Student voice shaping the future of sonography in Canada

July 16, 2018 Jennifer LeBlanc Leave a Comment

By: Adrianna Broussard, Diagnostic Ultrasound Student

Adrianna has just completed her first year of the Diagnostic Medical Ultrasound program and is the new student advisor to Sonography Canada’s board of directors. During the PLANS African Nova Scotian Health Science Summer Camp (July 8-13, 2018), Adrianna was one of 18 current postsecondary and recent graduates that participated in a facilitated mentor session with the campers. Adrianna shared her experiences and helped Malyana Gero (from Amherst, NS) develop goals for her own journey.

In May 2018 Adrianna attended the Sonography Canada Conference in St. John’s, Newfoundland; here are her thoughts.

I had not envisioned the vast amount of experience I would gain when I set out to attend the Sonography Canada Conference in St. John’s, Newfoundland. This conference is the 36^th annual conference held by Sonography Canada, the credentialing organization for sonographers. For those of you that don’t know, a Sonographer is a health professional specialized in the use of ultrasound technology to perform diagnostic exams. The conference is a major event in the Canadian sonography community for professional development and networking. At the Conference I met with potential employers, learnt about scanning techniques, met ultrasound technology companies, networked with sonographers and attended informative lectures on pathologies.

At the event, I received the amazing news that I am the new student advisor for the Sonography Canada’s board of directors. At the conference I was able to meet all the board members as well as the previous student advisor. The previous student advisor was amazing at informing me of my new role on the board of directors. I was able to network and gain knowledge to prepare for my major role as the representative of all student sonographers across Canada. As student advisor I look forward to bringing diversity to the board and profession.

Not only was this conference a major asset to advance my career, but I was able to enjoy the wonderful city of St. John’s. The Johnson Scholarship Foundation Bursary made it possible for me to attend this amazing conference.

Adrianna Broussard with Malyana Gero

PLANS African Nova Scotian Health Science Summer Camp Mentor Session (July 8-13, 2018)

Crossroads 2018: The value of mentoring programs for students of African descent

July 9, 2018 Jennifer LeBlanc Leave a Comment

By: Kalkidan Gabre, Dalhousie School of Nursing

The Annual Crossroads Interdisciplinary Health Research Conference is a national student-led health and wellness research conference that was held March 9^th and 10^th, 2018 in Halifax, Nova Scotia. Crossroads is an adjudicated, peer-reviewed event for student researchers at all levels. It provides students from all disciplines with the opportunity to present their health-related research in a supportive and interdisciplinary environment. Student researchers are provided the platform to showcase their research, engage in dialogue and participate in interdisciplinary learning and collaboration with other students, faculty, and experts.

What my research was about?

At crossroads, I gave an oral presentation of a small integrative review that I conducted on the importance of mentoring for black students in nursing. Students of African descent in the university setting have different lived experiences than their European descent counterparts and encounter factors during their undergraduate that impede their success. These barriers include, inadequate academic preparation, financial problems, poor social adjustment and engagement, isolation, a lack of faculty and institutional support, and underrepresentation.

The preliminary findings from this integrative review concluded that mentoring programs are useful ways to support students as they enter postsecondary education. For black students specifically, the mentoring relationship can provide academic, social, and career guidance that is invaluable during the undergraduate years. Increasing recruitment and improving retention and graduation rates of black nursing students through mentorship programs, not only will it assist in diversifying undergraduate nursing programs and the workforce, it will lead to reduced health care disparities in underserved populations.

Kalkidan has just completed the third year of her nursing program. While her school work keeps her very busy she is always eager to explore new opportunities for learning outside the classroom. Kalkidan worked in the global health office as an outreach assistant in 2016 and she is currently a Queen Elizabeth Scholar with PASADA (Pastoral Activities and Services for People with AIDS Dar es Salaam Archdiocese), an HIV/AIDS service based in Dar es Salaam, Tanzania. until August. We look forward to future blog posts from her!

New Camp Reaches High School Indigenous Students

June 25, 2018 Jennifer LeBlanc Leave a Comment

Dalhousie University’s Indigenous Health Program works with school boards and organizations (including the Johnson Scholarship Foundation) to increase recruitment and retention of Indigenous students into medicine. As part of the program, the first Kitpu Wise camp was offered from March 12-16, 2018 in Halifax, Nova Scotia. The camp focused on learning about health careers and postsecondary life while meeting new friends and having fun. Students (aged 15-18) spent a week on campus receiving hands on exposure to clinical health education programs and cultural experiences.

