Islean Kinghorn, a 3rd year medical student at Brighton and Sussex Medical School, UK, takes the blog spot today. She attended an interesting event last week on “Becoming a doctor: journey or destination” and tells you more about it here. Rhona

Last week I attended a lecture tour being held at four universities around the UK entitled ‘Becoming a doctor: journey or destination’. The event was organised by the Kings Fund London and the speakers included the President of the Royal College of Physicians, Professor Ian Gilmore, Professor Graeme Catto, President of The General Medical Council and editor-in-chief of The Lancet, Dr Richard Horton.

The night was a lively affair with speeches, discussions, quizzes and question sessions encouraging medical students, doctors and other health professionals to talk openly about were medicine was and were it was going. There was a lot to take in and like any discussion of this nature the themes and issues were mixed and hard to exactly pin down but I will do my best to highlight some of the main points which came out of the evening. (more…)

More today on the campaign to support asylum seekers right to healthcare as per our blog entries last week. You can also vote on this topic in the poll below. Rob Hughes, a final year medical student from Bristol (who I am delighted to have as an Intern with us for the next month) was at a protest to protect the right to healthcare for vulnerable migrants in Bristol this weekend and tells us all about it below. So over to you Rob- Rhona

Protestors in Bristol

The UK’s General Medical Council says “Make the care of you patient your concern” (Good Medical Practice, GMC, 2006). The same document also reminds us that we must show respect for human life and promote the health of patients and the public.  On Saturday Bristol medics and members of the Medsin-UK’s Global Health Advocacy Project (GHAP) took to the streets to protest and inform the public about how they feel these core responsibilities are under threat.

A Home Office that is intent on appearing tough on immigration is pressing for further restrictions on access to NHS services for vulnerable groups including failed asylum seekers and undocumented migrants (Home Office, 2007). This is despite a dearth of evidence that health provision encourages migration, against the recommendations of the only impact assessment that has been carried out, and the opposition of 75 MPs and 314 Doctors who have signed a petition against the proposed changes. (more…)

Photo courtesy of Doctors for Iraq

To say this has been a busy week would be the under statement of the year so far. Richard Lane, web editor of TheLancet.com, and I discuss some of what has been going on in this week’s Lancet Student podcast. We discuss all the articles published this week on theLancetStudent.com (including the new brilliant one on Microbicides by Rishi Rattan and Chris Curry) and I interview Anand Bhat a medical student from Texas and author of our article on health on the US-Mexican Border to discover more about the health inequalities in Texas.

We also discuss the launch of The Lancet undernutrition series, and The Lancet editorial on Iraq, which I have copied for you below. I went to the launch of the Medact report on the Iraqi health system earlier this week, which is mentioned in The Lancet editorial. The Director of Medact presented the report. One of the problems she hlighlighted, which you can read for yourself in the report, is that right from the start of the war/occupation, the fundamental Geneva Convention on medical neutrality was not adhered to. Hopsitals and clinics were attacked and looted, and health workers attacked, kidnapped or killed. So this set the scene for the next five years and even implementing something as crucial as the Geneva Convention is now fraught with difficulty. Anyway, I strongly encourage to read the report, and The Lancet editoral (below) for youselves. I hope you have a good weekend and catch up with you all next week. Rhona

Lancet editorial: Morbidity and mortality among families in Iraq
How unfortunate that comment on the Iraq Family Health Survey (IFHS) Report, released by WHO on Jan 9, has sparked such a heated and distracting debate on estimates of civilian mortality. The shocking figure of 151 000 violent deaths between March, 2003, and June, 2006, is of the same order of magnitude as a previous figure and serves to confirm that far too many civilians have been killed during the US-led occupation. The sooner this fact is accepted, the sooner the crucial issue of rebuilding the shattered lives that lie behind such numbers can begin. (more…)

Rhona MacDonald and Richard Lane chat about what’s been happening in this busy week at The Lancet Student, and Texan medical student, Anand Bhat, discusses more about the health inequalities in Texas as featured in his recent article.

 

 Lancet Student 18/01/08: Play Now | Play in Popup | Download

Yesterday I went to the launch of The Lancet undernutrition series. It was a really interesting affair with loads of journalists, NGOs, and academics crammed into a room at the Science Media Centre at The Royal Institution in London. It was also a crucially important event. More than a third of child deaths and 11% of the total disease burden worldwide are due to maternal and child undernutrition. This is quite staggering, and completely unnecessary, given the abundance of food (which contributes to the rising prevelence of obesity) in many countries. As the Director of the World Food Programme says in a Comment: “Although our planet produces enough food for everyone, one person in seven still goes to bed hungry each night. 25000 people die every day-including one child every 5 seconds-from hunger-related causes.”

