. However, some students were resistant and disturbed. Some mocked the campaign and the participants through tricks and whistles and only accepted girls’ hugs so they could touch them.

Others acted indifferently and proceeded with their regular activities.

We concluded that the campaign had a positive impact on the local community. The repercussion of the activity was excellent among participants, contributing, undoubtedly, to the humanistic formation of these students and also to the perception of the dimension of this problem and its social importance to public health. Therefore, having Medical students in campaigns addressing subjects like this one is very relevant as it represents a physic and psychological health issue for women and is also capable of better integrating future professionals with people to, consequently, do a more effective job identifying cases of violence and receiving women.

References: BARSTED, Leila Linhares; PITANGUY, Jacqueline. O progresso das Mulheres no Brasil 20032010. Rio de Janeiro: CEPIA/Brasília: ONU Mulheres, 2011.

Leite Franciele Marabotti Costa, Amorim Maria Helena Costa, Wehrmeister Fernando C, Gigante Denise Petrucci. Violence against women, Espírito Santo, Brazil. Rev. Saúde Pública [Internet]. 2017 [cited 2017 June 16] ; 51: 33.

Pinto Lucielma Salmito Soares, Oliveira Ingrid Mayra Pereira de, Pinto Eduardo Salmito Soares, Leite Camila Botelho Campelo, Melo Auricélia do Nascimento, Deus Maria Castelo Branco Rocha de. Políticas públicas de proteção à mulher: avaliação do atendimento em saúde de vítimas de violência sexual. Ciênc. saúde coletiva [Internet]. 2017 May [cited 2017 June 16] ; 22( 5 ): 1501-1508.

23

Heartbeat: Sustainable Development Goals

Rousseou Project

- Aging Healthy

Letícia Carvalho Resende Pedro, Sarah Cristina Garcia Gomes IFMSA Brazil At the beginning of the 20th century, average life expectancy in Brazil was only 33.5 years.

According to the Brazilian Institute of Geography and Statistics (IBGE), it reached more than 73 years in 2009 (1). Aging is associated with the chronicity and progressive occurrence of several diseases, which represents a great challenge. Chronic diseases, presenting more frequently in the elderly, can have a lot of relation with change of habits (2).

Based on the Elderly Statute and thinking about health until the end of life, the Rousseau Project were created by the SCORP coordinators in PUCGO. The phrase of the philosopher who says that “in youth, it is necessary to accumulate knowledge and, in old age, make use of it” inspired the name of the project. The action was held in an asylum, the House of the Elderly, in the Northwest region of Goiânia. The objective of the project was to integrate the biopsychosocial aspects of each elderly and try to change bad habits On the first Saturday (10/29/16) of the project, there was an awareness about hypertension and diabetes, diseases that are very prevalent in the elderly population (3). The SCORP coordinators explained the definitions of each disease, the practical way of preventing and how to treat, focusing mainly on healthy living habits. In addition, the story wheel was also held, where each elderly person shared facts of his life with the students, with an exchange of experiences and perceptions.

24

On the second Saturday (05/11/16) of the project, an awareness about osteoporosis was made, in a practical and didactic way, with images to make the explanation palpable. After that, the Story Wheel had its second part. In this way, the therapeutic action of the conversations and the demonstration of interest on the part of the students was perceptible.

On the third and penultimate Saturday (11/12/16), the theme was cardiovascular health. A fruit salad

with oats was offered and the goal was to show, in practice, healthy foods important for heart health.

When delivering food, each student explained which foods were important to health and why. On that day, there was also the Talent Show, in which the elders presented some of their skills.

On the fourth and last Saturday (11/19/16), memory-related dynamics were performed. The cumulative memory game was made, in which each participant needs to speak one word and all previous spoken words. The “Tote Bag of Objects” dynamics was also carried out, in which ten objects were exposed on the table and then stored in the bag, and the elderly, assisted by the students, aim to remember as many objects as possible.

In addition, the project covered the entire biopsychosocial aspect of the elderly present and achieved the objective of making each one of them rethink their way of taking care of health and motivated to change bad habits. It was a lifetime experience for everyone who made part of it, learning about life, specially about what really matters at the end, and teaching about health.

References:

Enquanto E. Aging of the Brazilian population and challenges for the health sector. 2012;28(2):208–9.

2.

Muniz EA, Aliny C, Lima S, Ribeiro m. home care for the elderly in the family health strategy: perspectives on the care organization. 2017;11:296–302.

3.

Picon, RV, Fuchs FD, Moreira LB, Fuchs SC. Prevalence of hypertension among elderly persons in urban Brazil: a systematic review with meta-analysis. Am J Hypertens. 2013; 26 (4): 541-8.

medical students worldwide

Issue 2017

STOP VIOLENCE AGAINST WOMEN! Ana Vitória Suet Moraes Volpini Figueiredo, Lara Karoline Camilo Clementino, Letícia Carvalho Resende Pedrov IFMSA Brazil Violence against women is present in different forms and has different expressions, from emotional violence, with contempt and diminution of the feminine sex, to feminicide. Over the years, the murder of women in the country has increased exorbitantly, with a percentage increase of 111% from 1980 to 2013. In Goiânia, a city located in the Brazilian central plateau, the homicide rate is high, with 9.5/100,000 women murdered in 2013, the fifth worst capital to be a Brazilian woman (1). In face of it, SCORP coordinators academics from the Pontifical University of Goiás (PUC-GO), knowing the reality of the city of Goiânia and, even more, the lack of knowledge about violence against women in university curricula (2), planned the SOS Women Campaign, in celebration of Women’s Day (March 8).

Initially, the academics went to the City Hall of Goiânia and reported the idea of the campaign and the goal to the councilwoman Cristina Lopes, who is a human rights activist. She embraced the campaign and supported the role organization from the beginning to the end. In addition, the coordinators obtained support from the Popular Women’s Center of the state of Goiás, which is the oldest feminist group in Brazil and fights for gender equality and an end to violence against women.

care and shelter of victims of domestic violence occur in Brazil, especially in the state of Goiás. Medical students and components of the family health team, such as Community Health Agents, nurses and the unit diretor participated, in a total of 35 people.

Lastly, the realization of the campaign made it possible to recognize the psychosocial context that violence against women promotes and that, in fact, it happens in Brazil, but the main obstacle to its control is its invisibility. In this context, the training and the lecture given by Dr. Cristina showed that the lack of reporting, triggered by some kind of dependence on the aggressor, and the lack of notification by health professionals, in particular doctors, inviabilize the real knowledge of this problem and its transformation into statistical data for further development of strategies aimed at its improvement.

Therefore, it is well known that this problem should be more discussed, more exposed, in order to encourage women who are being beaten to report and to train professionals to fill out the notification.

The campaign took place at UESF Vila Mutirão, a basic unit of health, on March 17, and was attended by the councilwoman Cristina. Campaign participants were gathered in the Unit auditorium to listen Cristina. She spoke about how she became a militant in the fight for human rights and acts in the care of burn victims. It happened because she was a victim of a nationally known abusive relationship, in which she had 85 percent of her body burned by her ex-boyfriend.

After Cristina, the representative of the Popular Women’s Central, Ângela Café, explained how the

www.ifmsa.org

References: 1. THE VIOLENCE, Map. Homicide of Women in Brazil. 2015.

2. SILVA, Patrick Leonardo Nogueira da et al. Educational practices on violence against women in university education. Rev. bioét. (Impr.), V. 24, n. 2, p. 276-285, 2016

25

Heartbeat: Sustainable Development Goals

For a free world: no room for hate!

Jose Andrés Pohl Sánchez, Lourdes Fabiola Solano Tongo Luz Elena Bances Dávalos, IFMSA-Perú September 13th marks the tenth anniversary of the adoption of the United Nations Declaration on the Rights of Indigenous Peoples, an act of great importance for the great cultural diversity that these villages bring to the world. They inhabit the 20% of the world’s territory, only in Latin America there are 670 indigenous villages, and it is estimated that there are approximately 5000 different cultures totally.

Indigenous populations are communities that live within, or are attached to, geographically distinct traditional habitats or ancestral territories, and who identify themselves as being part of a distinct cultural group, descended from groups present in the area before modern states were created and current borders defined. Why is it important? They have a close relationship with their lands; have the great mission to preserve their resources and to pass from generation to generation their customs, language and religion. Unfortunately, despite the declaration of their rights, many of them are still marginalized and discriminated against, which means they represent one third of the population with extreme poverty. There is still a long way to go to ensure that our indigenous peoples can enjoy their rights.

26

Indirights is an IFMSA-Perú project carried out annually during the month of August. Its mission of bringing information and, at the same time, fostering a feeling of multiculturalism and love for its roots in the population makes it one of the most inspiring projects in which we have participated. Working with children, youth and adults alike; giving them the knowledge in such a way that it was more feasible for them to capture it. Whether through a scenic representation, an informative talk or a game of questions, the objective of expanding the knowledge about these 55 indigenous communities is fulfilled; and, in the medium term, raise awareness about their situation, and be able to take it to the

corresponding nongovernmental and governmental entities.

To successfully achieve these goals, coaching participants is necessary, teaching them about the development of an understanding of and appreciation for one´s own culture and that of others to be able to recognize the differences and similarities. For these reason, using our capacity building resources, the “Intercultural Learning” training was implemented, with the objective of sensitize and improve the involved students’ communication skills in a way that they can understand the important role that indigenous populations have in the development of our multicultural region; promoting the preservation of their assets and the indigenous rights, through dynamics and examples in which they can enhance the appreciation of the culture, respect their rights and be motivated to fighting against existing discrimination and recognition of the identity of these peoples. In other words, we need to encourage people to protect the identity, integrity and the development of indigenous populations.

We are pleased to have been able to be managers of change, hoping to encourage more projects of this type in other countries and thus, remain the voice of this vulnerable group.

References: 1. WHO | Indigenous populations [Internet]. WHO. [cited 18 june 2017]. Available from: http://www.who.int/topics/health_services_indigenous/en/ 2. Base de Datos de Pueblos Indígenas u Originarios [Internet]. Ministerio de Cultura del Perú. [cited 18 june 2017]. Available from: http://bdpi.cultura.gob.pe/ 3. Derechos de los Pueblos Indígenas en el Perú. Material de Capacitación N°2 [Internet].

