EUROMEDS

NCM 2013 Edition

"Yo u pru ng do Dom dent u ctors iniq se o pl a f ue M ant y a k onn ibio ey r o e t, ECDC t i c s . . l e i n pro ."

mo

tin

2013

Impressum................................................................................................................................................ 4 Opening word.......................................................................................................................................... 5 Living in public (health)

Promoting prudent antibiotic use in Europe (Dominique Monnet, ECDC)....................................... 6 How Hedgy the Hedgehog conquered Croatian Kindergartens! (Sven Pal, EMSA Europe)............ 9 A great heroic tale, or is it? Werner Forssmann (Borislav Manev, EMSA Europe) .......................... 14 Ending Ecocide in Europe (Andrew Miller, End Ecocide in Europe) ................................................ 16

Table of Contents

My doctor said it
Urban Gardening and Open Source (Joanna Borowska, EMSA Warsaw) ....................................... 20 Nutrition. Myths & Facts (Joanna Borowska, EMSA Warsaw) .......................................................... 24 From the day we are born (Olga Rostkowska, EMSA Europe)............................................................ 28

Planet EMSA
Internships and Opportunities for EMSAi (Sofia Ribeiro, EMSA Europe)........................................ 32 How to policy making and why? (Jacob Hildebrand, EMSA Europe)....................................... 36 Memories of an EMSA Alumni (Samuel Ribeiro, Portugal)................................................................. 38

For children, big and small

My triceratops has broken his horn (Nikos Korakas and Colleagues, HelMSIC Thessaloniki).... 40 Amsterdams Merry New Year (Chlo ten Broeke, EMSA-VUMC Amsterdam)............................... 44 The Elderly Brothers (Daria Gheorghe, EMSA Bucharest)................................................................... 47

List of Authors........................................................................................................................................ 50
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Impressum

Editor-in-Chief EuroMeds 2013 NCM Olga Rostkowska Editorial Board of EuroMeds 2013 Olga Rostkowska Sven Pal Articles Section Dominique Monnet Sven Pal Borislav Manev Andrew Miller Joanna Borowska Olga Rostkowska Sofia Ribeiro Jacob Hildebrand Samuel Ribeiro Nikos Korakas Melina Kourklidou Christina Eustathiadou Ipek Chatzisouleiman Chrysa Koraka Antonia Mpirniou Dafni Papanikolaou Kassandra Xanthopoulou Chlo ten Broeke Daria Gheorghe Proof-Readers Section Daria Gheorghe Khalid Masoud Vasil Toskov Ibukun Adepoju Felicity Jones

Design (inc. Cover Design) Sven Pal General Layout: Sven Pal Publisher EMSA Europe EMSA European 2012/2013 Print: Printex d.o.o, Croatia Olga Rostkowska Permanent Offier in Brussels EMSA Europe 2012/2013 rostkowska.o@gmail.com Board Sven Pal Fundraising Officer EMSA Europe 2012/2013 pal.sven@gmail.com

EuroMeds 2013 was successfully published on-line and printed thanks to the special financial support received from the

Youth in Action 4.1. EACEA Grant.

Opening word

Welcome on the first (well, fifth) page of this years release of the EMSA Europe magazine EuroMeds. On the 10th of March the first draft of the first article was sent over to us. Turn the page to see what happened afterwards The core of this release is dedicated to the challenges posed by antimicrobial resistance resulting from inappropriate use of antibiotics. In the early days of our practice as health-care professionals we might already have stumbled across alarming examples of prescribing antimicrobial agents in a wrong dose, for an incorrect period of time or due to a diagnosis which misses the target. This causes bacteria to start tolerating the available pharmaceutical weapons and stimulates them to develop strains which can only be tackled by very complex medical measures (e.g. methicillin-resistant Staphylococcus aureus, MRSA). Bearing all this in mind and taking precautions to stop it, EMSA through EuroMeds joins the voice of a friendly hedgehog from the ECDC campaign towards prudent use of drugs: Cold? Flu? Take care, not antibiotics! What else did we prepare for you? There are tips on how to treat a broken rhino horn in a TBH and information on where in Brussels EMSA offers you internships. You will find out who placed the first catheter into a heart (being a patient and an operator at the same time) and how to plant tomatoes in a city jungle. Last but not least, we will have a look at how to prepare New Year surprises for children in the Netherlands and why on Earth do we have a policymaking officer in EMSA?! All in all, we dont want to anticipate how far your creative and technical support can carry us when enhancing the EMSA magazine for its next edition. One thing is sure - the work of issuing EuroMeds regularly, in print, hopping swiftly towards increasing levels of professionalismis just at its very beginning. Olga Rostkowska, Editor-in-Chief

Living in public (health)

Promoting prudent antibiotic use in Europe
Young doctors have a key role to play in promoting and practicing prudent use of antibiotics, in general practice and in hospitals.

by Dominique Monnet

ECDC Contribution to EMSAs journal EuroMed Promoting prudent antibiotic use in Europe: European Antibiotic Awareness Day Antimicrobial resistance, or the ability of microorganisms to withstand treatment with medicines to which they were once susceptible, is a multifaceted public health problem. Infections with multidrug-resistant bacteria, i.e. resistant to multiple antibiotics, are increasingly being responsible for infections in European patients that therefore require treatment with last line antibiotics. The societal and

financial costs of treating multidrug-resistant infections place a significant human and economic burden on society, as individuals infected with multidrug-resistant bacteria are more likely to remain in the hospital for a longer period of time and to have a poor prognosis. Multidrug-resistant bacteria are a threat to patient safety, in Europe and globally. The number of options for the treatment of infected patients is limited and there are only few new antibiotics currently under development. This means that prevention and control of these infections

relies on prudent use of existing antibiotics and on infection control measures such as hand hygiene, screening and isolation of positive patients. European Antibiotic Awareness Day (EAAD) is a European public health initiative coordinated by the European Centre for Disease Prevention and Control (ECDC). Each year on 18 November, it provides an opportunity to raise awareness about the threat to public health posed by antimicrobial-resistant bacteria and to communicate about the importance of prudent use of antibiotics. The establishment of EAAD follows on the heels of successful national public awareness campaigns on appropriate antibiotic use in European countries, in particular in Belgium and France.

EAAD provides a focus for national campaigns, for the engagement of key stakeholders and for communication capacity development. The involvement of European countries has grown since the first EAAD in 2008 to which 32 European countries participated. In 2012, with the support of WHO/Europe, 43 European countries organised activities to mark EAAD. Importantly, EAAD has been able to secure broad political support at EU-level and in the countries through engagement of the EU institutions and partners at European and national level. EAAD also provides support to European countries by developing evidencebased key messages and materials for different target audiences. In the initial phase (20082010), EAAD developed messages and materials for the general public and for medical doctors (primary care prescribers and hospital prescribers). Working together with the European Commission and focal points in each country, as well as professional societies and other experts in the field, ECDC developed communication toolkits which included template campaign materials for adaptation at national level, as well as guidance documents for the implementation of campaigns. These materials are available and translated in all European Union official languages from the EAAD website (http://antibiotic.ecdc.europa.eu).

