AMSA President Elise Buisson’s Address at the 2016 Global Health Conference

AMSA President, Elise Buisson, delivered an address to 700 medical students at the 2016 AMSA Global Health Conference. She spoke about Australia’s treatment of asylum seekers and refugees, and the responsibility of doctors to take action against indefinite detention.

You can read a full transcript below (check against delivery).


I want you to imagine that were somewhere nice and warm. You’re in France lying, safe and at home on a sunny beach in Nice, wearing long loose, comfortable clothing and soaking up some sun. That is until armed police showed up and require you to take off parts of your clothing. It sounds like a dystopian future, doesn’t it? But we all know it happened this week in France. Because in France, the burkini, is outlawed. And it’s outlawed on the basis of the fact that it’s believed in France that wearing it means that you’re not “adhering to good morals and secularism”. Now I have just one question about that, and that is, are you kidding me? That is exactly the same rhetoric used in other parts of the world to force women to wear the exact same piece of clothing; that they’re not “adhering to good morals and religion”. And I think we all know that the clothing was never the problem. The item of clothing as no inherent moral value. The problem was always whether or not women had a choice that they wanted to wear it or that they didn’t. Whether you’re politicising women’s bodies for religion or for secularism, you’re promoting division either way.

Meanwhile, in the Australian Senate, Pauline Hanson has mostly moved on from the Asian and then Indigenous peoples that she vilified in the earlier parts of her career, to claiming that it’s now Muslims who are ruining our way of life. Now if Pauline ever does come down to visit me in Campbelltown, Western Sydney and partake of a Halal Snack Pack, I’d love to ask her: what is that way of life that you’re protecting? What do we most value and want to preserve about being Australian? Is the Australian way of life the Cronulla riots? Is the Australian way of life the Reclaim Australia rallies? Because I think we all know that we’re proud to be Australian for the opposite of those reasons. Proud because the national code of conduct is one of working hard, looking out for your mates, and not taking life, or yourself, too seriously. Is that the way of life that Pauline Hanson embodies? When a politician taps into something you fear, don’t fall for the rhetoric. Refuse to be used against yourself.

We find ourselves living in a time when all around the world, we are seeing the rise of the politics of fear, and policies of division. When our nation’s Treasurer frames the Australian population as the lifters and the leaners. The taxed and the taxed-nots. The leaders of our nation are trying to take human beings and put them into two clean columns and label just one of them as worthwhile. I want to take a moment to reflect on the fact that as a group of people who are at the hospital without pay during working hours, then studying lectures and tutorials after-hours, and therefore rarely working enough to pay tax and often instead receiving a student Centrelink payment, as defined by your politicians the people in this room are the taxed-nots. In a divided society, we’re the leaners.

I believe that we, as the future of the medical profession, have a significant role to play in reversing the politics of fear. Our profession inherently stands for unity. We treat people regardless of their race, religion, gender, sexuality, political affiliation, and bikini, burkini or mankini. No matter who a person is, when they walk into a clinic or an office or a theatre, we will do our best for them. Now that is the Australian way of life. No matter who you are, we will do our best for you.

There’s a question I want to ask you: in a political environment when a nation is being encouraged to turn in on itself, what do you think becomes of the most vulnerable in that society? You already know the answer. We’ve heard the answer over and over again already at this conference. We heard it when Julian Burnside spoke on the first morning.

We live in a time where the Supreme Court of Papua New Guinea says “indefinite detention of asylum seekers is illegal”, the United Nations says, “Australia is violating the Convention Against Torture”, the Nauru files say, “children are being abused”, and the Prime Minister of our country says… “can’t be misty eyed”.

In this, our role is clear. The medical profession stands for the physical and mental health of all. Indefinite detention harms health, so indefinite detention is not acceptable public policy. It has been tried, and it has failed, and the Australian public has been failed by all sides of politics who have allowed this practice to continue. We can try to make it sound more complicated than that by deferring to the wisdom of the political powers that be or referencing lives lost at sea. But nations are culpable for what they allow their political leaders to do when they do those things in plain sight. And our national conscience isn’t unburdened if people are now dying in their homeland instead of drowning off our shores.

So where does the buck stop? Is it with the guards who stand accused of witnessing and even perpetrating abuses of those in their care? Is it with the media who report on asylum seekers as potential terrorists? Is it with our politicians, who call asylum seekers “illegals”, in full knowledge of the fact that it is legal to seek asylum, even to Australia, even by boat, even without papers? The answer, it seems obvious, is yes, and yes, and yes. And yet. The buck has not stopped and neither has the indefinite detention of persecuted people who have done nothing wrong.