Ministerio de Cultura del Perú. [cited 18 june 2017]. Available from: http://centroderecursos. cultura.pe/sites/default/files/rb/pdf/DerechosdelospueblosindigenasenelPeruMaterialesdecapacitacion2.pdf

medical students worldwide

Heartbeat: Sustainable Development Goals

Dear SCOMEdians, It is not a secret that in the past decades, medical students have become a key element in the medical education and have taken an active role in the decision making processes. Of course, the context of each society changes the influence power of the medical students. In the Americas, with such a rich diversity of medical education systems and health systems, students in SCOME have found several ways to make their voice listened.

In my experience, when you ask a medical student to define what is medical education, they struggle to find a description that covers all the aspects involved. It becomes a problem, because most students stay apart of the decisions made on their medical formation, or have little participation to make changes. But, if you analyze who could give the best feedback to medical faculties, is obvious to think that medical students are the best ones to do so.

If I am a medical student who wants to actively participate and make positive changes in the medical system, how can I do it? In fact, there is not just one correct answer, as there are a lot of approaches. However, SCOME have found several. One approach is to create leaders and trainers specialized on Medical Education, through TMETs (Training Medical Education Trainers). This is an international capacity building event that is meant to give tools and a space for medical students to acquire and develop skills on advanced advocacy/lobbying, empowerment, educational strategies, curriculum development/design, among others.

Other approaches to promote the educational and health advocacy, is to make local, national or even international activities, projects or campaigns. These is a method, which SCOME in the Americas have some experience, where most active NMOs make several initiatives to tackle a specific issue in their own unique context. But something that has amaze me in the past years, is to see how effective is to work between SCOMEdians from different countries, to achieve common goals. It doesnâ&#x20AC;&#x2122;t matter if it is a worldwide antimicrobial resistance awareness campaign or a regional manual of rare diseases, the impact is more powerful when people from different cultures and backgrounds work together as a team.

Social Accountability is a topic that has been really present in medical education in the past few years and we SCOME have work a lot in the region. Students and medical faculties have a crucial role to improve primary care services by reorienting the education, research and service into the health priorities that each country has. Those improvements can be made directly by educational authorities in a local or national level or by student organizations such as IFMSA. So basically, as medical students, we can achieve and advocate for making real changes in the way we learn, in our medical curriculum and at the end, in our health system. We need to seek for the right tools and stakeholders. That is why I invite you to join the amazing SCOME family, and work together to reach global goals.

28

Pablo Estrella SCOME RA for the Americas

medical students worldwide

Issue 2017

Evolving the UWI Medical Education Paradigm

Nikolai J. Nunes & Reneique Deidrick JAMSA

Since the Flexner Report that revolutionized American medical education at the turn of the 20th century, innovation in medical education slowed until the start of the new millennium. With the quantum leap in technological evolution facilitating rapid breakthroughs in genetics and molecular medicine, medical education has evolved from faculty instructing concepts to students for memorization to curricula that espouses active learning. This curricula transitions classroom pre-clinical teaching into para-clinical learning by introducing clinical exposure and skills training from day one, renewing focus on primary care, population health, global health, and health systems sciences alongside integrating research, increasing elective options, and emphasizing volunteerism, community service, and social accountability cultures.

SCOME was one of the first standing committees of the International Federation of Medical Students’ Associations (IFMSA) from its founding in 1951. Medical Education shapes the quality of future doctors, which is then reflected in the quality of healthcare. SCOME works with all stakeholders in the development of an optimal learning environment for medical students. As medical students are directly exposed to medical curricula, they are the first quality-check of medical education, the second check being if graduates can meet the standards of the profession, healthcare systems, and community needs.

SCOME’s mission is to work with faculty and students to contribute to the development of the academic and learning environment of medical students, to contribute to medical students’ professional and personal development, and to contribute to the development of the healthcare landscape via advocacy and community service.

In the 2016-17 academic year, a new SCOME leadership team assumed office at UWI Mona with a phased two-year strategic plan aimed at inculcating

www.ifmsa.org

a new medical student culture at UWI, helping develop medical students who are leaders, communicators, team players, researchers, public health and global health advocates.

The first phase initiated developing programme streams linked to IFMSA such as Curriculum Development, Inter-Professional Education, Medical Education Outreach, Medical Specialties Interest Groups, and addressing the issue of medical student burnout. The second phase involves formalizing Small Working Groups (SWGs) addressing specific projects including the Dundee Ready Educational Environment Measure (DREEM) survey of medical students, the establishment of the Student Academic Representation, Student Curriculum, and Student Inter-Professional Education committees, as well as advocacy projects such as pursuing BLS certification for all medical students.

Over the past academic year SCOME has also hosted a student town hall meeting on the pre-clinical curriculum with the Faculty’s Director of Medical Education as well as several professional and personal development seminars on various medical specialties and graduate medical education options (USMLEs), trained students in basic clinical skills for a rural inter-professional healthcare clinic, and launched the campaign addressing medical school burnout.

The UWI is renowned for producing healthcare professionals par excellence and SCOME looks forward to working with the University community across the region in contributing to the continuance of this legacy.

29

Heartbeat: Sustainable Development Goals

Rousseou Project

- Aging Healthy

Estella Ramos Rezende, Larissa Cristine Lopes DENEM Brazil

Three of the highly regarded researchers in the field of Medicine which integrates spirituality into healthcare, Dr. Alexander Moreira, Dr. Harold Koenig and Dr. Giancarlo Lucchetti, have defined spirituality1 as one’s personal seek to comprehend queries about life, meaning and relationship to the sacred or transcendent. Recognized by World Health Organization2 (WHO) and international medical associations as the Association of American Medical Colleges3 (AAMC), this integrative approach has been earning space in medical studies.

According to WHO, health4 is the outcome of biological, phycological and social factors harmonically combined and not only the lack of diseases. From this perspective, there are no illnesses, but rather ill individuals. Each person would therefore undergo the impact of these parameters in a particular way, according to the concept of integrality. It was addressing this outlook that the greatest international event of Medicine and Spirituality – MEDNESP5 – introduced its themes related to basic concepts of Modern Physics, Spirituality and Health.

By experiencing this background as academics of the second period of Medical School we had the opportunity to reflect on the magnitude of using spirituality as a grounding principle in health treatments. The great demand for approaches linked to this idea – which is evidenced by the exponential rate of articles that has already been published on the subject – and the current proven benefits of applying spirituality to medical practice have led us to uphold the incorporation of the binomial Health-Spirituality into academia.

30

Numerous researchers have already supported the referred binomial. The pioneer in the definition of spirituality, transcendence and meaning of life, Dr. Cristina Puchalski6, and the Psychiatrist that investigates the boundary between Spirituality and Religiosity though epistemological, methodological

and historical studies, Dr. Harold Koenig7, are distinguished examples of scientists dedicated to this cause. Also set in this context is the recent bibliometric survey8 from PubMed. It revealed that more than 30,000 publications have been produced in the last decade, demonstrating the claiming of knowledge in the field.

Furthermore, it is interesting to note that spirituality in clinical practice track two pathways. Considering the patient’s perspective, a meaning for life can enhance the prognosis and reduce9 symptoms of depression and suicide attempts. Whilst by the medical duties’ view, empathy10 comes alongside spirituality influencing doctor-patient relationship and hence the medicinal therapy to be chosen.

Therefore, the mechanistic paradigm from Academic Medicine shall undergo a transformation process taking into account the personal, transcendental and religious aspects of the human being. As the foundress of the movement responsible for MEDNESP, Dr. Marlene Nobre11, once stated, Medicine cannot be divided into systems, since it is an integral man who calls for medical aid, not a split one. In the role of founders of the newborn Academic League of Health and Spirituality (LASE)12 of our university – UNIRIO (Federal University of the State of Rio de Janeiro) – such background inspires us to pursue our journey hopefully, having ahead of us many promising projects expecting to be developed.

References: 1. Moreira-Almeida A, Koenig HG, Lucchetti G. Clinical implications of spirituality to mental health: review of evidence and practical guidelines. Revista Brasileira de Psiquiatria. 2014.

2. World Health Organization (WHO). WHOQOL Spirituality, Religiousness and Personal Beliefs (SRPB) Field-Test Instrument. Available at < http://www.who.int/mental_health/media/ en/622.pdf> 3. Puchalski CM, Blatt B, Kogan M, Butler A. Spirituality and Health: The Development of a Field. Academic Medicine: January 2014 - Volume 89 - Issue 1 - p 10–16.

4. World Health Organization (WHO). What is the WHO definition of health? Available at <http://www.who.int/suggestions/faq/en/> 5. MEDNESP 2017 - Congress of Medicine and Spirituality. Available at <https://www.emedevents.com/conferenceview/brazil/rio-de-janeiro/rio-de-janeiro/medical-conferences-2017/ mednesp-2017-congress-of-medicine-and-spirituality-68570> 6. Christina M. Puchalski, MD, MS, FACP, FAAHPM. Available at <https://smhs.gwu.edu/ gwish/about/dr-puchalski> 7. Harold G. Koenig, M.D. Available at <https://spiritualityandhealth.duke.edu/index.php/ harold-g-koenig-m-d>

medical students worldwide

Issue 2017

Missing Tittle

Jonathan E. Hill IFMSA-Grenada

Mental health is an oft times overlooked area of medicine. Discussions about mental illness typically involve discomfort, embarrassment, anger and shame. The stigmatization of mental illness prevents people from seeking appropriate care. As a result, many people suffer in silence and some of those people are medical students1. Studies reveal that approximately 25 % of surveyed medical students qualify for the clinical diagnosis of depression2.

Additionally, medical students also exhibit higher signs of burnout3 and suicidal ideation4,5.

A contributing factor is the inherent stigmatization of mental illness within the general and medical populations. Society dictates that people with mental health are the “other.” They are somehow inherently wrong, and in some locales indecent. Individuals suffering from mental health issues are judged and outcast, often times seen as a lesser person.

The same is true within the medical establishment.

Mental illness is largely considered a “career killer.” Students and physicians who seek treatment could be subject to peer judgment and feelings of inadequacy.

