Pulse May June 2012 by International Federation of Medical Students' Associations

PULSE

The IFMSA Asia-Pacific Magazine May/June 2012

Sustainable Development and Human Health

IFMSA

The mission of IFMSA

The International Federation of Medical Students’ Associations (IFMSA) is a nonprofit, non-governmental and non-partisan organization representing associations of medical students internationally. IFMSA was founded in 1951 and currently maintains 106 National Member organizations from about 100 countries across six continents with over 1,2 million students represented worldwide. IFMSA is recognized as a non-governmental organization within the United Nations’ system and the World Health Organization and as well, it is a student chapter of the World Medical Association. For more than 60 years, IFMSA has existed to bring together the global Imprint medical students community at the local, national and Editor-in-Chief Editor in Chief international level on social and health issues. Mariam New Zealand Omar H.Parwaiz, Safa, Egypt

is to offer future physicians a comprehensive introduction to global health issues. Through our programs and opportunities, we develop culturally sensitive students of medicine, intent on influencing the transnational inequalities that shape the health of our planet.

Objectives:

• To expose all medical students to humanitarian and health issues, providing them with the opportunity to education themselves and their peers; • To facilitate partnerships between the physician in training community and international organization working on health, education and social issues; • To give all medical students the opportunity to take part in clinical and research exchange around the world; • To provide a network that links active medical students across the globe, including student leaders, project managers and activists, so that they can learn from and be motivated by each other; • To provide an international framework in which medical student projects can be realized; • To empower and train medical students to become advocates in leading social change.

RegionalEditors Co-ordinator Content Renzo Guinto, Philippines Helena Chapman, Dominican Rep. Jatinder Narang, IFMSA-Grenada Editors Parawiz, New Zealand Mariam MichaelZaher, Valente, Australia Ahmed Egypt Jim Paulo Sarsagat, Philippines Sujoy Ray, India Photography Editor SuranjanaJones, Basak, India Bronwyn Australia Design/Layout Airin Aldiani, Omar H. Safa,Indonesia Egypt Proofreading Mariam Parwaiz, New Zealand Betty Huang, Taiwan Pushpa Hossain, Egypt

Publisher

International Federation of Medical Students’ Associations General Secretariat: Generalc/o Secretariat: IFMSA WMA IFMSA B.P. 63 c/o WMA B.P. 63Ferney-Voltaire, France 01212 01212 Ferney-Voltaire, France Phone: +33 450 404 759 Phone: +33 450 404 759 Fax: +33 450 405 937 Fax: +33 450 405 937 Email: gs@ifmsa.org Email: gs@ifmsa.org Homepage: www.ifmsa.org Homepage: www.ifmsa.org

Contacts Contacts publications@ifmsa.org

da.pub.ifmsa.asiapacific@gmail.com Printed in Ghana.

Contents Message from Regional Coordinator

Editorial

Go For Zero, 5-2-1 and None

TBXCHANGE

March Meeting 2012 Asia-Pacific Moments

Write for August Issue

Be a Part of Us!

Theme Article: Sustainable Development & Human Health

AMSA - Australia Launches Green Guidelines

Whatâ&#x20AC;&#x2122;s Up Asia-Pacific?!

Medical Research

IFMSA Asia-Pacific Regional Meeting (APRM) 2012

Rio+20 at a Glance

R.G. is

your R C

Message from the Regional Coordinator!

Redefining Development When our Publications dynamic duo – Mariam and Airin – began to brainstorm about the second issue of the Pulse, I personally requested that the magazine dwell on the subject of sustainable development and human health. This issue almost coincides with the upcoming United Nations Conference on Sustainable Development, also known as Rio+20, which will happen on June 20-22, 2012 in Rio de Janeiro, Brazil. I felt that the medical students of AsiaPacific should spend some time learning about this crucial theme – and I also believe that our members in the region have thoughts and experiences to share about the subject. Let me share some of mine. The conference commemorates the 20th anniversary of the 1992 Rio Earth Summit, which laid down the foundation of sustainable development. This year, heads of state, UN agencies, and civil society will again convene in Rio to re-examine the state of world development and discuss ways on how to solve the problems we continue to face and how to further improve our approach to global development. I see the Rio+20 as a crucial turning point in our goal of global redesign, amidst today’s depleting resources, increasing vulnerabilities, widening inequities, and deepening moral crisis. For decades, the world has embraced the concept of development, but while our economies have grown and technologies advanced, health and human welfare have been largely forgotten, or at least superficially addressed, at the center of all endeavors made in the name of development. I personally hope that the outcome of the Rio+20 will result in a redefinition of development by adding a few, often-ignored, but crucial components in the global debate. The first milestone I hope to see is that health becomes the ultimate goal of sustainable development. I am not calling for a “healthization” of development, or for what some people call “medical imperialism” to happen in the development arena. But shouldn’t health – the complete state of physical, mental, and social wellbeing as defined by the World Health Organization – be the main objective of all development efforts and the end goal that all countries aspire for? Or are we lacking in ambition, hence we aim for things that are obviously of less value than, or rather just means to achieve, health, such as greener technologies, material wealth, and international cooperation? Eventually, greater health will lead to better development, so health not only becomes an end but also a

means to achieve the same end. Development itself is not the goal – it is the process by which societies progress and advance in all aspects – socially, economically, politically, and environmentally – in order to achieve an ultimate end, which for me is and should be health. The other aspect is for equity to be enshrined as a partner principle to sustainability.The message of sustainable development is to meet our current societal needs without depleting the resources of future generations. Certainly, for decades the world has striven to solve its problems and provide for its basic necessities, but unfortunately these benefits are not shared equitably by people within and among countries. Sustainability without equity is unfair and unjust, while equity without sustainability is short-lived and leads to crisis in the long run. Therefore, the global community should adopt equity as an inevitable partner to sustainability, and the ongoing global discussion on sustainable development should be transformed into “sustainable development for all.” And so, what is the relevance of understanding the nexus of sustainable development and human health, especially to medical students in Asia-Pacific? For a long time, our region has been wrought with formidable challenges in sustainable development, from food scarcity and absolute poverty to environmental degradation and natural disasters. As future physicians, we are the ones who will witness first-hand the symptoms of unsustainable development, from the infant who dies of diarrhea due to unclean water to the farmer who complains of a skin rash due to contact with agricultural chemicals. It is not enough that we are satisfied with treating the diseases – we should be calling for the elimination of the deep-seated underlying causes. Therefore, we medical students should support reforms that aim to transform how the world operates – and I believe the upcoming Rio+20 is one of these opportunities. This isn’t the end of the struggle though – so we must not stop here.

