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IFMSAwas founded in May 1951 and is run by medical students, for medical students, on a non-profit basis. IFMSA is officially recognised as a non-governmental organisation within the United Nations’ system and has official relations with the World Health Organisation. It is the international forum for medical students, and one of the largest student organisations in the world.

is to offer future physicians a comprehensive introduction to global health issues. Through our programs and opportunities, we develop culturally sensitive students of medicine, intent on influencing the transnational inequalities that shape the health of our planet.

ImprintEditors in ChiefLujain Elqodmani, Kwuiet

EditorsRodney de Roché,GrenadaPhilip Chao, New Zeland

Design/LayoutAhmed Badawy, EgyptDiana Tashkova, Bulgharia

ProofreadingDiana Tashkova

PublisherInternational Federation ofMedical Students’ AssociationsGeneral Secretariat:IFMSA c/o WMAB.P. 6301212 Ferney-Voltaire, FrancePhone: +33 450 404 759Fax: +33 450 405 937Email: gs@ifmsa.org

Homepage: www.ifmsa.org

Contactspublications@ifmsa.org

Printed in Indonesia

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SCOPH DirectorDear SCOPHians, Dear IFMSA friends,I am very pleased that we can present you the March Edition of the Morning SCOPHian of 2011. Who do I mean by we? I mean ALL SCOPHians; not only those who directly contributed to this newsletter, but also those who even made it possible for us to write about something: the local SCOPHians, by organizing their projects day by day with such dedication and energy. I have already said this a few times during this term, but you are the real heroes of our Standing Committee. You are the ones that make our Standing Committee what it is and make us so strong. Thank you =).I cannot tell you how proud I am to be able to accompany you through this term as the SCOPH Director. It has been simply AMAZING to work with you. I could not have wished for a better team, than you. We have already achieved great things this year, as you can see in the NPO-Midterm report, which is also distributed during this General Assembly. The Morning SCOPHian has three main aims: 1) to highlight these achievements of ours, 2) to empower SCOPHians to publish their ideas, knowledge and actions on an international level and 3) to open your eyes to new concepts and ideas in Public Health, through articles. Ultimately, SCOPH lives through the ideas and dreams we put into reality each day, through organizing projects (“Think Globally – Act Locally”). So, if this edition of the Morning SCOPHian inspires only one SCOPHian in one NMO to set up a new, sustainable project, it will have been more than worth all the effort put into it. It’s a fascinating thought what effect one good idea can have. You, fellow SCOPHians, do this every single day you work for SCOPH. I can only ask you to keep onto this spirit and continue making your ideas a reality. Every day. On another note: I would like to encourage you to pass the issue you are holding in your hands at the moment to your fellow SCOPHians and IFMSA members in your NMO, when you are back home. As you well know, our resources are very limited, and printings are expensive. This way we can circulate our publications to many members, so not only the participants of our General Assemblies can benefit from these and be part of the SCOPH spirit, but also our dear colleagues and friends who can’t be with us at his meeting. Thank you very much!Enjoy reading!Yours truly,

Christopher Pleyer – Director of the Standing Committee on Public Health 2010 / 11

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Adieu Old SCOPH Logo, Good Morning New Face of SCOPH!

Dear SCOPHians,As many of you might have already read from our discussions on the SCOPH server, the IFMSA is currently undergoing some changes in its corporate identity. Parts of these changes concern the unification of all standing committee logos. In the past, the logos of standing committees looked quite different from eachother. Many of them didn’t even have the same format. Additionally, some standing committees didn’t even have a logo they could use. In an effort to make the face of the IFMSA more professional, National Member Organizations decided to unify the standing committee logos.Within the past months we have been in contact with designers concerning the looks of the new logos. In the end we received several options for each standing committee. We have been presented these options and we have all had the opportunity to vote for one of these logos. SCOPHians all over the world have decided on a logo! This logo

By the end of this General Assembly in Indonesia, we will know if all National Member Organizations also accept this logo and if we will definitely be using it in our federation. However, I am quite confident that this will be the future face of SCOPH.Although this logo might not be as colorful and creative as our old logo, I deeply believe that this change is for the better of SCOPH and the IFMSA. Not only do we have a strong position between standing committees now, but we are deeply anchored within the corporate identity of the IFMSA now. An additional benefit is that the logo is more easily usable for everyone. In the future it will be easier to incorporate our logo into publications, posters, leaflets, banners, etc.At the end I would like to make one more tribute to our old SCOPH logo. It was AMAZING and served us well for years. It will always be part of our SCOPH heritage. - May our new logo be even more successful!Yours,Christopher PleyerDirector of the Standing Committee on Public Health 2010/11

Christopher Pleyer

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SCOPH Exchange ... Let's Get it Started

For 30 days , IFMSA - Egypt Standing Committee On Public Health inviting the motivated students who are pursuing a career in medicine in the field of epidemic diseases to attend a training about Hepatitis Control and Prevention in 3 different cities in Egypt

The course lasts for 60 hours and the last week will be only for the social and cultural activities .

