Vector Issue 5 - 2007

spreading the challenge of addressing international health issues
indigenous health issues — real people and real lives at risk
issue 5
october 2007
1 editorial
by nicola sandler & cara fox
1 reflections on six months
in alice springs
by bae corlette
2 close the gap
by tom crowhurst &
michael cilento
2-3 story of jonathan
humphries
by kia alizadeh
3 john flynn scholarship
by justin sherwin
3 reflections on dwc ‘07
by alp atik & ming chen
4 ifmsa aug ‘07 ga report
by anthea lindquist
4 news review
by kong
5 global health quiz
by kong
5 prizes for prose comp
Photo © Charlie Lawrence, www.sxc.hu
e d i t o r i a l
We’ve all heard the statistics. The Indigenous
people have a lower life expectancy,
less access to health care, and prevalence
of diabetes and cardiovascular disease.
Indigenous health has been shown to be
worse than some of the third world nations.
But what does this all mean to us as
medical students? And what can we really
do to help? As many of you know, these
are not just statistics. They are not just
numbers and facts, but they are real people
and real people’s lives at risk.
This edition of Vector focuses on
Indigenous health, where we have heard
a lot of great things about what medical
reflections on six
months in alice springs
—a unique 3rd year experience
Alice Springs is an unusual place and the
population here is very transient. It is
a service town whose number one industry
is health and social services, followed by
tourism as perhaps a close second.
The gravity of health and social services
need on the ground is almost impossible
to overlook. Although sadly, ‘almost’
is the operative word. Not less than six
weeks after I arrived here it struck me that
in the course of daily work I hadn’t managed
to engage with the indigenous community
– who make up the vast majority
of our patients – at all. Despite spending
my time between the Central Australian
Aboriginal Congress, the Alice Springs
Hospital and remote community clinical
visits, the opportunity for conversation
remained amongst the staffing realm only.
And what’s more, conversations proved to
be unceasingly about the great dilemma of
patient behaviour frustrating their health
outcomes. We are endlessly inquisitive on
our short-term visits, which is probably a
good thing, but might also serve to perpetuate
this dissonance if we don’t stop
to catch ourselves from jumping on board
and blaming patients before we’ve even
had a chance to know them. Bridging this
dissonance means somehow finding time
that we don’t have to spend with patients
in a setting where dominance is in equal
balance between us.
So am I saying that we must have a deep
appreciation for the socio-cultural context
of all our patients’ before we can work effectively
with any of them? I don’t know,
maybe that’s not feasible in practice. But
surely as a student it is the time to explore
students are doing around the country to
help raise awareness, and to help to try
and make this situation better. Some have
raised money in their hometowns, and
some have gone into the Indigenous communities,
and gotten to know the people
first hand. Each of these stories signifies
a step forward, and each signifies an effort
to make a change.
As this was our first issue as the new
co-editors, we found it an imperative issue
to start on, and one that could not be more
relevant. We hope that this too inspires you
to action, and at the very least, gives you a
good idea of what is really going on.
by nicola sandler &
cara fox, editors of vector
that alternative rather than simply learning
how to deal with a presumed problem.
True, we are pressed for time to learn our
basic syllabus, but really what’s the worth
of all our medical knowledge without the
humanity to apply it?
The perennial theme I hear is one of
feeling helpless in the setting of such immense
problems that are too big to be addressed
by medical care. And can anyone
really dispute that the determinants of
indigenous ill health go well beyond the
confines of the clinical setting? Equally,
can we hope to have any impact in indigenous
health if we choose to accept that our
role is unrelated to the determinants of ill
health? The rational conclusion from this
line of argument can only be to move away
from medicine or from indigenous health
all together, in which case was there really
anything to gain from a stint in a place like
Alice Springs to start with? Could this disillusionment
with indigenous health somewhat
underlie the recent surge in interest
in global health amongst medical students
nationally?
The truth is that without efforts to
engage with local people in the community,
the opportunity for greater insight
into working with indigenous people can
be lost. While it is the curriculum of third
year medicine that will help to pass exams
(wherever you learn it), it is the experiences
with people in the community will help to
become a doctor. I hope that I never forget
that.
by bae corlette,
flinders university

indigenous health issues — real people and real lives at risk
close the gap
fundraiser report
On Wednesday, 22nd August 2007, fifteen
second year MBBS students from the
University of Adelaide conducted a fundraiser
in support of the Oxfam “Close the Gap”
campaign - which endeavours to reduce
the shocking inequality in life expectancy
currently existing between Indigenous and
non-Indigenous Australians.
