KALEIDOSCOPH 25TH EDITION by SCOPH CIMSA Indonesia

kaleido scoph. STANDING COMMITTEE ON PUBLIC HEALTH

NEWS HKN-WDD Hari Gizi Nasional

HEALTH ISSUE ISYA ABIYYU Access to Diabetes Care KENSHA FIRSTYPUTRI Understanding the Triple Burden Imagery from The Hunger Games LOCALS UNAND UPH UB UWKS UNS PEOPLE SAMANTHA GERALDINE Triple Burden of Malnutrition: Is It Happening?

KaleidoSCOPH #25

NATIONAL LEADERSHIP SUMMIT 2022

SCOPH STANDING COMMITTEE ON PUBLIC HEALTH 26 LOCALS 2 OBSERVERS

Cover Photo ABC (2022) Photo by Prasasti Probowirasmi - CIMSA FK UNS

KaleidoSCOPH NATIONAL LEADERSHIP SUMMIT 2022 - VOL. 25

Editorial Page

Meet the NPC

05 07 09 10

Note from NPO Meet the LPO

Meet the NPC Team SCOPH News 11 12

Health Issues 14 16

HKN-WDD Hari Gizi Nasional Access to Diabetes Care Isya Abiyyu - CIMSA UI Understanding the Triple Burden Imagery from The Hunger Games Kensha Firstyputri - CIMSA FK UIN SH

SCOPH Locals 19 21 23 25 27

MARVEL by CIMSA-BEM KM FK UNAND MANTRAxHGN by CIMSA UPH TREATS by MSCIA UB STARVING by CIMSA UWKS ABC by CIMSA FK UNS

SCOPH People

SCOPH Gallery

Triple Burden of Malnutrition: Is It Happening? Samantha Geraldine

Social Media

Editorial Page Welcome to KaleidoSCOPH's twenty-fifth edition. On behalf of the National Public Health Committee (NPC) and our tireless editorial staff, the Media and Communication Team, we would like to extend warm welcomes to our magazine's readers and wish them a good reading. Despite significant improvement since the Reformation period, malnutrition remains a major issue for those who are concerned. It is usual to observe triple burden malnutrition in the developing world: the coexistence of undernutrition, obesity, and micronutrient deficiencies all at the same time. The situation has now worsened as a result of the restriction, and all resources have been redirected for COVID-19 care. With this topic, we wish to communicate the word about the necessity of reducing malnutrition. We believe that through publishing this magazine, we can spread the word about SCOPH and promote awareness of its presence among our loving locals and SCOPHeroes. We arranged two campaigns for the second period: HKN-WDD, or Hari Kesehatan Nasional (National Health Day) with World Diabetes Day, and Hari Gizi Nasional (National Nutrition Day). We also provide current updates from our locals' activities throughout the previous three months. Finally, we'd like to share a piece written by Samantha Geraldine, NPO CIMSA 2019-2020 and PHLT-T IFMSA-Certified. We are also keeping current health issues up-to-date with two papers provided by two of our favorite Public Health Leaders, Isya Abiyyu from CIMSA UI and Kensha Firstyputri Fariko from CIMSA FK UIN SH. We hope you find it interesting and useful! Warm hug, Faiz Dzulfikar Media and Communication Coordinator SCOPH CIMSA 2021-2022 and our dearest Media and Communication Team: MUHAMMAD ABIMANYU

PATRICIA ALINE

CIMSA UI

CIMSA UGM

Faiz

ALMIRA AZZAHRA

REYZKI FIRLIANES

MSCIA UB

CIMSA-BEM KM FK UNAND

Note from NPO Issues related to nutritional status are still a major problem in Indonesia. One of the problems that have the most significant impact is malnutrition. Many factors influence this high number, ranging from lack of nutrition, environmental hygiene, and low-income family upbringing. I hope that all readers of KaleidoSCOPH can help to tackle the issue of malnutrition by spreading awareness on the importance of breastfeeding and weaning food, early detection of malnutrition through monthly weight and height measurements of children under five at Posyandu, also promoting health eating and active living.

It is my utmost pleasure to welcome all our beloved readers to the 25th edition of KaleidoSCOPH. This magazine was released eight months after I served as the National Public Health Officer of CIMSA and the extraordinary experience I went through because I was able to work with NPC, NPC teams, LPOs, PHL, and all SCOPHeroes from all over Indonesia. Even though we have never met in person, I hope that through KaleidoSCOPH, this can be a means of communication with all SCOPHeroes. KaleidoSCOPH is a magazine published by SCOPH CIMSA every four months. By reading KaleidoSCOPH, you will know more about SCOPH CIMSA. The next page will uncover the great people behind SCOPH, SCOPH News, Health Issues, SCOPH People, and many other exciting contents.

Lastly, I would like to thank the content creators, editors, and designers who have worked hard the past few months to create great articles, edit and design amazingly. I would also like to thank the NPC and LPOs for their contributions over the period. I hope you all enjoy reading the 25th edition of KaleidoSCOPH!

In the 25th edition of KaleidoSCOPH, the theme is malnutrition.

