The mission of IFMSA
IFMSA was founded in May 1951 and is run by medical students, for medical students, on a non-profit basis. IFMSA is officially recognised as a non-governmental organisation within the United Nations’ system and has official relations with the World Health Organisation. It is the international forum for medical students, and one of the largest student organisations in the world.
is to offer future physicians a comprehensive introduction to global health issues. Through our programs and opportunities, we develop culturally sensitive students of medicine, intent on influencing the transnational inequalities that shape the health of our planet.
Imprint Editor-in-Chief Uboh, Uboh Udosen (Nigeria) Text Editors Lloyd Loruo Jasiah (Botswana) Etuk, Eno- Abasi Etim (Nigeria) Phillip Chao (New Zealand) Photography Editor Oluwaseun John Adeyemi (Nigeria) Proofreaders Egwuelu Emuyemikan (Nigeria) Eromosele Isaac (Nigeria) Layout Design Waruguru Wanjau (Kenya) Cover Picture: Designed by the IFMSA New Technologies Support Division Director-Pero Markunović (Croatia)
Publisher
International Federation of Medical Students’ Associations General Secretariat: IFMSA c/o WMA B.P. 63 01212 Ferney-Voltaire, France Phone: +33 450 404 759 Fax: +33 450 405 937 Email: gs@ifmsa.org Homepage: www.ifmsa.org
Contacts
publications@ifmsa.org Printed in xxx
Editorial
This edition is Africa’s contribution to IFMSA’s 60th anniversary celebration and thus it is enriched with a variety of articles intended to showcase the African medical school in the light of its antecedents and its present status. It dissipates talents, various views of medical student about prevailing conditions, lifestyles in our different medical schools and covers the articles related to the MDG. Also includes an interview with a great Icon and pride to the region, a fun area for comic relief It is a must read edition. Happy reading!!! Uboh, Uboh Udosen Editor in Chief
Contents 3 Editorial Uboh, Uboh Udosen 4 Message from Regional Coordinator Charles Chineme Nwobu 7 My Role; My Capabilities Anan Mfizi, Rwanda 8 IFMSA 60th Anniversary John G.G. Banin, Ghana 10 MDG; The JOurney So Far Ibrahim M.B. Abubakar, Nigeria 12 Achieving The MDGs In Africa Egwuelu Emuyemekun, Nigeria 15 MDG5 In Nigeria Adeyemi Oluwaseun John, Nigeria 18 Photo Story Waruguru Wanjau, et al, Kenya 20 Fun Corner Olaseinde Ayomideji, Niyi Oyetunji, Nigeria 21 Unique Colloquial Sandra Danso-Bamfo, Ghana 22 Interview with Prof. Dorothea BaxterGrillo 24 Doctors Like No Other Mohammed Al-Bagir Ali, Sudan 25 The Healthy Health Workers Josephine Sekhaolelo, South Africa 27 Mental Health Campaign Bienvenu Muvunyi, Rwanda 29 Medical Students and Politics Ramsys Nii Mills, Ghana 31 The Medical Student and The Society Chukwudi Nnaji, Nigeria 34 Why A.R.M.? Simiyu Bramwel Wekesa, Kenya
Auscultate is an IFMSA publication © Portions of Auscultate may be reproduced for non-political, and non-profit purposes, provided that the source is adequately and appropriately cited. Notice: Every care has been taken in the preparation of these articles. Nonetheless, errors cannot always be avoided. IFMSA cannot accept any responsibility for any liability. The opinions expressed in Auscultate are those of the authors and do not necessarily reflect the views of the IFMSA.
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Message From The Regional Coordinator
Charles Chineme Nwobu is a final year student in the University of Ghana Medical School, Korle-Bu, Accra. He has being involved in his national member organisation Federation of Ghana Medical Students Association (FGMSA) and IFMSA for almost four years and he is a global health advocate. Pictures showing Team of Officials: Next Page and and Page 5 and 6.
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The African region of the IFMSA has always faced challenges in terms of representation and involvement since the early times of the IFMSA. This should not be shocking considering the prevailing situations and hardships that we all face in our home countries as nationals and medical students. Although this may be true, we have hindered ourselves from achieving great heights. How? This is because most of us have chosen not to recognize our potential and our roles and are therefore not fully involved. We have chosen not to add some effort and have tagged ourselves with labels that we do not deserve. We have inherited the concept of the past where we decide to blame others and look for excuses instead of being ingenious and resourceful. Notwithstanding all this all this, there are some people in the region who have decided to think and act differently. They have decided to set their priorities right and have shown so much dedication locally in where they live, and to the region as a whole. I am glad to say that the region is now looking as promising as it has ever been in recent years.
My journey as an IFMSA official as the Regional Coordinator for Africa has being quite interesting and dramatic, not surprising though, considering that you all know that it is ‘Africa’ we are making r eference to. I am glad to say that it has been very enlightening and rewarding. It has definitely not being a cheap experience, especially when you decide to actually try to attend to all your responsibilities, but the honest fact is that I have had no regrets at all. I have had the honour to work with an amazing team of officials, which are like a bunch of theatrical friends who value their roles and responsibilities and have been working hard towards the mission of IFMSA. Secondly is the opportunity to develop myself in so many ways, meet the most amazing people and to understand and appreciate the diversity among all. Most importantly is the opportunity to co-ordinate, direct and ensure that Medical Students’ Associations in the region are actively participating locally in community and global health activities and are also involved and attending IFMSA activities so as to develop themselves and their local community – all leading towards regional development.
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This term started with our major IFMSA regional event, the IFMSA African Regional Meeting (ARM), which was hosted by the Nigerian Medical Students Association (NiMSA) and took place from 18th to 23rdDecember 2010 in Nigeria. This year had the theme ‘MDGs 3, 4, 5 & 6 The Journey so far in Africa’. A sub-event (Pre-ARM) was held in Lagos at the Lagos State University College of Medicine, Ikeja and the main event at Kebbi Hotels in Abuja, Nigeria. Though we faced a lot of challenges in terms of logistics, and the event was quite a ride, I am glad to say that it all ended with solid outcomes and we as IFMSA achieved our goals in the event. The next ARM will be hosted by the Medical Students’ Association of Kenya (MSAKE) in Nairobi, Kenya. They have chosen a modern a theme called ‘Health Insurance, Internal and external funding, Health Management and Information Systems’ and we are looking forward to this event and expect it to be one of the best ARMs IFMSA has ever had.
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The IFMSA has had its first international event, which was the March General Assembly held in Jakarta, Indonesia with the theme ‘Health inequalities and Disparities’. It was really an amazing event thanks to the wonderful Indonesian Organising Committee of the event. African delegates from various national member organisations of IFMSA were able to make it to this event and it was really rewarding. Now we have reached the pinnacle of this term, which is this General Assembly (GA) in Copenhagen, Denmark and the theme for this event is ‘Health and the future’ and we are having our 60th Anniversary celebration. We will be celebrating our presence, recognition, work, achievements, growth and sustainability throughout all this years. In addition to all these, I am so proud to share with everyone is that the next IFMSA March GA in 2012 will be hosted by one of own African NMO FGMSAGhana. We are really glad of this development
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and it is so great that we are bringing IFMSA in a large way back home to Africa. I am dedicating this firstly to all in the African region in dire conditions facing difficulties due to the prevailing health conditions and those who have lost loved ones due to the health delivery systems in the region. Secondly I dedicate this to our dear Auwal Shanono, the President of the Nigerian Medical Students association who passed away in a tragic incident; we will never forget you. Then also to the amazing team of officials in IFMSA who have all done a wonderful work, my regional team especially the Development Assistant (General) who has assisted me in my work, not forgetting also, every active member in all national member organisations in Africa and in other regions, who have supported the region in so many ways. Lastly and most importantly, I dedicate this to God almighty and everyone in my amaz-
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ing family made up of a great dad, mum and my three awesome brothers who have all supported me in my work. Now to everyone reading this publication, I believe that we all have a role to play and I leave it to you all to decide on the direction to take in order to contribute for a healthier tomorrow.
