Welcome to the twenty-seventh issue of KaleidoSCOPH. On behalf of the National Public Health Committee (NPC) and our workaholic editorial team, the Media and Communication Team, we would like to give our warm greetings to the reader of our magazine and wish all the readers a happy reading.
Even long before the COVID-19 pandemic, mental health was a big issue. Anxiety disorders are the most common disease experienced by adolescent. Anxiety disorders can affect the psychosocial of the sufferer, such as anhedonia, decreased self-confidence, depression, etc. According to WHO, depression is the 4th leading cause of disability. With this magazine, We hope that we can spread the message of mental health awareness and raise the existence of SCOPH itself to our beloved locals and SCOPHeroes.
For the first period, we have organized one campaign: World Mental Health Day. We also present current updates from our locals' activities which were conducted in the last few months. At ast, we present you an article written by dr. Zahra Mustavavi.
Ariella Ramadhini Hakim Media and Communication Coordinator SCOPH CIMSA 2022/2023
Jane Limantara
Rafif Ryandra Tabina Putri Cut Putri Yasmin Eny Wulan Clara Meyly Media and Communication Team SCOPH CIMSA 2022/2023
JANE UB RAFIF UMS TABINA UGM ENY UNAIR CLARA UGM YASMIN UBIt has been a fantastic journey an NPO with you, NPCs, LPOs, NPC Teams, PHL, and SCOPHeroes throughout four months. With great honor, we have finally released the umpteenth edition of KaleidoSCOPH and can share many memorable and exciting things with you over the past few months. Many happy, precious things happened, and we hope that we can meet in person and not virtually anymore in Committee on Public Health, is the Standing Committee on public health areas such as health promotion, disease prevention, and many more. Through KaleidoSCOPH or every four months by SCOPH CIMSA, stories, achievements, fun, and other good things
We hope you can get to and increase your knowledge through articles written in KaleidoSCOPH. And for KS 27, the theme we bring up is
Although the COVID-19 pandemic has reached the recovery stage, the after effect of the pandemic, namely mental health, has been a concern for many people. I hope you can take care of your mental health with some effort, such as participating in activities related to increasing mental awareness and practicing mindfulness and well-being.
Finally, I would like to thank all the contributors to this article, the editors, and the people who were involved in editing this KaleidoSCOPH.
I would also like to thank the NPCs, LPOs, PHLs, NPC Teams, Peer Counselors, Alumni, and others who have contributed over the past period. We will not be here without all of your remarkable
Muhammad Ilham Suharto Observer CIMSA
Salma
Amatillah
After the pandemic, we get several effects, such as the habit of multitasking, not focusing on our activities and other impacts that our friends may also feel. Every individual has a different psychological condition. Each circumstance experienced in themselves and their surroundings can psychologically impact each individual in the future. Therefore, many individuals find it difficult to validate their feelings and often do not focus on the current state of affairs. Mindfulness is an effort to maintain healthier and calmer mental health.
Mindfulness is expected to improve mental health wellness. Well-being is defined as a point of optimal functioning of the sides of an individual, which includes: physical, socio-emotional, spiritual, cognitive, and behavioral. Having good mental health, or being mentally healthy, is more than the absence of disease but a state of overall well-being. Generally, mental health well-being relates to enjoyment of life, having the ability to cope and "bounce back" from stress and grief, being able to set and meet goals, and having the ability to build good relationships with others. The mental condition of each person is different depending on individual factors, supportive social communities, a safe living environment, ememployment, education, freedom from discrimination and violence, and access to economic resources. Therefore, mental health and well-being are essential for individuals, families, schools, workplaces, and communities. On each side, we can do many things or roles to improve Indonesia's mental health welfare.
Article by Hanny NPO SCOPH CIMSA
In commemoration of WMHD, we’re holding a campaign to increase public knowledge about mindfulness and wellbeing and, of course, be able to apply it in daily life by practicing it to improve people's mental health levels. In making this happen, we work closely with several external partners on our series of campaigns.