Renzo Ramon Lorenzo Luis R. Guinto Regional Coordinator for the Asia-Pacific International Federation of Medical Students’ Associations

Editorial

Greetings, Kia ora, Salaam, Namaste, Ni Hao, Selamat, Konnichiwa, Sà-wàt-dee and Kumusta!

Greetings to medical students across the Asia-Pacific!

Early registration for the APRM is still open; you can read more about the exciting program in store for us on pages We are very excited to bring you the second issue of Pulse 17-19. There is also the opportunity to win a free slot for 2012. The theme of this issue is Sustainable to APRM. All you have to do is write an essay about the theme: Health in the Asia-Pacific in 2050. The winning Development and Human Health, and it is entries will be published in the September issue of Pulse! designed to coincide with the United Nations Conference For more information visit the APRM website: on Sustainable Development happening in Rio de Janeiro http://www.aprm2012.org/ right now. Climate change is an important issue of our time and its impact on human health cannot be underestimated. Pulse is your magazine and we would love to hear from you. We have an excellent theme article for you from Nicholas Email us at: da.pub.ifmsa.asiapacific@gmail.com. Our next Watts and Claudel P-Desrosiers on page 6. issue will come out in time for the August Meeting in InPPulse is the official magazine of the IFMSA Asia-Pacific region and every issue is full of articles relevant to our region. Each issue is made possible due to the many wonderful contributions we receive from medical students from around the region. You too can be a part of Pulse. You can write an article for us, help us as part of the editorial team, or you can contribute to ‘What’s Up Asia-Pacific?!’ – our newest segment for sharing ideas and opinions. Find out what students are thinking in this issue on pages 8 and 9. See if you can spot yourself or your friends in the photo collage we’ve made of the 2012 March Meeting. Your publications duo was unable to be there unfortunately, but we are eagerly looking forward to meeting you all at the AsiaPacific Regional Meeting (APRM) happening in September in Malaysia!

dia and our theme will be the same as the AM: Universal Health Care. Submissions for the August issue of Pulse are open now and close on 8 July. Get your articles, photos, projects and conference reports to us now! We look forward to receiving them!

We hope you enjoy this issue of the magazine :) Until next time, Mariam and Airin

Thanks to our editorial team: Michael Valente, Australia Jim Paulo Sarsagat, Philippines Sujoy Ray, India Suranjan Basak, India

Thanks to our contributors: Mariam Parwaiz Airin Aldiani Development Assistants for Publications and Communications for IFMSA Asia-Pacific da.pub.ifmsa.asiapacific@gmail.com Disclaimer: Pulse is the official magazine for IFMSA Asia-Pacific. Opinions shared in Pulse are not necessarily those of the Editorial Team or of IFMSA.

Nicholas Watts, Australia Claudel Pétrin-Desrosiers, Canada-Quebec Freya Langham, Australia Joana Choa, Philippines Ghina Fedora, Indonesia Sujoy Ray, India Yeap Hsiao Hui, Malaysia Greco Malijan, Philippines Motoko Kametani, Japan Renzo Guinto, Philippines 5

Theme Article

Sustainable Development Human Health

According to The Lancet, “climate change is the biggest global health threat of the 21st century”. Climate change is already having profound effects on health, with the WHO estimating it to directly cause over 200,000 deaths annually. It affects the most vulnerable ones, who are the least responsible for climate change and who will bear a far larger burden than citizens from the richest countries. In order to prevent social and economic inequalities to grow even bigger due to a lack of good infrastructures or poor public policies, we must rethink global health issues and we must think more about sustainable development. What is sustainable development? It may look vague to you, but it’s pretty easy to understand. Sustainable development aims to meet the needs of the present, like poverty reduction and economic growth, without compromising the ability of future generations to meet their own needs; for example environmental protection and intergeneration equity. (Brundtland, 1987) So you get the idea? Sustainable development is an integration of economic, social and environmental goals to maximise human well-being, not only now, but also in the future Sustainable development puts human beings at the center of concerns and can’t be achieved if disease, hunger or insecurity decrease people’s functional capacities. Both leading economists and health experts agree that there’s a strong link between health and economic development. Health is vital for sustainable development. Over the last few years, governments have committed themselves to action for health equity, in an economic development perspective. For example, at The World Summit on Sustainable Development in 2002, they agreed on a few of strong health related commitments: health was even identified as a priority area! As Dr. Gro Harlem Brundtland, director-general Emeritus from the WHO said, “healthy life is an outcome of sustainable development, as well as a powerful and undervalued means of achieving it.” Health is not only a precious asset, but also a way to stimulate economic growth and reduce poverty. Sustainable development may look like this incredible thing, but some people have criticized it, saying that it set limits on the developing world. The current first world countries encourage the third world countries to reduce pollution, while they polluted significantly themselves. Some others think that if we implement sustainable development as a way of living, it would mean a reversion to our pre-modern lifestyles. Finally, others criticized the overuse of the word “sustainable”.

