Digital Health l Medical Students International (MSI) 43

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Imprint Editor in Chief Amine Youcef Ali, Algeria

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Editorial Stories Around the World Rex Crossly Awards & Programs Theme Event Articles

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SCOME Articles SCOPE Articles SCOPH Articles SCORE Articles SCORA Articles SCORP Articles Poetry

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From the Editor in Chief Amine Youcef Ali IFMSA Vice-President for Public Relations & Communication

Dear IFMSA Members, Dear readers, Digital health is the utilisation of digital technologies, information and processes in health and healthcare with the aim to enhance the efficiency of healthcare services through a personalised and precise approach.

Over the past year, the world as we knew it changed drastically. From one small virus to a pandemic that has completely paralysed the globe, which required necessary changes to our habits, our lifestyles, and most importantly, to the way we do health and healthcare.

And with the social distancing, lockdown and people forced to stay at home, digital health found its place as a solid contender for the new normal.

The development of digital technologies is revolutionizing the health sector everywhere in the world. However, some questions are still to be asked to better unfold all the mysteries around this new way of providing healthcare.

With that being said, It is my utmost honor to present to you the 43rd edition of Medical Students’ International (MSI) Magazine. This edition serves as a place for reflections, thoughts and perspectives provided by medical students worldwide on digital health, as well as its intersection with medical education, professional exchange, public health, research exchange, sexual and reproductive health and rights and human rights.

MSI is a publication that represents 1.4 medical students and their voices and efforts to promote access to healthcare to everyone everywhere. And this edition is no different. Thus I can assure that an exciting journey is awaiting you through the following pages, from which you will get a better understanding of our members’ perspectives on digital health, as well as their work and activities around IFMSA’s Standing Committees.

Finally, I would like to express my deepest gratitude to the executive editor, content editors and content designers, a team of passionate individuals that have been extensively working on this edition to bring you with the best quality possible for both the articles and the visuals. As well as to the IFMSA Officials that have contributed to the magazine.

I wish you a pleasant reading experience!

Warm regards,

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STORIES Around the World

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ROSHNI: A Microtale about Abortion Rights & Awareness in Rural India Jainil Devani The Maharaja Sayajirao University of Baroda | MSAI India

Her heart sank as she held up, with trembling hands, the pregnancy test: positive. Roshni lived in a village, not far from Amritsar. Her family was traditional, conservative - she’d grown up having her worth measured by her future marriage. She was 21, and merely four days ago, matched with a boy from Delhi. Her heart had been elated, to escape her provincial life, to find a bigger purpose, an identity, her own feet to stand on. But now, as she quietly disposed the test, she felt numb, hollow. As if something inside her had snapped, broken, disappeared.

Roshni, she thought. Her name meant ‘a glowing divine light,’ the kind that shines inside hearts, warm and all encompassing. But in that moment, it felt distant, dim and lost.

Six weeks ago, as Roshni was walking home in the dusk, she was raped. What she had gone through was indescribably harrowing. Worse yet, she had no-one to turn to. She couldn’t tell anyone - how could she? Her parents, her entire family would bombard her with accusations, blame her incessantly. No proceedings would go forward against the man; but Roshni - she’d have her entire life defined by it. “The girl who was raped.” It was all anybody would think of when they’d look at her. No chance of a marriage, a better life... no chance of a better future. She’d be relegated, confined to the back corner, like she was damaged goods.

So she kept it hidden, dealt with her whirlwind of emotions all by herself. Roshni had a strong, stoic demeanour: She was raised to have a resolve to carry on like nothing happened, and so she did.

But, today was different. She felt like someone was repeatedly punching her in the gut, the light inside of her had shut off. her future flashed in front of her eyes. A baby. She was carrying the child of her abuser.

In a few weeks, she’d start showing. She had to come

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clean, eventually. Her marriage would obviously be called off. She’d be shunned, whispered about all over the town. This would be her entire life to be “the girl who was raped,” the spinster who raised a fatherless child, just a pitiable nobody.

The sun rose slowly, etching its hue over the lush green fields of Punjab. Roshni hadn’t slept a wink. After a quiet breakfast, she headed over to her best-friend’s house. Saroj, a trainee architect in Amritsar was home for the holidays; she was the only one who ever understood Roshni, yet she always was wary of Roshni’s orthodox family.

As Roshniwalked into her room, Saroj could tell something was wrong. She shut the doors, gave her a glass of water, and sat her down: “You can tell me. Anything it is, we’ll figure it out.”

“I wish you had the answers, Saroj, but nobody does. It’s over.” Roshni’s eyes welled up with tears, as she struggled with her words. She told Saroj everything. About the assault, her marriage, her pregnancy.

“Oh my, I’m so sorr—”, before Saroj could finish, Roshni leapt into her arms and wept.

All of reality came crashing down on her. “My life’s been taken from me, Saroj,” she said, trying to compose herself,

“It’s been stolen.”

“We’ll get you out of this,” promised Saroj. “Trust me.”

Two days later, at the pretence of weddingshopping, Saroj took Roshni to Amritsar. The busride was bumpy, and their seats uncomfortable.

“What wedding shopping?” asked Roshni, “There’s not going to be a wedding.”

“Roshni, this is your life. It’s all been laid ahead of you, beckoning you. And I’m not going to let anything stand in the way of it.” Roshni was confused as to what Saroj could possibly do.

Saroj continued, “I know an ObGyn in Amritsar.

It’s a proper clinic. We’ll get the baby aborted, and you’re gonna have the life you’ve always dreamt of.”

“Abortion? That’s a… sin. No. I can’t do that.”

“Listen to me. That clump of cells that’s growing inside your womb was thrust upon you by a disgusting man, a devil, a rapist. Abortion is not a sin. It is your right, Roshni.”

stood beside her, every step of the way. Roshni got married six months later, and also won the case against her rapist.

Roshni now lives a blissful life in Delhi, working as a teacher. The life she thought was stolen from her, because she had to carry an unwanted pregnancy, a result of her rape. But Roshni wasn’t a damaged nobody. She was a brave and capable woman. Her spirit was strong, and the light inside her shone ever brighter.

There are countless Roshnis out there: Raised in orthodox ideals, not knowing their abortion rights, and having no access to them. They go unheard and unseen. Abortion Rights shouldn’t only be talked about in megacities on screens, they should be informed and made accessible to every woman who needs it. To every woman, with an unwanted pregnancy that stands in the way of the life she deserves. So no woman’s Roshni is ever dimmed.

Saroj’s words rang loud in Roshni’s mind, as she struggled to dismantle the baseless ideas she’d been taught.

“It is your right to terminate a pregnancy, at your will. Legally, ethically. Your right to choose not to carry the child of your abuser. Abortion is not a sin. It is your right to a better life. The life you deserve.”

As

Saroj slowly explained, Roshni felt like a dark veil had finally been lifted off her life — she felt liberated, like she could finally breathe.

Her life was in her control, not under the clutches of an unwanted pregnancy.

“Yes, It is m y right.

My right to choose what’s best for me.”

Roshni’s pregnancy was safely terminated. Saroj

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A Town and a Scalpel João Pedro Medeiros Gomes Universidade Federal de Juiz de Fora | IFMSA-Brazil

I adjusted my glasses and prepared myself for the trip. The town was not far away from the city, but my mind was. There, my siblings lived for a while but I didn’t. I was raised in the city. I am not going to say that I had no attachment to the place, but among us, I was the most distant to that reality.

The small town followed the same rules as any small town, there was a church in the middle, a park surrounding it, some big houses around it and, throughout narrow streets, little houses, all of this making up the town. Definitely, it was never the place that I would go to stay for more than 6 months, but everything had stopped because of the virus and so had my university course.

I got into the car and suddenly I was on the outskirts of the town. I sleep pretty easily during car trips and there was no reason for this day to be an exception. I was just going to stay for a while, but a while turned out to be mouths and I got bored. At this time, my mom gave me a pretty good idea “Go help the Doctor. Or just observe, you might learn something, otherwise, you are gonna crawl up these walls anytime soon”. Done and dusted. A couple of phone calls and from then on I was going wherever the Doctor went.

For those who might not know, in small towns there is God followed by the Judge and then the Doctor. Everyone knew him and paid respect to his ‘image’. Well, he was an obstetrician, and when was not doing a cesarean — he only did cesarean, he acted as General Practitioner and everyone in town would go to see him.

On the first day, the sun had not even risen and I was at his house. He greeted me and asked the cliché question “So... in what do you intend to specialize, boy? I heard that you are pretty clever, they say. Have you ever thought of delivering babies? It’s a great thing to do, really meaningful”.

I had no idea, to be honest, I still have no clue, but I said that I liked obstetrics. If I was going to follow him, the least that I could do was to take part in this. Done. He told me that we were going to another town, to do what he loved most, bringing

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life to this place.

He drove like a mad man through the asphalt. He had already taken that road at least one thousand times in his life, he knew it like the palm of his hand. Soon we arrived in the other town, pretty much the same as mine, but poorer. There, we approached a large concrete building painted red with large windows. “Here the magic happens, boy. Today we are going to take good care of Rosa and deliver her child. It is her sixth. You know, she’s a junkie, I delivered four of her children and the last one died, unfortunately. She does drugs, so they were all born underweight”.

The room was cold and I don’t know why but I had a bad feeling. Do you know when you feel that you do not want to be somewhere?

But I had to carry on and help him. So he started. The procedure was precise and cold, like the room. The poor woman had a big nasty scar due to many cuts and her skin was so thin that a blunt scalpel could cut through it. In one moment there was the child. I took her in my arms and she started to cry. I felt awesome and quickly handed her to her mother. Rosa did not seem to care, showing none of the emotion one would expect. I was bewildered.

I returned to the Doctor and suddenly took a glance at something strange. Quickly the Doctor tied her tubes and started to stitch all the layers.

“It gets thinner every time boy, the body cannot stand it. Do you wanna stitch the skin? It’s good practice, I bet they don’t let you do that at medical school.” Bothered, I had no courage, he was not supposed to have done that to her.

The baby was underweight but seemed fine.

“It’s a pity she can’t breastfeed, her milk is full of drugs”, said the nurse, “we will find some milk for you honey” she comforted the baby. “What is her name, Rosa?” I asked. “Angel... quite pretty I think.

Unfortunately, they will take her from me as soon as possible, as they took all of them, those pricks”.

I kept quiet, stepped aside and in a moment we were back on the road.

“Why did you do that?” I asked. “What?” He returned the question. “You sterilized her”. He frowned “That’s a nasty word boy”. “Strictly speaking, that’s what you have done”. He took a deep breath, looked into my eyes, and said “Hey boy, listen to me, it’s for society. We don’t have to

carry the weight of so many children, they are all gonna be outcasts, scumbags. I did her a favor”.

“But you didn’t tell her”. “Ok, ok, listen up boy, life’s not an academic book, it is not fair at all, so don’t be bothered by that and let’s keep going, we are almost getting back to town.” We were silent.

My mind couldn’t process it and as we arrived he said in a flat, direct tone, which you learn to use at medical school to try to transmit confidence and sobriety, the one he had mastered throughout all these years “Hear what I say, kid. Someday you will get it. Until then keep it as our secret, capiche?”.

Then he drove away in his car while my mind was rumbling around. I don’t get it, I can’t get it.

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Believing in a Better Tomorrow Luis Guillermo Navarijo López Universidad San Carlos de Guatemala | IFMSA-Guatemala

Normal life I woke up in the morning and I could only imagine how beautiful and amazing was going to be this day, another day with my patients at the clinic, another day with my friends, and another day living this amazing dream of becoming a doctor.

The news I can remember, it was March 13th here in Guatemala, we were having that day free from university so I decided to hang out with some friends in the morning. It was like 5:00 pm when the news went crazy, “The first case of Covid-19 arrived to Guatemala”, we were trying to figured out what was happening, talking about what was going to happen with classes, with hospitals, with us.

I said goodbye to my friends, without knowing if we could see each other in one week, one month or one year.

I was on the bus to my house, looking around, no one had mask on, it was normal, nobody, including me, realized how big and important this situation could be.

Last party At night I went to a party, we really enjoyed it, we were drinking from the same bottle, dancing with our friends, we were all together, just thinking about that moment, we didn´t know if it could be repeated or it could be the last party.

Behind a screen The next day we receive the news, we were not going to continue with our hospital practices until new notice, and we wait it for days, for weeks, for months, but it never comes, we were living one of the best times of the career behind a screen, nothing was as we thought.

Mentally exhausting 2020 was crazy, a lot of things were happening around me, and I had very little time to process everything, but so much time to overthink dim situations, old fears came back to my life, and

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new ones were attacking, my mind was trying to get everything under control.

The biggest loss Something that I will not forget, my grandpa, an 87 years old man, he got sick, and with all the chaos around us, we took care of him, even though our mind screamed to stop, even though our forces could not do no more.

He was the happiness on my house, there was always a joke, a hug, a history or a game, but after fighting against all odds, he passed away.

And I will not forget this situation because it was a very different funeral, only 10 persons, no one could give us a hug, no one could give the support and no one could give him the goodbye he deserved.

But despite of the ache, we decided to continue with our life, to don’t give up, to stay strong, we decided to fulfill our jobs and projects, and reach out our goals.

Another reality After all, I just dream with another reality, I believe in a better tomorrow, one where we can be together again, with no fears, where we can hang with our friends, where we can laugh with our family, or just hug someone we love, and I really hope that people take this as new lesson, I hope we reflect what we do right and what we don’t, because the world deserve better humans, the world deserves people passionate about what they do, more empathetic people, more just and supportive people.

Together again I know that we will be together again, maybe incompletes, maybe not totally happy, maybe a little more destroyed,

or less motivated, but what really matters is that we are going to feel the human warmth again.

And when that day comes, we will know how to treasure what really matters, a hug with a friend, a family reunion, a day at university, the contact with patients, or an activity with people from other countries.

But until it happens, we should stay strong, stay safe, take care of people who need it, give the value to those we have in our houses, enjoy a talk with our parents and siblings, or just say thank you for the opportunity to be here, to be healthy, to be alive, and for having our lovely ones with us.

“I know that we will be together again, maybe incompletes, maybe not totally happy, maybe a little more destroyed, or less motivated, but what really matters is that we are going to feel the human warmth again.”

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REX CROSSLEY AWARDS

Meet the Winners!

1st Place

Fresh COVID-19 perspectives in a Halted World AMSA Hong Kong

2nd Place

Antimicrobial Resistance Awareness Campaign MSAI India

3rd Place

Research Integration in Medical Education LeMSIC Lebanon

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DIGITAL HEALTH Theme Articles

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Telemedicine Implementation for Brazil’s Vulnerable Communities Jackeline Cavalcante de Mattos, Caroline da Silva Teixeira, Daniela da Silva Fontes Santos, Camilla Regina Perez, Ana Carolina Carneiro Faculdade Santa Marcelina | IFMSA-Brazil The COVID-19 pandemic, which prompted the World Health Organization (WHO) to declare a State of Emergency of Public Health of International Importance (SEPHI) in January 2020, continues hitting with increasing numbers and is about to reach 100 million diagnoses and 2.2 million deaths worldwide. With over 8 million confirmed cases and more than 217,000 deaths, Brazil suffered its main impacts on the economy and public health, jolting the lives of people who were already in vulnerable situations1.

Social inequalities that already existed in the country, added to Brazil’s continental geographical extension, have all contributed to increase the informality in the labor market, aggravating the unemployment rates, the precarious housing conditions and the difficulties in accessing healthcare services1, 2.

In view of this public health emergency, on March 20, 2020, Brazil’s Ministry of Health regulated the practice of telemedicine in the forms of preclinical care, assistance support, consultations, monitoring and diagnosis through information and communication technologies in both the Unified Health System (SUS, in Portuguese) and the private sector3.

Telehealth has since been able to reduce the spread of the new disease, both by reducing the circulation of individuals and by giving them access to specialized health care, especially in places without an organized health structure to support and guarantee the care of patients with pre-existing comorbidities, who could not attend traditional medical appointments4.

Aiming at bringing specialized health services to people in situations of vulnerability and living in Brazil’s remote regions, the non-profit organization SAS Brasil developed a project to cope with COVID-19 that uses telemedicine as the main tool for providing access to healthcare. With its own technology, since March 2020 SAS Brasil

has attended over 25,800 patients who had not only the flu syndrome, but also any other health demand.

