January/February 2006, Volume 2, Number 1

IFMSA-Africa Newsletter January/February 2006 Page 1

IFMSA-Africa NewsletterEvents in Africa 21st January-3rd February 2006 Winter school, Egypt 13th-24th February 2006 Community-Based Family Planning Workshop, Nairobi, Kenya 8th – 12th May 2006 HIV/AIDS, Food Security and Nutrition Conference, Lusaka, Zambia 19th -21st June 2006 2nd African conference on Sexual Health and Rights, Nairobi, Kenya 29th October – 2nd November 2006 Global Forum for Health Research, Cairo, Egypt IFMSA-AFRICA Leadership 2005-2006 Regional Coordinator Africa Ahmed Ali, Sudan Regional Assistants Africa • SCORA

Jennifer Mbabazi, Rwanda Oluwatosin Omole, Nigeria

• SCOPE

Charles Obeng Mensah, Ghana

• SCORE Hany Ezzat, Egypt

• SCOPH

Hossam Hamad, Sudan • SCORP

Tana Mohammed, South Africa Mubashar Ahmed, Sudan

• SCOME Vacant Liaison Officer WHO Serini Murugasen, South Africa

Means of communication for African Medical Students

Contents Who is who? 2 Student advocacy in the HIV/AIDS Pandemic Era 3 Commentary: Africa Needs Freer Markets - and Fewer Tyrants 4 Godfrey Msemwa 5 From Rwanda to Darfur: Lessons learned? 6 Forum: Chronic Diseases 9 SCORE-Africa 10 Report: Latrines Construction Project Launching 11 The Regional Students’ Conference: Antiretroviral therapy and the Latest Development in HIV/AIDS Care 12

Editorial

Knowing each other is the first step in a good cooperation. Therefore, we want to introduce a couple of students who are active in IFMSA-Africa in each edition of the newsletter. In this edition we have four students from the IFMSA-Africa leadership, introducing themselves and their general plan in the way forward for Africa. We also included articles which focus on the promotion of different activities and discussions, like the latrine project in Rwanda and the Chronic Diseases discussion in SCOPH. This improves the communication among medical students in Africa. Furthermore, the political situations in Africa are being discussed in two opinion articles. In one of them it is suggested that situations in Darfur

Jennifer Mbabazi Editor in Chief

could have been avoided if the example of what happened in Rwanda had been followed. The knowledge of the political situation in Africa helps in increasing awareness and working towards a stable and united Africa.

Serini Murugasen, South Africa Liaison Officer for WHO

Some of you already know me (a fifth year female medical student) as the current President of the South African Medical Students Association, but I have recently had the pleasure of being appointed as the IFMSA Liaison Officer to the WHO for the new term. I apologise for the delay in my formal introduction, but it’s been a hectic few months since my appointment and we have only recently completed the handover process. The purpose of this email is to provide a brief introduction to the World Health Organization and to the portfolio of IFMSA’s Liaison Officer to the WHO. Liaison Officers are appointed by the Executive Board to represent IFMSA to an external agency. Tasks to fulfil with regards to the NMOs include: • Provide IFMSA members with

information about the agency • Facilitate and initiate contacts between

IFMSA members and the partner-agency when requested and beneficial (for workshops, projects etc).

• Find points of possible collaboration and match IFMSA’s needs with the partner agency’s offer and vice versa.

• Secure sustainability to our partner agencies

• Encourage the NMOs to report on collaborations with the agency on national level to ensure an overview of all contacts between IFMSA and the agency.

The World Health Organization is the United Nations specialized agency for health. It was established on 7 April 1948. WHO's objective, as set out in its Constitution, is the attainment by all peoples of the highest possible level of health. Health is defined in WHO's Constitution as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. WHO is governed by 192 Member States through the World Health Assembly. The Health Assembly is composed of representatives from WHO's Member States. The main tasks of the World Health Assembly are to approve the WHO programme and the budget for the following biennium and to decide major policy questions. The objective of the World Health Organization is the attainment by all peoples of the highest possible level of health. In this way, the WHO shares similar goals to IFMSA and this is why they have enjoyed a long-standing and valuable working relationship. As the new Liaison Officer, it is my pleasure and privilege to work to strengthen that relationship in the new term. I would like to focus on relations between IFMSA and WHO regional offices with a final view to: 1. Running joint projects 2. Gaining logistical assistance and

resources for all NMOs in that region 3. Promoting the individual NMOs and

IFMSA within the region to all functioning externals

4. Establishing or strengthening partnerships with other regional NGOs such as the Stop TB and Roll Back Malaria partnerships

