Bulletin de Santé Mondiale - Global Health Newsletter by IFMSA-Québec

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Bulletin de Santé Mondiale — Global Health Newsletter

Volume 7 Numéro 3 Juin 2014

Bulletin de Santé Mondiale - Global Health Newsletter

Tellement Plus Des fois, il y a des choses qui m’agacent sincèrement, le plus sincèrement du monde. Tout naturellement comme ça. Des choses que je refuse d’accepter comme étant la normalité, la seule façon de penser, d’agir, d’éduquer.

Claudel P-Desrosiers Présidente IFMSA-Québec president@ifmsa.qc.ca

Comme cette semaine par exemple. En médecine, on apprend par problème: on reçoit un cas fictif (mais bien souvent très fortement inspiré de la réalité), on fait des hypothèses, on assimile la matière, on fait des liens, on réussit à résoudre le casse-tête que peut être l’humain frappé par la maladie. Cette semaine, on parlait des enfants en bas-âge, de l’aspect psychosocial lié à la pauvreté, du syndrome hémolytique urinaire. J’avais le goût de leur dire que la petite, si elle vit dans un milieu de stress chronique pendant les premières années de vie, elle a plus de chance de s’en sortir avec des troubles d’apprentissage, le stress ayant un impact particulièrement nocif sur le développement du cerveau des enfants. J’avais le goût de leur dire que même si la mère n’avait que 19 ans, ancienne droguée, ballottée de familles d’accueil en familles d’accueil dans son jeune âge, n’était pas pour autant une mauvaise mère. Que même si cette jeune mère n’amenait pas sa petite à l’urgence dès qu’elle toussait un petit peu, qu’elle ne l’aimait pas moins pour autant. J’avais le goût de leur dire que si le père ne se pointait pas à tous les rendez-vous médicaux, ce n’était pas parce qu’il se foutait de sa petite fille pour autant. J’avais le goût de leur dire que la DPJ est parfois bien efficace et bien utile, mais qu’il faut aussi considérer l’impact sur la relocalisation d’un enfant, de la perte complète de ses repères, de sa stabilité. J’avais le goût de tellement. Mais à la place, il y a eu des rires, un peu malaisés, des regards hésitants; et on

a sauté directement aux composantes physiopathologiques du problème: le retard de croissance utérin, la maladie pulmonaire chronique du nouveau-né, les infections nosocomiales. C’est chiffrable, c’est scientifique, ça se mesure, ça s’apprend sur des listes. Ça ne demande pas qu’on développe cette humanité, cette sensibilité, ce regard qui ne juge pas, mais qui veut comprendre, qui veut soulager cette souffrance qui dépasse toutes les cellules du corps et tout ce que la recherche pourra nous dire. Je ne dis pas que c’est nécessairement plus important – non, car pour être des bons médecins, il faut être érudit, il faut savoir la science biomédicale, il faut la comprendre. Mais j’étais choquée de savoir qu’on prenait pour acquis que tout le monde comprenait réellement cet aspect psychosocial au coeur du problème. Peut-être aussi que j’ai un point de vue un peu distortionné, après avoir fait un stage au magnifique Centre de Pédiatrie Sociale de Gatineau l’été dernier, après avoir intégré complètement le concept de déterminants sociaux de la santé. Mais je me dis que pour au moins 50% des étudiants dans notre classe, la médecine de famille sera notre choix, et ce regard humain, cette volonté de comprendre et d’accepter l’individu,

«C’est chiffrable, c’est scientifique, ça se mesure, ça s’apprend sur des listes. Ça ne demande pas qu’on développe cette humanité, cette sensibilité, ce regard qui ne juge pas, mais qui veut comprendre, qui veut soulager cette souffrance qui dépasse toutes les cellules du corps et tout ce que la recherche pourra nous dire.»

IFMSA-Québec | www.ifmsa.qc.ca

sera déterminante et nécessaire dans notre pratique. J’ai eu l’impression cette semaine qu’on prenait pour acquis que tout le monde comprenait. Alors que c’est faux. Tellement faux. C’est comme il y a une dizaine de jours: j’ai dû remplir un rapport de police pour une altercation survenue au centre-ville d’Ottawa. Au-delà de l’homme qui m’a approchée, il y avait un jeune autochtone aux prises de problèmes beaucoup plus importants et difficiles auxquels je ne ferai probablement jamais face dans ma vie. La prison, ça ne lui sera pas bénéfique, ne résoudra pas sa santé mentale instable. Un suivi serré par un travailleur social, une équipe communautaire: apprendre à s’adapter, apprendre la stabilité, réapprendre à vivre dans une communauté qui lui est étrangère. C’est ce que j’ai par ailleurs écrit sur ma déclaration. Ou c’est comme l’autre jour à l’hôpital. J’y ai fait la rencontre d’un jeune homme, à peine 30 ans, souffrant d’un diabète multicompliqué. Il a longuement hésité avant de me dire qu’il avait eu un passé trouble. Il avait peur que je le juge, que je le catégorise, que je le regarde différemment pour quelque chose qu’il avait déjà été, qu’il aspirait à ne plus être. Mais j’ai rarement vu quelqu’un aussi fière de sa petite fille, aussi prêt à se battre pour elle. La compassion, ce savoir-être, cette volonté de ne pas vouloir poser un regard critique trop rapidement, ce sourire sincère: ça devrait s’apprendre en médecine, tout comme on apprend la cascade de coagulation, les facteurs de virulence des bactéries, les mécanismes d’absorption de la vitamine B12. La santé, qui dépasse la maladie mais qui englobe un état de bien-être psychologique: elle est partout. Il ne faudrait surtout pas la laisser aller.