In the series, we hold webinars, talk shows, and workshops combined into one series of events. In this series, SCOPH collaborated with the Indonesian Ministry of Health, UNICEF, Mengenal.diri as a speaker for talk shows and with The Golden Space Indonesia as a Mindfulness Meditation instructor. We also held an online consultation with HIMPSI and produced new peer counselors who UNICEF trained, HIMPSI, and Pijar Psikologi and immediately launched to conduct counseling to the public.
We hope that through this series of campaigns, people will become more sensitive to mental health issues, be more
Fatih Husnaa Ersandra from
Maybe we will not be surprised when we eventually feel extremely tired after doing so many things in our life. For example, when you have to phys ically work 24/7 in your office or intensely exercise without taking a rest. But do you know that unwittingly you can feel tired too even when you did nothing?
There is a study that explains this phenomenon, based on study by Current Biology on August 11th 2022, when our cognitive intensely works until it takes several hours, it causes some products that potentially poisonous pile up in our prefrontal cortex brain. This, in turn shifts will control over your decisions so then you move and choose on low-cost actions that require no effort or waiting for cognitive exhaustion to set in. Basically, our brain is not a machine that can work continuously because every need to recycle potentially toxic substances comes from the brain or in specific it’s neural activity.
So, are there any solutions or tips to do to prevent our brain from thinking and working too hard that can also affect our body fatigue too? The good news is: yes! Adequate rest and sleep are the best ways. Some researchers also advise people to avoid making important decisions when they’re tired. But in spite of that, did you know there’s a condition where the body still feels so tired and not getting better even though you have already rested and slept enough?
It is called Lethargic. Not only are they tired, someone who is lethargic will usually find it difficult to do many activities in a day because they often feel sleepy, unmotivated, and hard to concentrate. We commonly feel tired after doing so many things and busy with our activity, so we basically use heavy fatigue or lethargy as a sign or a symptom of some diseases. But dif ferent from feeling tired after activity, lethargic won’t disappear even though the sufferer has slept and rested enough.
Why are You Tired When You did Nothing And Keep Tired When You had Already Slept?
MMSA UMY
Other symptoms caused by lethargic are moody, easily bored, lose focus and alert, and body lacks energy. Lethargic needs to be watched out more if it doesn’t go away in 2 weeks and is accompanied by other more serious symptoms such as chest pain, severe headache, hard to sleep and breath, weaknesses of paralysis of limbs, seizure, and fever.
Several diseases or medical conditions that can cause lethargy are iron deficiency anemia, malnutrition, thyroid disorders, psychological disorders (such as depression, burnout, anxiety, and stress), side effects of drugs (such as antihistamines and chemotherapy). Lethargic can also be caused by dehydration or poisoning, such as carbon monoxide poisoning. Besides that, your lifestyle could also contribute to feeling tired and affect lethargic. Those lifestyle reasons are poor diet, alcohol consumption, and caffeine consumption.
There are solutions and ways to prevent us from being lethargic. It actually depends on our lifestyle and personal circumstances. Eat healthy foods, drink water much, don’t sleep too late, regularly exercise, don’t give much pressure to yourself a.k.a. no more mental burnout, positive thinking, and doing many good things in life that could put us in the best condition. But if it feels too heavy to remove and it doesn’t heal in a very long time, you have to rapidly go find a doctor and seek help. As lethargic can be caused by so many things and to determine the cause of your lethargic, the doctor may perform a physical examination and supporting examinations. The examples of those examinations are such as blood tests, urine tests, and radiological examinations like CT scan or MRI of the brain.
Non-Communicable Diseases (NCDs) arise from a combination of non-modifiable and modifiable risk factors. Risk factors that can not be modified by an individual include age, gender, and genetics. Mean while, modifiable risk factors are factors that can be changed through individual awareness and social intervention (Alifariki, 2015). The high incidence and mortality due to NCDs makes its control important.