The fundraiser had two aims:
1. To raise student awareness of the
inequality in life expectancy, and general
health, that Indigenous Australians currently
suffer; associated with this was the goal to
raise awareness of, and support for, the
Oxfam “Close the Gap” campaign
2. To raise funds to donate to the
Oxfam “Close the Gap” campaign
This event took the form of a barbeque,
located outside the School of Medicine.
Thanks to the help of Jenni Caruso, from
the Indigenous Health Unit, this turned out
to be a highly successful event, where:
• Students, staff, and passers-by were able
to choose from a delicious range of
lunchtime selections, including halal and
vegetarian options.
• A PA system was organised, through
which a pair of Indigenous artists
performed two fantastic sets of
Indigenous music featuring a wellbalanced
contemporary influence.
• A large canvas was sourced, on which the
“Close the Gap” slogan was dot-painted
by students as they ate their lunch: this
piece will soon be hung in the University
of Adelaide Medical School as a lasting
tribute to the “Close the Gap” campaign
and the event itself.
• Aboriginal and Torres-Strait
Islander flags were hung from
the wall of the Medical School
for the afternoon, and;
• Oxfam “Close the Gap” posters,
stickers and pamphlets were to
be seen everywhere.
Aboriginal and Torres Strait Islanders have a life
expectancy 17 years less than other Australians.
The fundraiser successfully
achieved its two primary aims. By
the end of the afternoon, over
200 students and staff had signed
the petition pledging their support
for the Oxfam “Close the Gap”
campaign and a great deal of
Oxfam “Close the Gap” pamphlets
and stickers were handed out
– it is hoped that these items will
raise awareness for the cause. The
“Close the Gap” dot-painting, will
be hung in the medical school,
where it shall serve in the years to
come as a poignant reminder of the
health inequality that Indigenous
Australians currently face. Thanks to
the huge amount of support offered
by University of Adelaide staff and
students, the event also managed
to raise $663.20 for the Oxfam
“Close the Gap campaign - and it
was raised in just one afternoon by
a few medical students. Let’s help
close the gap.
tom crowhurst
& michael cilento
university of adelaide
Close the gap: The fi nal touches are added.
Music: Two fantastic sets of indigenous music added
another dimension to the day.
BBQ: The fi nal sausages are sold to conclude an
overwhelmingly successful day.
page 2
met Jonathan Humphries in the town of
I Kellerberrin, WA. It was a meeting by
coincidence, yet he insisted that I afford
him the time to listen to his story, record
the interview and pass it on to as many as
I can.
Jonathan begins his tale by citing the story
of his grandfather, who was born in 1910
in Beverly, only two years prior to when the
local post office was built in Kellerberrin.
He tells me the sad story of a man who was
practically forced to help clear the sacred
land around Kellerberrin – ready for seeding
and harvest. Jonathan claims this legacy of
agriculture as only one of the factors which
the story of
jonathan humphries
to this day prevents him from passing on
practical and traditional aboriginal knowledge
to younger generations; “I want to teach the
kids the traditional way, the traditional way
to hunt, to cook – but what was always a
black man’s property is now a white man’s
property”. He recalls the plight of his mother
and grandmother, who although would work
in the town during the daytime – would
retreat to the outskirts as soon as curfew
came around each evening. The time before
1967 (when aboriginal suffrage is granted) is
remembered for racism and injustice.
Jonathan stumbles through his story
– He says that he is a qualified welder and
slaughterman – with traditional aboriginal
skills in tracking. He is angry and frustrated,
and blames prejudice for his unemployment
“…they think we don’t know how to work”.
According to Jonathan his unemployment is
continued on page 3
the cause of his alcohol and substance abuse,
but the effects are self proliferating. At only
thirty-eight years of age, Jonathan looks
more like a man in his mid-fifties. He lives
within a family structure where everything is
owned and shared by all – even alcohol and
cigarettes are shared – a ‘kind’ gesture which
only diffuses and replicates his problem with
other younger family members.