CHARLES CHINEME NWOBU Regional Coordinator for Africa International Federation of Medical Students’ Associations (IFMSA) Accra, Ghana.
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My Role; My Capabilities by Anan Mfizi, Rwanda The biggest question that surfaces each time someone anticipates being a doctor is, “Am I ready for the responsibilities?” No one has ever felt ready till the responsibilities are handed to him/her; does that mean that we are not ready yet? Are we not capable or not qualified? Most of the time we don’t give things a good thought until their time comes, in more colourful terms, we don’t eat fruits until they are ripe. None of us feels ready until we learn from experiences and achieve certain goals. Self confidence is the first step and it helps us to cruise through what at first sight looks to be beyond our capabilities. Note that we are capable being: we just don’t know what we are capable of yet. Next comes self-trust, and just like quality it comes with the experiences we encounter if we have the eagerness to learn. Over the last few years, the healthcare sector in Africa is showing signs of remarkable improvement both in the quality of hospitals and in the availability of qualified doctors. This marked growth is mainly due to the transformation from traditional medicine to a modern, well-structured healthcare system that has provided the platform for many African countries enabling them to meet the growing demands for quality healthcare services for their people. It is our role as young Africans to help in build the healthcare system in Africa by contributing in our respective societies. The experience that one acquires from engaging oneself in IFMSA and similar institutions teaches the individuals integral life skills. We learn to face the reality of the outside
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world, widen our horizons and learn that being “yourself” is the best person you can be. There is a lot to learn from IFMSA and its projects; the exposure makes you sharper and ready to modify what you learnt through various trainings in your respective communities or countries. We underestimate our strength and what we gain in engaging ourselves in IFMSA. We fail to realise that this exposure opens our eyes and enables us to see things from a three dimensional perspective. Knowledge can be acquired from any source. As long as you are in a heightened state of awareness, observant and imaginative enough to visualise something where others cannot this is possible. Students believe being a doctor is an isolated phenomenon and are blinded from the many implications of the profession. I believe there is a lot more to medicine than treating patients. There is being able to reach patients on different levels and helping them morally not just medically. There is also developing our communities since doctors are key figures in them and are respected even more than presidents (there is good evidence to a local that you have helped them than any other politician who’s always on their doors laying down dreams of what he/she is going to do in the future). We as the future of Africa should think of bigger projects that will improve our communities and be role models to the coming generations. We should think broadly and remember that he who fights for himself is strong but he who fights for others is the strongest.
Anan Mfizi is the Development Assistant (General) for the African region of the IFMSA and is currently a fifth year medical student in the National University of Rwanda
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IFMSA 6Oth Anniversary
Africa celebrates its involvement in the IFMSA by John G.G.Banin, Ghana The clock ticks away, the countdown is on, the timeline set for achieving The Millennium Developments Goals approaches fast!
John G. G. Banin is a final year medical student at the University Of Ghana Medical School. He served as a national executive of FGMSA between 2009 and 2010 and currently serves on IFMSA’s Publications Team as a text editor. John has special interest in Public Health and believes the solution to Africa’s problems can only be solved by Africans themselves!
“It is important to nurture any new ideas and initiatives which can make a difference for Africa.” Wangari Matu Maathai – A Kenyan environmental and political activist and first African woman to win the Nobel peace prize in 2004.
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Now may be a good time for a sober reflection on our involvement in this respect. Our involvement in achieving these goals as members of a wider international community of medical students working to change the world and make it a better place.Our involvement and impact as members of IFMSA. The world celebrates; Africa celebrates;IFMSA celebrates 60 years of thousands of yearly international medical student exchanges throughout the world; several community and global health projects wholly student initiated and implemented; influencing policy making and changing lives the world over! The world celebrates IFMSA’s 60th Anniversary. Africa’s relevance within the IFMSA cannot be laid on with a trowel. My bold claim of the above statement can be corroborated by the fact that, the African continent is bedeviled with
many issues of public health concern and it is in Africa that we see a lot of displaced people due to wars and conflicts. These are even aggravated by the fact that HIV/AIDS continues to be major problem various governments across the continent have to spend their meager resources on controlling. The working of the various standing committees such as Public Health, Human Rights and Peace, Reproductive Health and AIDS and even Medical Education are thus more relevant to the African NMOs probably more than it should matter to any NMO in other continents. Yet in these challenges, medical students in Africa have made significant strides in improving the lives of countless people in and out of Africa. NMOs in Africa continue to contribute significantly to IFMSA and to the world at large by their involvement in the student body leadership and also in the organization of various programs of relevance to the communities they live in. First published in the Montreal Gazette, Judith Kumin – the UNHCR representative in Canada made a profoundly true remark on the humanitar
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ian condition in Africa in 2003. She said “While the world was mesmerized by thewar in Iraq, Africa’s refugees have slipped a little bit deeper into misery and despair”. How true this statement was and how relevant it is even now that the world turns its attention to the earthquake in Japan. It is indeed commendable that even during that same time the IFMSA issued a press release against the embargo placed on the Republic of Cote d’Ivoire in the wake of the crisis in the country. My hats off to the students in Cote d’Ivoire who protested against this embargo in white coats in front of the WHO office.An attestation to the popular IFMSA slogan; medical students do change the world. Certainly IFMSA in Africa has come a long way and seen a lot of changes and influence. To have been actively engaged in IFMSA despite the challenges demonstrates the resilience and dynamism within IFMSA-Africa. In the area of leadership, Africa has not disappointed at all. Africans have held and are still holding important leadership positions within the IFMSA and have contributed significantly to influencing IFMSA policies and by-laws and the direction of the organization. The region can perform better and contribute meaningfully even as we push forward to achieving the MDG’s in the final lap of its implementation! The African region still has significant challenges and these needs to be looked at and addressed promptly by all involved. It is a known fact by many an enthusiast in the region that when it comes to representation at IFMSA General Assemblies, Africa falls short. A number of factors could account for this as we have problems such as delegates having difficulty in acquiring visas sometimes which is a challenge in Africa in general because applicants fail to reach the exuberant expectations www.ifmsa.org
of the immigration authorities of the hosting countries or there is non-adherence to laid down protocols by the Organizing Committees of such General Assemblies. Also burgeoning and persisting is the lack of adequate funds or the needed sponsorship for such trips. Maybe it’s about time more alumni put their hands on deck to provide support for NMOs. Communication seems to have improved in the region but I believe there is still more to be done. The number of people on the African online server however is not commendable considering the number of Medical Students in Africa. We can all contribute more in this regard. I believe co-operation and friendships within the region has improved considerably with the successful organization of IFMSA African Regional meetings the last one of such being held in Lagos and Abuja in December 2010. One area we can improve upon and achieve more is partnerships. NMOs in Africa can take advantage of such regional meetings to build useful partnerships to organize programs that are suited for the problems endemic within the region. Problems within African countries are generally similar and NMOs can share ideas and come up with projects that are tailored to address such problems. Certainly we have a cause to celebrate IFMSA in Africa and also to join in the celebration of 60 years of IFMSA’s existence and influence in the world. 60 years of medical students changing the world! Africa will continue to be a big player in making the vision of IFMSA more relevant and its impact profound. Hurray! Africa celebrates. IFMSA is 60 years!!! Long live IFMSA, long live IFMSA-Africa!!! Sources quoted: 1. Kumin Judith, Editorial. REFUGEES Vol.2 No.131, 2003. 2. Maathai, Wangari, http://thinkexist.com/ quotes/with/keyword/africa/3.html 9
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MDGs: The Journey So Far Challenges, Prospects and Roles of the Youth In Achieving the MDGs by Ibrahim M.B. Abubaker, Nigeria
Ibrahim Abubaker is a 500 level medical student of University of Maiduguri, Bornu State, Nigeria. Benjamin Disraeli once said, “Almost everything that is great has been done by youths. The youths of a nation are the trustees of posterity.” For every nation to develop and realise the MDGs, the role of young people must be put in place.
