Today we’ve posted a great article on medical ethics, focussed on the philosophy of utilitarianism. As healthcare students don’t tend to be exposed to much philosophy we hope it will interest you - we certainly learnt something! We’d also like to draw your attention to something that might be of interest; BBC World news is currently screening a series of documentaries called “Survival” on global health, with particular emphasis on health challenges in low-income countries and regions and how communities are responding. The documentaries go up on their website after they have been screened and you can watch them for free. They’re aimed at a general rather than medical audience but definitely give food for thought. Our blogpost today is on recent developments in the conflict in Darfur, Sudan and the importance of maintaining international civil and political pressure as the situation continues.

Photo courtesy of the ICRC

The plight of Darfur seems to be going the way of most long-term conflicts; gradually dropping out of the media and international interest. The violence and massive civilian displacement began in 2003 but, despite numerous political discussions, the presence of the UN/African Union joint peacekeeping mission (UNAMID), billions of dollars worth of aid in one of the world’s largest relief operations and despite even the threat of the International Criminal Court (ICC) issuing an arrest warrant for Sudanese president Omar Al-Bashir on charges of genocide, little seems to have changed on the ground. Recent peace talks in Khartoum seem to have had limited success and credibility and have led many to accuse Al-Bashir and his government of doing the minimum necessary to divert international attention from the crisis. On top of this, a new report from the International Crisis Group voices worries that Sudan could experience a Darfur-like conflict in another region, Southern Kordofan. (more…)

Today we have an interesting report from Ajit Dhillon, a fifth year medical student at the University of East Anglia, just returned from an elective at King Edward Memorial Hospital in Mumbai, India, after spending four weeks working in the varied field of general medicine. You can read the report here. The week also comes with worrying reports from Zimbabwe of the Cholera outbreak having spread from urban to rural areas. There is a heavy threat of the waterborne disease becoming endemic within the country with the imminent onset of the rainy season, unless action is taken by the state owned, Zimbabwean National Water Authority (ZINWA) and Ministry of Health to address the current water and sanitation problems the country faces. Chitungwiza, one of the areas of Zimbabwe hit hardest by the outbreak, also played the host to this year’s national commemorations of the United Nation’s Stand Up and Speak Out Against Poverty Campaign earlier in the month where the issues of sanitation and water supply took centre stage.

photo taken from www.sxc.hu

The UN have been aware of the Cholera outbreak, which has been a cause of concern since February this year, with estimates of one hundred and twenty deaths countrywide already; the greatest number of these being in the north of the country, in Mashonaland Central Province. Cholera outbreaks have been identified as originating from three main locations in Zimbabwe; Chitungwiza, a dormitory town, southeast of the capital Harare; Mola, in the district of Kariba; and Chinhoyi, West Province.  Ministry of Health figures indicate sixteen deaths nationwide in the last month alone; however there is widespread speculation as to figures being largely under-represented, with many accusing the Ministry of Health and ZINWA of neglecting the needs of residents. The World Health Organisation identify in their Crisis Affecting All the Population Report (CAP 2007), the lack of chemicals for water treatment and the breakdown of the sewage systems in most urban areas of Zimbabwe, as important risk factors for the spread of water-borne diseases such as Cholera. With people often forced to dig shallow wells to obtain their own water source, frequently contaminated with sewage. Currently, UNICEF has dispatched some 30,000 litres of potable water to these areas daily, along with hygiene education to help bring the spread of the disease under control. The Combined Harare Residents Association (CHRA) says some areas of the country have been without a reliable water supply for up to years, with poor or non-existent sewage maintenance programmes. (more…)

I’m Sophie Ratcliffe, student intern here at The Lancet and Lancet Student. I’m a final year medical student at Cardiff university and over the coming week I will be helping Rhona and Hannah post your blogs and articles and with the general running of the Lancet Student website. This week sees the launch of the Lancet’s China series, which focuses upon the key issue of Health System Reform in China. China is currently debating an ambitious strategy of reforms with the aim of universal health insurance provision, under the Healthy China 2010 Plan. The Lancet, in a series of scientific collaborations with Peking University Health Sciences Centre and the China Medical Board, examines the major health challenges China faces, and the implications these are set to pose for future global health.

