EMR Newsletter 2009 2010

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It Should Be Safe To Be A Child Eastern Mediterranean Region (EMR) International Federation of Medical Students Association Newsletter 2009-2010

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Content: • Editorial • Message from our RC • EMR6 o SCORA sessions o SCORP sessions o SCOPH sessions • Child rights • Effects of child abuse • Child Abuse: Worldwide • Child rights committeeKuMSA-Kuwait • Street children and MedSIN Sudan • Conventions on the Rights of Children, IFMSA-Egypt • Children Cancer Center Christmas Party • Oh Teaching... How many ethical concepts are violated in thou name!!

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Ed

Editorial: Dear IFMSA members,

m

I’m proud and honored to present to you our first EMR newsletter 2009-2010. The theme of this edition is taken from EMR6 meeting which was held in Bahrain….”It should be safe to be a child ”. Each page presents our collective work and thoughts in EMR focusing mainly on child rights. The aim of this newsletter is to share our activities, event and thoughts.

I would like to thank all who participated in this edition and my friend Hatem Alaa (IFMSA-Egypt), my partner in the EMR newsletter team, for his great help and support..

Lujain Al-Qodmani Co-Newsletter and Website Coordinator NPO-KuMSA 2009-2010

Enjoy!

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Dear EMR family & IFMSA friends all over the world!

Hatem Alaa IFMSA-Egypt 2009-2010

Welcome to the first EMR newsletter ever! We are thrilled to share with you a glimpse of what our great region has to offer. In this newsletter you will be able to know more about our ongoing projects, activities & initiatives.

The idea of the newsletter was born in MM09 in Tunisia where me & Lujain were the only 2 members of the SWG created for the EMR newsletter. It has been quite an exhausting task to compile articles from all the EMR regions & encourage people to write something. Lujain takes most of the credit for that , I do admit!

I hope that you find the newsletter useful & interesting. We are looking forwards to have more editions; which requires more contributions, ideas & feedback from you, so please do share your opinions!

Hugs from sunny Cairo

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Dear EMR family,

Manel Hafsi (Associa-Med, Tunisia) RC EMR 2009-2010

Already Six months have passed since the beginning of my term as the Regional Coordinator For Eastern Mediterranean Region 2009/2010 , and I have to say that I m so happy and honored to be able to work with all of you .

EMR is one of the oldest and most active Region of IFMSA that currently counts 11 NMOs with thousands of motivated members, successful projects, load of opportunities and big achievements. I m really proud seeing that this region is still growing and looking to be bigger and stronger and I believe that we still can do more and more and make it one of the Best ☺

Being a member of this region of IFMSA is an incredible experience and a real Honor for me! I was able to meet many great and really special new friends and share enriching experiences and unforgettable moments of hard work and fun. I really enjoyed every moment of exiting meetings, motivating projects, funny souvenirs and friendly discussions that I shared with everyone of you.

One of the biggest achievements during my term is The 6th Eastern Mediterranean Regional meeting (EMR6) that was organized by (IFMSA-Bahrain) and was held in Manama during 1st-5th January 2010. Around 200 medical delegates registered from : Bahrain ,Tunisia, Sudan , Jordan , Palestine , Lebanon , Kuwait , Oman , UAE , Saudi Arabia , The Netherland and UK . The Child abuse was chosen as a theme of this meeting under the title of “it should be safe to be a child”. The presidents, SCs, NMO management and Theme event Sessions were a great opportunity for every participant to share ideas and aspirations and a lot of energy. Many outcomes and decisions were taken and we started working to realize them just after the end of the meeting.

The Regional Session at the March Meeting MM10 in Thailand gave us the chance to meet again and continue the next steps. It was a really productive meeting and all the EMRians actively participated and worked in coordination with me and the Regional Assistants on preparing a concrete plan of action for the upcoming months.