The students also met the incoming Dalhousie University student union president who is the first Indigenous (Mi’kmaq) student to hold this position. In addition, the students presented handmade drums to the Deans of Medicine, Dentistry and Health.

Learning about Health by Kayla Steeves

In March 2018, I spent a week in Halifax attending the Kitpu Wise camp. It was one of the most influential and fun encounters that I have had the pleasure of experiencing as a high school student. I met a wonderful group of students and faculty, participated in intriguing activities, and learned amazing things.

Throughout the week, we did activities that taught us more about our Indigenous heritage, as well as aspects of the medical field. We made drums, shadowed a dentist during a real appointment with a patient, filled a cavity on false teeth in the dental simulation lab, as well as completed a certified first aid course.

My personal favourite activity was shadowing a last year dental student. I observed the interactions between a physician and patient, as well as viewed the techniques used to solve the issue. It was a different and fascinating view into what a job in the medical field would look like.

The information I have taken away from attending Kitpu Wise are resources and facts that I will forever hold onto. I cannot thank the brilliant people who put this program together for the knowledge and opportunities they have gifted me.

Kayla is a grade 12 student who participated in the Kitpu Wise camp in Halifax during her March break. She will be joining Dalhousie University in September 2018.

For more information on these programs please visit our Indigenous Health webpage.

My Summer Experience: Promoting Leadership in health for African Nova Scotians

April 16, 2018 Jennifer LeBlanc Leave a Comment

By Tobi Adeoye, Halifax Regional Centre for Education Student

Last summer PLANS (Promoting Leadership in health for African Nova Scotian) hosted health science summer camps in Halifax at Dalhousie University, Sydney at Cape Breton University and NSCC-Marconi Campus, and Antigonish at St. Francis Xavier University. Black students from across Nova Scotia in grades 8, 9, 10, and 11 submitted applications to attend. Tobi Adeoye first attended the health science camp at Dalhousie University in 2016, and in 2017 took the opportunity to attend all 3 camps – meeting new people and learning about postsecondary health programs in the province.

Here is her story.

Dalhousie University (July 9th- July 14th, 2017)

2017 PLANS Health Sciences Camp Dalhousie University

The first camp I went to was at Dalhousie University (Dal). There I noticed that the medical science field was more diverse than the other Universities. We did a lot of hands on learning throughout the week including audiology, speech language pathology and nursing.

Some of my favorite activities at Dal that week, was Kinesiology and how parts of our brains affect the way we move through fun games like Rats and Rabbits, and Catch. Another favorite was dentistry and dental hygiene where we learned the importance of brushing our teeth. We also put the skills learned is a test using a pink pill to reveal the plaque in our teeth and the proper way of brushing it away. We were given a fake tooth that had a cavity in it and taught how to drill and fill in the fake tooth with the help of the staff.

In the evenings, we met with some Black university students who helped us set goals and health professionals of African descent who informed us on what they do, and how they were able to get there.

Also during this week, Imhotep Legacy Academy came to talk to the campers about the programs and scholarships they offer to African Nova Scotian students. They gave a presentation about what they do, and illustrated how to measure acidity in a liquid with red cabbage juice, and the reaction when luminol is mixed with bleach – quite exciting stuff!

Cape Breton University (July 18th- July 21st, 2017)

2017 PLANS Health Sciences Camp CBU

At the Cape Breton University (CBU) camp, we visited NSCC-Marconi Campus. The instructors there talked to us about some of the programs they offer such as: practical nursing, continuing care assistance and cosmetology. We also got to play some fun games with the Human Services staff.

The next camp day, we learned about Sport and Physical Activity Leadership program offered at CBU. We played dodgeball in connection to the program. We also learned about the public health program and dressed up in personal protective wear (pictured). Later that afternoon, Cape Breton Business College visited us and we learned how to brush our teeth at a forty-five degree angle to get the plaque in between our gums. We also learned how to perform CPR on adults and children.

We ended the week at the CBU nursing school. There, we learned how to wash our hands, give needles, feed each other while we had visual impairment, take our blood sugar and do yoga.