Ratna Fitranti Lanasiwi National Public Health Ofﬁcer CIMSA 2021-2022

Meet the NPC

CIMSA 2021-2022

Ratna Fitranti Lanasiwi National Public Health Ofﬁcer

Caesariska Deswima Vice NPO for Internal Affairs

Klarissa Salma Raesita Vice NPO for External Affairs

Viena Sabrina Secretary

Hanny Cynthia Elisa Siahaan Human Resource and Development Coordinator

Ige Estu Utami Treasurer

Faiz Dzulﬁkar Media and Communication Coordinator

Nyi Raden Nadya Elvina Project Coordinator

Muthik Hanim Mufallahah Fundraising and Merchandise Coordinator

Sekar Melati Timur Agtaputri Executive Observer and Supervisor

Muslimah Utami Raihani Siregar Executive Observer and Supervisor

Meet the LPOs CIMSA 2021-2022

Amalia Nanda Mutia CIMSA USK

Haur Syakira Radra CIMSA UNIMAL

Rava Olga Sari CIMSA UISU

Christie Emeli CIMSA USU

Elma Seplidarwati CIMSA UNRI

Syifa Salsabila CIMSA-BEM KM FK UNAND

Azizah Nur Rahmah CIMSA FK UNILA

Athaya Talissa Soemadji CIMSA FK UIN SH

Trisha Rahmi Dian Reswara CIMSA UI

Nabila Ghufraeni Rona CIMSA YARSI

Kimberley Colfoort CIMSA UPH

Muhammad Ramanda Pasha CIMSA UNISBA

Raissa Kayana Putri CIMSA FK UNPAD

Raissa Almira Rahmadea CIMSA UGM

Meet the LPOs CIMSA 2021-2022

Dian Meilisa Tampubolon CIMSA UKDW

Prasasti Probowirasmi CIMSA FK UNS

Ulung Kurnia MMSA UMY

Luhung Sekar CIMSA UNSOED

Salma Nurjehan CIMSA UMP

Khairunnisa JC Wijaya CIMSA UMS

Ni Putu Ayu Tarissa Aprilia CIMSA UWKS

Iﬁcian Sabeta CIMSA Lokal UNISSULA

Firstly Najmi Ulya Maritza CIMSA UMM

Muhammad Hasan Al Banna CIMSA UNAIR

Kameela Dilis Baheera MSCIA UB

Alza Anisa Nidaa an Khoﬁyyaa CIMSA UNEJ

Putu Risya Sadhu Putra Observer SCOPH CIMSA PSSKPD FK UNUD

Daniela Subanias Duha Observer CIMSA UNJA

Meet the NPC Team CIMSA 2021-2022

p team Timothy Gerardo - MSCIA UB Devi Anggraeni - CIMSA UNAIR Valensia Mutiara - MSCIA UB

Dwiarsi Sajariana - CIMSA UGM Nadhifa Aqila - CIMSA FK UIN SH Namira Azzahra - CIMSA FK UNPAD

hrd team Sabrina Herfika - CIMSA-BEM KM FK UNAND Adistya Hasna - CIMSA UNSOED Mikhael Akbar - CIMSA UNAIR

Anditha Jasmine - CIMSA UNEJ Grania Nipha - CIMSA FK UIN SH Ariq Fadhil - MSCIA UB

fnm team Ariella Ramadhini - MSCIA UB Putu Anissa - MSCIA UB Beauty Deannisa - CIMSA-BEM KM FK UNAND

KaleidoSCOPH NLS 2022 - VOL. 25

SCOPH News

CIMSALABIM (2021) Photo by CIMSA UNEJ

Photo by CIMSA UNAIR

HKN-WDD

Faiz Dzulﬁkar MCC SCOPH CIMSA 2021/2022 The World Health Organization (WHO) defines diabetes mellitus (DM) as a chronic illness with a range of causes that is defined by elevated blood sugar levels and metabolic abnormalities caused by insulin hormone functional insufficiency. According to the International Diabetes Federation (IDF), diabetes affects 351.7 million individuals aged 20–64 and 704.4 million people aged 65–99 in 2019. According to the Ministry of Health of the Republic of Indonesia (Kemenkes RI), diabetes prevalence in Indonesia was estimated at 10.9 percent among those aged 15 years and above and at 2% based on a doctor's diagnosis in 2019. When all ages are included, the prevalence of diabetes in Indonesia based on a doctor's diagnosis is 1.5 percent, ranking Indonesia ninth in the world in terms of diabetics. Despite the high incidence of diabetes in Indonesia, eleven provinces had a proportion of diabetics getting health care that was less than 10% of the total population of diabetics in the province in 2019. Indeed, if diabetes mellitus is

not managed appropriately, it may degrade the quality of human resources and result in significant increases in health care expenses. As a result, attempts to regulate diabetes mellitus have become a widespread issue, with an emphasis on prevention, particularly among high-risk populations With the theme of Access to Diabetes Care, HKN-WDD (Hari Kesehatan Nasional-World Diabetes Day) SCOPH CIMSA intend to increase public knowledge and understanding of diabetes mellitus, its prevention via a healthy lifestyle, and access to services during the COVID-19 epidemic in Indonesia, particularly among medical students and persons with diabetes through an extensive social media campaign, with polls opinion, articles, and video campaigns that collaborated with Indonesian Ministry of Health and Sobat Diabet. As an appreciation to SCOPH CIMSA locals, we compiled several documentation from our locals and made it into a recap video. The longer you ignore it, the worse it will become.

Photo by CIMSA UGM

Hari Gizi Nasional Klarissa Salma Raesita VNE SCOPH CIMSA 2021/2022 Malnutrition is one of the most important nutritional challenges in Indonesia. The triple burden of malnutrition refers to inadequate, excess, and imbalanced nutrition (UNICEF, 2020). Stunting (low height for age), wasting/thinness (low weight for height), and underweight (low weight for age) are all indications of malnutrition (lack of essential vitamins and minerals). Indonesia ranks fifth in the world for stunting in children under five. As of 2018, 30.8 percent of Indonesian children under five were stunted, 10.2 percent were wasting, 35.4 percent of adults were nutritionally adequate, and 48.5 percent of pregnant women were anemic. This high number is due to poor diet, environmental cleanliness, and family upbringing. Due to many instances of malnutrition in Indonesia, SCOPH CIMSA contributes yearly to efforts to combat malnutrition by commemorating Hari Gizi Nasional. Since CIMSA's policy declarations and the government's focus on non-communicable illnesses align, this year's Hari Gizi Nasional subject is

"Triple Burden of Malnutrition and Its Prevention." SCOPH CIMSA invites all medical students and the public to participate in a series of public discussions with experts to learn more about the impact of the issue. Volume 1 discusses lifestyle and obesity in adolescents, followed by Volume 2 on overcoming malnutrition in Indonesia with input from the Ministry of Health, Presidential Staff Office, Negeri Anak, and UNICEF, and Volume 3 on stunting prevention with input from IDAI and Negeri Anak. SCOPH CIMSA also undertakes a social media campaign on the Triple Burden of Malnutrition, including video campaigns, health articles, and public awareness surveys. With the celebration of Hari Gizi Nasional, SCOPH CIMSA seeks to raise awareness about the Triple Burden of Malnutrition and how it threatens future generations' lifespan. To end the Triple Burden of Malnutrition in Indonesia, all sectors must work together. Eat wisely for a great future!