One of the most important plans was the Regional newsletter and I m very proud today that I can present you the first edition. Many members worked hard and tried to publish it since years and we are finally reading the EMR electronic newsletter that will help us introduce our Federation and our region, share activities and news and spread all that to everyone.

I want to take this chance to thank every EMRian who worked on this edition and sent articles and helped to make this challenge come true. Special thanks to the lovely Lujain Al-Qodmani (EMR Newsletter& website co RA)and for the great Hatem Alaa for all their efforts and help.

Thank you BARSHA for all the EMRians , Enjoy reading!

Salam ☺

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SCORA in EMR6

I think the saying carpe diem is applicable as a descriptive metaphor for the SCORA sessions during EMR6.

Karim Richard Masri (LeMSIC, Lebanon) Co-RA SCORA LeMSIC-NORA 2009-2010

Why do I say such, you may ask? I shall tell you; later.

After breakfast on January 1, I descended reluctantly and hesitantly, full of anxiety to what new task lay before me. I had been preparing with my Co-RA Eman from Egypt for two weeks prior and in the midst of my medical rotation during Family Medicine. In the back of my mind, I was also hindered by the daunting yet obvious scenario that I have to make up the days I’m missing from the rotation. Just to add for completion, I’m also going to the March General Assembly in Thailand, so more days to miss and make up – how dreadful.

I arrived to the “SCORA” room at 8:05am. I set up my laptop, began writing on the flipchart and white board preparing for the first session, my first session as an RA in four-hour-session-day. Time is 8:10am and one member joined the bright lit cold empty room. At 8:15am another member joined. At 8:20am, I decided to accept the truth… SCORA EMR6 wasn’t the powerhouse I was accustomed to.

The introduction of the members then followed. One was new to SCORA with no prior experience and the other was from Africa, technically, not part of the EMR, but more than happy to have had him attend and participate. Despite the paucity of attendance, the SCORA sessions were given with the full intent of teaching the members new material, awareness, projects, and activities going on in the EMR. They were

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excited and benefitted from the sessions, as per the evaluations.

Back to the question I posed at the beginning about announcing carpe diem as a descriptive term. I would now like to explain why. When given an opportunity, one may choose one of two routes: 1) make the most of what you’ve got; or 2) give up.

SCORA represents issues that are taboo in our Middle Eastern society, pertaining to sex, AIDS, and STIs. These three topics are all linked and that is what makes them objects of intimidation.

Having people attend, participate, and spread awareness about the reality that our world is facing is a difficult achievement by itself, but trying to propagate sex in a conservative society is like throwing stones at a bee hive – you’re looking for trouble. It is unfortunate, yet true, and this is what makes SCORA a challenging and evidently less favorable committee to be a part of (the low turnout is a mere depiction of such).

Misleading is the name, but SCORA also extends its spectrum into targeting women’s’ rights, including female genital mutilation awareness and reproductive cancers. Therefore, SCORA is a potential tool in several domains limited only by the imagination and determination of the members.

With this said, I do respectfully call all interested EMRians to dismiss our society’s stigma. We are the present and the future and if we keep sticking our heads into the earth like a bunch of ostriches, we’ll never progress and only digress. I dare to say seize the day – carpe diem – do you?

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SCORP, EMR6 The East Mediterranean Region Meeting for the term 20092010 was an enlightening experience at many different levels. For one, members of the NMOs of this region met each other, exchanged ideas, addressed problems and thought about solutions for them. In addition, we all got the chance to discover the beauty of Bahrain and the hospitability of its people.

Khairat Al-Habbal (LeMSIC, Lebanon) RA SCORP 2009-2010

I landed in Bahrain on Jan 1st, 2010. On my first day I learnt that the Bahraini people are known to be the friendliest people in the gulf- I have never been to the gulf before, but I can assure you that everyone in Bahrain was extremely sweet to us. The sessions of the standing committees were to start on Jan 2nd under the theme of child abuse. In SCORP, we started out our sessions by setting a very important ground rule: “SPEAK UP”! We introduced and explained all the aspects pertaining to child abuse on the first day. We had presentations about what is child abuse, its forms, ways of detection and various other topics.

