Congratulations studentBMJ and IFMSA

Learning from each other can be the best way to share the knowledge which we have in our different localities though sometimes we take that for granted. The arena which have been provided by studentBMJ should be used fully and I believe it's from places like studentBMJ where the world will be making it's future doctors and scientists.

I have heard of and seen the studentBMJ for the first time here in London.I have just completed my medical doctor degree at the University of Dar es salaam Tanzania.I have been in London for eight weeks now as part of an exchange between university of Dar es salaam and UCL attached basically at Whittington hospital and International health and medical education centre.It's within this valuable time of my life I came across and I have read all the 2003 editions of studentBMJ. The work which is been done by medical students is amazing and I can't wait to praise them all over again.

Iam hoping the unification of IFMSA and studentBMJ will be very beneficial to medical students all over the world. It's not suprising that I have not come across studentBMJ in Tanzania as the cost of subscibing for medical journal is very expensive for someone who is fighting to meet his/her physiological needs. The point I want to rise here is that through the unification with IFMSA the IFMSA can make changes in the amount of money the member organisations pay per year to include the cost of having a copy of studentBMJ. When made this way it may be easy to have studentBMJ as the cost will be shared among the students.I believe by putting down this kind of a plan the studentBMJ,IFMSA and medical students from poor countries will all benefit from the unification. More medical students will have access to studentBMJ, more articles will come from the developing world and as a result the studentBMJ will be taking a global shape which I think is the best thing to have.

The medical journals which are popular and desribed as international journals do not have the real international shape interms of articles it contains and where it's read. The people who are reading and writing articles in the studentBMJ are mostly medical students and recently graduated doctors. I can reasonably predict that if we make studentBMJ truly international journal we will be bringing more future writters in the international arena hence making medical journals in the future with a global outlook. The study done by Obuaya C-C on reporting of research and health issues relevant to resource poor countries in high impact medical journals found out that between 1989 and1998 only 6% of papers were submitted from developing countries in BMJ and 5% in Annals of internal medicine. (1)Now we are living in a global village where movement is easy and fast. We can't think of being protected by boarders any more and I think is very important to know what is happening in other parts of the world before the problem is in your locality.

Now is the right time studentBMJ and IFMSA have to move forward in their union and work about to give medical students allover the world their best journal studentBMJ, congratulations!!!

Reference

1. .Obuaya C-C. Reporting of research and health issues relevant to resource-poor countries in high-impact medical journals. Euro Science Edit 2002;28:72-77

Editor,

I was very interested to read Stephen Goldie's recent piece 'Religion must not influence medical practice' (StudentBMJ, November 2003). This is something he clearly feels is crucial, as his strong language attests. However, some of his points concern me.

I would certainly agree with him that the best possible standard of care must be provided by all doctors and to all patients. There is also no excuse in this day and age not to act on the basis of medical evidence. I would also agree that physicians hectoring or pontificating to patients about any matter is unacceptable and detrimental to the doctor patient relationship, but I cannot accept that there is no place for religion in the practice of medicine. I am a Christian, so this may make some of my points instantly invalid but, in contrast to what he suggests, it is in part my faith that directs me towards this position, as well as encouraging me to rise up and fight the real evils in life-poverty, oppression, and disease.

Goldie writes that Hippocrates was the first to separate medicine from religion. He indeed introduced science to medicine, as well as acting on logic and reason, but a quick glance at the opening few lines of the Hippocratic Oath ('I swear by Apollo Physician and Aesclepius and Hygeia and Panacea and all the gods and goddesses, making them my witness, that I will fulfil according to my ability and judgement, this oath and this covenant...') suggests that the Hippocratic School in fact did not reject the place of religion in medicine. Faith and medicine have been intimately linked since those times; much of the medical infrastructure in the UK is the result of Christian input. I wonder whether Hippocrates would have had much sympathy with the bio-psycho-social model that encapsulates the sort of medicine Stephen is advocating, completely denying the transcendental dimension.

