Report writing for doctors

Report writing for doctors supplying evidence on asylum applications – training, 24 September, Coventry Refugee Centre

GPs with asylum seeker patients are asked to write medical reports for asylum cases, and are often well placed through their knowledge of their patient to provide evidence and information. However, writing full, “expert” medico-legal reports requires training and experience. A network of GPs writing medico-legal reports on asylum applicants was set up in 2008 to provide training and support for GPs. Ongoing training and accreditation in medical report writing should strengthen the role of GPs and the effectiveness of their reports at the Home Office.

Sponsored by the Department of Health, the 4th GP Medical Report Training Day will provide both new and experienced GP report writers with presentations from legal and medical experts, and with a forum for GPs to present their own reports. UKBA staff will explain the role and importance of medical reports in decision-making. Expert legal advisors will present on legal aspects, and medical presenters on recognising and documenting the physical and psychological evidence of trauma/torture. There will be a session on how to structure and present expert reports.

Attendance is free. Certificates of attendance will be provided.

Anyone interested in attending should send their name and contact details to Dr Alison Callaway to book a place:

Dr Alison Callaway (Lead GP)

The Meridian, 15 Bishop Street, Coventry CV1 1HU T: 02476-223921 F: 02476-223923

Children doing time with their mothers

(IRIN) – Sarah Moyo, 24 – not her real name – clasps her stunted one-year-old child to her chest as she talks to her visiting husband through a chain-link fence at the Central Remand Prison, on the eastern fringe of Zimbabwe’s capital, Harare.

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EWTD damages patients’ safety-Surgeons

By Lyndsay Moss

EUROPEAN laws limiting the hours doctors can work have “failed spectacularly” and damaged patient safety, surgeons have claimed.

The European Working Time Directive (EWTD), which was fully implemented a year ago, means junior doctors across the UK are not supposed to work more than 48 hours a week.

But a new survey has revealed concerns among consultants and their trainees over reductions in the amount of practical training they now receive and the impact on patients of repeated change-overs in medics looking after them.

Royal College of Surgeons (RCS) president John Black said: “To say the European working time regulations have failed spectacularly would be a massive understatement.”

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Mental Health of Refugees and Asylum Seekers

Publisher: Oxford University Press

Thoughout the world the number of refugees and asylum seekers continues to increase at an astonishing rate. Given that most will have left their country due to persecution, war, or appalling violations of their human rights, many will have specific mental health needs. Cultural and socioeconomic factors play a major role in expressions of distress, help seeking, pathways into care, and acceptance or rejection of treatments.

Being a refugee or asylum seeker raises questions about an individual’s self respect and altered identity. Too often though, the needs of this population are ignored by policy makers and clinicians, and these people are left to fend for themselves. Mental Health of Refugees and Asylum Seekers presents both the theoretical and practical aspects of the mental health needs of refugees and asylum seekers. It looks at the impact of migration on mental health and adjustment, collective trauma, individual identity, and diagnostic fallacies. A practical section highlights cultural factors, ethnopsychopharmacology, therapeutic interaction, therapeutic expectation and psychotherapy.

The final part of the book focuses on special problems – such as bereavement, sexual violence, and post traumatic stress disorders, as well as considering mental health problems in special groups, such as child refugees. This book will be an essential resource for all mental health professionals- helping them better understand the needs of refugees and asylum seekers, how their problems can be managed, and how they can best be helped.

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Family Planning Association (FPA) training

This one-day course aims to increase participants’ awareness of asylum seekers’ and refugees’ sexual health information needs and is aimed at anyone who works with asylum seekers.

Those attending the course will:

All participants on this course will receive a free copy of Sexual health, asylum seekers and refugees: a handbook for people working with refugees and asylum seekers in England (FPA).

The training will take place on 28 September 2010 in London at a cost of £120. Anyone interested in the training should Fill in a training booking form, call Helen Shipley on 0845 122 8661 or email helens@fpa.org.uk.

Asylum health project expands provision

By Melanie Singhji

The free healthcare advocacy programme, Project: London, is to open its doors one Saturday of every month to accommodate the rising numbers of users.

Run by the charity Doctors of the World UK, Project: London has been working since 2006 with the aim of helping the most vulnerable get access to medical treatment and advice. It aims to reach asylum seekers, migrants, homeless people, and vulnerable women, such as sex workers or migrant domestic workers, and as such, the project’s free services have become increasingly in demand.

Starting on Saturday 3 July, the new opening hours of the walk-in health clinic will allow access for those unable to make it during the week. The clinic’s volunteer medical support staff offer users practical information and assistance about how to access mainstream medical services, which are often denied or are inaccessible to the most vulnerable.

Project: London is based at Praxis, Pott Street, Bethnal Green, London E2 0EF, and is open Monday, Wednesday and Friday, 1-5pm, and the first Saturday of every month, 10-3pm. No appointment necessary.