Hepatitis B virus (HBV) infection is a global health problem. About 2 billion people have been infected worldwide; of these 350- 400 million suffer from chronic HBV infection. It was reported that, 15-40% of HBV infected patients would develop cirrhosis, liver failure, or HCC). It is estimated that, 1 million of these will die each year from HBV-associated liver disease. The prevalence of chronic HBV infection varies geographically, from high (>8%), intermediate (2-7%) to low (<2%) prevalenceChronic hepatitis B is an important medical problem in Egypt. The prevalence of HBsAg in Egypt is intermediate (2%-7%)Approximately 170 million people are affected with HCV worldwide, comprising ~3% of the global population, most of whom reside in developing nations and many of whom may be co-infected with HIV and/or HBV and have very limited access to treatment. Even if only 10% of such individuals advanced to cirrhosis, the global burden of this infection is staggering. Egypt has the highest prevalence of HCV infection all over the world, averaging 15%-25% in rural communities.

Both infections can lead to an acute or silent course of liver disease, progressing from liver impairment to cirrhosis and decompensated liver failure or hepatocellular carcinoma (HCC) in a 20-30 year period. In addition, hepatitis B and C infection rates differ in different settings, and prognosis may be worse in conjunction with schistosomiasis in Egypt

Unlike hepatitis B virus (HBV), for which the prospects for controlling the spread of infection by vaccination are promising, prospects for development of an effective vaccine against hepatitis C virus (HCV) are limited. As well as screening of blood for transfusion and using sterile needles for injection, preventive measures should be undertaken to reduce the risk of contact (often described as community-acquired infection). Until more is known about the unidentified routes of transmission in tropical and subtropical settings it will be difficult to be specific about the kind of measures which may be effective. Success may largely depend on changing habits within the population. Prevention should be the main goal of current efforts until low-cost, effective therapies become available.Here in IFMSA Egypt we aim to set priorities in how to prevent and control spreading of infection around the world by delivering a course to medical students who are interested in such casesAfter finishing the course students must be able to obtain from the patient an accurate medical history and perform in a highly skilled manner both general and abdominal examination (Accurate history in case of jaundice to differentiate between hepatitis and other causes of jaundice. Searching for manifestation of acute and chronic hepatitis, manifestations of liver cirrhosis, hepatocellular failure and portal hypertension, Signs of hepatic precoma, signs of Hepatoma )Also , They must be able to communicate effectively with patients and their families through verbal, written, or other means regarding patient›s health and well being and find a way how to set awareness campaigns in their countries that help increasing the knowledge of public about the disease .

Mahmoud SaadIFMSA – Egypt SCOPH Exchange National Coordinator

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Noha ElzaydyIFMSA-EGYPTSSS Cairo

imply Atopic individuals respond to certain harmless environmental antigens”allergens” by producing larger amounts of IgE

than normal individuals. having higher number of Th2 cells which produce IL-4, a cytokine that can increase production of IgE, and a lower number of Th1 cells that produce gammainterferon, a cytokine that decreases IgE production.Then the sequence of reactions happens: Fc portion of IgE binds to the surface of mast cells and basophils. When the allergen cross-links the Fab portions of the mast cell-bound IgE, this triggers histamine release by the mast cell,a process called degranulation, and the synthesis of other inflammatory mediators such as platelet-activating factor, leukotreins, bradykinins, prostaglandins, and cytokines that contribute to inflammation.

Are all reactions to medications or foodsallergies?One must note the difference between food allergies,intolerance and side effects. Allergies are only those which involve interactions with the immune system. Medication and food reactions can also result of side effects or intolerance (such as stomach or intestinal upset) and not an allergy.

«Can you be allergic to vaccines?»The site of a vaccine injection can appear red, itchy orpainful (usually) as a result of skin or muscle irritation or an infection at the injection site.Exceptions to this are vaccines that contain egg proteins.The key to identifying true allergies is to give yourhealth-care provider a precise description of yoursymptoms, including the amount of time between thereaction and the exposure to a specific medication,food or other medical treatment.food or other medical treatment. Used lines of treatment of Allergy are:a.) Prevention: is just as important as treatment, if not more.Treat the symptoms: e.g.: (Epinephrine, Histamine H1-receptor antagonists, Beta2- agonists, Leukotriene receptor antagonists, sodium cromoglycate, Corticosteroids).b.) Desensitization shots: (allergy shots): in severe cases, it appears to suppress production of IgE by inducing tolerance and/or by activating T8-suppressor cells.c.) RhuMab: (recombinant human monoclonal antibody): A new experimental approach which involves giving the person with allergies injections of monoclonal antibodies that have been made against the Fc portion of human IgE.

The Strange Disease

Firstly we have to know the difference betweenhypersensitivity & allergy. Hypersensitivity: is an inappropriate and excessive reactionto an antigen causing tissue damage. There are four categories of Hypersensitivity reactions; i.e., based on the mechanisms involved and time taken for the reaction. Allergy: is Type I hypersensitivity is also known as immediateor anaphylactic hypersensitivity, as The reaction usually takes 15 - 30 minutes from the time of exposure to the antigen, although sometimes it may have a delayed onset (10 - 12 hours).it’s mediated by IgE.

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These agents cause the early phase of allergic reactions that appears within minutes after exposure to the antigen.