In order to implement its telemedicine project, SAS Brasil selected patients from communities and cities with vulnerable populations, considering the location of the territory where they live and a family income of up to 3 minimum wages (around 570 US dollars as of 2020).

After identifying community leaders in the slums of Jardim Colombo (São Paulo), Maré and Complexo do Alemão (Rio de Janeiro) and Natal’s North Zone (Rio Grande do Norte), SAS Brasil presented them with the telemedicine project.

With the approval of entry into the communities, a specific phone number for each region was released to the population through banners and sound-equipped vans. Field teams with nursing technicians were structured, with professionals from both SAS Brasil and locals, in addition to community agents, all prepared with health equipment and PPE. These teams started to give face-to-face support to teleconsultations when it was necessary to check vital signs, deliver oximeters or even lend cell phones so that patients without resources could make the video calls.

The patient’s first contact with the SAS Brasil’s volunteers is made through WhatsApp. The Medical Reception Coordinator (CAM) collects the patients’ main medical complaints and prioritizes the cases, which is validated by the organization’s nursing staff. Personal data of the patient are recorded on SAS Brasil’s telemedicine platform and on an electronic medical record (SIAS), both developed by the organization itself to carry out the teleconsultations in a safe manner, and respecting regulations of the General Personal Data Protection Law (LGPD).

The patient is then referred to a Medical Care Assistant (AAM), a volunteer who carries out a video test with the patient and adjusts their phone

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through SIAS platform. The AAM also completes a brief health record at the same platform with the patient’s medical information and then schedules the appointment.

Medical, psychological, dental, nutritional and speech therapy consultations, among others, are offered free of charge to patients by health professionals, who are all volunteers. Only when utterly necessary, patients are referred to health units, which are previously informed of the project, so they can perform additional exams or get emergency assessments.

For those patients who do not have a cell phone, internet connection or privacy in their household environment, telemedicine booths are also available within the communities. These booths feature automatic sanitization between each patient and offer internet access so they can contact the health professional with privacy.

At the end of their health experience, patients are asked to respond to a post-consultation questionnaire in order to help with indicators of satisfaction, efficiency and resolutiveness. They can also clarify any doubts and make suggestions in a last free call.

By December 2020, SAS Brasil’s Telemedicine Project Against COVID-19 had carried out 23,829 consultations. It had 19 health specialties offered by 78 doctors, 62 psychologists, three occupational therapists, 19 nutritionists, seven dentists, eight physiotherapists, three speech therapists, five nurses, two nursing technicians and approximately 330 screening volunteers (CAM and AAM).

Data collected from April to September 2020, a period in which there were 11,060 teleconsultations, show that, of this total, 9,404 were medical appointments. There were also 1,656 mental health consultations. In addition to the 5,629 patients who received direct consultations, another 3,229 people were also instructed, which shows the project’s ability to go beyond patients with telemedicine. For this period, about 72% of patients were women, while men were around 28%5.

It is also worth mentioning that only about 24% of the teleconsultations were performed due to the flu symptoms, and 91% of the patients denied having any previous contact with individuals infected by the new coronavirus. Of those impacted by SAS Brasil’s telemedicine, about 74% sought the service for the first time, and around 96% did not need face-to-face medical support during the treatment.

Most of these patients underwent medical reassessments (65%), about a third of them were discharged, and only about 2% were asked to seek the nearest emergency room5 (Table 2). In addition, the Net Promoter Score (NPS) measured on the post-consultation call shows a satisfaction rate of 96.2 obtained until September 20206. Data show the project achieves its goal of bringing access to comprehensive care to vulnerable people, who are even more fragile within the pandemic.

An Experience Account as Volunteers By offering part of these telemedicine services as volunteers, it was possible for us to learn about welcoming patients, value humanized care, as well as to deal with the technological difficulties of this population. The biggest public health deficits for this target group were also made explicit, such as psychological support, which is so necessary in a context of anxiety and fear.

As volunteers, we were able to incorporate, in practice, the relevance of the teleconsultations.

We saw how this type of service reaches patients with little or no access to health care, and understood its complementary functionality to the Unified Health System (SUS).

SAS Brasil’s project presents not only a resolution in the quality of life of the patients seen, but also that of volunteers like us, since it motivates us to search for a more humanized medicine and to understand the needs of different realities.

Refrences 1.

Estrela, F.M., Soares, C.F.S., Cruz, M.A., Silva, A.F., Santos, J.R.L., Moreira, T.M.O, Lima, A.B., Silva, M.G. (2020). COVID 19 Pandemic: Reflecting Vulnerabilities in Light of Gender, Race and Class. Rio de Janeiro, Brazil.

2.

Ranzani, O.T., Bastos, L.S.L., Gelli, J.G.M., Marchesi, J.F., Baião, F., Hamacher, S., Bozza, F. A. (2020). Characterisation of the First 250,000 Hospital Admissions for COVID-19 in Brazil: a Retrospective Analysis of Nationwide Data. Rio de Janeiro, Brazil.

3.

Ordinance No. 467, of March 20, 2020. Official Diary of the Union, Brasília: Health Ministry.

4.

Caetano, R., Silva, A.B., Guedes, A.C.C.M., Paiva, C.C.N., Ribeiro, G.R., Santos, D.L., Silva, R.M. (2020). Challenges and Opportunities for Telehealth During the COVID-19 Pandemic: Ideas on Spaces and Initiatives in the Brazilian Context. Rio de Janeiro, Brazil.

5.

Belo, J.V.A.L. (2020). Data Analysis on Teleconsultation Usage During the New Coronavirus Pandemic Period. São Paulo, Brazil.

6.

Zink, S., Bento, R., Toueg, G., Cardoso, M. (2020). Report: SAS Brasil Telemedicine Project. Campinas, Brazil.

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Digital Health Myriam Boueri Lebanese American University | LeMSIC Lebanon

With the world living in a rapidly evolving technological era, over 50% of the worldwide population had access to the internet in 2019, with the population of developed countries reaching a stunning 86.7% access. With this unprecedented worldwide access to technology, many new devices are popping up to serve the business, engineering, agricultural, and medical sectors to count a few. These devices have transformed every sector they serve but have a long way to go before they become the norm. In the medical field, the introduction of medical devices has resulted in a new way of thinking about medicine.

That is why Dr. Tom Ferguson coined the term “e-patient” with the rise of a new type of patient who is more empowered and engaged in their own medical decisions. This patient is a product of what is called “digital health”, where sensors, software, computing platforms, etc. are being used to assess the patient’s health. As with all new advances, digital health is facing numerous ethical, policy, legal, and social challenges. These challenges are forming a roadblock that subdues the development of digital health and suppresses its countless benefits. In this paper, we discuss the benefits of digital health and ways to overcome the challenges it faces.

With the advancement of medicine and technology, large amounts of health data are being gathered by both public and private entities.

In the public sectors, programs such as the 100K Genomes Project in the UK, which has sequenced 100,000 genomes collected from National Health Service (NHS) patients with cancer and other rare diseases; and the All of Us Research Program in the US, which will sample a million Americans to gather clinical data that will be then used for research of better treatments. In the private sector, companies like 23andme has had over twelve million customers which have allowed them to gather three billion phenotypic data points.

With vast amounts of data such as these being gathered, many concerns are raised including data management, privacy protection, and oversight. For example, a major concern of data

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management is data variety to make sure the full potential of the data is used. In fact, studies have shown that a focus on genes and drugs while disregarding data concerning other risk factors, such as smoking, poor diet, and insufficient physical activity; will result in a poor variety of data and result with ineffective ways to determine diseases. Another reason for data variety is creating the ability to generalize treatment and research to cover different ethnicities, ages, sexes, and geographic and socioeconomic distributions. The lack of regard to these factors may lead to considerable biases which result in non-generalizable predictions.

Assuming that all data has been collected properly and carry enough variety to avoid biases and inefficiencies, the data now faces a new type of challenge: security. The medical world has been electronically attacked several times, with attacks as recent as December 2020, when the European Medicines Agency had documents related to COVID-19 medicines and vaccines leaked following a cyberattack. More serious crimes have been initiated with forms of “data kidnapping”. For example, in May 2017, after the NHS suffered from a cyberattack, a ransom of $300 was demanded to release the individual data sets. These attacks create a need to improve internet infrastructure security at both the medical and patient end in order to create a more stable environment where a patient’s data is safe.

In the event of any attack, policies should be implemented to determine accountability and the penalties of such lack of preparation. With the increased need for data, the human element of gathering and analyzing data is being lost and replaced by AI-guided tools. When the computer is doing all the work, who is to blame for wrong diagnoses, life threatening surgical procedures, or even incompatible treatment? Policies such as the General Data Protection Regulation (GDPR) which was implemented in the EU should be studied and executed in countries around the world in order to provide enough coverage.

Escaping from the world of ethical, policy, and legal challenges, a major aspect to take note of is the fact that the “client” of such services is a human. In the business world, trust is major indicator of whether or not a client will buy their product. To achieve that, companies build qualities such as: Reliability and Dependability, Transparency, Fairness, and Openness to build the bond with their customers. Given that the private sector is already following these principles, it would be beneficial for the public sector to learn these techniques in order to pave the way for easier incorporation of the patients into the programs.

In conclusion, with the world shifting into a different way of looking at medicine and health, the world should undergo a paradigm shift in the way it treats technology and human beings. Firstly, a reassessed look at the type and quality of data gathered is required to make sure that future use of this data will lead to effective, non-biased, and generalized predictions. Secondly, increased efforts in building a sustainably safe infrastructure that will store and protect medical records and data from any and all breaches. Finally, both the private and public sectors should implement policies that specifically dictate how to protect patients’ data and who is held accountable in case of trouble. All these points gather to increase consumer trust which will eventually lead to increased usage of digital health products and services, in turn allowing for the evolution of the field as a whole.

Refrences: 1.

Clement, J. “Global Internet Usage Rate by Gender and Market 2019.” Statista, January 11, 2021. https://www.statista.com/ statistics/333871/gender-distribution-of-internet-usersworldwide/.

2.

“About Us: SPM Blog.” Blog: Society for Participatory Medicine, May 12, 2015. https://participatorymedicine. org/epatients/about-e-patientsnet#:~:text=Tom%20 Ferguson%20coined%20the%20term%20e-patients%20 to%20describe,and%20health%20professionals%20and%20 systems%20that%20support%20them.

3.

Center for Devices and Radiological Health. “What Is Digital Health?” U.S. Food and Drug Administration. FDA. Accessed January 21, 2021. https://www.fda.gov/medical-devices/ digital-health-center-excellence/what-digital-health.

4.

“The 100,000 Genomes Project.” Genomics England, May 13, 2020. https://www.genomicsengland.co.uk/aboutgenomics-england/the-100000-genomes-project/.

5.

“All of Us.” National Institutes of Health. U.S. Department of Health and Human Services. Accessed January 22, 2021. https://allofus.nih.gov/.

6.

“About Us.” 23andMe Media Center, June 13, 2020. https:// mediacenter.23andme.com/company/about-us/.

7.

Khoury, M. J., Iademarco, M. F., & Riley, W. T. (2015, November 4). Precision Public Health for the Era of Precision Medicine. American Journal of Preventive Medicine. http://www.sciencedirect.com/science/article/pii/ S074937971500522X.

8.

Muin J. Khoury, M. D. (2015, June 2). Public Health Perspective on a National Precision Medicine Cohort. JAMA. https:// jamanetwork.com/journals/jama/article-abstract/2300607.

9.

FRANCISCO, Estela Miranda. “Cyberattack on EMA - Update 4 European Medicines Agency.” European Medicines Agency, January 12, 2021. https://www.ema.europa.eu/en/news/ cyberattack-ema-update-4.

10. “NHS Seeks to Recover from Global Cyber-Attack as Security Concerns Resurface.” The Guardian. Guardian News and Media, May 13, 2017. https://www.theguardian.com/ society/2017/may/12/hospitals-across-england-hit-by-largescale-cyber-attack.

11. Price, Stephanie. “AI in Healthcare: Navigating Uncharted Territory.” Health Europa, November 24, 2020. https://www. healtheuropa.eu/ai-in-healthcare-navigating-unchartedterritory/104076/.

12. Sharp Cookie Advisors. “The Principle of Accountability in the GDPR.” GDPR Summary, December 10, 2018. https:// www.gdprsummary.com/the-principle-of-accountability-inthe-gdpr/.

13. Jaffe, Dennis. “The Essential Importance Of Trust: How To Build It Or Restore It.” Forbes. Forbes Magazine, December 5, 2018. https://www.forbes.com/sites/ dennisjaffe/2018/12/05/the-essential-importance-of-trusthow-to-build-it-or-restore-it/?sh=1e665f7864fe.

MSI 43 | 19

Technology and Domestic Violence Thaís Abreu Borges, Andressa Bianca Reis Lima Universidade Federal do Maranhão | IFMSA-Brazil

By itself, violence against women (VAW) is a global problem that affects millions of women every year. World Health Organization (WHO) data indicates that at least 1 in 3 women of reproductive age have experienced some form of physical or sexual violence throughout their lives, and although some may be at greater risk than others violence can happen to any woman, anywhere1. In Brazil, for instance, 3739 homicides of women were registered in 2019 alone, with 35% of them classified as femicides, the most extreme form of VAW which means a sex-based hate crime that have the intentional killing of women or girls only because of their gender. In 88% of those femicides the aggressor is the partner or expartner2, which means that some women cannot feel safe even in their homes.

To make it worst, the social isolation imposed by the COVID-19 pandemic caused not only an increase in domestic violence, due to the prolonged coexistence between victim and aggressor, but also maintained women apart from their support networks since they could be monitored all day by their aggressors and prevented from talking to family and friends.

Other factors such as stress, economic problems and fear of virus contamination are also involved in this equation2. Therefore, coping strategies are essential both for the survival of the victims and for overcoming the various forms of violence to which they are subjected.

Coping can be characterized as a set of cognitive and behavioral efforts, adapted according to individual demands, which allow individuals to avoid problems, seek distraction or support and even face them actively3. The use of technology, with emphasis on social networks, comes into this context as an innovative alternative for positive coping of VAW around the world, since many digital channels and platforms can be used to assist women in need.

In order to combat VAW, WHO released an infographic material4 that addresses the acronym RESPECT which each letter refers to a strategy

20 | MSI 43

for the prevention of this problem. The first letter E stands for Empowerment of Women and aims creating safe spaces for both sharing experiences and seeking help. That way, social networks like Instagram, Twitter and TikTok can be used by them as a way to share testimonials and find people who have gone through similar situations.

Even in the midst of lockdowns and restricted social isolations, it is possible to maintain a support network that is not necessarily close to the woman physically, but it could still help with coping and recovery. In addition, women also need to know their rights, which is why creating content in the legal field, especially through videos, is so important. As an example, on Youtube there is a channel called “Direito Delas” created by two Brazilian lawyers whose main objective is to empower women through the law and make legal knowledge more accessible to them.

Another fundamental factor is knowing where to seek help, since access to health services and police stations has been restricted during the pandemic. Some services that were not previously offered on the internet, such as making complaints and report filing, were launched on digital platforms in Brazil5, an innovation that although simple did not exist before the pandemic but can remain as a legacy for the future.

That switch to the virtual environment is crucial to ensure that complaints continue to be made.

The confinement of the victim with his aggressor, intensified by social isolation, means that the search for reporting channels by phone tends to decrease, since the victim cannot privately ask for help. Enabling complaints to be made over the internet and through apps facilitates access for the victims and also for neighbors and society as a whole.

Another aspect to be considered is the omission by police and the justice system, which is still present in Brazil as a reflection of male chauvinism and patriarchal thought of society itself. There is a popular saying in Brazil which goes “em briga de

marido e mulher, não se mete a colher” meaning that in fights between a couple, presumably man and woman, no matter how violent they may be, might be seen as normal for many brazilians and will not always be denounced or dismissed by a third person, despite being a crime of omission under the Brazilian Penal Code that can lead to up to 6 months in prison6.