St Francis Xavier University (July 23rd- July 26th, 2017)

2017 PLANS Health Sciences Camp St. FX

Lastly, I attended the camp at St.FX and met more new people (pictured). There, we learned about various scholarships and bursaries offered students, the new Bachelor of Arts and Science in Health, and had a campus tour. Also, we learned about human kinetics: how it is related to sports and why we play sports as a pastime.

We visited the biology department and were taught how to extract DNA from strawberries and observed bones in animals. At the end of the session, we looked at animals through a microscope and touched sea anemones, starfish and hermit crabs.

The following day, we went to the School of Nursing to observe their new simulation laboratory and learned the different simulations that happens there. We had an art session where we drew shoes and our own image, by looking in a mirror and also drew an object with the help of a partner using their descriptions of the object. After that, we had a poetry session, make our own poem and perform as spoken word.

Finally, we went to the Department of Human Nutrition and built a package for an uncooked s’more that can withstand water, heat and damage from a four feet drop in the air while spending the least amount of money to make it.

From these experiences, I gained awareness about the entry requirements into all of these medical science field and vocational training course in NSCC. I now have a better understanding as to what these professionals do, and how they were able to get there. I am more confident and more determined to do my best at school to get into the program of my choice when I complete my high school education.

Conclusively, my exposure to all these programs in all these three camps has stimulated my appetite and aspiration to pursue a career in dentistry.

PLANS is accepting applications now for the 2018 summer programs at Dalhousie University, St. Francis Xavier University, and Cape Breton University. Download the application here or talk to your local school!

-For more information about PLANS and the Health Science Summer Camps visit dal.ca/health/plans or email plans@dal.ca

Growth and Evolution of the Service Learning Program

March 5, 2018 md918395 Leave a Comment

Written by Madeline Kubiseski, Master of Health Administration Student

At Dalhousie Medicine, the Service Learning Program (MEDI2612) is offered during the first two years of Undergraduate Medical Education at Dalhousie University. The program integrates community engagement concepts into classroom-based learning (Professional Competencies 1) in first year with an optional community-based project experience in second year. Students who opt to take part in the “for credit” program do a minimum of 20 hours in order to complete the service learning experience during the academic year. The experience includes preparation, critical reflection assignments and a project deliverable that is relevant and useful for the community partner and the people engaged with their organization. Since the programs introduction in 2015, the program has expanded in community partners and students participating. I had the opportunity to speak with Jordan Boudreau and Allison Maybank, current service learning participants and student representatives, to capture their unique perspectives and experiences of the program during the two years.

How does the Service Learning Program respond to community needs and what is the community impact that you’ve seen in the past two years?

Service learning involves working with a community partner to address a community-identified need. Participants bring human resources, man-hours, and possibly institutional support to address the need that the organization may be otherwise unable to tackle alone due to lack of time, affiliations, or technical skills. The projects that were developed last year were remarkable, as were the depths of students’ reflections.

This year, there are 44 students working with 24 community partners between the two campuses in Saint John and Halifax. If we consider the mandatory minimum requirement of 20 person-hours spent in the community/on the project, then that’s nearly 1000 hours spent in the name of community service and self-reflection by the class of 2020 this year. By the midpoint reflection, it seemed that many of these projects were well underway and that students had some new relationship with their community, as well as an awareness of that relationship, that they hadn’t had before. Over time, having this introduction to community programs and their populations will lead to a better relationship between the medical school and community partners and a better understanding of community populations for medical professionals.

How does the Service Learning Program respond to feedback and evaluation of students and partners?

The service learning program responds well to feedback and evaluations and is always eager to improve for those involved. The ability for the program to respond to feedback is one of its major strengths. When it began last year, the leadership team had already done much to try to ensure that the program would fit nicely into the curriculum established for the students. All barriers to implementation couldn’t be known before trialing the program, however; snags inevitably came up with the hectic, dynamic, and individually-variable schedules of the second-year medical students. Sarah Peddle, the program manager, made every accommodation possible to shift the program to meet the students’ requests and is continuously working to make the program as effective as possible. At the mid-year review, students noted that a chance for small funding would be helpful and within a couple months they had figured out a way to do this!

Beyond managing logistics, feedback was also used to help better identify potential matches between students and community partners and to improve communication between them. Other changes were made during the recruitment phase to help students understand the nature of Service Learning and appreciate the difference between service learning and volunteering. We are eager to hear the feedback from the larger group of students and partners that are involved with the program this year. It’s important that the SLP is providing an opportunity that meets everyone’s expectations and is providing a stimulus for reflection and growth.