KaleidoSCOPH NLS 2022 - VOL. 25

Health Issues

EINSTEIN (2022) Photo by CIMSA-BEM KM FK UNAND

Photo by WDD CIMSA UGM (2019)

Access to Diabetes Care Isya Abiyyu from CIMSA UI

According to the International Diabetes Federation, 537 adults all around the world contracted diabetes in 2021. Deaths caused by diabetes total 6,7 million people, or 1 per 5 seconds. In Indonesia, the prevalence of diabetes reached 10,6% or 19,47 million people. The Indonesia Ministry of Health also said that diabetes is the third most common cause of death by disease in Indonesia and that the number of deaths will keep increasing until the year 2030.

can happen at any time, such as hyperosmolar hyperglycaemic state and diabetic ketoacidosis. These complications can happen in the body because high blood sugar levels can damage the blood vessels over a long period of time. When blood vessels are damaged, they cannot travel to the parts of the body that need them. Therefore, some parts of the body may not function properly. When problems already occur in one part of the body, other similar problems may follow in other parts of the body.

Diabetes mellitus is caused by increased blood glucose level. Patients with diabetes mellitus will not always have a symptom, but when they do, they can have polyuria, excessive thirst, and a drop in body weight. When having a physical examination, the the patient will have a decrease in skin turgor and fruit-like breath. Diabetes can cause major complications in the body. Complications can build up over time (called chronic complications) or happen at any time (called acute complications). Complications that build up over time, if left unchecked and untreated, may cause serious damage such as eye problems, foot problems, heart attacks, strokes, kidney problems, nerve damage, and mouth problems. Some complications

In Indonesia, access to diabetes care is still limited. The government spends so much money on treating complications from diabetes even though it is easily prevented. It is predicted that a lot of people have not been diagnosed with diabetes. A large number of people also have not reached the target HBA1c of under 7%. It causes a lot of people to suffer from untreated diabetes.

Insulin plays a major role in treating diabetes, especially type 1 diabetes mellitus. When administered to the body, insulin could lower blood sugar levels. Patients with type 1 diabetes mellitus must use insulin injections daily to help keep their blood sugar levels in a normal range.

Photo by Remedy CIMSA FK UNPAD (2019)

But, in reality, insulin is not equally distributed among all medical care in Indonesia. Some medical care and hospitals still do not have sufficient insulin for treatment even though it is important for diabetic patients. More importantly, untreated diabetes may lead to complications that are harder to manage. That is why access to insulin is very important and needs to be improved. While access to diabetes care is important, education about diabetes is also important to lower the prevalence of diabetes. Education about prevention, symptoms, and treatment of diabetes is important for the community. A lot of people are afraid to get a check-up because they are afraid of being diagnosed with diabetes. With adequate information, people may develop healthy habits that help avoid diabetes altogether and get immediate treatment if diagnosed with diabetes. References Diabetes UK. 2022. Complications of diabetes. [online] Available at: <https://www.diabetes.org.uk/guide-to-diabetes/complications> [Accessed 27 February 2022]. Direktorat P2PTM. 2018. Diabetes: Penderita di Indonesia bisa mencapai 30 juta orang pada tahun 2030 - Direktorat P2PTM. [online] Available at: <http://p2ptm.kemkes.go.id/artikel-sehat/diabetes-penderita-di-indonesia-bisa-mencapai30-juta-orang-pada-tahun-2030> [Accessed 27 February 2022]. Katadata.co.id. 2021. Jumlah Penderita Diabetes Indonesia Terbesar Kelima di Dunia. [online] Available at: <https://databoks.katadata.co.id/datapublish/2021/11/22/jumlah-penderita-diabetes-indo nesia-terbesar-kelima-di-dunia> [Accessed 27 February 2022]. KOMPAS.com. 2022. 3 Tantangan Penanganan Diabetes di Indonesia, Termasuk Keterbatasan Akses Pengobatan. [online] Available at: <https://www.kompas.com/sains/read/2021/12/15/210000423/3-tantangan-penanganan-d iabetes-di-indonesia-termasuk-keterbatasan-akses?page=all> [Accessed 27 February 2022]. Republika Online. 2022. Ketersediaan Insulin Belum Merata di Indonesia. [online] Available at: <https://www.republika.co.id/berita/r2ib3j328/ketersediaan-insulin-belum-merata-di-indon esia> [Accessed 27 February 2022]. Sapra, A. and Bhandari, P., 2021. Diabetes Mellitus. [online] ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK551501/> [Accessed 27 February 2022].

Understanding the Triple Burden Imagery from The Hunger Games Kensha Firstyputri Fariko from CIMSA FK UIN SH

We are probably all familiar with The Hunger Games (2008), a dystopian film set in Panem, the future analogy of the USA, where everyone is divided into 13 districts that struggle with poverty and conflict, one of which is malnutrition. While the children of the poorer districts of Panem are subjected to the life and death penalty in the form of survival games, they also deal with a lack of food and nutrition to feed themselves and their families.

and early childhood years, and the change in food systems, which leads to increased exposure to cheap and convenient sweet drinks and unhealthy foods with high salt, sugar, and fat content but lacking in essential nutrients. In The Hunger Games, Prim (one of the main characters) suffers from undernutrition. She is underweight, with her bones often protruding from inside her coarse, inelastic skin, and her hair is dry and falls easily.

Although Panem does not exist in real life, the stated problem is genuine and happening now. Southeast Asia and the Pacific regions contain almost half of the individuals worldwide, with the triple burden of malnutrition, characterized by the coexistence of undernutrition, overweight, and micronutrient deficiencies.