The second day was more interactive: KuMSA members, Loujain and Ahmad, gave us a workshop about the theme.

Time was allocated for each country to present its SCORP projects; we got to know what SCORPians of Sudan, Bahrain and Saudi Arabia are doing in the hope of bringing about chances for collaboration. We introduced the “Blue Ribbon Project” which aims towards raising awareness about child abuse. Work on this project started with us brainstorming about ideas of what we can do to raise awareness about this matter in our countries with all the information that we have acquired during the sessions.

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Each group had members from the three different countries attending to enrich the thought process further and promote communication. Bright ideas sparkled all over: some thought about raising awareness in malls, others thought about going to schools, others about working with the health care workers‌ SCORPians were as busy as a bee; during the sessions they were working on their presentations, preparing their homework, exchanging ideas within their groups and working on solutions for the challenges that stand in the way of fulfilling our projects. In the end, I am glad to say that everyone SPOKE UP! During the EMR project presentations, we presented our SCORP project, GO GREEN. This is a one year old project which we started in LeMSIC. It is basically a SCORP exchange project; we want to give a chance for medical students, members of IFMSA, to travel to countries in the aim of volunteering in those countries.

We took it with us to the March General Assembly (GA) in Tunisia. A group of IFMSA members joined our small working group and Tunisia along with Romania put 2 projects forward for exchange. A Saudi student went GREEN and he traveled to Romania to help with their refugees project. His feedback was very positive! During the August GA in Macedonia, we presented GO GREEN again.

We formed a small working group to formulate a structure for our exchange program. At the end of the GA, we won the first prize in the SCORP sessions! During this EMR, we presented GO GREEN to introduce the idea to the EMR countries. We won first prize! GO GREEN was voted for as the best EMR project! The interest of more and more countries has been piqued, and many

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are planning to join us. We have already applied for GO GREEN to become a transnational project; we will present our candidature this March in the Thailand GA and we have high hopes towards turning this project into a transnational one!

The EMR meeting ended on January 4th, 2010. The SCORP members were loaded with motivation; they have more connections now and they are all working on the Blue Ribbon Project… in the hope of formulating the start of another transnational project!

“The key to success is confidence. The key to confidence is preparation!” The reason why our sessions turned the attention of many countries is that they were very well prepared. The passion of many of the amazing LeMSIC SCORP members was very well received internationally. For all the effort that has been invested, I would like to thank all those who followed Matin Luther King’s words "Take the first step in faith.

You don't have to see the whole staircase. Just take the first step."

Thank you: Abboud, Abdallah Ajam-Oghli, Hanadi Achkar, Tala Alameddine, Ramzi El Masri, Jad Ernani, Thatyana Turassa Halawi, Ali Hamieh, Lana Hassan, Sarah (NOME) Jurdi-Kheir, Wajiha Khairallah, Pascale Current SCORP D: Mori Mansouri Former SCORP D: Thatyana Former IFMSA president and current supervisory board member: Melhim Bou Alwan I would also like to thank the organizing committee in Bahrain for all the effort they put into this meeting. If we were to get out of the SCORP sessions with only one ides, then let that golden idea be communication. I would really like to see us communicate about our projects more, to speak about them on the servers so that we can reach out to others who share our interests; the only way to accomplish more successful campaigns is by learning from each other’s experience- it all starts with sharing those experiences. I wish all the EMR SCORPians the best of luck on their upcoming projects; shall you need any help, please feel free to contact me. It is my pleasure to work with you on bringing out the best in our region.

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SCOPH session in EMR6 SCOPH sessions in regional meetings are a fabulous opportunity to unify our collaborative work and share our experiences.