Jordan and students at the year-end celebration for the Service Learning Program in May 2017 in Halifax.

How has the program prepared you for your future as clinicians?

“While I do not believe that my perceptions of this population/community have changed dramatically, there is an undeniable change in my valence toward providing Opioid Substitution Therapy for people who use drugs. I already feel more responsible for the provision of addictions medicine now that the social consequences of drug use are not only an abstract idea, but tied to a concrete group of people whom I have met, who are much like me (and in other ways, completely unlike me), and have actionable ideas about how they can best be served.” – Jordan

In keeping with last year’s cohort, students are already more able to speak to the availability of, as well as the barriers and facilitators to the provision of, community resources. The credible and compassionate way in which they do this is worth considerable weight alone.

“Personally, working with Big Brothers Big Sisters, I have learned a lot about the diversity of children and their families and the needs they have. This is generalizable to many populations, but as I am interested in pediatrics, it will benefit me when I am caring for children and families to remember that there are many variables to take into account when treating a child.”- Allison

Allison and her little, Ethan, enjoying some time outside together.

The service learning program is a natural extension of the everyday lives and motivations of today’s medical students. With program leadership steering the ship as they have been, and with their ability to respond to feedback from all involved, we have no doubt that this program will only grow in its ability to supplement student’s self-reflection, develop professional competencies, and help build capacity for change in the broader community and the social determinants of health of its constituents.

To learn more about the Service Learning Program, please visit our website, read our previous blog posts, or email Sarah Peddle at sarah.peddle@dal.ca.

Find that pot of gold—my working-abroad experience in Tanzania

January 8, 2018 Jennifer LeBlanc Leave a Comment

By: Beatrix Yuan,

“I should like to bury something precious in every place where I’ve been happy and then, when I’m old and ugly and miserable, I could come back and dig it up and remember.”

—Evelyn Waugh

When I grow old, I will hop on a plane to Ifakara, Tanzania, and to dig up that pot of gold that I buried in the summer of 2017. Thanks to Dalhousie Global Health Office and Universities Canada, I was very fortunate and beyond honoured to receive the Queen Elizabeth II Scholarship to work at Tanzania Training Centre for International Health (TTCIH) as a student intern. Through this experience, I learned a lot about Tanzanian culture, about conducting academic research in an international research team, and about myself and my future career goals.

The incredible view at Udzungwa National Park

Professional and academic growth

The goal of my internship at TTCIH was to learn about qualitative data analysis through working on the Focus Group Discussions (FGDs) transcripts for the Access to Save Delivery In Tanzania (ASDIT) project. Dalhousie University researchers collaborate with partners from the

TTCIH and other local institutions, explore the challenges that women face when try to access quality obstetric care in rural Tanzania. Through this work experience, I gained deeper understanding on the health systems in Tanzania, the benefits and challenges of conducting global health research, as well as efficient communication strategies among different stakeholders in international settings.

The TTCIH Compound

Thanks to the local institutes’ hospitality, I was also able to visit several nearby organizations including Ifakara Health Institute, the Kilombero District Health Centre and St. Francis Referral Hospital. I was especially amazed by the work conducted by the One-Stop

Clinic at St. Francis Referral Hospital. The One-Stop Clinic offers comprehensive health services to families that are affected by HIV/AIDS. These services include free HIV/AIDS testing, counselling services, informational sessions on HIV/AIDS, and community outreach services.

Free HIV/ADIS Testing offered at the One-Stop Clinic at the St. Francis Referral Hospital; these stripes can show results in roughly 20 mins.

Personal growth-a humbling experience

This working-abroad experience also drastically helped me with my personal growth. It forced me to leave my comfort zone and to connect with friends from all over the world. As a Chinese immigrant in Canada, I have always been self-conscious about my English not being my first language, and this self-consciousness often makes shy away from connecting with others. Through this experience, I understood that language proficiency is not a deal-breaker; as long as I treat people with kindness and an open-heart, people will always accept me for who I am. I appreciate all the amazing people with different backgrounds that I made real connections with in Tanzania. Learning about their interesting life experience was very inspiring and humbling.

I miss all the friendly faces!