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In the year 2000, owing to the yearnings for a better world for all, the world’s governments adopted a blue-print known as the ‘Millennium Development Goals’ with the acronym MDGs aimed at building a better world in the 21st century. The MDGs centre around the collective efforts of the world community on strategies towards achieving crucial and significant improvements in people’s lives across the globe. Indeed the MDGs are poised at eradicating poverty and all its ramifications. The goals adopted include; poverty and hunger eradication, achieving universal primary education, promoting gender equality and women empowerment, reducing child mortality, improving maternal health, combating HIV/AIDS, malaria and other diseases, ensuring sustainable environment and, finally, creating a global partnership for development. These are all targeted to be achieved by 2015.
vices but the involvement of the youth is often unsatisfactory. As the target year approaches, Sub-Saharan countries are regrettably performing below par in terms of accomplishing the set goals. This is evident in the growing rates of unemployment, school dropouts, poor enrolment especially of the girl child, HIV/AIDS incidence, and increase in maternal and infant mortality just to name a few. Hence there is need to alter the traditional approach of tackling these challenges and focus must be placed on interventions channelled through the youth. Policymakers in African governments should remember that, “today’s investment in children is tomorrow’s peace, stability, security, democracy and sustainable development.” The youth should be the ones spearheading initiatives affecting their future and they are the best tools for nations to use to achieve the MDGs. It is vital to note that the strength of future development a nation has The millennium campaign puts is a sole function of its youth. strong emphasis on member This is evident in developed nations to act on their promises countries as they place great and deliver the necessary ser- emphasis on programmes and www.ifmsa.org
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Youths give the impetus to both the urgency and the opportunity to achieve the MDGs considering the vital role they play. Youth integration in the fight against poverty, which is the major hurdle faced by developing nations, should be achieved. There is therefore the need for sustainable economic programmes to boost the youth’s participation in tailoring suitable developmental projects for a sustainable livelihood. The areas of interest should include; capacity building and entrepreneurial development as catalysts to self-reliance as well as feasible agricultural research and development, in relation to accelerated food supply, economic empowerment and employment generation. Suffice is to say overcoming poverty is invariably achieving the MDGs as a whole. Youth led projects have overtime proven success, as they are based on peer-to-peer relations. As such, governments should create modalities to incorporate youths in promoting and propagating the ideas and ideals of the MDGs through advocacy campaigns, and peer enlightment programmes, through this, the HIV/AIDS, malaria and other healthcare issues may be positively addressed. Involving youths in promoting and monitoring policy implementation at the grassroots will also
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help immensely in meeting the global targets. Governments should realise that national development and the accomplishment of MDGs is a collective responsibility, where all citizens, including the youths, must be informed about and engaged in building a thriving society for all. Youths on the other hand should be ready and willing to take advantage of their roles not only as evolving future leaders but as partners of today in a collective responsibility.
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policies targeted towards youth development. In integral concept to note is that youth development, nation building and MDGs are a mutually re-enforcing triad.
Imagine a society where both the young and the old are together on the think tank, brainstorming and crafting solutions for the betterment of society. Imagine a HIV free generation, where malaria is no longer a cause for concern, a society with improved maternal health and robust infant healthcare facilities. Imagine a society where all children of school age are enrolled regardless of social status. Imagine an economically buoyant and socially sound society. This is the Arica I want you to envision for the near future. In conclusion, the United Nations has released a new product termed the ‘pasta of life’. The pasta, packaged with 8 ingredients for sustainable livelihood, expires in 2015 and the recipe has been entrusted in the hands of our leaders, to microwave it to the taste of the people in time and engage the youths in delivery, so that by 2015 the society may live a worthy life.
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Achieving The MDGs in Africa The Role of Medical Students by Egwuelu Emuyemeken, Nigeria
The Millennium Development Goals [MDGs] are 8 time-bound goals- with a deadline of 2015which was extracted from the United Nations millennium declaration adopted by representatives of 189 UN member nations at the September 2000 millennium summit held at United Nations headquarters in New York, USA.