Dans ce numéro Tellement plus Claudel P-Desrosiers

5 health issues youth care about for post-2015 Alexis Fogel & Ben Campbell

Think Local, Speak Global Nina Nguyen

Compte-rendu de la conférence Health and Human Rights Camille Pelletier Vernooy

Is this really progress at all? Anya Gopfert

No checklist needed Olivier Gagné

Impact d’IFMSA-Québec Claudel P-Desrosiers

Messages d’IFMSA-Québec Conseil d’administration

Une mention spéciale pour l’excellent travail du comité organisateur du Colloque de Santé Mondiale 2014, sous la direction de Fannie Lajeunesse Trempe

Bulletin de Santé Mondiale - Global Health Newsletter

5 health issues youth care about for post-2015:

Reflections from the World Conference on Youth 2014 in Colombo, Sri Lanka Alexis Fogel & Ben Campbell Co-Directors at the Akili Initiative

The Akili Initiative is a youth-led, youth-focused effort uniting young people around the world in the movement towards a healthier post-2015. To learn more about this initiative, visit: www.akiliinitiative.org

“Adolescence is a risky period,” said Alain Sibenaler, UNFPA Representative for Sri Lanka at a health panel during the World Conference on Youth. Adolescence certainly is a unique time in one’s life, filled with experimentation and highrisk behavior that can lead to negative health consequences. What’s more, though there is good news to be celebrated as we approach 2015 such as improved access to sanitation and health information, UNICEF Representative Una McCauley reminded us of less optimistic news as well: “the world [we] are growing up in is unequal. Systematic inequalities exist in education, healthcare, and how you are able to influence change.” With more young people in the world than ever before – 1.8 billion below the age of 25 – this puts a huge piece of the global pie at high risk for oft-neglected health problems with uncertain pathways to impact these disparities. At the World Conference on Youth (WCY) 2014, young people from all around the world joined to ensure that major health issues affecting our generation are adequately addressed in the post-2015 agenda. Akili played a major role in advocating for these neglected health issues in the breakout sessions, and found 5 top issues that featured most prominently at WCY: 1) Road Traffic Injury Previously untouched by the Millennium Development Goals, road traffic injury (RTI) has emerged as one of the most important global health issues of the 21st century. Killing more people than HIV, TB, and malaria, RTI is the number one cause of death for young people aged 15-29 around the world. RTI was a hot-button topic at the WCY, and many voiced the need to include it in the post2015 agenda. The following excerpt is from Man-

preet Darroch, WCY Youth Delegate from the UK: “As a representative of YOURS: Youth for Road Safety, the principal voice for youth and road safety issues worldwide, I was pleased that road traffic crashes were mentioned during the health roundtables at WCY. In our modern world, infrastructure has been created for the use of vehicles. We only have to look around to see how much cars dominate our landscapes. In this vein, unfortunately, the consequence of such mobility is the horrendous loss of life on our world’s roads. Over 1000 young people die every day mainly in low and middle-income countries and predominantly young males. As the primary health concern facing the youth of the world, safe and sustainable transport must be addressed in the Post-2015 Development agenda or the world will continue to lose their beloved youth every day. It was disappointing to see that the Colombo Declaration omitted reference to the biggest killer of young people in OP16 and chose to bundle it under the catch all term of ‘non-communicable diseases and injury’. We must go beyond generalizations if we want to be specific about priority health concerns facing youth. We only have to look at the official statistics from the World Health Organization to see renewed focus on RTIs as a major health concern facing youth. A few days ago, WHO released a report on the state of Adolescent Health entitled, Health for The World’s Adolescents. We are seeing time and time again that road safety is being neglected in national agendas and therefore there must be increased efforts to engage young people in road safety action.” 2) Mental Illness As the number one cause of disability for youth in the world, mental illness rightfully emerged as a key priority issue