5. Providing members of NMOs with opportunities to work within the WHO framework at regional level

The above is in addition to organizing the IFMSA delegation to the World Health Assembly to establish partnerships in person and to gain support for our regional meetings and General Assemblies. This is the basic plan and I have already sent out calls for input into an annual plan of action to the current Team of Officials, but welcome any input that any member of IFMSA may have. I look forward to working with all of you and with our current Team of Officials and aim to represent this organization in a competent and comprehensive way.

IFMSA-Africa Newsletter January/February 2006 Page 2

It’s a pleasure to introduce myself as the regional assistant for our distinguished Africa! Though I introduced myself on the server already. I’m so grateful for the trust they put on me and I’m willing to work with all of you to achieve our goals for this year. Well, I guess for those we have not met mostly during the GA, I’m Mbabazi Jennifer, a sixth year medical student in the National University of Rwanda. I would like to be able to coordinate our activities and debates in the upcoming year for a better IFMSA- SCORA-Africa. I also want to thank my predecessor Mr. Oluwatosin Omole and at the same time my partner again as RA-SCORA-Africa for the great work done during his time and I hope it will be much better with our joint effort. I’m so confident that we will have a great year with this brilliant team of enthusiastic NORAS and expert people in Africa. With good communication, team spirit and desire to make a difference. We would like to focus on relations between the different NMOS in Africa and improve on the communication which is the main barrier to the development of African NMOS. We have already sent out calls for input into our plan of action to all NORAS and we also encourage input from any member of IFMSA-Africa who has the objectives of development of Africa. So, let us go ahead and make an unforgettable year for SCORA-Africa and the IFMSA!

Jennifer Mbabazi, Rwanda SCORA Regional Assistant

Who is who?This is a new section in the newsletter. Students who are active in the African region introduce themselves. In this issue Serini Murugasen, Jennifer Mbabazi, Oluwatosin Omole and Ahmed Ali.

IFMSA-Africa Newsletter January/February 2006 Page 3

I was born 21 years ago. I attended King’s College, Lagos for my secondary education. At present I am a 4th year student of Medicine and Surgery at the Obafemi Awolowo University, Ile-Ife, Nigeria. Currently, I am a member of the Students Representative Body of my faculty and the African Regional Assistant on Reproductive Health and HIV/AIDS for the International Federation of Medical Students Associations. I volunteer with the Campus Health and Rights Initiative, a project that

Ahmed Ali, Sudan

Regional Coordinator

Oluwatosin Omole, Nigeria SCORA Regional Assistant

works to promote the reproductive health and rights of students. Additionally, I am on the Genesis Learning Network of AIESEC Ife – the HIV/AIDS network of AIESEC International. I am a team player, have excellent interpersonal and communication skills, and above all, I have a highly analytical mind and am committed to continuous learning. I am fluent in Yoruba (native), English and understand French.

My name is Ahmed Ali. I'm a sixth year student in the University of Khartoum, Sudan. I joined IFMSA as an exchange student, then worked with SCOPE, as an NMO president and finally as the IFMSA Regional Coordinator for this distinguished region! Why I joined IFMSA? When I was in my clerkship, I was inspired by the differences in medicine, people, culture and students' work. I discovered that IFMSA opened new "era" in my mind, it was think global, act local! Now I believe that IFMSA gives me another good reason why I'm studying medicine ;-) I had the chance to visit Nigeria, Ghana and Ethiopia and I'm looking forward to visit others! My biggest dream is to see Africa active in IFMSA and taking part in its leadership and management! You can make my dream true!