Emuyemiken is a fourth year medical student in the University of Benin, Edo State, Nigeria and is the Proofreader of the Auscultate Editorial Board. Ask not what your country can do for you. Ask what you can do for your country”. John .F. Kennedy January 20 1961
Since the adoption of the goals in 2000 a lot of progress has been made globally and of course there have also been important setbacks [The 2008/2009 global economic crisis for example]. A quick run-through of the MDGs progress report [www.undp.org/ mdgsprogress.html as at January 18th 2011] will show that Africa especially Sub-Saharan Africa has taken only baby steps in achieving the MDGs and as such have made very little progress. All these can be changed not just with the unity of our nations and political leaders but with students’ involvement especially medical students from all over the continent. Although our political leaders have failed to see the usefulness
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of medical students in achieving the MDGs, over the last few years activities of medical students have helped bring awareness of the Goals to the public. For example, in Nigeria the Nigerian medical students association [NiMSA] over the past few years have organized rallies, outreaches, seminars and workshops that has enlightened the public on environmental and climate change and it’s effect on health, maternal mortality, HIV/AIDS and the benefits of education to the Nation. The effects of these projectshas been manifold; For example the environmental workshop held at the university of Benin, Benin City Nigeria in July 2010, has led to the change of most of the electric bulbs in the university to energy saving bulbs, and most streetlights within the city to solar powered streetlights. Another typical example of students’ activities that has boosted the MDGs awareness in Africa [Nigeria to be precise] is the nationwide rallies against maternal mortality which has drawn the attention of stakeholders to the issue. The last regional meeting www.ifmsa.org
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At the 2010 world summit, the United Nations member states came together to see how close they were to achieving the MDGs in 2015. While many nations in Europe, Asia and America were on the fast track to achieving the goals, African countries were still www.ifmsa.org
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[RM] of the African region of IFMSA which was held in December 2010 at Abuja was also focused on achieving the MDGs [3, 4, 5 and 6]. The ARM culminated the efforts of medical students in several African countries to bring to the fore the effects of maternal and child mortality on our societies and how female literacy and gender equality could go along way in preventing maternal and child mortality. All over Africa medical students are making efforts The effects of these projectshas been manifold; For example the environmental workshop held at the university of Benin, Benin City Nigeria in July 2010, has led to the change of most of the electric bulbs in the university to energy saving bulbs, and most streetlights within the city to solar powered streetlights. Another typical example of students’ activities that has boosted the MDGs awareness in Africa [Nigeria to be precise] is the nationwide rallies against maternal mortality which has drawn the attention of stakeholders to the issue. The last regional meeting [RM] of the African region of IFMSA which was held in December 2010 at Abuja was also focused on achieving the MDGs [3, 4, 5 and 6]. The ARM culminated the efforts of medical students in several African countries to bring to the fore the effects of maternal and child mortality on our societies and how female literacy and gender equality could go along way in preventing maternal and child mortality. All over Africa medical students are making efforts
making little strides. This most assuredly is not the fault of just our leaders. A random survey among any society in Africa will show that only three maybe four out of ten people know about the MDGs. It is however sad to note that sometimes even medical students are not part of the three or four. The truth of the matter is that we as African medical students involved in IFMSA we should rise up to the task and stop waiting for our leaders to include us in their action plan. It is time for us to start acting and not just making policies and waiting for our leaders to recognize us and accept these policies. Action they say speaks louder than voice. Let us start acting today and our leaders will pay attention, nay they will be all ears. The next question is how do we act? What can we do to achieve these goals in our continent? The measures could be individual or collective; Actions we can take as individuals include; •Wearing a white band to show our support for the MDGs and encouraging other people to do the same. •Speaking up in our communities; Talk to people about the MDGs and why they matter •Volunteer to teach or work to empower people. •Write codes for example figure out a cheap way to purify water. •Help in monitoring schools and clinics. As you might have experienced your white ward coat, stethoscope and ID card can give you access to any school, clinic or office. Activities that we can undertake as groups to support the MDGs would include; •Organizing seminars, workshops and symposia. •Organize rallies to 13
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government offices [especially those of legislators] and outreaches to the general public. • The use of mass media, the internet, TV, music and print to educate our communities about the MDGs. • Organizing bon-fires, dinners, luncheons, pageants or even concerts in support of any or all the MDGs By virtue of the profession, medical students are respected and when we talk people listen. We should not fail to use this virtue wisely. A closer look at the MDGs will reveal that they are interrelated, that means that achieving just one of the goals will go along way in achieving all the others. A good example is that gender equality and women’s empowerment have large chain reaction effect on the other MDGs as an educated mother will have healthy and educated children, which will reduce poverty and which will inturn reduce gender inequality and promote education of the girl child and also promote environmentally friendly practices. In conclusion, a lot has been done by IFMSA students and medical students in general to
achieve the MDGs even when our leaders have failed to see our usefulness. We can still do more with or without recognition. About six of the MDGs are focused directly or indirectly on the children, this tells us that the MDGs are goals that promise a better future for us and our planet. We should make determined efforts to achieve them. To assess these information and more information on this topic visit: “What will it take to achieve the MDGs?- An international assessment”-www. undp.org/mdg as at January 18 2011. “The MDGs: Challenges and opportunities-poverty practice group bureau for development policy”- www.undp.org/mdg - as at January 18 2011. “How can we track the MDGs p ro gre s s ? ”w w w. u n d p. o rg / m d g s p ro gre s s. html as at January 21 2011. “The millennium Declaration And Development Goals: A Blueprint For Progress”www.unicef.org/mdg/index_aboutthegoals. html
Millenium Development Goals The 8 MDGs are Goal 1: Eradicate Extreme Poverty And Hunger Goal 2: Achieve Universal Primary Education Goal 3: Promote Gender Equality And Empower women Goal 4: Reduce Child Mortality Rate Goal 5: Improve Maternal Health Goal 6: Combat HIV/AIDS, Malaria And other Infectious Diseases Goal 7: Ensure Environmental Sustainability Goal 8: Develop A Global Partnership For Development 14
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MDG 5 In Nigeria: Where Are We Going Wrong? by Adeyemi Oluwaseun John, Nigeria
The Chase 1987. Nairobi, Kenya. The race started with the launching of International Safe Motherhood Initiative. Nigeria, the most populous country in West Africa was a prime player. Much was expected but little was achieved. And for thirteen years, the statistics remained unchanged. 2000. New York, U.S.A. Yet another initiative – The Millennium Development Goals! Coupled with the dawn of democracy leadership, the Nigerian government embraced the ideas with verve. Internal policies and initiatives sprang up, enlivening the model of a transformed Nigeria by 2015. 2005. Nigeria, Africa. 59,000 recorded maternal deaths accounting for 10 percent of all deaths in the world.1 Nigeria’s five year assessment was poor. With a relentless spirit, the Nigerian leaders made their way back to the drawing board. This resulted into newer strategies and policies.
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2010. Ile-Ife, Nigeria. The scenario was typical. Four doctors, ten nurses, several orderlies and the eclamptic woman with obstructed labour in the centre of it all. The history was virtually the same – gravida 5 para 4, all alive, EGA of 41 weeks 5 days, no history of antenatal care, spent 48 hours in labour with a traditional birth attendant, brought in unconscious from a village one hour away at 1 a.m. The anaesthesiologist and paediatrician joined in the operating room. It was an emergency lower segment caesarean section. The doctor was smart – he brought the baby out three minutes forty seconds after incision time. And the cleaning up started but didn’t end well. We lost her. Pregnancy and childbirth for any woman should be a thing of joy but this is not necessarily so in Nigeria – at least, not yet. Nigeria has one of the highest maternal mortality ratios in the world: 1,100 maternal deaths for every 100,000 live births.2 This gives cause for concern. There is no
Adeyemi Oluwaseun John is a final medical year student of Obafemi Awolowo University, Nigeria and the Photography Editor, of the IFMSA Publications Team.