Whenever terrible things happen in the world, at some point a little later on, the world reflects and says, “how could that possibly have happened? How could a whole nation possible have allowed that to go on, right under their noses?” People ask those questions again and again because they’re they’re looking for an explanation for how a whole nation of people turns out to be just awful. But that’s just it. Atrocities throughout history didn’t happen because nations were awful. They happened because people read it in the papers and heard it on the news, but they convinced themselves that it wasn’t their problem, and they stood idly by.

There’s this technique that politicians use in interviews, you’ve all seen it. The interviewer asks them a question that, as a leader of our nation they should rightfully be able to answer. But they don’t answer. Instead they say over and over again, “It was the other party that caused this problem” as if that abdicates the current leadership’s responsibility to fix the problem now. If you want to lead this country, you get it with all its victories and all its failures, and you lead us as a nation forward from wherever you find us.

Now, in a funny way, we as medical students find ourselves in a similar position. Doctors and nurses and allied health, we lead the health of this country and we do it from the coalface. Now we can say that indefinite offshore detention is a problem created by the government, which is absolutely true. But regardless, we’ve chosen to take a position of responsibility for this nation’s health – every doctor has – and asylum seekers are under the care of our nation. So even though we aren’t responsible for the creation of this problem, it’s going to be on us to help solve it, and get these people to conditions where they are safe, and well.

If we do not take the lead in protecting the health of the most vulnerable people in our society being put at risk, we have squandered the respect afforded to our profession. We pledge when we become doctors: “I will maintain the utmost respect for human life”. That isn’t a passive requirement, it’s a powerful one. I will maintain the utmost respect for human life. I will not allow human life to be locked up indefinitely without cause and deprived of hope.

Being the President of AMSA this year has taught me a lot of things, but maybe even more importantly, it’s left me with a lot of questions. First and foremost being, “Why are we here?” Here in AMSA, here at this conference, here in medical school. Are we here to fight for our jobs, our education, our quality of life?

There’s nothing wrong with caring about those things. Everyone cares about those things. But if that’s all that we’re here for, we should just about pack up and go home. In a fair society, you only get to ask for more for yourself when you’re putting what you currently have to good use.

And what do we already have? We have a bright future. We have a world-class education. Since the release of the Nauru files, we have more insight into the situation facing our asylum seekers than ever before. And we have an opportunity, when historians re-examine this period of time looking for what went wrong, not to be the people who stood idly by.

It’s time that we showed that the Australian way of life, and the courage of the medical profession, are alive and well. I know the people in this room care about this issue, it’s why we’re here. But we’re not a higher moral class of bystander if we come to a global health conference, or if we know that we care about the issue deep down inside. We need to put our actions where our ideals are and do something.

Or better yet, let’s do something together. Be a part of a united voice: we are the future of the medical profession in this country, and we will not stand idly by. You’re about to get a notification on your app during this conference – if you’re ready to take action, it’ll show you how you can do it with me.

The day I first watched Julian Burnside speak, he was asked a question from the crowd about what he believes the future holds. And he said, “This issue will not be resolved in my time. But I’ll die knowing I did my best for them.” Let’s do the best we can for them. After all, that’s the Australian way of life.

Thank you


To take action: http://tiny.cc/amsa

Applications open for Convention and GHC 2018 Convenors

We are currently looking for students to convene the 2018 AMSA National Convention and Global Health Conference. This provides an exciting opportunity to inspire, challenge and connect medical students from around Australia and for medical students in Hobart or Perth to be involved in shaping a unique program. You will both lead a team of medical student volunteers and hold a position on the AMSA Board.

In August/September 2017, the 13th annual AMSA Global Health Conference will be held in the city of Brisbane or Melbourne. We are now seeking applications for the position of AMSA 2018 Global Health Conference Convenor from either Queensland or Victoria.

In July 2018, the 59th annual AMSA National Convention will be held in the city of Hobart or Perth. Students from Tasmania and Western Australia are welcome to apply

Please see below for further information on the positions and application process.

GHC Convenor 2018

Convention Convenor 2018

 

 

PRESS RELEASE: New medical workforce data affirms need for Doctors for Rural Communities

The Australian Medical Students’ Association (AMSA) has warned that the latest national data showing declining numbers of doctors in the rural medical workforce highlights the need for increasing funding into rural training pathways, especially GP training, and not new medical schools.

This week’s Australian Institute of Health and Welfare (AIHW) report, Medical Practitioner Workforce 2015, showed that the overall supply of medical practitioners was lowest in outer regional and remote areas.