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Indonesia and Tobacco : Medical Students Efforts«The future is not something we enter. The future is something we create.» --Leonard I. Sweet

Smoking is a classic problem that has existed for a long time in human history. Smoking is already known to cause a lot of health problems. Although smokers already know that smoking can cause cancer, heart attack, impotence, etc. which are displayed at the end of each advertisement of cigarettes (even if only for a moment), in reality they still smoke. The World Health Organization (WHO) reported that Indonesia is the third biggest smoker in Asia. It reached 146,860,000 people! The research in four cities - Bandung, Padang, Yogyakarta, and Malang - in 2004 showed that the prevalence of 59- year old smokers increased drastically from 0.6% in 1995 to 2.8% in 2004. However, the highest prevalence age group of smokers in Indonesia is 1519- years old. This is because teenagers in Indonesia tend to smoke from high-school age. Ironically the impact of smoking is not just for those who smoke, passive smokers also have to bear this burden. Now passive smoking is increasing every year. Noor Atika Hasanah is one of the victims who died because of passive smoking in Indonesia. She died aged 28 years old because of bronchopneumonia duplex. Tika’s death made people more aware of the dangerous effects of smoking even if you are not a smoker. Trapped in a circle of smokers, passive smokers have a 30% risk of deadly disease, ranging from lungs spots to lungs cancer. From the realities that exist, Indonesian Medical Student Executive Board Association (ISMKI) held activities on

World No Tobacco Day

“Moving Forward through Synergism Act for Better World without Smoke” was the theme that we upheld in 2010 that aimed to reduce morbidity and mortality rates due to active and passive smoking by providing information to the community about the dangers of smoking, and increase comprehensive community health status through increased public awareness of the dangers of smoking.

Forms of activities included:1. Collecting 100 signatures for the support of tobacco prevention.2. Medical students’ long march while distributing anti-smoking pamphlets and stickers and also exchanging a cigarette with a flower or a candy.3. Holding counselling for 1000 high school students who are vulnerable to smoking addiction.Besides those activities, the medical students also tried to make the medical campus become a no smoking campus. With the help and support from Ministry of Health, Ministry of Education, Educational Department, and Indonesian Medical Association, ISMKI had successfully held the projects and activities in more than 25 universities spread throughout Indonesia and brought awareness to our community about the dangers of smoking.But we won’t stop. Annual projects and activities will always be held by ISMKI to increase Indonesia’s health status. Because the policies that the government makes also affect the health status of Indonesia, ISMKI as a medical students board, will not only make projects aimed at the community, but also aimed at the policy made by the government.

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Mental Health Awareness

He was alcoholic, later, he complicated a mental illness, his life was ruined by alcohol and being disrespected from his society even his friends and may be his family too, he got into a mental institution, stayed there for 8 months, rejected from his closest people, long time isn’t it ? But for you to imagine he got out completely cured for you can say a brand new person, yes he made a change he changed his life to the better, after being rehabilitated he worked at the same hospital helping other people to start over, he became one of the rehabilitation team there, yes he was a rule model to follow. He became a part of the cure not a part of the disease .So do you think this one should be rejected or stigmatized?

Stigma is negative judgment based upon lots of misconceptions and fears; it was once a common perception that mental illness is a personal weakness. Facts:• Depression has the largest effect on worsening health compared with the other listed chronic illnesses.• Major depressive disorder is a risk factor in the development of incident coronary heart disease events in healthy patients and for adverse cardiovascular outcomes in patients with established heart disease.• Depression is present in 1 of 5 outpatients with coronary heart disease and in 1 of 3 outpatients with congestive heart failure

• The continued presence of depression after recovery of heart disease increased the risk of death to 17 percent within 6 months after a heart attack (versus 3 percent mortality in heart attack patients who didn‘t have depression). • Depression increases the risk of mortality in people with diabetes by 30 percent. Most of the people around me have this stigma against mentally ill people. They think they are aliens in the society or may be criminals who don›t have the right to live, to socialize or even to have a normal life like most of us do. We don’t give mental health the attention needed and, personally, I don’t know why. I think that we›ve to be more aware about it since it may be as destructive and harmful as any other physical disease.Stigma may lead to these feelings of anger, frustration and loss of self-esteem leading to social discrimination and devastating consequences on the mentally ill patient. Standing from our belief here in Egypt that the mentally ill person is one of our societies we started our national project under the name of “Mental Health Initiative” beginning with TOT presented by the Egyptian Mental health secretariat and then establishing our campaign to raise the mental health

awareness in our communities.And remember that «just because there is no scar on the outside; it doesn’t make it less painful than a real one.

Hassan Osama Abulnour(Tanta Students› Scientific Society)IFMSA - Egypt

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Renal Failure and Healthy HeartHossam Hassan IsmailIFMSA-EGYPTMansoura Students› Scientific Association

New prospective where you can find the link between Renal failure and Heart disease updated by recent papers, researches, and international achievements.

What are the main risk factors for patients with kidney failure?• Enlargement and strain of the left side of the heart (left ventricular hypertrophy)• Smoking• Cholesterol and abnormal lipids• Hyperparathyroidism and abnormal calcium and phosphate metabolism• Calcification of blood vessels, heart valves and heart• Elevated levels of homocysteine (an amino acid in the blood)• Obesity• Inactivity• Fluid overload• Dialysis instability• Arrhythmias• Diabetic nephropathy• Microalbuminuria and proteinuria

What does kidney failure have to do with my heart?