by: Nicholas Watts and Claudel P-Desrosiers

Since the UN World Summit of 2005, several sustainability standards and certification systems have been established, based on the three pillars of sustainable development. Those well-known standards include organic, fair trade, Rainforest Alliance, and a few more. These are major steps in the way of rethinking global health and economic development. So what can you do as a medical student? You must not only act as health care specialists, but as responsible members and leaders of your communities. For example, you can join the team of Healthy Planet International, which mission is to act within our sphere of influence to educate and raise awareness about the threat of climate change to health. Also, if you plan on going to the IFMSA August Meeting 2012 in India, you could attend the “Rethinking Global Health: A Sustainable Development Approach” pre-GA workshop. The practical advocacy training will provide you with handy strategies on how to take action on local health equity issues and to lobby for international policy change. Remember that good medicine is not only clinical care but also includes comprehensive prevention and promotion. As MD students, we have a moral responsibility to understand and to the extent possible act upon the causes of health inequity, both within medicine and in society at large. The UN Conference on Sustainable Development, which is to be held in Rio De Janeiro from the 13th to 22nd June, is happening now and will probably be the most important UN summit of our generation. A new paradigm for development, which embraces and seeks to harmonise social, economic and environmental sustainability and growth, is expected to flow from “Rio+20”. Let’s fight for the future we want. To learn more on sustainable development, we suggest you to take a look at the UN Division for Sustainable Development (DSD) at: http://www.un.org/esa/dsd/

Nicholas Watts Coordinator of Healthy Planet International AMSA-Australia

Claudel Pétrin-Desrosiers Field Director of Healthy Planet International President of IFMSA-Québec

S E H C N U LA e To inspir ate our and educ on how s r e b m e m aningful e m e k a to m ards a w o t s e g n cha tainable more sus future

Green Guidelines

by: Freya Langham Global Health Officer AMSA Australia

Climate change has been described as “the biggest global health threat of the 21st century”. Disturbances in climate will adversely affect the health of both individuals and communities in a number of direct and indirect ways: extreme weather events and natural disasters, floods and resulting diarrhoeal disease, degradation of farming land, widened areas of malaria and dengue fever, and more. These effects will also affect the world’s most disadvantaged populations earlier and most severely. There is universal political, scientific and public consensus that climate change is man-made, and is currently occurring at unprecedented rates.

tion, and running completely carbon-neutral events.

In response to this, the Australian Medical Students’ Association (AMSA) is committed to making changes to reduce the carbon footprint of our organisation, and encouraging our members – both local member organisations and individual students – to do the same. However, making such changes is not always easy, and it’s often difficult to know where to start – so we have put together a simple series of ideas and suggestions for change: the AMSA Green Guidelines.

Ultimately, AMSA hopes to contribute to what is demanded of the global community – a reduction of carbon emissions to levels which ensure the survival of our planet’s eco-system and the protection of human health.

Within AMSA, we have started to implement some of these changes at our national events. At our first National Council of 2012, all delegates were asked to bring their own mug for drinks (we did not provide any plastic cups), over fifty percent of meals were completely vegetarian, only public transport was used, and all flights were offset in order to achieve carbon-neutral status. We will be continuing to incorporate new strategies into our practices this year, and also running campaigns to ensure our members are aware of the ways they can also act.

References Costello A, et al. (2009). Managing the health effects of climate change. Lancet. doi:10.1016/S0140-6736(09)60935-1 AMSA Policy Statement on Climate Change and Health. 2010. http://media.amsa.org.au.s3.amazonaws.com/policy/2010/2010_climate_change_and_health_policy.pdf

The AMSA Green Guidelines were adapted from the Canadian Federation of Medical Students’ Green The AMSA Green Guidelines. 2012. http://media.amsa.org. Charter, and include suggestions for three main au/publications/green_guidelines_2012.pdf areas: administration, initiatives to raise awareness amongst medical students, and practical solutions for individuals to perform. We have also divided these ideas into three categories: “easy changes that can be made now” such as avoiding printing and bottled water; “changes that require short term planning” such as replacing office equipment, catering materials, transport, etc with energy efficient options; and “changes that require long term planning” such as incorporating environmental practice into official policy for your organisa-

! ? IC IF C A P IA S A P U ’S T A WH ts’ thoughts

uden Asia-Pacific medical st

ent Sustainable Developm and Human Health

First things that come to your mind about sustainable development!

Brilliansy Gajah Mada University,

CIMSA-Indonesia

tant for Regional Assis acific SCOPH Asia-P

That it’s the most unselfish act to do!

In your opinion, what’s the biggest threat from climate change?

Effects on weather

What can you do to be environmentally friendly and sustainable?

Bike to campus, recycle, reuse, use less paper, and grow plants!

First things that come to your mind about sustainable development!

Energy and economy efficiency

In your opinion, what’s the biggest threat from climate change?

Effect on biological sytems

Atikah Isna Fatya University of Indonesia,

What can you do to be environmentally friendly and sustainable?

turn off the lights, use less papers, use less plastic bags

CIMSA-Indonesia

t for Regional Assistan SCORE Asia-Pacific

Random poll! Who is the hottest NMO President in Asia-Pacific? ;)

Niko from CIMSA-Indonesia 8

“What should Asia-Pacific do to reach a sustainable and healthy future?” The Asia-Pacific Region should start turning its attention and focusing its advocacies on reaching those at the health-policy decision making levels within each respective country. The focus should also be on educating medical students and if need be, making changes to medical Lloyd Mesina education to reflect the needs of providing competent and socially dynamic physician-leaders who are equipped to tackle this task. Only with Ateneo De Manila University, proper changes to social and health policy, will sustainability in health AMSA-Phillippines and health systems be achieved.

The future is the echo of what we do today, and for a healthy future we need to have a healthy today. The future belongs to the youth of today. If we can unite the youth and have advocacy programs or SWGs, where they can point the issues that we are facing today and formulate policies on how these can be tackled and exchange ideas and discuss on how to prevent further aggression of these issues. One of the biggest issue is the medical curriculum in most of the countries of Asia-Pacific region, where, health policy making is ignored. Pointing out a problem is easy, but formulating policies to tackle a problem needs a lot of training. To reach a sustainable and healthy future we need to enlighten and unite under one roof. We need to illuminate Asia!