IFMSA-Québec | www.ifmsa.qc.ca for youth in the post-2015 agenda. Not only is it a major cause of disability for youth, mental illness oftentimes leads to suicide, which is another major public health problem disproportionately affecting youth. 3) HIV/AIDS and Sexual and Reproductive Health Despite great progress in increasing access to screening and anti-retroviral medications, there are still 5 million young people living with HIV/AIDS around the world. The disease is also the number 1 cause of death for those 10-14 years of age, with youth representing 41% of all new infections each year. If we want to see an AIDS-free generation, it will require a youth movement on a grand scale, and WCY showed that there is a loud voice from youth to ensure HIV/AIDS is represented in the post-2015 agenda. Lack of access to sexual and reproductive health education and services is a major concern for youth around the world. According to Shrey Goyal, in his awardwinning essay about the need for sexual and reproductive health rights in India, this is a key priority for the post-2015 agenda because it will improve population health in many ways: “With nearly 1.8 billion aged 10-25 today, we represent history’s largest generation of adolescents, and it’s our decisions about sexual behaviour and reproductive health that will go on to define humanity’s future. f we wish to address population issues, gender equality, maternal deaths, sexual violence and exposure to HIV/AIDS, and give young people a good, healthy start on their lives, our right to sexual & reproductive health and family planning information and services must be promoted, because SRH is no child’s play.” 4) Accessible and Youth-Friendly services

‘Youth-friendly services’ was definitely a buzz-phrase at WCY. When it comes to delivering care to young people, health providers and community-based initiatives need to be sensitive to the needs of young people. For example, mental health and sexual health are two highly stigmatized

““For the first time, the UN system is opening itself up to the youth, and recognising them as a resource. Youth participation in decision-making at all levels has to be ensured.”” areas pertinent to young people. In order for young people to feel comfortable seeking and receiving care for issues such as mental illness and screening for STI’s, screening and treatment services need to be youth-friendly and ideally, created with the input of youth themselves. As stated by Subinay Nandy, Resident Coordinator/Resident Representative at United Nations/UNDP, Sri Lanka, “For the first time, the UN system is opening itself up to the youth, and recognising them as a resource. Youth participation in decisionmaking at all levels has to be ensured.” Youth friendly also means paying special attention to the needs of youth from minority communities. At WCY, there was an impressive representation of youth from the deaf, LGBT, and other historically marginalized groups. These groups have unique needs when it comes to health, and health providers and services need to ensure these needs are met. 5) Multi-Sectorial Engagement While young leaders discussed the above topics at WCY, there was one common theme throughout: in order to address each of these issues, we need to engage sectors beyond the health sector. For instance, to reduce deaths due to road traffic injury, we need to make sure road engineers are thinking about the safety of pedestrians and cyclists when designing roads, and we need law enforcement officers to ensure safer driving. A ‘health-inall’ policies approach will be critical for addressing all the above roads, and we need law enforcement officers to ensure safer driving. A ‘health-in-all’ policies approach will be critical for addressing all the above. Below is an excerpt from Catherine Ji,

Bulletin de Santé Mondiale - Global Health Newsletter third-year medical student at McGill University and member of IFMSA-Québec: “The Millenium Development Goals (MDGs) showed the importance of health as 3 of the 8 goals directly target health issues. However, the MDGs, wanting to be concise and specific, left out many of the fundamental factors influencing development, such as peace building, good governance, and human rights. We know that improving health is not only about having better medicine. Medicine can diagnose physical diseases and treat them, but we need to go further and make social diagnoses of the upstream multi-factorial etiologies causing most of the mortality and morbidity down the line. Some examples of these upstream factors, also known as social determinants of health, are unavailability/ unaffordability of healthy foods, lack of employment opportunities, bad road and housing infrastructure, difficult access to healthcare, illiteracy and limited political power. From there, we understand the need for intersectoral collaboration to include health considerations in all policy making. The best example for the crucial role of intersectoral engagement is probably the issue of climate change, which has been recognized as the biggest global health threat of our century, and on which the Colombo Declaration on Youth calls for action.” SO HOW WAS WCY ABLE TO SHED LIGHT ON THESE ISSUES? Throughout the conference, our discussions on the above topics, in addition to a variety of other debates concerning the health of young people, were integrated into negotiations conducted by youth ministers and delegates from around the world. The grand result was the Colombo Declaration of Action, a document of recommendations and demands that will be directly considered in subsequent UN deliberations to shape the post-2015 development agenda. However, this Declaration is by no means the end of the process to involve youth at all levels of participation. In a rare moment of un-guardedness that displayed his dedication to this movement, UN Special Envoy on Youth Ahmad Alhendawi implored us in his breakout session to continue leveraging the unique global networks and passion young people have for their central roles in development. “This conference, this document, cannot slow the work each and every one of you are doing today as you build partnerships and take matters into your own hands. Do not wait for us.” In addition to pushing forward our own fields of work, we as young people must follow ongoing discussions in the U.N. to ensure that these priorities we have voiced are codified in the post-2015 Sustainable Development Goals. Getting these priorities into the post-2015 agenda is a key step, but the most effective way for these goals to be addressed is for our generation to be proactive and start living these goals in the present. We must be advocates in our communities and work to rally behind the work of our peers to promote safe driving and safe sex, support active lifestyles, maintain healthy diets and reduce the stigma around mental illness. We need to voice these priorities to policymakers, but most importantly, we need to live the changes we want to see.

Picture : Ben Campbell and Alexis Fogel, co-directors at the the Akili Initiative, with Shrey Goyal (middle), winner of the Akili Initiative Essay Competition, at the World Conference on Youth 2014.