“The heights great men reached were not attained by sudden flight but while others slept, they worked all night climbing the ladder of greatness.” Seven Pillars of Wisdom Next page: picture of Nigeria Medical Students
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other country with the amount of resources Nigeria has that has such grim statistics. Nigerian leaders are trying but there is something structurally wrong with our approach to reducing maternal deaths. The Challenge I don’t doubt Nigeria’s commitment to reducing maternal deaths but the possibility of achieving MDG 5 by 2015 seems uncertain. My misgiving is not unconnected to the evident roadblocks ahead. These problems are multifaceted, akin to Nigeria’s geographical, ethnical and religious diversity, masked by the widespread poverty in the oil-rich country and greatly undermined by sheer lack of political will in achieving this goal. The factors that cause maternal mortality
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are known to the average individual and to the government. Chief among them are complications associated with pregnancy and childbirth such as bleeding, infection, abortion, prolonged or obstructed labour. All these can be contained if there are skilled personnel, adequate facilities to handle emergencies and appropriate afterbirth care. As simple as this sound, it takes great financial investment. There’s no achievable MDG without funds. It goes beyond the policies. It’s about action stemming from practicable policies channelled with a determined mindset. Most well-conceived policies and programs are donor driven, with no substantial funding coming from the
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portrays a dismal picture – total spending on health care reduced compared to preceding years, and worse still, government spending amounts to merely one-seventh of private-sector spending!3 Also, laws and policies related to critically important problems that affect safe motherhood, such as early marriage, unsafe abortion and women’s reproductive rights, are still lacking. Lack of understanding and misleading information about the importance of the issue impede enactment of relevant legislation. Skilled birth attendants are in short supply in Nigeria. Roughly 60% of births are attended by unskilled birth attendants, while up to 50% of practitioners with skills work in the private sector.4 Programs to deliver high-quality maternal and child health services are both limited and uncoordinated at various levels of government. Political commitment and support for issues related to maternal and child health are lacking at the sub-national levels, especially at the local government level. Local government councils have given little support to primary health care facilities, which provide an entry into maternity services in Nigeria for most women. Besides all these are the other sectored problems like very low power generation in the country, low level of education and poverty. The frequent ethnic and religious crises also divert government’s attention from the salient issues that serve as common denominators to every Nigerian. Way Forward The most important interventions for safe motherhood are ensuring that a trained provider with midwifery skills is present at every birth, transport is available to referral services and that quality emergency obstetric care is available. This should not only be located in the urban regions but more in the rural setting where a larger percentage of the population resides. Free or subsidized treatment should be made available for all and sundry. Also, there should be an increased training of all levels of medical staff providing maternal health services, improved education of birth attendants so that they can
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M.D.G Corner
public sector. A report released by WHO in 2005
better help women in labour, and motivation of paraprofessionals to work in remote regions The Nigerian government must be willing to commit adequate resources, particularly financial resources, to meet the needs of the health system. This system must be significantly overhauled to promote proper coordination among the three levels of government—federal, state and local—both to reduce bureaucratic bottlenecks and wastage of resources and to ensure availability of the trained providers, up-to-date equipment and supplies needed to provide appropriate contraceptive, prenatal and obstetric services. Once all the challenges are tackled and the interventions necessary in salvaging the health of our mothers are enacted at all levels of government, especially at the local government level, then we would be firmly on track on reducing maternal mortality. The mathematics will add up and all the labours of the NGOs and the policy makers would come to fore. In Conclusion Who gains if MDG is achieved? Who benefits when their maternal mortality ratio reduces? It’s sure not the United Nations. It’s the people. People like the eclamptic patient I shared earlier, and many more whose deaths are consistently swept under the carpet and no one knows save their family. They are the benefactors. Achieving MDG 5 is a dream. And like every dream, some are born and some become stillbirth. What is needed is commitment. As the saying goes, dreams become reality only if we keep our commitments to them.
References
1. World Health Organization (WHO), Maternal Mortality in 2005: Estimates Developed by WHO, UNICEF, UNFPA, and the World Bank,Geneva: WHO, 2007. 2. World Health Organization (WHO), Maternal Mortality in 2005: Estimates Developed by WHO, UNICEF, UNFPA, and the World Bank,Geneva: WHO, 2007. 3. Guttmacher Institute, Barriers To Safe Motherhood in Nigeria: Akinrinola Bankole, Gilda Sedgh, Friday Okonofua, March 2009. 4. Guttmacher Institute, Barriers To Safe Motherhood in Nigeria: Akinrinola Bankole, Gilda Sedgh, Friday Okonofua, March 2009.
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Taseer listens keemly to a forensic pathology lecture, Elijah auscultates a patient, Jeanette bonds with the paediatrics patients while Daisy works hard in the wards
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when...
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INTERVIEW
Celebrating an Academic Icon In Medical Education An interview with Prof. Dorothea Baxter-Grillo Egwuelu Emuyemeken, for AUSCULTATE “I saw the first Electron Microscope ever made in Hamburg� said Professor Baxter-Grillo, A renowned researcher and Professor of Embryology who has held professorial positions in both Nigeria and Jamaica. She is presently a Professor and Head of Department, Department of Anatomy, University of Benin (UNIBEN), Benin city, Edo State, Nigeria. Professor Dorothea Baxter Grillo was born in Kingston Jamaica in 1931 to George Frederick a Medical doctor and Lillian Baxter a house wife where she was brought up in her earlier years. She got married to now Emeritus Professor Taye Adesanya Ige Grillo in 1955. Her interests include art, archaeology, travelling and gardening. Professor D. Baxter-Grillo qualified as a Doctor from the Royal College of Surgeons, Dublin in 1955. She specialized in Paediatrics before she decided to further her education in Anatomy. She was the first person to get a PhD in Anatomy in Nigeria. This incredible woman has served as a Professor of Anatomy for different Universities in Nigeria and one in Jamaica and has trained a lot of Professors who themselves have trained more academicians.
Interview Auscultate: Ma, please can you give us a brief recap of your experiences and where you have been around the world and the nature of your work with the institutions in Africa you have worked with? Professor Grillo: I have been to every country in the world except Australia and Iceland. But my travels have not all being for academic purposes. I did my Internship in Denmark and I had a degree in Electron Microscopy in Japan and I also have a Fellowship in Paediatrics from Stanford University in California but most of my travels have been for leisure. Most of my teaching experiences have been in Nigeria. I started teaching at the University of Ibadan many years ago; I was the first Professor of Anatomy at the University of Maiduguri. I was also a Professor of Anatomy at the Obafemi Awolowo University (OAU) Ile-Ife, and presently
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I am a Professor and Head of Department of Anatomy, University of Benin, Benin city, Nigeria. I was also a Professor of Anatomy in Jamaica. Auscultate: Why did you leave Medicine to practice Anatomy? Professor Grillo: Well my husband was the first Nigerian Anatomist and he was working at the University of Ibadan at the time and I was a aeditrician working at the University College Hospital (UCH), Ibadan and the distance from the hospital to the campus was far I had to shuttle between the campus and the hospital. It was very exhausting so I decided to change to Anatomy so I could be closer to my husband. I also wanted to do some basic research. we got it we had to send people to Japan to train them on how to use it. Auscultate: Would you say the educational system in Nigeria is progressing or retrogressing? Professor Grillo: It was progressing before the Civil war (1966-1970) but the Civil war slowed everything down but it is picking up slowly.