As a result, the SCOME of IFMSA-Grenada has sought to design a mental health campaign to promote awareness, education, and break down the stigma around mental health: The Never Alone Project. The campaign is one of the longest running programs in IFMSA-Grenada, being hosted twice a year. The campaign provides a week long series of events that address mental health concerns, presented by collaborating organizations within the University community. Each workshop is designed to promote a specific coping strategy that has been supported by previous research, such as: meditation, yoga, and animal therapy.

For example, our Project Grassroots Workshop encourages students to plant and foster seeds.

Throughout the process of planting, the concepts of stewardship and mindfulness are discussed. Furthermore, research has shown that a connection with

www.ifmsa.org

nature and exposure to the environment reduces stress, elevates mood, and enhances immune response6-8. All workshops are free and open to any member of the University community. In addition to coping strategies, informational pamphlets about our University Psychological Services are promoted at every event.

The Never Alone Project also has a social media platform whereby we can promote articles or stories relevant to each ongoing event. It also allows us to keep track of which activities are most successful, in conjunction with old-fashioned head counting. This allows the Never Alone Project to be fluid, so that each term we can make it more relevant. For example, the first campaign consisted of a lecture, but that was removed due to low turnout.

However, current discussions and feedback indicate that the incorporation of a lecture in future campaigns would be well received.

Mental health is an issue that involves everybody regardless of whether one is a patient or a caregiver. Understanding mental illness as a medical issue is critical for medical students to meet the obligation of best patient care. Deconstructing the myth, breaking the stigma, and educating each other is the best way to accomplish this and that is why IFMSA-Grenada SCOME created the Never Alone Project.

References: 1. Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: a cross-sectional study. Med Educ. 2005;39(6):594-604 2. Givens JL, Tjia J. Depressed medical students’ use of mental health services and barriers to use. Academic medicine : journal of the Association of American Medical Colleges. Sep 2002;77(9):918-921.

3. Dyrbye LN, Thomas MR, Power DV, et al. Burnout and serious thoughts of dropping out of medical school: a multi-institutional study. Acad Med. 2010;85(1):94-102 4. Tyssen R, Vaglum P, Grønvold NT, Ekeberg O. Suicidal ideation among medical students and young physicians: a nationwide and prospective study of prevalence and predictors. J Affect Disord. 2001;64(1):69-79 5. Hays LR, Cheever T, Patel P. Medical student suicide, 1989-1994. Am J Psychiatry.

1996;153(4):553-555 6. Park BJ, Tsunetsugu Y, Kasetani T, Kagawa T, Miyazaki Y. The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan. Environ Health Prev Med. 2010; 15: 18-26.

7. Li Q, Otsuka T, Kobayashi M, Wakayama Y, Inagaki H, Katsumata M, Hirata Y, Li Y, Hirata K, Shimizu T, Suzuki H, Kawada T, Kagawa T. Acute effects of walking in forest environments on cardiovascular and metabolic parameters. Eur J Appl Physiol. 2011 Mar 23.

8. Li Q, Morimoto K, Nakadai A, Inagaki H, Katsumata M, Shimizu T, Hirata Y, Hirata K, Suzuki H, Miyazaki Y, Kagawa T, Hoyama Y, Ohira T, Takayama N, Krensky AM, Kawada T. Forest bathing enhances human natural killer activity and expression of anti-cancer proteins.

Int J Immunopathol Pharmacol. 2007; 20 (S2): 3-8.

31

Heartbeat: Sustainable Development Goals

The profile of practice fields in medical education in Brazil Adelmo Isaac Medeiros DENEM Brazil

From a more comprehensive conception about health, in which it aims to establish a more desirable horizon for medical courses in Brazil, was that in 2001, the National Curricular Guidelines were established. In it, the active role of students in the teaching-learning process is proposed as a necessity, proposing a shift from the emphasis on contents to the process of active and independent learning, and overcoming the dichotomy between theory and practice, valuing work articulated with Health services and populations. (BRAZIL, 2001) Nevertheless, in the perspective of completeness, there is still a great distance between what is prescribed and what is practiced. Considering that each educational institution has an identity and, therefore, the reforms are not perceived in the same way. This means that only the practice of each institution, each course, and each teacher, imbued with the significant desire for reform, will tell what knowledge and practice is being offered to prospective physicians.

32

What we have, at the beginning, in the present, in the medical formation of the country, is the existence of two fronts: biomedical and biopsychosocial. The biomedical focuses on the disease category and adopts instruments to act on the patients, in search of repair of their defects (disease) (NOGUEIRA, 2012). In opposition to these values and principles there is the biopsychosocial or social health production strand, which seeks to overcome the first one (PEREIRA; BARROS; AUGUSTO, 2011) and is based on the perspective of the integral vision of being and illness, encompassing The various dimensions of the assisted subject (DE MARCO, 2006).

In relation to the learning scenarios, Ferreira et al.

(2007) state that academic performance helps in the perception of the health-disease process, when students are taken to health services in order to understand the functioning and the reality of the population, thus forming more critical and reflective

professionals.

Despite this, what can be observed is that teaching practices are developed at the tertiary level of health care, with few opportunities for training at the primary level. In this context, curative medicine is prioritized and has as a consequence the stimulus to the early specialization of students during graduation, which denies the original orientation of the Pedagogical Model of the course that proposes “the formation of general practitioners equipped with theoretical- Practical and technical and humanistic skills “.

In addition, there is also a predominance of theoretical activities to the detriment of practical activities; Reality observed even in the specific disciplines that propose in their menus the approach of the theoretical contents in articulation with the practical activities.

Finally, the conclusion of this analysis points to the fact that medical education seems to persist in a strong tendency towards super-specialization, which, in the last instance, corresponds to a requirement imposed by the current market. Thus, there is a need for reflection on the inclusion of contents related to humanistic formation in the daily life of teaching-learning practices and in the relationships established there.

References: Brasil. Ministério da Educação. Conselho Nacional de Educação, Câmara de Educação Superior. Resolução CNE/ CES nº. 4, de 7 de novembro de 2001. Institui diretrizes curriculares nacionais do curso de graduação em medicina. Diário Oficial da União. Brasília, 9 nov. 2001; Seção 1, p.38.

Brasil. Ministério da Educação. Parecer CNE/CES n. 1133 de 07 de agosto de 2001. Diretrizes curriculares nacionais dos cursos de graduação em enfermagem, medicina e nutrição.

Brasília; 2001 DE MARCO, Mario Alfredo. Do modelo biomédico ao modelo biopsicossocial: um projeto de educação permanente. Rev. bras. educ. med., Rio de Janeiro, v. 30, n. 1, abr. 2006.

Ferreira RC, Silva RF, Aguera CB. Formação do profissional médico: a aprendizagem na atenção básica de saúde. Rev Bras Educ Méd. 2007; 31 (1): 52-59.

NOGUEIRA, M.I. Trabalho em saúde e trabalho médico: especificidades e convergências.

Rev. bras. educ. med., Rio de Janeiro, v.36, n.3, set. 2012.

PEREIRA, T.T.S.O.; BARROS, M.N. dos S.; AUGUSTO, M.C.N. de A. O cuidado em saúde: o paradigma biopsicossocial e a subjetividade em foco. Mental, Barbacena, v.9, n.17, dez.

2011.

medical students worldwide

Issue 2017

First years medical students’ vulnerability Bruna de Oliveira, Bruna Marzullo & Amanda Torres IFMSA Brazil

Common mental disorders (CMDs) include symptoms such as forgetfulness, difficulty in concentrating and in making decisions, insomnia, irritability and fatigue, as well as somatic complaints, affecting the quality of life and their interpersonal relationships1.

According to research in Brazil, CMDs is prevalent among medical students1. There are several factors in medical university to cause mental health problems: competition in the selection process, overload of knowledge, difficulty in managing time between a large number of activities and little time for leisure activities, individualism, responsibility, social expectations of the doctor’s role2. Beyond that, other context in the arrival of medical university contributes to mental health disorders such as a disturbed medical hierarchy where the professor means more than the student, the doctor means more than the patient and the second years more than the first years3, creating a solid environment for a common culture in Brazil, hazing - a social, cultural and historical phenomenon of the university environment that results in the formation of oppressors in which their greatest tool is violence, it’s defined as an act of violence in the academia4.

Thus, this stage in life also implicates in medical students’ social development, not only as an individual as well as a future professional, and it’s necessary to take a closer approach into students in this period of university.

In this context, IFMSA Brazil’s Local Committee PUC-SP initiated a reception project for 2017 first years in PUC-SP, located in Sorocaba-SP. The project consisted of weekly meetings of an hour and a half along the entire first semester and a coaching approach was used, as well as the participation of externals such as professors and older students who were of interest to the meetings’ subjects.The project was divided in 3 axis of discussions: academic curriculum (active methodologies, tutoring

www.ifmsa.org

groups, primary health in medical education), mental health (time management, frustrations and dreams in their career) and power relations in medicine (hazing, medical hierarchy). Twenty first years participated out of a hundred. They shared they were more confident with the academic curriculum and the new life in a university compared to the students who didn’t come to the meetings as well as more aware of their mental health quality and the academia’ social context and nuances.

The reception project conducted in PUC-SP is one of the many approaches to achieve the commitments and goals idealized in two IFMSA Brazil’s national policy statements - Hazing and Medical Students’ Mental Health for which intend on promoting hospitable and safe reception’s interventions to diminish vulnerability situations in this population, to educate students on hazing and advocate against its culture and to contribute to mental care of medical students5,6.

IFMSA Brazil invites and supports IFMSA Americas region into taking part towards this issue in order to create a safe and positive environment for first years and every medical students.

References: 1.

LIMA, M. C. P. et al. Prevalência e fatores de risco para transtornos mentais comuns entre estudantes de medicina. Available from: <http://www.scielo.br/pdf/rsp/ v40n6/11.pdf>.

2.

DAMIANO, R. F. et al. O Primeiro Ano do Grupo de Apoio ao Primeiranista.

Available from: <http://www.scielo.br/pdf/rbem/v39n2/1981-5271-rbem-39-2-0302.pdf>.

3.

ALMEIDA, M. T. A ordem médica e a desordem do sujeito na formação profissional médica. Available from: <http://revistabioetica.cfm.org.br/index.php/revista_bioetica/ article/view/647/694>.