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Think Local, Speak Global As we say goodbye to our classmates, some of us are already checking in their flights and setting their watches on another time zone. As the exchange officer of my campus for the past year, I have been–and still am–delighted to see that medical students are more than ever eager to step out of their boundaries to do clinical rotations in foreign countries. Lots of preparation is usually needed before hopping on a plane, but aside from the paperwork and the logistics, one single task might appear more daunting: learning a new language. So, how does one start? Here are some tips. Find the right resources Depending on how committed you are, you can choose among a plethora of free and paid resources. However, no matter your learning style, all four language abilities–reading, listening, writing, speaking– need to be covered by the resources selected. The most popular self-learning resource is the textbook-recordings combo. Good for self-learning but also for classroom-guided lessons, these textbooks often offer electronic self-assessment material. Some publishers, like Living Language, Pimsleur and Teach Yourself, offer a good range of products for English speakers. For less popular languages, universitybased publishers are an invaluable source of learning material. Computer-based learning material, especially if they offer speech recognition exercises, are becoming increasingly popular, like Rosetta Stone. However, since it is an expensive software, cheaper alternatives have made their way. Online-based and often available in mobile versions, Duolingo, Busuu, Babbel and Byki, just to name a few, offer a less extensive vocabulary bank but are cheaper. Most electronic resources, by offering lessons in the form of flashcards, are a great way to acquire

vocabulary in a short amount of time. Find opportunities to practice Self-learning constitutes a great start, but real-life interactions, if possible, are the best way to assess your level. One of the easiest way for busy medical students to learn a new language is to attend classes. Most universities offer affordable classes: look them up! Also, university-based language clubs are also a great way to work on those speaking skills. Online classes can also come cheap if they belong to the same national or provincial university network as your home school: however, some of them might require in-class final examinations. If your schedule does not allow extra course load, online language exchange forums or communities, like Memrise and LiveMocha, are another way of meeting native speakers, if you do not have fluent friends or acquaintances. Also, needless to say, IFMSA events and exchanges opportunities, both local and international, allow to meet native speakers from all around the world.

Nina Nguyen Coordonatrice locale des échanges cliniques Université de Sherbrooke usherbrooke.leo@ ifmsa.qc.ca

Be patient Learning a language is an important time commitment: sometimes it can take years to fully master one. Your progress will hit a plateau, you will struggle to find the motivation to keep going, and your accent will be laughed at: keep in mind that you are a learner and be indulgent with yourself. However, there is no shortcut: mastering a language requires daily learning, even if it is only for fifteen minutes. Find your routine, and stick to it! The life of a medical student being what it is, our busy schedules may not allow such a time-consuming enterprise. However, it might be practical to take a few hours to learn pronunciation and writing basics, especially if the language does not have a Latin alphabet. So if your flight is already scheduled for next week, be sure to bring a classic phrasebook and a compact dictionary with you. Also, make the most out of mobile technology by loading some learning apps before turning the airplane mode on. Bon voyage!

Bulletin de Santé Mondiale - Global Health Newsletter

Compte-rendu de la conférence Health and Human Rights Montréal, 28 avril 2014

Camille Pelletier Vernooy Trésorière et Coordonatrice nationale du comité Droits humains et paix IFMSA-Québec norp@ifmsa.qc.ca

Le 22 mars 2014, le comité Droits humains et Paix a organisé la toute première conférence Health and Human Rights en partenariat avec IFMSA-Québec à l’Université McGill. Le thème était “Beyond International borders: Advocating for Refugee health”; au courant de la journée, nous avons reçu plusieurs conférienciers, tous offrant une perspective différente sur la santé des réfugiés et des migrants allant des derniers changements aux politiques fédérales d’immigration jusqu’à la garde sous détention des migrants. Environ une centaine de personnes était présente, remplissant facilement l’auditorium Martin de l’édifice McIntyre de l’Université McGill. Notre première conférencière, Dre Lavanya Narasiah, directrice de la Clinique des Réfugiés du CSSS Champlain Charles-Lemoyne à Brossard, a présenté une introduction sur les nombreux problèmes encourus par les réfugiés, demandeurs d’asile et migrants; ce qui a permis aux participants de mieux cerner les enjeux des récentes coupures au programme fédéral de santé intérimaire. Un panel de discussion a ensuite suivi. Cinq conférenciers: Dr Gilles de Margerie, Dr Juan Carlos Luis Chirgwin, Jenny Jeanes, Dr Narasiah et Dre Ellen Rosenberg comme médiatrice du panel ont présenté quelques points très importants sur la santé des réfugiés, tous basés sur leurs expériences professionnelles provenant d’horizons très variés. En outre, Madame Jenny Jeanes, coordonnatrice de programme pour l’organisme Action Réfugiés Montréal, a expliqué les conséquences considérables de la détention sur la santé mentale des migrants et ce particulièrement, chez les jeunes. La discussion qui a été