In 2012, ECDC, in cooperation with the European Commission, promoted the One Health message that everyone is responsible for the prudent use of antibiotics: patients, parents, doctors, pharmacists, farmers, veterinarians, etc. ECDC is actively preparing EAAD 2013 and looking at ways to address the issue of self-medication with antibiotics. Despite being illegal, over-the-counter dispensation of antibiotics without a medical prescription still occurs in some European Union Member States and result in self-medication. Moreover, leftover antibiotics from previous prescriptions and dispensations may be available at home and may be used by patients for self-medication.

Young doctors have a key role to play in promoting and practicing prudent use of antibiotics, in general practice and in hospitals. by ensuring that antibiotics are only prescribed when indicated, that the right antibiotic is chosen and that it is administered with the correct dosage and duration of treatment; by correctly informing patients about when and how to take the prescribed antibiotic, and stressing that compliance with treatment as prescribed is important; by informing about the risks of self-medicating with antibiotics and about the fact that antibiotics do not work for viral infections, especially important during the cold and flu season.

How Hedgy the Hedgehog conquered Croatian Kindergartens!

ECDC support campaign in Croatia - a different approach
by Sven Pal

Picture 1. A page from the book

His name translated into English would be literally 'Hedgy the Hedghog' but all the children in Croatia know him as Jeko Jei. Jeko is a bit modified character from ECDC's worldwide campaign in fighting antibiotic resistance. It grew on me couple of years ago, in my first years of Medical school in Rijeka. Prof. dr sc. Vera Vlahovi Palevski is one of our clinical pharmacology professors. She invited me to join a public educative campaign in Rijeka to raise awareness of bacterial resistance to antibiotics. We would stand on the main street in the city, for every weekend in February, and together with Branka Popovi MD, Nives

Radoevi MD, student volunteers we would educate people (mostly elderly) about the responsible use of antibiotics and the right indications to use them. We have been advising people and distributing flyers on how to prevent common cold and give them fruit, tee bags and soaps all in the aim to make them understand the ways of spreading and preventing the common cold and flu. Right before the start of the campaign activities the following year, mid January, I thought, why not aiming primarily children? If we instill the teach them ways of fighting the common cold or flu while they are still young it will surely give us positive results in the near future. We all remember

Picture 2. A scene from the theater

the principles we learned as children and follow them both consciously or subconsciously. Then an idea came to my mind, and I decided to write a book for children. Since I'm a medical student, not a pedagogue, I asked my friend Marta Viduka to help me. Marta has been engaged for a couple of years now in a project called Tete prialice (Talking Aunties), where volunteers visit hospitals, especially children oncology departments, and tell bed time stories to sick children. The stzries being told are being chosen carefully for every child, depending on the age, gender and severity of illness, and there have been results proving faster recovery in children who were the part of that par-

ticular project. Marta helped me with the text, adopting it for children, so I had to find a designer. I remembered a friend of mine who had a two year old child, so I thought who is better for this then Maja Beni? She knows how to draw for children, since she has one at home. With a very few corrections from my side, she illustrated our text in a couple of weeks. From the idea to realization it was less then four weeks. Our campaign started again, and we had something new to offer, a different perspective to preventive actions and a new asset. A 20-page children book: Kako je Jeko pobijedio prehladu (How Hedgy the Hedghog beat the cold?) was created.

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Picture 3. Little doctors with the poster

Picture 4. Children drawings after the theater

Fundraising for the book, at least initially wasn't that hard. The Student council of the Unversity in Rijeka recognized the project as a valuable preventive method, so together with the School of medicine and money from the campaign we printed the first version of the children book. After those couple of weekends the children book was literally wiped. Children loved it. Even the mayor of Rijeka came to give us his support so the PR around the project was big.

Since my mother is in the Croatian Intersectoral Coordination Mechanism for Antibiotic Resistance Control (ISKRA), the children book got really fast to the governmental institutions. ISKRA coordinates national activities in the field of the antibiotic consumption and antibiotic resistance surveillance and education on prudent use of antibiotics which includes guidelines for medical professionals but also nation wide public campaign since 2008. With a lot of help, not just

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Picture 5. Medical students as Hedghogs for the carnival in Rijeka

from prof. Vera Vlahovi-Palevski, but also from the ISKRA president, prof. Arjana Tambi Andraevi and dr. Marina Payerl-Pal, a member of ISKRA, the children book got to the Ministry of Health and they decided to distribute it to all the kindergartens in Croatia. Around 3000 copies were printed and sent to the kindergartens nation wide. The children books were delivered through September and October 2012, and in many parts of Croatia education of kindergarten teachers was carried out. When you are coming from a little place, there are a lot of different work branches you are familiar with and you get to know and become friends with a few people in each branch.Two of my close friends spent their whole life in a theater, as actors, directors and everything needed. Davor is also directing theater shows

in which actors are mainly high school students. When I showed Davor and Jelena (she's a school teacher) the childrens book, they really liked it, so I asked them to help me make a theater show for children based on the book. In a couple of weeks they sent me a few different songs for the show, and this year in February the show had it's premiere. Children came from the main kindergartens and surrounding children schools, so more then 600 children saw the premiere only. Both the children, their teachers, parents and critics loved the show. After the show, children went to their kindergartens, and teachers organized, mainly thankfully to Snjeka Vugrinec (btw. my kindergarten teacher), a workshop on the antibiotics and the Jeko book. The results of the workshop included a lot of drawings that children made. An importantresult was also that children remembered and im-

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plemented messages both from the children book and the theater show in their everyday life. This year's campaign was expanded from Rijeka to all the biggest cities in Croatia (Zagreb, Split, Rijeka, Osijek), and through the coordination from both professors and students the campaign was carried out. On the opening of the campaign in Zagreb (the capital of Croatia), the Minister of Health came together with the heads of Croatian leading Health institutions, which resulted in a big response both from the media and the public. The campaign was very productive and almost a half of the population of Croatia was affected by it. Both by the campaign in the cities and the media. Last but not least, over 150 students from Rijeka Medical School participated in the carnival in Rijeka (second biggest after Venice carnival) all dressed up as Hedgehogs which showed the impact of the campaign, but also the support that students are willing to give. Once again the general public noticed campaign and medical students gave their contribution to raise the awareness of bacterial resistance to antibiotics. On the GA in Istanbul, a workshop was held, where the idea for the new children book regarding hand washing was held, and thanks to the participants of the workshop new ideas were born and hand washing children book is on it's way. As a conclusion, I would like to thank all

of the people that gave their support to the campaign both physically, mentally and with their own ideas. We are always open for cooperation and sharing our experiences in this campaign. I can just hope that in every country there is such a good communication between the students, professors and governmental institutions and that this example will help you organize your own campaigns and push your ideas. We are in a desperate need to reach people and make them become aware of threats that are not miles away, but just around the corner. P.S. Jeko is being translated in English and German and we would like to translate it in your language as well! If you're willing to help, please contact me: pal.sven@gmail.com You can see the children's book (for now only in Croatian) at: http://www.fritula. hr/radovi/jesko/

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A great heroic tale, or is it? Werner Forssmann

All his professors and colleagues thought he was insane and refused him permission to perform the procedure on animals, let alone humans!

by Borislav Manev

Cardiac catheterization is the insertion of acatheterinto achamberor vesselof theheart. Even in modern times, its still a tricky procedure that requires local anaesthesia. Its a common procedure done by physicians who underwent years and years of training and many patients take this skill for granted. Now turn the clock back 85 years ago

Werner Forssmann, a 25-year old surgical intern at the time, hypothesized that a catheter could be inserted directly into the heart. All his professors and colleagues thought he was insane and refused him permission to perform the procedure on animals, let alone humans! It turns out he was slightly crazy and in 1929, he ignored the advice of his professors and colleagues, and after tricking an OR nurse,he performed the pro-

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cedure on himself!Imagine the bravery needed to cut open your own vein, insert a 3 feet long tube inside and poke around until it reaches your heart. And this happened before all the fancy stuff like ultrasounds and CT scans appeared. He could have nicked a vein and/or artery and died from internal bleeding. He could have introduced a massive systemic bacterial infection and as a result, die a very painful death. Realizing the importance of his discovery, the scientific community awarded him the Nobel Prize in Physiology or Medicine in 1956. Dr Forssmanns contributions lead to the founding of the field of Cardiology.

