It’s Friday again, which means a new issue of the Lancet (a special edition this week) and our Lancet digest, a concise round up. We’ve also posted a brilliant article on rheumatic heart disease. When one thinks of heart disease it is usually in association with the chronic cardiovascular disease so prevalent in countries such as the UK but this article instead highlights an important condition arising from a communicable disease that has largely been forgotten in the developed world. Also, Sense About Science have recently launched an Evidence-Based Medicine Matters board to mark the 40^th anniversary of the 1968 Medicines Act. Visit the board to have your say on why evidence-based medicine is important (along with many others including doctors, nurses, patients, researchers and the Lancet’s Richard Horton) or click here to find out more about the campaign. On Tuesday, the UK’s Department for International Development (DFID) launched its new report called “Water: an increasingly precious resource. Sanitation: a matter of dignity”. Of course notably missing from this title is “health”, which is surely what clean water and sanitation are fundamentally about, rather than a “resource” or a generalised “matter of dignity”. Fortunately the Lancet and TLS’s Dr. Rhona MacDonald was at the launch to ask some tough questions about health and about the action that needs to be taken. In today’s blog we talk a bit more about the report and the wider issues of water and sanitation. Photo courtesy of End Water Poverty

This year is the International Year of Sanitation, but how often do the simple issues of clean water and sanitation turn up in development and public health priorities? As huge amounts of money are (rightly) spent on big-name diseases such as malaria and HIV, it seems to have been passed over that decent water and sanitation would alleviate an estimated tenth of the global disease burden according to WHO. (more…)

Today’s blog looks at bird flu following Saturday’s meeting in Sharm el-Sheikh, Egypt, which saw global leaders in the field convene to discuss the emerging virus and current preparations underway to limit its spread. People have been catching H5N1 from birds for the past decade, but as of yet, it has not triggered the global outbreak many predicted, experts however, warn against a growing complacency with the US pledging a massive $320 million in additional funding.picture taken from http://www.sxc.hu

Lethal flu epidemics tend to occur 3-4 times a century say scientists, with predictions that a new outbreak could be imminent and likely to be caused by bird flu.  According to a World Bank report, a mild outbreak has the capacity for killing 1.4 million people, whilst a severe global pandemic could reach a staggering 70 million and cut global gross domestic product by 2- 5% (5% equivalent to three trillion dollars). However, what remains unclear is if, or when this may happen, and how many will be affected. (more…)

Breaking news – the new Lancet website has gone LIVE and will have spread around the world by early tomorrow. It’s very swish so go and take a look. There’s some more info about it below below which highlights all the changes that have been made. You still have to register to read articles but registration is FREE (as is a lot of the content, incuding ALL of the Global Health content) and literally takes one minute, so it is well worth registering. The Lancet Student website is also going to get an overhaul in the near future and we’ll keep you posted on that. As for other changes, we’ve mentioned before our new facebook group, which will get a permanent link soon and will make discussing TLS and global health easier than the current “leave a comment” system. Back to global health – today we’ve posted a perspective by a medical student working in New York. It’s fantastically written and shows that often you don’t need to travel long distances to be exposed to different cultures and people and to practise global health. Finally, as per usual – keep your blogs, articles and elective reports coming in!

Well, today is a big day here at The Lancet: our main website, TheLancet.com relaunches with a big fanfare (and lots of cake too!) Please check out the video on The Lancet homepage which explains it all. 

We’ve been so lucky that so many of our site users  (hundreds of medical students, junior doctors, senior consultants, medical researchers and top academics from all over the world) have given up lots of time over the past year to work with us as ‘development partners’ in creating this all-new online home for the 4 Lancet journals (The Lancet, The Lancet Infectious Diseases, The Lancet Neurology and The Lancet Oncology). We’ve listened to what they said they needed and tried to deliver it. (more…)

We’ve got a fair few things going on today – first of all Simukai Chigudu, who was at the Medsin conference this weekend, gives us a brilliant summary of some of the issues that were raised and a global call to action, so please have a look at that (and also at yesterday’s conference blog). Also, we’ve posted another great elective report. The author has some interesting experiences to share of her time this summer in Malta and Trinidad and Tobago, two very culturally as well as geographically distant countries. And on an entirely different note, the UK Secretary of State for Justice, Jack Straw, spoke yesterday at the Royal Society for the encouragement of Arts, Manufactures and Commerce (RSA) (which incidentally often has lots of good speakers so check out the events list if you live in or near London) on punishment and reform in the UK. In the second half of our blog below one of the Lancet Student interns reports back, so keep scrolling down!