You can listen to the presentations from key authors of the series and access all of the articles in the series here. I have also copied the summaries for the key papers below. Rhona

Nutrition has slipped through the gap
Nutrition is a desperately neglected aspect of maternal, newborn, and child health. The reasons for this neglect are understandable but not justifiable. In a comment that opens the maternal and child undernutrition series, The Lancet Editor Dr Richard Horton draws together the themes of the series, and calls on agencies, donors and political leaders to step up to this very serious challenge. He says “Undernutrition is the largely preventable cause of over a third - 3.5 million - of all child deaths. Stunting, severe waste wasting and intrauterine growth restriction are among the most important problems. There is a golden interval for intervention: from pregnancy to 2 years of age. After age 2 years, undernutrition will have caused irreversible damage for future development towards adulthood”. The comment concludes by saying that the international nutrition system is broken. Leadership is absent, resources are too few, capacity is fragile, and emergency response systems are urgently needed. (more…)

Today I have been to the press launch of The Lancet’s undernutrition series and another one on the Medact report of the Iraqi health system. More on both of these later. But for now I want to hand straight over to Jienchi Dorward, a final year medical student from Bristol, UK, who picks up from where I left off in yesterday’s blog entry. So over to Jienchi- Rhona

The recent coverage in the Lancet about healthcare for refused asylum seekers in the UK highlights global health inequalities in a stark manner. People who seek asylum (refugee status) in the UK are entitled to the same healthcare as UK residents, but if their claim fails then they lose the right to free non-emergency hospital treatment. The UK government are considering extending this to primary care as well. A group of us medical students in the UK are part of a campaign to try and stop this but there is a lot of support to these changes amongst the British public. (more…)

Photo from www.eapn.org

The global health focus of next General Assembly of the International Federation of Medical Students Association (IFMSA) in March is immigration health. Here is what they say about it on their website:  “Our responsibility as future physicians is to emphasize that every woman, man, youth and child has the human right to the highest attainable standard of health wherever he is or he comes from. We can not claim that we are improving health programs if the incidence of diseases is still different between the regular citizens and the immigrants.”

Therefore I thought you would be very interested to hear about this editorial and letter ( signed by 276 doctors) that the Lancet press released today that has already been picked up by several news sources including the BBC online. It really is a truly shocking situation and shows how the UK Government is letting down one of the most vulnerable groups in the UK: undocumented migrants. As the editorial points out, doctor leaders have been deafeningly silent on this issue and are not right out there publicly defemanding that undocumented migrants have access the healthcare and  treatment that they need. So perhaps it is up to medical students and their leaders, and organisations, such as the IFMSA, to show doctors’ leaders how it’s done and make a lot of noise about this issue themselves. I have copied the editorial and letter for you below, along the recent editorial (another one-published in the 22 Dec 2007 issue of The Lancet) that the letter refers to which shows how varied the situation is across Europe. C’mon folks. Let’s do something about this so that appalling situations, such as the outrageous case of Ama Sumani, where doctors have to watch their patients being forced off their lifesaving treatment and sent back to their original country to die, are NEVER repeated. Rhona (more…)

Hello there. I hope you had a good weekend. I have just published some more peer reviewed articles and uploaded the first Lancet Student podcast of 2008, which includes an interview with Elizabeth Leyland, the author of our article about Facebook, to further discuss the pros and cons of Facebook (in the lives of students!).

Now to the Articles. Continuing in our theme of the influence of the pharmaceutical industry, Matthew Kirkman discusses the influences and pressures on the prescribing habits of doctors. Oh, and please remember to vote in our poll on this topic below! Anna Shore explores the merits of including global health in the undergraduate curriculum, and Anand Bhat tells us more about the health inequalities in his home state of Texas. He also shares his experiences of working at Frontera de Salud, an NGO set up by the University of Texas Medical Branch.  Well done everyone! Rhona

Rhona MacDonald discusses this last week in the life of TheLancetStudent.com and introduces this week’s published articles. She discusses the influence of the pharmaceutical industry on doctors and medical students, runs though Rhona’s rules, and interviews medical student, Elizabeth Leyland, the author of an opinion article about Facebook

 

 Lancet Student podcast 11/01/08: Play Now | Play in Popup | Download

Jacob Zuma

I have previously mentioned the political situation in South Africa and how this affects the health of the population. So I thought you might be interested to read an editorial in this week’s issue of The Lancet which I have copied below. Rhona

Lancet Editorial: Can Zuma lead South Africa to a healthy future?

South Africa entered 2008 amidst political turmoil. On Dec 18, Jacob Zuma was elected as leader of the African National Congress (ANC). As the country’s ruling party, this makes him the likely successor to Thabo Mbeki, who is due to retire next year as South Africa’s President. Zuma is a controversial figure. Hailed as a poor-man’s hero, he retains huge popularity among the country’s trade unionists and rural poor population. But he is also disliked by many for his ignorance and his alleged dishonesty. He is currently awaiting trial for arms-related corruption and fraud and has proudly reported protecting himself from HIV infection, after allegedly raping an HIV-positive woman, by showering. Can a country really be entrusted to someone so misguided?

South Africa’s disastrous health situation makes public health an area where Zuma could win some credit. It is the country with the highest number of people living with HIV/AIDS, with almost a quarter of all 15-49-year-olds being HIV positive. In his election speech, Zuma acknowledged this by calling for AIDS to be “treated as a national emergency”. On Jan 12, the ANC releases its annual statement outlining plans for the year ahead. Reassuringly, the party acknowledges the need for drastic action to prevent new HIV infections and to provide care for all HIV-positive people at all stages of disease. But the crisis needs more than lip service. (more…)