4.

Silva AF et al. Uma nova medicina para um novo milênio: A humanização do Ensino Médico. AME Brasil, 2016.

5.

IFMSA Brazil (NGO). Policy Statement: Hazing. 2017.

6.

IFMSA Brazil (NGO). Policy Statement: Mental Health of Medical Students.

2017

33

Heartbeat: Sustainable Development Goals

FROM BUDVA to ECUADOR (a TMET story)

Ximena Núñez AEMPPI Ecuador

This journey began before my first GA. I was really excited for being picked to be part of the TMET during the pre GA in Budva, Montenegro.

My biggest motivation was becoming the second medical education trainer in my country and the opportunity to have our first TMET for Ecuador.

I had the amazing luck to learn from experts in medical education, and to share this pleasure with a lot a scomedians who gave me the inspiration I needed to fill my heart with SCOME moments and prepare the best TMET for my NMO. The next months were full of emotion and work, together with Pablo (the SCOME RA, and the first TMET trainer in Ecuador) we looked for the best topics and activities for the guys. Since they were all new in the training area we used every tool we found so they would they learn as much as they could.

listened in every university, we empower them to discuss about teaching methods and learning theories, in order to be part of decisions in their schools.

Also, something that makes me incredibly proud is that we talked about the differences we have as persons, as leaders, as students, so they will understand that dealing with a group is hard if you don’t have the skills to handle that differences, and to use them in a positive way to improve development.

After this experience I love my committee even more than I did before, because I truly believe medical education is the best tool for students, I invite you to get involved with SCOME, to take a big step in your preparation and sign up in the closest TMET to your country, you won’t regret it.

Medical Education has a lot of surprises that I dare you to find out.

Just before the SRT started I was really nervous, because I thought that my way and Pablo´s way (from Mexico to Ecuador) was completely different.

However since the first training started it was perfect, our ways weren’t equal but we both wanted the same for the participants and we gave they as much as we wanted and more.

It was great, we had 20 guys ready to get full of MedEd knowledge and passion, 19 from Ecuador and one from Perú, who was voted as the best participant, but was as awesome as the rest. All of them showed a lot of interest, some of them, who weren’t part of the committee before found SCOME amazing, and they wanted to acquire more more ideas to change education in their faculties.

34

We included our favorite topics, and we formed new trainers, who will not only train more students, they will also be involved in their education systems, we gave them the tools to create impact by getting

medical students worldwide

Issue 2017

Medical Education as a Good Springboard for a Prosperous Nation Edwin Osmar Chinchilla IFMSA-Honduras

This journey began before my first GA. I was really excited for being picked to be part of the TMET during the pre GA in Budva, Montenegro. My biggest motivation was becoming the second medical education trainer in my country and the opportunity to have our first TMET for Ecuador.

I had the amazing luck to learn from experts in medical education, and to share this pleasure with a lot a scomedians who gave me the inspiration I needed to fill my heart with SCOME moments and prepare the best TMET for my NMO. The next months were full of emotion and work, together with Pablo (the SCOME RA, and the first TMET trainer in Ecuador) we looked for the best topics and activities for the guys. Since they were all new in the training area we used every tool we found so they would they learn as much as they could.

listened in every university, we empower them to discuss about teaching methods and learning theories, in order to be part of decisions in their schools.

Also, something that makes me incredibly proud is that we talked about the differences we have as persons, as leaders, as students, so they will understand that dealing with a group is hard if you don’t have the skills to handle that differences, and to use them in a positive way to improve development.

After this experience I love my committee even more than I did before, because I truly believe medical education is the best tool for students, I invite you to get involved with SCOME, to take a big step in your preparation and sign up in the closest TMET to your country, you won’t regret it.

Medical Education has a lot of surprises that I dare you to find out.

Just before the SRT started I was really nervous, because I thought that my way and Pablo´s way (from Mexico to Ecuador) was completely different.

However since the first training started it was perfect, our ways weren’t equal but we both wanted the same for the participants and we gave they as much as we wanted and more.

It was great, we had 20 guys ready to get full of MedEd knowledge and passion, 19 from Ecuador and one from Perú, who was voted as the best participant, but was as awesome as the rest. All of them showed a lot of interest, some of them, who weren’t part of the committee before found SCOME amazing, and they wanted to acquire more more ideas to change education in their faculties.

We included our favorite topics, and we formed new trainers, who will not only train more students, they will also be involved in their education systems, we gave them the tools to create impact by getting

www.ifmsa.org

35

Heartbeat: Sustainable Development Goals

EXCHANGES

Issue 2017

Dear Reader, The Exchanges Committees have been, in our opinion, one of the biggest surprises of the whole year. Not knowing what to expect from our NEOs or NOREs at the beginning of the year, and maybe even uncertainty of our work at the beginning of this term, they have amused us with all of the work they have done to make their exchanges grow both in academic quality and cultural exchange.

Since the RM, we realized that we are supported by an awesome exchanges team, where we found NEOs and NOREs interested in developing their exchanges.

This year, more than any other region, we have built many Capacity Building opportunities, with at least 4 PRETs being organized in the Americas this year, giving our exchange officers and enthusiasts a vast number of opportunities to further increase their skills in both Professional and Research Exchanges.

Overall, we believe that both SCOPE and SCORE are the committees that have it all. Two committees that bring all of the other ones together, and creates amazing opportunities for each one of our members. As an eye opening experience, this year we have learned a little from every other committee, SCOME, SCORA, SCOPH and SCORP, and gladly, they have all helped us to prepare our students for new adventures and to make our NEOs/NOREs realize all of the opportunities they have within the exchanges committee.

It has been a pleasure to work with such an amazing team, feeling proud that each time our representation worldwide becomes stronger. We just love how all of the work has been reflected in our exchanges and how each year we build better doctors. Overall, IFMSA is a place to build physicians that will think differently, and what a better way than to go for an exchange where you can experience a different health system and culture. We love our exchanges people and our Regional Team, the ones that with hard work have made it possible for the Exchanges Committee to grow so much this year, Thanks to all!

Andrea Falconi SCOPE RA for the Americas

Erwin Barboza SCORE RA for the Americas

37 www.ifmsa.org

Heartbeat: Sustainable Development Goals

“Discovering” Brazil through National Exchange Matheus Felipe Nascimento IFMSA-Brazil

When studying the history of Brazil, it was discovered that this country was inhabited by Indians who, according to calculations of the National Foundation of the Indian (Funai), totaled 5 million inhabitants throughout the Brazilian territory¹ and contained hundreds of tribes with cultures until arrival Of Europeans - Portuguese, French, Dutch and English - and, consequently, of the African population due to the slave period. From this arrival, Brazil faced, during 4 centuries, the birth of a national identity of its own generated by the union of the different cultural conceptions, creating the diverse identities present in Brazil today.

38

Besides, Brazil is not content to have only a vast cultural diversity², because the nature itself already reflects that Brazil is a country of diversity. An excellent example of this is to compare the regions of the country, that is, by looking at the biodiversity provided by the world’s largest equatorial forest, the Amazon, it is noticed that the Northern region of the country presents a great specificity in relation to the Northeast region, which, in turn, by containing a large region belonging to the semiarid climate and a large coastal extension, has a great divergence from the Central-West region, since this one presents its own wealth by the large rivers that get through the Cerrado, ending in Pantanal in Mato Grosso or originating the largest fluvial island in the world - Island Of Bananal. Unlike the three major regions mentioned above, the Southeast region contains the largest city in Latin America, which is composed of more than 10 million inhabitants, and large tourist flows to the historical region of Minas Gerais or to the coastal regions, such as Rio de Janeiro and Espírito Santo. Not only are these typical characteristics of a tropical country, Brazil also contains a region with subtropical climate, that is, the South region, which presents a specific flora and fauna of colder and more humid regions, making the brazilian territory one of the richest in diversity and natural beauties of the planet³.

In view of the above, it is understood that, by introducing this reality into the context of medical education in Brazil, the realization of a national interchange between the medical colleges of the 27 brazilian states is as important as an international interchange between Brazil and other countries belonging to the IFMSA, due to the fact that the huge brazilian diversity is similar to the enormous divergence of cultural aspects between Brazil and other countries.

Therefore, IFMSA Brazil, through the Standing Committee on National Exchange,provides for local committees the great opportunity of being a part of one of the best experiences that a medical student in Brazil can have, since the natural wealth intrinsic to Brazil and wealth cultural development created by brazilians need to be explored for the full graduation of a great brazilian doctor.

References: ¹ - http://revistapesquisa.fapesp.br/wp-content/uploads/2012/07/086-089-173.pdf ² - http://www.observatoriodadiversidade.org.br/revista/edicao_001/Revista-ODC-001-11. pdf A DIVERSIDADE CULTURAL E O DIREITO À IGUALDADE E À DIFERENÇA ³ - http://www.mma.gov.br/biodiversidade/biodiversidade-brasileira

medical students worldwide

Issue 2017

SCOREbels, more than a committee

Johan Alejandro Gamba ASCEMCOL-Colombia

Three years ago, when I was starting my career at something called “IFMSA,” all the time I was asking “SCOR-What?,SCOP-What?” Because at that time I wasn’t used to the abbreviations of this huge family.

Currently, I couldn’t imagine a world without IFMSA and my lovely committee: SCORE! So I just want to share with the rest of my lovely region a little piece of our work.

At the beginning, the committee was organized into 3 different subcommittees: internal regulation, which is mainly to keep the database of our group updated and to activate the SCORE Team where the Local Organization needed. Publicity, which creates and shares the official images of our group but also presents the LOREs a welcome manual in order to show them all the work they have to do to be at the others level. Finally, the external regulation or regulation of activities, which is the responsible of the calendar of the year (created by all the LOREs) , and the SWG (Small Working Groups) outcomes.

tal workshop that consists in explaining,via online, through videos or other sources, how to use some medical database in order to explain to them how they can create their own article!

Our next SWG wants to create promotional videos to our incomings and outgoings in order to motivate both to do a research exchange in our country or to apply for it, respectively. Finally we want to open a new committee in our country consisting in national exchanges, knowing that it’s a long process but also another opportunity we can give to our members.