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AUSCULTATE 2011 Auscultate: What do you think can be done to improve the Nigerian and indeed African Medical Schools and bring them to lime light? Professor Grillo: Well we could try to get good academic staff and modern equipments. But the main problem is infrastructure for example; electricity and water. Auscultate: Ma, where do you see the Nigerian Medical schools in comparison to other schools in the world in the next five years. Professor Grillo: Nigeria has a lot to do to get all the proper standards and facilities for research. Auscultate: Ma, are you aware of any plans both governmental and non-governmental to improve the quality of the Medical schools here in Nigeria and what are the prospects of these plans? Professor Grillo: Oh yes there has been a lot of research proposals, The Education Trust Fund (E.T.F) is helping in these research and for prospects… they are going to do well a lot of students are interested and when they are through their work will be published in international journals and UNIBEN journal. They will also attend conferences. We even have M.Sc and Ph.D studies. Auscultate: What would you advice the different African regions to do from your wealth of experience, if there was an opportunity to reach out to them? Professor Grillo: They already know what they should do. Like giving Scholarships and grants, exchanges to other countries so that they can get foreign experience because when you have new experiences then your way of thinking will change and they can learn new ways of doing things. But development is a two way thing, you need dedicated people both staff and students. Auscultate: Prof. can you tell us about your Academic Biography? Professor Grillo: (Laughs) I cannot tell you all of them. They are so many that I cannot remember some of them. Well, I qualified in 1955 from the Royal College of Surgeons in Dublin and got my L.R.C.P (licencate in Medicine). I have my L.R.C.S (licencate in Surgery). L.L.M (licencate in midwifery) D.C.H (a Special degree in Paeditrics) I also have a PhD in Anatomy. I was the first
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person to have a PhD in Anatomy in Nigeria. You know I did all my research for my PhD on my own in my garden in Ibadan and sometimes on a table in my kitchen with support from my husband and when I needed to analyze something and the necessary facilities were not in Nigeria I would go to the United States to the University of Michigan, they were very supportive and always gave me the assistance I needed. This is an advice to the young generation of today; you do not have to have teachers or facilities in your country before you do researches. The world has become a place that if you do not have what you want in your own country you hop-on to the next country where it is available, yes that is what I do, if I want something in Nigeria and it is not available here I hop-on to a country where it is available. I am a Fellow of Anatomical Association of Nigeria. I am also a Fellow of the Royal College of Surgeons. I have a Fellowship in Cambridge something about IVF. I was also a Professor of Anatomy in Jamaica. You know I am from Jamaica? Auscultate: Ma, can you tell us about your researches. Professor Grillo: Well a lot of my Researches have been on Embryology basically and some I did on my own and some with my husband. I cannot remember all the topics now but we developed a lot of techniques in Biochemistry and Histochemistry. Auscultate: Any final advice to the students? Professor Grillo: Why! Yes they should keep up to date by; Reading recent editions of books but our libraries only have outdated books. They can also go online but they internet is full of incorrect information mixed with the truth and you may not know how to decipher one from another. So the “best way to keep updated is to attend conferences” and have exposure in another setting. Auscultate: Thank you very much Ma for your time. Prof Grillo: Oh, you are welcome. Auscultate: With all your travels, I think you deserve to be in the Guinness book of Records. Professor Grillo: (laughs) …. Yes oooo. Auscultate: Thank you very much Ma and bye. Professor Grillo: Bye.
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Doctors Like No Other by Mohammed Al-Bagir Ali, Sudan Take a second and think about
their productivity in their roles as
African doctors practicing here on
doctors. But what makes them great
our continent. Almost certainly, the
is their ability to look for positive
thought that comes into mind is their
outcomes in-between all the chal-
poor working conditions and lack of
lenges they face. A way to overcome
advanced equipment. This is the gen-
them and turn these hindrances into
eral picture identified by all, Africans
strengths they can use to serve them-
and non-Africans, and the big picture
selves and their communities.
is constantly missed. What is not ap-
Dr. Mohammed Al-Bagir Ali is a MBBS graduate of University of Kordofan and is an alumnus of MEDSIN (Medical Students International Network). mobagir@ hotmail.com
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preciated is the way in which these
Unlike other areas of the globe, doc-
doctors are still able to do their jobs
tors here in Africa still command a
and make a positive difference in the
great deal of respect from their com-
lives of their patients amidst all their
munities. They are placed amongst
challenges.
the most elite of members in their societies and thus the added pressure
Owing to the technologically de-
for them to work hard, be good at
pleted working environment, doctors
what they do and not to jeopardise
have had to get accustomed to the
any patient’s health in any way. In
current state of affairs but still pro-
some areas of Sudan, a doctor is still
vide an acceptable degree of care to
referred to as “hakeem� which is an
their patients. This has led to a great-
Arabic term for a wise man. This term
er emphasis to be placed ongood
suggests that a doctor is not only a
clinical sense and judgement which
doctor per se, but also a counsel-
allows them to make very good calls
lor with a wise voice that people can
when necessary.
turn to for advice.
This is not to say that African doctors
Yes they have almost nothing in
are flawless, or that they are able to
their armamentarium, with nothing
manoeuvre around all obstacles pre-
to back them up. Yet what makes
sented on their path. No, there are
them different from all other doc-
things and situations that make them
tors around the world is that they are
weak, things that threaten to hinder
AFRICANS.
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The Healthy Health Workers by Josephine Sekhaolelo, South Africa When one thinks of a health worker, he or she thinks of someone who works for the health sector, and who knows and understands the importance of living a healthy lifestyle. Their primary intention is to enhance the health of the society. This shows that people expect health workers to be eating healthy food, exercising regularly and be at a healthy mental state. However, a study that was done in the province Messina (Italy) showed that there is an alarming increased incidence of obesity among health workers. Most of them also had lifestyle diseases like hypertension and diabetes. According to World Health Organisation (WHO), unhealthy diets and physical inactivity are key risk factors for the major non-communicable diseases such as cardiovascular diseases, cancer, and diabetes. Most of these non-communicable diseases can be prevented by lifestyle modification. It is about time that health
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workers lead by example change to healthier lifestyles. In South Africa, most of the restaurants at medical schools and hospitals sell fries, fizzy drinks and the list of unhealthy food goes on. This is another factor that contributes to the increasing incidence. This has led to the architecture of a public health project called The Healthy Health worker. This is a project that was initiated by South African Medical Students’ Association (SAMSA) with the aim of promoting healthy living in health workers including medical students. The project consists of the following activities: • Selling healthy food at medical school and surrounding hospitals for a week as a way of raising funds and promoting healthy diets. Simple recipes pamphlets will also be sold to encourage people to make healthy eating their daily bread. • Having exercising challenge games as a way of
Josephine Sekhaolelo is the acting President of South African Medical students’ Association (SAMSA) South Africa Before reading this article: Are you a healthy health worker or are you just a health worker?
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Just a health worker keeping fit and having fun as health workers. Indigenous games will also be played to emphasize their importance in preserving culture and keeping fit. • Assessment of vitals such as pulse, blood pressure, Body Mass Index, exercise tolerance test and peak expiratory flow. • Awarding all who participated and persevered throughout the week. • Weight loss challenge for those who are overweight and obese.
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A healthy health worker This project will be officially launched early 2012 and will be done at different hospitals and medical schools in South Africa. Suggestions are accepted as we would like this project to be a success and have a positive impact on our health workers’ lives. Medical students are the future health workers; therefore they need to also lead their communities by example.