Shihab Arefin Chowdhury Bangladesh Medical College,

BMMS - Bangladesh

We, as the future leaders of tomorrow should have the accessibility to bring forth the healthy lifestyle and changes to our society Vanitha by promoting routinely daily activities, advocating, and teaching Perinparajah others from young to elderly the importance of one’s health and an RCSI-Bahrain, healthy environment. IFMSA-Bahrain

Asia-Pacific should involve youth from all discipline to take part in small group works actively towards healthy future and take ideas from them to update strategies & health-policies in a practical group work based way. Health issues should be included in all curriculum and issues like Global Health should be given first priority. I think change is needed by small group practical implementation in health issues for sustainable healthy Dr M. Tasdik future rather than theory based high ambitious strategies in Bangladesh Asia-Pacific

Hasan

9 9

“GO FOR ZERO, 5-2-1 AND NONE” The New Trends Towards a Healthier Children’s Lifestyle

by: Joanna Choa With the advent of a more industrialized society, it is estimated that obesity amongst the population is three times higher than before. And this recent pandemic has not spared our children. We see our young ones at around 7 or 8 years of age weighing twice their age’s standard weight. Researches show lifestyle changes are to be blamed for this sudden rise. The introduction of fast food and technology has made life more convenient and time-efficient but at a cost. It is estimated that 10-15% of children in Asia and the Pacific are obese and this rate is increasing as we speak. Dr Rebecca Abiog Castro, chief of the Section of Gastroenterology, Hepatology, and Nutrition of the University of Santo Tomas (UST) Hospital Department of Paediatrics in the Philippines, together with the other staff members of the section namely: Dr Portia Monreal, training officer, and Dr Ma. CharinaDizon, consultants, GI fellows in training namely, Drs Denise Lucille Francisco, Caroline Anne Castro, and Katrina Anne Valera and the dieticians, Misses Melisa Ortono and Joy Alteza, have introduced a nutri-plan for a healthy lifestyle for children, making it the new dietary prescription guide. Last July’s Nutrition Month, doctors together with the Junior Medical Interns of the University of Santo Tomas, pooled their hearts and minds to come up with the slogan “Go for ZERO, 5-2-1 and NONE”, which encompasses all the important aspects of a child’s wellbeing. Maintaining an ideal body weight represented by zero in a WHO Standard Deviation Growth Curve is of prime importance. Five pertains to the 5 major food groups that comprise a complete daily diet of an infant, child and adolescent given at the right amount and proportion sufficient to meet the nutritional needs to reach their growth potential. They are: energy foods (e.g. lugao, rice, bread, camote/potato, sugar, fat); 2 groups of Regulating foods, namely fruits and vegetables; Body Building foods (e.g. poultry/fish/meat, egg yolk, whole egg, dried dilis, mashed beans, taho); and Milk (breast milk, breast milk substitutes). Two stands for restricting children to spend only 2 hours of TV viewing, computer surfing, or any sedentary activity. One means including 1 hour of physical activity per day, whether it be playing with friends, exercising, walking, jogging, or riding the bicycle. Lastly, NONE is directed towards the “No Bottle Feeding” and “No Sugary Drink” campaign. Bottle feeding and sugary drinks have been pointed out to be the major factors that researchers have identified to be the cause of the sudden rise in obesity. Excessive milk intake through bottle feeding during early infancy has been associated with subsequent risk for obesity and all its associated metabolic problems (hypertension, hypercholesterolemia, obesity, diabetes mellitus) later in adult life. during early infancy has been associated with subsequent risk for obesity and all its associated metabolic problems (hypertension, hypercholesterolemia, obesity, diabetes mellitus) later in adult life. On the other hand, sugary drinks which include soft drinks, commercial fruit juices, energy drinks, bottled teas, coffees, and the like have been responsible for dental caries and obesity among children.

14 10

Raising awareness to more families is the key to the success of this project. The team has been vigilant in getting this project known to more audiences by publishing it in several literatures in the country and, hopefully, beyond. The challenge to the team is how to spread this gospel of nutrition that will reach all mothers in all corners of the country and potentially the world. An all out campaign using tri-media (TV, radio and print papers) would be a strategy that needs to be tapped. For infants, breastfeeding is highly recommended as the sole nutrient source for the first six months. Breast milk imparts a lot of benefits to both the child and the mother; it is clean and safe and imparts immunoglobulins, which protect the baby from easily getting gastroenteritis, allergies, and other infectious diseases. It is also cheap and readily available and would lessen the many costs of raising a child, especially to those in developing countries. Breast feeding also helps form the precious bond between mother and child and keeps them closer. It also helps the mother lose the excess weight gained from pregnancy as breast feeding requires burning more calories. Because of all these benefits, it should be continued until two years of age or even beyond. Breastfeeding has also been found to reduce the mortality rate of the under fives by 12%. Breastfeeding can be achieved either through direct (meaning the baby gets the milk directly from the mother’s breast) or through expressed breastfeeding using a pump or the hands for manual expression and asking the child to drink from a cup. Both are acceptable forms of breast feeding. However, direct is more preferred as it promotes bonding and skin-to-skin contact between the baby and the mother. At around six months old, it is a must that complementary foods should be initiated starting with pureed foods. Complementary feeding should be introduced at the right moment, starting from six months and be well established by 24 months. This is the ‘critical learning period’ for children to adopt good eating habits. Failure to fully develop complementary feeding by 24 months is the reason for several feeding errors, such as picky eaters (dislike for foods commonly eaten), neophobia (refusal to try new foods), and obesity that we see in many children nowadays. Another benefit of proper complementary feeding is its ability to reduce the mortality rate of the under fives by 6%. Complementary feeding should include the feature PAST, which stands for:

P A S T

Proper feeding using cups, spoon, fork, and bowl, with appropiate consistency and frequency

Adequate diet using the dietary prescription guide pamphlet

Safe washing hands before eating and handling foods, covering foods and storing them properly

