Monthly Archives: December 2016

BJGP Blog Christmas charity: Help Malawi medics this Christmas

christmas_pound-1Perhaps you are thinking of giving of some money to charity rather than sending Christmas cards or maybe you want to give a different type of gift package. Or maybe you’d  just like to support a worthy cause. UK registered charity Medic to Medic supports disadvantaged students training at the College of Medicine in Malawi by providing student scholarships. Here’s an update on the work they do and the problems faced by medical students in Malawi.

“On the opening day of school, a few students litter the registry whilst a multitude are packed at the assistant registrar’s office pleading for waivers in order to get registered. Many have come as far as Karonga, the district bordering Tanzania and Zambia on the far north. The queue is slowly winding the pillars, meandering back and forth outside the assistant registrar’s office. At the dean of students’ office, there is an uncomfortable sight of premedical students wrestling the queue, pushing and dragging one another to the back on a hot summer day longing to meet the dean of students. Both students standing at the Assistant Registrar’s office and the Dean’s office have one problem akin to them; the insufficient tuition fee.

Following the overwhelming tuition fee hike of 600% at the College of Medicine, the students at the only medical school in Malawi are in dire situation and are languishing due to the inhumane hike. About 60% of the students have failed to register for the 2016/17 academic year and others have opted to withdraw temporarily on financial grounds.

The fee hike has rendered many students destitute as it comes at a time when Malawi’s economy has nosedived into oblivion. On the household level, most of the people in Malawi about 80% are in the rural areas and many of the students are from the rural areas where poverty has sky rocketed. In the villages, the parents can hardly afford three meals a day and most of them are going to bed on empty stomachs. If the parents can’t afford a descent daily meal, where will they get the huge money demanded of them to educate their children with the fees at 350,000 Malawi Kwacha (£400) per annum?  The only resort for the impoverished students is to ask for temporary withdrawal since they cannot get admitted in the college.

Malawi ranked the world’s poorest nation has been marred with intermittent blackouts, inconsistent water supply and insufficient harvest as the result of climate change. It is unbearable for medical students to be attending lectures as well as clinical sessions at the hospital on an empty stomach. Following the non-residential policy put in place about half a decade ago, more than half of the students at the college live outside the campus where their security is very unreliable, poor studying environment, pitiable sanitation and very high rentals.

Currently, the future of Malawi’s competent health practitioners hangs in the balance as mass withdrawal of the students on financial grounds has already commenced and it ought to deteriorate in the second semester if the current situation persists. The battle to reduce the fees had taken the students to the state president of the republic of Malawi who also doubles as the university of Malawi chancellor but it yielded almost nothing as the fees were only slashed by about fifty-five pounds from about four hundred and fifty pounds. The present situation for the medical students at College of Medicine is worrying.”  Fatsani Gundah, MBBS year 5 student.

UK registered charity Medic to Medic supports disadvantaged students training at the College of Medicine in Malawi by providing student scholarships. Scholarships cover the cost of tuition fees, provide a twice yearly stationery allowance, medical books, medical equipment and if funds allow, a laptop. This enables each student to study optimally so that they can fully concentrate on their studies and successfully qualify as health workers in Malawi, a country that has just 2 doctors for every 100,000 people.

Malawi desperately needs more health workers. It has some of the worst infant and maternal mortality ratios in the world. For many of the students training at the College of Medicine, the tuition fee increases are unattainable and there are more students struggling than ever before. Many students will be forced to drop out of their training, go back to their villages where the cycle of poverty will continue. Normally Medic to Medic have been able to take on 15 new students each year, but because of the 600% tuition fee increase, they have not been able to take on any new students.

This Christmas you can support Medic to Medic by buying a gift package for a loved one from their website. There are pre-set amounts starting from £10, through to £1,000. Each package goes towards a different aspect of a students training, ranging from paying for a stationery allowance, through to providing a laptop, medical pack and covering tuition fees. For each gift the recipient will receive a certificate, student profile, their latest student update and a selection of Medic to Medic gifts. Gifts can be sent direct to the recipient or back to the buyer. Packages can be sent internationally, although there is a minimum donation for these packages. It’s also possible for overseas friends to purchase gifts online in their own currency.

In an era when not knowing what to get someone for Christmas is such a first world problem, Medic to Medic offers a solution: an ethical gift of giving this Christmas.

For more information please visit:
www.medictomedic.org.uk
Email: info@medictomedic.org.uk
Call 0208 869 3603

Child & Adolescent Mental Health Problems – Twitter Journal Club

img_4397Carrie Ladd is a part time NHS GP, a spare time RCGP Clinical Fellow in Perinatal Mental Health and a full time mum… doing overtime! You can find her on Twitter @LaddCar and she has a website.

On Sunday 28th November, Dr Lucy Pocock and I co-hosted a session of the Twitter based journal club #gpjc to discuss one of the emerging priority areas of General Practice – Child and Young People’s Mental Health. The BJGP paper we discussed was a systematic review of primary care practitioner’s perceptions to barriers in managing these problems. All contributors seemed to agree that GPs are seeing more and more cases of mental health problems in adolescents but there was some debate as to whether this piece taught us anything new about the challenges we face in supporting these young people.screen-shot-2016-12-05-at-14-36-21

The themes identified in this review as ‘barriers’ were familiar to those joining the discussion and they are in common with most other mental health sub-specialities. Fear of judgement or stigma may limit disclosure, concerns over confidentiality may limit discussion and lack of referral options locally may restrict what help is available. This review also highlighted a lack of confidence in GPs themselves recognising childhood mental health problems and this may prove a springboard piece of work to address this unmet need in the near future.

This was a large systematic review covering 4151 articles in initial stages with 43 being looked at in detail – 30 quantitative and 13 qualitative. The articles were from a range of countries and one of the points in our discussion questioned whether this undermined or strengthened the validity of the results. Although Australia and Ireland could be seen to have similar health systems/ socioeconomic factors to the UK, perhaps South Africa and Puerto Rico less so? Also many of these studies were not specifically GPs but paediatrics as well which is important to be aware of.

In the final section of the discussion, we looked at how we can mitigate these barriers and collaboration seemed a key theme. Several people suggested better lines of communication with our mental health colleagues. Quarterly MDTs between psychiatry/CMHT & the GP practice, Psychiatry colleagues spending a day a week in General Practice is being done in one innovative GP surgery. In another great example of collaborative working, a specialist eating disorder therapist is based in a predominantly University Population Bristol based GP practice.

Finally, close of discussion included signposting to the RCGP Mental Health Toolkit which is available free, open access to all and mention of Young Minds and MindEd resources which are well worth a look up if new to you. The conversation continued after the scheduled hour and the 10 minute consultation model was cast aside as not fit for purpose when a patient comes to talk about mental health problems with longer appointments welcomed by the #gpjc group.

It is clear that from the GPs who joined the discussions on Sunday, this is an area of general practice we could do better, and we need to galvanise interest and support for a society wide movement to raise awareness and prompt further investment in Child and Young People’s Mental Health services.

If you haven’t popped over on a Sunday evening, check out @GPjournalclub for their monthly discussion group – see you there.