It remains a sad fact of so-called 'tolerant' pluralism that those such as the Christian lobby who voice exclusive claims to truth, will seldom be welcome. Indeed there has been a deliberate drive to replace the Judaeo-Christian philosophy underpinning Western society. However, the public perception of religion in general continues to evolve and there is currently great interest in spiritual matters. Although advocates of the bio-psycho-social model of healthcare try to, it cannot be denied that spiritual beliefs form an important part of life for many individuals. I would argue that to try and ignore this dimension in ourselves and our patients flies in the face of the evidence and particularly holistic care which we are repeatedly told is in our patients' best interests. To provide effective care, matters of the spirit as well as the body and mind must be addressed, particularly when for many patients, their beliefs will be a big influence in their decisions about treatment. Although Goldie concedes that patient beliefs should be sacrosanct above clinical judgements, I wonder how he does this in practice when, by his own admission, he feels such revulsion towards 'illogical' religious belief

Helen Barratt

Editor,

I respect the ideas put forward by the author but in my opinion he's thinking of only one extreme,taking into view only the extremes of a subject he's tried to address.

And I am not saying that because I am a religious fanatic.I believe in destiny and I believe in spirituality minus its orthodoxies.

But I believe as a doctor that something beyond our evidence based medicine exercises power over our and our patients' lives.I don't believe in miracles but I believe in the power of faith.

And I think religion is the medium that streamlines faith.Like you need a language to communicate.Words are only a means of getting across your thoughts to other people,the language in which you do that should not be a datum for any discrimination.Same way,religion is what streamlines your ideas about the omniscient divine,the unknown power into something fathomable for a naive mind.Everybody can't be the master of abstract theology.

Religion is what binds the wandering mind on a purposeful road.Its a rein to a mad horse called wishes and thoughts,hopes and disappointments ,a medium for wishful thinking.

As an aspiring neurologist ,I should be tempted to gather evidence helping narrow down the neurotrasmitter that incites faith and concomitantally enhance the body's immune system and awaken it to fight the antigen.That would be evidence based medicine for me.

Yes,religion has its adverse reactions and idiosyncrasies but don't all evidence based tried and tested medicines do?

That doesn't make us give them up.They are useful at the end of the day so we use them.Say -its a pragmatic view point but say -is it wrong?

The point I am trying to make here is -its good to take a stand and stick by it.But for a moment,let your heart rebel and mind open to this-how a little twinkly smile can make the little crying child in your ward forget his pain, stop crying for a while and stare at you.Compliment that smile with a small colorful candy and you'll see the angel smiling back at you.Where's the evidence based medicine!!!its still there .Smile is contagious ,try finding an evidence for it.

My point here is not to convince you of anything that you dont believe in.Every idea is right in its own dimnesions taking as a datum the circumstances that incited those views but sometimes look beyond through the window,look if there's another side to the picture.Look out and see and you will find a whole new perspective that doesnt fit either of the extremes.It bounces between the two.And just because its bouncy doesnt make it indecisive.It makes it something call "LIFE"...............

i am experiencing similar feelings on the eve of exams. i am to appear for my finals on june 2004

i am astonished to know that ayurveda is so expensive in west. perhaps the price is high so that this ancient art is kept alive. i believe ayurveda is more about life style modification and prevention of diseases though it has cure for lots of ailment. meditation is about calming your mind. it is sad that enforcement of such culture has created a sense of repulsion for some. i belive if your mind is healthy so will be your body. meditation is one way of achieving that. the thing in principle is not bad but maybe some people are creating a fortune out of that. ayurveda and meditation do have some rational behind them but as far as yagnas are concerned it is more a matter of faith . if you believe no matter in whom you believe, you will develop a faith and faith is important to live a life.

so you cant call the whole thing a fllawed science as it is not only a science but a faith. therin lies the answer to how music can bring rain. faith. you can call coincidence , some will call it fate. there is story about tansen singing from depths of his soul and there was lightening of lamps. no proofs. no mention in any journals or publication (there were none at his time) but people believe his legacy. atleast ayurveda has anceint texts. i think it is but right people will question it but the answer lies in verifying its knowledge with modern means.

i dont mean to sound irrational about my views on ayurveda or faith. but a fine line can be drawn between faith and science. one has to take what one deems suitable for ones rationality but when it comes to faith it is whelther yo believe it or not and this should never be forced.