Kidney failure and heart disease are closely associated.This is because having kidney failure creates certain imbalances in the body, which, if untreated or ignored, can affect the health of blood vessels and the heart.These are additional to the standard risks factors for heart disease, which all members of our community face.Having an unhealthy heart will ultimately affect your long term health and enjoyment of life. Heart disease remains the leading cause of disability and death for people on dialysis and for people who have been transplanted.

Can anything be done to prevent heart disease?

Keeping your heart healthy is possible by firstly reducing the standard risk factors for developing heart disease and secondly, by reducing the extra risk factors for heart disease that exist because of kidney failure. This can be achieved by adherence to your prescribed medication, diet, fluid intake and exercise. Such measures should be taken from the earliest stages of kidney failure. This will help to prevent irreversible damage.

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What are the risk factors for heart disease in the general community?

The standard risk factors for cardiovascular disease are:.Smoking• Hypertension• Diabetes mellitus• Abnormalities in lipid profile - total cholesterol and LDL cholesterol• Obesity• Family history of early heart attack e.g. before age 65• Pre-existing arterial disease

Why does early treatment help?

A major aspect of avoiding cardiovascular disease, must first and foremost be to slow progression of renal failure and to eliminate risk factors for cardiovascular disease EARLY in the course of renal failure. When renal failure is well advanced and / or irreversible, then it is vital to reduce all known risk factors and to be committed anddiligent about your care.

What do you mean by commitment?

Renal patients can reduce the risk factors for heart disease. Success will depend upon the commitment of each patient to follow ALL the advice they have been given. This will involve taking medications, following dietary and fluid guidelines, exercising and not smoking.It is often not easy to do all these things but your health really does depend on it. Your health team will work with you to help you maintain a healthy heart. Just follow their advice and ask for all the encouragement you need from them!

So what exactly should I do to avoid heart disease?You can avoid serious heart disease by addressing each of the known risk factors: MEDICATIONS•Blood pressure medication to achieve targetBP of _< 130/85• Phosphate binders and other medications designed to regulate your phosphate and calcium balance•Folic acid in combination with vitamin B12 and vitamin B6 to reduce homocysteine levels• Diet or cholesterol lowering medication aiming for optimum targets of:Total cholesterol < 4.0mmol/LLDL cholesterol < 2.5mmol/LHDL cholesterol > 1.0mmol/L

DIET AND FLUID CONTROL• Follow your diet.Talk with your dietician regularly.• Low salt diet will make fluid restrictions easier to follow.• Tight blood glucose control, if diabetic.• Try very hard not to overload yourself - this increases blood pressure and enlarges and weakens the heart.

QUIT SMOKING• Don›t smoke - under any circumstances! Talk with your doctor about quit programmes.

EXERCISE• Be sure to exercise on a regular basis. Walking, swimming, jogging, tennis, golf, dancing, etc are all suitable. Talk with your doctor about how to startan exercise programme.• Start gently and gradually increase frequency and duration.

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Build up Your Bones

Authors: Malgorzata Lurzynska, Zuzanna Pawlikowska, Aleksandra HerbowskaContact us: npo@ifmsa.pl or kostek@ifmsa.pl

It occurs in any age group, affecting both men and women, rich and poor… Can be a result of a serious accident or just a slip… A bone fracture. Painful, sometimes complicated, a disability... Cannot be always prevented, but what we can do is to lower its incidence, minimize the complications and make the treatment easier. This year, IFMSA-Poland implemented a unique project called “Build up Your Bones”, for the first time in polish SCOPH focusing on the issue of osteoporosis prevention. Through many different activities we are aiming both children and adults. So the target group is quite wide, but so is the methodology.

To reach children and make our efforts the most effective as they can be, we decided to base our project on peer education methods. These include interactive lessons, discussions with children, games. We wish to educate them on the importance of the level of calcium and vitaminum D, suitable diet, sport activities, … - everything that makes their bones stronger. A very important part of the project was creating a project primary mascot whom the children can learn from. This is Kostek – a small bone who is learning in a primary school. While reading a specially prepared by IFMSA-Poland book containing stories and adventures of Kostek and his friends, children can learn together with him how to strengthen their bones. In the book children can also find challenges, quizes, excercises. Moreover there is included a chapter for their parents with information how important the early prophylactic of bone fracture is.Apart from running peer education lessons in primary schools, we want to organize special events in shopping centres, during which children will have the opportunity to meet Kostek, listen to his stories and learn more how to build up their bones. At the same time we will have the opportunity to talk to parents about prevention of osteoporosis and to measure their fracture risk. In order to do it we will use a special method called FRAX, which is possible thanks to our collaboration with Polish Osteoarthrology Society.

How to reach the target group? Childhood – the peak bone producing years - is the best time to educate children on building strong bones. Several lifestyle factors particularly nutrition, physical activity and sun exposure can substantially influence the gain of bone mass during childhood and adolescence. Developing good dietary and exercise habits will help children to have strong, healthy bones throughout their lives. Inversely, poor diet and lack of exercise, especially between age 1018- years, can result in weaker bones in adulthood.