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Mental Health Campaign Rwanda Medical Students Against Mental Health Problems by Bienvenu Muvunyi, Rwanda After the 1994 Genocide against Tutsis in Rwanda, signs and symptoms of mental problems has become more serious and challenging in Clinical Practice. To deal with this, 30 Medical students came with the idea of initiating the Medical students’ Mental Health Association, MMHA. Our role as Medical students MMHA is from the faculty of Medicine at the National University of Rwanda (NUR). It is composed of 120 students coming from General Medicine, Clinical Psychology departments, and Social Work department of the Faculty of Arts, Media, and Social Sciences. Our objective is to improve Mental Health in the country where incidence of mental problems like Post-traumatic Stress Disorders (PTSD), Depression, etc is increasing considerably. In order to achieve our objective, we have worked through the Mental Health Empowerment Project (MHEP) which activities are: 1) Psycho-education: since 2007 we have been training Secondary schools’ student on mental health in 30 different schools. 2) Advocacy for orphans: we
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also do advocacy for orphans for funds that would help them start small income generating projects in order to improve their socio-economic status which has an impact on any health problem, especially on mental problem. So far we have funded in collaboration of Danish Medical students 3 different projects. 3) Consoling in periods of National Genocide commemoration: each year 80 MMHA members work as volunteer consolers to give Bienvenu MUVUNYI First Aid to traumatized patients in MMHA in charge of crisis on 71 different commemoraCapacity building and tion sites (each site per cell) in the Networking district of Huye. MHEP members are trained by experts in counseling and First Aid on trauma, from the Ministry of Health and the Faculty below: Secondary students of Medicine before we help. 4) Radio Programs on Mental in first aid competition Health Issues: We have been invited several times to speak about Mental Health issues, live on Isango Star and Salus Radios, two local radio stations broadcasting from Rwanda. People were
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sensitized and informed about causes, epidemiology, symptoms, preventions, and complications of mental problems, and where to consult if possible and how to care after someone suffering from these illnesses in their everyday life. We believe Rwanda will be healthier than today if Medical students play its role in prevention and health education in the Country. There still is a lot to do, and if we continue to work harder with a compassionate mind, within 5 years, we will say that mental health has been improved in Rwanda. MMHA member in a Radio program ( Isango star studio).
MMHA volunteers helping a traumatized young woman in crisis
Secondary students in first aid competition
Reference: http://www.newtimes.co.rw/print.php?issue=14198print&article=26800
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Medical Students and Politics by Ramsys Nii Odartei Mills, Ghana
As I medical student with an acquired chronic predilection for politics, I had no trouble finding mentors who had already trodden the path I have chosen to take. Even though I may never experience the hardships that forged the strength and character of Steve Biko or benefit from the perspectives that unleashed Frantz Fanon’s awesome intelligence, I still find solace in their thoughts. For sentiments expressed at the height of such men’s travails are often comparable to the words of Solomon. Fanon shares a common sentiment when he says, “each generation must discover its mission, fulfil; it or betray it, in relative opacity.” The schema may have changed, globalization and neo-colonialism have replaced apartheid and slavery as the order of the day, but the weapons of our warfare; truth, justice and equality that our forebears fought to instil, have not lost their relevance. The challenges of today have to be tackled head on by our generation, so that our children will have it easier, build on our successes and etch our names in letters of gold. Frantz Fanon was born in Martinique in 1925. From 1945 he studied medicine and psychiatry in Lyons and began to write. His first analysis of the effects of racism and post-colonialism, Black Skin, White Masks, appeared in 1952 and became a foundational text for the liberation movements of the 1960s and later for postcolonial studies. In his book Black Skin, White Mask, he makes a point that “sometimes people hold a core belief that is very strong. When they are presented www.ifmsa.org
with evidence that works against that belief, the new evidence cannot be accepted. It would create a feeling that is extremely uncomfortable, called cognitive dissonance. And because it is so important to protect the core belief, they will rationalize, ignore and even deny anything that doesn’t fit in with the core belief.” I find this statement increasingly true when medical students argue out the reasons they cannot be interested in anything else apart from their books. In my opinion, every new batch of medical students constitutes some of the best brains in every country who can apply their brilliant questioning minds to a plethora of issues but choose not to. We medical students and doctors, for that matter, for many reasons such as complacency, economic security, busy schedules and fear of public sentiment have failed miserably in our exercise of suffrage and developed a political inertia that Africa can no longer afford. However our national and local medical organizations are not political and must remain free of partisan politics. But as individuals, we must realize that we should exercise our right as citizens to take an active part in politics. Today we are being challenged to take our rightful place as citizens and share in the problems and aspirations of society. Medicine is in politics for better or worse. It cannot be considered separate from socio-economic problems or cultural and physical developments. The Medical Student and The Society: The Nigerian Experience 29
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Steve Biko was a noted anti-apartheid activist in South Africa in the 1960s and 1970s. A student leader, he later founded the Black Consciousness Movement which would empower and mobilize much of the urban black population. While living, his writings and activism attempted to empower black people.
began the 1100 km drive to Pretoria to take him to a prison with hospital facilities. However, he was nearly dead owing to the previous injuries. He died shortly after arrival at the Pretoria prison, on 12 September. His funeral was attended by over 10,000 people, including numerous ambassadors and other diplomats from the United States and Western Europe.
At this point If you are wondering if Like Frantz Fanon, Biko origiany medical student in today’s Africa nally studied medicine, and, will give up a white coat for martyrlike Fanon, Biko developed an dom like Biko did years ago, you are intense concern for the develnot alone in that regard. Steve Biko Dr. Frantz Fanon opment of black consciousness and Frantz Fanon were medical stuas a solution to the existential dents like you and I when they started struggles which shape existhe moral revolutionary fires that still tence, both as a human and as burn with the same intensity of our an African. In 1972, Biko was Hippocratic Oath and like them, if we expelled from the University want generations to remember us, we of Natal because of his politimust leave our zone of comfort and cal activities. On the 18th of apply ourselves to the world around August, 1977, he was arrested us. Politics is as much the business at a police roadblock and of the physician as any other person. interrogated. The interrogation The medical profession today is more lasted twenty-two hours and deeply affected by social and political included torture and beatings developments than at any time in hisSteve Biko resulting in a coma. He suffered a major head tory and vice versa.The physician is challenged injury while in police custody, and was chained to adopt a political philosophy that is courato a window grille for a day. On 11 September geous, energetic, and imaginative in working 1977, police loaded him in the back of a Land for the best interest of humanity. Rover, naked and restrained in manacles, and
Ramsys Nii Odartei Mills is currently a medical student at the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Niiodartei2002@yahoo.com
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The Medical Student and The Society: The Nigerian Experience by Chukwudi Nnaji, Nigeria
The Human Society is in every regard a valueminded one. And man has, over the ages, tried to create value through his endeavours, by which he strives to make himself a better being. Medicine, as an endeavour, is considered all over the world a noble Profession. No doubt, the study of medicine has come to be so revered among the numerous fields of learning. One may want to attribute this professional nobleness to the relatively herculean psychomental effort medicine demands, both in study and in practice. It is, therefore, not surprising how being a medical student can earn one a noble place in the society. This I have come to appreciate as a medical student myself. Let me illustrate the Nigerian scenario of the societal value of a “Student Doctor”. When I got an offer of admission from the University Of Benin to study Medicine and Surgery in 2005, it came as a great piece of delight, not just to me and my family, but also to friends, former classmates, neighbours and distant relatives. To many of them, I became a doctor from the very moment they heard I was a Medical Student. Initially, whenever addressed by the usually over-emphasized “Doctor” title, I often felt more cajoled than dignified, sometimes even subtly embarrassed. But with time, I got used to it. Hence, I have learnt not to feel flattered whenever someone addressed me as “Doctor Chuks” or “Doctor Nnaji”. Today, it encourages me to make the best out of my medical training, to graduate a good medical practitioner, to become a “Good Doctor” indeed. www.ifmsa.org
