Newsbites

Burma

Medical students help after cyclone

Burma’s cyclone and floods have drawn hundreds of local medical students and junior doctors to help treat survivors. Many went to work in camps organised by the military government, which has been widely criticised for shutting out foreign aid workers. Other volunteers bypassed the army’s centres and took courses in disaster medicine provided by charities before heading out to the Irrawaddy delta, which was battered on the night of 2 May by Cyclone Nargis.

More than 134 000 people are dead or missing, and about 2.4 million are thought to be destitute. “They’ll see things most doctors have never seen,” the Swedish surgeon Charles Randquist said of junior doctors learning what they would face in the delta at a one day seminar organised by a Malaysian charity.

A group of 20 junior doctors said that about a week after the cyclone they had begun treating hundreds of homeless people crammed into a monastery and primary school.

“There was a lot of diarrhoea and bad cuts,” said one 21 year old junior doctor. “But we couldn’t stay long because military intelligence people kept photographing us and asking us what we were doing there” (http://uk.reuters.com/article/topNews/idUKBKK9284320080519, 19 May, “Brave young Myanmar doctors head to disaster zone” and http://ap.google.com/article/ALeqM5hg7sefniNfLInrLXNhWqUj-5UZIgD90M7AEG0, 15 May, “Local heroes step in to help cyclone victims”)

China

Earthquake draws massive medical effort

China mustered nearly 140 000 medical workers for relief work after 12 May’s earthquake, centred in the southwestern Sichuan province, which left almost 90 000 people dead or missing.

A nurse searches for supplies in the ruins of a hospital in China's Sichuan province after the earthquake

Nine foreign medical teams, with members from the United Kingdom, Japan, Russia, Italy, France, Cuba, Indonesia, Pakistan, and Germany, were also working in the areas hit by the earthquake.

At least 9000 children were killed, and many of their parents have promised to push for charges against officials who they say allowed unsafe schools to be built.

While medical personnel tried to treat people in the quake’s aftermath other disaster relief teams worked to prevent unstable lakes formed by landslides breaking their banks and flooding the areas below (http://news.xinhuanet.com/english/2008-06/02/content_8300166.htm, 2 Jun, “Facts of medical relief work in China’s quake zone,” http://news.xinhuanet.com/english/2008-06/04/content_8312820.htm, 4 Jun, “China open to foreign assistance in disaster relief,” and www.alertnet.org/thenews/newsdesk/PEK264073.htm, 4 Jun, “China quake parents unbowed in pressing complaints”).

United States

Drug company gifts

Medical schools should keep a closer eye on free gifts from drug companies, according to a survey by the American Medical Student Association. The conflict of interest policies at 150 US medical schools were ranked by the association. Only 5% achieved the top grade, and 60 schools were awarded a grade F.

The campus activities of drug firms and medical device makers are coming under greater scrutiny as experts question whether they have any place in medical education. In April the Association of American Medical Colleges advocated that schools ban many of the gifts and free lunches commonly offered as perks.

The president of the students’ association, Brian Hurley, said, “These policies are incredibly important to protect the educational experience students have at school and the quality of the education they’re getting.” The association’s ratings are available at www.amsascorecard.org (www.nytimes.com/2008/06/03/health/03conflict.html, 3 Jun, “Survey of medical schools is critical of perks”).

South Africa

Price controls on private health care

South Africa is pursuing legislation to control private healthcare charges in the hope of improving access. But critics fear that doing so may push more healthcare workers to emigrate.

The rules will allow inspectors to visit private doctors’ practices unannounced to check the level of consultation fees that they are charging. The health department’s deputy director general, Kamy Chetty, thinks that lowering fees will give more people access to private medicine and take some pressure off the public healthcare system, even though the changes could more than halve doctors’ incomes.

The South African Medical Association’s president, Norman Mabasa, said, “Instead of finding solutions to the things people are unhappy about, government officials think they can fix the problem by simply legislating. It won’t work. We need sustainable solutions, not the meddling and micromanagement we’re seeing from this bill.”

In a recent survey by the Southern African Migration Project 37% of medical students in their final year of study said that they would emigrate within six months of graduation, and 48% wanted to leave after two years of practice (http://free.financialmail.co.za/08/0509/cover/coverstoryb.htm and www.thetimes.co.za/News/Article.aspx?id=781342, 13 Jun, “Manto not prepared to compromise”).

United Kingdom

Heart surgery at night may be safer

UK patients undergoing cardiac operations at night may receive better care than patients operated on in the day. The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) found that almost two thirds of 800 patients who died after coronary artery bypass operations had received substandard care but that this proportion was lower for patients operated on at night.

The inquiry found that night operations were tackled by more senior surgeons, while juniors played a larger part in those done during the day. More than a sixth of operations in normal hours were carried out by junior surgeons compared with less than 1% at night, investigators found.

George Findlay, intensive care consultant in Cardiff and an author of the report, said, “The message of these findings is not that heart patients should seek operations at night, but that if you need surgery you want to be reviewed by a consultant who makes the decision and is around to see it through . . . Out of hours patients are more likely to have a senior doctor’s input” (www.independent.co.uk/life-style/health-and-wellbeing/health-news/increase-in-consultants-makes-heart-surgery-safer-at-night-839594.html, 4 Jun, “Heart surgery safer at night”).

HIV

Infections outstrip treatment efforts

Almost 2.5 million people worldwide became infected with HIV in 2007, far outstripping the one million who started antiretroviral treatment, United Nations’ figures have shown.

A progress report on the fight against the epidemic showed that a target to start treating three million people in poor countries with life prolonging drugs was met in 2007, two years behind schedule. Twice that number are thought still to need treatment.

The report also highlighted improvements in care for pregnant HIV positive women, about a third of whom were treated to prevent vertical transmission last year, compared with 10% in 2004.

But Kevin De Cock, director of the World Health Organization’s HIV/AIDS department warned, “Treatment doesn’t close down the epidemic . . . More investment in prevention is needed while scaling up treatment” (www.nytimes.com/2008/06/03/world/africa/03aids.html, 3 Jun “Progress has been made in fight against AIDS, but not enough, UN report says” and www.reuters.com/article/healthNews/idUSCOL26211020080602, 2 Jun, “HIV treatment access improves, but coverage low”).

   

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