Projects performed in one country, no longer have limits, but rather can be expanded to include the different NMOs of the region. In our EMR6 SCOPH sessions, I was impressed by the motivation and passion expressed by SCOPHians, particularly the newly established committees. New SCOPHians were introduced to SCOPH, and were pleased to find out that their driving motive overlaps with that of SCOPH’s; The Promotion Of Public Health!! We had our SWOT analysis as for SCOPH in the Eastern Mediterranean Region (EMR) and discussed how to overcome our weaknesses and expand our collaboration as EMRians.

Ahmad Younes (LeMSIC, Lebanon) RA SCOPH 2009-2010

The “Child Abuse” theme gained interest of all attendees and conclusive discussions were constantly driven by valuable input.

There was a consensus that “Child Abuse” is endemic in our area, and as public health activists, we need to interfere promptly to end the vicious cycle that transforms an abused child into abusive parent. There were special presentations about projects done by LeMSIC and MedSin-Sudan that dealt with child health which gained the interest of all attendees.

SCOPHians were divided into four Small Working Groups & chose to discuss Tuberculosis, Diabetes, Tobacco Control, and Child health!! The topics chosen were the ones needed to be tackled by professional activists due to their direct threat on our Health in the EMR. These SWG had culminated their efforts on the last day of the EMR and did thorough presentations of what was discussed and we were all happy to hear that a basis for

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creating a transnational project to fight Diabetes was already setâ˜ş.

Occurring in parallel, each SCOPHian had the chance to present the work done by his NMO. It was a wonderful and fruitful session, in which we had the chance to share our experiences and exchange ideas that were found to be relevant to everybody. It helped us draw conclusions on how to tackle different kinds of obstacles in a productive and constructive manner.

A big discussion was initiated so that everyone was able to discuss his plans and future SCOPH activities with the subsequent steps that need to be taken in order to implement new SCOPH projects that were learned during our EMR SCOPH sessions.

Our session ended by a critical evaluation of the meeting. Each SCOPHian was given the chance to express what he/she liked or disliked during the meeting.

Most SCOPHians didn’t like the fact that some NMOs were absent and wished they were able to attend, and many also disliked the fact that the meeting duration was short and fast. However everybody was pleased with the outcome of the meeting particularly that it offered the opportunity to get together a multitude of different nationalities and the exchange of fresh ideas. They loved the teamwork and the face-to-face meetings with people they used to communicate with from long distances.

Being the SCOPH Regional Assistant for the Eastern Mediterranean Region (EMR), and after meeting my fellow SCOPHians in the region, I can state with confidence that our EMR has tremendous potentials that SCOPH must benefit from and we must direct our efforts toward our goals as SCOPHians; namely, to empower our struggle against the Public Health problems we face as future physicians.

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Child rights: As minors by law children do not have autonomy or the right to make decisions on their own for themselves in any known jurisdiction of the world.

Instead their adult caregivers, including parents, social workers, teachers, youth workers and others, are vested with that authority, depending on the circumstances. some believe that this state of affairs gives children insufficient control over their own lives and causes them to be vulnerable.

Researchers have identified children as needing to be recognized as participants in society whose rights and responsibilities need to be recognized at all ages.

So children's rights are the perceived human rights of children with particular attention to the rights of special protection and care afforded to the young, including their right to association with both biological parents, human identity as well as the basic needs for food, universal state-paid education, health care and criminal laws appropriate for the age and development of the child. Interpretations of children's rights range from allowing children the capacity for autonomous action to the enforcement of children being physically, mentally and emotionally free from abuse, though what constitutes "abuse" is a matter of debate. Other definitions include the rights to care and nurturing.

The Universal Declaration of Human Rights is seen as a basis for all international legal standards for children's rights today. There are several conventions and laws that address children's rights around the world. A number of current and historical documents affect those rights, including the 1923 Declaration of the Rights of the Child, drafted by Eglantyne Jebb and her sister Dorothy Buxton in London, England in 1919, endorsed by the League of Nations and adopted by the United Nations in 1946. It later served as the basis for the Convention on the Rights of the Child.