Student advocacy in the HIV/AIDS Pandemic Era This year the Federation of Uganda Medical Students’ Association (FUMSA) under its full member organization Makerere Medical Students’ Association (MUMSA) has embarked on the formation of Student Advocacy groups. This is because as we health providers in training need to raise our voices and contribute our rightful role in the fight against this global challenge HIV/AIDS. There is need for AIDS action .The AIDS epidemic is the most devastating crisis in the history of human health. Today more than 40 million people are living with HIV worldwide. 70% of the 40 million are adults and 80% of them are children in Sub-Saharan Africa, where Uganda falls. 22 million men, women and children have already died and 15,000 people are infected everyday. if the current trends don’t change by 2010 there will be 40 million children orphaned due to AIDS in Africa alone –about the time one finishes ones 5th year in Medical School if one is in year one. HIV is a preventable infectious disease. From 1991 to 2002, Uganda successfully reduced the HIV prevalence rate from about 15% to 6% where it has remained stagnant. This has been explained by improvement of the longevity of life of

those with HIV/AIDS which has resulted from the improved care for them. However, it could also be because of the relaxation in Uganda’s prevention Strategy implementation. With the help of Physicians for Human Rights (PHR), America Medical Students Association (AMSA) and Action Group for Health, Human Rights and HIV/AIDS –Uganda (AGAH) a MUMSA action group was formed and later named Students For Equity in Health Care (SEHC). Its vision is ‘‘A WORLD OF EQUITABLE HEALTH CARE’’ and the mission of SEHC is to advocate for equity in health care service delivery in Uganda and worldwide in partnership with other groups with similar objectives. SECH organized an Action week from 14th to 19th March 2005. This attracted a number of medical students. Guest speakers included Sarah Kalloch; PHR representative in Uganda and Health Action AIDS Africa Coordinator, Prof. Sam Luboga: Deputy Dean Makerere Medical School, Dr. Nelson Musoba: Director AGHA –Uganda, to mention but a few. Dr. Nelson Musoba credited the organizers of the action week and encouraged participants to continue advocating for health rights of the Health care providers and consumers.

Other activities included: • Talks and small group discussions

about HIV/AIDS, Advocacy and strategies on how to enhance advocacy.

• Knowledge dissemination on the magnitude of the HIV/AIDS pandemic and the relevance of Post Exposure Prophylaxis(PEP) especially in the protection of the healthcare providers

• Televised documentaries on HIV/AIDS in Uganda and other parts of the world.

The Action week marked the birth of Students advocacy in Uganda. Enthusiastic participants after the action week advocated for the accessibility of PEP services for Mulago Hospital Staff (Uganda’s National Referral Hospital and Medical Students which was made available. SECH has also written petitions to the Uganda Parliament on matters affecting health care providers. Also several signatures were collected from over 200 medical students and sent to the G8 summit of 2005 to advocate for more funding to the health sector in Africa to cab on the brain drain which has paralyzed the healthcare system. Most health care workers are leaving Africa to work in Europe.

IFMSA-Africa Newsletter January/February 2006 Page 4

much of the remaining 44% got siphoned off by corrupt officials, nor could he explain why $400 billion dollars of aid over the last 30 years has left the average African poorer. Rwandan President Paul Kagame told Ugandan journalist Andrew Mwenda in April, "There are projects here worth $5 million and when I looked at their expenses, I found that $1 million was going into buying these cars, each one of them at $70,000. Another $1 million goes to buy office furniture, $1 million more for meetings and entertainment, and yet another $1 million as salaries for technical experts, leaving only $1 million for the actual expenditure on a poverty-reducing activity. Is this the way to fight poverty?" The only way to give food security to 200 million sub-Saharan Africans is to give them the tools, not to rely on yet more aid and government mismanagement. World food production has increased with population by 90% in the last 50 years; the real price of food has declined by 75%. Yet Africa has none of the factors that made this possible: greater agricultural productivity, internal economic freedom and international trade. The one thing that could give us drought-resistant and highly productive seeds is biotechnology. Experience shows that genetically modified (GM) crops could increase yields by 25% and cost less than Green Revolution techniques. But GM produce faces bans from rich countries, especially the EU, using unscientific "biosafety" protocols under the guise of environmental protection. This kind of hysteria made Zambia, Angola and Zimbabwe reject famine aid because U.S. or South African maize could not be certified GM-free. Africans therefore have to hope that the U.S., Canada and Argentina win their case against the EU barriers to GM crops: The World Trade Organization is due to rule early in 2006. African leaders must be pushed to reduce economic intervention, free financial markets, remove bureaucratic obstacles to setting up businesses, establish property rights and enforce contract law. These are the forces that release entrepreneurial energy. But the ruling cliques will do none of these unless forced to do so as a condition of aid. The Sachs aid model has financed tyranny and corruption for 40 years, leaving Africans destitute. The world trade meeting in Hong Kong will hear cries for "Trade Justice" for Africa, representing more protectionism and more state-run, aid-fuelled schemes. What we really need is economic freedom and the rule of law at home: We are perfectly capable of improving our own lot if only allowed to do so.

