My beloved Scotland
Hello There! I am back. And it is SO good to be here. Sorry for just dropping out of action like that and many thanks to Richard Lane for manfully holding the fort while I was on sick leave. And thanks so much all of you for your continued enthusiasm - and patience! I am just catching up with everything and I can see that many of you sent in blog entries and articles and so I will be posting them all very soon. Also, from Monday, I will have two student interns working with me to help with The Lancet Student (more about that later)  so I have every confidence that we will be bigger and better than ever before and get more students involved in all things global health. As for the photo? I was back in my beloved Scotland recovering and surrounded by mountains like this one which definitely helped me back to health. Anyway, enough of me prattling on. Now for the serious stuff.

I have written previously about the treaty to ban cluster bombs.  As part of that process, at The Dublin meeting this week over 100 countries have now signed the treaty, including (I am delighted to say) the UK. Unfortunately, the big 4- The USA, China, Israel, and Russia will not engage in the treaty process and still think that there is a need for such munitions. As I said previously, remember that cluster bombs are designed to cause maximum damage to the most people over the largest area for the longest possible time . So lets do something to show the leaders of the Big 4 that we oppose such weapons. I am not quite sure what that could be yet but I am working on it and would love to hear your ideas too.

Anyway, I hope you have a great weekend and The Lancet Student will be back with a bang next week.  I  have really missed you all and it is truly is great to be back. Love Rhona x

Thanks to Pete Witzler, Health Action AIDS Student Organizer for Physicians for Human Rights, for an update on the US Presidents Emergency Plan for AIDS Relief (PEPFAR).

As you may know, the House of Representatives has already passed their version of the PEPFAR program. The next step in the process for the bill to become law (think schoolhouse rock) is for the Senate to pass their version of the bill. Any differences between the two bills will be sorted out in a conference committee, made up of key stakeholders from the House and Senate, which then sends the bill to the President to sign into law.

We still have a big fight ahead of us to get the best possible bill signed into law. Unfortunately, a group of fiscal conservatives in the Senate, led by Tom Coburn, are using a procedural hold to stop the bill from going to the floor of the Senate. Michael Gerson has written a great op-ed in the Washington Post, which explains:

The seven, led by Coburn, complain that the reauthorization is too costly. They object to “mission creep”—the funding of “food, water, treatment of other infectious diseases, gender empowerment programs, poverty alleviation programs”—as though people surviving on AIDS treatment do not need to eat, work or get their TB treated. And the senators are concerned that AIDS funds might be used for things such as abortion referrals and needle distribution, though the legislation doesn’t mention these possibilities. So they are pushing for the extension of a superfluous spending mandate requiring that at least 55 percent of PEPFAR resources be used for treatment, on the theory that this will starve “feckless or morally dubious” prevention programs. (more…)

News of the Australian Medical Students Association conference being held in Melbourne, Australia, in early July.

Thanks to Caitlin Keighley for this contribution.

On behalf of the 2008 AMSA Global Health Conference (GHC2008) Organising Committee it is with great pleasure that we introduce the readers of The Lancet Student to this unique and inspiring event.

AMSA, the Australian Medical Students’ Association, is the peak national representative body for all 12,000 Australian medical students enrolled in the 17 medical schools around the country. The Global Health Conference-being held in Melbourne from July 4-8-is AMSA’s annual student-run conference devoted to informing and educating medical students from across Australia and the Asia-Pacific region about key issues influencing Developing World Health. Through a world-class academic program, the conference offers delegates a holistic approach towards understanding economic, social, political and environmental determinants of health in developing world communities. This program combines plenary sessions, seminars, and debates with interactive workshops and small group discussions to equip delegates with the tangible skills and the knowledge necessary to empower them towards enacting positive social change.

This conference is the only student-run academic event held in Oceania which focuses solely on global health, and attracts the regions most motivated and engaged medical students as its audience. This year, the conference sold out nationwide in less than 10 minutes. This is testament to the phenomenal interest amongst medical students in attending this event and hearing addresses of the highest quality delivered by Australia’s forefront intellectual and policy experts. The conference has been widely endorsed and supported by a number of leading academic, research and non-governmental organizations, including the likes of World Vision, Red Cross, Caritas, Oxfam and Medecins Sans Frontieres. (more…)

 An interesting perspective on studying, if not medical practice and indeed life itself, from third-year medical student Ohad Oren, from the Technion - Israel Institute of Technology, Haifa, Israel.

Admit it or not, medical students can be strictly divided into two groups, when comparing their self-style predictions. There are the Nobel Laureates to-be, who always seem not to appreciate their academic abilities as they really deserve to. And then there is the confident “surely-another-A” type, whose constant explanation for their lower-than-anticipated results is a probable miscalculation in points counting.

You may guess that I am some kind of exam-grades forecaster. To be honest, in my case it is not as straightforward as that. My self-grade evaluation varies roughly as a function of the grades-rating of the student with whom I am exchanging words. Meaning that his or her average yearly score is somehow spontaneously translated by my latent senses into a unique scale of numbers. And it definitely provides fertile ground for further discussion. (more…)

Tushar Patel from Tufts University School of Medicine, USA, recently revisited an area of rural India after an initial visit more than two decades ago. There remain many parallels in relation to poverty and health inequity…

‘Even now, I can still see her.  Her face is disfigured, swollen in some parts and normal in others.  My cousin’s body glows red from the fluorescent lights shining on her rash.  There is a hole in her cheek. She cries, yet smiles in my presence and I smile in return. I remember little of the time I spent with Priti on her farm in India.  Yet, her last days are imprinted in my memories.  At the age of twelve, Priti died of an allergic reaction to penicillin. Her chicken pox and high fever should have been treated without penicillin.