The Nigerian Medical student is, no doubt, admired by the society. He/she is considered to be studying the ‘Hardest’ course in the University. He/she is regarded not just as an undergraduate but as a doctor in training. Clad in his/her white ward coat, the Stethoscope gracefully slung across his/her shoulders; the medical student commands an admiring smile of approval from patients and passers-by. In my university, the medical students have their separate hostels, which is in fact the best hostel within the campus. If there is anything that would generate obvious envy from other students, it is the fact that the medical student, among other things, enjoys the privilege of a ‘Medical Hostel’ accommodation, where the facilities are noticeably better than what is obtainable in ‘regular’ Campus hostels. In Nigeria, when you become a medical student, your mother automatically becomes ‘Mama Doctor’. People’s attitudes towards you suddenly change. Your opinions are viewed with esteemed consideration. Among your peers, you are venerated. To your siblings, you are a source of pride, and to your parents a testimony of fulfillment. I recall several occasions when Dad would tell me how he was being commended for my training. My little sister would never cease to inundate me with accounts of how much she and her friends want to secure a University admission to study Medicine. I’m also reminded of an incident that took place in 2009: I visited a former Primary School teacher with two former Primary School classmates. Now this is no boast, I recall that
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throughout the 30-minute-period of the visit, our former teacher was particularly more keen about my ‘Medical School experience’, the two other guys didn’t have as much chance, even though they too were University Undergraduates like me. The reason is Medicine or at least Medical. It wasn’t my fault, or was it? In Nigeria, there are just a few Medical schools when compared to the population and demand. Not all Universities can adequately afford the facilities needed to run a medical school. According to the Medical and Dental Council of Nigeria (MDCN), which is the country’s regulatory body on Medical Education, there are just about 23 fully accredited medical schools (as at March 17, 2011). This makes medical training in Nigeria highly competitive, and becoming a medical student has assumed
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a serendipitous dimension of chance, and of providence. This partly accounts for the esteem accorded the medical student. People tend to associate with those they value. Similarly, a medical student does not lack for acquaintances, especially when he/she has got an amiable nature. According to a blog thread I viewed on the website amazon.com, on why people admire medical students, the responses were quite interesting. Many of the respondents had the opinion that they respect medical students for their intelligence, some others claimed that medical students are often good natured, whereas others simply had no reasons or whatsoever for their admiration. Even as the society has conferred such regards on the medical student, he/she in turn owes the society certain obligations. Such obligations, if not
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exercised, becomes an infringement of social rights, a breach of trust and an abuse of privilege. Medical students must respect and observe the statutory medical code of ethics. The dignity of patients is of paramount importance that must not be a victim of compromise, nor of sheer negligence. It follows, therefore, that since the society holds one in high reverence, it is one’s duty call to reciprocate as much as one can afford. Now, it is true that some medical students can best be described as ‘not sociable at all’ such behavioral anomalies need not be an attribute of a Medico, lest people misconstrue it and associate it with medicine itself. It is not uncommon for people to generalize. The attitudes a medical student portrays may add gloss to or dent the image of a universally acclaimed noble medical profession. I was browsing through the online page of yahoo ‘answers.yahoo.com’ sometime ago, when I saw a blog topic that drew my keen attention. Someone posted “Why are medical students so arrogant?” Well, it didn’t come to me as a shock. Hear one of the respondents: “Because they believe that their career and intelligence is [are] higher than most people’s.” Yes, medicine is a most intelligence-demanding endeavour. Yet, we cannot argue that medical students are the most intelligent. I have seen Theatre arts and Linguistics students who are exceptionally intellectually bright. Medicine is hence not a monopoly of intellects and erudition. And if I may trivialize this issue a little bit,
being a medical student could mean making friends easily too, including from the opposite sex. But, that shouldn’t, by any means, justify a copious flirting or promiscuous habit. Such tendencies are an abuse of social privilege. People find medical students easy to confide in, once they ascertain a level of integrity. I was once asked by a female friend who is my male friend’s girlfriend to examine what she thought was a lump on one of her breasts. That is the trust. And trusts must be earnestly protected. Medicine is what we are all proud of. While we establish our proficiencies and exercise our aptitudes upon it, we should be careful how far these define our senses of ego and personality. We may be called “doctor” today, even as students. That, to me, should spur us to the pinnacles of our training that we may eventually graduate and serve humanity to the best of our capabilities. There is this cousin of mine, who would always remind me “graduate and be my family doctor”. Such encourages one to strive harder. Thus, “doc” as many of our friends would fondly call us is a call to fulfill. And to fulfill means to sustain our drive, our purpose, our consciousness…our orientation in time, place and person. So help us, God. REFERENCES http://www.mdcnigeria.org/recognisedmedicalinstitutions http://answers.yahoo.com/question/ index?qid=20110117063637AA5iRiP http://askville.amazon.com
Chukwudi Nnaji is medical student of the University of Benin, Benin City, Edo State, Nigeria. chuksmannaji@yahoo.com Previous page: Pictures of medical students in Nigeria www.ifmsa.org
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Why A.R.M.? A Call To Medical Students All Over Africa by Simiyu Bramwel Wekesa, Kenya The IFMSA African Regional Meeting (ARM) is a forum for all African medical students to meet and work for better health and healthcare in Africa and it unites over 100 students on the continent of Africa. Such medical schools are represented by their national organization.
activities within the region, exchange African national member organiza-
Aims of the meeting are to create a regional and global network of medical students and friends, empower students with skills, understand cultural issues affecting medicine, discuss other country’s solutions to common health problems, experience culture from the north, south, east, west and central Africa as well as expand the knowledge and discuss about issues of public health significance. This is achieved through IFMSA Standing Committee sessions, trainings in different aspects an example of such is project management, workshops , cultural shows, mind games that are intriguing, sharing resources on matters discussed, establishment of networks that cut across the world and of course tours to see beautiful places in the heart of the hosting country and fun social events. The main objectives are very clear though: to allow general update of 34
tion’s experiences, have trainings on some aspects of International Federation of Medical Students organization’s (IFMSA) activities, recruit more African countries to the IFMSA, to develop regional plans and policy statements and finally elect the next regional meeting host. Am sure you are all wondering how does the hosting national member organization (NMO) of IFMSA benefit from hosting such a meeting? Well they get to establish new networks
Top Left: Simiyu Bramwel Wekesa is final year student of Moi University School of Medicine, Kenya and is the current Vice President Internal (VPI) of the Medical Student Association of Kenya www.ifmsa.org
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both within and outside the country, get great publicity and recognition within the country, a great opportunity to display its capability to host a big meeting and hence its growth in IFMSA. It as well attracts and strengthens neighboring national member organizations to stimulate their growth. Challenges never seem to miss in any task assigned to anyone in any organization and the ARM is not an exception. Representation from countries within the continent of Africa is still low i.e. only four to five countries being able to send delegates while we have almost fifty four countries on the continent and such is associated with poor fundraising capabilities. Acquisition of visas is also implicated but really such
should not be a barrier, communication on information about such meetings is said to be either received late or procession delayed.
Conclusion
African regional meetings are essential for all African medical students and we should always prepare in time to attend. Great ideas on how we can better fundraise to ensure more representation in the meeting should be embraced and shared openly. International conferences organized by NMO should be well publicized and attended. Adequate information on visa acquisition should be displayed and the organizing committee should shoulder the burden and help accordingly by contacting the various embassies. Ensure your NMO is represented!
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