«Cinq conférenciers: Dr Gilles de Margerie, Dr Juan Carlos Luis Chirgwin, Jenny Jeanes, Dr Narasiah et Dre Ellen Rosenberg comme médiatrice du panel ont présenté quelques points très importants sur la santé des réfugiés, tous basés sur leurs expériences professionnelles provenant d’horizons très variés.» alimenté par les questions de l’auditoire a permis de survoler les différentes définitions du terme réfugié et les interprétations rigides qui s’en suivent. Le service de traiteur pour le dîner provenait de l’organisation Les Petites mains, une initiative de solidarité sociale employant des femmes immigrantes et permettant à ces dernières de s’intégrer à leur communauté. Les ateliers de l'après-midi portaient sur: 1) le mouvement contre le viol et l'inceste , 2) l’impact positif de la recherche sur l’immigration à Montréal et 3) comprendre qui sont les femmes qui accouchent sans une carte de la RAMQ . L' atelier sur les violences sexuelles (mouvement contre le viol et l'inceste) , a présenté des études de cas pour explorer les conséquences psychosociales de la violence sexuelle et aussi les interventions possibles pour aider les réfugiés et les migrants qui sont aux prises avec ces problèmes. En outre , le conférencier a encouragé une discussion autour de l'utilisation des meilleures pratiques . Dans le deuxième atelier (l’impact positif de la recherche sur l’immigration à Montréal), les participants ont décidé de créer un comité groupe google/action, qui permettrait de garder les discussions autour de la santé des réfugiés, le plaidoyer direct et d'accroître

IFMSA-Québec | www.ifmsa.qc.ca l'accessibilité aux soins. Le groupe a effectué un remue-méninges sur le plaidoyer pour la santé des réfugiés grâce à l'utilisation de la recherche-action impliquant des réfugiés, des cliniciens et des décideurs. Dans le dernier atelier, Zoé Brabant (infirmière, et possédant une maîtrise en santé publique), a présenté un apperçu de la situation des femmes migrantes arrivant au Canada et les enjeux auxquels elles sont confrontées à la fois avant et après leur arrivée au Canada. En après-midi, le Dr Janet Cleveland, chercheure au CSSS de la recherche Montagne CSSS et à l'Institut de recherche du Centre universitaire de santé McGill, a exposé les problèmes sous-jacents de la politique d'immigration du Canada. Enfin, notre conférencier, le Dr Paul V. Nguyen de Médecins Sans Frontières, nous a fait voyager à travers les différents camps de réfugiés, et il nous a expliqué ce que c'est que d'être un travailleur de la santé oeuvrant dans les milieux à situation précaire. Il nous a présenté une conférence avec une touche d'humour,d’humanité et une profondeur touchante qui nous a transporté au cœur des camps, dans le coeur des réfugiés. Du début à la fin, la journée fut riche en discussions, nous a permis de développer notre esprit critique et d’analyser les différents enjeux auxquels font face les migrants aussi bien avant qu’après leur arrivée au Canada. Il était clair que, malgré la diminution de l'attention des médias sur la santé des réfugiés, les difficultés d'accès aux soins continuent de peser sur les réfugiés et les migrants déjà vulnérables. Ce fut une journée très réussie, remplie de discussion intéressante et stimulante haut-parleurs. Nous espérons poursuivre cette initiative l'année prochaine. Contact: Kelly Lau & Alexandre Ferland: mcgill.lorp@ifmsa.qc.ca Camille Pelletier Vernooy: norp@ifmsa.qc.ca

Bulletin de Santé Mondiale - Global Health Newsletter

Is this really progress at all? ‘Trade’ at the 67th World Health Assembly Trade is a myriad concept to most of the health profession. Negotiated by economists, industry, foreign ministers and the World Trade Organisation the health profession muzzle down and continue their own work. But the potential impacts of trade on health are colossal and cannot be ignored. This fact is not revolutionary; but ‘new’ (or revived) trade agreement negotiations currently under discussion have led to renewed interest in the topic among the health sector and health activists.

Anya Gopfert Think Global Co-coordinator IFMSA thinkglobal@ifmsa.org

What are these trade agreements? The Trans-pacific partnership (TPP between the US and 12 other countries) and the Transatlantic Trade and Investment Partnership (TTIP between the US and the EU) are free trade agreements currently under secret negotiations. A global momentum is calling for increased transparency on the negotiations in order to allow experts the opportunity to analyse the potential impacts on health as well as all other sectors. Why trade Assembly?

the

World

Health

The International Federation of Medical Students Associations (IFMSA) passed a policy statement on ‘Trade and Health’ in March 2014. This was as a result of a growing awareness and concern among medical students internationally of the potential impact of these current trade agreements on both health and medical education; namely restricting access to medicines and health systems globally, as well as increasing the price of medical education. As a group predominantly consisting of medical students in-depth understanding of trade, economics and law was lacking but through