This mentality also affects some professionals who work in the security field, including police officers and sheriffs, which can increase the sense of impunity of the aggressors and even prevent women from seeking help because they may think they will not be heard.

Refrences:

In this context, social networks can also be used in favor of women as a way to learn how to defend herself physically, since there are several profiles and websites that offer self-defense tips. That is an alternative to try to fill a gap that should be the government’s responsibility: the human right to security. It is worth mentioning that this type of content does not replace the search for the responsible authorities or even face-to-face classes with trained instructors, but it is a valid alternative for emergencies.

On the other hand, there are some obstacles regarding the use of technology to face this problem. It is estimated that 1 in 4 Brazilians do not have access to the internet7. Thus, although the proposal to combat VAW through the internet is innovative, it is not able to reach all Brazilian women immersed in this cycle of violence on a daily basis. In addition, the partner often ends up restricting the victim’s internet use, which prevents her from accessing apps and websites or even contacting family or friends when necessary8.

1.

“Violence against Women.” World Health Organization.

Accessed January 21, 2021. https://www.who.int/healthtopics/violence-against-women#tab=tab_2.

2.

Vieira, P. R., Garcia, L. P., & Maciel, E. L. N. (2020). Isolamento social e o aumento da violência doméstica: o que isso nos revela?. Revista Brasileira de Epidemiologia, 23, e200033.

Epub April 22, 2020. https://doi.org/10.1590/1980549720200033

3.

Souza, M B & Silva, M F S da. (2019). Estratégias de enfrentamento de mulheres vítimas de violência doméstica: uma revisão da literatura brasileira. Pensando familias, 23(1), 153-166.

4.

“RESPECT Women: Preventing Violence against Women.”

World Health Organization. World Health Organization, July 1, 2020. https://www.who.int/reproductivehealth/topics/ violence/respect-women-framework/en/.

5.

“Governo Lança Canais Digitais De Atendimento Contra a Violência Doméstica Durante a Pandemia.” Governo do Brasil, April 3, 2020. https://www.gov.br/pt-br/noticias/ assistencia-social/2020/04/governo-lanca-canais-digitaisde-atendimento-contra-a-violencia-domestica-durante-apandemia.

6.

Folha Vitória. “Cidadão Pode Ser Preso Por Até Seis Meses Se Negar Socorro à Vítimas De Violência Doméstica.”

Folha Vitória, June 17, 2020. https://www.folhavitoria.com. br/policia/noticia/06/2020/cidadao-pode-ser-preso-porate-seis-meses-se-negar-socorro-a-vitimas-de-violenciadomestica.

7.

Agência Brasil. “Brasil tem 134 milhões de usuários de internet, aponta pesquisa”. May 26, 2020. https://agenciabrasil.ebc. com.br/geral/noticia/2020-05/brasil-tem-134-milhoes-deusuarios-de-internet-aponta-pesquisa

8.

DUTRA, Maria de Lourdes; PRATES, Paula Licursi; NAKAMURA, Eunice and VILLELA, Wilza Vieira. “A configuração da rede social de mulheres em situação de violência doméstica”.

Ciênc. saúde coletiva [online]. 2013, vol.18

9.

https://doi.org/10.1590/S1413-81232013000500014.

10. Agência Brasil. “Em 91,7% das cidades do país, não há delegacia de atendimento à mulher’’. September 25,2019. https://agenciabrasil.ebc.com.br/direitos-humanos/ noticia/2019-09/em-917-das-cidades-do-pais-nao-hadelegacia-de-atendimento-mulher

Still, the benefit of technology to prevent and combat domestic violence is undeniable, even though there are obstacles to be faced. It is also important to recognize the role of new apps and websites to monitor cases of VAW, considering that 91.7% of cities in Brazil do not have a police station dedicated exclusively to the defense of women9. Although using digital platforms and social media may not be a definitive solution, it is definitely an alternative to fill the gaps that still exist in tackling domestic violence. Furthermore, all the innovations put into practice during the COVID-19 pandemic will not be in vain and will be able to perpetuate and improve as the world returns to its normality.

MSI 43 | 21

Remote Work in Health Care Wiktoria Zasada Poznan University of Medical Sciences, IFMSA-Poland

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MSI 43 | 23

Articles

24 | MSI 43

Production of Research Within the Reach of IFMSA: an Experience Report Tamara Miranda Fretta & Carolina Turra Fadanelli Universidade do Sul de Santa Catarina | IFMSA Brazil

The human body, when analyzed under the anatomic bias, is constituted by organs that together make the system work. Metaphorically, if each discipline taught at the university were to be considered a functioning part of the body, surely Research would be the backbone, which provides the necessary support for all the rest to exist.

Since it is considered an extension axis, within the normative curriculum there are few subjects that cover the topic. Even so, Brazil is the 13th largest producer of research publications in the world and its academic production grows annually1. However, the access of undergraduate students to the scientific area is not standard, requiring external stimuli for it occurs.

Although simple, the session “Research Production Within the Committee”, held by IFMSA Brazil UNISUL, fostered the will not only to act in the scientific production axis, but also to spread its importance. In the midst of a world health emergency, in which even the vehicle for executing the session had to be adapted, being part of an activity that values the axis that provides humanitarian development is a unique and indispensable experience, which generates reflexes in the future performance as health professionals - in which curiosity and craving for knowledge are essential constituents.

Coordinating this activity brought with it the change of look at research. Being in the third semester of graduation, the academic life was reduced to books on pharmacology and microbiology, but a little was deepened about scientific production. However, the session made

it clear that academics are interested in finding numerous answers in research. And if with a single event, in a single night, we can increase knowledge and will, besides giving the possibility of medical students to become researchers, what could we do through a curricular grid that would give a crucial focus to research and scientific process in our formations? How could our pandemic reality and constant health crises be changed if medical students and professionals had from the beginning a more attentive look and an inborn curiosity to foment research?

Would it be too utopian to expect to change our present and future through research production?

This session presented such possibilities, having a direct reflection on the way in which we act in this federation, but also coming up with an alarming reality in relation to how much the medical schools around the country remain oblivious to this teaching.

In the current scientific and medical environment conjuncture, we can see how many flaws there are in the whole scientific process, gaping the necessity of the teaching institutions to worry about how to disseminate in a competent way the knowledge produced intellectually2. Besides the pandemic of the new Coronavirus, we live a pandemic of promising scientists who do not receive enough education, having the main pillar - the backbone of their knowledge - underdeveloped. The solution to that problem needs to be distributed without moderation and it is within the reach of IFMSA: the research as change.

References: 1.

Libório, Bárbara. “Em meio a cortes e críticas, os números da produção acadêmica Brasileira”. Last modified May 11, 2019.

2.

Ohira, M. L. B. (2005) Por que fazer pesquisa na universidade? Revista ACB, 65-76, 1414-0594.

MSI 43 | 25

Consensus Groups: An Experience Report of the Teaching-Learning Methodology in Human Anatomy Adriely Lais de Souza Pereira, Leandro de Souza Coutinho, Luana Izabela Azevedo de Carvalho, Olívia Cristina Marques Silva Universidade do Estado do Amazonas | IFMSA Brazil

Introduction

Results

The teaching-learning axis of anatomy presents a series of difficulties in the initial stage of academic training1. The lack of knowledge of anatomical terms, the availability and conservative state of the anatomical parts and the rhythm of study and memorization of a vast content present themselves as barriers1-3. William Glasser’s learning pyramid demonstrates that in practical classes, the union of “seeing” and “hearing” increases the percentage of content absorbed to up to 50%. When the active methodology is introduced, up to 95% of the total content is fixed and learned4. This methodology aims to make students more participatory by creating their own methods of reasoning and memorization and is proven effective in fixing knowledge5-6. Based on this logic, the search for methodologies that facilitate learning is notorious. The purpose of this article is to report the experience of students who observed the use of active methodology in the study of anatomy with cadavers, proposing new teaching-learning techniques focused on the area of human anatomy.

It was known that class A obtained slightly higher grades compared to class B in the practical test (A: 41% of the grades above average, B: 36%). Class A interacted well with the group methodology. The initiative of the class A to study among themselves added to the explanation of the structures and the review of anatomical terms became frequent and independent. It was noticed that class A adhered and approved the methodology, since the students asked for the realization of the dynamic when it

Experience report Two classes, named A and B, were observed. The students of class A were encouraged, after some lessons, to get together in groups to review the content. Then, the groups should explain to all the classes a part of the subject that was chosen by the monitors and teachers. In the meantime, class B followed the methodology of traditional expository classes and individual review of anatomical pieces. The two classes spent three weeks in the same module.

26 | MSI 43

was not proposed to them. The methodology was described by them as effective. The difficulties observed were the shame and insecurity of some students. To overcome these questions, an attempt was made to create a peaceful and non repressive environment during the application of the method, with the fewest possible corrections.

References: 1.

Salbego, Cléton; Oliveira, Elaine Maria Dias de; Silva, Márcia de Almeida Rosso da; & Bugança, Paula Renata. (2015).

Percepções Acadêmicas sobre o Ensino e a Aprendizagem em Anatomia Humana. Revista Brasileira de Educação Médica, 39(1), 23-31.

2.

Calazans, Natália Contreiras. (2013). O ENSINO E O APRENDIZADO PRÁTICOS DA ANATOMIA HUMANA: UMA REVISÃO DE LITERATURA. 59 p. Monografia (Conclusão de Curso) Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Salvador.

3.

Junior, Josival Araújo; Galvão, Gabriel; Marega, Patrícia; Baptista, Josemberg; Beber, Eduardo; Seyfert, Carlos. (2014). Desafio anatômico: uma metodologia capaz de auxiliar no aprendizado de anatomia humana. Medicina (Ribeirão Preto);47(1):62-8.

4.

Malheiros, Gustavo; Malheiros, Bruno. DESCOMPLICANDO A APRENDIZAGEM: 5 passos que vão mudar a sua forma de adquirir conhecimentos. Recto Aprendizagem Descomplicada.

5.

Filho, Ernann Tenório de Albuquerque; Cavalcante, Labibe Manoela Melo; Cavalcante, Klaus Manoel Melo; Jatobá, Marcelo Augusto Vieira; Santana, Eduarda Cavalcante. (2020). Aplicação de metodologias ativas de ensino no estudo da anatomia humana frente ao modelo tradicional. Brazilian Journal of Health Review, 3, 1457-1464.

6.

Yan, J., Ding, X., Xiong, L., Liu, E., Zhang, Y., Luan, Y., Qin, L., Zhou, C., & Zhang, W. (2018). Team-based learning: assessing the impact on anatomy teaching in People’s Republic of China.

Advances in medical education and practice, 9, 589–594.

Conclusion It is essential to a good quality teaching for it to have a participatory nature. These objectives are believed to have been achieved by the application of this method. It is possible that if the methodology were applied effectively, after all classes, and not only on alternate days, the percentage of grades above the average would be higher. It is necessary to stimulate students’ participation so they can be capable of not only knowing, but also communicating and putting into practice what they have learned, so they can achieve an education that is not only focused on the mind of the students, but that can also reach their language and their actions.

MSI 43 | 27

The Protagonism of Women’s Participation in Campaigns Related to Men’s and Women’s Health: a Report by the IFMSA-Brazil-USF Committee Lívia Gallo Coletti, Maria Julia Pereira Ferreira, Laura Beatriz de Godoi Balastrero São Francisco University | IFMSA Brazil Manuscript The campaigns promoted by the International Federation of Medical Students’ Associations (IFMSA) contribute to broadening the worldview of the medical student and highlighting current health needs. Due to the Coronavirus Disease 2019 pandemic and the virtual scenario in which the campaigns of the IFMSA-Brazil local committee at San Francisco University (USF) took place, it was observed an increase in the promotion and greater participation of USF medical academics in the events held throughout 2020 compared to 2019.

In this context, by monitoring the data obtained from the certificates, it was observed that, in campaigns related to women’s and men’s health, men constitute the minority of participants.

This article assessed the following campaigns: “On Wednesdays We Wear Pink” and “Blue November”, which took place presentially in 2019 and online in 2020. The first campaign reinforces the importance of breast cancer prevention, and the second, aimed to raise awareness of prostate cancer.

Based on the certifications data, Table 1 was compiled; illustrating the number of male and female participants in the mentioned campaigns, as well as the percentage they represent. There was a prevalence of women in both years of the campaigns. Regarding the “On Wednesdays We Wear Pink” event, women had over 90% of participation in the two successive years analyzed, and the male audience had a small increase, from 3.58% in 2019 to 6.25% in 2020, equivalent to the attendance of 4 men in the last event compared to 60 women.

Concerning the “Blue November” campaign, the female participation was also the majority, despite the fact that it was a campaign focused exclusively on male health.

Women’s presence has increased on the online edition, rising from 73,33% to 90,90% in 2020. In contrast to the campaign’s goals, men’s participation has decreased remarkably even with the greater accessibility of a web event, from 26.66% to 9.10% the following year, corresponding to 3 men out of 30 women.

These data support the phenomenon of medicine feminization in Brazil, which according to Scheffer and Cassenote (2013)1 has been occurring since 2009

28 | MSI 43

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Such sao paulo tendency was observed at the local committee IFMSA-Brazil-USF, as guarulhos parana shown in Table 2; female participation curitiba among local coordinators is over 80% in san ta both years, followed by a decrease in catarina florianopolis rio grande do sul male participation. porto alegre Therefore, it is observed that women represent a very active majority in the medical environment and that they assume a wide-ranging posture towards attending events involving themes that are not only restricted to the health of their gender, a phenomenon illustrated by the majority of women participating in the Blue November campaign. In contrast, men, who are already in minority with the feminization of medicine, have a small participation in the campaigns no matter the subject addressed, as seen in the low rates of attendance in the campaigns.

Bibliographical Reference: 1.

Scheffer M. C., Cassenote A. J. F. (2013). The feminization of medicine in Brazil. Bioethics Magazine, 21 (2), 268-77.

Tables Event

On Wednesdays On Wednesdays We Wear Pink We Wear Pink

Year

Blue November

Blue November

2019

2020

2019

2020

Modality Presential / Virtual

Presential

Virtual

Presential

Virtual

No. of women /Percentage

27 women / 96,42%

60 women / 93,75%

1 man / 3,58%

4 men / 6,25%

8 men / 26,66%

3 men / 9,10%

28

64

30

33

No. of men / Percentage Total number of certifications

22 women / 73,33% 30 women / 90,90%

Table 1: Number of men and women who participated and obtained the certification in the events “On Wednesdays We Wear Pink” and “Blue November”, during the years 2019 and 2020, in the presential and virtual modalities, represented in raw numbers and in respective percentages. Women’s participation in both campaigns is highlighted, independently of the theme approached in the two years analyzed.

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Table 2: Number of local IFMSA-Brazil-USF coordinators in 2019 and 2020, according to gender and their respective percentage. A majority of women is observed in both years.

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MSI 43 | 29

Curriculum Digital Revolution: Between Modernization and Traditionalism Abdul-Rahman Al Komy Kasr Al Ainy Medical School, Cairo University | IFMSA-Egypt

A Few years from now, surgical robots will become an average sight in a well-equipped Operation Room (OR) and pharmacies in hospitals will 3D print personalized drugs in specific dosages.

Healthcare has undergone a major transition due to digital health technologies that provide both patients and medical professionals with data. As medical students, a new challenge we meet is to take advantage of technologies and advancement, without rejecting solid principles and traditional missions. Medical training and education need to be continuously modernized to keep pace with new practice trends.1 Nowadays, the medical education process does not prepare students for the world they will face when they start practising medicine. Instead of only burying students in libraries with hundreds of books for memorizing data, they should get a chance to acquire proper digital literacy skills and a general overview of digital health as well.

A key task we all have is to narrow the gap between how we learn medicine and how we will practice it. Disruptive technologies start to replace jobs and nobody, even in medicine, is safe without constantly learning and improving. But how would medical schools teach this attitude if they are far behind the latest innovations and are not eager to catch up?2 A generation born with gadgets all-around their desks can obtain digital skills much easier and faster. It’s a golden chance to let students participate in curriculum designing in alignment with professors and teachers.