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Moreover in the near future we wish to organize a special celebrations of the International Osteoporosis Day (20th October), where the educational event and nordic-walking will take place. What can you do? By joining the project “Build up Your Bones” you can help children to be more aware of the risk factors of bone fracture and to introduce good habits in their lives. Together, we can organize one of the biggest events in SCOPH - International Osteoporosis Day celebrations! This action can integrate IFMSA members. So let›s act for the idea!!! Let`s give it a try!!!

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BEING A TEDDY DOCTOR

In European Capital of Culture 2010, meaning Istanbul, we’ve captured the chance to get involved in the greatest Teddy Bear Hospital organization of Turkish Medical Students’ International Committee. It was held in April,2010 with participation of Cerrahpasa Faculty of Medicine, Istanbul Faculty of Medicine, Marmara Faculty of Medicine and Yeditepe Faculty of Medicine.

There were 30 attendants from Istanbul Faculty of Medicine. I was one of them and also the conductor of them. Likewise me, most of the attendants were from 1st Grade. It’s beacuse the excitement of starting medical faculty forces them to do something and their loose academic schedule makes it easy for them. Cerrahpasa was the leading faculty, so all the medical students who volunteered for Teddy Bear Hospital gathered there for briefing on the 19th of April. In the briefing, we are told how to approach a child. Five or six year-old children would bring their sick teddy bears and the medical students who pretend to be Teddy Doctors would examine the teddy bears. The Teddy Doctors was going to perform some medical procedures such as taking medical history, listening with stethoscope, using tongue spatula and writing prescription in the examination.

On the 20th of April, we went to the elementary school which was arranged for the meeting of children and Teddy Doctors. Wearing a white coat, carrying a stethoscope around the neck, having a Teddy Doctor ID card over the upper chest, putting a big smile on the face: We were ready to help the children overcome their fear of doctors. At first, the children hesitated, but then they quickly got used to us and we had a lot of fun together.

The curiosity of the amused kids and the joy of the helpful Teddy Doctors has provided the SCOPH of TurkMSIC a strong will to organize new Teddy Bear Hospitals and improve this project. Maybe, we might organize an international Teddy Bear Hospital someday. Who knows?

Selin ARSLANStudent from 2nd GradeIstanbul Faculty of Medicine of Istanbul University

It was very fundamental to collaborating with the children on the procedures. When the procedure finished, each child would be given a pretend doctor set so that they can play doctor any time, any where. Thus, children would understand that visiting the doctor was not something to be afraid of.

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DREAMS COME TRUE…

Before november, we began to work about world diabetes day. We looked for sponsors for our activies. We had big dreams, but no one believed us. Our dream is to make one of the most well attended diabetes research in Türkiye. After a difficult process, we found a sponsor. After that, all our SCOPH family became more motivated.

And we began to plan our national activities. The first goal; to increase public awareness. We thought the best way to achive it. Finally we decided that the best way is measuring blood sugar. In this way, we would pick up a lot of data. But blood sugar is not enough to make a research. So we prepare a survey which include age, weight, height, business, education and eighteen yes/no questions about diabetes. These questions related to awareness of diabetes. e.g “ Polyuria is a symptom of diabetes--- Yes/no” After a long preparation, it’s time getting started. Exactly in seventeen cities, but we made activities a few times in some cities.( İstanbul, İzmir, Ankara, Antalya...)

We could measure the blood sugar of only 10,000 people but we informed much more people. If we had more materials; we could have measured blood sugar more and more people. One of the most important gain is having about 400 new volunteers from all around Türkiye. Now, we can think bigger. Because i have seen what we can do. But first of all, we have to analyze datas of 10,000 people. As you guess, it’s quite hard. But we will do our best.

Metin YeşiltepeTurkMSIC National Public Health Officer

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World diabetes day (WDD) is a campaign led by the International Diabetes Federation (IDF),celebrated annually on the14 of November in almost all countries worldwide. This year many SCOPHians played a huge part in organising a successful WDD within their NMOs in increasing awareness and measuring glucose levels and other parameters. We have received 13 reports this year from:Egypt ,Argentina, Brazil, Ecuador, El Salvador, Indonesia, Taiwan, Tanzania,, Kingdom of Saudi Arabia, Catalonia, Greece, Malta, Italy.IFMSA CELEBRATED WORLD DIABETES DAY THIS YEAR AS WELL!! 2

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Go Green, Be Green, Feel Green

I’m sure that all of you have already heard about what’s happening in our environment and what actions must take place to protect it. However, the question is: Do we really know the current status of our Mother Earth and what is happening to it!To be honest, I have always considered myself as a “green” member in society. I try to recycle all my papers, to increase awareness of and encourage carpooling with my friends, but I never realized how much we are destroying our earth!Well, on one of those days when you get back home after a long day at hospital and you just want to relax and watch TV, I was flipping through TV channels and I saw Al Gore (a famous environmental activist). I have heard about him before and his famous book/film “An Inconvenient Truth” that won the Grammy award for the Best Spoken Word Album. So I thought let me check it out and see what it is all about. Basically, he is educating people about global warming.