While most people consider living in a resource-limited setting a challenge, I considered it a blessing. I appreciated that I finally got the chance to take a break from all my electronic devices and be a more compassionate person and a caring friend. Without having to constantly check my smartphone and laptop for news that were happening thousands of miles away, I learned to be attentive to the present moment. During weekends, I would go for hiking and bike rides with friends. One of the most exciting things that I did was going on my very first Safari trip at the Ruaha National Park. We saw many animals that we were only able to see in movies, like elephants, giraffes, monkeys and lions. At one point, a leopard were only 3 feet away from our vehicle!

At the Ruaha Park, a lion enjoys his afternoon laziness

Reverse culture shock is a real thing

Reverse culture shock hit me harder than I expected. Although I have been back in Canada for over three months, I still miss Ifakara and all the friends that I met there. I miss the simple things like buying groceries from farmers that I made friends with and going for mishkaki (barbeque meat) on the side of the streets. I cannot express my appreciation enough to Dalhousie Global Health Office and Universities Canada, for giving me this life-altering experience to work in Tanzania as a student intern for a summer.

The author attending a bachelorette party in Ifakara, Tanzania.

To learn more about the Global Health Office please visit our website.

To learn more about the Queen Elizabeth Scholars program please visit the Dalhousie QES website.

With great opportunity, come great responsibility (QE Scholars)

November 12, 2017 Jennifer LeBlanc Leave a Comment

By: Justine Dol, PhD in Health

With great opportunities, come great responsibilities: Three key responsibilities for students volunteering internationally. Lessons learned from experience as a QES Scholar in Tanzania.

As a Canadian student working in a foreign country during the summer of 2017, it was essential for me to consider how my actions influence both the individuals I had the opportunity to work with as well as the community and place in which I was working. For my Queen Elizabeth Scholar (QES) placement, I worked at Muhimbili University of Health and Allied Science (MUHAS) located in Dar es Salaam, Tanzania. Based on this experience and my previous international experiences, I was reminded of several responsibilities that come along with these experiences that I would encourage other students to be mindful of before embarking on international travel. These include the need for co-operation and consultation with locals, being aware of personal motives and limitations, and enabling the exchange of information and capacity development.

The first key responsibility that I would argue that we as student volunteers have is co-operation and consultation with the local people in the area that we are working in. Communication is essential to develop the partnership mentality, where you can work together with your supervisors and peers at your placement, rather than approaching the placement with an (un)conscious bias of a ‘me versus them’ perception. Despite some of the best intentions, if local people or local organizations are not consulted, it can result in an “othering” of the people you are trying to help. It is important to work with local individuals to know the best way to help and contribute, rather than making them feel inferior or by compromising ongoing work. This will allow growth in both the host communities and the volunteers. Unfortunately, far too often this responsibility is ignored.

For my placement at MUHAS, I worked closely with my supervisor, Dr. Thecla Kohi, to assist with ongoing projects as was needed, rather than trying to complete my own agenda. When I did have the opportunity to lead my own research project, I made sure to involve my supervisor at every step and utilize her expertise in conducting research in Tanzania. Her expertise with postnatal mothers and nurse midwives advanced my project and contributed to the ongoing research in the School of Nursing at MUHAS.

The second key responsibility of being a student volunteer is being aware of our personal motives and limitations. I had to ask myself: am I going to put the experience on my CV? For personal development and growth? Because I have an autistic desire to build capacity in others? To participate in research in an international setting? I think for me, it was a little bit of all the above. But maybe for other students, it is for some other reason. But by acknowledging where your desire to volunteer internationally comes from, it allows you to approach the trip in an honest manner. Additionally, it is important that as a volunteer, we acknowledge our limitations. For instance, why is it okay if I go build a house in a developing country when I have no house building experience in Canada and would not want to live in a house I built myself? I think that a large responsibility as a student volunteer is to acknowledge why we want to volunteer in the first place, and then acknowledging our limitations to assist the people we want to help. Rather than going into another country pretending to know all the answers because I come from a Canada, I think it is important to work alongside locals who are knowledgeable and capable of doing the work that is necessary but our assistance could lighten their load.

