Rhona MacDonald and Richard Lane discuss all that has happened with TheLancetStudent.com since its launch less than five months ago and discuss the way forward for 2008.

 

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 Bonnie Scotland! Where I’ll be going v soon!

First thing this morning I was part of The Lancet podcast with Richard Lane, web editor, and Richard Horton, editor of The Lancet, where we looked back over the last year at The Lancet. Richard Lane and I will be doing something similar with TheLancetStudent and that podcast should be up later today. (Note from Rhona: it’s 3.30pm and this is now up. You can listen to it by going to the audio page or by clicking here). So, in preparation, it has got me thinking over all that TheLancetStudent has achieved over the last (almost) five months since it launched. We have all been very busy! I am delighted with the growing collection of peer reviewed Articles on (mostly) global health topics written by students from around the world for students around the world. And of course, these couldn’t be published without the hard work of our 80 odd peer reviewers. I love getting your blog entries to get a glimpse of what life is like wherever you are and these entries really help to give TheLancetStudent its strong international focus. Then of course there is The Lancet Digest,  the polls, the Reading Room, and our podcasts to mention just a few more features. So I don’t know about you, but I think that together, we have achieved a tremendous amount in 2007. Thank you so much to all of you for making TheLancetStudent such a success and I really look forward to working with you more in 2008.

Now for something a bit more downbeat.  I just want to draw your attention to the list of the ten most under reported stories of 2007 that Medecins Sans Frontieres (MSF) launched yesterday. This is the tenth year that MSF has done this and sadly, some of the stories are all too familiar. Top of the list this year is the growing number of displaced people living in appalling conditions in Somalia. MSF says that it is extremely frustrated by its inability to reach more patients in the Mogadishu area due to security concerns. I have described what is happening there to you before. I also mentioned that I hadn’t heard from my friend who was working there. Thankfully, he is now safe and relatively well but, as it happens, I was talking to him last night and he is sad and angry that the world is continuing to ignore the dreadful plight of the Somalians . I don’t want to put you on too much of a downer over the holiday period, so those of you who are interested can read the rest of MSF’s report for yourselves.

This is my last “official” day in the office before the holiday period and I am really looking forward to going back home to Scotland. But I imagine that I will be posting some blog entries over the holiday period and answering the odd email or two! Have a great holiday and catch up again soon—love Rhona x

As you may be aware, The Lancet chronic disease series was launched earlier this month. We mentioned it in a previous blog entry and it is included in the last 3 instalments of our weekly Lancet Digest.  Why am I mentioning it again? Well, because I have just published on TheLancetStudent.com a peer reviewed article by Joshua Schulman-Marcus which looks at the global diabetes epidemic— and of course diabetes is a very prevalent global chronic illness.

The first article in our Lancet Student series looks at a very important but hugely neglected topic: diabetic foot disease. The statistics are scary. As Joshua points out in his article, it is estimated that 4.5% of the developing world population had diabetes in 2003, with a 31% increase in prevalence projected by 2025. In 2000 an estimated 1 in 10 people aged 35-64 in the developing world died as a result of diabetes.

So why the focus on diabetic foot disease? One of the most significant complications of diabetes is foot disease, which most often presents with ulcers or infection. Studies in developed countries have estimated that 15% of people with diabetes will ultimately have diabetic foot ulcers. And in the absence of comparable studies, it is estimated that people with diabetes in developing countries have similar rates of disease.  I would thoroughly recommend that you read Joshua’s article. It is very enlightening and shows very clearly that the global health community must act very quickly if they are to have any chance of slowing the epidemic. Which brings me back to The Lancet chronic disease series. (more…)

The hole in the fence at Brooklyn Chest TB hospital in Cape Town, South Africa, through which four XDR-tuberculosis patients escaped. Garth Stead/Die Burger

The African National Congress (ANC) has just began to vote for its new leader in a bitter battle between the current leader and President of South Africa, Thabo Mbeki, and his main opponent,  Jacob Zuma, who is tipped to win. There is quite a lot of media coverage about the election [for example see Link 1  (Times Online) Link 2 (South African Financial Times) and Link 3 (South African Mail & Guardian) for more information] especially as it is messy, chaotic, and cloaked in scandal.

The election also has huge health implications. Thabo Mbeki does not believe the HIV virus exists and, as I reported in a previous blog entry, recently fired the popular deputy Health Minister, Nozizwe Madlala-Routledge, who was responsible for rolling out a national AIDS plan. Yet AIDS is not the only hot political health issue in South Africa. The emergence of XDR TB (extensively drug-resistant tuberculosis) in South Africa last year has the authorities freaked. The current issue of The Lancet Infectious Diseases reports on the forced isolation of TB patients in South Africa (article by Adele Baleta) and I have copied it for you below. A patient was recently shot (in the leg) for trying to escape. Do you think that would ever happen wherever you are? Rhona

The Lancet Infectious Diseases: Newsdesk
The recent shooting of a tuberculosis patient at Johannesburg’s Sizwe Tropical Diseases Hospital in South Africa, after a protest about conditions turned violent, has raised the contentious issue of forced isolation of patients being treated for resistant forms of the disease. (more…)

Today is press day for The Lancet rather than the usual Tuesday as we have two issues to get to press this week thanks to the holiday season. So I am busy running around the office and don’t have time just now to tell you about the very moving film, The Invisibles,  which I went to see yesterday organised by MSF (Medécins Sans Frontières) which highlighted the appalling situation of people in five of the most neglected crises throughout the world. Even though I used to work for MSF, I am still very affected by the powerful images and heart-breaking stories and I do really want to tell you more about it when I have a bit more time. But now I want to hand over to these busy people at the Asian Medical Students Association Hong Kong who recently formed into a large bowel, among other things, to make people in Hong Kong more aware of colorectal cancer. Well done guys!— Rhona

Recently, a group of 33 inspired medical students from both the Chinese University of Hong Kong and the University of Hong Kong hit the busy streets of Hong Kong to promote and educate the local community on the importance of colorectal cancer prevention.