I’m not trying to advertise for his book/film or ask you people to buy it; it’s just that I want to share with you why I was so shocked about what’s happening on earth. During his talk, he showed some current pictures of many places worldwide comparing them with pictures taken 30 or 40 years ago. You definitely can notice the difference! 40

years ago there was snow covering mountains, now the mountains are “naked” and much much more examples were mentioned that may shock you. When you are free, just done with exams or with your hectic work with IFMSA, take a look at that movie and I’m sure you would want to MAKE A DIFFERENCE!

Lovely SCOPHians, of course as we all know that Earth Day is coming up on 22nd of April. I believe it has the same importance as other world days, if not more. Why an earth day? “Earth Day Network was founded on the premise that all people, regardless of race, gender, income, or geography, have a moral right to a healthy, sustainable environment.” So what’s the point of focusing on main diseases and morbidities when the environment itself, that our community, family, friends, future generation live in, is sick and needs treatment. I’m not underestimating the impact of morbidities and the need of action but we should never ignore the fact that our earth needs us!

So, get ready for Earth Day! Well, not just Earth Day EVERYDAY! Simple actions do matter! Carpool with your friend, use your bicycle today instead of your car, close the lights before going out, use less papers, recycle the things that you have, have separate containers for plastic, glass and papers, talk to families and friends about it and how much they can do and help!We as SCOPHians with great spirit and amazing potential, can make a difference! So Lets start, with our Mother Earth!

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Lujain Al-QodmaniSCOPH Regional assistant for EMR

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Stigma is a very real problem for people who have a mental illness. Based on stereotypes, stigma is a negative judgment based on a personal trait - in this case, having a mental health condition. It was once a common perception that having a mental illness was due to some kind of personal weakness. We now know that mental health disorders have a biological basis and can be treated like any other health condition. Even so, we still have a long way to go to overcome the many misconceptions, fears and biases people have about mental health, and the stigma these attitudes create. Stigma may be obvious and direct, such as someone making a negative remark about their mental health condition or treatment. Or it can be subtle, such as someone assuming they could be violent or dangerous because they have a mental health condition. These and other forms of stigma can lead to feelings of anger, frustration, shame and low self-esteem, as well as discrimination at work, school and in other areas of their life. For someone with a mental illness, the consequences of stigma can be devastating. Some of the harmful effects of stigma include: • Trying to pretend nothing is wrong• Refusal to seek treatment• Rejection by family and friends• Work problems or discrimination• Difficulty finding housing• Being subjected to physical violence or harassment

Omar M. Abdel-KareemIFMSA Egypt NPOOmar_smsa@yahoo.com

And more other effects that may be harmful not only to the mentally-ill people, but to the whole society as well.So we should not stigmatize them and try to isolate them away from the society. On the contrary, we should talk to them explaining the nature of the disorder they have, suggest them to see a professional and express our willingness to help and support.

The ‹Biking Depression Away› was a positive step taken by active IFMSA Egypt SCOPHians in the track of overcoming the stigma of mental illness in Egypt. They have the right to have a lovely life in their families,They have the same rights of all people in their countries,They have the right to liveWe chose the depression as one of the most common mental health disorders to be the theme of the World Mental Health Day celebration 10th of Oct. 2010 when more than 250 medical students from all over Egypt took their bikes in a circular tour around the city of Cairo - wearing the t-shirts of the event and holding banners to attract public›s attention - trying to deliver our message to all people that the mental illness is like any physical illness and the people living with mental illnesses have the same rights as people living with physical illnesses in being treated, rehabilitated to get involved and being accepted from the society.They have the right to not being discriminated in any place

Biking Depression Away

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Why am I SCOPHian ?

It’s nearly 3 years passed away and I started to ask my self why I am SCOPHian?Why keep going on SCOPH? Is it magic? Or I am drunk or or or !!!!!I tried to find brief answer to this question?But how can I sum up Great SCOPH? I will not be fair if I did that I must write pages and books about SCOPH!

Story of SCOPH with me!I was just ordinary medical student in 1st year of his study, I went to college and came back; May study! May go out! May waste a lot of time!!!!And nearly before world diabetes day celebration with few days a friend asked me if I like to join?

At start I said it’s ok for me but where? She replied in Cairo in Cultural place Called Sakyet Elsawi, at this time I didn’t knew much about MSSA my LC and what was all this about and who were these people??I went Cairo to celebrate WDD and I consider it “My turn point in my life up till now “ I see how we started from zero with just balloons and some charts and brochures And make A great day really it was! . I knew how much medical information people Knew? And how really they need to know?!! I also gained Great experience from this day. Then I came back home after amazing day From it’s start to it’s end!

Time passed away! I didn’t feel it I gained enough experience during this year to represent my LC in every SCOPH event . Next year I became LPO ( local public health Officer ) . New world in my world, I learnt how to be in charge of big responsibilities to represent my University in a good way . I started to gather a team really big one ;Organize campaigns, Finish National Projects; create new local projects and share in international ones. Now I am in IFMSA SCOPH publication Team, Next year; who knows where I will be?SCOPH learn me how to be Cooperative, leader, responsible, organized, active Look forward the future, creative and I can’t count the rest!! I just feel it !After this short story ,really I sum up as much as I could and every SCOPHian know If I wrote every thing I will fill the whole magazine!