Project London (http://www.doctorsoftheworld.org.uk/projectlondon/default.Asp)

Doctors of the World (http://www.doctorsoftheworld.org.uk/)

Health of Migrants − the Way Forward: Report

World Health Organisation, International Organisation for Migration and the Ministry of Health and Social Policy of Spain organized a Global Consultation on the health of migrants in Madrid on 3−5 March 2010.This publication provides a synthesis of the key discussion points of the Consultation, its outcomes and the background materials prepared for the event.

Full report:

http://www.who.int/hac/events/consultation_report_health_migrants_colour_web.pdf

Belgrave Library hosts health and well-being event

By Tichaona Manomano

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Zimbabwe: Cholera Keeps a Low Profile

IRIN – A year ago Zimbabwe was immersed in one of the continent’s worst ever cholera outbreaks, and more of the same was expected in 2010, but the waterborne disease has so far kept a low profile.

The cholera epidemic that began in August 2008 and lasted for a year before it was officially declared at an end in July 2009 caused the deaths of more than 4,000 people and infected nearly 100,000 others.

The 2008-09 outbreak was attributed to dilapidated and broken sanitation and water infrastructure, much of which is still in the same state, raising the fear that the 2009-10 rainy season would bring a resurgence in cases.

Cholera, a waterborne bacterial disease, infects the gastrointestinal system, causing vomiting and diarrhoea that can lead to acute dehydration; left untreated, the disease can kill within 24 hours.

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Medsin NC09: ‘Vulnerability in Health’

Medsin-UK recently held their annual Medsin National Conference in Nottingham.  Following a successful round of talks, workshops, inspirational opportunities and campaigning most notably by Erica Pool (former TLS Intern and Medsin-UK Campaigns Director),3 Medsin enthusiasts Dare Oladokun, Anand Bhopal and Nicholas Swetenham and Erica herself wrote(below) on what the conference meant to them, and what messages they took home for their friends and colleagues.

Watching 400 arms rise up in quick succession, I truly believed that we could make a difference.

Dare Oladokun:

The Medsin National Conference 2009 took place in Nottingham centring around the theme ‘vulnerability in health’. The conference involved four plenaries covering older people, migrant health, mental health and physical disability as well as over 60 workshops.

The conference started with an opening speech by Medsin-UK President Jonny Currie. Jonny recounted the story of how he became involved with Medsin, highlighting that that our engagement in Medsin was a reflection of our responsibility both towards people in our country but also towards poor and marginalised communities abroad who lack a voice in the current world order.

The first plenary, entitled “Dismissed?”, was introduced and chaired by Prof. Gladman.  He emphasized the plight of elderly people and how simple gestures can make a difference.  Other speakers were Charlotte Potter (Age concern &Help the aged), Deborah Sturdy (Department of Health) and Prof. David Oliver (Royal Berkshire NHS Trust). The panel highlighted bad attitudes, ageism and substandard care towards the elderly from healthcare workers and society as issues needing our urgent attention.  Recommendations issued included combating negative attitudes; prioritising care of the society’s elderly; and planning for both nationally and internationally elderly care as a global issue as their numbers will only increase in the 21^st century.

The second plenary (“Displaced?”) was chaired by Dr Joseph O’Neill who opened with the question of whether doctors should have any role in ‘policing’ patients’ immigration status.  The panel comprised Don Flynn (Migrant Right Network), Adam Hundt (Pierce-Glynn Solicitors) and Ezinda Franklin-Houtzager (Refugee Health Network/Medact). The ethical, medical and legal aspects of denying free healthcare to refused asylum seekers became the key discussion; the overriding message that doctors are not border guards and should not be made to police patients’ residency status was recurrently made.  Since the current system allows for doctors discretion of whether or not they can provide care, doctors were encouraged to act as advocates for their patients and their health needs. A challenge was also addressed to the British Medical Association and others to provide leadership and advocacy by speaking out on the issue.

Prof. Jennie Popay provided the day’s endnote address, titled pathways to health equity.  She discussed approaches to the facilitation of health equity, considering methods such as behavioural conditionality (rewarding people for good health behaviours) and empowerment for the poor. She concluded that focussing on the science of these approaches is not enough and efforts should not be “disconnected from reality”.

Dare Oladokun, 3^rd year medical student, University of Leeds.

Nicholas Sweetenham:

During the weekend Medsin held its inaugural ‘Question Time’ event giving delegates the opportunity to challenge local politicians – Ms Lillian Greenwood (Labour),  Cllr Tony Sutton (Liberal Democrats) and  Mr Ken Brown (UKIP, the UK Independence Party), all of whom are standing in next year’s UK General Election.  It was eye-opening to hear of each party’s policies and the extent to which the local candidates grasped the issues covered. In turn, the politicians themselves were made well aware of some of the technical issues they might not have been previously appreciated.