For instance, during my placement at MUHAS I was involved in data analysis for several qualitative projects where the data had been collected but my supervisor was over burden with other responsibilities and unable to take the lead on the analysis. As someone who has had previous experience with qualitative research and analysis, I was in the position to assist with the qualitative analysis. I did not attempt to get involved in areas where I do not have the necessary skills, such as working in a clinical setting, as I do not have the necessary qualifications. Instead, I contributed the skills I possess in a meaningful way to meet a need identified by my placement.

This leads into the third key responsibility of student volunteering internationally, which is the goal of exchanging information and building capacity. This responsibility is two-fold. First, an equal exchange of information between volunteers and locals is important, as it reflects partnership building, mentioned in the first responsibility. The goal of volunteering should be to share knowledge and empower locals to increase sustainability and capacity. I believe knowledge transfer is important in terms of volunteering because this reciprocity will build local capacity through building the tools they need to develop their own successes. It is also important that the knowledge exchange works both ways, as volunteers cannot assist in providing knowledge without knowing, from the individuals or community itself, what their needs are. The only way that proper exchange of knowledge will occur is through listening to the partners for their true needs, rather than using top down ideas to assist. Secondly, student volunteers are in a unique position to pass on knowledge of a country that other people might not know about. By having student volunteers share their experiences once they return to their home country, it could help to correct the stereotypes that people might hold.

For myself, after spending over three months in Tanzania, I have unique knowledge of the country and can share first-hand knowledge of the culture with people at home in Canada. I believe this is important as student volunteers because we should take what we learnt and continue to spread knowledge of our time away when we return home. The QES program is set up in such a way that public engagement is a requirement. This is key to ensure that exchange of information occurs and continued building capacity in Canada and internationally.

Overall, being a student volunteer in a country different than your own can offer some amazing opportunities, both personally and for the people you will be working with. However, before leaving, it is important to ask yourself some questions. Is what I am going to be doing there needed? Why am I going? How can I share about my experiences once I get home? I believe that the QES program at Dalhousie University has the right ideas, as it involves pre-training before volunteers arrive, co-operation between partners and universities as well as evaluation and public engagement afterwards. If we understand our responsibilities, it will result in the best experience not only for the student volunteer but also for our partners.

To read more about this program please review the 2017 Dal News Story or visit the QE Scholars Dalhousie website.

Queen Elizabeth Scholars’ Experiences in Tanzania

November 12, 2017 Jennifer LeBlanc Leave a Comment

By: Beatrix Yuan, Bachelor of Science in Health promotion

It is hard to believe that my time in Tanzania is coming to an end soon. During my stay, I learned Swahili, explored nearby sceneries, and made some great friends. I really appreciate the opportunity to come to Tanzania and to spend time with all the amazing people that I met here.

During my internship at TTCIH (Tanzania Training Centre for International Health, Ifakara) my overarching goal is to learn about qualitative data analysis through working on the ASDIT (Accessing Safe Deliveries in Tanzania) Focus Group Discussions (FGDs) transcripts. The FGDs were conducted in the five catchment areas served by five different health facilities in Morogoro region, Tanzania. In each catchment area, three groups of participants were interviewed: pregnant women and their husbands, post-partum women and their husbands, as well as community leaders and health facility staff members. The FGDs were recorded, transcribed and translated into English. During the FGDs, the following topics were discussed: the social context for women to access obstetric care, quality of care, family norms and support related to childbirth, eighteen-and-under pregnancy, and recommendations for the public health services. Through analysing the transcripts, I was able to identify several key factors that affect women who live in rural Tanzania and their access to quality obstetric care.

A few weeks ago, I had the opportunity to shadow at the One-Stop Clinic at St. Francis Hospital. The Clinic offers comprehensive services for HIV/AIDS testing, counselling services, informational sessions on HIV/AIDS, and community outreach services. I observed the testing service and follow-up counselling services. Through this shadowing experience, I learned about facilitators and barriers of people infected by HIV/AIDS accessing health services.

(HIV/AIDS testing kit)

I also went on my first Safari trip at the Ruaha National Park, which was very exciting. We were greeted by many lovely animals, such as elephants, giraffes, monkeys, lions, and a leopard (which is very rare to see).

I really appreciate the opportunity QES and the Global Health Office gave me to conduct research and experience cultures in Tanzania. I would really love to come back sometime in the future. It is not easy to fit in to a new environment, especially in another country; but as long as you go in with patience, respect, an open heart, and a respectful and understanding attitude, you will be able to find your way in and make some true friends for life.