purchaser must have plans to make the land profitable. If there is no sale, owners might have an incentive to invest in their own land and future, having, at last, the collateral of the land on which to get a loan. After decades of socialism, Ethiopia's agricultural sector -- the mainstay of the economy -- is less productive per capita than 20 years ago when Band Aid tried to defeat famine. Although 60% of the country is arable, only 10% has been cultivated. Ethiopia is entirely dependent on donations; but instead of grasping reality, Mr. Zenawi, a member of Tony Blair's "Commission for Africa," is forcing resettlement on 2.2 million people. In Zimbabwe, the murderous kleptocrats of Robert Mugabe's regime deny that land seizure has pushed their rich and fertile country into famine: Some three million people face starvation today. Meanwhile, Prof. Jeffrey Sachs, the U.N.'s Chief Advisor on the Millennium Development Goals, believes Africa needs more cash for an African "Green Revolution" -- a pale imitation of the very different Asian agricultural revolution of the 1960s and '70s. The equivalent of "some 40 euros per villager" (roughly $50) in aid, Prof. Sachs says, holds the key. His Green Revolution would spend that money to improve agricultural infrastructure, soil nutrients, water quality and seeds ability to survive harsh climates and insects, and better agricultural infrastructure. These, however, are precisely the benefits that come from property rights, which also inspire the motivation to invest in, improve and preserve the land -- motivation that does not come from aid, central control and state serfdom. Prof. Sachs is right about tougher seeds but not about more aid. By his own calculation, "out of every dollar of aid given to Africa, an estimated 16% went to consultants from donor countries, 26% went into emergency aid and relief operations, and 14% went into debt servicing." He could not account for how

by: Franklin Cudjoe Famine in Niger is no surprise -- desert wastes, locusts and decades of Marxist rule keep it second-to-last on the world poverty list. Famine in the fertile climes of southern and eastern Africa, however, seems more shocking. But there's a common thread: centralized state rule -- incompetent at best -- marked by corruption and sustained by aid. These are the shackles that keep Africans poor: It would be nice if EU and U.S. trade barriers were removed at trade talks in Hong Kong this week, but exports are a distant notion to the 75% of Africans who live off the land. Niger is little-blessed by nature, but it has also spent its postcolonial era trying various forms of failed government, with Marxism reigning longest. A quarter of the population -- 2.5 million people -- faces starvation. Yet more temperate southern and eastern African countries are on the edge of famine, too, with 10 million affected in southern Africa alone. Again, we find the same economic profile: Zimbabwe, Malawi, Zambia, Mozambique, Swaziland and Lesotho all lack economic freedom and property rights; all have economies mismanaged by the state; all depend on aid. All these countries have a history of utopian schemes that failed to produce everlasting manna. State farms, marketing boards, land redistribution, price controls and huge regional tariffs left few incentives or opportunities for subsistence farmers to expand. Despite torrents of aid, these cruel social experiments could not turn sands verdant or prevent the granaries of southern and eastern Africa from rotting. Ethiopia's Prime Minister Meles Zenawi believes that allowing Ethiopians to own their land would make them sell out to multinationals. He seems to have overlooked a basic market principle: It demands a willing seller and a willing buyer at an agreed price. If that price is worth selling for, the farmer might have some money to reinvest elsewhere; if that price is worth buying for, the

Commentary:

Africa Needs Freer Markets - and Fewer Tyrants

IFMSA-Africa Newsletter January/February 2006 Page 5

Since Godfrey’s passing, more and more people in Tanzania and around the world have expressed their commitment to this project. I am personally very grateful to them. It has been a long journey to accepting that Godfrey is no longer with us, but I personally believe that his spirit lives on. His words to “work hard, persevere and above all, work for the humanity of others” has become like an anthem that rings in my ears – even now as I painfully write these words. I will remember Godfrey as my friend, confidant, and soul-mate. He showed me so much about life and about what it means to be in service of others. So, whether a doctor, teacher, or parent, word toward humanity. That’s what Godfrey did. Neema Mgana Iowa State University of Science and Technology December 2000 Source: The IFMSA Newsletter Vagus Volume 49, Number 1 Winter 2000 / Spring 2001