Through a collaborative care curriculum framework that guarantees the best health care service, the student-professor relationship will turn from a hierarchical, asymmetric power

30 | MSI 43

relationship into an equal-level partnership.3 A pilot course for lessons in digital health should be mandatory in every medical curriculum. It is of utmost importance to familiarize students with technologies that will shape their medical practice in the coming years. Artificial intelligence, VR/AR, 3D printing, robotics or cheap genome sequencing will all change how we know medicine today. Put in mind that practising medicine is based on communication. Therefore, as social media play a major role in today’s communication, digital literacy must be included in the medical curriculum.2 The Standing Committee on Medical Education (SCOME) has been always alert of every new initiative that aimed to improve medical education. As SCOME members, it’s a high priority to consider digital skills as a partner in our Teaching Medical Skills (TMS) Program. A new scope will be available for all NMOs and LCs to propose ideas and the floor will be shared all around the globe to pick the optimum options to qualify medical students to be exceptional future doctors whose minds can handle a textbook in a hand and a gadget in the other one.

References: 1.

DDGDGD“What We Believe In – The Medical Futurist Mission Statement.” The Medical Futurist, November 11, 2020.

2.

“Let Medical Students Become 21st Century Physicians.” The Medical Futurist, August 8, 2018.

3.

“Collaborative Care Curriculum.” Medicine, Nursing and Health Sciences, May 12, 2020

Articles

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Talkings by our hearts: a chance provided by international exchange Camila Fonseca Carneiro Universidade do Estado do Amazonas | IFMSA-Brazil

Exchange, in its etymological root, means a cultural symbiosis that does not necessarily last only the time in which an individual is outside his usual territory1. The changes of thought departing from the cultural exchange are replicated in attitudes, dialogues and cascades of domino effect within the social circle of the exchange student back in the country of origin. The airport, the first site of rupture of customs, is usually the door to new phenotypes, mixed languages and cultural shock, and the changes of travel are perpetuated in the course of the personal and professional trajectory of the individual.

The set of these metamorphoses of mentality are mirrors of the newly known culture and, according to Albert Camus, “Without the culture, and the relative freedom that it presupposes, society, however perfect it may be, is nothing but a jungle. That is why all authentic creation is a gift for the cult”2. In this context, medicine is full of culture, since patients go to the clinics with their psychosocial complexities, beliefs and unconscious traditions. Migration within a country is common, and even if a doctor works in the same city where he was raised, it is inevitable to receive patients from other states and even continents. The ability to listen, the flexibility to understand and respond with empathy are essential sequential steps for clinical practice and all are widely trained on an international journey.

Although the Standing Committee for International Clinical-Surgical Exchange (SCOPE) proposes to offer practical knowledge in a medical specialty, the main learning is the adequacy of language, understood as a set of facial expressions, body gestures and spoken signs. Theoretical knowledge is undoubtedly of paramount importance for maintaining exchange vacancies at IFMSA, however it is emotional resilience and social skills the main gains of spending 4 to 8 months in another country.

From this perspective, according to Nelson

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Mandela, a pacifist leader, “If you talk to a man in a language he understands, it gets into his head. If you speak to him in your own language, you reach your heart.” In this context, the first achievement of the doctor, in his consultation, is to know how to communicate well with the patient and gain his/her trust. The nonviolent communication, arranged by Marshall4, provides for the correct management of language and international exchanges are excellent tools of humanization, being therefore the window of IFMSA to enter the hearts of students and medical preceptors.

References: 1.

Dalmolin, I. S., Pereira, E. R., Silva, R. M. C. R. A., Gouveia, M. J. B., & Sardinheiro, J. J. (2013). Intercâmbio acadêmico cultural internacional: uma experiência de crescimento pessoal e científico. Revista Brasileira de Enfermagem, 66(3), 442-447.

2.

Araújo, L. D. (2014). Universidade e sociedade. Revista da Faculdade de Letras: Filosofia, II série, vol. 10 (1993), p. 237248.

3.

Yngaunis, S. A singularidade da pessoa surda se evidencia por meio da comunicação (Doctoral dissertation, Universidade de São Paulo).

4.

Rosenberg, M. B. (2006). Comunicação não-violenta: técnicas para aprimorar relacionamentos pessoais e profissionais.

Editora Agora.

“Without the culture, and the relative freedom that it presupposes, society, however perfect it may be, is nothing but a jungle. ”

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The SCOPExperts Rebecca Kassab Saint Joseph University | LeMSIC Lebanon

SCOPE has always been about exchanges. Most of the time, it’s the only word that comes to member’s mind when they hear about SCOPE. This association is deeply founded, and completely understandable. Exchanges are something to look forward to. A motivation to make it through the semester. A reward.

But, let’s forget a little bit about exchanges for now. Let’s try to focus, for once, on the word Professional rather than the word Exchange.

Where can we get from here?

Professional means competent. Experienced.

Qualified. Skilled. And so on. We all aspire to be professionals in our future careers. Someone that novices and learners will think highly of, that they will regard as a role model.

But how do we become professionals? Let’s review the process.

We wake up. We attend classes from 8 am till 5 pm. And then we study. We devour notes and books and articles. We struggle to memorize all the important and not-so-important notions.

We break down a few times along the way. We wake up again after 3 hours of sleep. We go to our exam. We submit our answers. We forget pretty much everything. And the cycle goes on for several years. This has always been the flow. It’s being Book Smart that will get us the knowledge and the grades. There is absolutely no escaping it. There is unlimited new information to learn every day and then put in practice once we graduate.

But, if every future doctor follows this pattern, what will actually make you stand out of the crowd?

What about a more StreetSmart approach to medicine, that focuses on potentiating a set of both hard and soft

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skills that every doctor should master? Efficiency, time management, first aid, problem solving, resourcefulness, communication, empathy, research… Those are not topics that we learn during our curriculum. They are often neglected because they are not pointed out.

To become a Professional, you will need the knowledge and the skills. And while SCOPE can’t give you the knowledge, it can certainly give you the skills.

Some people are naturally gifted. They’re simply born accomplished. And then there are the rest.

But, don’t worry, it is not an “All or Nothing” situation. All these skills can be learned and perfected.

This can be done by joining strengths with the other Standing Committees. Every single one of them has something great to provide. Just think about one skill. The Standing Committee name will automatically follow. And together, all the Standing Committees, within the SCOPE mindset of becoming Professionals, could help you build your capacities and unleash your inner expert so that even the most Professional Doctors will soon enough have – almost – nothing on you.

The Pandemic effect on the Medical Students Mobility Shahd Idais, Yazan Dumaidi AlQuds University | PMSA-Palestine

There are recognized factors that can affect students’ decision to apply for a study abroad programs. For example, cost and language barrier (1) . The pandemic added one more barrier with travel restrictions, students and families’ consideration of safety and health, and the teaching institutions’ priority to reduce the risk of transmission of coronavirus (COVID-19), which resulted in a profound influence on international student mobility (2,5) . Taking into consideration the uneven distribution of the pandemic, the mobility flows will also be different in various countries and regions (3) .

While students have concerns about personal safety, some decided to remain committed to their role as part of the healthcare team, putting in mind that they are the future of the medical workforce.

However, the anxiety levels are elevating among workforce who are concerned about the continuously changing impact of COVID-19, which puts the merits of continuing clinical placements in question by clinical supervisors (4) .

References: 1.

Brown, M., Boateng, E. and Evans, C., 2021. Should I Stay Or Should I Go? A Systematic Review Of Factors That Influence Healthcare Students’ Decisions Around Study Abroad Programmes.

2.

Webcache.googleusercontent.com.

2021. [online] Available at: <https://webcache.googleusercontent.com/ search?q=cache:nT-i3Tif60UJ:https://www.dhhs.vic.gov.au/ student-clinical-placements-updated-guidance-notes-Covid-197-October-2020-doc+&cd=1&hl=ar&ct=clnk&gl=ps> [Accessed 25 January 2021].

3.

Times Higher Education (THE). 2021. Global HE As We Know It Has Forever Changed. [online] Available at: <https://www. timeshighereducation.com/blog/global-he-we-know-it-hasforever-changed#survey-answer> [Accessed 25 January 2021].

4.

Halbert, J., Jones, A. and Ramsey, L., 2021. Clinical Placements For Medical Students In The Time Of COVID ‐19.

5.

Mok, K., Xiong, W., Ke, G. and Cheung, J., 2021. Impact Of COVID-19 Pandemic On International Higher Education And Student Mobility: Student Perspectives From Mainland China And Hong Kong.

6.

Bized.aacsb.edu.2021.International Student Mobility And The Impact Of The Pandemic | Bized Magazine. [online] Available at: <https://bized.aacsb.edu/articles/2020/june/covid-19-and-thefuture-of-international-student-mobility> [Accessed 25 January 2021].

A recent study from mainland China and Hong Kong stated that 84% of students showed no interest in studying abroad after the pandemic.

Students re-ordered the pull-push factors that they consider when deciding to study abroad (5) . Higher percentage is expected among medical students specifically as more risks are in sight.

In the light of all mentioned above, still, optimism is held by some scholars that mobility will stay strong in countries with solid basis for student mobility (6) .

In conclusion, higher education institutions and international organizations must take action regarding international mobility in times of a pandemic. Even though scientific evidence supports limiting mobility, advantages of mobility oversee its disadvantages. This pandemic may take longer than expected and such limitations not only affect students’ education but also countries’ economics, which is a big matter.

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Educational Activities as a step towards the fullest exchange experience Marcela Sousa Araujo Universidade Estadual de Santa Cruz (UESC) | IFMSA-Brazil

Key Words: Academic Quality; Educational Activities; Experience Educational Activities (EAs) can be defined as the process of developing and training medical and scientific skills on understanding the peculiarities of the country 1 . In International Federation of Medical Students Association’s (IFMSA) context, providing EAs during the exchange is extremely important since one of the exchange’s goals is closely related to developing in the students a holistic view about global health and diversity 2 .

According to IFMSA’s, one of the Standing Committee on Professional Exchange’s (SCOPE) aims is to provide medical students with the possibility to experience healthcare in another culture with different health and education systems, and to learn how differences in culture and believes are of influence 7 . In addition to the steps, working in partnership with the Activities Standing Committees (SCs) can help to strengthen the bond inter-axis 5 and provide an enlarged vision of the experiences themselves.

Academic Quality

EA Cultural and Healthcare System Diversity

Figure 1

Principles” (Figure 2) starting by the “why”, elaborating the “how” and finally putting the “what” into practice.

Finally but not the least, it’s important to highlight that EAs not only impact and contribute for the

Moreover, considering the great diversity of cultures and healthcare systems worldwide, developing EAs during the clerkship is an unique opportunity for the incomings to get to deeply know the reality of the country he or she will be living for a month, which also contributes to elevate the Academic Quality (AQ) of the exchange 3-4 .

Owing to the fact that AQ and EAs are intrinsically related 4 (Figure 1), exploring it’s potential during Pre-Departure Training (PDT) and Upon Arrival Training (UAT) and assessment the quality of the activities might be the best strategy to evaluate the outcomes and measure their impact. Taking into consideration that even if the EA is made by the same National Member Organization (NMO) in the same country, there might be differences between distinct regions and targets, which requires customized activities for each situation and this can be done using the “Golden Circle

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Medical and Scientific Skills

What How Why

Figure 2

incoming’s growth but also for the local university, community, and students of the host country 4 .

Therefore, for everything that was said above, we decided to write this short article in order to encourage local exchanges officers to develop this activities aiming to enable the incomings to live their clerkships the fullest and have the best experience they could ever have.

References: 1.

Macedo, G., Dinesh, C., Angulo, R. I. A., Osi, E., da Cruz, D. G., Daoud, S. G. R., Prashanth, P., Otero, G. J. O., &amp; Aduappiah, B. (2016). Academic Quality Manual SCORE and SCOPE International Teams.

2.

Macedo, Gabriela, Chaitra Dinesh, Rodrigo Ignacio Almonacid Angulo, Elina Osi, Diogo Gomes da Cruz, Saker Gassan Rashid Daoud, Pranav Prashanth, Gabriel José Ortez Otero, and Bismark Adu-appiah. 2020. “Profissional Exchange.” International Federation of Medical Students’ Association. 2020. https:// ifmsa.org/professional-exchanges/ .

3.

Waterval, D., Frambach, J. M., Scott, S. M., Driessen, E. W., &amp; Scherpbier, A. J. J. A. (2018). Crossborder curriculum partnerships: Medical students’ experiences on critical aspects.

BMC Medical Education, 18(1), 1–9. https://doi.org/10.1186/ s12909-018-1239-6

4.

Holmes, D., Zayas, L. E., &amp; Koyfman, A. (2012). Student objectives and learning experiences in a global health elective.

Journal of Community Health, 37(5), 927–934. https://doi. org/10.1007/s10900-012-9547-y

5.

Dupont, E., Martins, M., &amp; Denicol, T. (2017). Manual UAT e EAs.

6.

Boelen, C., Dharamsi, S., &amp; Gibbs, T. (2012). The social accountability of medical schools and its indicators. Education for Health: Change in Learning and Practice, 25(3), 180–194. https://doi.org/10.4103/1357-6283.109785

7.

Macedo, Gabriela, Chaitra Dinesh, Rodrigo Ignacio Almonacid Angulo, Elina Osi, Diogo Gomes da Cruz, Saker Gassan Rashid Daoud, Pranav Prashanth, Gabriel José Ortez Otero, and Bismark Adu-appiah. “Profissional Exchange.” International Federation of Medical Students’ Association, 2020. https:// ifmsa.org/professional-exchanges/.

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Articles

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Brain doping: Misuse of prescription stimulants among Medical Students Ana Júlia Nascimento dos Santos & Gabriel Soares de Souza University of Pernambuco campus Serra Talhada | IFMSA Brazil

Stimulating substances of the Central nervous system (CNS), such as Methylphenidate and Amphetamine, are drugs commonly used in attention deficit/ hyperactivity disorder (ADHD)¹.

In this disorder, these substances can decrease the feeling of fatigue and promote a better cognitive performance temporarily, with increased alertness, memory, cognition, and euphoria. As a result of that, they have been widely used in an indiscriminate and nonprescribed way, especially in the university environment and between medical students2,3. However, it is important to analyze the social factors that lead to such use, as well as the potential and serious damage to your physical and mental health.

The demand for an adaptation to society desires, that exerts great pressure on university students for positive results, has led students to resort to psychostimulants. This can be explained because the advent of postmodernity - characterized by the instability of social functions and liquidity of relationships4 - has been causing an endless search for self-affirmation and belonging to a social body that often requires the fulfillment of inhuman goals as a passport to fit in that society. A research carried out with medical students from the 1st to the 8th period shows that 52.94% of the students use some psychostimulant substance, and these, 76.76% do not have a medical prescription and 66.66% started using it during college, thus emphasizing a medicalization of life as a way to achieve academic goals5.

It is noteworthy that the vast majority of students who use PS do not seek information from health professionals before using it6. This fact is problematic when analyzing the safety of these drugs: On a scale validated in 2007, that classifies drugs according to a damage matrix, amphetamines and methylphenidate were ranked 6th and 12th,

respectively, for substances known to cause physical damage and 8th and 13th for causing addiction6. This exposure to unwanted symptoms creates a lack in the quality of life. In medical course context this fact represents a dual nature of a society that, at the same time, demands from doctors a humanized care to build a good doctor-patient relationship and glorifies sacrifices that lead these students to psychological suffering, in an attempt to supply the desires of an inhuman education system.

Despite the large and well-documented obstacles related to the non-prescribed use of psychostimulants, the use of these substances is a reality among medical students. The pressure for better results, the easier access and the subjective effectiveness reported by users are some of the reasons that still encourage the growing search for the use of OS². Therefore, the existence of institutional and public policies has a huge importance to reduce the misuse consumption of these substances among medical students in order to promote an improvement in quality of life and, as a result, in the quality of health service provided to society when these same individuals are trained and exercising their professions in search of general well-being.

References: 1.

Clark, M. A., Finkel, R., Rey, J. A., & Whalen, K. (2013). Farmacologia ilustrada (5a ed.). Porto Alegre: Artmed.

2.

Weyandt, L. L., Oster, D. R., Marraccini, M. E., Gudmundsdottir, B. G., Munro, B. A.; Rathkey, E. S., & McCallum, A. (2016). Prescription stimulant medication misuse: Where are we and where do we go from here?.