Werner Theodor Otto Formann (29 August 1904 1 June 1979) was a German physician who won the 1956Nobel Prize in Medicine(which he shared withAndre CournandandDickinson Richards) for developing a procedure that allowedcardiac catheterization. In 1929, he put himself under local anesthetic and inserted a catheter into his own arm. Not knowing when the catheter might pierce a vein, he risked his own life and was fortunately able to pass the catheter into his own heart. *He was also a member of the Nazi party from 1932 to 1945. Interpret that as you will.

References: NEJM - Two Hundred Years of Surgery; Wikipedia;

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Ending Ecocide in Europe

by Andrew Miller

We can stop this today; if one million EU citizens vote for Ending the Ecocide in Europe, the European Commission will have to take action.
issues garnered by the ecocide cannot be overlooked any longer. The destruction of the natural ecological community that is meant to sustain us, is currently also devastating our bodies. This is becoming more obvious by way of a rise in the incidence of illnesses caused by the introduction of unnatural byproducts into our systems Few people know that the opportunity to improve the health of over 7 billion people lie in their hands. Environmental toxins released through the careless acts of unregulated corporate bodies and industries, continue to harm the health and wellbeing of all the earths inhabitants and ecosystems. We can however stop this today; if one million EU citizens vote for Ending the Ecocide in Europe, the European Commission will have to take action. It is time that we hold ourselves accountable for acts such as the gradual destruction of the entire habitat, particularly spectacular ones such as the Norwegian fjords and the inspiring Alp glaciers which have been described as here for 10,000 years, gone tomorrow. The associated health If you could prevent it, would you? I guess so. This is precisely what the End Ecocide in Europe movement is aiming to accomplish. Following the January 22nd launch of the initiative in the European Parliament co-hosted by three of its members- Keith Taylor, Jo Leinen and Eva Joly, a group of concerned EU citizens are determined to criminalize ecocide which is defined as extensive damage, destruction and loss of ecosystems in a given territory. By voting electronically to support this initiative, you could help end the environmental havoc. German EU Parliament member Jo Leinen says the End

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Ecocide movement emphasizes the importance of holding the individuals responsibile and accountable for the damage done to the ecosystems. This bears a remarkable semblance to initiatives in both the Ecuador and Bolivia, which also strive to give the earths ecosystems and creatures rights similar to those accorded to humans. This European Citizens Initiative which aspires to garner the signatures of one million Europeans is accessible at: www.endecocide.eu.

infrastructures and developing projects that are affecting the balance of the ecosystems and the local inhabitant communities. Although the ruling was cheered by the indigenous tribes who have seen the devastating effect of development on their air, water and land it has become a Stick in the craw of both industries and developers who were indirectly benefitting. Indigenous Bolivian leader Evo Morales throws his best phrase If we want to safeguard mankind, then we need to safeguard the planet Our health and wellbeing is heavily reliant on our caring about the planet. We can nurture an epidemic of disease and illness by turning a blind eye to this, or we can heal our planet and ourselves by promoting a clean environment for all current inhabitants as well as for our future generations. Penalties End Ecocide in Europe insists that the penalties proposed for damage to the environment are more than appropriate. According to a report by Trucost for the United Nations, the top 3,000 public companies caused $2.15 trillion worth of environmental damage a figure that is equivalent to one-third the value of estimated global ecosystem destruction. Penalties are proposed for: When ecocide occurs within the territory of EU states When companies which are directly or

Other Recent Initiatives In Ecuador, a law announced in 2008 referred to these ecosystems as Pachamama- the goddess of mother earth as recognized by the indigenous Andean people. The referendum was voted in by two-thirds of Ecuadorians, making Ecuador the first nation on earth to legislate the rights of nature. This ruling included a clause that says: Earth is not to be affected by the mega-

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indirectly involved have their headquarters in the EU When EU citizens are involved When products resulting from activities causing ecocide are imported into the EU When EU banks and other financial institutions invest financially into activities causing ecocide, no matter where these activities take place. This initiative has been inspired by the efforts of Polly Higgins, an environmental lawyer and author. In March 2010, Higgins spoke to the United Nations asking for Ecocide to be named the 5th Crime against Peace. Her reason was simplepresently, there is no law to task the runaway mega-corporations, irresponsible developers or any other entity for

decimating the earth. This means that ecocide is taking place every day and the judiciary has no means of stopping it. She stressed that Corporate ecocide has now reached a point where we stand on the brink of collapse of our ecosystems, triggering the deaths of many millions in the face of human-aggravated cataclysmic tragedies. Criminalizing environmental disruption would not only provide the funds needed for remediation, but would also force corporations to evaluate their products in terms of cradle-to-grave, or even cradle-to-cradle production costs. As seen in that light, corporations might reevaluate the real costs of their more polluting products and find cleaner ways to manufacture them or even to stop them altogether.

green & unclean factories

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Taking Action Under the EU rules, one million signatures are needed to bring this citizens initiative to the attention of the European Commission-the requirement before they can consider the proposed legislation. Further, if the United Nations makes Ecocide the 5th Crime Against Peace, environmental destruction would become illegal worldwide, and culprits would be convicted under the aegis of the International Criminal Court. This will however still mean that the United States and other countries outside the EU still have to come to this decision themselves through policymakers, appellate litigation and lobbyists.

As a final note, I must add that I find it interesting that the Ecocide directive defines inhabitants as any living species dwelling in a particular place. It would be nice to finally have all earths creatures measured by the same benevolent yardstick, as well as to ensure a healthier environment for everyone. Andrew Miller is a passionate member of the End Ecocide movement, an avid blogger, environmental law student and co-founder of the tech startup Scan & Ban (www.ScanandBan.com); a free mobile app developed to empower the public to find out what toxins are in their food and pass legislature to ban those dangerous ingredients.

End Ecocide in Europe is a European Citizens Initiative aimed at criminalising environmental destruction. Harming our earth must become a crime for which individuals and companies can be held accountable. Do you agree? Then vote today for our initiative at www.endecocide.eu When one million EU citizens votes for our proposal, it will be consider for implementation at EU level. Make your voice heard today!

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My doctor said it
Urban Gardening and Open Source
by Joanna Borowska

I still remember my surprise when I watched a movie on TED about eyewriters built by members of the Graffiti Research Lab. The goal was simple; to build a painting tool for a completely paralyzed friend who was an active graffiti painter before the accident. The impossible became possible.