The world is evolving at a rapid pace. The global socio-political landscape is becoming increasingly treacherous and frightening to traverse. Established and emerging issues such as climate change, the “war on terror”, and the threat of global economic recession are fostering a universal atmosphere of anxiety and pessimism. And the greatest challenge in this gloomy reality is also the most pertinent one – how do we as a global community respond to the unique and complex threats of our time? (more…)

If you’ve been keeping up with our posts over the last week you will know that it was the Medsin national conference in London this weekend! Medsin is a student organisation campaigning on local and global health issues and the conference was a two-day action- and information-packed event on “Power and Politics in Global Health”, attended by 500 students, including one of us from the Lancet Student as well as our very own Rhona MacDonald and the editor of the Lancet, Richard Horton. We recorded his closing speech on Saturday and we have uploaded it today as an audio file. We cannot recommend this enough so please please have a listen- you will see why it was such a hit at the time! One of our interns also reports below on some of what happened at the conference. There is so much to say that she’s only been able to pick up on one or two themes so we would love to hear from anyone else who was there and what they took away from it. Whether it’s a paragraph or four pages email us at student@lancet.com! In another bit of Lancet Student news – we’ve now got a facebook group going that we’re hoping to use to share more information and get more discussion going. We don’t have a permanent link to it on the site just yet but check it out! 

As is summed up rather nicely in one of the articles we posted on Saturday, medicine in its theoretical form is apolitical. The basic ethics and tenets of medicine, including the Hippocratic Oath, define the integral relationship between patient and practitioner. Health itself has been classified as a right in the Universal Declaration of Human Rights and is something that everyone should be entitled to. However, to hold that medicine and health are independent of politics and economics is naïve and simply wrong. The recent WHO report on the social determinants of health, for instance, strongly underlined the role of social factors and inequity in health outcomes.

The aim of the Medsin conference was to discuss these issues and, more importantly, what we (and indeed anyone) as students, citizens and health professionals can do about them. As someone who does not have a strong background in global public health, I learnt an incredible amount and was really inspired to help bring about the fundamental changes needed in our world. (more…)

Over 500 UK students met in London over the weekend to learn more about Power, Politics, and Global Health. The conference was  organised by the UK medical student organisation, Medsin and as highlighted in today’s blog, it was a very stimulating affair with lots of discussion and debate. And controversy. None more so than this AMAZING talk by Dr Richard Horton, editor of The Lancet. And we are not just saying this because we are biased! Once you have listened to it (it was recorded by current Lancet Student intern, Hannah Barton, who was sitting in the audience so the recording has a real live and ‘unplugged’ sound and feel), you will understand why this speech caused such a stir at the conference. But be prepared. This talk may just change your life!

 

 Medsin conf talk Oct 2008- Richard Horton: Play Now | Play in Popup | Download

Today was the start of the Medsin conference at UCL on global health. Medsin is a UK group for healthcare students campaigning for local and global health. A very big thank you to everyone who submitted essays for the conference booklet. All fifteen of the selected articles are now online and talk about everything from US foreign policy on abortion, to the relationship between medicine and politics, to medical education in Cuba and to the healthcare system in Rwanda. The standard is very high so please take a look at them. Until next week!

We’ve posted a fantastic article today from some students at Cardiff University on how homeless people are treated by the healthcare system. Among other things they highlight how important it is for future healthcare professionals to be aware of the needs of this group. Also, as it’s Friday, we’ve got our new Lancet digest summarising the issue released today. In the blog today we mention some of the recent developments in public health policy on smoking and tobacco use. Finally, it’s the start of the Medsin conference tomorrow so look out for more on that, including the winning articles, over the weekend…   

 Photo courtesy of the Lancet

It’s an issue that is drummed into most of us so consistently it is almost painfully obvious – smoking is bad for you. But despite this and numerous public health campaigns, the fact remains that millions of people around the world use tobacco, in part due to low prices in many countries, lack of awareness of the risks and aggressive marketing. A WHO report on the global tobacco epidemic, released earlier this year, estimates that 1 in 10 adult deaths worldwide are due to tobacco. In the 20^th century, 100 million people died from using tobacco and WHO extrapolate that this could rise to the calamitous figure of 1 billion in the 21^st century if the issue is left unchecked. While tobacco use has been falling in many countries (for instance in the UK after the smoking ban) it remains high in others. In China 60% of men smoke, though interesting only 3% of women do, highlighting the involvement of cultural factors in the epidemic. As a worldwide trend, women in general are less likely to smoke. In a bid to tackle tobacco use there have been a few recent, interesting developments in legislation and policy which we would like to highlight. (more…)

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…)