Experimental and clinical psychopharmacology, 24(5), 400–414.

3.

Pires, M. S., Dias, A. D. P., Pinto, D. C. L., Gonçalves, P. G., & Segheto, W. (2018). O uso de substâncias psicoestimulantes sem prescrição médica por estudantes universitários. Revista Científica FAGOC-Saúde, 3(2), 2229.

4.

Bauman, Z. (2001). Modernidade Líquida. Rio de Janeiro: Jorge Zahar.

5.

DeSantis, A. D., Webb, E. M., & Noar, S. M. (2008). Illicit use of prescription ADHD medications on a college campus: a multimethodological approach. Journal of American college health, 57(3), 315-324.

6.

Nutt, D., King, L. A., Saulsbury, W., & Blakemore, C. (2007). Development of a rational scale to assess the harm of drugs of potential misuse. The Lancet, 369(9566), 1047-1053.

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Role of Primary Health Care Given the Challenges Imposed

by COVID-19 Marjory Mayara Freire Alencar, José Jefferson da Silva Cavalcanti Lins, Evelyn de Oliveira Campos, Ricardo Augusto Barros dos Santos Filho Universidade de Pernambuco Campus Serra Talhada | IFMSA Brazil

Introduction The 2019 new coronavirus disease pandemic, Covid-19, reached more than 92 million people around the world1.

This situation has sparked debates involving different social segments, impacting the socioeconomic, political and cultural dynamics around the world and putting in jeopardy the countries’ ability to govern2.

The first government responses were directed, above all, to the spread of measures of social distancing and the race to provide hospital beds for the intensive care unit for critically ill patients1. However, it is necessary to discuss the place of Primary Health Care (PHC) in dealing with this pandemic, since studies indicate that about 80% of cases are mild and most moderates seek the primary health care network as the first access in the search for care3.

Objective Analyze in the existing literature the role of PHC in the face of the challenges imposed by Covid-19.

Methods It is a literature review in the databases of PubMed, Google Scholar and Scielo. The Health Sciences Descriptors (DeCS) were adopted: “Primary Health Care” and “COVID-19”, combined with the Boolean operator AND. Complete articles were included, without restrictions on location and language, published between 2020 and 2021. The research resulted in the selection of eight scientific articles thoroughly evaluated2-9.

Results and Discussion From the analysis, it became evident that PHC has important attributes to deal with critical times, such as the Covid-19 pandemic3. The decrease in new cases

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is associated with PHC’s ability to promote health education, especially in times of increasing fake news spreading4,5. Furthermore, telemedicine in PHC emerges as an effective tool in reducing face-to-face contact between professionals and users, and that offers continuity of care, especially to patients with chronic non-communicable diseases that, when poorly managed, increase the demand for highly complex services.5-9. In addition, the Brazilian Ministry of Health provides digital channels and services, including a telephone exchange and apps for people to seek health information not only related to COVID-1910.

The initiative, by providing information at a distance, sought to reduce the burden on the health system, queues and agglomeration of patients6,10. One of the major challenges facing PHC in the context of the pandemic is the need to ensure the health of PHC workers by ensuring the availability of personal protective equipment and adequate training for use and disposal4,6.

Conclusion PHC can play a central role in mitigating the effects of the pandemic, however, it is necessary to be recognized as a protagonist in order to have full operational capacity and to resolve moderate cases in a timely manner, and to refer serious cases to referral services. Therefore, it is essential to legitimize the importance of collective effort in reaching agreements between different levels of health care, emphasizing a line of longitudinal care focused mainly on the prevention of Covid-19, and there is no better place to develop it than in PHC.

References: 1.

World Health Organization (WHO). Coronavirus disease (COVID-19) pandemic - Outbreak situation. Geneva: WHO. 2021. [acesso em 2021 Jan 16].

2.

Sarti TD, Lazarini WS, Fontenelle, LF et al. Qual o papel da Atenção Primária à Saúde diante da pandemia provocada pela COVID-19? Epidemiol. Serv. Saúde. 2020. 29(2), e2020166.

3.

Dunlop C, Howe A, Li D, Allen LN. The coronavirus outbreak: the central role of primary care in emergency preparedness and response. BJGP Open. 2020. Jan;4(1):1-3.

4.

Cabral ERM, Melo MC, Cesar ID et al. Contribuições e desafios da Atenção Primária à Saúde frente à pandemia de COVID-19.

InterAm J Med Health. 2020;3:e202003012.

5.

Gois-Santos VT, Santos VS, Souza CDF et al. Primary Health Care in Brazil in the times of COVID-19: changes, challenges and perspectives. Rev Assoc Med Bras. 2020. 66(7):876-879.

6.

Daumas RP, Silva GA, Tasca R et al. O papel da atenção primária na rede de atenção à saúde no Brasil: limites e possibilidades no enfrentamento da COVID-19. Cad. Saúde Pública. 2020; 36(6):e00104120. doi: 10.1590/0102-311X00104120

7.

Harzheim E, Martins C, Wollmann L et al. Ações federais para apoio e fortalecimento local no combate ao COVID-19: a Atenção Primária à Saúde (APS) no assento do condutor.

Ciênc. Saúde Colet. 2020. 25(6):2493-2497. doi: 10.1590/141381232020256.1.11492020.

8.

Majeed A. The impact of COVID-19 on academic primary care and public health. J R Soc Med. 2020. 113(8):319. doi: 10.1177/0141076820947053

9.

Sullivan, E.E.; Phillips, R.S. Sustaining primary care teams in the midst of a pandemic. IJHPR.2020. 9:77, p. 1-3.

10. Brasil. Ministério da Saúde. Protocolo de manejo clínico do coronavírus (COVID-19) na Atenção Primária à Saúde - Versão 9. Brasília (DF): Ministério da Saúde. 2020.

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Self-medication during the COVID-19 pandemic Ana Beatriz Albuquerque da Cunha Universidade de Pernambuco | IFMSA-Brazil Introduction Self-medication (SM) is a practice related to when individuals take medications without a diagnosis given by a doctor, with its recommendation and prescription of the appropriate course of action. 1 The consequences of self-medicating can vary from an increase in drug expenses, a misdiagnosis, side effects, drug interactions and even antibiotic resistance.2 Recently, with the outbreak of the COVID-19 pandemic, a rise in searches on this topic through Google was observed, which could indicate an increase in interest in self-medicating during this period. 3This possibility has also been corroborated by the news about the use of ivermectin and chloroquine, which are typically used in other diseases and, however, have been being used by some people as a prophylactic treatment for COVID-19. 4,5 Objective Analyze the existing relating self-medication COVID-19 pandemic.

literature and the

Methods A review of the literature was conducted, using Pubmed as a database. There was no restriction regarding the location or language of the articles.

The keywords “covid-19”, “SARS-CoV-2” and “selfmedication” were used.

Results and Discussion The search resulted in 10 articles regarding the subject aimed.6-15 The studies presented different approaches, however, they were similar in appointing recurrent factors of the pandemic that

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contributed to the self-medication of individuals.

Three articles demonstrated the influence of news and social media in presenting misinformation about medications whose use on SARS-CoV-2 were still being studied, which, as a result, stimulated people to take it. Lockdown was also named a factor that increased SM even though, the employment of teleconsultation was a fundamental component in order so that this increase was not even greater.6 While health professionals and individuals with risk of mental illness were pointed as more likely to self-medicate during the COVID-19 pandemic, the rate of other individuals self-medicating for the first time also grew. In one of the studies, workers in economic vulnerability were found to be reluctant to search for medical help when needed because of the fear of being fired, having their salary reduced or shifts cutted if a disease interfered with their work.7 There were some limitations regarding the quantity of studies in the database concerning this topic, which might be given to it being related to recent events.

Conclusion There is a close relationship between selfmedication and the COVID-19 pandemic. A broad spectrum of individuals were more likely to selfmedicate in those circumstances. Misinformation, fear towards the coronavirus, difficulty to go to consults because of lockdown or economic reasons favored self-medication. Despite that, more specific studies towards different groups are necessary to determine the impact of the pandemic in this scenery in order to allow an appropriate plan of action.

8.

Malik, M., Tahir, M. J., Jabbar, R., Ahmed, A., & Hussain, R. (2020). Self-medication during Covid-19 pandemic: challenges and opportunities. Drugs & therapy perspectives: for rational drug selection and use, 1–3. Advance online publication.

9.

Alessi, J., de Oliveira, G. B., Schaan, B. D., & Telo, G. H. (2020).

Dexamethasone in the era of COVID-19: friend or foe? An essay on the effects of dexamethasone and the potential risks of its inadvertent use in patients with diabetes. Diabetology & metabolic syndrome, 12, 80.

10. Sadio, A. J., Gbeasor-Komlanvi, F. A., Konu, R. Y., Bakoubayi, A. W., Tchankoni, M. K., Bitty-Anderson, A. M., Gomez, I. M., Denadou, C. P., Anani, J., Kouanfack, H. R., Kpeto, I. K., Salou, M., & Ekouevi, D. K. (2021). Assessment of self-medication practices in the context of the COVID-19 outbreak in Togo. BMC public health, 21(1), 58.

11. Molento M. B. (2020). COVID-19 and the rush for self-medication and self-dosing with ivermectin: A word of caution. One health (Amsterdam, Netherlands), 10, 100148.

1.

Bennadi D. (2013). Self-medication: A current challenge. Journal of basic and clinical pharmacy, 5(1), 19–23.

12. Choudhary, N., Lahiri, K., & Singh, M. (2020). Increase and consequences of self-medication in dermatology during COVID-19 pandemic: An initial observation. Dermatologic therapy, e14696. Advance online publication.

2.

Afridi, M. I., Rasool, G., Tabassum, R., Shaheen, M., Siddiqullah, & Shujauddin, M. (2015). Prevalence and pattern of selfmedication in Karachi: A community survey. Pakistan journal of medical sciences, 31(5), 1241–1245.

13. Makowska, M., Boguszewki, R., Nowakowski, M., & Podkowińska, M. (2020). Self-Medication-Related Behaviors and Poland’s COVID-19 Lockdown. International journal of environmental research and public health, 17(22), 8344.

3.

Onchonga D. (2020). A Google Trends study on the interest in self-medication during the 2019 novel coronavirus (COVID-19) disease pandemic. Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society, 28(7), 903–904.

4.

Rathi, S., Ish, P., Kalantri, A., & Kalantri, S. (2020).

Hydroxychloroquine prophylaxis for COVID-19 contacts in India.

The Lancet. Infectious diseases, 0(10), 1118–1119.

14. Onchonga, D., Omwoyo, J., & Nyamamba, D. (2020). Assessing the prevalence of self-medication among healthcare workers before and during the 2019 SARS-CoV-2 (COVID-19) pandemic in Kenya. Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society, 28(10), 1149– 1154.

5.

Mega E. R. (2020). Latin America’s embrace of an unproven COVID treatment is hindering drug trials. ature, 586(7830), 481–482.

6.

Shenoy, P., Ahmed, S., Paul, A., Skaria, T. G., Joby, J., & Alias, B. (2020). Switching to teleconsultation for rheumatology in the wake of the COVID-19 pandemic: feasibility and patient response in India. Clinical rheumatology, 39(9), 2757–2762.

7.

Tran, B. X., Vu, G. T., Latkin, C. A., Pham, H. Q., Phan, H. T., Le, H. T., & Ho, R. (2020). Characterize health and economic vulnerabilities of workers to control the emergence of COVID-19 in an industrial zone in Vietnam. Safety science, 129, 104811.

References:

15. Goodwin, R., Hou, W. K., Sun, S., & Ben-Ezra, M. (2021).

Psychological and behavioural responses to COVID-19: a ChinaBritain comparison. Journal of epidemiology and community health, 75(2), 189–192.

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The mourning in the pandemic of the new coronavirus: solutions for the new society an integrative review of the literature Fláuber Faustino de Sousa, Ana Vitória Romualdo de França, Bruno Varela Fernandes, Maria Vitória Moreira Dantas Universidade Federal de Campina Grande / IFMSA-Brazil Introduction The World Health Organization declared in March 2020 the pandemic of the new coronavirus, but the global community still didn’t understand the social, economic and health impacts it would face. Almost a year before the beginning of the state of calamity, we have more than 90 million infected and almost 2 million deaths from the virus worldwide 1, corroborating the increase in complicated mourning processes 2 and consequent increase in cases of mental disorders. Some U.S. researchers have stated that with each death

by COVID-19, 9 people face grief3. Therefore, we need to understand the changes in the aspects of mourning and how the care community can prepare to adapt to this scenario since approximately 10% of the bereaved have a high risk of developing complex reactions of mourning and another 30% are considered moderate risk4. It’s also frightening that some of these individuals don’t find enough support to continue the afterlife of loved ones5 and may develop a complicated, painful and disabling state of mourning.

Objective To analyze the aspects of mourning in the social scenario of high mortality of the Covid-19 pandemic, to indicate solutions, in the short and long term, to circumvent the implications on the mental health of the bereaved.

Methods The literature review was carried out on PUBMED, Scielo and BVS platforms, considering studies of the last five years, without any language restriction.

The descriptors used were “bereavement” and “coronavirus infections’’. Were disregarded reviews, letters to the editor and experience reports Results and discussion Understandably, grief is a natural human response to loss, so it’s essential to understand the aspects

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of the scenario of high mortality. The studies show the existence of four typical manifestations of grief: ambiguous loss, present in disappointments in the various areas of life; anticipated mourning, coming from the idea of imminent death; complicated mourning, the loss that is persistent, intense and worrying 5 and underprivileged mourning, a consequence of the unavailability of religious and cultural rituals concerning sanitary restrictions6.

Also, the short time between perception of the disease and death by SARSCoV-2 affects the capacity to adapt to the pain of loss and increases the prevalence in cases of disabling mourning 7,8.

Short and long-term resolution measures were seen in the studies.

Prioritize the autonomy of the sick over the way of dying9; support virtual communication between family members and sick people; disseminate symptom management;promote emotional assistance to both patients and relatives and, when appropriate, adapt to rituals should be actions made possible at first promote emotional assistance to both patients and relatives and, when appropriate, adapt to rituals10. Family members need continuous psychological follow-up and individualized care during decisions, in addition to discussing future expectations, avoiding symptoms of complicated grief 5,11.

Conclusion

References:

The aspects of mourning, especially in the pandemic, have singularities not understood by healthcare professionals, making their palliative approach insufficient. Therefore, training is necessary for that surpass the palliative content of the approaches, aiming to establish efficient and applicable solutions to patients, capable of comforting them regardless of the social environment.

1.

Eisma MC, Boelen PA, Lenferink LI. Prolonged grief disorder following the Coronavirus (COVID-19) pandemic. Psychiatry Res. 2020;288:113031.

2.

Verdery, A.M., Smith-Greenaway, E., Margolis, R., & Daw, J. (2020). Tracking the extent of the loss of COVID-19 relatives with a grief multiplier applied to the United States. Process of the National Academy of Sciences, 117(30), 17695-17701.

Doi:10.1073/pnas.2007476117

3.

Bertuccio RF, Mc Runion. Considering grief in mental health outcomes of COVID-19. Psychol Trauma. 2020;12(S1):S87-S89. doi:10.1037/tra0000723

4.

Aoun SM; LJ Breen; Howting DA et al. Who needs support for grief? A population-based survey on the risk of grief and the need for support. PLoS One. 2015; 10 : E0121101

5.

Zhai Y, Du X. Loss and grief amidst COVID-19: A path to adaptation and resilience. Brain Behav Immun. 2020;87:80-81. doi:

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Articles

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LEOPARD

(Let’s Learn Together to Prepare Research and Learn Yourself, Highschoolers!)

Neissya Nastiti Firmanto Universitas Airlangga Surabaya | CIMSA-ISMKI

Youth is a hope and an asset for a nation.

Youth roles are very important in building the community welfare. Hence, it can’t be denied that every country is trying to build knowledge, skills, and character of youth to make a better nation (Pamungkas,2017). As a Standing Committee which mainly focused on research activities, SCORE CIMSA UNAIR wants to contribute to improve our nation through developing Highschool students’ research skills. This is achieved through a community development called LEOPARD. LEOPARD was born on 2019, with a small group of students from SMA Muhammadiyah 2 Surabaya as our community target. The community target was chosen based on research that have been done before. The research showed that this school has a community of students who interested in research. Moreover, the principal and teachers of this school were very excited and support this project.