Like Prim’s condition, this phenomenon is particularly austere in Indonesia, which experiences a very high prevalence of chronic childhood undernutrition, over 30% in 2017. Undernourished children at an early stage of life experience a deficit in health, growth, and development worse during childhood and lower productivity, as well as poorer livelihoods in adulthood, resulting in a loss of human capital. In addition, children with stunted growth or wasted during the first 1,000 days are likely to experience metabolic and physiological changes in response to undernutrition. This will make them more likely to be overweight and get non-communicable nutritional diseases later in childhood and adolescence.

Our country, Indonesia, is a perfect paradigm of the triple burden of malnutrition. About 1 in 3 children under 5 years of age suffer from stunting, and 1 in 10 children are wasted, while another 8% are overweight. These three problems are caused by maternal dietary deficiency, the consumption of nutrient-poor diets in infant

Wealthier

kids

The

Capitol

are

Photo by ATTENTIVE MSCIA UB (2022)

experiencing a different problem, albeit still falling under the same roof. They showed lavish habits along with excessive eating patterns, resulting in many of them suffering from obesity. This issue is as alarming as undernutrition, with serious consequences for individuals in terms of general well-being and health, such as excess weight negatively affecting body strength, mobility, and the ability to perform daily activities. Body weight and obesity increase the risk of cognitive impairment. About 3.4 million deaths were caused by obesity and overweight in 2010. Overweight and obesity also increase the risks of non-communicable diseases, including ischemic heart disease, hypertension, osteoarthritis, sleep apnea, stroke, diabetes, and cancer. High BMI is an important factor contributing to cardiovascular, coronary heart disease, or stroke. Shifting to the real world, this also happened in our beloved country, as obesity rates in Indonesia are increasing briskly in both prosperous and poor households as they shift from traditional diets towards processed products that are often higher in fat and sugar and less expensive than wholesome foods. With all this imagery taken from a dystopian setting and an equally horrible reality stated, significant gaps remain in our understanding of nutrition in Indonesia, particularly among the factors and determinants of the triple burden of malnutrition. It is time to tackle the driving forces of the triple burden of malnutrition with synergistic and accelerated change through a broader and bolder multi-sectoral approach. It is our hope that this issue will lead to interventions, research, and necessary programs to preserve the nutritional well-being of the present and future generations. References Haddad, L, Cameron, L, Barnett, I. The Double burden of malnutrition in South East Asia and the Pacific: priorities, policies and politics. Health Policy Plan. 2015;30(9):1193–1206. doi:10.1093/heapol/czu110. Laporan Nasional Riskesdas 2018 . Kementerian Kesehatan RI. Badan Penelitian dan Pengembangan Kesehatan; Published 2018. Updated April 1, 2021. Accessed December 18, 2019. https://bit.ly/2V8yF2P. Popkin, B., Corvalan, C., & Grummer-Strawn, L. (2019, December 15). Dynamics of the double burden of malnutrition and the changing nutrition reality. The Lancet. https://doi.org/10.1016/S0140-6736(19) 32497-3. Blankenship, JL, Rudert, C, Aguayo, VM. Triple trouble: Understanding the burden of child undernutrition, micronutrient deficiencies, and overweight in East Asia and the Pacific. Matern Child Nutr. 2020; 16( S2):e12950. https://doi.org/10.1111/mcn.12950. Wealthy but Unhealthy Overweight and Obesity in Asia and the Pacific: Trends, Costs, and Policies for Better Health. McAuliffe, A. (2016). “Double burden: childhood stunting and obesity in Indonesia.” https://blogs.unicef.org/eastasia-pacific/double-crisis-the-dual-burden-of-stunting-andobe sity-in-indonesia/. Rah JH, Melse-Boonstra A, Agustina R, van Zutphen KG, Kraemer K. The Triple Burden of Malnutrition Among Adolescents in Indonesia. Food and Nutrition Bulletin. 2021;42(1_suppl):S4-S8. doi:10.1177/03795721211007114. Indonesia’s triple burden of malnutrition: a call for urgent policy change https://pubs.iied.org/16662iied.

KaleidoSCOPH NLS 2022 - VOL. 25

SCOPH Locals

GLUCOSE (2021) Photo by CIMSA USU

SCOPH CIMSA-BEM KM FK UNAND

Marvel

MENTAL ILLNESS PREVENTION IN SCHOOL

MARVEL (Mental Illness Prevention in School) is a community development program that has been going on for three years. The main goal is to make MARVEL into a sustainable project in SMAN 1 Kota Padang. Now that MARVEL is in its third year, it has developed a close relationship with multiple of its cadres. We are hoping that MARVEL is one step closer to becoming a sustainable project program.

well, such as lack of confidence, the presence of suicidal thoughts, the feeling of worthlessness, as well as guilt. The real problem with most depression cases is that the person does not want to seek help. This can be caused by two things: whether it's the depression itself that's hindering oneself, or the thought that suffering from depression is embarrassing. Because there are a lot of causes of depression, Mrs. Kus categorized them into only five: psychological, biological, neuro-immunological, genetic, and psychosocial. Thus, depression is not something simple nor a normal "sadness". Depression is a real illness, and people who have it should seek help immediately.

To get there, MARVEL 2021 is planning on doing two interventions and four mental health campaigns. The pre-intervention activity, which was done on August 21st, 2021, is the foundation of it all. It consisted of a comprehensive presentation by the founder of Mental Health Community Care of West Sumatera, Mrs. Kuswardani Susari Putri, about the relationship between depression and COVID-19.

After a very comprehensive lecture, Mrs. Kus held an open discussion. SCOPH members utilized this session thoroughly and asked everything that they had doubts about. After the pre-intervention, we followed with a quick awarding and photo session. Overall, the pre-intervention was a success, and we, as a member, gained a lot of knowledge about depression and its correlation with the COVID-19 pandemic.