NHS privatisation, healthcare for refused asylum seekers, the Human Rights Act, UNITAID’s patent pool for essential medicines and climate change were just some of the issues discussed.  Ms Greenwood of Labour felt the government had been successful so far on climate change and the NHS . Cllr Sutton proposed the Liberal Democrats’ policies on climate change were the widest-ranging, but felt that a mixture of private and public healthcare provision was good. Mr Brown found climate change ‘highly dubious’, and suggested not only that NHS staff should be drastically cut , and that the NHS should be replaced with a system of private insurance but also that the Human Rights Act was a ‘criminal’s charter’; on several occasions his comments drew gasps from the audience.

All agreed that asylum seekers should not be charged for care, although Mr Brown of UKIP suggested stronger border control was necessary to reduce the number of asylum seekers. Patent pools proved popular although the candidates all highlighted the need for profit for pharmaceutical companies. Overall, it was encouraging that they expressed sympathy for views held by many Medsin members – with the notable exception of UKIP’s stances on the NHS,  granting asylum, the Human Rights Act and climate change.  The opinions expressed by the candidates present suggests an existence of at least some motivation and sympathy to tackle the issues covered among today’s UK politicians. What remains is to persuade the government to prioritise them and legislate on them, so that global health equity can become a political reality and not just an ideal.

Nicholas Swetenham is a 4^th year medical student at Barts and the London School of Medicine & Dentistry and  a grassroots member of Medsin. He blogs regularly about health policy at www.blue-genes.net

Anand Bhopal:

As the dust settled from the lively ‘Question Time’ debate of yesterday evening, day two began with a plenary on access to mental health services and the quality of provision, both nationally and globally. Stimulating questions were raised: have prisons become the new lunatic asylums? Are we over-labelling mental health sufferers? Are foreign psychiatrists really appropriate in disaster zones where long term mental health care is required and there are many more pressing health problems? What a way to start a Sunday morning!

Throughout the day there was a global health futures fayre featuring a wide array of opportunities to get involved with global health career paths. This sort of informal setting is where the beauty of a Medsin conference lies. 400 students in an auditorium engaging in discussion is excellent, however, corridor debates between workshops, and the opportunity to engage with students from all over the UK is quite exceptional!

Similarly to day one there were also two workshop sessions. I attended an inspiring talk by Mustafa Abbas, Coordinator of the Healthy Planet Campaign: ‘Climate Change is the defining Global Health Issue of the 21^st Century’. Personally I prefer these smaller workshops and emerged from the discussions, further enthused and motivated. This topic will be a strong focus of the Newcastle Global Health Conference in March.

The afternoon plenary was on the integrity of the UK pledge to improve the rights of disabled people both at home and abroad. Again, more stimulating questions: In the developed world we have access to good health services, but are we letting down one of our vulnerable communities? Is this more bloviated policital rhetoric or a genuine intention for action?

Following this session, the weekend finished with a very interesting end notes address by Professor Kate Pickett on ‘why more equal societies almost always do better’. As a national organisation striving to “raise awareness of global health issues and reduce health inequalities”, it was an extremely fitting end to the conference.

Many congratulations to Nottingham on another inspiring weekend, further educating and empowering many Doctors of the future in to action.

Anand Bhopal is a 2nd year medical student at St Andrews

Erica Pool:

Watching 400 arms rise up in quick succession, I truly believed that we could make a difference. At the conference Medsinners from around the UK and abroad united in calling on world leaders to commit to tackling climate change. Part of a wider global movement, October 24^th was the international day of action on climate change with over 5000 actions happening in over 170 countries.  There has never been more urgency to campaign on this issue with the upcoming Copenhagen Conference this December where world leaders will make or break climate policy. The campaign ‘350’ highlighted the level of carbon (350 parts per million) that is safe in our atmosphere. Today’s levels are approximately 390 ppm and must soon be reigned in if we are to prevent any runaway climate change.  Politicians clearly then have a lot of work to do in Copenhagen.

In addition to campaigning on climate change Medsinners also called on pharma companies to ‘get on target, join the patent pool’. Ideally, current patent holders would donate their drug patents to a central fund allowing generic manufacturers the license to produce anti-reteroviral therapy for use in low and middle income countries. Competition between different generic manufacturers would drive prices down. Since a royalty would be paid for each time a company’s patent is used, the frequent complaint of pharmaceutical companies accusing others of stifling  incentives for drug development would be dispelled.

Campaigning ideals and issues pervaded the entire conference.  The Medsin Campaigns Community – an online forum which forms the hub of activism and advocacy within the Medsin network – was launched at the conference; a new and exciting venture for Medsin which students from around the world are invited to join.

Erica Pool is a 4^th year medical student at University of Leeds, she is also the Medsin-UK Campaigns Director and former TLS intern.

Further Resources

To find out more about Medsin-UK and their upcoming events – visit www.medsin.org

Information about Medsin Campaigns, including their Climate Change campaign ‘Healthy Planet’ and StopAIDS can be found at www.medsin.org/campaigns.

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