LEOPARD’s first project on 2019 was mainly focused on increasing the students’ knowledge about making a scientific paper, in a simple and fun way.

There was a lecture about scientific paper from medical student of Universitas Airlangga who often won scientific competitions, Alfian Nurfaizi.

On the other day, we divided the students into some groups to discussed about the environment’s problems and stimulated their critical thinking to make a simple scientific paper about how to handle that problems. At the end of the event, all of the groups presented their idea in front of us. The event was succeed and it made a great impact to the students.

A year after that, we continue to educate the students about research. We held LEOPARD on the same community but with a different theme.

“Youth is a hope and an asset for a nation.”

On LEOPARD 2020, we chose public poster as our theme. Before starting the intervention, SCORE UNAIR’s members were trained about how to make a public poster.

Hence, we hope that they can also developing their skills and help to educate the students. On the first intervention, the students were given a lecture about making a public poster’s content

by Nadhifah, a finalist and winner in public poster competitions. Then, we divided the students into some groups to make a public poster with an environment theme. On the second intervention, we held the event online since the pandemic has attacked us all. The students were given a lecture about how to make a great design and layout for public poster by Junjungan, a finalist and winner in public poster competitions. Finally, on the last intervention each of the groups presented their great public poster and we picked a winner for the best public poster. Lastly, we also chose five students to become a peer educator to educate their friends about public poster. We hope that LEOPARD could have a long-life and make a great impact to more students.

Reference : 1.

Pamungkas, Riyady Aji. 2018. “Partisipasi Pemuda Karang Taruna Desa

2.

Ambarwinangun Dalam Menumbuhkan Karakter Tanggung Jawab dan Karakter

3.

Peduli Lingkungan Guna Menciptakan Lingkungan Yang Sehat dan Bersih”.

4.

Skripsi. Cited from : eprints.ums.ac.id/view/subjects/HM.html

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Project of the Month Sophia Zimbal, Wassim Aziz Ouazzani, Cristian Noé, Rivera Rosas, Anna Martin, Muhammad Dwi Putra IFMSA SCORE Supervising Board 2020-2021

Dear MSI readers, During the summer months, we realized how important the work of Local Officers on Research Exchange (LORE) is within the IFMSA SCORE Research Program. Hours of writing emails, phone calls, filling out confusing Project Forms that look more difficult to fill than your last exam at university. Our LOREs’ passion and patience are bigger than the Eiffel Tower, and this needs to be appreciated.

We are pleased to present you a very new and never seen before project of the Supervising Board (SB) in the name of the SCORE IT, the Project of the Month (PoM)!

The IFMSA Research Exchange Program is a research opportunity based on projects of different types, departments, techniques, involvement, and outcomes worldwide. SCORE projects in an NMO are crucial for staying SCORE active and vital for raising research awareness and preserving the Academic Quality of our exchange program. A Project Form summarizes each research exchange’s characteristics, which helps the exchange student get an idea of what

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they are going to work on and can also be used to promote the LC and their research internationally.

By introducing the PoM, we want to give a voice to the project that fulfils the PoM criteria the most: Innovation, Uniqueness, Involvement of the student, and clearness when presenting Methods and Techniques. Afterwards, the selected project will be shared through different Social Media Channels and finally be published in the MSI magazine.

This way, we can raise more awareness for research, motivate NOREs/LOREs for finding the most exciting research projects, increase the popularity of SCORE & IFMSA, increase the approachability and transparency between the SB and the NOREs, and finally, honor the NMO/LC for their hard work behind the project!

The PoM winners sharing their experience: Having one of our projects be chosen as PoM feels like a huge honour and we wouldn’t have been able to achieve this without professor Aerts his captivating project! This inspires us to provide more fascinating projects for our incomings.

Andit shows us once again the great things we

accomplish within the IFMSA! — Joycelle & Imane, LOREs VUB, BeMSA Belgium It is a great honor for our NMO to receive this award! This is also a motivation for me to work hard for IFMSA - Thailand and also on the international level. — Bambam, NORE Incoming, IFMSA-Thailand Thank you so much for this award, we are very proud and motivated to do even better in the future!

— Flon, NORE Assistant for Project Development, IFMSA-Thailand

We are new LC here so I was clueless that you were contemplating us for this award. We are deeply pleased and honored to receive it. Blue hugs <3 — Boss, LORE/LEO, IFMSA-Thailand We’re happy to have reached such a number of SCOREans worldwide and we are very excited to receive all your amazing projects!

Your SCORE Supervising Board 2020-21

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The role of GSNO [Gezira Student Network Organization] and GMSA [Gezira Medical Students Association] SCORE on Research education during COVID 19 pandemic in Sudan July 2020 Hiba Mahgoub Eltayeb Mahgoub, Raghda Muhammed Ali Ibrahim University of Gezira | MedSIN Sudan Introduction:

- The data have been analyzed by Google forms.

The coronavirus diseases-2019 (COVID-19) pandemic has had and continues to inflict far-reaching effects on all sectors across the globe. With over 99 million cases [1] . Medical education has been greatly impacted by the pandemic globally. [2][3] Senior medical students in countries hit hard by the pandemic were fast-tracked to provide extra manpower at the hospitals. Sudan recorded its first COVID-19 case on 13 March 2020 [4]. The ministry of higher education in Sudan locked down all universities on the country by 14 th of March 2020 [5] .E-learning, also known as online education refers to the usage of electronic resources like internet, computers, and smartphones to acquire and disseminate knowledge [6] . The education of medical students and future scientists should be embedded in the principles of Responsible Research [7] . Research online course is an online activity was held from the 8th till the 25th of July in collaboration between GSNO research office and GMSA SCORE. It was the first of its kind in university and Sudan; inter professional collaboration between international doctors, researchers and Sudanese online platform “gomagra”. The activity was aiming to capacitate under graduated medical students and deepen their knowledge in research throughout 3 different levels.

Results: We got highly motivated members shown in the commitment , motivation and assignments quality from over 16 universities across Sudan, (53.7%) from first and second year, (34.4%) from third and fourth year and (44.9%) from final years. More than (70%) have poor knowledge about conducting medical research. Only (30%) have participated in research before. From level (A) (77.8%) see the content was highly beneficial, level (B) more than (90%) were satisfied from the platform and level

Figure 1

Figure 2

(C) more than (70%) were highly satisfied from the course. More than (80%) of the facilitators were willing to participate again in similar

Methodology: - We firstly open call for participant with criteria (motivation, availability, commitment, connection and variability), we spread online quiz to identify participants knowledge and then directed to basic, intermediate and advance levels.

- We spread pre assessment forms to each level A, B and C. - By the end of the course we shared post activity forms for each level.

- The course was included sessions, trainings and oral presentations.

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Figure 3

events. We get accreditation from the faculty the certificates were stamped by the faculty logo and dean in addition to great comments from international doctors.

5.

“Sudan news website”, 14 of March 2020. http://sudanfirst. com/2020/05/6983/

6.

Masic, I. E-learning as new method of medical education.

Acta Inform Med. 2008;16:102

7.

Institute of Medicine (US) Committee on Alternative Funding Strategies for DOD&#39;s Peer Reviewed Medical Research Programs; McGeary M, Hanna KE, editors. Strategies to Leverage Research Funding: Guiding DOD&#39;s Peer Reviewed Medical Research Programs. Washington (DC): National Academies Press (US); 2004. 2, Sources of Funding for Biomedical Research. Available from: https://www.ncbi. nlm.nih.gov/books/NBK215472/

Members:

Conclusion:

•

Fatima Abdulmonem | Sudan | MedSIN Sudan | Second year

•

Areej Alobeid | Sudan | MedSIN Sudan | First year

•

Hiba Abdelrahim | Sudan | MedSIN Sudan | First year

•

Saffaa Adlan | Sudan | MedSIN Sudan | First year

•

Ikram Hamza | Sudan | MedSIN Sudan | First year

The course was really excellent and the great efforts were put got an amazing impact. We hilly recommend more Student non-governmental organizations to organize these courses and collaborate with their faculties and research institutes in local, national, regional and international levels and involvement of medical education organization and national ministries of higher education to accredit and encourage these students’ activities.

CERTIFICATE OF PARTICIPATION THIS IS AWARDED TO

RAGHDA Muhammed ALI IBRAHIM In Appreciation of the outstanding performance as an event coordinator for : Research Online Course Organized by Gezira Student Network Organization-Training and Research Office and Gezira Medical Student Association-Standing Committee on Research Exchange , Sudan From 7th of July to 25th of July2020.

____________________________________

_______________________________________

_____________________________________

Dr. Wail N O Mukhtar

Ahmed A. Abbas

Mazin Mohammed

MD, MHPE, Associate Professor

Gezira Medical Student Association President

Gezira Student Network Organization President

Dean, Faulty of Medicine, University of Gezira

Reference: 1.

“World o meter about COVID 19 pandemic statistics” last modified 25 of January 2020. https://www.worldometers.info/ coronavirus/.

2.

Ahmed, H, Allaf, M, Elghazaly, H. COVID-19 and medical education. Lancet Infect Dis. 2020;20:777-778

3.

Ahmed, H, Allaf, M, Elghazaly, H. COVID-19 and medical education. Lancet Infect Dis. 2020;20:777-778

4.

“Relief web”, 16 of July 2020. https://reliefweb.int/report/ sudan/sudan-situation-report-16-july-2020

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“Is there evidence outside of medicine?”: an experience report of a Local Exchange Office in Brazil Miguel Godeiro Fernandez, Isabela Santos Oliveira, Mariana Sousa de Pina Silva Escola Bahiana de Medicina e Saúde Pública | DENEM Brazil

Evidence Based Medicine [EBM] displays itself as an effigy of modern medicine and represents decades of physicians endeavouring into the pursuit of evidence and efficient treatment decisions. Meanwhile, as a group speaking on behalf of a Local Exchange Office, we promoted an online debate themed around the importance and history of EBM. That event had a member of DENEM Brazil - a NMO of IFMSA -, medical students and a university researcher and professor in biology. However, suddenly, a conflict between the researcher and the students revealed some meaningful insights about science and EBM, which we will be unveiling in this article.

The professor stated that, during her years as a researcher, medicine, no matter what, was viewed as the pinnacle of science and a symbol of erudition, whereas other fields of knowledge were often despised. For that matter, the medical undergraduates, settled to their own niche, were confronted by a reality in which medicine may be self-centred and privileged.

Beyond that, do medical students even know how science works outside the “bubble” in which they operate?

Despite the professor’s statement, we can assert that modern medicine has significantly improved. Studies with low level of evidence were perceived as facts and conducts were defined by isolated findings, sometimes accidental or justified in some physiological principal. For instance, antiarrhythmic agents were prescribed prophylactically to patients with myocardial infarction, leading to tragic outcomes¹.

In this context, EBM ascends as a form of renewal, but why do we say so?

EBM ignited devotion for questioning, aiming for evidence and effectiveness, but also humility.

That´s because part of the EBM success is a result of recognizing and converging different fields of

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knowledge within medicine. The sophisticated help of statistics, combined with the sociological view of the patient and the philosophical approach to science, seeking to conciliate the precision of algorithms with the subjective side of doctor-patient relationship, makes EBM the most important tool that medicine has, so far.

Still, listening to a description of an antiquated and self-absorbed medicine, unexpectedly and in a live broadcast, was a point of catharsis.

Although medicine has improved with the values intrinsic to EBM, there is much to develop. In 2020, science went through a disastrous clash when trying to communicate with people, getting overpowered by the sensationalist media. As an example, miraculous teas for COVID-19 and medicines without any scientific proof were largely used in Brazil. This exemplifies steps that medicine, associated with sociology and statistics, has to overcome in order to connect with the population and achieve effective instruction and public health.

In conclusion, due to the interdisciplinary nature of good scientific production, EBM could not be separated from reflecting on the role, relevance and evidence in other fields. Sociological methodology, philosophical thinking, mathematical precision, and biomedical methods are all connected, taking the physicians off the pedestal where they were placed and inserting them in a team of thinkers. This is the scenario that EBM proposes to present and future medical practice and education.

Reference: 1.

Djulbegovic, B., &amp; Guyatt, G. H. (2017). Progress in evidence-based medicine: a quarter century on. Lancet (London, England), 390(10092), 415–423. https://doi.org/10.1016/ S0140-6736(16)31592-6

Articles

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Pink October and Blue November: The Importance of Cancer Prevention in Transsexual People Maísa Cristina de Lima Nascimento, Mylaryna Santos Araújo, Vitória Biesuz, Garcia Bertolin, Bárbara Marques e Silva Centro Universitário das Américas | IFMSA-Brazil

Despite the LGBTQIA + (Lesbian, gay, bisexual, transgender/transexual, queer/questioning, intersex, and allied/assexual plus) rights agenda being in vogue, there is still a lot of prejudice and medical negligence towards the transvestite and transsexual population. In addition, according to the National Association of Transvestites and Transsexuals (ANTRA)¹, the lack of representativeness and visibility in breast and prostate cancer awareness campaigns, in the well-known Pink October and Blue November months, contribute to the fact that transsexuals do not obtain adequate information regarding prevention and the need for constant monitoring, even if you have undergone sex reassignment surgery²,³.

Furthermore, according to the Revista Brasileira de Educação Médica ⁴, the health of the transsexual and transvestite population is not addressed in most curricula of Brazilian medical universities, contributing to and perpetuating medical unpreparedness towards this population5. For this reason, the students of the Standing Committee on Sexual and Reproductive Health and Rights, including HIV and AIDS (SCORA) of the IFMSA Brazil FAM, met with feminist collective Rita Lobato of the University Center of the Americas and invited obstetric gynecologist Dr. Ariane de Castro Coelho, endocrinologist Dr. Luciana Mattos Barros Oliveira and medical and law academics, respectively, Theo Brandon Pitanga Gonçalves and Yuna Vitória Santana da Silva, who are also transsexuals, to address the issues of breast cancer in transsexuals and cisnormativity in the Pink October campaigns. Not only, there was the presence of the family doctor, Dr. Rodolfo Luciano Galeazzi, Dr. Odair Gomes Paiva, a urologist who works at the STD / AIDS Reference and Training Center in São Paulo, and Rodrigo Franco, who is a transsexual and founder of the NGO Casa Chama6 - an LGBTQIA+ care association, to address the care of the transsexual population, prostate cancer and the importance of supporting transsexual NGOs, respectively.

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Not only, the event took place over two days, October 27 with an emphasis on Pink October and November 3, 2020 highlighting the Blue November. Both started at 6 pm and ended at 9 pm. It was carried out on the GoToMeeting online platform, and reached 32 people on the first day and 28 on the second.

In addition, digital media were used, such as Instagram and official WhatsApp groups from IFMSA Brazil FAM and Coletivo Rita Lobato for marketing the event. Furthermore there was no registration fee. At the beginning and at the end of the event, questionnaires were applied so that the impact could be measured. Thus, it was found that 100% of the participants found the discussion of the topic pertinent, and after the lecture, 68% of the listeners considered themselves able to attend a transsexual person. Therefore, it can be concluded that the topic was well approached, making it possible for students and health professionals present to learn how to correctly guide and help transsexual patients about breast and prostate cancer.

References 1.

Associação Nacional de Travestis e Transexuais. 2019.

“Travestis e transexuais podem desenvolver câncer de mama?”. https://antrabrasil.org/2018/10/09/travestis-e-transexuaispodem-desenvolver-cancer-de-mama/amp/

2.

Agência de Notícias da AIDS. 2019. “Travestis e mulheres transexuais também precisam se prevenir ao câncer de próstata” https://agenciaaids.com.br/noticia/travestis-emulheres-transexuais-tambem-precisam-se-prevenir-aocancer-de-prostata/

3.

Ana Paula Amorim. 2019. “Cuidado de Pessoas Transexuais e Travestis”. https://www.sbmfc.org.br/noticias/cuidado-depessoas-transexuais-e-travestis/

4.

Associação Nacional de Travestis e Transexuais. 2019.