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The United Nations' 1989 Convention on the Rights of the Child, or CRC, is the first legally binding international instrument to incorporate the full range of human rights—civil, cultural, economic, political and social rights. Its implementation is monitored by the Committee on the Rights of the Child. National governments that ratify it commit themselves to protecting and ensuring children's rights, and agree to hold themselves accountable for this commitment before the international community.

Children's rights tend to be of two general types: those advocating for children as autonomous persons under the law and those placing a claim on society for protection from harms perpetrated on children because of their dependency. These have been labeled as the right of empowerment and as the right to protection. One Canadian organization categorizes children's rights into three categories: Provision: Children have the right to an adequate standard of living, health care, education and services, and to play. These include a balanced diet, a warm bed to sleep in, and access to schooling.

Protection: Children have the right to protection from abuse, neglect, exploitation and discrimination. This includes the right to safe places for children to play; constructive child rearing behavior, and acknowledgment of the evolving capacities of children.

Participation: Children have the right to participate in communities and have programs and services for themselves. This includes children's involvement in libraries and community programs, youth voice activities, and involving children as decision-makers.

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In a similar fashion, the Child Rights Information Network, or CRIN for short, categorizes rights into two groups: Economic, social and cultural rights, related to the conditions necessary to meet basic human needs such as food, shelter, education, health care, and gainful employment. Included are rights to education, adequate housing, food, water, the highest attainable standard of health, the right to work and rights at work, as well as the cultural rights of minorities and indigenous peoples.

Environmental, cultural and developmental rights, which are sometimes called "third generation rights," and including the right to live in safe and healthy environments and that groups of people have the right to cultural, political, and economic development.

by : Hamdy Fliefl Salem IFMSA-EGYPT Alexandria LORP References: a-z of children's rights children's right information network children's rights in the canadian context "Children's Rights", Amnesty International.

Wikipedia, the free encyclopedia Convention on the Rights of the Child. United Nations Bandman, B. (1999) Children's Right to Freedom, Care, and Enlightenment. Routledge.

Children's Rights, Cornell University Law School Children and youth, Human Rights Education Association.

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Effects of Child abuse

General effects of any form of child abuse.

It starts by trials of the abused child to just understand why this happened. The point is the person feels a sense of control over the situation if they can blame themselves or something they did for the attack. Instead of the world being a dangerous place where violence occurs at random, the world becomes a safe place within certain behavioral parameters. This always lead to maladaptive behaviors that can lead to pathological problems, due to the fact that children’s thinking lack the logical sense specially that abuse is most likely to be committed by a relative or a family member that makes the situation even more hard to understand.

Then the child comes to the phase when he wonders if he can reveal this or not, and children tend not to reveal, specially when abuse comes from family as a child might believe it’s a family secret that they should hide. This prevents children from having real relationships and has life-long effects. And because our ability to form healthy social relationships is learned, abused children are deprived of many skills necessary to navigate the social world. Their entire concept of a relationship is distorted. This leads to problematic relationships in life and even on the job.

On the other hand, the Child him self develop further fears that limits his or her desire to explore new aspects of the world as normal children. Thus the child will lose his or her sense of curiosity and wonder at the world and will stop trying new things and exercising his or her mind. That child will never achieve his or her intellectual potential.

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Special Effects of child abuse: •

Academic difficulties

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Lying

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Aggressive behavior

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Malnutrition

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Alcohol and/or other drug abuse

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Oppositional behavior

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Panic attacks

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Physical symptoms such as headaches and stomach aches

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Repeated self-injury

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Risky sexual behaviors

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Running away

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Self neglect

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Separation anxiety

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Anxiety

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Attention problems

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Bad dreams

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Bed wetting

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Behavior problems

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Chronic pain

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Compulsive sexual behaviors

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Concentration problems

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Sexual dysfunction

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Dangerous behavior such as speeding

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Sleep disorders

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Social withdrawal

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Stealing

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Dehydration; Depression

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Dissociative states

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Stuttering

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Eating disorders Failure to thrive

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Substance abuse

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Suicide attempts

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Fear or shyness

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Fear of certain adults or places

Thumb-sucking or any ageinappropriate behavior

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Truancy

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Frequent injuries

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Insomnia

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Learning problems.