Photo from www.sxc.hu

Over the past few years, China has undoubtedly taken the world’s centre stage. Whether talking about its huge natural and human resources (accounting for over a fifth of the global population), its culture, its human rights record, its rapidly expanding economy or, most recently, the Beijing Olympics, the media has been alive with debate about China. Though China is now feeling the pinch of the global recession, many commentators have predicted that it would pass through the current market turmoil more unscathed than most. Much less attention has been given to public health in China, though events such as the SARS outbreak, the Sichuan earthquake and the melamine-in-baby-milk scandal have highlighted the strengths and weaknesses of the health system there. (more…)

We have a lot of exciting things coming up this week, not least the launch of the Lancet series on China later today, which we will be blogging on tomorrow. Today we’ve posted an elective report on cancer treatment in the US and the author’s involvement in patient advocacy groups. It’s a very interesting topic and discusses the role that medical students can play, so we’d urge you to take a look at that. There is also a short report below on the detrimental impact the international arms trade has on health and human rights and the action being taken against this, in particular the Control Arms campaign. Hannah and Sophie

Photo from the Control Arms campaign

Later this month, UN officials will decide whether to progress with plans to negotiate a new international Arms Trade Treaty (ATT); one that would, in particular, stem the flow of weapons to regions where they would likely be used to contravene human rights. Today the UN was presented with a petition from over 2000 government members from 124 countries, calling for a curtailment of the arms trade through a new, improved ATT. (more…)

We are delighted that Global Health Watch 2 -the alternative world health report- was launched yesterday, and is our new Lancet Student Recommends. Please visit the GHW website for a summary of the new report and information on how to order a copy, together with all the chapters of the previous report. Keep an eye open for the 27  chapters from GHW 2 which will be freely available on the GHW site soon! The launch was well attended by academics, NGOs, and students and we tell you a bit about it below. Please email us and give us your take on the report. We would love to hear from you! We’ve also posted our weekly Lancet digest today. Hannah, Vanessa & Rhona

Yesterday afternoon University College London hosted the launch of the eagerly awaited Global Health Watch 2, described by Anthony Costello, Director of the Centre for International Health and Development at the UCL Institute of Child Health, as ‘radical, challenging and alternative’. It is designed ‘to support existing advocacy, social action and active resistance’. Dr. David McCoy, managing editor of GHW 2, described GHW as being equity focused and ‘not just pro-poor’; a report that ’sets out to conquer the neoliberalisation that has shaped globalisation’.

Launched just two days after WHO’s  The World Health Report 2008, GHW is an alternative health report “on those who normally write the reports”, which echoes many of the analyses in the final report of the Commission on Social Determinants of Health, particularly the impact of power and politics on global health. (more…)

Today we discuss the ongoing financial upheavals across the developed world and the impact this is already having on the global food crisis. On a Lancet Student note, we receive a lot of articles from around the world (and keep them coming!) but we’d like to put out a call for blogposts too - if you’d like to write us something short and punchy on anything, from a recent health-related news item to a campaign you’re involved in or an event you’ve recently attended, we’d love to hear from you. Hannah and Vanessa

(Photograph courtesy of Islamic Relief USA)

As the global financial crisis continues and governments hastily draw up bailout plans, some of the lesser publicised consequences are already being felt. While governments and institutions seem to have endlessly deep pockets when it comes to hoovering up toxic debt and restoring market liquidity, it is becoming apparent that international aid is going to be among the first to suffer. Against a background where the G8 countries are already falling short by a massive 30% of the targets they set themselves at the 2005 Gleneagles conference, NGOs and activists are worried that aid seems set to be cut further. (more…)

Ahmed Magdy, who has previously been involved in IFMSA, sends out a call for active healthcare students and young graduates in the Eastern Mediterannean Region (EMR) to merge their efforts in order to improve the situation of health research in their countries. Networks such as these are a great way of promoting information sharing and providing an co-ordinated voice on important issues. In the same vein, we’d also like to draw your attention to two in particular of the many out there; HIFA2015, a global campaign and knowledge network aiming for healthcare information for all by 2015, and the Movement for Global Mental Health, which we mentioned in our post for World Mental Health day. Until tomorrow - Vanessa and Hannah.