Data from the World Health Organi zation (WHO) 2015 shows that the prevalence of hypertension in the world reaches around 1.13 billion individuals, meaning that 1 in 3 people in the world is diagnosed with hypertension. The number of people with hypertension is expect ed to continue to increase to reach 1.5 billion individuals by 2025, with deaths reaching 9.4 million individuals.
According to WHO, Hypertension is a condition in which blood vessels have high blood pressure (systolic blood pressure >140 mmHg or diastolic blood pressure >90 mmHg). Based on the results of the study, factors such as gender, age, genetic factors, blood pressure, nutritional status, smoking habits, coffee consumption habits, fruit and vegetable consumption, physical activity, and stress experienced have a relationship that can trigger hypertension. Therefore, running a healthy and balanced lifestyle is highly recommended in order to minimize the risk of contracting hypertension, because prevention is better and more economical than cure.
Individuals with parents with hypertension have twice the risk of suffering from hypertension than people who do not have a family history of hypertension.
The prevalence of hypertension in men is the same as in women. However, women are protected from cardiovascular disease before menopause, one of which is coronary heart disease.
The adrenaline hormone will increase when we are stressed, and it can cause the heart to pump blood faster so that blood pressure increases
Lack of physical activity increases the risk of high blood pressure because of the increased risk of becoming obese.
Excessive consumption of sodium causes the concentration of sodium in the extracellular fluid to increase. To normalize it, the intracellular fluid is pulled out so that the extracellular fluid volume increases. The increased volume of extracellular fluid causes an increase in blood volume, which results in hypertension.
Smoking has caused 5.4 million people to die every year (Gumus et al, 2013). The effect of smoking increases heart rate and blood pressure with increased levels of the hormones epinephrine and norepinephrine due to activation of the sympathetic nervous system.
A serious complication of hypertension: Some studies say high blood pressure is the most common risk factor for stroke, because it causes unnecessary tension in the blood vessels to thicken and worsen which can eventually lead to stroke. When the blood vessels thicken with increased blood pressure, cholesterol and other fatty substanc es can cause damage to the artery walls and blockage in the arteries of the brain, the increased tension that occurs in the blood vessels of the brain can also cause the walls of the blood vessels to weaken which can eventually cause the blood vessels to burst. And finally a stroke.
Photo by Gulali CIMSA UNAIR (2019)Stroke is divided into two types. The first type is ischemic stroke which is caused by a lack of blood supply to the brain due to narrowing or blocked blood vessels on brain tissue. Many factors can influence the incidence of stroke include age, gender, heredity, race, hypertension, hypercholesterolemia, diabetes mellitus, smoking, atherosclerosis, heart disease, obesity, alcohol consumption, stress, supportive socioeconomic conditions, poor diet, lack of physical activity, and the use of anti-preg nancy drugs. However, of the many factors that influence the incidence of stroke, only hypertension significantly affects the incidence of stroke.
This is a serious thing that can happen if not taken care of from now on! We can prevent it from now on, by living a healthy lifestyle. Living a healthy lifestyle has been shown to lower blood pressure, and is generally very beneficial in reducing the risk of cardiovascular problems.A healthy lifestyle is meant by losing weight, reducing salt intake, exercising, reducing alcohol consumption, and quitting smoking.
Let's see what a stroke is for a moment!
We
go towards a healthier Indonesia!
According to the World Health Organization, the prevalence of people with mental emotional disorders in the world increases in the age range of 10-19 years, mental health conditions account for 16% of the global burden of disease and injury. Half of all mental health conditions start at the age of 14 but cases go undetected and untreated for a number of reasons, such as lack of knowledge or awareness about mental health among health care workers, or stigma that prevents adolescents from seeking help. It may increase the likelihood of taking further risky behaviors and may affect the mental and emotional well-being of adolescents.