“Depression and COVID-19” is the theme of MARVEL 2021. Following last year’s “Anxiety and COVID-19”, we think this fits the best as the sequel. In her presentation, Mrs. Kus explained that there are physical symptoms of depression such as lack of energy, activity, efficiency, and productivity. Other than that, there are psychological symptoms as

On Saturday, September 18th, 2021, SCOPH CIMSA-BEM KM FK Unand held

their first intervention for the MARVEL Community Development, consisting of a presentation by the Local Public Health Officer, CIMSA-BEM KM FK Unand, Syifa, and MARVEL’s Project Officer, Gina, about the relationship between depression and COVID-19, followed by an informative discussion session, and closed with a fun game for the cadres. This presentation was made to three cadres who are members of the counseling club Let's Talk. Syifa discusses the causes and risk factors for depression, as well as its connection to the current situation, the COVID-19 pandemic. Gina then continued the presentation by discussing depression's physical and psychological symptoms.

presentation by Let’s Talk cadres, Shahnaz and Naila, about the relationship between depression and COVID-19. This lecture was intended for SMAN 1 Kota Padang students. Shahnaz discusses the causes and circumstances that contribute to depression, as well as how they relate to the present situation, the COVID-19 Pandemic. Naila then began the discussion by discussing depression's physical and psychological manifestations.

Mrs. Kus, the founder of the Mental Health Care Community of West Sumatera, was one of our pre-intervention speakers who inspired our presentation. We used the knowledge we acquired from Mrs. Kus to our cadres, illustrating it with several applicable instances. Our objective was to make this content as simple as feasible to comprehend.

Mrs. Kus, the creator of the West Sumatera Mental Health Care Community, and LPO-PO of MARVEL's presentation influenced this presentation. Our cadres' presentation was both informative and impressive. After that, the students posed a few questions. Following the intervention, we held a fun game session with our cadres and SMAN 1 Kota Padang students.

After an extensive presentation, the cadres asked a few questions, mainly about the best way to console and/or comfort their peers who have striking signs of depression. To close the intervention, we followed with a fun game session. We also did awards for our cadres and held a photo session afterwards.

Additionally, we presented awards to our cadres and followed up with a photo session. In general, the intervention was a success. We, as members of SCOPH CIMSA-BEM KM FK UNAND hoped that it would benefit the students of SMAN 1 Kota Padang.

On Sunday, September 26th, 2021, SCOPH CIMSA-BEM KM FK Unand held their second intervention for MARVEL, virtually via Zoom Cloud Meetings. It consisted of a presentation by MARVEL’s cadres, Let’s Talk, followed by an informative discussion session, and closed with a fun game for SMAN 1 Kota Padang students.

The series of interventions was a success in general, and we as members received a great deal of knowledge regarding depression and its relationship to the COVID-19 epidemic. We believe that this community development initiative will have a positive effect on and benefit our cadres.

This second intervention is the second to last step MARVEL 2021 took to reach its goal. It consisted of a comprehensive

SCOPH & SCORA CIMSA UPH

Mantra x HGN

MAINTAINING ANTENATAL AND POSTPARTUM CARE & HARI GIZI NASIONAL

Maternal health is an important thing to consider. It refers to the health of women during pregnancy, childbirth, and the postnatal period. Each stage should be a positive experience, ensuring women and their babies reach their full potential for health and well-being. However, in 2017, about 808 women died because of complications in pregnancy and childbirth. It is estimated that 295.000 women died during and following pregnancy and childbirth in that year.

about 130 times higher compared to women in high-income countries. Women in remote areas are the least likely to receive adequate health care because of poverty, poor quality of services, and lack of facilities. Indonesia itself is considered a lower middle-income country, which indicates that maternal deaths are typically high. Moreover, in Indonesia, some areas still practice early-age marriage. It may cause maternal mortality to grow even higher since early pregnancies among adolescents may harm the mother's health with complications in pregnancy and childbirth as the leading cause of death.

This situation may occur for many reasons. The most common direct causes are infection, excessive blood loss, unsafe abortion, high blood pressure, and obstructed labor. Meanwhile, anemia, heart disease, and malaria may become the indirect causes of maternal injury and death. After all, most maternal deaths can be prevented if a skilled health professional manages their time in a supportive setting.

The solution to these problems is the use of contraception to prevent pregnancy related health risks for women, especially for adolescent girls, when births are separated by less than two years. Contraception has a wide range of potential non-health benefits, including expanded educational opportunities and empowerment for women, sustainable population growth, and economic development for countries, especially in low-income countries.

But why is the mortality rate still high? According to the World Health Organization, the high rate of maternal deaths is due to inequalities in access to quality health services and highlights the gap between the rich and the poor. In low-income countries, the risk of women dying from maternal-related causes is

As Hillary Clinton once said, "You cannot have maternal health without reproductive

health. Reproductive health also includes contraception, family planning, and access to legal, safe abortion."

This event was held to educate parents, as well as prospective parents to understand the importance of maternal health and fulfilling nutrition in the first 1000 days of life to prevent stunting and malnutrition. The event was divided into three parts. The first was Pre-Activity Training (LPET), which was held on 22nd January 2022 and presented by Kak Andrea Pasha Josephine from PETRA. This training was intended for SCORA members with aims to educate the members about Maternal Health according to “Addressing Maternal Health Issues and Contraception through Health Promotion and Education Curriculum”.

Having seen the evidence, it is important to expand efforts to reduce maternal injury and disability among low-income countries. Every pregnancy and birth is unique. It is necessary to ensure all women have access to respectful and high-quality maternity care to overcome the inequalities that affect maternal health, specifically in sexual and reproductive health, rights, and gender. Maternal health starts with the health of mothers before and during pregnancy, even until delivery.

The second part was the Campaign Activity that was held for 6 days from 22nd to 28th January 2022 with Instagram as the platform. This campaign focused on maternal health and balanced nutrition. The third was the main activity, which was held on 29th January 2022 and divided into two sessions. The first session was “Antenatal & Postpartum Care Webinar”, by dr. Julita Dortua Laurentina BR. Nainggolan, Sp.OG as the speaker. The second session was “Stunting and Malnutrition Talkshow (The Importance of First 1000 Days of Life)” by Kak Rizki Aulia Febriana from IBU Foundation as the moderator, Pak Anthonny Adiputra from PKBI Riau, and dr. Andry Juliansen, Sp.A as the speakers.