Done by: Reem Waziry NPO IFMSA-Egypt 2009-2010

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Child Abuse: Worldwide • Most abused and neglected children never come to the attention of government authorities.

• This is particularly true for neglected and sexually abused children, who may have no physical signs of harm.

• In the case of sexual abuse, secrecy and intense feelings of shame may prevent children, and adults aware of the abuse, from seeking help.

• Therefore, official government statistics do not indicate actual rates of child abuse.

• Government statistics are based on cases that were (a) reported to social service agencies, (b) investigated by child protection workers, and had sufficient evidence to determine that a legal definition of "abuse" or "neglect" was met.

• Almost 53,000 children died worldwide in 2002 as a result of homicide.

• Up to 80 to 98% of children suffer physical punishment in their homes, with a third or more experiencing severe physical punishment resulting from the use of implements.

• 150 million girls and 73 million boys under 18 experienced forced sexual intercourse or other forms of sexual violence during 2002.

• Between 100 and 140 million girls and women in the world have undergone some form of female genital mutilation/cutting. In sub-Saharan Africa, Egypt and the Sudan, 3 million girls and women are subjected to genital mutilation/cutting every year.

• In 2004, 218 million children were involved in child labour, of whom 126 million were in hazardous work.

• Estimates from 2000 suggest that 1.8 million children were forced into prostitution and pornography, and 1.2 million were victims of trafficking.

Child Rights Committee- KuMSA

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Child Rights Committee-KuMSA

Child’s right committee is one of the first independent sub-committees under the umbrella of Kuwait medical association that is dedicated to the harmonious development of children in Kuwait especially those who are being abused.

It aims towards spreading awareness amongst medical students as well as doctors about child abuse and how to identify it to enable them to detect and hence prevent it.

Improving our health care system and current laws to protect our children from being abused, educating the society through active campaigns and implementation of the UNICEF convention of child rights that was signed by Kuwait are also some of our long-term goals.

100s of Innocent Children Are Being Attacked Every Day. Abusing today’s children equals destroying our society’s future. We, Not Only As Citizens of This Society, But Also As Future Doctors Have An Important Role In PREVENTING CHILD ABUSE. It Might Be a Dream But It Can Definitely Be A Reality and if we start today we will reach our dreams one day.

Lulu Al-Torah Head of Child rights Committee KuMSA-Kuwait

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Street Children and MedSIN-Sudan SCOPH HOPE Street children represent a major problem in many countries all over the world, especially in African countries. In Sudan for example, it is mainly concentrated in Khartoum state. This arises as a result Huzeifa Jabir of so many merging factors such as civil wars, famines MedSIN-Sudan NPO 2008-2009 and the resultant family disintegration. Street children HOPE (Help On Pain Ending) face many problems. national project x- coordinator ` Huzeifa_medsin@yahoo.com The number of street children in Sudan continues to increase at a moderate rate. This is due to the Poverty, Ignorance, and the lack of reliable statistics on the number and situations of those children. For this reason not much is being done to tackle the problem at the standards needed and street children continue to be neglected, respectively their numbers continue to increase.

As medical students we have to act on solving these problems. We attempt to do this through Health education and the fighting of diseases, poverty and illiteracy.

It is necessary to reintegrate them into society, or at least to fulfill their basic needs (Safe water, food, education, health and shelter) to render their interest to receive health related education, establishment of behavioral surveillance programs targeting street children and to strengthen the health sector’s involvement in providing health care for street children.