I heard about the so-called window farms two years ago. One of my friends found a video on YouTube (The Windowsfarms Project) which tells the story of a woman, Britta Riley, who decided to grow herbs and vegetables in the window of her Brooklyn apartment. Her inspiration came one winter afternoon when she realized how much of our day-to-day functioning is dependent on other people. The very same day, she read an article by Michael Pollan who said that if humanity would be able to grow at least some vegetables and herbs in their own gardens, it would be a huge positive change for the ecosystem and our environment.

Unfortunately, according to the author, people prefer to hand over this responsibility to appropriate specialists who they do not engage and which in fact is the cause of the many nutritional problems in the consumer market. This inspired her to get started on what is now a rapidly growing social action. Determined and motivated, she set up a mini-farm in her own window based on hydroponic technology (soilless cultivation of plants from water media), which was originally implemented by NASA while exploring the possibility of cultivating plants in space. The only thing she had to buy was a suitable seed.

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even tomatoes. In a short time (within 6 months), this idea was being adopted by people from all over the world, and the complicated technology was replaced by simple solutions suggested by the diverse people involved in the project. And so, a group http://our.windowfarms.org/ was created and the project has expanded strongly. About a year ago, while at the Venice Biennale of Architecture in the Spanish Pavilion, I saw a variant of this concept where crops filled the whole room and not just the window. The whole principle of this community is based on simple rules. You can login on their website to be informed and access the global system. In this case, it is the principle of open

From the recycling point of her building, she was able to collect the plastic bottles required to create the technology. In good faith, Britta dropped this information for free on the internet and in so doing, connected with a group of New Yorkers who had tremendously positive influence in developing and refining the whole project. They created an online forum which had all the instructions to enable others copy the system. Initially, the system was built "around" where the device was very noisy and would sometimes leak. Despite these facts, they were able to grow herbs and

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source system- anyone in the world can download the manual for the entire machinery and construct it at home for free! For the less patient enthusiasts there is an option to purchase the equipment along with adequate seedlings. The devices are often bought by schools and this serves as the basic source of income for the project. It seems a reasonable solution, especially when the price is not prohibitive. The simplest packages are available for $25. Those that are more advanced, with the appropriate fertilizers and free plants in the set are relatively more expensive ($399 is the most expensive option). However, as I wrote earlier, all the technology is available for free, and the components themselves are not expensive. More than that, if you have trouble, you can log on and join a great support group; there is always someone to help you. A very interesting aspect of the first login is that it performs an initial "interview" with a potential member. This includes checks: what is his/her knowledge of the technology behind the project? We can

encounter other questions like: prior experience with hydroponic technology? Are you a gardener, an engineer, scientist, or just a food enthusiast? Etc. That's how it works! The project has 18,000 followers. I really like the comparison addressed as I watched one of the videos: NASA at the same time as us is trying to learn how to grow food in such a thankless environment as space. We are trying to answer the question of how to grow it in such harsh and difficult conditions of urban space. Hydroponic crop systems will soon become one of the major investments in the USA. I nstead of the corporate system, the idea is based on what Riley calls the R&D-IY (Research and Do It Yourself). You can use the information contained on the website, but you have to refine the device to suit your specific needs and resources. In fact, this structure is more profitable when you are a follower who is supporting and developing the project than just being the inventor. This is an advantage because it does not oblige you to create your own system from scratch.

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The open source idea is a new consumer reality, which is appearing to be a bit of sociological mystery. Sharing knowledge is a new philosophy of our time with the major source/platform being the internet. Today you can download the instructions to build a 3D printer. Components will cost about $3000-4000 and of course one will need a person who will program it. The point however is that such a brilliant invention can be built by an individual on their own - just the same way you can share something too with the society. I still remember my surprise when I watched a movie on TED about eyewriters built by members of the Graffiti Research Lab. The goal was simple; to build a painting tool for a completely paralyzed friend who was an active graffiti painter before the accident. The impossible became possible. His friend invited some nerds to his home, and while he did not know anything about the technology he was able to gather the right people to do it. After weeks of hard work, the eyewriter was ready. It turned out to be a simple de-

vice based on rimmed glasses. This device reads eye movements and transfers it to a computer interface. The whole technology is available for free and its components are trivially cheap (all about $50). More than that, this product has been placed in a list of top 10 inventions by the New York Times. The webpage www.eyewriter.org shows all the ins and outs of construction. There are also documentaries which show the whole process involved in the creation of this unit. Once again, a paralyzed friend could paint using his eye movement. I do not know how many people use those glasses now, because this kind of open source is hard to find for most people. Here comes the question of our ability to go to google.com and ask the right questions. Is everyone aware that there are some free solutions on the internet? Probably not. So, now that you know, you should consider sharing this information. Who knows how many people can benefit from it?

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Nutrition. Myths & Facts

MYTHS & FACTS
MYTH: Potatoes are fattening. 100 g of potatoes are only 70 kcal! (this is a very small amount of calories for 100g). But they could be fattening when we eat them with sauces, butter, etc. In addition, simply cooked potatoes are easily digestible. MYTH: Crispbread is a diet product. This type of bread has more calories than the other types. Depending on the manufacturer, 100g contain 300-360 kcal, whereas normal bread has 250 kcal/ 100g. MYTH: Lettuce and spinach are good sources of iron. These products are rich in iron, but unfortunately it is not easily absorbed (about 2%). For comparison, the iron in meat is digested up to 40%. MYTH: Cottage cheese contains a lot of calcium. It contains only 100 mg/100g of calcium. In comparison, yellow cheese contains 10x more. This is because over 70% of the calcium is lost during the production process.

by Joanna Borowska

FACT: Red tea causes weight loss. It aids digestion and metabolism, which contribute to weight loss. FACT: Yogurt has a protective function during antibiotic therapy. But only if we drink at least 1 liter per day. FACT: Not all oils are suitable for the frying pan. We can pour into the pan only rapeseed and olive oil. FACT: Breakfast cereals contain a lot of sodium and sugar! This refers to cornflakes, which are one of the most significant products in terms of sodium (not indicated in HD) and sugar. Always pay attention to the label. There are cereals that have 35 g of sugar per 100 g (1/3 of the volume!).

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(during exam session) Caffeine

cognitive abilities, increases mental and physical efficiency, also an aphrodisiac Contains caffeine (3.5 g of guarana = 250 mg caffeine). Overdose: dizziness, tachycardia, insomnia, irritability

ENERGY DRINKS

Effects: improved mood and concentration, agitation, increased energy in the performance of tasks requiring longterm thinking The beneficial effects are observed at a dose of 200-300 mg (= about 250 ml of brewed coffee, 200 ml espresso, 400 ml of coffee, 1l of energy drink). Overdose: an unspecified dose, individual differences; symptoms: nervousness, irritability, abdominal pain, nausea, headache, insomnia, increased heart rate

Taurine

Effect: takes part in neurotransmission and brain development, increases physical endurance and stimulates the muscle building process, improves cognitive function Overdose: none observed, even when using very high doses

Guarana

Effect: stimulates, improves mood and

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Folic Acid

Effect: reduces the concentration of homocysteine in the blood, and consequently improves the mood, prevents neurodegeneration, increases the work of CNS Recommended intake: 400 mg a day (120 g chicken liver, 300 g spinach, cauliflower 350 g, 500 g broccoli, 8 eggs, 1.5 kg of oranges)

Sources: offal, red meat, egg yolks, dried legumes, whole grains, nuts

Fatty acids, n-3

Effect: increase the activity of the CNS, contribute to a faster reaction time and better memory, reduce aggression and stress Sources: Saltwater fish (salmon, mackerel, herring, tuna, halibut), canola oil Two times a week, dose of 150-200 g Rapeseed oil is 8x better composed by fatty acids than olive oil!