The global prevalence of eating disorders increased from 3.4% to 7.8% between 2000 and 2018. 17% of junior-high school students with the most ages 13-15 years experienced symptoms of mental emotional problems. Puberty is what
causes teenagers to be more concerned with physical changes than their behavior. This case is also experienced mostly by women with a prevalence ranging from 4% to 6% for women while 1% in men. In Indonesia there are 38% of people who have eating disorders or who experience loss of appetite and most of them are women, while there are 8.7% of adolescents aged 13-15 years and 8.1% of adolescents aged 16-18 years with thin and very thin conditions. Studies show that there is an increase in the prevalence of eating disorders from 3.5% in 2000-2006 to 7.8% in 2013-2018. This disorder is one of the psychiatric disorders with the highest mortality rate. This disease is basically dangerous because it occurs over a long period of time, generally occurs in women because more women have negative body perceptions and tend to want to look perfect.
MARVEL (Mental Illness Prevention in School) is a community development
program that has been going on for four years. The main goal is to make MARVEL into a sustainable project in SMAN 1 Kota Padang. Now that MARVEL is in its 4th year, we are going to recruit new cadres because the previous cadres have graduated from SMAN 1 Kota Padang. We are hoping that MARVEL is one step closer to becoming a sustainable project which we planned to be implemented in 2024. “EDIOMS (Eating Disorder On Modern Society)” is the theme of MARVEL 2022. To get there, MARVEL 2022 is planning on doing two interventions and three mental health campaigns. The pre-intervention which was held on September 11th is the foundation of it all. It consisted of a comprehensive presentation by a trainer from Mental Health Community Care of West Sumatera, Mrs. Puti Dewi Sartika, M.Psi, about eating disorders.
In her presentation, Mrs. Puti explained that there are many types of eating disorders such as Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and Eating Disorder, and Not Otherwise Specifies where each type has its own symptoms. There are a lot of causes of eating disorders, they are categorized into three causes: psychological, biological, and social. Eating disorders have several effects such as mood swing, sleep disturbance, depression, and social isolation, with even more severe complications if left untreated like internal bleeding, heart failure, faint, hair loss, headache, and death.
So let's love your body by being grateful for everything it does, wear comfortable clothes, spend time with people who love you, give your body the right energy or nutrients to help you make your dreams come true,
Mysterious acute hepatitis is an ongoing international problem. According to a report by WHO on 5 April 2022, there were 10 cases of severe acute hepatitis in children under ten years of unknown cause in Scotland. As of 1 May 2022, WHO spokesman Tarik Jasarevic said they had received at least 228 reports of probable cases of acute hepatitis. Most case reports came from Europe, but some came from the Americas, the Western Pacific and Southeast Asia.
In Indonesia, the Ministry of Health recorded 14 suspected cases of acute hepatitis consisting of 1 probable case and 13 pending classification cases as of 17 May 2022. A spokes person for the Indonesian Ministry of Health, dr. Mohammad Syahril, Sp.P, MPH said that the 13 pending classification cases were spread across the provinces of North Sumatra, West Sumatra, DKI Jakarta, Jambi, and East Java. However, as of
24 June 2022, the development of mysterious hepatitis disease in Indonesia has reached 70 cases across 21 provinces. Of course, this data clearly shows that the prevalence increase in Indonesia is relatively high and urgent action is needed regarding this problem.
On 23 June 2022, the Indonesian Ministry of Health again reported that 30 cases of suspected acute hepatitis were being investigated. The cases consist of 16 cases with probable status and 14 pending status. Reports of this case have increased since 1 May 2022. Until now, the cause of the mysterious acute hepatitis is still unknown about the truth. There is limited information due to the lack of sources and platforms that discuss this disease. Limited information has an impact on the level of public knowledge that is minimal about acute hepatitis. One example is the lack of public knowledge about the early detection of acute hepatitis,
which leads to delays in medical treatment, as experienced by one of the patients at Dr Cipto Mangunkusumo Hospital. Delayed treatment since symptoms appear can increase the patient's risk of death. The lack of awareness of the early signs that lead to this mysterious acute hepatitis is a problem that needs to be addressed. The symptoms anticipated as a preventive measure for mysterious acute hepatitis, quoted from the Ministry of Health page, are nausea, vomiting, severe diarrhea, dark urine, and pale white stools.