“Travestis e transexuais podem desenvolver câncer de mama?”. https://antrabrasil.org/2018/10/09/travestis-e-transexuaispodem-desenvolver-cancer-de-mama/amp/

5.

Negreiros, Flávia Rachel Nogueira de, Ferreira, Breno de Oliveira, Freitas, Danilo de Negreiros, Pedrosa, José Ivo dos Santos, & Nascimento, Elaine Ferreira do. (2019). Saúde de Lésbicas, Gays, Bissexuais, Travestis e Transexuais: da Formação Médica à Atuação Profissional. Revista Brasileira de Educação Médica, 43(1), 23-31. https://dx.doi.org/10.1590/198152712015v43n1rb20180075

6.

Casa Chama. 2019. https://www.casachama.org/category about

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Does Sexuality Have an Expiration Date or are we not Ready to Recognize Another Sexual Taboo?

Matheus Emanuel de Castro Henrique, Leila Gabriele Nunes Silva, Vítor Silveira Reis Canêdo, José Ícaro Silva Universidade Federal Rural do Semi-Árido | IFMSA-Brazil

Sexual health, for the World Health Organization (WHO)1, means “... a state of physical, emotional, mental and social well-being in relation to sexuality”. Thus, in order to reach it, sex education must be focused on all aspects and stages of life.

However, it’s noticeable an exponential increase in sexually transmitted infections (STIs) and stigmas to analyze the contemporary scenario of sexual health of the longevous. According to Smith et al2, this phenomenon is related to the lack of health education, affecting most severely the elderly population. Therefore, using the debate as a way to foster knowledge, IFMSA Brazil UFERSA held a session of the MedFlix project focused on the sexual health of the elderly.

The session “MedFlix: Sexual Health for the Elderly” aimed to raise issues and questions due the online exhibition of episodes from the series “Grace and Frankie” and “Parks and Recreation”, which addressed the possibility of falling in love again, sexual rediscoveries and safe relationships throughout longevity. Then, the participants and the guests - a geriatric doctor and a psychologist specialized in sexology - started a virtual debate.

The professionals started with speeches based on experiences, portraying the same problems of the episodes, in addition to solving doubts about how to approach sexual topics with elderly patients, reaching full medical care.

“Sexuality is an integral part of the human being personality”3, which, although wrapped in an infinity of taboos, constitutes itself as a natural dimension of the existence of our species and does not extinguish - contrary to what the popular view seems to consider - with advancing age.

Little considered in medical schools and scarcely treated by national health programs, sexuality in senescense is invisible and treated as nonexistent3,4, edifying fragmented views in the elderly care. Thus, gaps in health care are built, which translates into doctors unpreparedness to face the elderly sexual issues in the clinical context and a tendency for the emergence of

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many preventable barriers, such as the increased impact of STIs among older people4. Hence, activities that break the stigma of the elderly sexuality within medical schools are valuable in the process of overcoming the limited vision that permeates the sexual health of this age group.

Therefore, the use of audiovisual resources, explored by MedFlix, is useful and able to foster understanding and awareness for hypotheses not experienced by the viewer in a very dynamic way5, providing a space for debate more open to the visualization of a medical professional that recognizes the multidimensionality of your patient.

In summary, it becomes axiomatic the need to expand discussions and debates among students and health professionals to replicate activities that focus on the sexuality of elderly patients, given that recent data6 corroborate the scarcity of studies and research developed on this subject thematic. Thus, it is possible for doctors in training to develop a holistic view of patients, regardless of their ages, which allows reaching the concept of sexual health advocated by WHO and recognizing that sexuality has no expiration date.

Refrences 1.

World Health Organization. (2006). Defining sexual health: report of a technical consultation on sexual health, 28-31 January 2002, Geneva.

World Health Organization.

2.

Smith, M. L., Bergeron, C. D., Goltz, H. H., Coffey, T., & Boolani, A. (2020). Sexually Transmitted Infection Knowledge among Older Adults: Psychometrics and Test-Retest Reliability. International journal of environmental research and public health, 17(7), 2462. https://doi. org/10.3390/ijerph17072462

3.

Marques Moraes, Késia, & Paixão e Vasconcelos, Dayse, & Rodrigues da Silva, Antonia Siomara, & Carvalho da Silva, Regina Célia, & Montenegro Santiago, Luciana Maria, & Siqueira Lima Freitas, Cibelly Aliny (2011). Companheirismo e sexualidade de casais na melhor idade: cuidando do casal idoso. Revista Brasileira de Geriatria e Gerontologia, 14(4), 787-798. [consultation date: January 18, 2021]. ISSN: 18099823. Available in : https://www.redalyc.org/articulo.oa?id=4038/403834044018

4.

Maschio, Manoela Busato Mottin, Balbino, Ana Paula, Souza, Paula Fernanda Ribeiro de, & Kalinke, Luciana Puchalski. (2011). Sexualidade na terceira idade: medidas de prevenção para doenças sexualmente transmissíveis e AIDS. Revista Gaúcha de Enfermagem, 32(3), 583589. https://doi.org/10.1590/S1983-1447201100030002.

5.

Picanço, Thaíla Soares da Costa, Nazima, Maira Tiyomi Sacata Tongu, Santos, Braulio Erison França dos, Picanço Júnior, Olavo Magalhães, Cambraia, Maria Izabel de Albuquerque, Morais, Leila do Socorro da Silva, Pena, Luis Felipe da Silva, & Costa, Karina Suzany Nery. (2019). O Cinema como Recurso Educacional no Ensino de Atitudes Humanísticas a Estudantes de Medicina. Revista Brasileira de Educação Médica, 43(1, Suppl. 1), 57-68. Epub January 13, 2020. https://doi.org/10.1590/1981-5271v43suplemento1-20180164.

6.

Vieira, Kay Francis Leal, Coutinho, Maria da Penha de Lima, & Saraiva, Evelyn Rúbia de Albuquerque. (2016). A Sexualidade Na Velhice: Representações Sociais De Idosos Frequentadores de Um Grupo de Convivência. Psicologia: Ciência e Profissão, 36(1), 196-209. https:// doi.org/10.1590/1982-3703002392013

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Raising the Scope of Sexual and Reproductive Health Services in Vulnerable Populations Esther Bueno Diaz, Nediza Melina Zacarías Estévez, MD O&M Medical School | ODEM Dominica Republic

“It’s not the years in your life that count.

It’s the life in your years” -Abraham Lincoln Progress towards elimination of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) relies on the improved access and availability of sexual and reproductive health (SRH) services. The delivery of a comprehensive set of services to meet the needs of people living with HIV/AIDS is essential to achieve universal health coverage and the targets of the Sustainable Development Goals. The care of HIV-infected patients is complex and requires the implementation of a broad, multidisciplinary approach with special attention to vulnerable populations. Disadvantaged and marginalized groups, including female sex workers, men who have sex with men, immigrants, transgender persons, and people living in low-resource settings, are disproportionally affected by the HIV/AIDS epidemic and therefore require effective and targeted strategies to ensure optimal access to healthcare.1 Across the world, achieving national goals to decrease morbidity and mortality rates and prevent new infections has been possible through the integration of HIV programs within existing SRH services. This linkage can enhance coverage and uptake of services, reduce HIV-related stigma and discrimination, improve patient satisfaction, and increase knowledge and promotion of sex education. Furthermore, this plan of action can improve intervention efficiency and maximize the utilization of scarce resources for health.

These potential strategies and cost savings are particularly important in the context of a global response to HIV that focuses on ensuring longterm sustainability and comprehensive response to population health demands.2 aimed at expanding access, it is necessary to identify the different points along the care

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continuum where patients may fall out of care as well as the potential obstacles limiting usage of HIV services. Unfortunately, HIV-related stigma and discrimination are primary barriers to the utilization of health services. Fear of social exclusion and lack of a supportive environment can cause individuals to be hesitant to receive testing, disclose their HIV status or take antiretroviral therapy, thereby contributing to the expansion of the HIV epidemic and the number of AIDS-related deaths. It is a public health imperative to ensure that all healthcare providers comply with their ethical obligation to provide optimal care and confidentiality to all individuals in a stigma- and judgment-free environment.1 Essential conditions necessary to achieve universal access to HIV prevention, diagnosis, and treatment include a proper understanding of the epidemic trends, adequate identification of vulnerable and disproportionately affected groups, and the development of inclusive and supportive environments with trained staff to properly meet population needs. As such, we recommend the implementation of public health policies, at the regional and national levels, focused on distribution and redistribution of available resources to improve access and utilization of SRH services. Through this call to action, national health systems can ensure that all people, in particular the most vulnerable groups, enjoy the highest attainable standard of care.

References 1.

Bekker L-G, Alleyne G, Baral S, Cepeda J, Daskalakis D, Dowdy D, et al. Advancing global health and strengthening the HIV response in the era of the Sustainable Development Goals: the International AIDS Society—Lancet Commission. Lancet. 2018;392(10144):312–58.

2.

Hopkins J, Collins L. How linked are national HIV and SRHR strategies? A review of SRHR and HIV strategies in 60 countries. Health Policy Plan. 2017 Nov;32(Suppl 4):iv 57–66.

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The Long Road of Advocacy for School-Based Comprehensive Sexuality Education Islam Imad Masood Al-Azhar University | PMSA-Palestine

Comprehensive Sexuality Education (CSE) promotes the fundamental principles of a young person’s right to education about their bodies, relationships and sexuality and the full range of information, skills and values to make responsible choices about their own health and sexuality. Also, CSE promotes gender equality and the prevention of violence against women and girls.1 Thus, CSE should be delivered to all young people, both inside and outside schools by well-trained professionals in an evidenced-based way to empower them, build their self-esteem, share information about rights, and lead to better health and well-being for young people. Yet, sexual education is a sensitive matter and sometimes considered taboo in the conservative societies that adheres to its religious, cultural and moral values.2 Despite the growing body of evidence in support of sexuality education, it is still not being provided to young people in a majority of countries. 3 Barriers to implementing sexuality education stems primarily from a range of mistaken concerns and beliefs, e.g. that sexuality education leads to early sexual debut, that sexuality education deprives children of their innocence, that it is against the culture or religion, or simply fear on the part of lawmakers and education professionals that parents will object to it being taught in schools.4 Hence, there is a continued need to provide the evidence base for why school-based sexuality education is important, how to best implement school-based sexuality education programs, but also what factors need to be taken into consideration when implementing school-based sexuality education programs.

The IFMSA recognize the relevance of CSE for ensuring the respect to sexual and reproductive rights in the different stages of the life cycle.

IFMSA works and advocates through its standing committee on Sexual and Reproductive Health and Rights including HIV and AIDS (SCORA) for the inclusion of CSE in the national curricula to help

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youth to have a healthier sexual and reproductive lives, free from stigma and discrimination.4 But yet IFMSA work is on the international level; advocating for CSE in high level meetings, releasing policies and statements, providing manuals, toolkits and support for its members.

Hence, it is your role and responsibility to use these tools to advocate for CSE in your country, regardless of the situation wither CSE is included or not in the national curricula, there is always something you can do as CSE is much more than just a regular sex education class. The road starts by advocating for the inclusion of CSE in national policies and laws, sharing best practices to ensure quality in the cooperating CSE activities and therefore improve the positive outcomes achieved and developing and promoting evidence based CSE in formal and non-formal setting until achieving our ultimate goal “A world where every individual is empowered to exercise their sexual and reproductive health rights equally, free from stigma and discrimination.”

References: 1.

UNFPA. (2014). UNFPA Operational Guidance for Comprehensive Sexuality Education: A focus on Human rights and Gender. New York.

2.

“New Research Investigates Barriers To Sexuality Education”.

2019. UNESCO. https://en.unesco.org/news/new-researchinvestigates-barriers-sexuality-education.

3.

“Comprehensive Sexuality Education”.2020. Unfpa.Org.https:// www.unfpa.org/comprehensive-sexuality-education.

4.

“New Paper Busts Myths About Comprehensive Sexuality Education”. 2019. UNESCO. https://en.unesco.org/news/newpaper-busts-myths-about-comprehensive-sexuality-education.

5.

“Sexual & Reproductive Health And Rights Including HIV&AIDS”.

2021. IFMSA. https://ifmsa.org/sexual-reproductive-healthrights-including-hiv-aids/.

Articles

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COVID-19 Vaccine Distribution in the Context of Medical Ethics Kheloud Abdelnasser Mansoura University | IFMSA-Egypt

As of February 8, of 2021, The New York Times Coronavirus Vaccine Tracker listed 67 vaccines in human trials, 20 being in the final testing stages.

There are three COVID-19 vaccines whose use has been authorized by some national regulatory bodies. None has been authorized by the WHO, but the assessment process is ongoing. As the vaccine comes as a possible solution to a lifethreatening pandemic it raises many ethical concerns when it comes to distributing this solution.

The distribution of the vaccine has begun in many countries, but, due to limited resources, we don’t have consistency in countries or on the local level, about who can get vaccinated. In some areas it is first come first served; despite this being fair and guaranteeing equality of distribution, it does not take into consideration populations who may have obstacles that hinder their access to vaccination. In other areas, the priority is usually given to people over 65, over 75, healthcare workers, high-risk, nursing home residents, and those with comorbidities. Thus, attempting health equity. There is a difference between equality and equity, but, in this context, isn’t equity equality?

Isn’t giving everyone the same chance serves both?

Another question that arose was whether or not our responses are inclusive. Most of the official priority lists include health care workers, people with comorbid diseases, and the elderly in the first phase of vaccine distribution, but only a few lists include people with down syndrome; people with down syndrome, due to series of immune dysregulations, have four times the mortality rates compared to the rest of the population, yet they are not among the top priority group. Another group that is not included in any of the three phases are those with no legal documents such as stateless people, refugees, and undocumented immigrants, who are not given a chance to get vaccinated in any of the phases and will remain

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at risk until the governments consider them in the response plans.

Another group of interest includes individuals who refuse receiving the vaccine due to different reasons such as their concerns about vaccine safety or that they would like the vaccine to go to someone in more need. Should people have autonomy in this issue? Even though it can potentially harm others around them? Do we have the authority to mandate the vaccine?

In conclusion, there is a plethora of dilemmas and underlying ethical questions that come to mind when addressing vaccine distribution. These questions can help us see the bigger picture and improve our decision making to ensure equity to all.

Refrences: 1.

https://www.who.int/emergencies/diseases/novelcoronavirus-2019/covid-19-vaccines

2.

https://www.acpjournals.org/doi/10.7326/M20-4986

3.

https://www.medscape.com/viewarticle/944846

4.

https://jme.bmj.com/content/early/2020/12/16/ medethics-2020-106850

5.

https://www.medscape.com/answers/2500139-201124/ how-many-vaccines-are-under-development-for-coronavirusdisease-2019-covid-19

6.

https://www.gov.uk/government/publications/covid-19vaccination-care-home-and-healthcare-settings-posters/covid 19-vaccination-first-phase-priority-groups

The Impact of the Pandemic on the Mental Health of Older Adults Pamela Estefanía Ruiz Fonseca Universidad UTE | AEMPPI-Ecuador companion geriatric center2, or loneliness at home by the absence of a visit from a family member, and most importantly the fear of contagion generated a clearly negative impact on the mental health of older adults.

Human beings are characterized by adapting to change and as it is common knowledge, the pandemic led all of us from children to seniors to change the daily routine that we enjoyed in 2019 and recently the relevant enhancement was given to mental health as an axis of our cornerstone called daily life. One of the most affected population groups with the decisions taken by each government was the elderly, since they would have a higher risk of dying if they are affected by the virus1, so that visits in geriatric centers reached the point of being banned cutting in a very drastic way the contact with the outside world for our elders, similarly, the isolation at home of those adults who were not hospitalized in a specialized place for their care in different parts of the world caused that depression generated by the loneliness that they come to feel by the absence of the visit of a visit is exacerbated with the passage of days2.

So as entities of change in the future, what can we propose so that these types of situations have a lesser impact, it is really a question that I have asked myself and it has cost me a little to try to give an accurate and easy answer, first we could identify the risk factors in order to plan how to work on these, besides practicing active listening to both caregivers and older adults, emphasizing how they feel1, how their routine has changed, once established this parameter ask what things they are doing to cope with the current situation, besides that they at the same time can feel that they can make decisions about their lives.