To read more about this program please review the 2017 Dal News Story or visit the QE Scholars Dalhousie website.

2017 Canadian Global Health Conference – Day 1

October 30, 2017 Jennifer LeBlanc Leave a Comment

Written by Matt Jalink, MSc Candidate in CH&E

Canadian Global Health Conference – Day 1 – October 29, 2017

It is exciting being at my first Canadian Global Health Conference here in Ottawa! The first day of the conference opened up with a stellar line-up of global health celebrities including Partner’s in Health Co-founder and internationally recognized humanitarian Dr. Paul Farmer, former MSF (Médecins Sans Frontières) director Dr. James Orbinsky. Fellow panelist Shakira Choonara walked everyone through a simulation of what visually impaired individuals have to experience when taking their own medicine, which involved a blindfold and the reading of a prescription.

Dr. Paul Farmer giving the keynote address

(left to right) csih cochair Erica Di Ruggiero, Shakira choonara, Basimenye Nhlema, Paul Farmer, James orbinsky, Julia Sanchez

(right to left starting on podium) Justus Nsio (minister of public health DR Congo), Nicola Gailitis (PhD McMaster), Ali Tejpar (law, UOttawa,), Dr. Salim Bahramand (red crescent Afghanistan), Dr. Salim Sohani (international operations Canadian red cross)

Dr. Salim Bahramand

The concurrent sessions throughout the day were informative, educational, and captivating! Discussions about building capacity in different country contexts, implementation research in the context of HIV and HCV, and insights into community engagement in the context of Ebola were all fantastic symposiums and workshops to learn and talk about global health issues.

Tomorrow’s program looks just as impressive as today’s, and I am looking forward to more exciting, interesting, and creative discussions about global health!

For more information on these sessions please see the Conference Program.

Antimicrobial Resistance

October 16, 2017 mt219433 Leave a Comment

Written by Matt Jalink – MSc Candidate in Community Health and Epidemiology

“The world is running out of antibiotics” – WHO report

Antimicrobial resistance (AMR) occurs when bacteria, viruses and other microorganisms change in ways that cause existing medications (ex. antibiotics – bacterial infections, antivirals – viral infections) to be ineffective. These resistant microorganisms are commonly termed “superbugs” and are a major public health concern due to their ability to spread in populations and impose large individual and society costs (WHO, 2017). AMR organisms cause more than 2 million infections and approximately 23,000 deaths each year in the United States (Marston, 2016). The economic costs are also substantial, estimated at $20 billion in excess medical spending each year (Marston, 2016).

AMR is causing traditionally curable diseases are becoming increasingly more difficult to treat. Data collected from 77 countries shows that antibiotic resistance in gonorrhea is causing infections to be harder and sometimes impossible to treat, and is on the rise (WHO, 2017).

(WHO, 2017)

Factors Influencing Antimicrobial Resistance

Microorganisms resistant to modern medicine have existed for thousands of years, and appear to predate the antibiotic era. Frozen samples collected from Yukon contained bacteria with resistant mutations 30,000 years before the discovery of penicillin, the world’s first antibiotic (D’Costa, 2011). But despite naturally occurring antibiotic resistance, the number of cases of resistant microorganisms continues to rise, which can be attributable to human activity.
One example is through the overuse of antibiotics. The overuse of antibiotics is in many cases unwarranted, and regiments are frequently not completed, leading to drug resistance. A number of drug-resistant infections are found in hospitals, such as Methicillin-resistant staphylococcus aureus (MRSA). However, impatient antibiotic usage represents only 38.5% of the total antibiotic market (Marston, 2016). A recent American study found that 12.6% of outpatient visits in the US resulted in the prescription of an antibiotic, and 30% of those prescriptions were deemed inappropriate (Marston, 2016). Canada ranks in the middle of 30 European countries in outpatient antimicrobial use.

(Canada, 2017)

The overuse of antibiotics largely stems from over-prescribing of medications for conditions that don’t require antibiotics for treatment. The level of antibiotic prescription across Canada varies by province, with the highest levels found Newfoundland and Labrador.

(Canada, 2017)

Outside of North America and Europe, outpatient antibiotic prescription can account for 20 – 100% of antibiotic use depending on location (Morgan, 2011). In many of these nations, antibiotics are dispensed directly to the consumer, and are more likely to be inappropriately selected and taken at doses below optimum levels (Morgan, 2011).