I totally agree that universities should be under obligation to provide honest information concerning the relative crime rate for their area. Indeed, I was dissuaded from applying to two medical schools, one in a particular location of London of disrepute and one in the north, because of supposed high crime rates there. I have now found out that one of the universities from where I most hope to receive an offer actually has one of the worst crime rates in Britain. Until students are told of the reality beneath the shiny exterior of medical school life naivety will prevail amongst medical students on entering university, thus increasing the chance that they become victims of crime, not being cautious about the potentially higher than expected crime rate.

In response to the author's title and statement in which she says " At present, African universities examine students using essays and short answer questions." Though it may seem like I am being technical, I would like to correct this stereotype created by the author, as, being a student at the University of Cape Town, in South Africa, we are frequently assessed by the OSCE method. Furthermore, many of the universities in South Africa have changed the curriculum for medicine in order to make medicine a 'problem-orientated learning' degree. While I am not aware of the situation in other African countries, I feel that it is unfair to use the general term "African Medical Schools" in her title as the author has clearly overlooked the situation in South African medical schools.

Thank you for your response. I think it is important to understand that this was a news story, and I was reporting the results of a study, and not creating (composing)the information myself. As a result, I have to objectively report what the study findings were. It is not my personal study, neither my personal opinion. The purpose of a news story is to inform, to report waht has happened, what has been found etc.

The study was published in a peer-reviewed journal. I have to say that the authors used the terms "African Medical Schools" throughout their whole study when talking about their results. I think it might be interesting if you read the whole study(Academic Medicine (2003) 78: 899-906- i can provide you a copy by email if you wish), as you might be surprised to see that three of the authors( including the first two ones) are from South Africa. Maybe you could contact them, and discuss with them the issue. They hold the responsability for their finidings. My responsability is to accurately report their findings, in the way they reported them.

I appreciate your input on the situation in your university. I am sure that your view would be useful for the Academic Medicine, the journal that published the study, so i suggest you also write to them on these issue.

Miss Campbell's article on reasons for the failure of HIV prevention programmes has highlighted a number of very valid points.

In order to solve the HIV/AIDS epidemic problem, biological approach alone, such as the distribution of condoms for the prevention of STIs, will not be adequate.

The problem needs to be tackled from behavioural and social aspects too. These interventions will, by no means, be as quick or straightforward as merely distributing condoms. Attempts must be made to educate the population about the deadly disease, promote acceptance of the existence of the disease and eventually modify behaviours and cultural practices that may have contributed to the dissemination of the disease.

Indeed, from personal experience in the Department of Infectious Diseases, I have noticed delays in treatment seeking behaviour of HIV positive patients who deny the possibility that they might be infected. This attitude acts as a barrier against prevention of dissemination and also against early appropriate management of the disease.

As Miss Campbell suggests in her article, more work needs to be done in the assessment of the attitude and understanding of HIV/AIDS in populations where this disease is endemic. Incorporation of the findings of such studies may improve the success of prevention programmes.

Reading through the chapter on sickle cell from standard textboooks for under graduates like Davidson does not give much info on principles of management of sickle celll anaemia,just a fortnight ago i had my finals ,i had a full question on management of sickle celll anaemia i wished i had read this article then.this is a very nice article very simple uncluttered with jargon,yet highly informative about principles of management of sicle cell anaemia.ideal information on sickle cell management, bettter than any lecture notes.my best wishes to the authors carry on the good work.

The first headline that captured my attention in December issue of studentBMJ was the one on the Romanian gypsies. But I was quite disappointed with its content due to the inaccuracy of some of the statements.