Timely starting at 6 months

Birth to two years of age is considered the ‘critical window’ for the promotion of optimal growth, health, and behavioural development. Studies have shown that this period is the peak age for growth faltering and nutrient deficiencies, which could result in irreversible growth delay. Immediate consequences of poor nutrition during this period are increased morbidity and mortality and developmental delay. In the long term, nutritional deficits are associated with impaired intellectual performance, work capacity, reproductive outcomes and overall health during adolescence and adulthood. The cycle of malnutrition continues, as the malnourished girl-child faces greater chance of giving birth to a malnourished, low birth weight infant when she grows up. Poor infant feeding practices plus high rates of childhood illnesses have been identified to be the possible causes of malnutrition during the first two years of life. (WHO 2005) The new dietary prescription guide pamphlets are available at the UST Hospital Department of Paediatrics, Section of Gastroenterology, Hepatology, and Nutrition. It is being sold at a minimal cost for a cause. Proceeds received from selling these pamphlets shall be used to give mothers at the UST Hospital Clinical Division a free copy of the dietary prescription guide pamphlet, which they can use at home as reference for the proper choice of food at the right amount for their children. The section can also conduct seminars about healthy lifestyle for children and nutrition to interested parties. 2262 and look for Ms Melissa Ortono or Joy Pablo. Facebook page: http://www.facebook.com/GoForZero521AndNone

Half of humanity now lives in cities and within two decades, nearly 60 per cent of the world’s population — 5 billion people — will be urban dwellers. (source: UN-HABITAT)

Joanna Marie D. Choa AMSA-Phillippines

About the author: Joanna Choa is currently an intern at Chinese General Hospital and Medical Center. She has been a writer and editor for several school publications and is recently working with an international journal of medical students around the globe. *This article was previously published in the Philippine Star’s Starweek Magazine on 08 January 2012

Center for Indonesian Medical Students’ Activities (CIMSA) proudly presents

TBXCHANGE 2012 by: Ghina Fedora The Center for Indonesian Medical Students’ Activities (CIMSA) are proud to present Tuberculosis Xchange(TBX) 2012 (July 14th – 25th). The program, which is now in its second year, aims to increase local and international students’ knowledge about Tuberculosis (TB). This is especially important for the many attendees that come from countries where the prevalence of TB is low. This program also introduces the rich culture and the beautiful places of Indonesia.

The success of last year’s TBX was our strongest motivation for continuing the event this year. The CIMSA Standing Committee on Research Exchange (SCORE), as well as the Medical Faculty of Airlangga University, Surabaya, (where this event took place last year) are proud of the success that TBX 2011 was able to achieve. This success was evidenced by the many participants who received new information and knowledge about TB, as well as the many international participants that travelled for the event. From the 31st of July to the 16th of August, 2011, the program was joined by 6 international participants (coming from Canada, Bahrain, and Norway) and 1 local participant. We hope this success will continue to grow for TBX 2012. In keeping with last year’s event, TBX 2012 will involve 6 main programs that participants are able to join. The first of these programs involves a lecture series. Professors and doctors from the University of Airlangga and Dr Soetomo Hospital will hold the lectures at the Institute of Tropical Disease, Airlangga University. The aim of these lectures will be to provide participants with knowledge of the epidemiology, diagnosis, treatment, pathophysiology, and clinical approach of TB cases. Subsequent to the lecture program, students will be able to discuss TB in a roundtable discussion and plenary session. Here, the participants will be provided with a TB case which requires in-depth discussion and analysis.

Participants will also be provided with the opportunity to experience some practical programs. This will begin with a workshop held at the Microbiology Laboratorium, in the Medical Faculty of Airlangga University. This will involve a briefing about how to take a TB sample, which will be required later in the research program. The research program, which will be done at a Public Health center in Surabaya, will then allow participants to take some samples of patient sputum for evidence of TB. In addition, all students will also be given the opportunity to observe real TB patients and do a physical examinations on a hospital visit.

Nevertheless, we have not forgotten the importance of our Social Program. We hope that all participants will be given a true representation of traditional Indonesian culture. TBX 2011 was fortunately able to tour all participants across historical Surabaya. This included Monkasel, Hero Monument, AlAkbar Mosque, and a special historical city tour. To conclude, participants were also taken to Jogjakarta which boasts some amazing Indonesian foods, the epic Ramayana in Prambanan temple complex, Borobudur (the World’s largest temple), Ulen Sentalu Museum, the Water Castle and Merapi mountain.

We really hope that you don’t miss this golden opportunity to learn more about Tuberculosis. With TB being endemic in Surabaya, TBX 2012 will clue you into TB the right way and in the right place.

We look forward to welcoming you in Surabaya! Applications for international students have now opened and will close on July 4th 2012, 23:59 (GMT+7). For more information on the application process, please visit http:// www.tbxchange2012.co.cc/

Date Location Website E-mail Twitter Facebook Facebook Group

Ghina Fedora

: 14th-25th July 2012 : Surabaya, Indonesia : http://www.tbxchange2012.co.cc/ : tbxchangeindo@yahoo.com : @tbxindo2012 : TBXchange Indo : http://www.facebook.com/groups/tbxindonesia

Project Officer TBXCHANGE 2012 Vice Loco External - CIMSA Airlangga University, 2012-2013

March Meeting 2012

Asia-Pacific Moments

Photo credits: Greco Malijan (Philippines) Motoko Kametani (Japan) Renzo Guinto (Philippines)