Iron

Iron deficiency (anemia): visible deterioration in mood, lethargy, deterioration of concentration, depression

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(during exam session)

AMINOACIDS 1. Serine - Production of lecithin, sphingosine, acetylcholine. - Improves memory and playback information. Where? Soybeans, lentils, nuts, seeds 2. Aspartic Acid - Facilitates the formation of engrams (memory traces), learning, memory, playback information - Increases concentration and improves mood Where? Rennet cheese, meat, fish, peas, buckwheat 3. Tryptophan - Required for the synthesis of serotonin - Antidepressant, improves mood, guarantees a good nights sleep, reduces hyperactivity, and guarantees a feeling of satisfaction after eating Where? Semolina, pork, cheese, edam, sesame seeds, almonds

BRAIN DIET

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From the day we are born

by Olga Rostkowska

Mathematics cannot be cheated. As the years change, so does our metrical age. Still, the biology of our organism is a completely different story
From the day we are born we start getting old
But how to do it properly? In February 2013 I had the opportunity to participate in a conference on healthy and active ageing programmes for European doctors and citizens. The abovementioned quote was mentioned by one of the guests. will proceed. Tomorrow this could be the key to many challenges faced by our senior colleagues today, such as: The lack of adherence to treatment in the elderly. Minimal support from the patients family. Depression in pensioners excluded from their society. Impatience and frustration of the health-care personnel. Even rudeness reported by some elderly pa-

The Younger the Better.

At the same conference EMSA was the youngest association in terms of its members age. The majority of speakers, representatives of various associations and freelance doctors were middle-aged (or +). This, of course, makes perfect sense, as the pool of experts with several years of professional practice is the heart and soul of such meetings. Nevertheless, something was missing young people. Young medical professionals. Students. Young university lecturers whose tasks would be to plant the seeds of knowledge about the effects of long-lasting prevention, healthy lifestyle habits, better inclusion of the older members of society. The sooner such medical education is implemented, the smoother the assimilation of such information in young minds

tients mainly because their psychological or social needs are not fully understood. The demographical changes called the silver tsunami are no longer a prediction. They are an indisputable fact. We and those around us would live longer, but would such a life be necessarily better? Good news: that depends on us! Bad news? We have to work for it. A small piece of know-how arrives just below.

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The Miraculous (Lack) of Diet.

It was first proven over 70 years ago that a simple reduction in nutrients availability or caloric restriction contributes to the longevity in animals. That is most probably due to a block in some pathways (e.g. mechanic pathway of rapamycin, mTOR) leading to improved mitochondrial function, reduced use of RNA and increasing autophagy, i.e. consumption of the cells own refuse. The ultimate confirmation of this theory in human models is still a subject of research. However, conclusions have already come: diet and ageing could be somewhat interlinked. Can we make it a bit more practical? Here are some simple ideas how to adapt your lifestyle to a healthy ageing plan: Eat only when you are hungry. Drink water or herbal teas, but not during meals, as they dilute the digestive acids. No more coffee than necessary (a smile at digestion, again). Eat vegetables and fruits (less sugary). Consume chocolate containing no less than 70% of cocoa. No snacks 2 hours before going to sleep. Fast food is allowed, provided that you make it yourself. Never go on a diet (90% fail)! Chew your food slowly and thoroughly (pro-digestive and you will feel sated before you finish). Once a week switch off the meaty dishes. Take a power nap in the afternoon, yet not straight after a meal. When ill, start with natural remedies. Sleep on the right side of the body (less pressure on the heart). And sleep as much as you can!

State of Mind.

Have you ever wondered what keeps some actors still performing even after they reach their 80s? They are still able to come on stage and behave as if their memory failed in only one aspect: how old they actually are. Clint Eastwood (80) and Kirk Douglas (97) are just two examples. Its not rare that people carrying out their craft until great advance in years stay in remarkable shape. It is more pronounced in intellectual workers teachers, musicians, writers or doctors. The moment when their job cannot be continued for some reason, their condition starts to deteriorate rapidly. Thats why being included (with a purpose) in the community could be such a powerful medical tool. Staying active

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mentally, physically and socially cannot be underestimated. Moreover, studies have shown that those with a broad network of friendships have been spared some symptoms of depression or dementia until advanced age. Recommendations? Lets keep ourselves busy with what we love and with those that we love as long as possible.

I could look like this guy when I reach my 80 or Its incredible she is 70 and still enjoying life so much! . We come across similar stories often. There are differences in how people grow up and get older. Some of those differences have been defined by genes. Some by the way we were raised and how our life has been modeled by childhood habits. Yet, it is never too late to add one spoon of sugar instead of two, eat an apple after lunch, take a walk instead of the underground or spend time with people rather than profile pictures on Facebook. Optimal time to start: today. Mathematics cannot be cheated. As the years change, so does our metrical age. Still, the biology of our organism is a completely different story As medical students and future doctors, we might consider implementing some rules; not only as an example for our patients, but also for our precious wellbeing. To make the silver years, the autumn of our lives appear in bright colours, with plenty of sun. To enjoy the seasonal fruits to the fullest.

The Blue Zones.

There are places on our globe called the Blue Zones where people live evidently longer, better and happier. Maybe its the food or the climate. Or is it due to the search of meaning in life? Or rather good genes. Everything is possible. According to Dan Buettner, the author of the theory of Blue Zones, longevity is no accident. Buettner travels with the National Geographic team around our planet and visits communities where 90- and 100-yearolds are nothing unusual. Having spotted those, the next obvious step would be to define key ingredients of the recipe for such an impressive lifespan. Those vary from location to location and different cultures prove to have their own tricks to cheat time. For Sardinians it is red wine and family, for Japanese yoga and ikigai (the purpose of life), whereas for the Seventh Day Adventists in California faith and modest diet.

So How Do We Trick Time?

Each day is a challenge for our body and mind as we do not always treat them wisely. But there is hope! How many times did you hear somebody saying, I wish

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References
Action Group meeting: Healthy and Active Ageing (26th February2013). Brussels: European Commission. Buettner, D. (2010). The Blue Zones: Lessons for Living Longer From the People Whove Lived the Longest. National Geographic. CPME Statement on Mental Health in older people Healthy ageing. Brussels: CPME. Global Alliance of Mental Illness Advocacy Networks-Europe, GAMIAN meeting. (2013). Mental Health and Polimorbidities. Brussels: European Parliament. Kaeberlein, M. (2013, March 4). Longevity and aging. F1000 Prime Report . Susans Food for Thought. (2013). Retrieved from My 100 best ever health longevity tips: http://www.susansfoodforthought.com/longevity-and-extraordinary-health/my-100-best-everhealth-longevity-tipsThe 7 Oldest Currently Working Actors. (n.d.). Retrieved from http:// www.pajiba.com/seriously_random_lists/the7-oldest-currently-working-actors.php

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Planet EMSA
Internships and Opportunities for EMSAi
by Sofia Ribeiro