Most of the undergraduate medical/health care education programs in the Eastern Mediterranean Region are lacking in teaching or training in research. This explains the difficulties of the health care providers, especially young doctors, in keeping up to date and practicing evidence-based medicine. Also, those who decide to climb the ladder of health research at this stage need to strengthen their base so they can contribute towards improved policy and management of decisions made in the health sector in this region. These issues are part of the reason for the low contribution of the Eastern Mediterranean research community to global medical and health research and development. (more…)

We have some great blogs lined up for you this week, starting today with the release of The World Health Report 2008 , which focuses again on global health inequalities and how these can be tackled. The report is our Lancet Student Recommends and well worth a read. Thursday sees the launch of Global Health Watch 2 and we look forward to telling you all about this in our blog on Friday! In the meantime, please keep sending us your blogs. We would love to hear from you. Vanessa and Hannah

(Photograph courtesy of the World Health Organization)

“The World Health Report sets out a way to tackle inequities and inefficiencies in health care, and its recommendations need to be heeded,” WHO Director-General Dr Margaret Chan.

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Today we conduct a check up of health care in Iraq, a country which has experienced the severe breakdown of health infrastructure over the last 5 years, but which is hopefully on the road to improvement.  Tomasz Pierscionek (from Newcastle University in the UK) has written a brilliant article that looks at all aspects of health care in Iraq, and provides a valuable overview of the current challenges.  In the blog below, Rafi Rogans-Watson comments on the Iraqi government’s recent controversial decision to allow doctors to carry guns, and how an Iraqi organisation (Doctors For Iraq) has helped advocate for doctors’ and patients’ rights since the start of the invasion in 2003…  
Hannah, Vanessa and Rafi.

(Courtesy of Doctors For Iraq)

A fortnight ago, the Iraqi government decided to allow all doctors within the country to carry a gun for their own protection.  The news was understandably met with mixed feelings.  Some feel that the move had come too late to save many doctors lives and prevent others from fleeing the country.  Others question whether this is a dangerous precedent to set; firstly because it may actually increase the chance of doctors being involved in armed combat, but also because the move could potentially shift the role of doctors, placing them in the political - as well as literal - firing line.  Many feel that supplying doctors with weapons could result in “security chaos”, and that law and order should be left to the security forces.  It is also interesting to consider how this decision might correlate with the well-known Hippocratic Oath principle:  “First, do no harm.”

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Today is World Mental Health day, a chance to raise awareness of global mental health and the often sobering statistics. The theme this year is “Making mental health a global priority - scaling up services through citizen advocacy and action.” Raising the profile of mental health is essential for putting it on the public health agendas, improving services and reducing stigma. A WHO report, released yesterday aims to do this and provide workable strategies, especially for low- and middle-income countries. With this in mind, we’d like to mention the Movement for Global Mental Health, a collection of individuals and organisations giving a call for action (which anyone can join), formed after the Lancet’s series on global mental health last year. In this week’s Lancet there’s an editorial on the movement and a viewpoint on what the Lancet’s series has achieved one year on, so we’d urge you to have a look at those too (they’re all free but you do have to register first). We’d also like to draw your attention to an article on mental health in Sierra Leone that we put up a few days ago. In the words of the WHO report, “the time to act is now!” - the call is for governments and policy makers but also for everyone, including students and student organisations; our advocacy can make all the difference. 

Last but by no means least, we’ve posted our Lancet digest, a summary of what’s in the Lancet this week - Rafi, Vanessa and Hannah.

Photo from Oxfam

The title of this post, a quote from the WHO, emphasises the huge importance of mental health as part of general wellbeing. In fact, measured in Disability-Adjusted Life Years (DALYs), mental health disorders account for 14% of the global disease burden - and that’s 30% of the total non-communicable disease burden. This is probably an underestimate due to the difficulties and lack of diagnosis in many settings and the fact that mental health is inextricably linked with many other conditions. Despite this, less than 2% of health funds are given over to mental health in most countries. Against this background and where mental health is often stigmatised, ignored or misunderstood, a global step-up is needed for mental healthcare. (more…)