Lost in translation: the RM highlights party mix.

International IFMSA meetings will always be lost in translation. Yes, in a literal way one might say, the event takes shape – for the Americas at least – through English, Spanish, Portuguese and French speakers, with over 160 students from different backgrounds and conceptions of health, medicine and social justice. Then on a more philosophical plane, there are simply no ways to express and translate into words this energy and momentum, this constant feed of motion, invested now in a universal health training and then in a lateral thinking workshop, herein taking place at a carnival and therein on a beach by the moonlight. As was emphasized, there is a careful balance in attending and being “present” to everything, and caught in the whirlwind of the RM I haven’t had an opportunity to write at all, for a couple days now. Not that I could have cut down or sleep: I found myself running on an average of 1 hour and a half of rest per night for these past four days, an accomplishment previously unparalleled, the explanation of which I am still attempting to formulate (yes, that involved a lot of matté, but still!). So please excuse this gap in my blog: it was overwhelming, to say the least.

Thus, there would be no ways to translate the experience of the RM without stretching, unfolding, polishing a discourse which would be very time consuming. Maybe a book of short stories, an IFMSA novella, or a collection Montevidean poetry would better capture the essence of this RM. But as each stone sets the way to a long paved road, I will offer you here a collection of such “stones” (and will leave the road up for your imagination); so here is the “party mix” I spoke of in my last thread. They are mainly learnings I took from the many sessions I attended during the RM, but I will be closing with a more entertaining part: sentences that were truly lost in translation while I tried to communicate with a spanish-speaking community of medical students. Still, blame it on the linguistic gap, I blame those on my crooked mind and its never-ending faculty to amuse me. But for now, my favorite medical concepts and highlights !!

Access to safe abortions

In a workshop on maternal health and safe abortions, led by the SCORA Regional Assistant Carlos Acosta and his colleague Cecilia Espinosa, we focused on the tragic consequences of lack of access to safe abortions. These consequences were admirably well demonstrated by Cecilia as she gave each team as a case study the profiles of vulnerable pregnant women (and one transgender man), in order to identify and discuss the many barriers – social / economical / cultural / institutional / psychological – in having a safe abortion. Nicaragua, Chile, Salvador and Malta have the most restrictive laws on abortions, which are often permitted only if the mother risks death, or if the pregnancy results from rape or incest. In 2010, it is estimated that lack of access to safe abortions was responsible for 287,000 deaths, not counting all the mothers who have been left disabled (physically or emotionally) by the trauma. Most striking to me was unwanted pregnancy in the transgender population. In 2013, a UCLA study revealed that 32 to 40% of transgender men got pregnant (from rape for the most part, as a way for other males to express their disapproval of gender change), 23% of which didn’t get support from health care because of discrimination. In Brazil, transgender men can receive an abortion only if they are diagnosed with “gender dysphoria”, which implies having severe distress from your birth gender.

Advocacy

Contrary to a common opinion, advocacy is unlikely to show tangible results in a proximate time frame. No matter how large the initiative and strong the policy statements, institutional change takes time. And thus many are discouraged by the lack of attention their pleas and policy statements get from industries or decision makers. This was emphasized in a workshop on public health and advocacy, where we realized how important it was keep in mind that advocacy is like investing in a chain reaction: as chaos theory would have it, initiating an advocacy movement will impact much like the butterfly effect will, somehow unpredictably, depending on the amount of variables and actors in play, but mostly in an amplificatory fashion. Eventually a tipping point is reached, and advocacy has a concrete impact on policy making, or more sustainable ways. And sometimes, if we are lucky, the change is more immediate, like this Greenpeace campaign who managed to stop Lego’s partnership with Shell, who is wrecking havoc in the Arctic: https://www.youtube.com/watch?v=qhbliUq0_r4.

Chagas disease

Tryponosomia cruzi, the parasite is a nasty one. During a workshop on Communicable diseases, my group was charged of starting a discussion on a neglected disease such as this one. Chagas affects mostly Bolivia, where 80% of the population is thought to be infected, but also most Latin American countries such as Brazil and Paraguay, and affects 7 to 8 million people worldwide. The parasite will hide and feed mostly in the heart muscle and digestive muscles, accounting for hypertrophia of the right ventricle, heart disorders, enlargement of the colon, and neurological disorders, all of which can result into death at an advanced age. Untreated in its acute phase, the parasitic infection will remain for life. Transmitted vertically, it can infect the eyes and namely, induce blindness to newborns. The parasite is carried by the triatomine bug (also known as the “kissing bug” and the “assassin bug”!), an insect infesting households with neglected maintenance, increasing nesting places for the bug. Chagas thus adds to the diseases where the populations are disproportionately at risk.