For three hours I sit and listen. I fight
my own prejudices as I hear a meandering
account of misery and despondency – a story
that could leave anyone wondering where to
start helping and how to provide that help.
Jonathan bemoans the fate of his
people. He is an appeal not only to the
health professions but to all Australians to
acknowledge this situation – to become aware
of the wider picture of rural and remote
indigenous help, before embarking on an

continued from page 2
Friends
effort to contribute to a resolution.
No amount of learning regarding this
challenge is wasted. An understanding of
the history and customs of the Noonghar,
Wongi and Yamatji people for instance, could
assist a student of medicine hoping to be a
partner in healing.
Professions like medicine, nursing and
most allied health for that matter can be at the
forefront of the paradigm shift of thinking
required in this country.
The encounter leaves me embarrassed;
that for so long I have been part of the
neglectful majority. Before Jonathan and I
part ways we shake hands – he reminds me
that to progress we need to “be as one, live
as one people”.
by kia alizadeh,
1st year medical student
notre dame, fremantle
page 3
the john
f l y n n
scholarship
—a reflection of
my placement on
norfolk island
reflections on
developing world conference 2007
Photo © Dorothy Williams, www.sxc.hu
My placement took on more of a
community flavour on this occasion.
I undertook many different activities
aside from regular hospital duties. These
included assisting the doctor with a talk he
gave to members of a service club about
prostate cancer, as well as join him on his
weekly community radio segment. Items
discussed included fitness, nutrition and
mental health. I felt comfortable interacting
with the community because of my past
experience in the same setting. Memorable
moments from a social perspective included
attended the hospital’s staff Christmas party,
participating in a community triathlon,
as well as hiking with fellow medical
students.
My mentor provided me with a valuable
insight into being an efficient and successful
medical practitioner as well as an insight into
the role of a rural doctor. Because of the
need to cover basic surgical, anaesthetic and
obstetric services, doctors here are multiskilled,
and need to be able to hold up one
end of the operating table!
Overall, the experience has been
enriching, allowing a fantastic insight into
healthcare in a rural and remote community.
On further visits, I envisage improving my
diagnostic and treatment skills, as well as
continuing to build my relationship with the
community; all form the basic objectives of
the John Flynn experience.
by justin sherwin,
m o n a s h u n i v e r s i t y
Adelaide certainly delivered a fantastic
DWC. Whether it be the free ‘fairtrade
coffee’ given to all attendees in their
conference bags (something that was
certainly required throughout conference)
to the myriad of amazing speakers who
enlightened us with their knowledge
and experience, this year’s DWC was a
resounding success. We also saw the first
time a conference book was handed out to
delegates – a mammoth compilation with
contributions from students and doctors
around the world. Congratulations to all the
organisers – AMSA Global and the DWC
certainly have made massive progress.
b y a l p a t i k
ghn representative
university of newcastle
from Australia and New
Zealand re-unite!
Adelaide was the proud host of Bond’s
first DWC delegates. DWC provided us
with an understanding of just about every
discipline involved in improving global
health through not only excellent speakers,
debates and case studies, but also a brilliant
multi-cultural social program every night.
It was also an excellent opportunity to
meet students interested in global health
throughout Australia and New Zealand.
We were able to share ideas and learn more
about management through the IFMSA
training workshops.
We look forward to seeing a learning
more at next year’s GHC!
Reading the conference
book
Dressing up and being ‘south east Asian’ at the dinner of nations
b y m i n g c h e n
ghn representative
b o n d u n i v e r s i t y
Using the wooden
cutlery at dinner
indigenous health issues — real people and real lives at risk
Lending a Hand: the Aid Issue

indigenous health issues — real people and real lives at risk
ifmsa august 2007 ga report
Over the past decade, the growing
force of globalisation has facilitated
the unveiling of vast inequities in our
global community. Heralded in part by
the establishment of the United Nation’s
Millennium Development Goals in 1999,
these inequities have started to gain greater
recognition by people around the world
and we have witnessed rising pressure on
governments of developed nations for
increased commitments to foreign aid and
support and worldwide campaigning for
universal improvements in human rights
and quality of life. Despite these efforts,
the state of health of many communities
around the world remains as unacceptable
as ever before.