Godfrey Msemwa was the kind of person I believe I will only meet once in this lifetime. We met in 1996 at the Muhimbili Medical Center in Tanzania when he was a second year medical student and I was doing an internship in the Department of Epidemiology/Biostatics. I could tell in the first week of knowing him that he was special. His poise, demeanour and calmness suggested that he was well beyond his age. He would remind me many times to work hard, persevere and above all, work for the humanity of others. There is one Native American saying that says that you can only know someone by walking in their moccasins (a type of shoe) and it seemed that Godfrey had walked in the moccasins of many people. Godfrey would call me each week since I moved to the US in June. We would talk and reminisce about many things for at least 3 hours. Our conversations were so varied – going from the weather, school, AIDS prevention policies in Botswana, and coffee. We actually had to introduce each topic by saying “point 1, point 2…” so that we could always keep track of what we were talking about. The code between us was that the first and last point were reserved to saying “I love you”. In one of our conversations in September, Godfrey called me to tell me of the success of his speech at this year’s international Student Week in Tanzania. Quite naturally, he spoke about HIV/AIDS prevention as he was absolutely committed to this cause. He was so committed that he was the initiator of an idea of helping children infected and affected by HIV/AIDS. This was in September 1999. Godfrey worked tirelessly on this project and soon his idea quickly grew to a project that was named Everyone’s Child in recognition that we are all responsible for caring children – irrespective of gender, creed, language or HIV status.

His tongue was framed to music, And his hand was armed with skill, His face was the mould of beauty, And his heart the throne of will

Ralph Waldo Emerson,

The conduct of Life (1860, rev. 1876)

In memorandum

Godfrey Msemwa

Working For The Humanity Of Others

About the organisation: Godfrey’s Children

Godfrey's Children is an organisation dedicated in commemoration our lost friend Godfrey Msemwa from Tanzania, a true leader, always putting other people's interests before his own, especially when fighting HIV and AIDS.

Godfrey's Children is a youth-run organization dedicated to assisting orphans and vulnerable children in Africa infected and affected by HIV/AIDS. We work *within* communities to build capacity in identifying the needs of vulnerable children and youth in order to develop community-based programs that are sustaining and culturally appropriate.

Godfrey's Children has official status with the International Federation of Medical Students' Association. Our collaboration with youth and youth organisations around the world reflects our commitment to empower and create advocates amongst youth in the fight against HIV/AIDS. Source: www.geocities.com/godfreyschildren/

Everyone’s Child initially looked at the creation of a home for such children in Mbeya, Tanzania, but later grew to recognize the more comprehensive needs of the children, their extended family and their community. In honour of Godfrey’s memory, this project is now called Godfrey’s Children.

IFMSA-Africa Newsletter January/February 2006 Page 6

By: Gerald Caplan What lessons did the international community learn from the Genocide in Rwanda ten years ago, especially in relation to the crisis in Darfur? Gerald Caplan, an expert on the Rwandan genocide, charts the response of the international community in Rwanda and then discusses what the response has been in Darfur. Once again, the international community, with key players only able to serve their various economic and strategic interests, have shown a scandalous disregard for human life and failed to act and prevent genocide. Even before the 1994 Rwandan genocide ended, some began wondering when "the next Rwanda" would be. Not "if", but when. Despite Indonesia in 1965, Burundi in 1972 and Cambodia from 1975 to 1978, genocide had receded in the public consciousness. From the late 1960s, it's true, memory of the Holocaust was in full bloom. But the Holocaust was treated as almost a self-contained phenomenon separate from "ordinary" genocide. The earlier Armenian genocide was mainly the crusade of Armenians, the Hereros' extermination was unknown beyond a few experts. As for the post-Holocaust massacres of half-a-million Chinese and Communists in Indonesia, the slaughter by the Tutsi army of perhaps 200,000 Hutu in Burundi, including all those with secondary education, and the deaths by beating, starving or torture by the Khmer Rouge of a million and a half Cambodians, none quite seemed to meet the standards set down in the 1948 Convention on the Prevention and Punishment of Genocide (UNCG). Rwanda was different. Rwanda was a classic UNCG genocide, fulfilling all the conditions, and it reminded the world that a half century after the world first vowed "Never again," genocide had not disappeared. What Primo Levi had said of the Holocaust was now said about Rwanda: It happened, so it will happen again. For some, it happened soon enough. . For them, Srebrenica in 1995 seemed "another Rwanda", and indeed, the International Criminal Tribunal for the former Yugoslavia eventually decided that the murder of 8000 Muslim Bosnian males by Bosnian Serb militias was indeed genocide. But this has been a controversial issue. Cold-bloodedly murdering 8000 Muslim Bosnians was beyond question an egregious war crime,