Medical Research

Challenges and The Road Ahead by: Sujoy Ray

As my first impression of “research” I visualized microscopes, laboratories and sophisticated equipment. Down the line as a med student, I have long since realized that research in fact starts in a very simple manner. It springs from a very basic idea –something innovative and the will to question “why not...”? This “why not” is the beginning of it all. The courage to disagree with existing norms and the “eagle-eye” vision: to notice areas of improvement. Disagreement doesn’t mean disrespect. It is just an innocent question arising out of pure curiosity. It may be accepted or rejected, and both situations should be treated similarly. On one hand, research opens up new methodology, which makes previously impossible tasks easy. On the other hand, it also stimulates interest in ageold traditions and customs, bringing out the rationale and importance in them. It inspires the current generation to think of the intelligence exhibited by the people in that time and invokes a sense of respect and pride. Turmeric, a simple herb and a routine household spice, used in Indian medicine for over 2000 years has been found to have value in Alzheimer’s disease, pancreatitis and so many other diseases thanks to research. Research seems intriguing and fascinating at first glance. However, it is not as easy as it sounds. Inventions and theories are not proposed overnight. It takes a lot of time for ideas to take shape and finally present them in an appropriate manner. Scientists and researchers have spent ages, literally their whole lives, toiling hard and sacrificing a lot. This hard work is the main deterrent and the major obstacle. One has many things to do; to study, work, earn and build up a life. If given a choice between jobs with definite payments and lab work going on for years with no guarantee of the result, many would prefer to go for the former rather than the latter, and it is the obvious thing to do. It is a myth that research does not offer money. The gap between research and money is closing and it must be bridged completely. The importance of research merits funding so that it becomes a reality.

Dr. Sujoy Ray

Kasturba Medical College, Manipal University, Publications Director MSAI-India

It is imperative to give research appropriate recognition. Gregor Johann Mendel, the father of genetics, aced a severe disappointment when his work on pea plants failed to get a favorable response. His work was “rediscovered” and given its due importance late after his death. History is replete with examples of many unfortunate scientists lost in the sands of time who have never been given the requisite recognition. It becomes the duty of the institutions to encourage such scientists and give them the needed assistance. A new idea/concept maybe met with skepticism from the scientific community because it is seems too “out-of-the-world” or defies established facts to an extent that people are not comfortable with it. The scientific community and public should keep an open mind and learn to accept that their beliefs may be wrong. Conferences and more importantly, journals play an important role. It takes a great deal of an effort to get a study published in a journal which, at times, can force one to seriously consider giving up, the level of frustration being too much. Writing an article correctly is an avenue, which has a lot of scope for improvement since presentation of a research can make all the difference to the reader.

Another deterrent to research that is muc h worse than not getti ng recognition is the “the ft” of research. Constant vi gilance is the only way to pr event such a situation. Another deterrent to research that is much worse than not getting recognition is the “theft” of research. Constant vigilance is the only way to prevent such a situation. Knowledge about research should be shared with only those who can be trusted. Once stolen, the original author will have a tough time proving it is his/her own work. There are instances where an invention has been credited to a person who actually had no role in making it whereas the people who really did something are shunned into oblivion. Many are still in a state of controversy as to the true inventors of certain inventions such as the wireless. Many techniques claimed to have been recently “discovered” or “invented” were in fact known since time immemorial and have been mentioned in ancient texts. Unfortunately, the “new” inventors have either too much influence or the original inventors are too weak – the ultimate result is that the credit never goes to the one who deserves it. All things considered, research needs hard work, caution, acceptance of the enormity of the task, of the sacrifice needed, and the fact that a long time might elapse before concrete results are obtained. With the help of the institutions, friends, teachers and the community in general, research will prosper.

IFMSA

Asia - Pacific Regional Meeting

APRM 2012

by: Yeap Hsiao Hui - Secretary APRM 2012

Introduction..

The Asia-Pacific Regional Meeting (APRM) is an annual meeting of medical students and young doctors in the Asia-Pacific region. This annual meeting allows the future doctors to exchange opinions, share knowledge, gain new skills, and increase awareness on local and global health issues through various workshops, trainings, debates, discussions, seminars throughout the meeting. Date: September13th to 16th, 2012 Venue: The Pearl of the Orient – Penang Island, located in the Northern part of Malaysia.

Highlights..

Keynote Lecture on Transitions 2012

Dr. Tikki Pang, the former WHO Director for Research and Cooperation, who delivered the World Health Report 2012, will be giving a keynote lecture to the delegates, during the Gala Dinner and Opening Ceremony on 13 September 2012.

Theme..

“Transitions 2012: Doctors-in-training Changing the Global Health Landscape of Asia-Pacific” This year’s APRM will inaugurate the first-ever Global Health

Global Health Debate

Asia-Pacific is a rapidly evolving and changing region and so are its health care systems, which are as diverse and unique as its many cultures and populations. Countries in this region are now striving hard to transform their health systems by adopting new medical technologies while addressing the emerging health threats, and reduce lingering health inequities. Indeed, the health system of entire Asia-Pacific region is undergoing a major transition. The medical students of the region should also join this massive transformation. Now more than ever, we need a new generation of doctors with a deep understanding of the complex changes happening in global health, both in the region and in the world. Furthermore, the 21st century Asia-Pacific doctor must be in the forefront of action in addressing these transitions, committed to achieve a global health future that we all profoundly want and truly deserve.

Debate in the whole history of IFMSA. In this competition, two teams comprising of members from various NMOs of the Asia-Pacific region will engage in a highly charged discussion on a specific pressing health issue that the region is currently facing. The debate aims to deepen mutual dialogue and critical thinking amongst participants, and encourage contribution of new insights to the selected issue that will certainly shape the future of Asia-Pacific’s health.

Student Panel on Comparative Global Health

This panel will allow medical students to give a presentation about their respective health care systems, raise issues that are shared by the different countries, and identify features that are unique to their country settings. 17

Global Health Film Festival

Soon to evolve as the “Asian Oscars of Global Health,” this event will enable participants to watch thought-provoking films covering different health themes and issues. The show will be followed by a moderated discussion, hoping to synthesize global health lessons gained from the movies.

Asia-Pacfic Global Health Fair

This global health fair will showcase the best projects, campaigns, and other activities of the various NMOs of the Asia-Pacific region. Each NMO will also install an exhibit of the country’s health system, trends, and determinants. Sponsors and partners such as nongovernmental organizations and UN agencies will also be invited to set up a booth and present various global health work opportunities for the participants.