For sure we will show everyone the results of this awesome family. Finally we want to have a special mention to the SCOPE committee that is working with us all the time. So remember, the work of one won’t be never as good as the work of a group, and even more the work of a team, but the best results are with your family! Thank you SCORE!

We have also decided to create 5 SWG (the LOREs are the members of this SWGs) that will work through an specific period of time in order to have their outcomes consisting in the most urgent ideas according to our national assembly and LOREs. The first one is called SCORE WEEK which initially wanted to make publicity and activities during the whole week to show exchanges to our students but a similar idea came from SCORE and SCOPE of IFMSA with ExWeek, so we decided to complement all their ideas with a national focus and have an international impact. It was a complete success during the time of the event.

The second one is the simplification and/or translation of the IFMSA manuals, suggested by our national assembly to bring the IFMSA world to non related medical students. Right now we are finishing the first manual. After that, there is the medical por-

www.ifmsa.org

39

Heartbeat: Sustainable Development Goals

SCORE IN THE AMERICAS

Germania MuĂąoz AEMPPI Ecuador

Innovative methods of diagnosis and treatments are developed through a very complex process that takes time, motivation and commitment. There is where the importance of research work involved in medical formation at its whole stands out. Working on this committee as NORE in this short period of time has left me a clearer vision of the activities held in SCORE in the Americas region and what is more important, it has motivated to work harder in order to improve quality and cooperation among the exchange community. As a background point, SCORE involves more than 65 active NMOS, offering over 3000 research projects to provide over 2400 med students worldwide the opportunity to participate in this IFMSA program.

As it is already known, the importance of going for a research exchange goes way further than just broad-based benefits and outcomes for students keen to embark on a travel experience at other country. From an educational perspective, there are reasons such as international learning and knowledge; this helps students towards acceptance and understanding of an array of different cultural and community perspectives. Then we have language acquisition while getting to meet people that are aware of the importance of adopting alternatives when facing different health systems, as well as avoiding cultural shock.

40

der to spread ideas and experiences that will improve a defined medical field. This can be gotten by encouraging students to share independent opinions, make informed decisions and strive to attain fresh goals.

One of the most challenging but satisfying accomplishments established in SCORE is the collaboration with other standing committees, so that their topics can be useful for the students during their exchange or to develop and conduct training sessions within their specific areas of interest.

When going for an exchange, the experience gained lets the student develop a prospective vision of research methods used at different health systems and the impact obtained reflected on the creation and improvement of research techniques of group dynamics and personal sensitivity towards others.

We have to be sensitive and raise awareness about another countryâ&#x20AC;&#x2122;s medical reality taking advantage of a new generation of students committed to work and contribute in the research field. And letâ&#x20AC;&#x2122;s always remember that an exchange is not a month of your life, it is an entire life in one month.

The most important point, a student has the opportunity of getting involved into a research project that goes along with their field of interest as well as they improve their research and procedures skills.

Analytical and problem-solving skills. The most relevant outcome of the activities that develop and shape these skills is the enhanced interest in actual worldwide issues as well as a wider general knowledge concerning global health. The integration into another medical community as well as the development of future peer relationships helps to establish and facilitate collaboration across the globe in or-

medical students worldwide

Issue 2017

PRET at Latitude 0º and Professional Exchanges in Ecuador Nicolás Jara AEMPPI Ecuador

My name is Nicolas Jara, I am a LEO at Universidad Internacional del Ecuador active LC of the NMO Asociación de Estudiantes de Medicina para Proyectos e Intercambios (AEMPPI) Ecuador. I am honoured to write about my experience at the Sub Regional Meeting (SRT) in the province of Imbabura located in the mountain region of Ecuador between the 26th to 28th of May. During the SRT we had the opportunity to participate in the PRET, were medical students got involved in a training that helped them have a better understanding of the professional and research exchanges that our organization has to offer.

We had participants that mainly got involved in the PRET as we wanted to become experts in our committee, so we could improve our exchanges. The training was also focused on how to organise our time, in order to prevent ¨burnouts¨. It was very dynamic and we had the privilege of having two experienced trainers sharing with us their knowledge and support.

We count with two RAs of our region, Andrea Falconi Regional Assistant for SCOPE and current NEO OUT from AEMPPI-Ecuador and Erwin Barboza-Molinas, Regional Assistant for SCORE and former NORE in IFMSA Paraguay. They teached us how to become a team and manage one, how to reduce the cultural shock for our students and the importance of how to give feedback and evaluation.

The other trainees and myself are really thankful for all the hard work that they put into the training, for all of the knowledge they shared with us. As a medical student I recommend all of the students around the world to participate in a PRET, because you will learn not only about SCOPE and SCORE committees but also on how to become better student and professional, by giving you the tools to be more organized and teaching you on how to become a better speaker.

www.ifmsa.org

The professional exchanges in Ecuador are growing every day, as a LEO, I see many students getting interested in going to another country, learn their culture and practicing medicine in a health system different from ours. Comparing to last year, where we had just 45 outgoings, this year we have more than 81 students from all of our LCs going for a professional Exchange! AEMPPI-Ecuador is a great opportunity to do an exchange as we have tutors that will guide our Incomings on how to treat the patient and interact with them. From the educational part, we are also getting prepared to do more Pre Departure and Upon Arrival trainings, which will for sure help our students during their exchange. Finally, we take advantage from our small country that counts with so much diversity in all of their regions, giving our Incomings the opportunity to experience our culture, visit our UNESCO Heritage places and enjoy our delicious gastronomy, because at the end all you need is Ecuador.

41

Heartbeat: Sustainable Development Goals

About maps, questions and answers

Mariana de Melo Rocha IFMSA Brazil

Iâ&#x20AC;&#x2122;ve heard it once that the best trips are the ones where we come back with answers to questions weâ&#x20AC;&#x2122;ve never asked ourselves. Definitely, my trip to the Czech Republic in July 2016 made me understand the depth of these words.

I went by SCORE because I was always attracted for the possibility of searching. I live in a country where, unfortunately, investment in education and science is very limited, and I wanted to know how those areas worked in another place. I believe that doubts move the world, and who better than researchers to transform reality with their questions?

gal, Spain. I learned a lot from people in Russia and Finland. All these people have added me a lot as a human being and Iâ&#x20AC;&#x2122;m sure, a piece of each of them came with me back to Brazil.

Today I have a map with me from Brno. In it I put a pin in each country I visited and the intention is that, until the end of life, there is no more space for any pins. Certainly, after this trip, I am no longer the same, and I am grateful for that. With my map, my answers and my questions, I continue to plan the next trip and bring to my daily life everything that Brno has left in me.

My internship was at Masaryk University in Brno, the second largest city in Czech Republic. I had a first impact soon to know the university, which is modern and equipped with an infrastructure far superior to what I am accustomed to. I met a laboratory and had contact with very different techniques than I know in my daily life. Along with me was a student from Canada who was very familiar with this kind of routine. The different reactions that she and I had to the same experience highlighted even more in my eyes the lag of Brazil in the matter of science, and strengthened in me the desire to contribute to change that reality.

42

Parallel to these experiences in the academic field that have magnified my view of the world, I have experienced similarly intense cultural experiences.

Together with me, there were about 26 exchangers.

The exchange program offered in Brno helped us form a united group and live wonderful things. The staff responsible for welcoming us has sought to be as organized as possible and to provide us with different activities that have brought us into the local culture. I could also travel to nearby countries and these trips alone have brought me great learning.

I met people from Japan, Mexico, El Salvador. I made sincere friendships with people from Portu-

medical students worldwide

Heartbeat: Sustainable Development Goals

Dear Reader, At the beginning of Medicine career, we are given two options: the first one, being an average medstudent, like one of the thousands of medical doctors that graduate every year, or we can either choose a second option, being a different medstudent, one of those who does not conform with “average”, one who wants to make a change in the world, thinking globally and acting locally, one who thinks the change start with ourselves. If you are reading this is because you probably choose option number two, even if you did not notice at the moment, and I am glad you did because is YOUR work, passion and motivation that make IFMSA the biggest medical students association in the whole world, so THANK YOU for choosing option number two.

I know the road haven’t being easy, maybe your classmates or some teachers think you are “crazy” or “losing your time” for doing that teddy bear hospital campaign, thinking you CANT change the world, maybe your first SCOPH campaign wasn’t what you expected to be, the overload of homework and SCOPH projects sometimes make you lose your mind or a few nights of sleep, and you spend most of your savings in regional meetings across the continent just hoping to meet more “crazy” people who thinks like you, instead of buying those expensive pair of shoes, but let me tell you something, IS WORTH IT, nothing is compare with the satisfaction of helping others, nothing worth so much that the smile of child after the teddy bear hospital or the first thank you from a women after you teach them how to self-explore to prevent breast cancer. Sadly that is not something we are going to learn inside a classroom, this human side of medicine, this compassion and empathy is not on the books, is in the world, is the teenage pregnant woman across the street, is in those kids selling candy in the stop lights instead of going to the school, is in that adult who cannot stop smoking or that couple of seniors that have to walk hours to get to a health care center.

IFMSA give us the amazing opportunity to start acting, PUBLIC HEALTH give us the chance to make a change in our environment and SCOPH give us the privilege of being able to think globally and act locally, all together they give us HOPE to believe that WE CAN MAKE A CHANGE regardless in what stage of the career we are, you can always do something. The world is needed of LOVE and people passionate about what they do, let’s love what we do, let’s do what we love and together change the world, as Vincent Van Gogh said: “Your profession is not what brings home your weekly pay check, your profession is what you are put here in Earth to do, with such passion and such intensity that it becomes spiritual in calling”.