AMSA President, Elise Buisson, stated that a lack of funding for young doctors to train in regional, rural and remote Australia was a significant contributor.

“This latest report confirms that GP and specialist services in regional and rural Australia need sustainable investment. While overall rates of medical specialists and generalists are increasing nationally, they are decreasing in these areas where we need them the most,” said Ms Buisson.

“A 2015 OECD study showed that Australia has the highest medical graduate rate per capita with 3.4 per 1000, compared to New Zealand and the United Kingdom (2.8 per 1000) and the United States and Canada (2.6 per 1000), with Australian medical graduate numbers more than doubling in the past decade.

“Despite this, the people of rural and remote Australia still face worsening access to specialists and GPs, higher rates of chronic disease, and higher rates of death compared to those in our major cities.

“This rural doctor shortage is a problem not of numbers but of distribution, as doctors are faced with a lack of adequate training and working opportunities in rural communities.”

While many medical students and junior doctors are passionate about becoming regional and rural GPs and specialists, upon graduation they find there are few opportunities because of a shortage of accredited training positions outside of the metropolitan centres.

Furthermore, the AIHW report shows that the rural GP workforce is under threat by increasing hours of workload and an aging population. AMSA’s proposal for the expansion of rural GP and specialist training positions for junior doctors would serve to relieve this. In contrast, more medical schools producing more graduates without training opportunities would worsen the strain.

“Of all medical practitioners, GPs represent the most aging population of doctors, having the highest proportion aged 55 or over, while rural GPs work the most average hours per week compared to their metropolitan counterparts,” said Ms Buisson.

“We need to use evidence-based strategies to resolve rural workforce shortages, which includes making the funding of rural training positions a priority.”

The Government is set to establish a National Rural Health Commissioner. AMSA looks forward to working with them on these sustainable workforce strategies.

Media Contact:

Tabish Aleemullah

0401550952

pro@amsa.org.au

Applications for Council 3 Minute Taker

AMSA is calling for expressions of interest for the position of minute taker for Council 3 2016. If you are interested in the role please read the attached information and apply by 20th August 2016. Council 3 will be held 16th -18th September, 2016 in Sydney, NSW from 9am- 5pm (you should be available 8am-6pm). It should be noted that AMSA will not cover the cost of transport and accommodation for the minute taker but the fee of council registration will be waived.

Please see here for more information see below

Application Information Council 3 Minute Taker

PRESS RELEASE: Medical students take action on climate change

The Australian Medical Students’ Association (AMSA) is calling on the Government to firmly enact climate change policy and invest towards fulfilling its commitment to the UN Paris Agreement.

AMSA President, Elise Buisson, spoke of the need for action to minimise the detrimental health impacts of climate change during the Association’s National Code Green Week, a project founded in partnership with the Doctors for the Environment Australia (DEA) and Climate and Health Alliance (CAHA).

“AMSA is challenging the nation’s leaders to invest in climate-resilient development and to lower greenhouse gas emissions,” said Ms Buisson.

“Climate change is one of the defining health issues of the century and one of the biggest threats to global health. It has the potential to kill thousands of people around the world through changing patterns of disease, rising water and food insecurity, threats to housing, extreme climatic events and unstable population growth and migration.

“By reducing the use of fossil fuels and increasing reliance on renewable energy we can mitigate climate change and improve health, Ms Buisson said.

“As Australia is one of the signatories of the UN Paris Agreement, it is imperative that we actively work towards holding the increase in the global average temperatures to well below two degrees Celsius above pre-industrial levels.

“To have a reasonable chance at meeting this target, up to 80 per cent of known fossil fuel reserves must remain in the ground. This would significantly reduce the risks and impacts of climate change.”

Although primary prevention is key, one of the fundamental points of the Paris Agreement is to concurrently increase the ability of global citizens to adapt to the adverse impacts of climate change.

“AMSA’s National Code Green Week engages hundreds of Australian medical students with initiatives to educate future doctors about the medical concerns associated with climate change, while offering active opportunities to clean up local beaches and advocate for divestment,” said Ms Buisson.

“We must all play our part in creating a climate resilient healthcare system and partnerships with experts such as Dr Hamish Graham, co-founder of Global Health Gateway, discussing solar powered oxygen concentrators for use in hospitals, to Rike Wolf, founder of Food Rescue, are significant.”

AMSA’s National Code Green Week is internationally-acclaimed, having been awarded top honours at the International Federation of Medical Students Associations’ (IFMSA) General Assembly and the World Health Organisation’s (WHO) Towards Unity For Health Conference in China, 2016. To find out more, visit https://www.facebook.com/AMSA.global.health/.