The fact that gypsies are not integrated in today's Romanian society is not due to discrimination and stigma but to a widespread anti-educational and anti-modernisation belief that they share. Gypsy parents would not allow their children to go to school and this is particularly true for the girls. Usually one of the sons learns how to read so that he can get a driving licence. The Romanian government has developed an educational programme aimed to attract gypsy children to school. But Romanian teachers are frequently threatened upon and decide to give up teaching in schools based in gypsy communities. Each University has tax-free places for Gypsy students but there are only few to use them.

The horse-driven carts are used during the night without any light signalling and there are a lot of accidents because drivers cannot see them on time. The 'noisy night-time parties' are domestic fights and children's screams.

The communist regime did not offer them any better protection, they even deported them in the 50's. But the press was very well monitored and the non-governmental organisations non-existent. Besides communist prisons were not very nice places for thieves to stay in while nowadays police prefers not to deal with them. You might remember an event that was related in your newspapers as well - a 12-year-old gypsy girl was forced to marry her arranged partner and was basically raped in front of the whole gypsy community by her 'husband'. The police did nothing but watch.

Gypsies have always been self-employed. They are named according to their occupation - bucket-makers, iron-dealers, horse-dealers, singers. In the restricted communist market their products were attractive but they couldn't face the competition with modern merchandise. Their skills are no longer required in the modern economy and they are reluctant to retrain.

It is easy to report on gypsies' health when an outside observer. But their GPs are frequently attacked, the mothers do not cooperate, they do not know their babies by name. It is almost impossible to keep an accurate record of the vaccinations. No wonder that the last poliomyelitis cases were among the gypsies.

I wonder if John-Paul Smith happened to be working in the hospital when a gypsy patient was inside. He would have seen how you cannot get out of the hospital because the tribe is in the street threatening everybody and forcing the security to get in and 'deal' with doctors in their own way.

Still some of the bad things mentioned about them are also untrue. They would never abandon their children, they don't use drugs and the authentic gypsies wouldn't have tattoos.

As in every society there are rich people and poor people. The rich are quite famous for their large houses, with multileveled, sparkling roofs. But in the backyard one might see a large tent where the family lives. Overcrowding and poor living conditions are not always a matter of poverty but of tradition.

As a romanian medical student, I would have to agree with Ioana's comments. The situation of the gypsies that is prsented in this article is quite inaccurate.

The lack of education is due to the fact that many gypsies do not send their children to school. The romanain law gives them equal rights to study as any romanian citizen.

The lack of health care is due to tradition, as Ioana said. Even the rich gypsies, that have really lots of money, most of the times don't care about hygene. One should also be aware that the general population in romania is not enough educated is the aspects on hygene and its importance for health, so it is not only a problem of gypsies, but of many poor people in romania.

One more thing: there are many examples of gypsies that went to schools, got a normal job and integrated very well in the society. But one has to understand that the traditional gypsies could not really integrate in a society where they have to work for someone else. The culture of gypsies is based on freedom, many of them don't want to work, and when they work, they are self-employed.

I don't want to insist now on the way that gypsies affect the public safety in romania. even the police fears the gypsies gangs. They stole my mobile phone twice in the middle of the day, and this is not uncommon happening.

Don't get me wrong, I agree that they should have the right to keep their culture. i agree that they should be integrated in society, tolerated, and have the same rights- which they do already. But this will only be possible when they will be willing to repect at least some of the laws of the state they belong to.

I read with great interest Anahita Kirkpatrick's article focusing on inappropriate relationships between patients and doctors or students[1]. Although semi-fictitious, I would not be surpised to see a real-life example of the scenario in which a medical student is unsure as to whether or not they may pursue a relationship with a patient. Although I can only speak for my own university, such situations do not seem to be discussed at medical school. I have already spent time on the wards and in general practice, yet there has been virtually no teaching covering the issues raised in this article, or about where boundaries lie for relationships between patients and students. Before each clinical attachment, the importance of obtaining appropriate consent and maintaining confidentiality is (rightly) reinforced, yet nothing is said about how to handle 'amorous advances from patients'.