44

Maria P. SCOPH RA for the Americas

medical students worldwide

Issue 2017

HOW TO GUARANTEE THE STOCK OF BLOOD BANKS IN A POOR REGION OF BRAZIL

João Octávio Augusto Murta Nathalia Lages Monteiro DENEM-Brazil

In contrast to the economic opulence experienced by the Brazilian region of the Jequitinhonha Valley in the state of Minas Gerais during the colonial period, the current reality of this region is of poverty and precariousness of the public services offered to the population, including healthcare. (2) According to a study presented by the Minas Gerais Health Surveillance Office, the gross mortality rate in the Jequitinhonha Valley is 6.4%, higher than the 5.9% mortality rate in the state of Minas Gerais. (1) In this scenario of high mortality rate, blood replacement is often vital and it is in this context that the project Blood Drop: Saving Lives in Diamantina, from the newly created School of Medicine of the Jequitinhonha and Mucuri Valleys Federal University is justified. Ensuring the supply of blood banks is a problem of worldwide concern; hemocenters have difficulty maintaining blood stock to meet specific and emergencial needs. (3) The Blood Drop Project aims to increase fixed donors and the number of new ones. For this purpose, the students of the project carry out a mobilization and awareness work in the teaching institutions and among the population of the city of Diamantina, through interventions in classrooms and individual approaches in public places that aim to contribute to the education of the population about the blood collection. To intensify awareness, the project is promoted on social networks, television and radio.

Diamantina’s hemocenter, in Jequitinhonha Valley, has the monthly goal of collecting 350 bags of blood and an annual goal of 4,319 bags. In 2014, the first was achieved in just 5 months and there was an annual collection of 4,103 bags – a number below the target. In 2015, when the project started, the institution had lost the professional responsible for the multiplication of new and fixed donors.

Nevertheless, the maintenance and increase of the number of donations in 2015 and 2016, when compared to the year of 2014, suggest a positive impact of the Blood Drop Project on the number of

www.ifmsa.org

donations. Until June 2017 the project have directly reached 1391 people.

For the academics, participation in the project makes possible the contact with the reality of the healthcare system in which they are inserted, as well as with the degree of information, myths and taboos of the population regarding blood donation. It is a unique opportunity to apply the theory assimilated in classrooms to the practice, from the perspective of a critical view that reality is often not the same as that found in books.

In addition, the project assists the University to accomplish its social role by closing the ties between the institution and the population. Although the project has proved important in maintaining the supply of blood banks in the city of Diamantina, the answer to the title of this article is to understand that the challenges are increasing, and energy must not be spared in order to change this reality and guarantee a conscious and altruist blood donation.

References: 1.

DATASUS. SIM – Sistema de Informações de Mortalidade. 2011. Disponível em: http://www.datasus.gov.br 2.

MARTINS, A. L. “Breve História dos Garimpos de Ouro no Brasil” in: Rocha, G. A .(organizador) “Em busca do ouro: Garimpos e garimpeiros no Brasil” Rio de Janeiro.

Editora Marco Zero. 1984.

3.

RODRIGUES, Rosane Suely May; REIBNITZ, Kenya Schmidt. Estratégias de captação de doadores de sangue: uma revisão integrativa da literatura. Texto contexto - enferm., Florianópolis , v. 20, n. 2, p. 384-391, June 2011

45

Heartbeat: Sustainable Development Goals

“Don’t break your heart”: A campaign to prevent hypertension Viktoria Weihermann, Thiago Augusto da Silva, Lucas Eduardo Venâncio IFMSA-Brazil Hypertension is a major public health challenge worldwide. It is a high prevalent disease, strongly associated with increased morbidity and mortality. As an example, approximately 7.1 million deaths yearly can be directly attributed to poor control of blood pressure [1]. Besides, some projections show an increase of 60% in the overall number of adults with hypertension until 2025 [2]. In developing countries this number is even bigger, reaching 80% [2]. Furthermore, these same projections estimate that almost three-quarters of the world’s hypertensive population will be in developing countries, such as Brazil [2]. Analyzing the national context in Brazil, data from the National Health Survey of 2013 found that 22.8% of the population have blood pressure measurements ≥ 140/90 mmHg [3].

Aware of the importance of preventing hypertension, members of IFMSA Brazil - Local Committee UFPR, organized a campaign to provide information, measure blood pressure and alert about the risks of hypertension to the population of Curitiba, Brazil.

46

The campaign was called “Don’t break your heart”, and took place on March 26th. Three places for this intervention were selected: Botanical Garden of Curitiba, Largo da Ordem and Barigui Park. The event was announced in social medias for the students and registrations were opened online, with 88 medical students of UFPR (Federal Paraná University), from all graduation years, been enrolled. In this manner, the interaction between students was stimulated, giving them the opportunity to improve knowledge, making friendship and sharing different experiences from Medical School. Before the intervention, on March 25th, a special training was offered to students, where a cardiology professor gave a lecture about hypertension and taught them how to check blood pressure. On March 26th, the event occurred all day in the places mentioned above. The campaign reached 846 people, all of which had the

blood pressure checked and answered a brief questionnaire about hypertension. The collected data is being used in an epidemiological study of hypertension applied to local population. Preliminary results revealed a prevalence of 41% of hypertensives.

An inspiring outcome of this campaign came from first-year students, which, in their freshman year, have little contact with patients during classes. In the event, however, they had the opportunity to interact with the community and help people. Some participants reported that this campaign was their first contact with the community as medical students.

They also remarked that the experience was a motivation to keep pursuing their dream to become doctors. On the other hand, even sixth year students reported that the campaign was a rare opportunity to interact with the community, since there is a the lack of social action in our Medical School.

Currently, we are working on the idea of turning this campaign on an annual event, as a permanent project, giving more students the opportunity to participate and reach people of other communities.

References: [1] Nature Web Collection: Hypertension. Available: http://www.nature.com/reviews/collection/hypertension/index.html. 2017.

[2] CHEN, Jing. Epidemiology of hypertension and chronic kidney disease in China. Current opinion in nephrology and hypertension, v. 19, n. 3, p. 278, 2010.

[3] MALTA, Deborah Carvalho et al. Prevalence of high blood pressure measured in the Brazilian population, National Health Survey, 2013. Sao Paulo Medical Journal, v. 134, n. 2, p.

163-170, 2016.

medical students worldwide

Issue 2017

Singular Therapeutic Project: improving equity in public health

Paulo Victor Zattar Ribeiro & Marcella Zattar Ribeiro.

IFMSA-Brazil

The creation of the Unified Health System (UHS) in 1988 was the largest social inclusion movement ever seen in Brazilian history and represented, in constitutional terms, a political affirmation of the Brazilian state’s commitment to the rights of its citizens1. Since then, the model provides health by following the principles of equity, completeness and universality.

It is known that equity is an unfolding idea of universality, ensuring that the availability of health services consider the differences between the different groups of individuals2. In this way, it consists of assuring actions and services of all levels, according to the complexity that each case requires. Also it is important to affirm that every citizen is equal in the UHS and will be served according to his needs3.

However, reality shows that, in the current agenda of the Health Sector, the principle of equity is conditioned to “cash limits” and cost-effectiveness4.

This approach not only ends up disregarding the individual in its entirety but also treat the unequal in the same way.

Thus, aiming at a greater singularity treatment, the Singular Therapeutic Project (STP) was created. The same will analyze objective and subjective demands of individuals, working in a multidisciplinary way and evaluating numerous aspects that increase the economic and social spheres of the people. For greater effectiveness, it can be divided into six steps. Firstly, it is necessary to select an individual with difficulties in following his or her poly-therapeutic plan or with a set of personal difficulties that affect the pathology. After this, it is important to perform a bio psychosocial evaluation, in order to define the moment and situation experienced by the subject, realizing whether or not their current condition may interfere with the treatment of the disease.

Next, it is necessary to set goals, defining together with the user, the time for the treatment

www.ifmsa.org

to be completed. The fourth moment corresponds to the division of responsibilities among professionals, where the coordinator will be the one who has the best link with the user. Subsequently, it is necessary to negotiate proposals, considering the differences and peculiarities of the subject, to further respect the limits and differences of each one. At the last moment, a reevaluation should be made, reflecting on the progress of work and new proposals5.

However, STP is not a ready recipe; its methodology will vary for each patient according to their needs. For example, we have a patient who lives alone, elderly, hypertensive, diabetic, with vision problem and illiterate. The standard protocol would be with the prescription of numerous medications and counseling for dietary and physical changes. Therefore, it is increasingly necessary to understand that people have individualities and limitations. For this patient, for example, we could elaborate boxes for medications, colored her insulin with identification stickers, send her to a group of activities for the elderly and help with food consumption restructure. As a conclusion, it is believed that with simple measures we can improve equity in public health: treating unequally persons that are different.

References: 1.

BRASIL. Conselho Nacional de Secretários de Saúde. Sistema Único de Saúde.

Brasília, DF, 2007c. (Coleção Progestores - Para entender a Gestão do SUS, 1).

2.

RONCALLI, A.G. O desenvolvimento das políticas públicas de saúde no Brasil e a Construção do Sistema Único de Saúde. In: Odontologia em Saúde Coletiva: Planejando Ações e Promovendo Saúde (A. C. Pereira org.). Porto Alegre: Artmed Editora, 2003, p.2849.

3.

MINISTÉRIO DA SAÚDE. Secretaria Nacional de Assistência à Saúde. ABC do SUS Doutrinas e Princípios. Brasília, DF, 1990.

4.

Luiz OC. Direito e equidade: princípios éticos para a saúde. Arq. Méd. ABC 2005;30(2):69-75.

5.

LINASSI J, STRASSBURGER D, SARTORI M, ZARDIN MV, RIGHI LB. Projeto terapêutico singular: vivenciando uma experiência de implementação. Rev Contexto e Saúde.

2011; 10(20): 425-434

47

Heartbeat: Sustainable Development Goals

KEEP CALM AND BE AN SCOPHero

Marcela Gándara Broos AEMPPI Ecuador

The first time I Heard about the Standing Committee on Public Health was five years ago when I was a first year student who wanted to be a helpful human being for the rest of Humanity. Back then, I thought studying hard and having good grades was the only way to persuade my dreams and be a famous and talented doctor. But, as it happens most of the time; I was terribly wrong. On that year, someone older than me that I didn’t even know invited me to an induction about an organization called IFMSA Ecuador. I thought about making an excuse and just going out with my friends; instead of sitting in my universities auditorium to listen to a group of people that I thought would have no impact on me. Nevertheless, I was curious about this mysterious organization so I ended up going with some of my friends. The auditorium was full with first and second year students so I started getting more and more interested and it was then when the induction started. One by one, the local officers started speaking about their Committees and what they did in each one of them. All of them were interesting for a girl like me who was just starting the journey in this amazing career and who could be amazed by almost everything. But, when it was SCOPH turn, something in my heart told me that this was what I was looking for. Promoting global health? Working in Public Health Policies? Veing able to change people’s lifes by making promotion and prevention activities on the most prevalent diseases in a population? Being able to work in almost every health topic that you can think of? Collaborating with other committees? Speaking even about mental health? What a better way to create the impact that I wanted in my society than this. So, as simple as that, I felt in love with this Committee and its ideas.