Media Contact:

Tabish Aleemullah

0401550952

pro@amsa.org.au

Paris Agreement 2015

Paris Agreement 2015

 

PANACEA VOL. 50: THE NOSTALGIA EDITION

Promo 1

We’re celebrating the FIFTIETH BIRTHDAY of the Official Magazine of the Australian Medical Students’ Association. If you’re a budding writer hoping to be published, look no further. Our theme for the first edition is Panacea: Go – The Nostalgia Edition.

If you’re reminiscing on your first years in med school, how entry into medicine was like for you – or if you just really love the 150 original Pokemon, then get in contact with publications@amsa.org.au. Articles, creative writing and visual pieces with any interpretation of NOSTALGIA are all welcome!

Check out past editions here!

Submissions due at 11:59PM, Sunday 14th of August, 2016.

PRESS RELEASE: Medical students call for independent advisory body for asylum seeker health

This World Refugee Day, the Australian Medical Students’ Association (AMSA) has urged the Australian government to establish an independent health advisory body for immigration detention.

AMSA President, Elise Buisson, said that the current policy of indefinite detention of asylum seekers has detrimental physical and mental health outcomes. This is the result of inadequate medical care, and poor oversight of the processes by which health care is delivered.

“All communities have a right to the best attainable health, and our responsibility is greatest to those who are most vulnerable,” Ms Buisson said.

“Those in offshore detention are under Australia’s care, and must be afforded a standard of health care equivalent to that received by any Australian citizen.

“The circumstances that lead an individual to seek asylum also create a ripple of ongoing mental and physical health impacts. As a result, asylum seekers are in particular need of specialised, high quality health support.”

The Australian Human Rights Commission (AHRC) released two reports into immigration detention, The Forgotten Children (2014) and The health and well-being of children in immigration detention (2016).

The Forgotten Children found that children detained on Nauru suffered from extreme levels of physical, emotional, psychological and developmental distress.

Furthermore, clinical assessments by doctors working in immigration detention revealed that 34 per cent of children suffer serious mental illness, a stark contrast to just 2 per cent of children in the general Australian community.

“Children are at particular risk of suffering psychological and developmental harm as a result of immigration detention. The Forgotten Children report recommended that all children and their families be released into community detention, or the community,” Ms Buisson said.

“Until this recommendation is met, strong protections must be put in place to ensure those in detention are receiving adequate health care.”

Since the disbanding of the Immigration Health Advisory Group in 2013, there have been increasing calls for the Federal Government to establish an independent body of experts to oversee health care in immigration detention.

“Installing an independent health advisory body for immigration detention is an essential step in delivering transparent and effective health care to this particularly vulnerable community,” Ms Buisson said.

“Currently, the final call on medical decisions rests in the hands of Department of Health officials, not the doctors working in immigration detention themselves.

“Australians want health decisions to be made between them and their doctor. Those in immigration detention deserve the same. An independent panel of medical experts would put health decisions back in the hands of doctors, where they belong.”

Today on World Refugee Day, AMSA would like to recognise the enormous challenges that refugees worldwide face in rebuilding their lives from the chaos of conflict and persecution, and celebrate the invaluable contribution refugees have made to Australian society.

Media Contact:

Tabish Aleemullah

0401550952

pro@amsa.org.au

Convertibles: Urban medical students who go rural

MorganJonesMorgan Jones

Third Year Medical Student, The University of Notre Dame Sydney & Member Without Portfolio, AMSA Rural Health Committee

It is widely accepted that students who originate from a rural location are likely to practice rurally – known as the “rural background effect”. The considerable research base on this topic has directed policy makers to focus on rural background students as the solution to rural health inequality. However research is lacking around the role urban medical students can play in bolstering the rural medical workforce alongside current initiatives. Current programs to increase the rural medical workforce tend to target students with a rural background, and opportunities for urban students may be limited.

Urban medical students already make up a notable proportion of students at Rural Clinical Schools (RCS), and many enter the rural workforce. In a retrospective survey of doctors who studied at the Flinders University RCS [1], close to half were practicing medicine rurally and half of these doctors were not of rural origin, but had grown up in a metropolitan centre. Clark & Freedman [2] suggested that RCS placements appear to even have a stronger association than that of rural background for students’ preference for adoption of rural medical practice. Naturally those who both have an extended rural placement and a rural background have the strongest predictor for rural medical practice, however the potential for urban background students has become sidelined. The potential of urban students must not be overlooked, as they can play a significant role in addressing the workforce shortage alongside their rural counterparts.