Now, you should know Why I am still SCOPHian and I will keep going in SCOPH for The 4 years remaining in my study!! You think this is the end??? Simply I am in love with SCOPH and SCOPHians

Ahmed Badawy RashadMSSA Menofia LPO IFMSA-Egypt

The next day I went college very active need to know more about this great work?My first task was to get a design for a brochure!!! At this time really all I knew about Photoshop its tools but I wasn’t good enough so I went to a friend and sit beside him While making the brochure!! From this

time I started to get interested in Photoshop And such programs, I started to go GAs and attend SCOPH session and I meet Lifetime friends and I consider

them my family. Really I can’t express how great to have friends in every governorate of my country !

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Public HealthA Science and an Art

What is Public Health? Well, when I wanted that question answered, I asked Google and he took me to the site www.whatispublichealth.org. The site defines public health as, “the science and art of

protecting and improving the health of communities through education, promotion of healthy lifestyles, and research for disease and in injury prevention”. What is interesting is the site’s use of the word “art” in its definition. Then there is a definition by Charles-Edward Armory Winslow who defined Public Health, in 1920, to be “the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals». Even in Winslow’s definition the word ‘art’ is used and I began to wonder as to why Public Health is even considered an art.

Well let’s see how one can define the word art? It can be safe to define it as the product of human creativity. Or maybe, the expression of the innovations of a people in the form that is a deliberate arrangement of elements, so as to affect the senses or evoke emotions. Public Health encompasses a diverse range of human creations, that take the form of activities and modes of expression; for example, the way we use songs in primordial education to teach kids to brush their teeth, pictures that are so vivid that persons stop to think about their actions and the actions of others and how it affects one’s health status, the way we use film and literature to tell a story and what we can do to change our world. So yes, Public Health is an art.

In today’s world, let’s admit it; there is a lot of mess to clean up. Actually, the mess is piling up into large heaps. There are a lot of social behaviors that are, or are yet to be seen, as an endangerment to the lives of others and to those that commit them. For instance, in some countries in the world smoking has remained

a big problem. People smoke no matter what anti-smoking campaign is created. Diabetes is on the rise and people still consume unhealthy foods. Coronary heart disease is still killing millions while Malaria and tuberculosis is still in existence. Neonatal infections are still taking lives of the unborn in the world. Of course, let us not forget HIV/AIDS and her gang of friends called “STI’s and STD’s”. The quality of life of people all over the world is being affected in so many ways. When will it stop? Would it ever stop? I think we are yet to rediscover the art in Public Health and become more aggressive in bringing about the social change needed.

In our world the old and traditional techniques to break bad social habits have reached their plateau. They are not going to work in the future if they clearly are not working now. We need to return to the drawing board with the realization that Public Health is still an art as much as it is a science. Once we recognize the power of this art, we can begin to facilitate the production of innovations. We can only facilitate this process through much motivation. Eventually we will begin to see an auto-aggressive take on changing our world again. Public Health is an art.To conclude I would like to share with you my definition of Public Health. To me Public Health is a way of using the innovations of the people in various deliberate forms of art mixed with science to contribute to social change.Oh and by the way, don’t forget the part where we have fun doing stuff

Rodney de RochéNational Public Health Officer (IFMSA-Grenada)

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Global Climate Change and Human Health

The Australian Greenhouse Office of the Australian Department of Environment and Heritage (2005) reported «most climate models indicate that in many places global warming is likely to increase the frequency and duration of extreme events such as heavy rains, droughts, and floods» (p.1). The Intergovernmental Panel on Climate Change (IPCC) has noted that there has already been evidence of increases in the intensity or frequency of some of these extreme events throughout the 20th century (IPPC, 2001a). The United Nations University Institute for Environment and Health Security (UNU-EHS) has reported that the impact of extreme weather events around the globe has already created million’s of environmental refugees (UNU-EHS, 2007). These refugees have been displaced from their homes and countries due to sudden extreme weather events and slower environmental shifts such as an increase in desert area, diminishing water supplies, and rising sea levels. There is mounting evidence that global climate change is already affecting human health through extreme weather events, changes in air and water quality, and changes in the ecology of infectious diseases (Patz, Epstein, Burke, & Balbus, 1996; Stott, Stone, & Allen, 2004). Extreme weather events, such as extremely hot weather, increase the death rates of the elderly and the very young. In 2003, Europe experienced its hottest summer in centuries, with temperatures averaging 3.5º Celsius above normal (Luterbachter, Dietrich, Xoplaki, Goosjean, & Wanner, 2004). Over 22,000 individuals throughout Europe died during or directly after the summer heat wave of 2003 (Kosatsky, 2005). In July of 1995, hundreds of Chicago residents died as a result of a heat wave that reached 106º F, with a heat index of over 120º F (Centers for Disease Control and Prevention, 1995). However, in the 1999 Chicago heat wave, there were fewer deaths. This decrease in deaths may be attributed to lessons learned in 1995 (Naughton et al., 2002). In the summer of 2005, the US experienced first-hand the impact of another extreme weather event