Furthermore, maternal health should be followed by nutrition fulfillment in the first 1000 days of life. The First 1000 Days of Life is a period of opportunity when the foundations for optimal health, growth, and neurodevelopment across the entire life span are laid. The right nutrition and care during these first 1000 days of life can have positive effects on a baby’s growth, brain development, digestive tract, metabolism, and immune system. It should also be understood that a child’s health is not only determined by what they consume but also how the mother’s nutrition is fulfilled during pregnancy and breastfeeding. For this reason, a well-balanced diet with the right amount of important nutrients in the right places during early life is very important for setting the stage for good health in the future.

From this event, SCOPH and SCORA CIMSA UPH hope that people, especially parents, as well as prospective parents can understand the importance of maternal health and fulfilling nutrition in the First 1000 Days of Life. It aims to provide mothers, the knowledge to have a healthy pregnancy and then deliver healthy babies. It is also expected that people will raise awareness regarding this matter and be able to face the problem of malnutrition and stunting seriously. Because the health of Indonesia’s future generation starts from healthy mothers and adequate nutrition.

According to the State of the World's Children 2019 Report: Children, Food, and Nutrition, 50-59 percent of Indonesian children under five years old (toddlers) are in the "not growing well" category. Therefore, SCOPH together with SCORA CIMSA UPH held an event called MANTRA x HGN (Maintaining Antenatal and Postpartum Care X Hari Gizi Nasional).

DOPH MSCIA UB

Treats

TOGETHER FIGHT AGAINST DIABETES

As we already know, according to the World Health Organization, diabetes is a chronic disease that occurs both when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Uncontrolled diabetes can cause high blood sugar, or hyperglycemia. Over time, this can cause a lot of damage to many parts of the body, especially nerves and blood vessels.

the second most common comorbid disease among COVID-19 patients, after cardiometabolic disease. People living with diabetes are at a higher risk of contracting COVID-19 infection and have the potential to experience more severe disease when infected (Wicaksana et al., 2020). Based on data compiled by the COVID-19 Task Force as of October 13th, Ministry of Health, 2020, the total confirmed cases of COVID-19, 1,488 patients were recorded to have co-morbidities, of which diabetes mellitus contributed 34.5% and the number of deaths was 11.6%.

Is it true that diabetes is still one of the top 10 diseases in Indonesia? Yes, it is. According to Megawati et al. (2020), Indonesia is in seventh place in the world when it comes to having diabetes. This is after China, India, the United States, Brazil, Russia, and Mexico.

Seriously, an 11.6% death rate is not a joke! Dr. Johanes Purwoto, an internist specialist in endocrinology at the MRCCC Siloam Semanggi Hospital, explained that diabetics have an impaired immune system, so if they are infected with the SARS-CoV-2 virus, the infection can get worse.

The results of Riskesdas in 2018 showed that almost all provinces showed an increase in prevalence in 2013-2018, except for the province of East Nusa Tenggara. Meanwhile, East Java province itself is in fifth position with a prevalence of diabetes sufferers of 2.6% (Kemenkes RI, 2020). Data from Malang City's Central Statistics Agency shows that diabetes melitus is the third most common disease in the city. In 2019, there were 9,214 people with diabetes melitus. In this pandemic era, diabetes is ranked as

High blood glucose levels poison blood vessels throughout the body, including the heart, brain, and male organs, as well as blood vessels in the legs and kidneys. In diabetes conditions, blood vessels are easily damaged, while in COVID-19 there is a blood clotting disorder that accelerates the damage process

throughout the body, not only in the lungs. Inflammation can occur throughout the body so that blood vessels are damaged, including in the blood clotting process. As a result, it can cause a heart attack, stroke or other disorders.

Consultation for Diabetes Patients Undergoing Self-Isolation: Role of GP" and presented by Prof. Dr. dr. Sidartawan Soegondo, Sp.PD-KEMD, PhD, DTM&H, FINASIM, FACE. The event was continued with a case discussion session regarding the cases that had been made by each presenter. The entire agenda for the first webinar was moderated by dr. Perdana Aditya, Sp.PD.

Therefore, the Department of Public Health (DOPH) MSCIA UB held an annual event, namely, TREATS (Together Fight Against Diabetes), to help educate the public in order to support the government's strategy for dealing with diabetes in Indonesia. This activity also supports SDGs number 3 (Good Health and Well-Being), the CIMSA Program (Non-Communicable Diseases), and the IFMSA Program (Non-Communicable Diseases).

The second series of events will be held on November 21, 2021, at Zoom Meeting and Live Streaming YouTube. The target audience for this second webinar is the general public, including volunteers. In this second webinar, we presented a material entitled "Utilization of Teleconsultation for Diabetes Patients", which was presented by dr. Rulli Rosandi, Sp.PD-KEMD. Then continued with the second material entitled "Why Do Diabetic Patients Need to Get Vaccination against COVID-19? : When and How?" brought by dr. Dirga Sakti Rambe, M.Sc, Sp.PD. After that, it was followed by a talk show with one of the diabetes survivors named Melissa Yunita, S.Psi with the title "COVID-19 Vaccination from the Diabetic Patient's Point of View". The entire agenda for this second webinar was moderated by Kak Aufa Fadhil from PSKED 2019.

TREATS (Together Fight Against Diabetes) aims to increase public understanding of diabetes as well as commemorate World Diabetes Day, which falls on November 14th, 2021. Specifically, TREATS coming out with the big theme, namely "Diabetes and COVID-19", was held in two series of webinar events. There was also a campaign going on at the same time as the series, which was in the form of a ground campaign where volunteers were asked to teach their friends about diabetes 101 with the leaflet platform that the committee had given them.

The post-event of TREATS came up with two virtual runs, "Treat Yourself with Some Sweats" and "Cut Your Sugar Challenge," which are open to the public and both provide rewards for the best challenge participants.

The first series of events was held on October 18th, 2021 at Zoom Meetings and Live Streaming YouTube. This first webinar is a webinar with SKP IDI, so that the target participants for the webinar are doctors and health students. Dr. Rinadhi Reza Bramantya, Sp.PD, presented a material titled "How COVID-19 and Its Treatment Affect Glucose Control" in this first webinar.Then continued with the second material entitled "Update on COVID-19 Vaccination Eligibility for Diabetes Patients: Does Glucose Level Affect Efficacy?" presented by Prof. Dr. dr. Ketut Suastika, Sp.PD-KEMD. After that, it was continued with the third material entitled "Telemedicine

The series of TREATS events collaborated with various media partners and external partners such as SOBAT DIABET and PERKENI, so the enthusiasm for this event was very high. This was shown by the number of webinar participants, who reached more than 900 people in total, and volunteers, with more than 300 registrants. See you on TREATS 2022!