The spread of cases of acute hepatitis without a clear etiology continues to expand. With the number of patients continuing to increase, of course, it is something that deserves attention from all parties. Through the Ministry of Health, the Indonesian government strives to detect cases of acute hepatitis in Indonesia by con ducting pathogen analysis using Whole Genome Sequencing Technology (WGS) and socializing NAR Hepatitis to the public. As for other actions taken by the Indonesian Ministry of Health to anticipate the spread of acute hepatitis in Indonesia, such as collecting global information about acute hepatitis quickly, increasing public awareness by conducting socialization and education about this disease, and compiling management guidelines related to acute hepatitis. As previously mentioned, increasing self-awareness regarding acute hepatitis is one of the preventive measures that the community can take. Of course, education is needed about this widespread disease
to prevent the increasing prevalence of acute hepatitis in Indonesia.
Therefore, this mysterious acute hepatitis issue needs to be criticized and studied more deeply by students in the health sector, especially general medicine, so that interventions can be implemented to increase public awareness about this issue. Through CIMSA, SCOPE and SCOPH CIMSA FK Unpad are expected to collaborate in formulating appropriate intervention patterns to carry out preventive and promotive efforts on this issue to the community through webinars, talk shows, volunteering, air campaigns, and ground campaigns.
The goals of ANTIS activities are to hold a series of interventions in the form of webinars, talk shows, air campaigns, ground campaigns, and volunteering which are carried out for two days and volunteering for three weeks to increase public knowledge and awareness, especially students aged 15-24 years and people adults with an age range of 25-64 years regarding acute hepatitis which is a world health problem is measured by increasing post-test results compared to pre-test at least 10% and volunteers can educate at least 30 people through ground campaigns.
Each intervention in this ANTIS activity went smoothly. For the number of participants from each of our activities, we have met the target, namely 147 Webinar & Talk Show participants, 30 volunteer participants, and 100 ground campaign participants. We are also very grateful to be able to present great resource persons for our activities, especially in the intervention of the Talk Show. We are very proud to be able to invite representatives from the Indonesian Ministry of Health, namely dr. Fatcha Nuraliyah, MKM (Work Team for HIV, PIMS, Hepatitis and PISP-Ministry of Health RI) and representatives from WHO, namely Dr. B. B. Rewari (Regional Advisor-Hepatitis/HIV/STI, World Health Organization, Regional Office for South-East Asia).
ANTIS (Acknowledge More about Acute Hepatitis of Unknown Aetiolo gy) has succeeded in realizing each point of the aims and objectives of
the establishment of this activity, namely, increasing awareness and concern for members of SCOPH-SCOPE CIMSA FK Unpad towards world health problems, especially acute hepatitis problems, increasing the ability of OCs in projects management that is carried out in a hybrid manner can be seen from the implementation of webinars and online talk shows as well as the ground campaign in the Bandung city square well. In addition, ANTIS has also succeeded in increasing the knowledge of SCOPH-SCOPE CIMSA FK Unpad members and the public regarding the contents of mysterious acute hepatitis. Hopefully, this ANTIS activity can benefit us medical stu dents to positively impact the com munity and increase public awareness and knowledge about mysterious acute hepatitis so that the incidence can be reduced. We hope that through this activity, we can inspire other medical students to jointly make good changes in the health of the Indonesian people.
In this pandemic era, many people experience ever-increasing pressure in their daily life, including in the education sector. Then, medical students have more psychological problems than other students. It takes at least 5 years to become a doctor and during the process and because of the pandemic the student should be adapted to the online academic process. Sometimes students are faced with academic stress that occurs due to the intense competitive environment in medical school.