About Penang! Penang is an island off the west coast of Peninsular Malaysia. It is located within the Penang state. Although it is the second smallest state in Malaysia, it is the most densely populated. Penang state comprises of Penang Island and Province Wellesley, nowadays known as Seberang Perai (in Malay), which is on the mainland of Peninsular Malaysia. Penang Island and Seberang Perai is separated by the Malacca Strait and connected by Penang Bridge, which is one of the longest bridges in Malaysia and South East Asia. The capital city of Penang State is George Town which is located on a cape on the northeast of the island. Although Penang is one of the most industrialized states in Malaysia, its capital George Town has managed to retain much of its old world charms. On 7th July 2007, George Town’s rich living heritage, culture and history were officially recognized when the World Heritage Committee in Quebec City, Canada officially inscribed the city as a UNESCO World Heritage Site.

Today Penang Island is a major tourist destination, one of Malaysia’s finest in fact. People from all over the world come here to experience its unique blend of different cultures, taste food that makes Penang the gastronomical paradise of Malaysia, laze on its beaches and explore its old city enclaves and heritage sites. Penang is arguably most well known for its street food – so much so that it was recently voted one of the top food destinations by New York Times readers. Locally known as “hawker food”, because it was traditionally prepared and sold by vendors who roamed on the streets shouting out their wares, there is a huge variety from noodles to rice originating from the different races, which make up Penang’s rich culture. Hold on! We have more than that! We have both street food and home-cooked food, all equally popular with young and old, locals and visitors alike. It might interest you that, on the 3rd Day, we will be having a Penang Hawker Festival, specially prepared for our delegates! Probably, due to the easygoing nature of the island, many visitors find it to be a very charming destination. That would justify the increasing rate in people wanting to settle in Penang permanently. Perhaps, you might want to opt for a longer stay to enjoy all that the beautiful island has to offer after APRM 2012!

Essay Writing Competition.. There is an Essay-Writing Competition on “Healthcare of Asia-Pacific in 2050” whereby two winners will be selected and their registration fees for the APRM will be waived. In addition to that, the winning articles will be published in the meeting booklet and the IFMSA Asia-Pacific quarterly publication Pulse.

Registration..

Pre & Post APRM..

The delegates also have the chance to participate in the Pre-APRM Workshops where more intensive and thorough Have we got you interested yet? workshops on various health-leadership related skills will The registration for APRM 2012 starts from May 1st be conducted to strengthen their skills and knowledge in 2012 with the early registration period lasting until 20th the field of their interest. The Pre-APRM Workshops will June. The deadline for the closing of registration will be be conducted from the 10th to 12th September 2012 at August 1st 2012. The registration fees for APRM are Hospital Universiti Kebangsaan Malaysia (National Uniavailable on our website, www.aprm2012.org. Fee versity of Malaysia Hospital) in Kuala Lumpur and delis inclusive of twin-sharing accommodations at a 4-star egates will be staying at the International Youth Centre. hotel, lodging and meals, transportations during the meeting, Penang Island tour and all meeting activities. At the end of APRM, the delegates can opt to unwind with the Post-APRM 2012 Tour by joining the trip to the mythical island of Langkawi from September 16th to 18th , 2012.

Special Project: International Day of Democracy Theme: “Democracy as Path to Health for All”

On the 3rd day of APRM 2012, the world will commemorate the International Day of Democracy, which falls on the same date that is September 15th 2012. We, medical students from across the region, have planned to organize an afternoon of public gathering in celebration of democracy and educating the locals about the gifts and the ways of democracy.

Even in the Alma Ata Declaration (1978), and the 2008 Commission on Social Determinants of Health under WHO, the recognition of the need of enhanced participation of individuals, communities, and civil society groups in the shaping of health systems and addressing of various health determinants is undeniable. The timing of the conference vis-à-vis the International Day of Democracy is perfect, as now we see a great transition in the global health landscape in Asia-Pacific.

‘Health is now gradually being put in the hands of the people at last!’

Enquiries, Facebook, & Website

The Asia-Pacific countries represented in IFMSA, including Don’t forget to LIKE our Facebook page: the host country, Malaysia, share the common desire to “IFMSA Asia-Pacific Regional Meeting 2012” enhance people’s participation in everyday governance. and stay updated. Visit our website at: www.aprm2012.org As doctors-in-training, we acknowledge the role of de- If there are any enquiries, please contact the APRM 2012 mocracy towards achieving the vision of health for all. organizing committee at: enquiry@aprm2012.org.

What is Rio+20? Rio+20 — the short name for the United Nations Conference on Sustainable Development to take place in Rio de Janeiro, Brazil, in June 2012 — is a historic opportunity to define pathways to a safer, more equitable, cleaner, greener and more prosperous world for all.

Why do we need Rio+20? ► The world now has 7 billion people — by 2050, there will be 9 billion.

► One out of every five people — 1.4 billion — currently lives on $1.25 a day or less.

Twenty years after the 1992 Earth Summit in Rio, where countries adopted Agenda 21 — a blueprint to rethink economic growth, advance social equity and ensure environmental protection — the UN is again bringing together governments, international institutions and major groups1 to agree on a range of smart measures that can reduce poverty while promoting decent jobs, clean energy and a more sustainable and fair use of resources. Rio+20 is a chance to move away from businessas-usual and to act to end poverty, address environmental destruction and build a bridge to the future.

► A billion and a half people in the world do not have access to electricity. Two and a half billion do not have a toilet. And almost a billion go hungry every day.

► Greenhouse gas emissions continue to rise, and more than a third of all known species could go extinct if climate change continues unchecked.

► If we are to leave a liveable world to our children and grandchildren, the challenges of widespread poverty and environmental destruction need to be tackled now.