It is clear that there are urban students who have a preference for a rural medical career, however there are structural barriers which affect both rural and urban students to take up rural careers. These barriers include: perceived lack of support from supervisors or teachingn staff; belief that rural placements limit career options; a preference for a metropolitan lifestyle; perceived isolation from metropolitan based family and friends; and most significantly a partner who is not committed or able to work rurally [3]. One of the most modifiable barriers, and one that is a current hot topic for discussion, is to increase vocational training opportunities in the bush. It has been shown that students and junior doctors are interested in rural training opportunities that provide long-term prospects for permanent, rural-based junior doctor terms and greater breadth of postgraduate training choices [4].

Unfortunately there are only scant opportunities to continue to work in rural Australia if you wish to specialise in a discipline other than general practice. While the country needs specialists like surgeons, psychiatrists, paediatricians and obstetrician/gynaecologists, junior doctors must move to metropolitan locations to undertake the majority of such training. It is no surprise that specialist intentions are a negative indicator for a rural career [5, 6]. This relocation is during a crucial time where many life decisions such as meeting a partner, starting a family, buying a home and finding career role models in the city significantly reduces the likelihood of returning to rural practice. Despite having the best of intentions initially long-term training remains a further barrier for urban students to fully convert.

In summary, students of urban origin are open to a career-determining rural experience, even if they may not have seriously considered working in a rural location previously [4]. These students should be identified and supported at every opportunity, including after graduation for rural vocational training. Opportunities in these areas must be cultivated and promoted in future rural policy and workforce recruitment efforts.

References:

1. Stagg, P., J. Greenhill, and P.S. Worley, A new model to understand the career choice and practice location decisions of medical graduates. Rural Remote Health, 2009. 9(4): p. 1245.

2. Clark, T.R., et al., Medical graduates becoming rural doctors: rural background versus extended rural placement. Med J Aust, 2013. 199(11): p. 779-82.

3. Henry, J.A., B.J. Edwards, and B. Crotty, Why do medical graduates choose rural careers? Rural Remote Health, 2009. 9(1): p. 1083.

4. Walker, J.H., et al., Rural origin plus a rural clinical school placement is a significant predictor of medical students' intentions to practice rurally: a multi-university study. Rural Remote Health, 2012. 12: p. 1908.

5. Jones, M., J.S. Humphreys, and M.R. McGrail, Why does a rural background make medical students more likely to intend to work in rural areas and how consistent is the effect? A study of the rural background effect. Aust J Rural Health, 2012. 20(1): p. 29-34.

6. Woolley, T., et al., Predictors of rural practice location for James Cook University MBBS graduates at postgraduate year 5. Aust J Rural Health, 2014. 22(4): p. 165-71.

PRESS RELEASE: Medical students fear for jobs as internship crisis looms

The Australian Medical Students’ Association (AMSA) has warned that a nationwide shortfall in medical internships will leave recently graduated doctors unemployed. This will most significantly affect rural Australia and areas of health workforce need, which continue to suffer from a lack of access to medical practitioners and health services.

As the first internship offers are made this week under a cloud of uncertainty for many prospective junior doctors, AMSA President, Elise Buisson, said major investment is needed from the Council of Australian Governments (COAG) to drive expansion of internship placements in non-traditional settings.

“A crucial step in resolving the internship crisis will be investing in placements in non-traditional settings. An example of this is the Commonwealth Medical Internships (CMI) Initiative, which is an innovative Federal government program that provides an extra 100 internship positions each year,” Ms Buisson said.

“As recommended by the Review of Medical Intern Training released by the COAG Health Council in 2015, expansion of internship placements into appropriate private, not for profit and community settings is needed to increase the system’s overall capacity.

“Without an internship, medical graduates are unable to continue the necessary training to become the practising doctors that Australia needs and we will still have junior doctors missing out.”

Australia lost up to 40 of junior doctors earlier this year due to the lack of internships, despite an AMSA survey showing that 95 per cent of students without an internship would consider practice in a rural area, where demand for doctors is higher.

“These young doctors want to work in the Australian health care system – to give back to the communities that trained them, to give back to rural Australia and to our areas of need. Without an internship, they’ll have no opportunity to do that,” Ms Buisson said.

“We need a sustainable health workforce where continuing funding and expansion of internship positions is matched with expansion of vocational training positions, especially in rural, regional and remote Australia.”

AMSA is calling upon the Federal and State governments to make the expansion of medical internship positions a key health priority this election year.

Media Contact:

Tabish Aleemullah

0401550952

pro@amsa.org.au

1 2 3 55