EMSA currently offers you two different internships - one at the Standing Committee of European Doctors (CPME) and another at the European Public Health Alliance (EPHA)
Whether you are at the beginning or the end of your medical studies, participating in an internship or spending some time abroad under the Erasmus program can shape your medical career and help you define your future goals. If like many other students you are still wondering if you are meant for clinical, surgical or community work, then a short experience with EMSA internships is definitely something you should consider. Working in another country might entail some difficulties and you may find it challenging to adapt to a new working environment with a different work ethic and culture, not to mention a possible language barrier that you would need to cross. Nevertheless, as you consider the experience a learning curve, you will gain a wide range of skills that will make you a more competitive applicant in future job search. For those of you who are considering working in your own country post-graduation, an internship could give a new perspective as regards your career plans and might open your eyes and mind to opportunities you had never thought of. EMSA currently offers you two different internships - one at the Standing Committee of European Doctors (CPME) and another at the European Public Health Alliance (EPHA). Both placements are competitive and require you to move to Brussels, but you need not worry if you are not a master in French or Flemish; all your work will be carried out in English. However, you will connect with people from different countries and might eventually make use of the opportunity to learn a new language. The internship at the CPME is ideal for you if you have a good level of written and spoken English and if you like public health and health policy in general. You will be based at the CPME office which is in the European headquarter and you will be required to work for approximately eight hours a day. You will be working closely (and be supervised by) the CPME Secretariat and will gain an insight on CPME work, policy papers and positions. Sometimes you might be required to attend meetings on behalf of the CPME as a representative, which will allow you to develop a sense of respon-

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Picture 1. General assembly of CPME in Limassol, Cyprus, November 2012

sibility and train your reporting skills. This position is paid (approximately 1000 euros a month) and is offered generally as a renewable per 6 month tenure. Furthermore, you will be considered a member of the EMSA European Board (EEB) while you are doing the internship, having the full rights of an EEB member by serving as the Permanent Officer (PO). Our current PO is Olga Rostkowska, who was the Medical Ethics and Culture Director in 2011/2012. Recently, EMSA was approved and accepted as a member of the EPHA. The department of external affairs was able to negotiate internships at the EPHA office in Brussels (which is located not very far

from the CPME office) under very special conditions: you have to work for a minimum of three months, but the starting date and the duration of stay are up for negotiation and are flexible. If you are interested in Public Health, then this is the right position for you; the EPHA works on a wide range of topics and are also active in health policy, though their work is not so focused on certain medical issues such as professional qualifications and working conditions. The position is unpaid, but its flexibility allows you to combine it with the summer holidays, for example. (The application is also in turns, so you can decide on later)

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Last but not least, you can only apply to these positions if your faculty is an active EMSA FMO. If it is not, and you really want to try for one of these internships, please join us in EMSA, and start an FMO!!

If you wish to know more about the internships, or you have any suggestions on other internship opportunities you would like to see for EMSAi, kindly write to me! Sofia Ribeiro, Vice President External Affairs sigmaserena@gmail.com

Picture 2. EMSA representation at CPME GA in Limassol, Cyprus

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35

How to policy making and why?

by Jacob Hildebrand

Policy is about the topics you want to handle. Its not about talking about the paper you are writing. Its about ideas, the future, your bonding to the past.
Making politics is an obscure term. The first image popping up is normally a group of people in a room, sitting at tables in a circle, the air is thick and musty, the thermos flasks are as empty as the mugs and they are still talking about the same abstract topic. Policy is debate. Policy is communication and its a complex process. EMSA is spread all over Europe. Its practically impossible to meet regularly in person and to sit at the table. Though we are permanently discussing and shaping opinions locally and internationally. Our communication is obviously abstract, we are working with online documents and mailing lists and deadlines, which reach weeks into the future. While working, we often dont see anything else than our computer screen. The working processes have become more and more efficient in the last decades. Anyway, the number of possibilities to act and work and accomplish something puts the efficiency into perspective. Its not easy to start working on policies. The essential sensation of policy making is feeling the aim of your political ideas. All these technical procedures, these online mind-mapping tools, training seminars, skill shaping whatever all these things are technical paddings. Policy is about the topics you want to handle. Its not about talking about the paper you are writing. Its about ideas, the future, your bonding to the past. The technique you need for achieving your political aim arises from the topic itself. Philosophically speaking this is a hermeneutical interpretation of the process of policy making. The way you should go lies in the topic. The topic defines the media you use, the audience you are contacting, the type of reasons you are listing. Ill give you some examples. Why did we choose the topics we chose for policy making of EMSA in the last months? The mobility directive will limit the possibility of medical students within the European Union to work in other member states. So it is our topic. Tobacco policy, obesity in children and the rise of dangerous antimicrobial resistances all over Europe are the new major topics of

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European health care policy, so we have to think and talk about them. This is the first step of policy making: the definition of relevant topics in your political field. How to handle these topics? Well, first you need an opinion. So you have to communicate about it, sit at the table with others, write to the mailing list, and shape the policy paper itself. This is complicated. Shall we write about tobacco in general? About medical facts? About personal experience of a patient, who suffers due to the consequences of his lifelong consumption of cigarettes? No. You need to stay short and comprehensible. You need to focus on demands. Only a short introduction is necessary, as well as a few sentences, which give the background of facts leading to your demands. Best thing is that you dont request things like lets conquer Mars, but lets develop the machines to get there. Being precise about the things you want to accom-

plish and then reaching the slogans is the way of reasoning in such texts, in talking about policy or addressing an audience. Is it important that you as a writer arent the president of the European Commission? Do you have to care that you have no real authority and political position to implement and to campaign your ideas? No, you dont. In Europe we have a democratic culture and as long as you have expressed your demands, you did a perfect job. The European public and especially the vanguards of society, such as the youth of Europe, need to be part of the public discourse. We as citizens of Europe and citizens of our particular European nations make the policies of our continent. This is policy making.

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Memories of an EMSA Alumni

by Samuel Ribeiro

EMSA gives you many tools that a medical faculty isnt equipped with. Essentially, it provides you with the insight and ability to understand the bigger picture. It also taught me time management and tolerance, while giving me a true feeling of European citizenship.
What is your experience in EMSA? How did you started? What things did you achieve during your terms as MSD and LO? I applied for the position of Medical Science Director shortly after going to the 2005 NCM meeting in Plovdiv. Although it was a small meeting, the enthusiasm of the little over 50 participants compelled me to get further involved in EMSA and apply to the European Board. During that following year, I continued the work of my predecessor, Davor Lessel, who had done a fantastic job in arranging a collaboration with Thieme Medical Publishers. This protocol culminated in the first European-wide printed issue of the Journal of EMSA on Medical and Scientific Affairs (JEMSA). Also, during that time, EMSA fostered a stronger collaboration on a scientific level with the European Pharmaceutical Students Association (EPSA), namely on raising awareness about the effects of drug interaction and how they may be prevented. Cooperation projects like these enhanced my appreciation for the benefits of working with other organisations and were the reason why I applied for the position of European Medical Organisations Liaison Officer (EMO-LO) in the following term. During this second year EMSA stood out amongst the other medical organisations when, in collaboration with the European Junior Doctors Association (EJD, although it was called the Permanent Working Group of European Junior Doctors at the time), we elicited a very strong response to the European Working Time Directive (EWTD) green paper. This policy statement was later adopted by all the main European Medical Organisations as their own, leading to the Europeanwide demonstration in Strasbourg on 15th December 2008. Three days later, against all of what was predicted before the demonstration, the European Parliament voted in favour of the new Working Time Directive. This new directive was very important for patient safety, since it limited the extremely long working hours doctors were being subjected to. It is still astonishing to see how one paper

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first approved in the 2006 EMSA-GA in Ankara affected European policy, which is still enforced today. What did you gain from EMSA? Did it affect your career? How? Why should people be a part of it? Being part of the EMSA-EB affected my life tremendously! When I started medicine I had no idea of how a healthier lifestyle could impact so many aspects of our lives. EMSA gives you many tools that a medical faculty isnt equipped with. Essentially, it provides you with the insight and ability to understand the bigger picture.