Colorectal cancer is currently ranked as the No.2 cancer killer in Hong Kong, a city where western influences have deeply infiltrated into peoples’ everyday lifestyles in contemporary history.  (more…)

Memorial for victims of the LRA’s violent attack at Geregere, Pader, northern Uganda. Francesca del Mese

Hi there. A couple of things to mention today. First, we have just done the second of our weekly podcasts which you can find in our audio section (see the navigation button above). This week, I chat to two of the authors of some of the articles we published this week. Islean Kinghorn on unsafe abortions and Jienchi Dorward on Cuban doctors in Bolivia and user fees. Richard Lane (web editor of TheLancet.com) and I also discuss his recent trip to Northern Uganda. He has written a world report about it in this week’s Lancet which is mentioned in this week’s Lancet Digest but I have also copied it for you below. It is very powerful. Hope you have a great weekend and catch up soon—Rhona

Lancet World Report-Northern Uganda: looking for peace
After two decades of civil war, the Ugandan Government and the rebel Lords Resistance Army could be close to a peace agreement, raising hopes that people in the north of the country can begin to recover from the mental and physical trauma caused by a brutal conflict. Richard Lane reports.

A small wooden monument stands in the tiny village of Geregere, in the Pader district of northern Uganda. A reminder of a violent past, it commemorates the massacre of 27 local people 5 years earlier by the rebel Lords Resistance Army (LRA). All the victims’ names are listed, three of them in red. When a member of our group questions the names in red, the answer seems hardly credible. The bodies of the three individuals, once cut to pieces, were roasted in a giant cooking pot by members of the rebel army. (more…)

In this week’s podcast Rhona MacDonald interviews Islean Kinghorn and Jienchi Dorward, two student authors who published on TheLancetStudent.com this week to find out more about the topics they write about: unsafe abortions and the healthcare system in Bolivia. And Richard Lane discusses his recent trip to Uganda. There is also a special audio feature about his trip.

 

 The Lancet Student Podcast, 14th December 2007: Play Now | Play in Popup | Download

See the article by Jienchi Dorward

Hi there. Just a quick one today. I want to draw your attention to three peer-reviewed articles which we have just published. I know you can see them on the left hand feature but here they are again just in case. Islean Kinghorn has written about the public health implications of unsafe abortions. Islean covered the Women Deliver conference for us and she got interested in the topic then.

Jienchi Dorward, a final year medical student from Bristol, has been busy. He has done two features for us based largely on what he witnessed and experienced in Bolivia, where he recently went on his elective. His first feature looks at the role of Cuban doctors in the Bolivian health system and whether they are a help or a hindrance.  His second discusses the complex problem of user fees-– where patients have to pay out of pocket for their health-care. Just as a wee aside, conventional estimates of poverty do not take account of out-of-pocket payments to finance health care.  The Lancet published a paper last year which calculated the number of individuals living in 11 countries in South Asia with less than the internationally accepted threshold of absolute poverty (US$1 per head per day) after making health payments. The authors found that 78 million more people in south Asia ended up with less than $1 per day after they had paid for health care.  Something to think about! That’s it for today and well done to all the reviewers and authors involved in these articles. Rhona

Continuing our post-disaster theme after yesterday’s blog entry where Ioanna-Maria Athanasopoulous updated us on the situation in Greece four months after the forest fires, I just want to draw your attention to a new article I have just posted by German medical student Kayvan Bozorgmehr about the emergency relief effort after cylcone Sidr struck southern Bangladesh. Our Bangladeshi correspondent Mohammad Rakibul Hasan (Rakib) , has written two blog entries about the disaster, the first entry reported on events immediately after, and the next 2-3 weeks  after Cyclone Sidr.  

Kayvan was also in Bangladesh at the time of Sidr and joined the efforts of a local NGO, Gonoshasthaya Kendra, in providing emergency medical relief to the affected areas. He gives a powerful and honest account of what he witnessed and experienced, including discussing some of the problems in co-ordinating the humanitarian relief effort and providing much needed aid.

Talking of which, a wee while ago I said that I would tell you more about the humanitarian response index after its launch event a couple of weeks ago and I have copied below a Lancet editorial I wrote about it. Bye for now—Rhona (more…)

 The world was shocked at the terrible fires that swept through Greece a few months ago. The awful events were felt very personally by Ioanna-Maria Athanasopoulou, our Greek student correspondent studying at the Medical Faculty of the University of Athens. She describes some of what happened and also gives an update on the situation 4 months on—Rhona

 On the 25^th of December, millions of people around the world will be celebrating Christmas. On the same day, there will be a rather melancholic “anniversary” in western Peloponnese in Greece. Four months after the catastrophic fires, which killed 64 people and vanished unique acres of  forests, the situation of the habitats and nature are rather disappointing. I do not want to sound melodramatic, as I have always believed that action is much better and more effective than tears. The difference in this issue is that I have experienced the inferno of the fire for myself. The birthplace of my mother is Nea Fygaleia , a beautiful village 12 km south from Zacharo, where the first big fire appeared. Our fields were burned down and our house was seriously threatened by the flames which encircled the village in an hour.

Silent demonstration against the fires which have damaged a great part of the land of southern Greece. Mourn for the disaster and anger for the criminals who have caused it. Syntagma square 29/08/2007  

It’s really difficult for me to adequately communicate what we experienced those days.

(more…)