“Something’s fundamentally wrong when a corporation can challenge government policies introduced to protect public from product that kills.” perseverance we have developed a thorough foundation and campaign plan. At the World Health Assembly, representatives of the IFMSA and Universities Allied for Essential Medicines (UAEM) worked together to put forward the youth voice on trade and the impact on health. During the four day youth training prior to the WHA a policy brief was created, and a blog submitted to the Lancet Global Health articulating youth concerns, “Stepping out of the Silos – Integrating Global Health into Trade Negotiations”. Attendees were also able to practice a melange of advocacy skills preparing them for intervening in plenary and meeting Margaret Chan in the elevator … As it turns out, the youth contingent were far from alone in their concerns about trade. In her opening speech Margaret Chan did not hide her fear of the impact of trade stating, “If [trade] agreements open trade yet close access to affordable medicines: Is this really progress at all?” followed by a specific mention of the terrifying provisions for investor state dispute settlements (ISDS) contained in TPP and TTIP, “Something’s fundamen tally wron g when a corporation can challenge government policies introduced to protect public from product that kills.” (ISDS allow corporations to sue governments if national health policies affect the corporation’s profits directly).

IFMSA-Québec | www.ifmsa.qc.ca Building on momentum and buoyed on by similar feelings from other delegates at WHA, IFMSA and UAEM delegates fielded a series of excellent questions regarding the impacts of trade in side-events on NCDs and access to medicines, drawing debate from the likes of Richard Horton and support from many other NGOs and academics. Trade was also gaining mentions for governments during discussions on access to medicines, and the involvement of non-state actors, namely industry, in health policy making. A side event organised by Medicus Mundi allowed interested parties to further explore the issues; with many participants delighted that trade was finally receiving some prominence at the WHA. Speakers, David Price from Queen Mary University, London and Tamar Lawrence-Samuel from Corporate Accountability International delved into trade and waved red flags for public health; particularly emphasising the dangers of ISDS, the potential impacts on access to medicines and how a lack of political autonomy would be devastating for governments. A loud, angry audience provided colourfully varied accounts from their work of their concerns with regards to trade. And so, the first trade event was a success, much was learnt and anger was revealed. But I feel that a lack of key stakeholders or government ministers may reflect the political will regarding these issues. That is where the real power lies, and where the concerns need to be heard. Nevertheless, it was a start and I gather that trade gathered more prominence than ever before at the WHA. “Don’t trade health for wealth” was the mantra of the IFMSA and UAEM. We are ever learning and have an increasingly strong voice on the impact of trade to the health of future populations; we are the next generation of health leaders and will not rest whilst our governments negotiate away our health in secret. Think Global is the IFMSA’s premier global health initiative; if you want to get involved campaigning on trade in health; or any other of a wide range of global health issues, don’t hesitate to get in touch on thinkglobal@ifmsa.org.

Bulletin de Santé Mondiale - Global Health Newsletter

No checklist needed

Olivier Gagné 3rd year medical student olivier.gagne@ mail.mcgill.ca

When I was a kid, I remember listening to my uncle who had travelled through most of his twenties across Asia and Europe and went to places where foreigners were rarely seen. It was difficult to travel back then. There were very few English-speakers, no free Wi-Fi in airports, few credit cards accepted and definitely no online booking for hostels. The first edition of the Lonely Planet guidebook was not published and John Lennon was still alive. Over the two years he spent as a nomad, he probably called my grandmother 5 times, sent numerous postcards and packages that would take months to come back home. This trip laid the foundation of the person he later became. Times have changed. Travelling is an art. Some people have an innate talent for it, others pretend they can and others might never give it a shot. It has to be clear that being a good versus being a bad traveler has nothing to do with the choice of destination or the amount of preparation one can do. Travelling is more than simple logistics, more than budget and definitely more than personal taste for activities. It is about knowing when not to ask for directions, it is about making local friends on a train, its about choosing the good option over the easy option and adapting your route to stay out of the mainstream path. To me, the optimal way to enjoy a trip to its full potential is to ideally disconnect from emails / Facebook account / phone and leave with a predetermined amount of money with no credit card back-up. However what ends up happening to most of us is somewhat different. It is now pretty common to leave for a week in an all-inclusive bundle that just essentially allows you to lay flat on a beach. Moreover, people tend to stay connected, sending photos or simply checking-themselves in airports not only

to keep people up to date, but as a need to impress their audience as the journey takes place, addicted to the feedback. The appreciation is not from the trip itself, but from the envy shown by others and that pattern only gets stronger as the content is filtered to elicit that popularity reaction. Exposure to the local culture is very small, if not biased or misrepresented to entertain the tourist. There is also an overemphasis to meet the tourist’s expectations. There is, up to an extent, a consumption of destination as if they were pair of shoes you could try on and throw away after. Tourists have ambitious plans of “country-hopping” spending as little as 2 days per cities across many different countries in the same vacation to be able to tick them off the map. As a proof that he/she has been there, there is typically a picture with an emblem to show everyone that they were really there. The bigger the smile, the sunnier it is and the higher they jump in the photo, the more exciting the trip sounds. For example taking a photo in front of the Big Pen with two of your friends might make it seem like you had a blast in London, while you were really there for 8 hours on a layover and had to reposition many times to take a good photo. Not surprising in a society where no efforts are done to dig deeper than our first impression, knowing that this is a false impression most of the time. I have to say I don’t claim to be a perfect traveler, far from that. I have however had the chance to analyze many examples of bad tourism. During the summers of high school, I had a job in the touristic industry of Niagara Falls, in a restaurant owned by the Parks Commission. I have seen so many people come from the USA to Canada for two nights, to see the actual Falls, the parliament in Ottawa and go up the CN tower in Toronto and then go back to their tour of North America. Upon