Nowadays, many of the learning processes in medical school have gradually returned to the offline format. Theoretically, the education style should become more effective compared to online learning. However, it can also cause confusion and stress due to the ever-changing learning environment. If they feel stress for a long time, it will cause burn-out.
According to the WHO, burn-out is defined by Herbert Freudenberger in the 1970s; a syndrome conceptualized as resulting from chronic workplace stress that is not managed successfully. Burn-out syndrome has three classic symtoms:
1. Exhaustion or feeling of energy depletion.
2. Feelings of negativism or cynicism related to one’s job (depersonalization).
3. A sense of inefficacy and reduced a ccomplishment
Burn-out was worse than ordinary fatigue. Burn-out can disrupt not only personal, but also social functioning. If an individual is not able to handle the stress, then the body will respond psychologically and physically. Physiological processes that are caused by stress are involved by three systems, which are central and peripheral nerve system, endocrine system, and also immune system.
All of that system stimulates the hormone secretion to change homeostasis of the body. Then the body will be ready to change into a ‘Fight or Flight’ mechanism. Person with burn-out syndrome can be associated with physical symptoms such as gastrointestinal disorders, sleeplessness, and shortness of breath. They also can feel frustrated, angry, fearful, or anxious.
In 2019, Rossalina et al.in Ananda et al found low levels of wellbeing and high levels of burn-out among 1.792 respondents of Indonesian medical students, from across the six regions of Indonesia. Multiple causes of stress are 71% from studies, 46% because of relationships, 29% from financial and 7% from accommodation. Burn-out can reduce professional development of medical students. As a result, medical students feel uncomfortable in the educational process that can lead to inappropriate learning out-come even thinking to drop-out of college. They can be in a dangerous sitution, some of them would have suicidal ideation.
Burn-out doesn’t appear all at once.
Herbert Freudenberg and Gail North
described it in 12 stages and currently it is simplified into a 5 stage model.
It happens when you start the job or project, you feel enthusiasm, energized and no stress.
This stage is characterized by stagnation. During this stage you feel that life becomes limited to work, while family, social life and personal priorities are neglected. You are starting to feel stress about work.
During this stage, you are stressed everyday at work. You feel physically and emotionally exhausted and this stage leads to frustration.
It leads to a stage of apathy where despair and disillusionment occur. You feel physical and mental exhaustion and no amount seems to help. You don’t see a way out of the situation.
As the name stage, it happens when the experience of burning out becomes chronic and habitual. These may prompt one to look for help and intervention.
Here some tips to prevent Burn-out syndrome for medical students:
As we know that burnout is preventable. So, if you read the stage, signs and symptoms of burn out, and feel that you are at one of those stages, just follow the tips and it's important to reach out for help. But if you feel asking for help is difficult, consider developing self check-in with close friends and family members, so you can take care of each other during the times.
Ananda Nabila et al. Mental health and wellbeing of Indonesian Medical Students; A regional comparison study. International Journal of Social Psychiatry 2022, Vol.68960 1295-1299. Firdaus et al. Potensi Kejadian Burnout pada Mahasiswa Kedokteran di Masa Pandemi. Hang Tuah Medical Journal. Vol 18 No. 2. 2021 De Hert,Stefen Burnout in Healthcare Workers: Prevalence, Impact and Preventative Strategies. Dove Press Journal Local and Regional Anesthsia 2020;13 171-183. Soo Jin Lee, Young Jun Choi, Han Chae. The effects of personality traits on academic burnout in Korean Medical Students.Integrated Medical Research 6 (2017) 207-213.
WHO. 2019. Burn-out an “occupational phenomenon”: International Classification of Disease. Accessed from https://www.who. int/news/item/28-05-2019-burn-out-an-occupational-phenom enon-international-classification-of-diseases.
“There is no need to suffer silently and there is no shame in seeking help”