With increasing levels of drug resistant infections, new medications are needed. However, the pace of new antibiotic development has slowed considerably. There were 16 antibiotics were approved by the FDA between the years 1983 and 1987, but only 2 new antimicrobial drugs were approved between 2008-2012 (Boucher, 2013) and 5 in total since 2012 (Marston, 2016). There are certain characteristics of the antibiotic market that likely hinder pharmaceutical industry investment in new drug development. The limited duration of treatment, relative low prices per dose, and the potential for the rapid emergence of resistance (uncertain market longevity) all diminish revenue prospects for new antimicrobial drugs (Marston, 2016).

The agricultural sector also contributes towards the growing resistance of microorganisms. An association has been found between antibiotic consumption by animals and the existence in humans of microorganisms resistant to the same antibiotic classes (Chantziaras, 2014). In 2014, approximately 82% of antimicrobials important to human medicine were distributed and sold for use in food-producing animals (Health Canada, 2014). The influence of the agricultural use of antibiotics on human health has drawn a range of responses, including policies in Europe banning antibiotic use for animal growth, and regulation from the Food and Drug Administration (FDA) encourage similar practices.

Response, methods to combat antimicrobial resistance

Surveillance of antimicrobial resistance starting from local global health departments is very important for managing and controlling AMR. Surveillance captures information about AMR incidence, prevalence, and trends from particular regions. This information can be pooled together to see national and global trends of AMR. The Global Antimicrobial Surveillance System (GLASS) shares data internationally on antimicrobial resistance to inform decision-making, drive local and regional action, and provide an evidence base for action and advocacy (WHO, 2017). In Canada, AMR is monitored by the Canadian Antimicrobial Resistance Surveillance System (CARSS).

(WHO, 2017)

Basic public health measures like sanitation, hand washing, and food and water security can decrease the spread of AMR (WHO). Public Education Campaigns have proven effective on reducing inappropriate prescribing of antibiotics in Belgium and France (Gelband, 2015). There has also been a substantial effort to address inappropriate antibiotic use within hospitals; including implementation of antimicrobial stewardship programs, which seek to reduce inappropriate antibiotic and antimicrobial selection and reduce the inappropriate use of broad-spectrum antimicrobials. However, these stewardships have had limited implementation and acceptance in hospitals (Marston, 2016). Vaccines have a role as well. It is estimated that improved vaccine covered for Streptococcus pneumonia could prevent 11.4 antibiotic days per year in children under 5 years of age worldwide (Laxminarayan, 2016).

Citations

Canada, P. (2017). Government of Canada’s response to antimicrobial resistance – Canada.ca. [online] Canada.ca. Available at: https://www.canada.ca/en/public-health/services/antibiotic-antimicrobial-resistance/government-canada-response-antimicrobial-resistance.html [Accessed 13 Oct. 2017].

Chantziaras I, Dewulf J, Boyen F, Callens B, Butaye P. Antimicrobial resistance prevalence of pathogenic and commensal Escherichia coli in food-producing animals in Belgium. Vlaams Diergeneeskundig Tijdschrift. 2014;83(5):225-33.

D’costa VM, King CE, Kalan L, Morar M, Sung WW, Schwarz C, Froese D, Zazula G, Calmels F, Debruyne R, Golding GB. Antibiotic resistance is ancient. Nature. 2011 Sep 22;477(7365):457.

Gelband H, Molly Miller P, Pant S, Gandra S, Levinson J, Barter D, White A, Laxminarayan R. The state of the world’s antibiotics 2015. Wound Healing Southern Africa. 2015 Jan 1;8(2):30-4.

Laxminarayan R, Matsoso P, Pant S, Brower C, Røttingen JA, Klugman K, Davies S. Access to effective antimicrobials: a worldwide challenge. The Lancet. 2016 Jan 15;387(10014):168-75.

Marston HD, Dixon DM, Knisely JM, Palmore TN, Fauci AS. Antimicrobial resistance. Jama. 2016 Sep 20;316(11):1193-204.

Morgan DJ, Okeke IN, Laxminarayan R, Perencevich EN, Weisenberg S. Non-prescription antimicrobial use worldwide: a systematic review. The Lancet infectious diseases. 2011 Sep 30;11(9):692-701.

World Health Organization (WHO). Antimicrobial Resistance. 2017.

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