Never take away the feeling of being autonomous, since, being an older adult makes you a wise being but not a person who needs excessive overprotection, remember that it is always good to let be and let go so that a free soul is a happy soul.

Refrences: 1.

S. Huenchuan, COVID-19: Recomendaciones generales para la atención a personas mayores desde una perspectiva de derechos humanos (LC/MEX/TS.2020/6/Rev.1), Ciudad de México, Comisión Económica para América Latina y el Caribe (CEPAL), 2020.

2.

Valero, N; Vélez, M; Durán, A; Portillo, M. Afrontamiento del COVID-19: estrés, miedo, ansiedad y depresión Enferm Inv. 2020;5(3):63-70

It should be emphasized that both caregivers and older adults needed at some point in this chameleonic and tortuous year felt the need to dispel their thoughts and focus their minds on something positive, many turned off their light prematurely, sadly did not return to see their loved ones and that projection of sadness of a

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Internalized Homophobia: How Prejudice Builds the Most Dangerous Weapon of all: The Self-Hate Letícia Lourenço Botelho Centro Universitário de Valença | IFMSA-Brazil

Homosexuality exists for as long as the humankind, passing through different cultures and centuries. Nevertheless, distinct human societies have extremely different perspectives about it, especially when it comes to accept it and have a positive conduct towards homosexuals.

When one realizes their homosexuality, a complex chain of events starts. According to the theoretical model of the homosexual identity formation1, the coming out process can be divided in six phases: Identity confusion, comparison, tolerance, acceptance, pride and synthesis. The stages of confusion and comparison are the most delicate ones. In these stages, the possibility of being gay or lesbian is yet to be accepted, and nonheterosexual behaviors and thoughts are taken as inadmissible. This non-acceptance occurs due to the incorporation of society’s dominant dogma of heteronormativity, which turns homosexuality into something wrong2.

Progress has been made when it comes to homophobic conducts, but homophobia is still a reality for thousands of people, specially masqueraded with a superficial tolerance, that shows its limits when homosexuality becomes “too visible”3.

Growing up and living in a homophobic society triggers the application of anti-gay and antilesbian stigmas to the self, leading to the development of an internalized homophobia.

This process gets even more intense when gays and lesbians live in homophobic countries, such as Brazil. Brazil maintains a high position in the ranking of the most dangerous countries for LGBT people worldwide. The South American country leads the statistics of most crimes against sexual minorities, overcoming countries where homosexuality is considered a crime.4 In 2019, 329 LGBT people had a violent death in Brazil, which 297 (90,3%) were murders5.

This process of internalizing homophobic beliefs occurs more often when added to parental rejection. In this case, gays and lesbians start to

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reject their homosexual identity because of their concern with the potential for stigmatization as a gay person6. Some may even express the desire to stay “in the closet”, in order to avoid the risk of rejection from others.

However, staying in the closet has its effects, since it avoids the development of a sentiment of freedom and honesty in their relationships.

According to Myers7, staying “closeted” can cause an emotional torment, that can be explained due to the existence of a double life that leads to a superficial relationship with family and friends.

Studies have shown that the consequences of internalized homophobia are severe. Lesbians and gays are most likely to present low selfesteem, depression, anxiety, substance abuse, suicide attempts and completed suicides8,9. When analyzing the influence of parental rejection, the results showed an even increased likelihood to develop depression and suicidal ideation10.

Thus, can be concluded that homophobia often leads to the development of internalized hate, which have severe consequences to homosexuals.

Therefore, we must, at all costs, fight against homophobia and for equality. Prejudice hurts and kills. No one should never suffer for something that can’t and shouldn’t be changed: their sexual orientation.

References 1.

Cass, V.C. (1979). Homosexual identity formation: a theoretical model. Journal of Homosexuality, 4, 219-235.

2.

Ritter, K. Y., & Terndrup, A. I. (2002). Handbook of affirmative psychotherapy with lesbians and gay men, Guilford Press.

3.

Dewaele, A.; Cox, N.; Berghe, W. V. den; Vincke, J. (2011).

Families of Choice? Exploring the Supportive Networks of Lesbians, Gay Men and Bisexuals. Journal of Applied Social Psychology, 41 (2), 312-331.

4.

Wareham, James. “Murdered, Hanged and Lynched: 331 Trans People Killed This Year”. Last modified April 05, 2020. https://www.forbes.com/sites/jamiewareham/2019/11/18/ murdered-hanged-and-lynched-331-trans-people-killed-thisyear/#6a1f76722d48

5.

Oliveira, J.M; Mott, L. (2020). LGBT Violent Deaths in Brazil – 2019: Relatório do Grupo Gay da Bahia/José Marcelo Domingos de Oliveira; Luiz Mott. 1. ed., Editora Grupo Gay da Bahia.

6.

Mohr, J.J.; Fassinger, R.E.; (2000). Measuring dimensions of lesbian and gay male experience. Measurement and Evaluation in Counseling and Development; 33: 66-90.

7.

Myers, M.F. (1982). Counseling the Parents of Young Homosexual Male Patients. Homosexuality and Psychotherapy.

A Practioner’s Handbook of Affirmative Models; New York: Haworth Press. Number 4 of the Book Series, Research on Homosexuality, pp. 131-143.

8.

Needham, B.L; & Austin, E.L. (2010). Sexual Orientation, Parental Support, and Health During the Transition to Young to Adulthood. Journal of Youth and Adolescence, 39, 1189-1198.

9.

Diamond, L.M; & Lucas, S. (2004). Sexual minority and Heterosexual Youths’ peer relationships: Experiences, expectations and implications for Well-being. Journal of Research on Adolescence, 14, 313-340.

10. Ryan, C; Russell, S.T; Huebner, D; Diaz, R; Sanchez, J. (2010).

Family Acceptance in Adolescence and The Health of LGBT young Adults. Journal of Child and Adolescent Psychiatric Nursing. 23(4): 205-213.

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Violence Against Women in Brazil and Social Media’s Importance in COVID-19 Pandemic Scenario Natan Viana Medeiros, Bruna Rocha Lopes, Isabela de Oliveira Araujo, Lara Santos Rocha, Nathany Adrielle de Ávila Pinheiro, Sofia Lucas Souza Federal University of Juiz de Fora | IFMSA-Brazil

In Brazil, every seven hours a woman is being victim of femicide, every eight minutes one of them is victim of rape and every two minutes one of them suffers domestic violence¹. Being a woman in Brazil means living constantly in fear.

This situation is due to the oppressive culture of rape and sexism, built year by year in our country’s history. Although Brazil has made efforts to stop it, the main mindset in our society includes tolerance towards domestic violence, ought to the normalization of males as the violent and most powerful figures. Additionally, the frequent social scenario of people blaming victims for the sexual violence they had suffered proves how some people still value following a standard imposed by society more than the women’s wellbeing.

Besides that, the context of social isolation promoted by the COVID-19 pandemic increased by approximately 17% the number of calls with complaints of violence against women during the initial period of social distancing, according to “Ligue 180” data, available by the Ministry of Women, Family and Human Rights². Therefore, it remains important to discuss and disclose this conjuncture, mainly through accessible ways of communication, such as the internet and social media, in order to encourage women to report their abusers and to promote greater awareness towards this cause.

According to the United Nations Organization (UNO), violence against women is also a human rights violation and a historical result of unequal power relations between genders³. Thus, the direct and indirect impacts in women’s health are undeniable and urgent, as they result in serious physical injuries, prolonged effects on mental health and limitations on sexual and reproductive health, which significantly impacts on female morbidity and mortality4,5.

Having to face the negligence of authorities and society, women who had experienced rape, aggression and brutalities began to use social

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media as a way to express their opinions and feelings, despite all the oppression that surrounds them. For this reason, they were able not only to connect with other women in situations similar to theirs but also to start a global movement based on raising domestic violence awareness. Thanks to the impact they are having on society, several other women from all around the world have found support in each other to report the abuses they suffer and to gradually change this disgusting situation in which they are forced to live. This entire movement has grown due to the internet’s incredible power to propagate information6.

However, the false ideal of male superiority still remains in our society, proving that the women’s rights movement is far from its end. Even though social media has allowed some of them to be listened to, there are still women out there who have a need for government measures to assure their safety. Furthermore, society as a whole should continue social mobilization towards this cause, in order to raise awareness and promote women’s wellbeing, especially in this dreadful pandemic scenario.

References: 1.

Brazilian Public Security Forum.”14th Brazilian Public Security Yearbook”. Last modified October 19, 2020. https:// forumseguranca.org.br/anuario-brasileiro-seguranca-publica/

2.

Galvani, Giovanna. “Domestic violence in quarantine: how to protect yourself from an abuser?”. Last modified March 29, 2020. https://www.cartacapital.com.br/saude/violenciadomestica-na-quarentena-como-se-proteger-de-um-abusador/

3.

UN. General Assembly (1994). Declaration on the Elimination of Violence against Women: resolution / adopted by the General Assembly. United Nations Digital Library, 48, 1993-1994.

4.

World Health Organisation. “Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence”.

Last modified October 20, 2013. https://apps.who.int/iris/ bitstream/handle/10665/85239/9789241564625_eng.pdf

5.

Ruxana, J. (2013). Health consequences of sexual violence against women. Best Practice & Research Clinical Obstetrics & Gynaecology, 27, 15-26.

6.

Fairbairn, J. (2020). Before #MeToo: Violence against Women Social Media Work, Bystander Intervention, and Social Change.

Societies, 10, 51.

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POETRY Voices & Verses

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Medicine Over Art Afreen Quadri Dr. V.R.K. Women’s Medical College | MSAI India

I pleaded,

sutures’

I cried,

The agony , the pain , I swallowed everything and asked

I tried, Did everything I could.

Thinking about the tandoor , the charcoal and the wood,

‘ why not a chef?’

He didn’t listen to it as if he was deaf .

His dream for me , was a nightmare,

The aromas of spices , the noise of their crackle.

Being some else was intolerable to me.

I really could face anything for my dream and was ready to tackle,

He then said ‘ Being a Chef would fetch you loosing a father’

THE WHITE COAT , yes !!! That was my dream.

I was awestruck!

I shouted, I quarrelled , I screamed.

My ambition, my hopes and my aspirations all buried deep in my heart,

Did everything I could !

Buttered , tried convincing,

I had to accept medicine over art.

Crying, weeping and mentally imbalancing .

Everyone appreciated my passion, But at the end all I got was compassion. “ The white coat is acceptable , so why not a hat on it?”

Dad simply told me a no and expected to be fine with it.

Late in the night I thought I am not a quitter , Kept requesting him about it on breakfast, lunch and dinner.

He started giving me clarifications, Replacing my dream , would just give me palpations.

Whipping off my tears, Surpassing all my fears.

I asked him for one last time ‘ Do you want to see me contented in my future?’

He said ‘ yes! Can already imagine you giving

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Anesthetized Mariana Sousa de Pina Silva Escola Bahiana de Medicina e Saúde Pública | IFMSA Brazil

Anesthetized Inside the bubble around me, plungeded into the ocean Anesthetized At every tragedy ad on TV At every strike news in the world Anesthetized Dipped in my own bubble Apathetic to the suffering and pain of others Anesthetized After all, it is normal There is so much information that none moves anyone anymore Anesthetized Unconsciously anesthetized In the middle of the pandemic I look at the ocean around me Several bubbles occupied by so many people Anesthetized However, there is an urgente need to break the dome around me To see beyond the bubble of each one Anesthetized?

I feel like I drown a little bit more when the water enters my bubble And now it is impossible to stop, to back up, to go back Anesthesia?

There is an urgent need to know about the vaccines And about the Thousands of deaths around the world Anesthesia?

To know each one And to positively change the world Coming out of my own bubble Anesthesia?

But, how to do that if there are so many immersed in the ocean itself Without realizing the others around them?

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Not even in the Middle of the pandemic Awake I feel my feet swimming towards the surface I can feel the icy water around me I realize that wanting to change is the first step to stop being Anesthetized To the pain of others To the joy of others To the Other But, how to make a difference by myself, in such a big ocean?

I look down to the bottom Three people, inside their bubbles, face me back Anesthetized?

I notice with a growing hope in my chest that their bell jar is also cracking The first step is the change inside me And by changing myself, I can change the world For the best To truly see the Other And to spread the love I emerge on the surface of the ocean Breathing relieved Now I see everything I’m Not Anymore Anesthetized.

MSI 43 | 71

Meet the Officials Executive Board

Roxanne St-Pierre-Alain (Quebec)

Po-Chin Li (Taiwan)

Gabriela Cirpriano (Peru)

Vice-President for Activities

President

Vice-President for Finance

Egle Janusonyte (Lithuania)

Alistair Mukondiwa (Zimbabwe)

Lucía Auñón (Spain)

Amine Youcef Ali (Algeria)

Vice-President for External Affairs

Vice-President for Members

Vice-President for Capacity Building

Vice-President for Public Relations & Communication

Regional Directors

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Joel ANANI (Togo)

Javier Shafick (Honduras)

Mathew Chow (Hong Kong)

Africa

Americas

Asia-Pacific

Abdallah Tom (Qatar)

Mariona Borrell Arrasa (Catalonia)

Eastern Mediterranean

Europe

Standing Committee Directors

Ali Channawi (Morocco)

Gabriel José Ortez (Honduras)

Mohamed Osman (Sudan)

Medical Education

Professional Exchange

Public Health

Fatima Rodriguez (Guatemala)

Veronica Moreno (Mexico)

Maha Rehman (Pakistan)

Sexual & Reproductive Health and Right Incl. HIV/AIDS

Research Exchange

Human Rights & Peace

Liason Officers

Abdullah Al-Khafajy (Iraq)

Omnia Elomrani (Egypt)

Christos Papaioannou (Greece)

Medical Education Issues

Public Health Issues

Sexual & Reproductive Health and Right Incl. HIV/AIDS

Mahmood Al-Hamody (Egypt)

Iris Blom (Netherlands)

Olayinka Fakorede (Nigeria)

Human Rights & Peace Issues

World Health Organization

Student Organizations

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Afghanistan (AMSA

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(TaMSA)

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(BoHeMSA)

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Nepal (NMSS)

Taiwan - China (FMS)

Bosnia & Herzegovina –

Grenada (IFMSA-Grenada)

The Netherlands

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Republic of Srpska (SaMSIC)

Guatemala (IFMSA-

(IFMSA NL)

Thailand (IFMSA-Thailand)

Brazil (DENEM)

Guatemala)

Niger (AESS)

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Brazil (IFMSA-Brazil)

Guinea (AEM)

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Togo (AEMP)

Bulgaria (AMSB)

Haiti (AHEM)

Northern Cyprus, Cyprus

Trinidad and Tobago

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(MSANC)

(TTMSA)

Burundi (ABEM)

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(MSANC)

(IFMSA-Québec)

(CIMSA Indonesia)

Panama (IFMSA-Panama)

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Catalonia - Spain (AECS)

Iran (IMSA)

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Peru (IFMSA-Peru)

United Arab Emirates

China (IFMSA-China)

Iraq – Kurdistan (IFMSA-

Peru (APEMH)

(EMSS)

China – Hong Kong

Kurdistan)

Philippines (AMSA-

(AMSAHK)

Ireland (AMSI)

Philippines)

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Israel (FIMS)

Poland (IFMSA-Poland)

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Czech Republic

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Republic of North

(IFMSA-CZ)

Jordan (IFMSA-Jo)

Macedonia (MMSA)

Democratic Republic of the

Kazakhstan (KazMSA)

Romania (FASMR)

Congo (MSA-DRC)

Kenya (MSAKE)

Russian Federation (HCCM)

Denmark (IMCC)

Korea (KMSA)

Russian Federation –

Dominica (IFMSA Commonwealth of

74 | MSI 43

Kosovo - Serbia (KOMS)

www.ifmsa.org

United Kingdom of Great Britain and Northern Ireland (SfGH) United States of America (AMSA-USA) Uruguay (IFMSA-Uruguay) Uzbekistan (Phenomenon) Venezuela (FEVESOCEM) Yemen (NAMS) Zambia (ZaMSA) Zimbabwe (ZIMSA)

medical students worldwide