48

es and mental health; being able to transmit some of the love that I have to SCOPH to others that I know that will work to make SCOPH shine brighter than the sun nationally and internationally when I leave. Also, throughout the years I have learned that there is not greater satisfaction than to transmit the knowledge that you have to people that are lost and need a guide, that there is not best reward than to make an impact in someone’s life and health and that big changes in health, can grow up from something that others will consider useless. Such could be a student’s campaign to prevent and promote health. So, keep your expectations high and always remember that being an SCOPHero can bring the changes that you want to see in your health system to reality.

Now, I have been working on Public Health for four years and a Half in Local and National positions and I have organized many campaigns about non communicable diseases, communicable diseas-

medical students worldwide

Issue 2017

EVALUATION OF PRIMARY CARE BY THE FAMILY DOCTOR ON FAMILY HEALTH UNITS

Raphael Felipe Freua Fontes, Victor Brito Prado Kallas Andrade, Jonas Niero Flores e Suellen Ferronato DENEM-Brazil The Family Health Strategy aims the reorganization of primary health care in the country, according to the precepts of the Unified Health System (SUS) and is structured from the Family Health Unit (FHU).

Therefore, it is essential that it´s guided by the principles of universality, accessibility, relationship, continuity of care, comprehensive care, accountability, humanization, equity and social participation. The family doctor and community has its main field of activity in the health system a level called Primary Health Care (PHC), which is based on the care of first contact with the patient, in addition to serving as the person gateway in the health system. The service is grounded in comprehensive care to the patient, as well as coordination and longitudinality care. Therefore, it is expected the family doctor and community to be able to demonstrate consistent and sufficient clinical skills to solve the most common situations in their practice, leading the case in APS or performing reference to specialists.

A cross sectional study was conducted in Basic Family Health Units in Ribeirão Preto, city of São Paulo, Brazil and evaluated the physical and electronic records of patients. During data collection, we evaluated the patient’s profile as age and sex, the quality of care, taking into account the clinical diagnosis, the doctor’s conduct and appropriateness of the referral to the specialist, according to the municipal protocol referencing and evaluation of the priority of care according to the complexity of the diagnosis.

A total of 153 medical records were evaluated by the family doctor, showing a female predominance (63%), with patient predominance over 30 years, with 44% aged 30-60 years and 29% over the age of 60 years. Of patients referred to specialist 92% received care, 70% in routine consultation and 30% with service priority. According to the information needed for referral to a specialist, we noted that 64% of them were missing some data, and the lack of physical examination data was the main item,

www.ifmsa.org

while 36% of them had all the necessary data.

The results indicate attendance prevalence in female patients aged above 30 years. Of patients referred for medical care specialist, 92% received care, according to the complexity of the case. It shows the importance of lifelong education of family doctor, since a large portion of referrals was missing required data, but without prejudice to the patient. We conclude that the Family Health Strategy is one of the major strategies, proposed by the Ministry of Health of Brazil, to reorient the care model of the Unified Health System, from primary care. It seeks to reorganize services and redirect professional practices in the logic of health promotion, disease prevention and rehabilitation, ultimately promoting the population’s quality of life, being in a proposal with technical, innovative political and administrative dimensions. The consolidation and improvement of primary health care as important guide to the health care model in Brazil requires knowledge and continuous participation on lifelong education, intending to achieve qualification of care practices, management and popular participation.

References: 1 - LOPES, José Mauro Ceratti. Princípios da medicina de família e comunidade. Capítulo 1. In: GUSSO, Gustavo; LOPES, José Mauro Ceratti. Tratado de medicina de família e comunidade I. GUSSO, Gustavo; LOPES, José Mauro Ceratti (org.). Porto Alegre: Artmed, 2012.

2 - GUTIERREZ M. R.; BARBIERI M. A. Sistema Único de Saúde e demanda ambulatorial -os pacientes do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP. Medicina, Ribeirão Preto, v. 31,p. 81-98, 1998. Available at: <http://revista.fmrp.usp.br/1998/ vol31n1/sus_demanda%20ambulatorial.pdf> Acess november 11, 2016.

3 - BRASIL. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Acolhimento à demanda espontânea: queixas mais comuns na Atenção Básica.

Brasília : Ministério da Saúde, 2012.

4 - PREFEITURA MUNICIPAL DE RIBEIRÃO PRETO. Secretaria Municipal da Saúde Sistema Único de Saúde – SUS. Protocolos de Encaminhamento do Complexo Regulador: Otorrinolaringologia. Ribeirão Preto, 2014. Available at: http://www.ribeiraopreto.sp.gov.br/ssaude/ pdf/otorrinolaringologia.pdf Aces november 11, 2016.

49

Heartbeat: Sustainable Development Goals

Disease Prevention Programs in the Dominican Republic Yessi Paulette Alcántara Lembert ODEM-Dominican Republic

The Dominican Republic (DR), a middle-income country located in the Caribbean, continues to report the burden of infectious and chronic diseases for population health. In order to reduce disease morbidity and mortality, the Dominican government has established national prevention programs with effective and timely prevention and treatment strategies. This article describes the current situation related to three diseases – tuberculosis, HIV/AIDS, and diabetes.

Tuberculosis (TB) is transmitted from person to person through airborne droplet nuclei infected with Mycobacterium tuberculosis. The World Health Organization (WHO) follows the directly observed treatment short-course (DOTS) strategy in TB management and control, focusing on political commitment, case detection with quality tests, treatment under supervision and patient support, proper medication management, and an evaluation system for the disease (1). Prevention programs in the DR have reported the increase in TB case detection rate from 5.9% in 2000 to 66% in 2006. As a result, the percentage of cured TB cases on DOTS have increased from 78.6% to 84.7% (2).

The HIV/AIDS epidemic has focused on viral inhibition for disease control and continued patient follow-up and support (3). In the DR, although estimated HIV prevalence rates in persons aged 15 to 49 years was 0.8–1.0% in 2012, those of vulnerable population groups, such as commercial sex workers, men who have sex with men, and batey community residents are significantly increased (4).

Since the beginning of antiretroviral treatment in 2004, mortality in persons aged 15 to 49 years declined from 3.2/100,000 in 2005 to 2.1/100,000 habitants in 2009 (2).

50

Diabetes mellitus, a chronic metabolic disease characterized by elevated blood glucose, can be classified by three types of diabetes: type 1, type 2 and gestational diabetes. As the most common

type, type 2 diabetes accounts for approximately 85−90% of new diabetes cases. In the DR, preliminary results of EFRICARD II cardiovascular risk factors reported that the prevalence of diabetes represented more than 15.5%, or one million, of the population in 2011 (2). Since risk factors include obesity, consumption of high fat foods, sedentary lifestyle, and tobacco use, universal strategies for diabetes prevention and control focus on modifiable lifestyle factors, such as weight reduction, cardiovascular exercises, balanced nutrition, and smoking cessation (5).

Medical students should be responsible for collaborating on national prevention programs and disseminating health messages to their local communities.

As a global community, if each national health system prioritizes preventive medicine programs, we can improve infectious and chronic disease prevention and control. With federal budgets allocated to health promotion activities, many Latin American countries, such as the DR, have improved case detection and prompt treatment strategies. Thus, preventive medicine is an instrumental component in strengthening disease prevention and control strategies of national health systems.

References: 1.

World Health Organization. Treatment of tuberculosis guidelines, 4th ed. Geneva: World Health Organization; 2010. Available from: http://apps.who.int/iris/bitstre am/10665/44165/1/9789241547833_eng.pdf 2.

Pan American Health Organization. Health in the Americas: Dominican Republic.

2013. Available from: http://www.paho.org/salud-en-las-americas-2012/index.php?id=34:dominican-republic&option=com_content 3.

Centers for Disease Control and Prevention. La atención para el VIH salva vidas.

2014. Available from: https://www.cdc.gov/spanish/SignosVitales/VIH_Cuidados_Medicos/ infographic.html 4.

Chapman HJ, Bottentuit-Rocha J. Medical students’ perceptions about the added educational value of student-run HIV/AIDS educational campaigns in the Dominican Republic.

Global Health Research and Policy. 2016;1:12.

5.

Chatterjee S, Khunti K, Davies MJ. Type 2 diabetes. Lancet. 2017;389(10085): 2239–2251.

medical students worldwide

Issue 2017

Yellow fever in Brazil: A Multicausal View

Laís C. Krasniak, Maurício Petroli & Ravinne Lourenço DENEM-Brazil

In December 2016, a Yellow Fever outbreak has affected a few regions in Brazil, especially the state of Minas Gerais. The Brazilian Ministry of Health reported that 792 people have been infected and 274 have deceased¹. This incident brings light to some very important issues such as the need for effective health policies in therms of prevention and control of endemic diseases, the lack of professional qualification in the matter of tropical diseases diagnosis and management and also the relevance of the environmental care as an essential practice regarding public health.

In that matter, despite Brazilian advances in the last decades in therms of prevention, having, for instance, one of the best vaccination systems in the world, we still have to deal with high incidence of infectious and parasitic diseases. The Yellow Fever is a viral sickness which exists in our country since the XIXth century and whose incidence is explained also by the sanitary and educational conditions of the population. Fighting this disease is also fighting the social inequalities.

On the other hand, we see several medical schools acting far from reality. The professionals graduated from some medical schools are not capable of make a diagnosis and managing endemic diseases. This makes us question what is guiding the education of our doctors: the interests of the population or the market regulation? Besides that, the investments of the pharmaceutic industry and the fomentation agencies are also aiming at more economically privileged fields. The immediate results of this unbalance are whole populations dying of neglected diseases².