SCOPH CIMSA UWKS

Starving

LET’S START LIFE WITHOUT STUNTING

Stunting is the impaired growth and development that children experience from poor nutrition, repeated infections, and inadequate psychosocial stimulation. Children are defined as stunted if their height-for-age is more than two standard deviations below the WHO Child Growth Standards median (WHO, 2015). In 2020, globally, 149.2 million children under the age of 5 were stunted (WHO, 2020).

health problems, we are attempting to understand the essence of healthy nutrition and nutrition for a child throughout his or her formative years. It is critical to understand that parents play a vital part in satisfying the needs of their children as well as identifying the root of their children's health issues. As part of the celebration of National Children's Day, the SCOPH CIMSA of Wijaya Kusuma University Surabaya hosted a webinar called "STARVING" (Let's Start Life Without Stunting) via Zoom by inviting the pediatrician, dr. Ardi Santoso, Sp.A, a well-known pediatrician as well as the CEO and Founder of "Rumah Ardi Santoso Indonesia", and a nutritionist, Rindra Prameswari Samphada, S.Tr.Gz from 'Personal Food Giziku’, the company she founded to give health and nutritional consulting, which includes advice on diet patterns and dietary arrangements. The event took place on July 25, 2021.

According to the Indonesian Ministry of Health, the number of stunting cases in Indonesia in 2019 reached 27.67 percent. This puts Indonesia at 4th in the world and 2nd in Southeast Asia in terms of stunting, with under five cases. The reason for the high rate of stunting in Indonesia is that some babies born there are already undernourished and then raised with nutritional deficiencies. STARVING contributes to the discussion of stunting and how to prevent it by focusing on children's nutrition. To understand good nutrition in children, we need to focus on what they are ordering; we need to adjust their diet by increasing protein sources in addition to still eating fruits and vegetables. This article argues that children are people who can make a difference in society and the world. Instead of reacting to other children's

The goal of this event is rather straightforward. We want to educate those who attend the webinar on how to overcome stunting as well as the need of providing children with a well-balanced diet in order to prevent becoming stunted.

SCOPH CIMSA FK UNS

ABC!

AYO BASMI COVID!

Pandemic is yet to over!

delivered by Dr. dr. M. Eko Irawanto Sp.KK, the chairman of IDI Surakarta. After the training from dr. Eko, there was a FGD to increase the understanding of the participants. This training’s objective is to prepare the members' knowledge and experience before the ABC’s main event at SDN Ngoresan No. 80. The training was attended by 32 participants from CIMSA’s members, with an increase of 18.66% from pretest to posttest score.

The reopening of school after nearly two years of a pandemic is a breath of fresh air for students in the midst of this era. However, every policy comes with a set of consequences. In October 2021, a new cluster of COVID-19 was found coming from 40 school students and 6 teachers. SD Kristen Manahan was the one with the most numbers (37 students and 5 teachers), followed by SDN Mangkubumen Kidul (1 student), SD Al Islam 2 Jamsaren (1 student), SDN Semanggi Lor (2 students), and SD Danukusuman (1 teacher). Because of the situation, those five schools are forced to postpone their reopening school agendas.

The training was followed by a two-day air campaign through social media as a follow-up method as well as to expand the reach of the information to the public. This activity was attended by 15 participants from the Pre-Activity Training. The air campaign got more than 1000 viewers for the past two days.

Considering this situation, SCOPH CIMSA FK UNS intends to raise awareness regarding the COVID situation in Indonesia as well as the prevention of its transmission from the school nearby.

Here it comes, January 14th, 2022, the main event of ABC. It started with an offline discussion session with students from SDN Ngoresan No. 80. The discussion's method was a small working group consisting of 6 students from SD Ngoresan No. 80 and one OC as the facilitator who delivered the information about PHBS and COVID-19. The activity was attended by 30 students, and they were very enthusiastic about the discussion. The knowledge of the students

So, we did an activity called ABC (Ayo Basmi COVID-19) that had "PHBS" as the main theme. ABC started with a Pre-Activity Training for CIMSA's members, which was held on January the 10th, 2022. The training was

from the pretest and posttest increased by 28,89%. This activity was followed by a drawing competition with "PHBS and COVID-19" as the main theme. All of the participants in ABC joined this competition. Their art was mesmerizing! As medical students, we always want a sustainable impact from our activities. To that end, we are urging the stakeholders of SD Ngoresan No. 80 to improve their implementation of health protocols during the reopening of the school in order to prevent the transmission of COVID-19.Stakeholders of SDN Ngoresan No. 80 took this advocacy as positive feedback for them and agreed to improve their facilities and implementation of health protocols as well as healthy lifestyle in SDN Ngoresan No. 80. Progress is impossible without change. Together, we take our small steps, and the pandemic will be over very soon, hopefully.

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SCOPH People

GULALI (2022) Photo by CIMSA UNAIR

Samantha Geraldine NPO CIMSA 2019-2020 PHLT-T IFMSA-Certified

Triple Burden of Malnutrition: Is It Happening? "Good nutrition allows children to survive, grow, learn, play, participate, and contribute." These may be some words that need to be reflected upon by us. There is a ‘golden period" for children to fully grow, called "1000 Days of Life." This period starts with the fetus until the child is two years old (270 days of pregnancy and 730 days from birth to 2 years of age). At this phase, there is rapid brain growth (≤80%), development of body metabolism, body growth, and immune system formation. The WHO defines malnutrition as a deficiency, excess, or imbalance in a person’s intake of energy and/or nutrients. The term "malnutrition" addresses three broad groups of conditions: Undernutrition includes wasting (low weight-for-height), stunting (low height-for-age), and underweight (low weight-for-age).