IFMSA-Québec | www.ifmsa.qc.ca talking to those tourist who thought they had more for their buck by being able to see more, I eventually came to realize that their goal was just to gather as many photos as possible of them in iconic places. There was very little culture transfer, let alone culture osmosis. They were eager to taste local food as long as it was good, not too spicy, not too fat with just enough sugar to remember them their own country. I have also encountered there and during my travels people who would be glued to their phone or to a hostel-computer as if they had travelled all this way to chat with their sister on a crappy Skype connection. As if travelling was a game that you could opt-in and opt-out when you did not want to be abroad anymore. To me, this is not travelling. This is being a passenger. A passenger is not here to see the destination as much as say that he has been to it. There is a particular English formulation that is very irritating whenever I come across it whereas instead of saying “I went to Dublin for two days”, they would say “I did Dublin in two days”. Again, it really goes back to a sense of consuming a destination in the quickest amount of time to move on with another one. I find it very arrogant and ignorant to assume that it is possible to “do” a city or visit everything there is to visit in two days, when a city dates back to the Middle Ages or even before. We tend to see life as a checklist or cherish all our life a bucket list that would make us so happy to finally accomplish some of the items. I have never really felt comfortable about that idea of making a list. To my ears, it sounds just like when someone is listing all the things to do upon retiring, though having plenty of time to do it now. We like to push things to later and say : ”when I’ll do this I’ll be happy but for now I don’t have the time.” If you don’t make the time now, how can you predict that you will still be in a good condition to do them? Just imagine bungee jumping with arthritis…

“We like to push things to later and say : ”when I’ll do this I’ll be happy but for now I don’t have the time.” If you don’t make the time now, how can you predict that you will still be in a good condition to do them? Just imagine bungee jumping with arthritis” That, I hope our generation has started to incorporate into their day-to-day life. As humans, we are among the few species aware of their eventual death and that awareness triggers us to do many things differently. Having lost significant others at an early age, I can’t emphasize more this concept of enjoying the moment and making it count. Bottom line is that we have to force ourselves to connect deeply instead of connecting widely, whether it is in terms of countries or in terms of interactions with friends through the new medias. We should keep in mind that life is a journey and not a destination. That said, one of the rising challenge of the twenty-first century will be keep the capacity to connect to the world offline just as well as we are able to do it online. References 1) http://blog.wehostels.com/people-at-every-hostel/ 2) http://www.calgarysun.com/2013/10/02/calgaryman-mike-spencer-bown-becomes-worlds-mosttravelled-after-finishing-23-year-odyssey

Bulletin de Santé Mondiale - Global Health Newsletter

Un premier pas vers une évaluation de l’impact d’IFMSAQuébec sur le parcours des étudiants en médecine au Québec

Claudel P-Desrosiers Présidente IFMSA-Québec president@ifmsa.qc.ca

La santé mondiale connait un intérêt grandissant au sein du domaine médical depuis quelques années, avec une augmentation notable d’étudiants s’impliquant dans diverses activités à caractère mondial au sein d’organisations étudiantes telles IFMSA-Québec, remplissant un besoin d’éducation en santé mondiale. Devant le manque de données apparent, une étude a été menée avoir de quantifier l’impact d’une implication à titre de leader dans l’équipe d’IFMSA-Québec par rapport aux compétences médicales CanMEDS. Ainsi, des étudiants impliqués à titre de coordonnateurs locaux pour l’un des comités d’IFMSA-Québec ont rempli deux fois le même questionnaire, à huit mois d’intervalle, afin d’évaluer leur niveau de compétence dans les champs thématiques CanMEDS : leadership, communication, gestion, professionnalisme, compréhension des enjeux globaux, culturels et sociaux de la santé, promotion de la santé. Le questionnaire consistait à une autoévaluation des compétences pour chaque champ thématique, sur une échelle d’unités de 1 à 7. Sur les 41 réponses reçues au premier tour et 35 au deuxième, 32 ont pu être jumelées. L’analyse des résultats des étudiants participant démontrent une amélioration nette perçue pour chacune des compétences CanMEDS, notamment :    

Leadership : +0,63 Communication : +0,56 Gestion d’équipe : +0,66 Impact en tant que promoteurs de la santé: +0,75

 Compréhension des mondiaux de la santé : +0,91  Compréhension des sociaux de la santé : +0,91

enjeux enjeux

Cette étude démontre que l’engagement parascolaire des étudiants dans le domaine de la santé mondiale augmente leurs compétences perçues dans les champs thématiques de l’éducation médicale. Il est toutefois important de noter que a) le questionnaire n’a été rempli que par un groupe d’étudiants non représentatifs de la population médicale étudiante et que b) il n’y a pas eu de groupe contrôle. De plus, les résultats n’ont pas été ajustés en fonction de l’augmentation des compétences et connaissances attendue de tout étudiant suivant un cursus médical. En conclusion, cette étude démontre que les organisations étudiantes offrant des programmes d’autoapprentissage en santé mondiale contribuent au développement des compétences CanMEDS, dont certaines qui sont difficiles à implémenter et à évaluer dans le curriculum médical classique.