Health Co-Benefits

In a session on climate change and health, we learned that the transition to a more ecological, sustainable lifestyle (aiming for “climate resilience”) was best met by adopting behaviors or technologies with health co-benefits. Riding a bicycle, for example, is a single action that will reduce the carbon emissions, while simultaneously keeping your cardiovascular system active and your muscles fit, helping you obtain a healthier weight and overall vastly contributing to reducing your risk for developing a chronic illness. Another example used was transiting from coal stoves to clean cookstoves, such as electric stoves, in India. Obviously coal stoves are more polluting for the environment, but they are also a harmful source of toxic particles for families making use of such technologies in their home.

Health habit education amongst children: here’s a nice idea. In elementary school, children are invited to pledge for behaviors they value, and against behaviors they don’t. A classical pledge is to say “I will not smoke cigarettes”. The pledges are exposed in the classroom on a billboard and, during all of elementary school, they remind the students of their principles. Not only is this a great way of doing positive reinforcement against bad habits; it’s also a powerful emotional tool, for they can remember the pledges they made as children when they grow up and face dilemmas with their principles. And tell me, has anyone more authority than the child in us ?

Lateral thinking

Children do it better.

True primary intervention

This concept was brought up by the brilliant, dynamic and charismatic program coordinator for Climate Change and Health, Samantha De Leon Sautu. The concept served to illustrate that primary intervention must address the determinants of health that underlie health inequities and are most of the time neglected, if not disregarded by the medical community. In a climate change scenario, different people of the same population will be affected differently, namely, both extremes of the demographic curve, the women, the poor, those in vulnerable occupational dispositions, those dependent on industries … In a situation of drought, for example, women are more likely to suffer since they are often responsible for fetching the water. Simultaneously, in case of a disaster situation like a flood, women are more vulnerable from having less education than men, having less opportunities to acquire critical competences, and carry the weight of a whole “invisible “domestic economy when natural disasters strike. As the trainer mentioned, “adapting to climate change is basic public health”, and the first step to adaptation will lie in working to make both society AND its distinct populations, from all backgrounds and situation, empowered and resilient. The path to achieve this goal is true primary intervention.

I know this is a bit of an academic overkill for a « party mix ». So let me now end by sharing with you « lost in translation » gems that I wrote down from the many conversations with spanish-speaking friends. It’s not always easy interpreting what someone is saying when you’ve not gotten accustomed to the accent. Here are a few deformities:

1st day
« Hey Charles, welcome ! you’re from Quebec ? oh ! who’s your animal president ?
Me: Animal president ? you mean, like, what’s my animal spirit or something ?
-No, not animal ! N.M.O., your National Member Organization president !

2nd day
(I’m overhearing Brazilians saying the pool is « exquisito »):
Me: Exquisito… ? that’s strange to say, plus the water is a little cold to be so exquisite, I find !
Friend: Oh, no Charles, this is not the spanish « exquisito », this pool is not delicious ! It’s the brazilian « esquisito », it means weird ! This place is weird, man… !

3rd day
« Now welcome everyone, Chile’s midget past president! »
Me: ugh, really I find it kind of rude, to be calling a president by its small stature…
Friend: hmm Charles, I’m pretty sure he meant « immediate past president ».

4th day
Friend: so, you work in the magical education field ?
Me: magical education… yeah I guess you could say that. Lighting a sparkle, sharing your passion, making magical things happen !
Friend: magic ? who said magic ? I asked you if you worked in the « medical » education field !

5th day
Presentor: And keep in mind, many communities here use alternative medicines. There came this woman the other day, she was treating her flu with hairball medicine.
Me: hairball medicine ?! what in the world…
Friend: hmm, Charles, I’m pretty sure he meant « herbal medicine »…

6th day
Friend: did you know, in Costa Rica we have sluts at our university ! we can watch them from the window sometimes.
Me: haha, really ! I don’t know what to say, I guess we have them at my university too, actually, but we think it’s a little derogatory to use this word.
Friend: derogatory ? sluts ?
Other friend: Charles, this is Costa Rica. He’s not looking at sluts, he’s trying to say he’s looking at sloths, the large, clawed mammals that live in the forests.
Me: oh, my bad… then yes, I wish we had beautiful, beautiful sloths on our campus too.

Next time, I will be writing from home and will be going through severe withdrawals from leaving the Regional Meeting, so expect a last post raising awareness on post-RM depression 😉 (what sexy topics I choose ! no need to tell me !). Until then, enjoy life ! 🙂