► We will incur far greater costs in the future UN Photo Sustainable development is “development that meets the needs of the present without compromising the ability of future generations Half of humanity now lives in cities to meet their own needs.” and within two decades, nearly 60 per cent of the world’s population Commission (1987) — 5 billion people — willBrundtland be urban dwellers. (source: UN-HABITAT)

Agenda 21 defines nine major groups: women; children and youth; indigenous peoples; NGOs; local authorities; workers and trade unions; business and industry; the scientific and technical community; and farmers.

— including more poverty and instability, and a degraded planet — if we fail to adequately address these critical challenges now.

► Rio+20 provides an opportunity to think globally, so that we can all act locally to secure our common future.

“Sustainable development is not an option! It is the only path that allows all of humanity to share a decent life on this, one planet. Rio+20 gives our generation the opportunity to choose this path.” Sha Zukang, Secretary-General of the Rio+20 Conference

UN Photo

“The sustainable development agenda is the growth agenda for the 21st century.” United Nations Secretary-General Ban Ki-moon

► Better managing forests to

provide a broad range of benefits — reducing deforestation by half through 2030 could avoid an estimated US$ 3.7 trillion in climate change damages from greenhouse gas emissions — and that’s not counting the value of jobs and income, biodiversity, clean water and medicines provided by forests.

Forests in Liberia

Dry riverbed in Niger

► Improving the way we conserve

and manage our water resources, in order to promote development and guard against desertification.

Does sustainable development work? Over the last two decades, there have been many examples of successful sustainable development in fields such as energy, agriculture, urban planning, and production and consumption:

► In Kenya, innovative finance mechanisms have stimulated new investments in renewable energy sources, including solar, wind, small hydro, biogas and municipal waste energy, generating income and employment.

► In China, steps to shift to a low-carbon growth strategy based on the development of renewable energy sources have created jobs, income and revenue streams for promising low-carbon industries.

► In Uganda, a transition to organic agriculture has generated revenue and income for smallholder farmers and benefited the economy, society and environment.

► In Brazil, a project under the Clean Development Mechanism

was adopted in Sao Paulo to transform two of the city’s biggest waste dumpsites into sustainable landfills. From 2004 to September 2011, the landfills have avoided the release into the atmosphere of 352,000 tons of methane, which instead have been used to produce over one million megawatts of electricity.

► In Nepal, community forestry — led by local forest user

groups — contributed to restoring forest resources after a steady decline in the 1990s.

► In Canada, EcoLogo — one of North America’s most respected environmental certification marks — has promoted thousands of products that meet rigorous environmental standards. ► In France, an estimated 90,000 jobs were created in green

sectors between 2006 and 2008, mostly in the fields of energy conservation and the development of renewable energy.

► In Haiti, the Côte Sud Initiative is expected to benefit an

estimated 205,000 people through the recovery and sustainable development of a severely degraded land area about half the size of Greater London.

UN Photo

Source: http://www.uncsd2012.org/

Write for August Issue: “Rio+20 will be one of the most important global meetings on sustainable development in our time. At Rio, our vision must be clear: a sustainable green economy that protects the health of the environment while supporting achievement of the Millennium Development Goals through growth in income, decent work and poverty eradication.” United Nations Secretary-General Ban Ki-moon

Universal What Health Care Theme for August issue of Pulse: Universal Health Care. It describes healthcare systems organized around providing a specified package of benefit to all members of a society with the end-goal of providing financial risk protection, improved access to health services, and improved health outcomes. We look forward to receiving your articles and your thoughts on Universal Health Care in the Asia-Pacific.

Ri Co pla ah sa pr

Tw wh The deadline for article submisson is July, 8th to 2012. So, don’t waste your time! Start think- an ag ing and writing now! ins Articles should be sent as Word (.doc or .docx) of pr file attachment: da.pub.ifmsa.asiapacific@gmail.com su

Also if you have any questions please don’t Ri as hesitate to contact us.

en th

Su me co to

“And by the way, everything in life is writable about if you have the outgoing guts to do it and the imagination to improvise. The worst enemy to creativity is self-doubt.” — Sylvia Plath 22

A you and tec

Be a Part of Us!

Pulse is IFMSA magazine for Asia-Pacific. Pulse is a way for medical students from very different countries to connect with each other and share their stories and opinions.

Fr om Asia-Pacif ic , acif ic, t o Asia-P Asia-Pacif ic! by Join us and become one of our:

Contributors — by writing any articles relating to theme, a health issue, an NMO updates, project updates, conference report, or anything else that matches our requirements.

Editors — by helping our editorial team to edit articles that have been submitted to us.

Proofreaders — by helping our proofreading team to proofread articles that has been submitted to us.

Respondents — by simply share your ideas, thoughts, opinions, projects, photos, or anything else in an informal way (less serious and lesser words than article) on our new segment called ‘What’s Up Asia-Pacific?!’.

Designer — by helping us to design the layouts for Pulse magazine.

Author Guidelines

1. Manuscripts are to be submitted via email to da.pub.ifmsa.asiapacific@ gmail.com as an attached electronic document. 2. The email should include the full name of the author (as they would like it to appear in print), their university and their NMO/Country. 3. The subject of the email should include the words “Pulse Article”, and the author’s name. A small photo of the author may also be submitted to accompany the article in print. 4. All articles must be written in English. 5. Articles should be no longer than 700 words and use standard type fonts (eg. Times New Roman, Calibiri). 6. Articles should have spelling and grammatical checking prior to submission, however as English is a second language for many in the region we have a team of proof-readers who can check your article and provide English and editing assistance prior to writing. 7. Photos and tables are encourages. These should be submitted separate to the article with a brief description. Photos taken from external sources must be referenced appropriately, and the author should have approval to use them. Photos should be sent as a separate attached file in .JPG form and in good resolution! 8. References to external publications are not necessary however if they are used then they must be references according to the Vancouver Referencing System. References must be cited in the sequential order in which they appear in the text. All references should be cited in text with a number following the reference. At the end of the article references should be numerically listed in the order they appear in the article.

Interested?

Contact our Development Assistant for Publications and Communications (Mariam & Airin):

da.pub.ifmsa.asiapacific@gmail.com 23

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