To this day Priti reminds me that life is a precious gift. 23 years later, recollections of Priti and a research opportunity offered by Dr Christine Wanke brought me back to one of India’s hospitals, Y.R. Gaitonde Centre for AIDS Research and Education (YRG CARE). This small non-profit hospital treats ten thousand HIV patients.  Providing patient care in their 16 bed hospital showed me the complexities faced by India’s destitute. (more…)

David Biles is a medical student from the University of Bristol, UK, though is currently involved in an internship at the Treatment Action Campaign in South Africa. Here is the first of hopefully several blogs that Dave will file for TheLancetStudent.com - this first one about a demonstration in Cape Town last weekend about gender violence in South Africa.

The cries went up, AMANDALA! (Power) AWETHU! (To the people) VIVA TAC VIVA! PHANTSI ERAPE! (Down with Rape). Hundreds were protesting against gender based violence in the heart of Khayelitsha, Cape Town’s largest township, last weekend.

I have just started volunteering for the protest organisers, the Treatment Action Campaign (TAC).

So, last Saturday morning I found myself in the middle of the passionate and noisy protesters.

Placards read “Real men don’t rape” and “Hands off our children”. The crowd of adults and school children loudly sung adapted anti-apartheid struggle songs. If you have ever seen “Amandala”, the film about the power of song and dance in apartheid, you might know how rousing it can be.

Despite the liveliness of the protest the issue is sobering. South Africa has the highest rate of rape in the world for a country not at war. Over 55,000 cases of rape are reported to the police ever year. Khayelitsha, home to 500,000 people, has some of the highest levels in the country. However most rapes never get reported to the police because of fears of retaliation, lack of faith in the justice system, economic dependance on the perpetrator or feelings of shame about the event.  Estimates say the incidence of rape is 20 times higher than reported cases. And this is not just adults; shockingly 41% of rape victims are under the age of 14.

(more…)

An interesting perspective on the relationship between art and medicine from rachel Pope in Be’er-sheva, Israel.

‘These last few weeks I have not been able to submit any blog entries because I have had too many things going on outside of class. All of the activities were well worth the time, though, and all of them, were unintentionally related to art in medicine.

“Art doesn’t give answers; art asks questions,” was the theme of my English class the first year of high school when our teacher decided to incorporate modern art into our literature and writing analysis training. In this vein, we learned that art can be an uninhibited expression of life experiences that can be used to show us the world through an individual’s unique perspective, and sometimes more deliberately, used to challenge the way we see the world. It’s easy to understand therefore, how physicians and physicians in training who work in fulfilling but also challenging and at times frustrating circumstances might have several experiences that may evoke a need to express their questions through various media.

In the last few months, I was fortunate to a have few chances to share some of my own questions as well as learn from others in my medical community. In March, a few of us at MSIH put on a theater production of “A Memory, a Rant, a Monologue, and a Prayer,” the 10^th anniversary edition of Eve Ensler’s Vagina Monologues, which focused on the seriousness of violence that persists in our world today and the need to prevent and stop it. In this piece of art, 12 medical students and community members were able to pass on the stories of women and men from around the world who needed to express the violence they had either survived or witnessed in order to process it themselves as well as raise awareness against it. This piece asked us, “Why do we continue to hurt each other?” and “How can we as physicians prevent and recognize violence?” (more…)

Hi everyone - just to let you know that our esteemed Editor Rhona is away for the next few weeks. So for the month of May-and it is truly wonderfully a warm and sunny month of May so far here in London-the site will not be quite as active as usual. However we are still keen to hear from guest bloggers, so please e-mail student@lancet.com if you have something to say on an important health issue. We are keeping eyes and ears open on the appalling situation in Burma following the cyclone on May 3; if you are in that part of the world and can enlighten us on this tragic event, do please get in touch.

Articles for the site and issues relating to peer review will be put on hold pending Rhona’s return at the end of the month.

Many thanks, and look forward to hearing from you soon.

In Rhona’s absence I’m posting this enthusiastic blog contribution from Kelly Anderson from a lecture given yesterday at the University of Western Ontario, Canada.

This evening, I had the good fortune of experiencing an extremely progressive commentary on medical student involvement in global health.

The inaugural Hungry for Change Gala at the University of Western Ontario aimed to foster increased global consciousness and draw attention to growing disparities in wealth and resource allocation worldwide. Azad Mashari, a fourth year UWO medical student, delivered a poignant speech that illustrated the need for deep reflection regarding medical student involvement in the delivery of medical care in resource-poor settings. He began with a statement too rarely articulated by contemporary global health experts: “Our potential to harm others is rarely as great as when we are trying to help them.”

Given the rise in expert discussion on ‘medical tourism’ and global health ethics, I am always surprised (and pleased) to see the most progressive views on global health collaboration, community-based approaches and social accountability come from students themselves.  More and more, we are concerned about the impact of our international electives on individuals, health systems and global health equity. (more…)