even a crime against humanity, but, some wondered, how could it belong in the same category as killing 1 ½ million Armenians or six million Jews? Rwanda, however, left no room for ambiguity. Ironically, the seeming absence of genocide since 1945 had made most observers refuse to take seriously in advance that an actual genocidal conspiracy was being hatched in Rwanda before 1994. Once it was over, it seemed all but inevitable that others could, would, follow. For many, early in the new millennium, Darfur seemed well on its way to becoming "the next Rwanda". The urgent question then emerged: Had Rwanda taught the world any lessons that might help prevent Darfur from following in its place? Three lessons from Rwanda Assuming of course that there really are any lessons at all that the past can teach the future, it is possible to isolate three from the unmitigated catastrophe of Rwanda in 1994. Of these, the first and most obvious is profoundly disheartening to all those who favour intervention in crises where no interests beyond the humanitarian are at stake. The second and third are apparently, or potentially, encouraging. To seek a ray of hope out of a genocide borders on the desperate, but in the curious universe of those who study genocides in order to prevent them, what else is there to hold on to? The horror of the Rwandan genocide extends beyond its intrinsic bestiality. What's also notable is, first, how swiftly it became evident that this was a perfect storm of a genocide, and, second, how easily it could have been prevented. (Before addressing the betrayal of Rwanda by the "international community", genocide prevention activists must not forget that it could have been prevented most successfully if the Hutu conspirators who plotted to "cleanse" Rwanda of its Tutsi citizens had simply called off their plot.) Yet the genocide was not formally named as such by the vast majority of governments and institutions, including the United Nations and Organization of African Unity, until the 100 days of slaughter had virtually come to an end. Moreover, not only was the genocide not prevented, it was not even marginally mitigated. From the first day to the last, not a single reinforcement arrived in Rwanda to bolster the puny UN force of 400 that was

trying desperately to save the relatively few Tutsi that it could. Thus, the first lesson from Rwanda: the harsh unwelcome reminder - as if the world needed another - that the global powers-that-be are capable of almost infinite callousness and indifference to human suffering if geopolitical or political interests were not at stake. Calls for forceful intervention bases strictly on humanitarian grounds, as we have learned the hard way once again in Darfur, are simply irrelevant to those with the means to intervene. Here I refer essentially to the Security Council, and within that body to the remarkably powerful five Permanent Members (P5) who alone hold a veto over all its resolutions. Since UN missions can only be authorized by the Security Council, and since any one of the P5 can veto any resolution, the leverage of the US, Britain, France, Russia and China can hardly be exaggerated. Those who have begged for a more assertive response in both Rwanda and Darfur understand the immutability of this phenomenon. Often, middle powers are looked to as a means to exert pressure on the inner sanctum of the P5. Canada, northern Europe and the Scandinavian countries are all seen, sometimes naively, as being less in the thrall of self-interest and more open to humanitarian projects. In trying to leverage action for Darfur, activists placed considerable hope on these countries. The role of Belgium in 1994 shows both the leverage that a middle power can play and the perverse use it can make of that leverage. For 110 years prior to the Rwandan genocide, no external power played a more deplorable role in Africa than Belgium - a tiny country responsible for giant crimes against humanity. Its impact on the Congo, Rwanda and Burundi was catastrophic. The turbulent history of the entire Great Lakes region in the 20th century would have been profoundly different if it had not been for Belgian colonial rule. Now, just as the genocide was exploding across Rwanda, the Belgian government sought to bring pressure on the Security Council to withdraw in its entirety its 6-month old UN Assistance Mission for Rwanda (UNAMIR). Ten of Belgium's UN troops had been murdered by Rwandan government soldiers less than a day after the genocide was triggered by the shooting down of the Rwandanpresident's plane. The Belgian government decided it was politically

From Rwanda to Darfur: Lessons learned?