when Hurricane Katrina made landfall near New Orleans, Louisiana.Katrina was one of the deadliest hurricanes in U.S. history. In Louisiana alone 1,464 people lost their lives and over 135

are still missing (Louisiana Department of Health and Hospitals, 2006). Although it may not be possible to correlate individual weather events to climate change, the catastrophic events described above illustrate the challenge of mounting an effective public health response to such destructive weather events. During the New Orleans storm, for example, thousands of individuals and families were displaced and crowded into shelters; floodwaters were contaminated with sewage; and there was a lack of food and potable water which created concerns about the possibility of a communicable disease outbreak. The National Environmental Trust (2006) warned of additional concerns about exposure to the toxic stew of 600 million pounds of toxic chemicals released to floodwaters when chemical plants, petroleum refineries, and petroleum bulk storage facilities were destroyed in the flood. Longstreth (2001) studied the special vulnerabilities of certain populations to the effects of climate change. Children are especially vulnerable since they may not have fully developed immune or heat-regulatory systems, because they breathe more air per pound than adults, and because they are more likely to play outside. The elderly are also at risk from extreme weather events which may result in falls, especially during evacuations; and they are more vulnerable to heat-related illness. Chronically ill people, such as persons with pre-existing heart or lung conditions, are at risk of illness or death from heat and air pollution.Immuno-compromised individuals are at higher risk of infectious diseases spread by contaminated food or water. The urban poor are also vulnerable because urban environments trap heat. Many of the urban poor may not have access to air conditioning or to cooled public spaces; nor may they have the resources to be able to seek early or preventative health care.

Ahmed TarekMSSA Menofia President IFMSA-EGYPT

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Food and HealthDiana Tashkova, SCORP Regional Assistant for Europe

The liaison between nutritional habits and health is indubitable. Half of the worlds’ nutrition problems are results of under-nutrition and nutrient insufficiency. Suffering from micro-nutrients, essential vitamins and minerals or just the lack of food brings about 25,000 people to death, according to the United Nations.

What a paradox that the other half is related to energy over-nutrition and imbalanced diets. What about the poor and children who are the most vulnerable? They have limited choices about the food they eat and the environments in which they live. It is not exceptional to find under-nutrition and obesity existing side-by-side in the same country, community and the same household.There is long- lasting tendency of consumption of unhealthy food with high content of fat, sugar or salt that are low in nutritional value. There is inappropriate pre-natal,infant and young child nutrition that influences the health. There are factors such as the television advertising, internet , social media sites that stimulate comsummation of caloric, delicious and absolutely unhealthy food.What is more, people have to manage it in this stressful daily life and the thoughts of well-being are on second plan. When it comes to physical activity people are too tired or it is not the right moment and it is a reason for the scary number of 43 million

pre-school children worldwide who are obese or overweight.

The European Commission›s Health and Consumer General Directorate states that cholesterol, Body Mass Index, inadequate fruit and vegetable intake and physical inactivity are four of the biggest risk factors for premature death in Europe. What can happen to us in this case?* Cardiovascular disease - heart disease, stroke,etc.* Diabetes.* Cancers-endometrial, breast,colon.* Musculoskeletal disorders –osteoarthritis.

Or we can be responsible and prevent them by:* Increasing consummation of fruits and vegetables, as well as legumes, whole grains and nuts.* Increasing physical activity - at least 30 minutes of regular, moderate-intensity activity on most days. For children it is preferable at least twice a week, this should include activities to improve bone health, muscle strength and flexibility.* Decrease the energy intake from total fats and shift fat consumption away from saturated fats to unsaturated fats.* Consuming moderate amounts of fat and oils.* Using less salt and sugar.References: www.who.intwww.unesco.org

ISSUE 4 MM 2011

SCOPH Publication Team

Ahmed Badawy Rashad Menofia Srudents' Scentific AssociationIFMSA-EGYPTLPO 2009/2011Email : ahmed.badawi@med.menofia.edu.egMobile : +201521377721 / 20183535966Website : www.mssa-mnf.org

Diana TashkovaSCORP Regional Assistant for Europe 2010/2011International Coordinator of Smile X Project 2011Association of Medical Students in Bulgaria (AMSB)www.amsb.orgmobile: +359887577044Email: dianatashkova@yahoo.com

Rodney de RochéEditor,IFMSA SCOPH Publication Team;2010-2011 Vice President-Internal (IFMSA-Grenada), 2009-2010, 2010-2011National Public Health Officer (IFMSA-Grenada),2010-2011 Tel: (868) 495-4336 (473) 410-0096

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Lujain Al-QodmaniNational Public Health Officer - KuMSA 2008-2009, 2009-2010National professional and research exchange officer 2010-2011SCOPH Regional Assistant (EMR), 2010-2011Developmental Assistant: Web site and Newsletter Director 2008-2009, 2009-2010Eastern Mediterranean Region (EMR)Email1: kumsa.neo@gmail.comEmail2: lujainalq@yahoo.comMobile: (+965)97913938

Phillip Pinhao ChaoEditor, IFMSA-SCOPH Publications Team 2010-2011New Zealand Medical Students› Association (NZMSA) ExecutiveTel: +64 21 892 421Email: pcha159@auckaldnuni.ac.nzSkype: phillipchaonz

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