If situations such as the scenarios in the article are to be avoided, and appropriate doctor/student-patient relationships are to be encouraged and maintained, then the subject must be covered by medical schools from the first year of the course. The studentBMJ should be applauded for covering these issues, and providing practical advice for students placed in awkward situations.

1. Kirkpatrick A. Dealing with amorous advances from patients. studentBMJ 2003; 11:460-1

female genital mutilation is made from traditional origin in some areas in eastern, and northern africa. Some believe that the sense of sexuality was decreased by this so females are more controlling their behaviour!. I heared that it was originated when females were riding horses, and find difficulties in doing so unless circumcised!.

It was inhereted from pherons.

the process of circumcission is simply making a pucket-like to cover the female genetalia by the labia majora after leaving a small orifice from below. It starts by operating off the clitoris whic is the most sensing part, taking off the whole labia minora, and lower part of the labia majora before suturing the two labia majora together.

It is harmfull and I believe it id dirt as it give chances for infection and inflammation.

Myself, I am againest it and hope that one day come with no more of it. It is the job of health education and certainly to reach aimed people who are poor an not educated it is not easy.

I thank u autour fore opening this serious matter.

with respect

Bakre

Thanks for being kindly refferining for such medical , psychosocial , and relegious disaster. AHFAD UNIVERSITY FOR WOMEN has a great deal in such problem , since they used to send the students regardless of their line of study (after they had already had the cource of reproductive health)to the rural areas to educate them about the risks of such procedour but, it is a rather difficult task since most of them hardly belive it has NO RELEGIOUS BASE, in the other hand the men themselves request to marry a circumcised female since this is more enjoiable!!!!. Do you belive that there were non-circumcized females when married they were reffered by their husbands to the midwife inorder to it for her ??

with my love

Hagir

Thank you for this valuable article.

One of the problems in leading a team I find is:

• members are being so friendly but with less effort,
• when they chat out of the main topics, I can not return them quicly,
• when they are lestining to me, I feel like I am talkin alot, thenI stop and ask them questions, but it bores them and me as well.
• I find struggles in attracting students to voulnatary work, and ask myself at the end is only me who is working in the group

With respect

Mark Griffiths makes solid points when leading a team. All are basic guidelines to follow, whether the setting be a medical environment or an athletic pitch.

An important point which I believe is insinuated but not explicitly stated, however, is the importance is understanding your team-mates. Although each person wants the group to do well, each person has a different motivation. To maximize the performance of the group, the exceptional leader will possess the subtle insight to recognize what makes each member "tick". The performance of the team can be maximized by the leader's ability to motivate each member on an individual basis, while still emphasizing the goals and objectives of the group.

Performance of the team reflects the leader's ability to motivate the individuals within that team. This ability can make an assembled group of capable individuals an exceptional team. This is the hallmark of an exceptional leader.

Measuring the pH of the cerebrospinal fluid is an easier and cheaper way to tell whether the clear fluid leaking from the nose after trauma or surgery is CSF than to test for tau protein.

dear Gandhi

Your observations are really fantastic towards betterment of healthy society

Yours

dr Ch Rajendar

MBBS DCH LLB[LLM]PGDMLE

Chairman Legal Cell IMA AP

I agree with Robin Edwards view in December 2003 (student BMJ Letters) on religion and medicine being complementary and not exclusive to one another. I think it is very important for doctors to be aware of different religious beliefs patients may have and be able to approach these beliefs in a consultation. This is especially relevant where their beliefs may affect management of their condition.

I think all medical students should be given an introduction to religious beliefs which they may come across as part of their career. If this is made an integral component of the medical curriculum, I can only see this as a positive way forward in improving the doctor-patient relationship by increasing the level of understanding between the two parties.

Surely by taking into account the patients spiritual beliefs when treating them supports the 'holistic' approach to patient care?

Science without faith?

"Religion and science are opposed, but only in the same sense as that in which my thumb and forefinger are opposed - and between the two, one can grasp everything."¹

Gavin Yamey and Amir Attaran address a serious health issue. Malaria is obviously a grave concern and threat to the continent of Africa. Action needs to be taken to save the lives of healthy.