The responsibility of ensuring that
existing global health needs are adequately
addressed is one shared by governments and
societies worldwide, but especially falls into
the hands of health professionals, including
current doctors and training medical
students. The International Federation of
Medical Students Association (IFMSA)
recognises this responsibility and for the
past 56 years, has hosted a biannual General
Assembly in a collaborative effort to improve
the understanding of, and response towards
global health issues amongst medical
students around the world.
In August this year, the IFMSA GA
was held in Canterbury, England, and
championed the theme ‘Access to Essential
Medicines’. Approximately 1000 medical
students from over 100 different countries
participated in a week-long programme
of seminars, workshops, formal meetings
and a string of memorable social events!
Morning sessions provided an opportunity
for Standing Committee’s of the IFMSA
to meet and share knowledge, project ideas
and enthusiasm. The 16-strong Australian
delegation was dispersed amongst the
Standing Committees that included Public
Health, Human Rights and Peace, Medical
Education, Reproductive Health and AIDS,
Professional Exchange and Research
Exchange. We were all inspired by the work
of medical students in different countries
and gathered a range of exciting ideas for
projects that can be adapted to an Australian
or Asia-Pacific context.
The complex issues relating to ‘Access to
If you have any questions, please feel free to access the IFMSA website
or contact us:
Website: www.ifmsa.org
Email: aclin123@gmail.com or jakeparker@hotmail.com
Essential Medicines’ (AEM), one of Medecins
Sans Frontieres strongest campaigns,
were explored through a pharmaceutical
debate and various small group sessions
hosted by prominent members of the
‘AEM’ campaign. Delegates learnt some
important truths about the negative impact
that unreliable funding, complex logistical
challenges and patents enforced through
global trade agreements has on the equitable
access to essential medicines throughout the
world. We were also given an insight into the
steps that need to be taken by governments,
doctors, allied health workers and medical
students to ensure positive changes are
galvanised in the near future.
The IFMSA GA provided an invaluable
opportunity to meet motivated colleagues
from around the world and be inspired
by their stories and their achievements.
Furthermore, the GA offered an important
reminder of the responsibility of all medical
students to strive towards improving existing
global health inequities and to enthuse
our fellow medical students to share this
commitment.
anthea lindquist
monash university
& jake parker
university of queensland
n e w s r e v i e w
page 4
Photo © Jonathan Hillis,
www.sxc.hu
Photo © Aram Dulyan,
www.wikipedia.org
saving the babies: a victory in africa
Botswana achieves a low mother-to-infant HIV
(MI-HIV) transmission rate of 4% this year, as
compare to the 12% global transmission rate.
Hailed as an “extremely impressive results”,
its efforts in reducing MI-HIV transmission
are cited as model to other African countries
with high HIV burden. To find out more, visit:
http://www.boston.com/news/globe/health_
science/articles/2007/08/27/saving_the_babies_a_victory_in_africa
world facing “arsenic timebomb”
BBC reported that about 140 million people,
mainly in developing countries, are being
poisoned by arsenic in their drinking water. With
a higher rate of developing cancer, long term
consumption arsenic is precipitating a global
“arsenic time bomb”, mainly affecting countries
with the least ability to respond. The full story
at: http://news.bbc.co.uk/go/em/fr/-/2/hi/
science/nature/6968574.stm
south asia floods
Diseases, deaths, devastation and destitution plague millions of South
Asian Flood victims since the starting of Monsoon this year. Latest death
toll hits 2000. With inadequate relief from local authorities, survivors
are struggling to rebuild their life; while another 145,000 suffer from
diarrhoea and other water-borne illnesses such as typhoid and hepatitis.
Visit: http://www.alertnet.org/thenews/newsdesk/DEL201802.html for
more information. In addition, Ian Bray, an Oxfam aid worker, has his
experience in Bihar, India, published on BBC. The full article is on:
http://news.bbc.co.uk/2/hi/south_asia/6941029.stm
Image by Ute Frevert & Margaret Shear,
www.wikipedia.org
Photo © Jim Gathany,
www.wikipedia.org
pre-empting new and old infectious diseases
pandemic: who 2007 health report
39 new pathogens, including HIV, were
identified since 1967. Together with other
worsening centuries-old infectious diseases such
as TB, they are threatening current global public
health security. In response, the new WHO
2007 report recommends upgrading current
surveillance and response to these potential
infectious diseases pandemic. For more details,
visit: http://www.who.int/mediacentre/news/releases/2007/pr44/en/
index.html
delivering insecticide-treated mosquito net
(itm): commitment, endowment, assistance?