Due to all of these things, MedSIN-Sudan SCOPHians attempt to help on street children pain ending; So HOPE (Help On Pain Ending) project begins…

Our actions include medical days with free clinics, free investigations, and free medications. Other things include Health and peer education, raising community awareness about street children problems and how to deal with it using different promotional materials, Gifts and Fun days.

We HOPE you are interested in what we are doing, and for any other things you can contact me and I will be there.

HOPE 1st medical day clinic “our alumnae are examining a street child”.

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IFMSA-Egypt at the 20th anniversary of the Conventions on the Rights of Children On November 20th 2009, IFMSA – Egypt has received an invitation from UNICEF to be part of the youth movements sharing in the organization of the 20th celebration of the conventions on the rights of children. It represents a major milestone in the historic effort to achieve a world fit for children. As a binding treaty of international law, it codifies principles that Member States of the United Nations agreed to be universal – “for all children, in all countries and cultures, at all times and without exception, simply through the fact of their being born into the human family.”

The Convention has achieved near-universal acceptance, having now been ratified by 193 parties. In fact, Egypt was one of the first countries that signed the CRC and has made significant progress over the past decade towards fulfilling the rights of Egyptian children. Substantial gains in child survival rates, school enrollment, immunization coverage and access to safe drinking water, were registered. Public policies have placed children rights on the development agenda, contributing to a significant reduction of underfive mortality and a high level of primary education attainment.

Further more in 2008, the Egyptian Parliament approved an amended child law which incorporated significant changes such as increasing the minimum age of marriage for girls to 18, criminalizing Female Genital Mutilation or Cutting FGM/C, and setting up child protection IFMSA – Egypt SCORA and SCOHP teams were there on that occasion to hold up activities directed towards children living on the streets, highlighting critical issues that represents a major burden upon the community in Egypt as child labour and violence against children and raising a particular concern about Female Genital Mutilation/Cutting.

We seized the approach of the World AIDS Day to raise the discussion about adolescents, the need for support and intervention programs that help adolescents to become more responsible, to advocate for enhancing the care and support for people living with HIV and AIDS and reduction of stigma and discrimination as well as promoting young people’s participation in civil society and development.

Special thanks for to Ms. Dina Khalid – HIV/AIDS Officer in UNICEF-Egypt – that made the participation of IFMSA-Egypt in this celebration possible and visible.

The team was lead by Mr. Talal Marouf the current National Officer on Reproductive Health including AIDS, assisted by Ms. Noha Salah the current National Officer on Humanitarian Projects.

By: Talal Marouf National Officer on Reproductive Health Including AIDS 2009 – 2010 IFMSA-Egypt

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Children Cancer Center Christmas Party Stress & behavioral changes, disruption to school, anxiety, social withdrawal and devastating physiological changes; These are the effects of cancer and its treatment on the quality of life children suffering from this treacherous disease. At this critical point of their lives, children need all the support they can be offered, that is crucial to their battle for survival.

This is when we, as Public Health activists, can interfere and make the most of the difference, decrease their sufferings and alleviate some of the pain that this emotionally fragile population faces.

As part of the Lebanese Medical Students International Committee (LeMSIC), the Standing Committee on Public Health (SCOPH) prepared a party for the kids at the Children Cancer Center of Lebanon (CCCL), where one of our own SCOPHian dressed up as Santa Claus, along with the other SCOPH members, acting as the elves, surprised the kids with the jingle bells, the candies and of most importantly, the gifts.

The event was funded by organizing a fund raising movie projection series of three movies that were projected over two days; in addition to a weeklong sale of candy canes at the university campus. SCOPH, with its wide gifted potentials, even designed the posters and tickets of the movie projection that attracted a copy center sponsor who was touched by our cause.

Tasks were distributed such that one subcommittee was in charge of the fund raising event: reserving a hall for the movie projection in order to accommodate the audience, designing posters and tickets, attracting a sponsor interested in taking care of the printing expenses, grabbing good deals for candy canes, setting up a stand where we can promote our goods in addition to approaching doctors and colleagues. Good media & advertisement was the golden reason behind the success of our event; posters were distributed over the hospital and the university campus, emails were sent on all servers, including the ones that could reach doctors, and finally the university bulletin at the university home webpage.

