Medical students expand their horizons in Tunisia

by Niloufar Rahim (Netherlands), Carlotta Conrad (Germany), Michelle Gin (USA)

We were invited by the International Federation of Medical Students’ Association (IFMSA) to join their Pre General Assembly (preGA) meeting, from 27 February to 3 March in Hammamet, Tunisia, leading up to their annual March meeting. Excited, we accepted the invitation, looking forward to meeting medical students from all over the world, and engaged to reinstall communication, exchange and collaboration IFMSA.

Our delegation from the International Student Movement of IPPNW was Niloufar, from the Netherlands and our ISR, Michelle, NSR from the US and Carlotta, Member of the German IPPNW Board. Sadly we were missing Arashdeep and Soumya from India, who unfortunately could not join us – due to some exam and visa issues.

After a day of wandering around in the medina of Tunis and being intoxicated by the many tastes, scents and the warm culture of Tunisia, we all arrived in Hammamet and were ready to learn new things about topics, not included in our normal curricula. Niloufar and Carlotta were joining the Disaster Risk Management (DRM) workshop, Michelle joined a workshop on Women’s Global Health and Human Rights.

Disaster Risk Management Workshop

The program of the DRM was sorted out quite well and contained many interesting and useful parts. We started the first day with a lot of basic information about disasters and their impacts on societies.

The second day built further on the basics and started with a very interesting presentation on the acute humanitarian response by Medicine Sans Frontiers. Dr. Helmy Mekaoui explained among others the complexity of emergencies during armed conflicts and what role MSF takes in those situations.

The International Committee of Red Crescent further elaborated this topic.

An intriguing part of this workshop though was a disaster simulation given by Dr. Luca Ragazzoni and Dr. Luca Carenzo from CRIMEDIM and EuSEM respectively, which illustrated the complexity of not only the management of a possible disaster but especially the triage of patients during a disaster. One important point that we learnt from this simulation was the great importance of good communication between hospital staff and sometimes shutting off emotions when it comes to choosing the patients to treat.

The WHO wasn’t able to send a representative in person, but screened an interesting workshop video on ethics in emergency. After an introduction about the close link of emergencies and ethics, the issues of patient care, research and surveillance in a public health emergency situation were discussed. Especially the question about allocation and distribution of limited resources and health care during the emergency brought up an interesting discussion among the participants.

On the last evening of the preGA all participants of different workshops watched the movie “Fire in the Blood” together, which shows the heartbreaking truth of the pharmaceutical industry and the reasons behind the lack of medications for HIV positive and AIDS patients in the developing countries, especially while cheap medications have been developed many decades ago but aren’t available for all due to patency and pharmaceutical profiteering.

Women’s Global Health and Human Rights workshop

This workshop included participants from U.S., Canada, Tunisia, Turkey, Austria, Luxembourg, Finland, Sweden, Norway, China, Taiwan, Thailand, and Australia.

Day one started by ensuring all participants were on the same level by reviewing the Universal Declaration of Human Rights, UN Millennium Development Goals, and concept of global health vs. public health vs. international health. It developed further as the workshop opened up for participants to share the roles of women, current policies, and cultural norms in their home country.

Day two covered several topics, from a guest physician from the local university speaking about breast cancer, to a physician from Doctors Without Borders/Médecins Sans Frontières. Another guest speaker was planned to discuss maternal health, but was unable to attend due to visa or passport issues. Therefore, the organizers asked Michelle to discuss the four leading causes of maternal mortality worldwide and identify what could be done from a local level. Further she was asked to co-facilitate a discussion about pregnancy and abortion for adolescent girls compared to women because of her Maternal and Child Health background. This put Michelle in a prime position for her peers to get to know her and later listen to her promote IPPNW and how to take awareness about an issue and turn it into action.

Day three looked at how cross-collaborative work and emphasized the importance of knowing one’s resources. Several activities involved case studies of women and prostitution. Participants were challenged on how they would respond to such a situation. This allowed for multi-cultural understanding of different perceptions, assumptions, and strategies to move forward. The media was another factor that influenced the degradation of women, impacting their health. Unfortunately, it seemed that all participants were aware of the struggle the media poses to women as well as the power behind the media industry. Not many participants felt their voice was strong enough to make a difference. Further, the role of men was discussed. Throughout the preGA, only one man participated in the Women’s Global Health and Human Rights workshop. He did not share his opinions and left after half a day. This demonstrated the struggles that men may face to be allies in such issues. One idea what that by naming them as women’s issues, it does not commit men to feeling that it is of importance to them. Many ideas were discussed with the final conclusion that men need to be at the table, too because they can effectively contribute to change as well. Finally, the day closed with a meditative ceremony to honor women.

Our contribution and future collaboration

This preGA was the first in IFMSA’s history to allow externals not only as speakers but also as participants. Our small group of IPPNW members attended two workshops.

Michelle attended the preGA workshop on Women’s Health Issues and was even asked to present her experience on this topic, during the second day.

Carlotta and Niloufar attended the preGA workshop Disaster Risk Management and were also one of the external speakers on the topic.

In our presentation we elaborated about the immense threat that nuclear weapons form against life and humanity. One would not be able to manage the catastrophic consequences of a possible disaster, due to nuclear weapons and the only realistic and efficient way would be to prevent this hazard into becoming a disaster by a worldwide ban on nuclear weapons.

Furthermore we talked about violence caused by small arms and addressed the possibility, to reduce hazards to public health by pushing for an arms trade treaty and a stop on production and export of weapons.

Tot slot, we presented our core activities within IPPNW and IPPNW Student Movement projects such as ICAN, NWIP, One Bullet Stories, Medical Peace Work and ReCaP.

Even students from other preGA workshops joined the preGA DRM for our presentation and were really much interested in our organization and projects. After these three days, students and doctors from several countries such as The United Kingdom, Switzerland, Indonesia, Denmark, Norway, The Netherlands, Canada, China, Australia, Italy and many more showed interest in joining the IPPNW Student Movement and would really much like to attend our European and/or international student congresses in the upcoming period. We want to invite the German speaking students from Austria and Switzerland to the students meeting in Germany.

We also built a strong collaboration with IFMSA, especially with the DRM small working group. We will be working together as the youth group in the United Nations International S Disaster Risk (UNISDR) and will release a youth statement together for the YFA.

Besides, the DRM small working group will attend the international student congress in Astana and hold a workshop on DRM within the topic medical responsibility.

Furthermore Niloufar Rahim is asked to hold a presentation during the national meeting of IFMSA in The Netherlands and will promote our activities and gain more members during the SCORP (Standing Committee On human Rights and Peace) meeting this April.

The Medical Peace Work course also attracted a lot of attention, and collaborations with SCORP, maybe a presentation on their next meeting are discussed.

Parties and fun in Tunisia

For all of us this was the first time to attend an IFMSA assembly and it was quite fun with parties every night and a great spirit amongst everyone. We were really well received in the group and weren’t at all treated as externals. The Tunisian OC was a team of approximately 45 people who were running around almost constantly and managed to keep everything running very smoothly.

Though it must be said, it did not feel as familiar as it does with IPPNW, on our meetings!

We’re also very glad to have had a few days of travelling in Tunisia. We saw the crowded souks (markets) of Nabeul and Tunis with lots of beautifully handmade pottery, visited the Roman ruins of Carthage with plunging rainfalls on our heads and met a lot of warmhearted Tunisians.

We’ll finish this report with a phrase of the DRM small working group, which states very well the essence of this workshop and our work within IPPNW:

“Disasters only occur because the society is not well enough equipped to deal with striking hazards. Disasters are preventable. Preventable by us!”