A recent Kenyan study, according to WHO,
“ends the debate” about how to deliver the
much needed insecticide-treated mosquito net
(ITM) in malaria infested regions. Free mass
distribution of long-lasting net has shown to
dramatically increase ITM coverage and reduce
mortality rate in vulnerable group. News article
on: http://www.who.int/mediacentre/news/
releases/2007/pr43/en/index.html
compiled by kong
university of melbourne

g l o b a l
h e a l t h
q u i z
2.
1. Globally, 10.7 million children die every year mainly due to
preventable diseases. Which of the following are the third most
common causes for under-five deaths (after pneumonia and
Neonatal deaths)?
a. HIV-AIDS
b. Injuries
c. Measles
d. Diarrhoea
2. From an ancient Chinese herbal medicine, what is the backbone
of a combination therapy most effective for the widespread
chloroquine-resistant malaria parasites?
a. Quinine
b. Artemesenin
c. Erythromycin
d. Doxycycline
4. 86%: More than half of the 800,000 are from the age group between 15 and 44,
with the highest suicide rates found among men in Eastern European countries.
Mental disorders are one of the most significant and preventable causes of suicide.
Visit the mental health facts file on http://www.who.int/features/factfiles/
mental_health/en/index.html for a glimpse on global mental health.
5. False: Through a 69 pages working paper exploring the linkage between
corruption and conflict (http://www.eldis.org/go/topics/resource-guides/
conflict-and-security&id=33053&type=Document), the author pointed out
that past study (http://globalpolicy.gmu.edu/pitf/PITFglobal.pdf) has shown
otherwise. IMR seems to be a better indicator of standard of living in a region
and therefore better in indicating potential political instability.
p r i z e s
for prose
competition
he AMSA Global Health Network (GHN) and
TVector magazine would like to extend a very warm
congratulations to the winners of this edition’s prizes
for prose competition: Bae Corlette, Anthea Lindquist,
and Jake Parker! These three budding writers have each
won sensational prizes from Wakefield Press for their
contributions to this edition of Vector magazine: books
packed with info about global health.
The GHN’s Vector magazine will continue its prizes for
prose competition next edition. So get your pens scribbling!
If you would like to be part of the writers pool for next
edition, please email vectormag@gmail.com.
GHN Publicity Officer
Nadine Ata
publicity.ghn@amsa.org.au
Editors
Nicola Sandler & Cara Fox
vectormag@gmail.com
Crop eradication is the one effective policy in tackling illicit
drug usage without causing any potential harm to other
communities.
True or false?
3. On average 800,000 of world population commit suicide every
year, how many percentages of them are from middle and low
income countries?
a. 74%
b. 86%
c. 53%
d. 24%
5. According to a new study published on Eldis, Gross Domestic
Product (GDP)/ capita has a higher significance than infant
mortality rate in determining the likelihood of political
instability.
True or False?
compiled by kong
university of melbourne
answers
1. d) Diarrhoea: According to WHO estimation, Diarrhoea causes 17% of under
five deaths (Measles 4%, HIV-AIDS 3%, Injuries 3%). Source: Bryce J, Boschi-
Pinto C, Shibuya K, Black RE. WHO estimates of the causes of death in children.
Lancet, 2005, 365:1147–1152
2. b) Artemesenin: According to a seminar paper on Malaria published on the Lancet
(Vol 365 April 23, 2005), few regiments of Artemesenin based combination
therapy (ACT) has shown great efficacy in some part of Asia and Africa. Visit
www.thelancet.com to access this article.
3. False: According to Id21 insight health issue #10, without complementary
development initiatives, crop eradication programmes can exacerbate poverty
among farmers, accelerate deforestation, and worsen armed conflict. Find out
more on: http://www.id21.org/insights/insights-h10/art00.html
Design & Layout
Vanessa Fitzgerald
orangebutterflyness@hotmail.com
credits...
Photo © dima v, www.sxc.hu Photo © Flaviu Lupoian, www.sxc.hu
page 5
indigenous health issues — real people and real lives at risk
Lending a Hand: the Aid Issue