It also taught me time management and tolerance, while giving me a true feeling of European citizenship. After leaving EMSA-EB and completing medical school, I went on to be part of the EJD for another 3 years, mainly because my experience in EMSA had already been so excellent! EMSA also made it easier for me to speak in public, even when English isnt my mother tongue. This was crucial for me to gain the courage to work abroad within Europe, as Im doing at the moment. Finally, EMSA gave me many friends that I will never forget!

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For children, big and small

My triceratops has broken his horn
by Nikos Korakas and Colleagues

She came next to me and asked Are you a real doctor? If yes, you should make my teddy bear smile again. I answered to her I am a student, but I promise I will try.
the children even more close to reality. In this hospital, youll meet some amazing and inquisitive children with their spontaneous questions and answers you will surely remember afterwards! Dont you think its worth a visit? He was barely sitting on his tiny chair as he was impatiently waiting for my call. Next one please. He almost jumped next to me. You are a bit late, I am looking forward to it he told me. How old are you?, 4, And how old is your teddy bear?, 40 (Oh my God, how old did he believe I was?). After we were done with the introductory questions, we went through the usual examination of his teddy bear (heart, lungs, mouth, ears, belly) and we also had him vaccinated. As our session was coming to an end, he suddenly told me Oh, his foot hurts, too. I examined the foot, and once again No, wait, his tail is also painful. He obviously didnt want it to end so quickly (I was with him for over 30 minutes so far though). After examining and curing literally all the body parts of his teddy, we eventually said goodbye. He later told his teacher he wanted to become a doctor. Like me. Nikos, 3 years in Teddy Bear Hospital

Teddy Bear Hospital is not just a project, it is exactly what it says: a hospital for teddy bears! Through role-playing games, in whichthe child plays the part of the parent bringing their sick teddy to the hospital, the teddy is diagnosed by a teddy doctor -us!- and the child receives a pawscription for their teddy.The aim of the project is for little children to overcome any worries and fears they may have regarding doctors and hospitals and to also learn in a playful and interesting way about medical treatment, physical examination and healthy living. Moreover,Teddy Bear Hospital has many clinics from every medical specialty, like a real hospital, which makes the experience for

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I felt nervous when I first joined Teddy Bear Hospital because I thought the kids might get bored or feel uncomfortable around us. And some of them did, but eventually it got better. I remember there was this beautiful girl who barely talked to me at first. She was so shy and got a little scared when I told her that I needed to vaccinate her doll. She didnt want me to do so. She was afraid of needles, as most of the 5-year olds actually. But I told her to hold the dolls hand and that the pain was going to last only for a while. She relaxed a little and then we started talking about her doctor and why she didnt like going there. By the time we were leaving she even smiled at me. It was really sweet. Christina, 1 year in Teddy Bear Hospital I still remember the faces of all the kids in the kindergarten. But one of them, a pretty little girl captured my gaze. She came next to me and asked ''Are you a real doctor? If yes, you should make my teddy bear smile again. I answered to her ''I am a student, but I promise I will try''. In the end of the examination she said ''You know something? It doesn't matter if you are a real doctor because youve made my teddy bear laugh again''. And as she was leaving she gave me a kiss. It was the first moment I felt like a doctor! Antonia, 3 years in Teddy Bear Hospital Children in kindergarten are sweet, with heartbreaking smiles and innocence that grownups are jealous of. One of them, a 4-year old, tiny and shy girl, is carved into my memory. Every time I asked her

a question about her teddy bear, "Is your teddy bear sick? Where does it hurt?", she whispered my questions into its ears and then she waited for the teddy bear to answer. Afterwards she transferred the answers to me! It was the most memorable conversation Ive ever had Dafni, 2 years in Teddy Bear Hospital Being part of last year's Teddy bear hospital was a great experience. I met new people and learned how to work together with them in order to deal with childrens fear of doctors. We tried to gain their confidence by treating their teddy bears. In a friendly and playful environment children learned that there is no reason to get upset and overreact in the presence of doctors. I would recommend this project to every medical student, especially to those who intend to become pediatricians. Ipek, 1 year in Teddy Bear Hospital I strongly remember that time at kindergarten when I was with seven little parents around me, each of them holding a sick toy. You could see their eyes looking so curiously at the medical stuff I had and they were all so happy when I allowed them to touch them and examine their teddy bears with me. When we were about to leave we went to say goodbye to the children. The seven little ones of my team came all together and gave me a huge hug that I will never forget! Then the rest followed and I found myself between almost twenty children who were happy and wanted to give a hug to the doctor! Kassandra, 1 year in Teddy Bear Hospital

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My triceratops has broken his horn, he told me with his eyes shining of excitement. He helped me make a splint for the horn and put it on. Oh, this horn is broken too!, so we made another splint. Well, I think that the third horn is also broken, he told me with a slight smile on his face. When we were finally done with the splints, he held his stuffed animal tightly into his arms and whispered to its ear: Dont worry little man, youll be fine now. How about giving him a little check up? I asked the parent, and so we checked every part

of its body. Then the teacher came into the room: OK, the triceratops is now healed, and took the splints off, as she was worried that the kid would hurt itself with it. Oh, no! Doctor, could we keep the splints on until tomorrow? he asked me obviously frustrated with his teacher. Well, look, your triceratops doesnt need the splints anymore, but we will keep a bandage on for two days, alright? and so the kid, the triceratops and the teacher lived happily ever after. Chrysa, 2 years in Teddy Bear Hospital

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Authors & Editors Nikos Korakas Public Health European Support Division Team 4th year medical student, Aristotle University of Thessaloniki Melina Kourklidou National Officer on Public Health 3rd year medical student, Aristotle University of Thessaloniki Authors Christina Eustathiadou 2nd year medical student, Aristotle University of Thessaloniki Ipek Chatzisouleiman 2nd year medical student, Aristotle University of Thessaloniki Chrysa Koraka 3rd year medical student, Aristotle University of Thessaloniki Antonia Mpirniou 4th year medical student, Aristotle University of Thessaloniki Dafni Papanikolaou 4th year medical student, Aristotle University of Thessaloniki Kassandra Xanthopoulou 3rd year medical student, Aristotle University of Thessaloniki

HelMSIC Hellenic Medical Students International Committee

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Amsterdams Merry New Year

by Chlo ten Broeke

...we wanted all our gifts to be sponsored by various shops and businesses. So we contacted some bookstores, drugstores and garden shops. As a result, we got 52 Christmas flower arrangements, 104 books, and even more products from drugstores...