The other subcommittee coordinated with the Children’s Cancer Center administration in order to reserve the playroom for our party where kids will be aggregating at a specific time, and to get the list of patients that will be present at the party a priori in order to buy gifts that are congruent with their age. The amount of money raised was enough to get gifts and candies for all the kids and most importantly, draw a smile over their face, alleviate some of their painful struggles, and make them feel that the world around them CARES FOR THEIR WELL BEING!!

Ahmad Younes NPO LeMSIC 2009-2010 SCOPH EMR RA 2009-2010

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Oh Teaching... How many ethical concepts are violated in thou name!!

The Psychiatry rotation is one of the rotations that most of us enjoy, not only because we are free of the usual level of stress that we usually deal with in other rotations, but also because its one of the rare opportunities where we have plenty of time practicing all aspects of the patient-doctor relationship and apply the ethical concepts that we have been discussing during our medical education.

Ahmad Younes NPO LeMSIC 2009-2010 SCOPH EMR RA 2009-2010

It was one of our regular rotation days when we were interviewing Ms.X in the presence of our mentor Dr.Y. Interviewing a patient, presenting for follow up in the outpatient-department (OPD), entails repeating a previous interview and asking questions that were asked many times before in front of a different group of people. Ms.X is a 28 year old woman, mother of two children, with a history of depression being treated with Selective Serotonin Reuptake Inhibitor (SSRI).

The patient is mentally competent and responding well to treatment. It was found in one of the previous interviews that the patient reported to a colleague that she has been experiencing sexual dysfunction. After finishing the group interview, Dr.X asked one of the female colleagues to go in private and ask the patient about her sexual life and if she is still facing any problem.

Our colleague did the job and answered this question in front of us, as a group, without asking the patient for her consent.

As part of our educational process at the beginning, and later in our career, we focus on the patient-doctor interpersonal relationship that will ultimately be essential in reaching our diagnosis and crucial in building our reputation. In this relationship, we as professionals, we practice the ethical self-evidence by itself. “We give the patient the dignity of being attended and listened to and understood. We receive the dignity of being a “good doctor”: humane, competent, and trustworthy.” One of the fundamental principles guiding the care of a competent patient, in addition to “Autonomy”, is “Confidentiality”. Confidentiality is an Ethical obligation of a therapist toward his patient. A doctor should ensure that information divulged within a professional-patient relationship will not be disclosed to other individuals or institutions without the client’s consent.

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In our case, none of the exceptional cases that waive us, as health care professional, from the restrictions “confidentiality” imposes is satisfied. This is one of the everyday cases, where we elect to violate one of the ethical principles in the name of education. All the patients already know that they are coming to an educational institution, this is when they accept to sit and discuss in front of a group; however, they never know that their cases may be revealed without their consent. Should we reconsider and inform our patients of the truth of what is going to happen since they are most of the times competent? Should we try to implement new laws regarding these situations or enforcing already existing ones?

Telling Ms.X about the situation was not going to make her non compliant with attending the sessions she is scheduled to have for her treatment. Aside from learning the ethical concepts by books, that our student colleague is fully aware about in that case, students should be followed and guided by ethical role models. Here, we reach a dilemma where one would claim that having “ethically nontrained” doctors, will ultimately produce students lacking the ethical basics in their profession, and there is no way to interfere and change. This might be true if our educational system lacks or doesn’t fully enforce the laws that shape the behavior of already existing “ethically untrained” doctors. In most of the institutions where such violations exist, there exist laws and rules that prohibit them.

Having students that report and rebel against such behaviors will empower the mission of the ethical teaching and make it more productive, for the benefit of the students and the health care system itself, because reporting such cases is the crucial gap that is missing.

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