Furthermore, the environmental conditions can also explain why we still live under the Yellow Fever threat. In our country, there are no reports of urban cycle cases of this illness since 1942. However, the jungle (sylvatic) cycle was the responsible for the Minas Gerais outbreak whose one of the

www.ifmsa.org

possible causes has to do with the environmental crime that took place in the city of Mariana in 2015. With the collapse of a mining dam owned by the company Samarco, a massive amount of mud was released, being responsible for the destruction of entire cities, the death of 20 people and a catastrophic environmental damage. The first cases of Yellow Fever have taken place in the same region, months later. According to specialists, this isn’t about a one cause outbreak, but surely an environmental unbalance caused by the dam collapse, which contributed to the disease progress³.

Hence, when you observe the dynamic of the Yellow Fever in our country, it gets clear that the social and economic conditions of the population have a lot to do with its heath. We can’t let ourselves believe that a single microorganism and a mosquito, by themselves, are able to generate the establishment of these diseases. Our form of organization as a society, the means of production we’re submitted to and how much we contribute to the environmental destruction also make us responsible for the process of development of a sickness.

References: ¹Epidemiological Bulletin of the Brazilian Ministry of Health, available at: http://portalarquivos.saude.gov.br/images/pdf/2017/junho/02/COES-FEBRE-AMARELA---INFORME-43---Atualiza----o-em-31maio2017.pdf. Accessed June 18, 2017. ²Fatal Imbalance — The Crisis in Research and Development for Drugs for Neglected Diseases. Médecins sans Frontières (MSF), Geneva. Available at: https://www.msfaccess.org/ sites/default/files/MSF_assets/NegDis/Docs/NEGDIS_report_FatalImbalance_CrisisInR&D_ ENG_2001.pdf. Accessed June 18, 2017. ³Report “For biologist, outbreak of yellow fever may be related to Mariana’s tragedy,” published in the newspaper Estadão on January 14, 2017. Available at: http://saude.estadao.com.br/noticias/geral,para-biologa-surto-de-febre-amarela-pode-ter-relacao-com-tragedia-de-mariana,10000100032. Accessed June 18, 2017.

51

Heartbeat: Sustainable Development Goals

CAPACITY BUILDING

Issue 2017

Capacity Building Opportunities in the Americas The Capacity Building workshops in our region allows us to grow and develop skills and abilities to help us improve as a person and as medical students, help us become the best version of ourselves, helps us be exactly the kind of physician we’d like to be, that human physician who has empathy and really cares about his patients.

Frida María Vizcaíno Rios CB RA for the Americas

Past Events Throughout this year we have successfully carry out four fantastic events in our region: SRT 2017 - Facing Today’s Global Challenges in Health Care Host NMO: IFMSA-Quebec.

Workshops: TNT (Training New Trainers) & HCiD (Health Care in Danger).

When: February 17 – February 19 2017. *picture here* SRT Paraguay 2017 Host NMO: IFMSA-Paraguay.

Workshops: TNT, TMET (Training Medical Education Trainers) & PRET (Professional & Research Exchange Training).

When: May 13 – May 17 2017. *picture* SRT Middle of the World 2017 Host NMO: AEMPPI – Ecuador Workshops: TNT, TMET, PRET & IPAS (Training on Maternal Health & Access to Safe Abortion).

When: May 26 – May 28 2017. *picture* TNT Honduras 2017 Host NMO: IFMSA-Honduras.

When: June 8 – June 10 2017. *picture*

53 www.ifmsa.org

Heartbeat: Sustainable Development Goals

Future Events If you missed any of these, but would like to be part of an amazing Capacity Building event, here are the ones you’re still on time to attend:

TNT Manizales 2017 Host NMO: ASCEMCOL – Colombia.

Contact Information: Juanita Muñoz – dse.ascemcol@gmail.com Facebook page: https://www.facebook.com/TNT-Manizales-2017-1312498225511916/ SCORP Camp Host NMO: ASCEMCOL – Colombia.

Workshops: TNT, TNHRT (Training New Human Rights Trainers), ITDM (International Training on Disaster Medicine), and Peace & Conflict.

When: July 10 – July 15 2017.

Webpage: http://scorpcampcolombia.com/ LACMA Host NMO: IFMSA-Brazil When: July 13 – July 19 2017 Contact Information: Bruna Oliveira - cbd@ifmsabrazil.org TNT México 2017 Host NMO: IFMSA-Mexico.

When: July 21 – July 24 2017.

Contact Information: Ángel López Castañeda - ddse.ammef@gmail.com SRT Panamá 2017 Host NMO: IFMSA-Panama.

Workshops: TNT, PRET, PHLT (Public Health Leadership Training) & LEAD (Leadership, Empowerment, Advocacy & Development).

When: August 10 – August 14 2017.

Contact Information: Amanda Mock - Amanda.mock@ifmsapanama.org TNT Perú 2017 Host NMO: IFMSA-Peru.

When: August 11 – August 14 2017.

Contact Information: Luz Bances - trainingsdd.ifmsaperu@gmail.com TNT Guatemala 2017 Host NMO: ASOCEM – Guatemala When: November 2017 Contact Information: Freddy López asocem-guatemala@ifmsa.org SRT México 2017 Host NMO: IFMSA-Mexico When: December 2017 Contact Information: Ángel López Castañeda - ddse.ammef@gmail.com

54

SRT Colombia 2017 Host NMO: ASCEMCOL – Colombia When: December 2017 Contact Information: Juanita Muñoz – dse.ascemcol@gmail.com

medical students worldwide

Algeria (Le Souk)

Latvia (LaMSA)

Senegal (FNESS)

Argentina (IFMSA-Argentina)

El Salvador (IFMSA-El Salvador)

Lebanon (LeMSIC)

Serbia (IFMSA-Serbia)

Armenia (AMSP)

Estonia (EstMSA)

Lesotho (LEMSA)

Sierra Leone (SLEMSA)

Australia (AMSA)

Ethiopia (EMSA)

Libya (LMSA)

Singapore (AMSA-Singapore)

Austria (AMSA)

Fiji (FJMSA)

Lithuania (LiMSA)

Slovakia (SloMSA)

Azerbaijan (AzerMDS)

Finland (FiMSIC)

Luxembourg (ALEM)

Slovenia (SloMSIC)

Bangladesh (BMSS)

France (ANEMF)

Malawi (UMMSA)

South Africa (SAMSA)

Belgium (BeMSA)

Gambia (UniGaMSA)

Mali (APS)

Spain (IFMSA-Spain)

Bolivia (IFMSA-Bolivia)

Georgia (GMSA)

Malta (MMSA)

Sudan (MedSIN)

Bosnia & Herzegovina (BoHeMSA)

Germany (bvmd)

Mexico (IFMSA-Mexico)

Sweden (IFMSA-Sweden)

Greece (HelMSIC)

Mongolia (MMLA)

Bosnia & Herzegovina – Republic of Srpska (SaMSIC)

Switzerland (swimsa)

Montenegro (MoMSIC)

Syrian Arab Republic (SMSA)

Morocco (IFMSA-Morocco)

Taiwan (FMS)

Namibia (MESANA)

Thailand (IFMSA-Thailand)

Nepal (NMSS) The Netherlands (IFMSA NL)

The Former Yugoslav Republic of Macedonia (MMSA)

Nicaragua (IFMSA-Nicaragua)

Tanzania (TaMSA)

Nigeria (NiMSA)

Togo (AEMP)

Norway (NMSA)

Trinidad and Tobago (TTMSA)

Oman (MedSCo)

Tunisia (Associa-Med)

Brazil (DENEM)

Ghana (FGMSA) Grenada (IFMSA-Grenada)

Brazil (IFMSA-Brazil)

Guatemala (IFMSA-Guatemala)

Bulgaria (AMSB)

Guinea (AEM)

Burkina Faso (AEM)

Guyana (GuMSA)

Burundi (ABEM)

Haiti (AHEM)

Cameroon (CAMSA)

Honduras (IFMSA-Honduras)

Canada (CFMS)

Hungary (HuMSIRC)

Canada – Québec (IFMSA-Québec)

Iceland (IMSA) India (MSAI)

Pakistan (IFMSA-Pakistan)

Turkey (TurkMSIC)

Catalonia (AECS)

Indonesia (CIMSA-ISMKI)

Palestine (IFMSA-Palestine)

Chile (IFMSA-Chile)

Iran (IMSA)

Panama (IFMSA-Panama)

Turkey – Northern Cyprus (MSANC)

China (IFMSA-China)

Iraq (IFMSA-Iraq)

Paraguay (IFMSA-Paraguay)

Uganda (FUMSA)

China – Hong Kong (AMSAHK)

Iraq – Kurdistan (IFMSA-Kurdistan)

Peru (IFMSA-Peru)

Ukraine (UMSA)

Peru (APEMH)

United Arab Emirates (EMSS)

Colombia (ASCEMCOL)

Ireland (AMSI)

Philippines(AMSA-Philippines)

Costa Rica (ACEM)

Israel (FIMS)

Poland (IFMSA-Poland)

Croatia (CroMSIC)

Italy (SISM)

Portugal (ANEM)

United Kingdom of Great Britain and Northern Ireland (SfGH)

Cyprus (CyMSA)

Jamaica (JAMSA)

Qatar (QMSA)

Czech Republic (IFMSA-CZ)

Japan (IFMSA-Japan)

Republic of Moldova (ASRM)

United States of America (AMSA-USA)

Democratic Republic of the Congo (MSA-DRC)

Jordan (IFMSA-Jo)

Romania (FASMR)

Uruguay (IFMSA-URU)

Kazakhstan (KazMSA)

Russian Federation (HCCM)

Uzbekistan (Phenomenon)

Denmark (IMCC)

Kenya (MSAKE)

Venezuela (FEVESOCEM)

Dominican Republic (ODEM)

Korea (KMSA)

Russian Federation – Republic of Tatarstan (TaMSA)

Ecuador (AEMPPI)

Kosovo (KOMS)

Rwanda (MEDSAR)

Zambia (ZaMSA)

Egypt (IFMSA-Egypt)

Kuwait (KuMSA)

Saint Lucia (IFMSA-Saint Lucia)

Zimbabwe (ZiMSA)

www.ifmsa.org

medicalstudentsworldwide

Yemen (NAMS)