There are two issues I disagree with, however. The authors believe in instituting a program to give every pregnant woman at least two doses of an effective antimalarial drug, whether or not she has malaria. It is stated that "about two thirds of pregnant women in sub-Saharan Africa attend antenatal clinics, so incorporating prophylactic antimalarials into their routing antenatal care should be straightforward." A rather large hole in his argument is the fact that the one third of pregnant women not receiving prenatal care are of lower socioeconomic status, and thus at a much higher risk of contracting malaria. A more effective approach would address the need to make available pre-natal to a broader base, as opposed to increasing the treatment efficacy of those at lower risk.

The other issue I have is the claim of a "simple conclusion" the authors make in the concluding paragraph. It is insinuated that this highly prevalent health issue in a continent as poor and burdened as Africa can be remedied with donated money. In issues such as these, it is convenient to make wide-sweeping generalizations in the interest of simplicity. Money will help, but will not resolve the issue. Innovative ideas of public health, education of those at risk, and political accountability are solid foundations which are hard to buy.

In Brazil the strategy to control malaria was effective, and today we have focal cases in places where the Amazon forest was changed by the hands of man.

I belive that this theme is very important, because we can think about why the world can not control a disease that is preventable and treatable, diferent from AIDS.

All in all, a well written, informative article that does much to highlight an oft-neglected problem.

In the above article, the authors claim that malaria aid would result in countries swiftly deploying "antimalarial drugs...and spray dwellings with insecticides, like DDT, that are highly effective at reducing malaria risk and have few or no associated health risks to the people who live there."

I would have thought that by now, the Western World would have learned their lesson about the broad-spectrum introduction of pesticides, and especially introducing them into a predominantly rural, agricultural-based ecosystem like those found in West Africa. Significant levels of DDT are detectable in humans today, a throwback to decades when we were much more liberal with our use of drugs (and in particular, DDT) in the environment than we are today. I suggest the authors read up on famous ecologist Rachel Carson, whose ideas developed into the "Look Before You Leap" ecological principle we value today. To this end, the use of DDT causes a range of health problems which only become more apparent in future years, as well as having a devestating impact on the local ecosystem, upon which I suspect these people rely heavily.

I am certainly not putting a lesser value on human life, I merely feel that solving one problem by creating a problem 10 years down the road would be doing these African nations an injustice.

This is a poignant example of how the healthcare field has to change its thinking when it comes to treating pain. The absence of illness should no longer be seen as "healthy". The patient’s perception of pain has a direct impact on mental and physical health. The reporting that MS patients who received cannabis "felt some of the impact of their painful and distressing symptoms had been eased" is encouraging. The health care field must become more liberal in its view of cannabis when it comes to alleviating pain and improving the health of the many who are suffering.

Drinking seems like a legacy for medical students they have inherited from their senior folks. An abstainee or even a teetotallar is induced to drinking. Binge is an easy and cheap way to celebrate weekends free from loads of studies.

Alcohol policy in medical school does not seem effective in reducing the number of consumers but it has decreased vandalism and such acts.

Easy availability of drinks is also a major factor. Premises of our medical school are alcohol and smoking free zone.Needless to say, medical students are the major consumers of tobacco and alcohol. Retailers around the premises seem more interested in selling alcohol, esp. home brewed which is more popular. Unless we set No Alcohol Zone prohibiting its sale within certain periphery of medical schools, we are not going to make it.

The scientific basis for healthcare by O Westwood sounds like a fabulous book.

Victoria Reeves in her review called it "a splendidly written summary of the foundations of health care at the turn of the millennium."

She also indicates that "The book is up to date, discussing many of the latest treatments, ... Indeed, the style of the book, which favours discussion of broad concepts rather than trying to cover every detail, makes it an enjoyable read."