In December 2012, a new project of EMSA-VUmc Merry New Year took place. The idea was the same as the internationally well-known project of EMSA Different Christmas. Not everyone can spend their Christmas pleasantly with their family and friends with a wonderful dinner. Many patients stay in the hospital or retirement home during this special time of the year. So, we decided

to bring a little change in their Christmas by organizing a wonderful and pleasant day during the holidays. Our plan is to spend a day with them playing some quiz games and handing out gifts. Our project is called Merry New Year, because it took place after Christmas and before New Years Eve. This year it took place in a retirement home instead of a hospital, because its easier to

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not have to take account of the changing amount of gifts due to changing amount of people. Besides, compared to a hospital, where silence is needed in almost every department, there is more time and space for fun and laughter during the activities in a retirement home. We took of with the organization of our project by dividing the main tasks. Some people took care of the gifts we were going to hand out and others had contact with the retirement home. A treasurer was appointed to manage the finances and someone else was responsible for the sponsorship. After we decided to do a quiz, we had to come up with questions! As one of us works in a home for the elderly, we asked their activity coordinator about their activities and programs. They had a great and very suitable game for us, as it handles the past of the Netherlands, some famous Dutch people of the old days and some silly questions as well. However, our budget was not very large. To solve this, we wanted all our gifts to be sponsored by various shops and businesses. So we contacted some bookstores, drugstores and garden shops. As a result, we got 52 Christmas flower arrangements, 104 books, and even more products from drugstores such as Rituals and Ici Paris for the winners of the game. As everything was now arranged, we carried out our first project! This took place on the 28th of December at nursing home

Het Zonnehuis in Amstelveen.We started our day with a lunch which was provided by the nursing home. It was a great way to introduce ourselves to the residents. In this way, we got to know the residents a little bit better while enjoying snacks and chips. After the lunch, we went to the joint living room to play the quiz with pictures and questions about former times. We divided the residents into two teams and the winning team got to pick presents first. After the game, we handed out the remaining presents to the residents who didnt participate in the game. Hereby, everyone eventually got a present. Because of a misunderstanding, Merry New Year could not be carried out at two floors at once, as was planned. As the residents, the staff and ourselves thought the day was such a success and really enjoyed it, we decided to do it again some other time, but then on the other floor. On the 12th of March we came back for Merry New year 2.0. Instead of a lunch, this time we had coffee and delicious pastries, now in style of Easter instead of Christmas. All in all, the project was a great success.The elderly were very grateful for the presents,and kept asking 'from who? And why?'.As mentioned earlier, the contact with the elderly home did not go smoothly. We planned to visit two floors at once, but when we arrived, there wasn't enough time, so we visited one floor and had to come back for the other. Later on, when we came back, there was another program planned, so we had to leave again.

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After that, we had one employee with whom we kept contact, instead of several and from then on it went well. The second edition went even better, because we had learned from the first. The elderly were prepared for the game and because it didn't take them by surprise, more of them wanted to join.Also the personnel was well prepared.To sum up, it is important to contact just one person, and tell them exactly what is going to happen and

that they inform and motivate the elderly. We had a great time organizing and carrying out this project and as a pleasant bonus, we also gave the elderly and the employees a great day. There is a lot of room to use your own ideas, in Leiden (NL) for instance, it is now being organized on Valentines Day. Therefore we recommend every faculty to organize this project as well!

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The Elderly Brothers

by Daria Gheorghe

Only until I saw it, I did realize how neglected they were and how being deprived from the chance to go to school can change ones life in a negative way.

Have you ever dreamed about having a younger sibling? Someone with whom you can share anything with; secrets and advices, laughter and giggles, sadness and tears. I know that I had, especially when I was little. But having a wonderful family and meeting some special people who I call them my friends, things did not look so bad. Although it was not the same, but it was as good as it can be. Now imagine what would it be like to have a caring mother and father to look after you, to love and support you. There is no replacement for this, not even all the money in the world nor the best friends can account for the most essential components of life, family. As tragic and unimaginable as it may seem to most of us, there are millions of children in this

world who are going through this daily, going to bed every night wishing that their life would change. However, waking up to see that it hasn't. I've had the chance to meet few of these children that are living in a shelter in Bucharest. Even though "chance" seemed a very optimistic word to choose, I stick to my choice. Since getting to know them was a life changing experience that truly altered my perspective of life and what is truly important. First thing to be asked, what is a shelter ? and how did these poor little ones end up there ? Well, The shelter is a place where children are taken to by their parents, who are financially unable or unwilling to take care of them, It is also a place

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where the runaway children living on the streets are taken to. On the safe circumferences, if they had the choice, the shelter would be their last option. But considering their situation, it is the best thing that could happen to them for the time being. Because here, they are being taken care of under good conditions by a personnel who is trying to get as close to them as possible. They are being well fed, having toys to play with and even starting to form bonds of friendship between each other. The sad part of the story is that, some of these children are rather unprepared for their age, due to the fact that they have partially attended school or maybe haven't attended at all. But However, the shelter has a specialized learning program for them and we, as medical students are a part of it. Thanks to the fact that the Society of Medical Students in Bucharest have made an agreement with the center, so we are now allowed to visit the shelter on Saturdays for a couple of hours to take their minds off their problems and even to teach them few things using some toys and books that we bought using the money we have collected during fundraising events. I am glad that out of all the available volunteering projects, I've chosen this one, because I am sure that I have learned as much, if not even more from them as

they did from me. The most important aspect of life is not to take everything for granted and to be grateful for what we have. Because even the simple acts such as reading and writing were difficult to them when they first arrived at the center. Only until I saw it, I did realize how neglected they were and how being deprived from the chance to go to school can change ones life in a negative way. But it is a wonderful thing that they want to learn and that they are striving to succeed and make effort, even though sometimes they get bored or tired. Also, something as simple for us as the Internet or television is a reason of happiness for them. When we live in an era where the Wi-Fi hotspots are everywhere, it is good to see that there are still some people who perceive it as a wonder of technology that helps them to develop through educational programs and games, as well as to relax through movies and music. We have so much and we appreciate a little, However they have a little while appreciating so much. What gives me joy is being able to see how much they have developed in these couple of months, from children that couldn't understand the importance of school and reluctantly embraced education to children that are coming to us asking to learn basic English. From children who were scared and defensive to other children to more open, talkative children to a point that they even enjoyed giving hugs. From children with poor manners

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to children who have learned how to share and be polite. It is amazing to see what patience and love can achieve. I could say that I have made some friends but honestly, I have made more than this. I have made some younger brothers and sisters which I look forward to visiting as soon as I leave the center.

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Authors:
Dominique Monnet Sven Pal Borislav Manev Andrew Miller Joanna Borowska Olga Rostkowska Sofia Ribeiro Jacob Hildebrand Samuel Ribeiro Nikos Korakas and Colleagues Chlo ten Broeke Daria Gheorghe France Croatia Macedonia US Poland Poland Portugal Germany Portugal Greece dominiquel.monnet@ecdc.europa.eu pal.sven@gmail.com manev86@gmail.com info@endecocide.eu borowska.joanna1@gmail.com rostkowska.o@gmail.com sigmaserena@gmail.com jacobmhildebrand@aol.de samueldsribeiro@gmail.com nickakor@gmail.com

The Netherlands camtenbroeke@gmail.com Romania gheorghedaria@gmail.com

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Proof-readers:
Daria Gheorghe Khalid Masoud Vasil Toskov Ibukun Adepoju Felicity Jones Romania Turkey Bulgaria Ukraine United Kingdom

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18th November