Micronutrient-related malnutrition, which includes micronutrient deficiencies (a lack of important vitamins and minerals) or micronutrient excess.

Overweight, obesity, and diet-related non-communicable diseases (such as heart disease, stroke, diabetes, and some cancers) Malnutrition in the golden period is irreparable damage or stunted growth in the next phase of life. Hence, good nutrition and parenting need to be well provided for in children’s development. Adequate nutrition during pregnancy will help the baby grow as well as be born healthy and perfect in every phase of its development and growth. The nutritional status of Indonesians is still low by international standards, and the variation across regions remains huge. Indonesia was one of the three countries with the largest number of wasted children. Based on the 2014 Global Nutrition Report, Indonesia is included in 17 countries with 3 nutritional problems, or Triple Burden of Malnutrition. So, yes, now we are facing it. Undernutrition co-exists with overnutrition and micronutrient deficiencies. Data from the Ministry of Health, 2019, showed 10.2% of children under 5 in Indonesia were wasted and 30.8% were stunted. There is also a report that states

Other than the food, the sanitation of the community is still a challenge that needs to be addressed properly. As long as the number of people still practicing open defecation has remained large, there has been no adequate access to safe and sustainable water. Malnutrition, especially stunting, does not only result from inadequate access to food (in the case of poor households), but also other socioeconomic, health, behavioral, and cognitive factors such as non-exclusive breastfeeding for the first six months and parental education. Malnutrition may increase health care costs, reduce productivity, and slow economic growth, which can perpetuate a cycle of poverty and ill-health.

that around 45% of deaths among children under 5 years old are linked to undernutrition. These mostly take place in low- and middle-income countries. At the same time, rates of childhood overweight and obesity are rising. Overnutrition has been rising, not confined to urban areas, and there is a phenomenon called "High Hunger," which is the increase of anemia among children under 5 years old and pregnant women. The government is working on stunting and wasting as they are included as the focus of the 2020–2024 RPJMN, where the reduction target for stunting is up to 14% and 7% for wasting in 2024. Now, the question is, "Why is it happening?" Poverty and high food prices related to low income remain the major challenges in the effort to increase access to food. A report said that the price of rice in Indonesia is considered high by international standards, despite the high amounts of fertilizer subsidies allocated to rice producers. The outbreak of COVID-19 has also increased the number of poor households in the country and those households would be at risk of becoming food insecure if the pandemic lasts longer and affects the economy more severely.

In conclusion, the cause of the nutritional problem can be caused by various factors such as lack of food intake, both in terms of quality and quantity of food, and also by certain diseases, especially infection as the direct cause. Indirect factors that can influence them are poverty and the condition of the population, poor health services, and poor environmental sanitation. We can prevent this problem by having balanced nutrition based on "Isi Piringku" or

Photo by Kenyang CIMSA UGM (2019)

other recommendations based on needs and age, proper education about malnutrition and its impact, increasing sanitation, and ensuring access to clean water. The United Nations also urged all countries to act on nutrition problems. This is also an action to achieve the Sustainable Development Goals (SDGs) agenda number 2 about zero hunger by ending hunger, achieving food security and improved nutrition, and promoting sustainable agriculture. It also urged all countries to act on number 3, about good health and well-being by ensuring healthy lives and promoting well-being for all at all ages. Led by WHO and the Food and Agriculture Organization of the United Nations (FAO), the UN Decade of Action on Nutrition calls for policy action across 6 key areas, such as: • Creating sustainable, resilient food systems for healthy diets • Providing social protection and nutrition-related education for all • Aligning health systems with nutrition needs and providing essential nutrition interventions universal coverage. • Ensuring that trade and investment policies improve nutrition • Building safe and supportive environments for nutrition at all ages

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Strengthening and promoting nutrition governance and accountability everywhere (WHO, 2021).

This is not only a health problem but also a problem for other sectors. It is also not only the government's problem, but it is ours. This problem is interconnected, relates to each other, and needs to be tackled together. A multi-sectoral approach and collaboration are important to be initiated. We can work together to decrease this burden from our community and improve Indonesia’s health. Are you ready? Let’s be part of it!

References BKKBN. 2017. 1000 HPK: Pondasi Penting Kehidupan Manusia Di Masa Depan. [online] https://www.keluargaindonesia.id/infografik/1000-hpk-pondasi-penting-kehidupan-manusia-di-masa-depan (accessed March 6th, 2021). Cegah Stunting. 2020. [online] https://cegahstunting.id/ (accessed March 6th, 2021). Direktorat Gizi Masyarakat Kementerian Kesehatan RI. 2018. Buku Saku Pemantauan Status Gizi tahun 2017. Jakarta Selatan: Kemenkes RI. Kementerian Kesehatan RI. 2018. Cegah Stunting dengan Perbaikan Pola Makan, Pola Asuh dan Sanitasi. [online] http://www.p2ptm.kemkes.go.id/kegiatan-p2ptm/subdit-penyakit-diabetes-melitus-dan-gangguan-metaboli k/cegah-stunting-dengan-perbaikan-pola-makan-pola-asuh-dan-sanitasi (accessed March 6th, 2021). Kementerian Kesehatan RI. 2020. Indikator Program Kesehatan Masyarakat dalam RPJMN dan Renstra Kementerian Kesehatan 2020-2024. Jakarta: Kementerian Kesehatan RI. Kementerian Kesehatan RI. 2014. Keluarga Sehat Idamanku, Kota Sehat Kotaku. [online] https://promkes.kemkes.go.id/download/jke/booklet%20penggunaan%20lembar%20balik%20KSI%2015x21 cm.pdf (accessed March 6th, 2021). Sirojuddin Arif, Widjajanti Isdijoso, Akhmad R. Fatah, Ana R. Tamyis. SMERU Report: Strategic Review of Food Security and Nutrition in Indonesia: 2019–2020 Update. [online] https://www.wfp.org/publications/strategic-review-food-security-and-nutrition-indonesia-2019-2020-update (accessed March 6th, 2021). WHO. 2021. Malnutrition. [online] https://www.who.int/news-room/fact-sheets/detail/malnutrition (accessed March 6th, 2021)

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