Health care is undergoing tremendous change at the turn of the millennium. The scientific basis is shifting from the pure basic sciences to include chaos and complexity science. This new science has gained credibility by the award of the 2003 Japan Prize for Science and Technology to Yorke and Mandelbrot for establishing chaos and fractals as universal structures of nature, and I would add should include society.

Various conferences are now being held on this subject and national healthcare organizations are starting to explore and use this. Complexity in Health Care organization is now in press in the UK with a book chapter "Community health promotion using chaos and complexity science." A book "Chaos 2000: making a new medicine for a new millennium (a 2000 reprinting of "Chaos: a new art,science and philosophy of medicine") illustrates this changing science for health care.

Westwood's book is a splendid description of the foundations of healthcare. The future of healthcare however draws from these foundations and now includes the new science of chaos and complexity.

For more on this please search internet for complexity health, or this web page - http://www.complexityprimarycare.org/Rambihar.PDF or various postings on bmj.com.

Scott Gottlieb points out the trends of medical students shying away from the more demanding specialties, such as surgery. He states that this may lead to shortages in the coming future in given specialities. I disagree with this statement, as there will always be International Medical Graduates (IMGs) more than willing to fill these spots. At Saba University in the Dutch Antilles, there are many competent and eager medical students who are eager to compete for these demanding specialties. Where the American medical students falter, IMGs will fill the holes. American medical student preference will not be a factor in future doctor shortages.

Tuberculosis (TB) is no doubt a very important infectious disease.Millions of people get infected each year and out of those many die.

Benjamin Geisler has rightly pointed out that medical students should also get involved in the fight for control of tuberculosis.Especially in developing countries like Pakistan and India,steps should be taken to educate medical students about the disease pathology,its spread in a particular area and the latest anti TB treatment.

The point of concern is that it is a treatable disease and still with all the necessary medications and treatment modalities available,so many people are dying annually.WHO's Direct Observation Treatment Strategy(DOTS) is being implemented in Pakistan but still the sitution is not good.Medical students can play an important role especially in developing countries because it is a common disease and they would come across many patients with TB.So they can educate them and refer them to an appropriate medical set-up.Because in developing countries poor socioeconomic status and lack of education are the main factorsin the disease spread,many people even don't even contact a doctor for their illness.If somehow there could be a system,in which medical professionals(doctors,students or even health care workers)can tell them and refer them to a hospital,their lives could be saved and many families can be protected.

Dear Student Leader,

Your help is needed as a fellow student leader and activist. I would like to ask you, on behalf of the students that you represent, to participate in one of the most expansive global student solidarity actions ever initiated in response to the global HIV/AIDS epidemic. It is a call to arms wherein students will unite around the world to demand that our governments provide HIV/AIDS information, services and treatment to those affected by the epidemic

AIDS kills more than 8000 people every day. Young people are the most vulnerable and the most affected.

Governments and organizations do not lack the resources to provide care and treatment; they lack the political will to do so.

NUS UK is working with the Student Stop AIDS Campaign to launch the "Unite to Fight AIDS Survey", a survey that will assess students'access to HIV/AIDS information, services, and treatment. We’re sending this survey to students worldwide via national students'unions on World AIDS Day 1st December. We will present the results on Valentine’s Day- 14 February 2004. Students can use the results to campaign for increased access to HIV/AIDS information, services and treatment.

Please visit http://www.surveymonkey.com/s.asp?u=11649329178 and take some time to fill out the survey. Please pass this letter and link along to as many people as possible.

We will send you the survey results, ways that you can mobilize these results, and information about the next stage of the campaign. Please join our global student campaign to increase access to HIV/AIDS care, services, and treatment. United, we can improve the lives of millions!

James Lloyd
National Executive Committee
National Union of Students
461 Holloway Road
London N7 6LJ
lloyd@nus.org.uk
www.nusonline.co.uk

Kate Sheahan
Network and Campaigns Coordinator
Students Partnership Worldwide
17 Deans Yard
London SW1 3PB
spwnetwork@gn.apc.org
www.stopaidscampaign.org.uk

Please forward this survey on to other students'unions so they may strengthen our message.