Assemblée générale d’IFMSA 5 au 11 août 2014, Taiwan IFMSA-Québec sera représentée à la rencontre générale d’août d’IFMSA, se tenant à Taiwan-Taipei, par six délégués: Claudel P-Desrosiers, Camille PelletierVernooy, David Alexandre Galiano, Peter Maliha, Wenzhen Zuo et Audrey-Anne Chevrier. Ils seront également accompagnés par deux membres expérimentés, qui se joindront à l’Assemblée en raison de fonctions internationales: Yassen Tcholakov et Maxime Leroux-La Pierre. Suivez leurs aventures sur le blog d’IFMSA-Québec: http://Blog.ifmsa.qc.ca

IFMSA-Québec | www.ifmsa.qc.ca

Messages d’IFMSA-Québec Prix Hommage Bénévolat Québec Lors de la 17e édition de la remise des prix Hommage bénévolat-Québec, le mardi 8 avril, le gouvernement du Québec a reconnu l’engagement exceptionnel de bénévoles et d’organismes dévoués au mieux-être de leur communauté dans toutes les régions du Québec. IFMSA-Québec a eu l'honneur de recevoir ce prix lors de cette soirée et tiens à remercier les milliers de bénévoles impliqués et impliquées de près ou de loin dans l'organisme depuis 10 ans, qui le font rayonner localement dans la communauté et sur la scène internationale au sein de la Fédération. Nous avons de quoi être fiers et fières et ce prix nous est tous décerné. Un immense merci!

Congrès National de Printemps: une fin de semaine motivante Nous avons eu le plaisir d'accueillir les membres la fin de semaine dernière à l'Université McGill pour une fin de semaine des plus motivantes et chargée d'émotions. Contrôle du tabac (Coalition Québécoise pour le Contrôle du Tabac), médicaments essentiels (Universities Allied for Essential Medicines) et aide médicale à mourir (Mme Véronique Hivon) ont été à l'honneur pour générer opinions, connaissances, échanges et débats. L'assemblée générale a aussi élu les nouveaux officier-ère-s de l'équipe 2014-2015 et adopté les Règlements Généraux d'IFMSA-Québec en tant que organisation légalement constituée. Un grand merci aux participants! Félicitations à toute la nouvelle équipe: -- Conseil exécutif -Présidence: Camille Pelletier Vernooy Vice-présidence aux affaires internes: Stéphanie Lanthier-Labonté Vice-présidence aux affaires externes: Nour Nofal Vice-présidence aux finances: Chérine Zaim Secrétariat Général: Anne-Lou McNeil-Gauthier -- Coordonnateurs nationaux -Santé publique: Audrey-Anne Chevrier Santé mondiale: Wenzhen Zuo Santé sexuelle: Sarah Khalife Droits humains et Paix: Joel Martin Échanges cliniques: Mathieu Hains & Peter Maliha Échanges de recherche: Laurie Dolce & David Alexandre Galiano Immersions: Maxime Leroux-La Pierre -- Conseil d'administration -Jouhayna Bentaleb, Yassen Tcholakov, Weronika Jakubowska, Catherine Ji & Joel Neves Briard. Nous tenons à remercier l'équipe sortante pour une année très spéciale et haute en couleurs: Anne PaquetteTremblay, Camille Marcoux, Alissar Jaber, Elyse Perron, Susan Ge, Tanya Girard, Kenjey Chan, Antoine Désilets, Laurence Veilleux, Estelle Leblanc-Mallette, Camille Bergeron-Parent, Fannie Lajeunesse-Trempe, Christine Neagoe, et un MERCI TOUT SPÉCIAL à notre présidente sortante des deux dernières années qui a tout donné à IFMSA-Québec et est une inspiration pour toutes et tous, notre très chère Claudel Pétrin-Desrosiers, à qui nous souhaitons la meilleure des chances l'année prochaine sur l'équipe internationale d'IFMSA!

Bulletin de Santé Mondiale - Global Health Newsletter

Équipe éditoriale / Editorial Team Antoine Desilets Claudel P-Desrosiers

Nos partenaires / Our partners

Auteurs / Authors Ben Campbell Alexis Fogel Olivier Gagné Anya Gopfert Nina Nguyen Claudel P-Desrosiers Camille Pelletier Vernooy

Photo de couverture / Frontpage picture: Human Rights Conference 22 mars 20141, Université McGill, Montréal

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