IFMSA-Africa Newsletter January/February 2006 Page 7

impossible for its troops to remain in Rwanda. Their withdrawal very substantially undermined UNAMIR's capacity, and its lethal consequences are not merely theoretical. It immediately and directly led to the death of some 2500 Rwandans being protected by Belgian troops at the Ecole Technique Officielle (ETO) school compound in the capital, Kigali. At least the Belgian government had the good sense to feel humiliated by the decision to abandon Rwanda at its moment of greatest need, and sought to cover its guilt by convincing the entire world to share its culpability. To the everlasting sorrow of Rwanda, the Belgians found the Administration of US President Bill Clinton ready and willing. Largely for their own entirely short-term partisan reasons, with pathological UN-hating Republicans breathing down their necks, the Clintonites were unprepared to have anything whatever to do with sending a new UN mission to a tiny African country which, as is invariably said, almost no American could even find on a map. Among the P5, France was the only country genuinely concerned about Rwanda for its own perverse reasons of francophone solidarity, and it was stealthily seeking a way to intervene on behalf of the Hutu extremist genocidaire government. It was left to the US Ambassador to the UN, Madeleine Albright, to lead a vigorous movement in the Security Council to literally decimate UNAMIR's 2500-odd force. Britain, for reasons British journalist-historian Linda Melvern is still trying to unravel, fell in solidly behind the Americans. Russia and China were largely uninterested, a situation that would change significantly in the case of Darfur. At the end of the genocide's second week, with an estimated 100,000 or more Tutsi and almost all prominent moderate Hutu already dead, and the genocide gaining daily momentum, the Security Council voted to reduce the UNAMIR mission to 250 men. Force Commander Romeo Dallaire, furious and sick at heart, disobeyed this explicit instruction and managed to retain 400 men for the duration of the genocide. Even now, it is impossible to recapitulate these events without feeling they cannot possibly be true. But as virtually all authorities on the subject agree, and as the Security Council's reaction to Darfur a decade later make entirely plausible, they were only too true, and their lesson was clear. There seemed barely any depths to which the "international community" would not sink if it deemed them necessary to its own national interests, even if that interest was nothing more nor less than, in Belgium's case, covering up a cowardly abandonment of a people at ultimate risk, or for the US, winning an impending election. Political

expediency was all, and human need seemed completely irrelevant. However, two other lessons of the international reaction, distressing as they were at the time, seemed to offer a certain hope for intervention in future crises. First were the lies told by both US President Bill Clinton and UN Secretary-General Kofi Annan in later apologizing for their inaction during the 100 days. Both claimed that they were insufficiently aware of the situation at the time. These claims, on the part of both men, have been repudiated beyond a shadow of a doubt. They knew everything, or at least everything they wanted to know. Nevertheless, their very disingenuousness permitted the inference that the next time "another Rwanda" loomed, if it could attain a sufficiently high public profile, the Security Council would have lost the excuse of ignorance and have little alternative but to intervene. This apparent truth initially gave heart to the movement to intervene in Darfur. Second, as already noted, almost no one in an official position at the time agreed to characterize Rwanda as a genocide and, led again by the Clinton administration, actually denied that a genocide was in fact in progress. This refusal to affirm the obvious was again tied directly to the Clintonites' electoral fears. Government lawyers studying the 1948 Genocide Convention appear to have decided that accepting the genocide label would trigger a major obligation on the administration to intervene actively. That such an interpretation was highly debatable is neither here nor there. It was perfectly possible to argue that a mere Security Council resolution satisfied the wording of the UNCG. But Clinton's advisors chose not to adopt this reading. Their judgment powerfully affected Clinton's public stance. Television captured a moment of true self-debasement when a US State Department spokesperson, a certain Christine Shelly, tried to explain to reporters that Rwanda was the scene of "acts of genocide" but not of genocide. When pushed to indicate how many "acts of genocide" constitute one full genocide, Ms. Shelly, obviously humiliated beyond words, explained that she wasn't authorized to deal with that question. (To her everlasting chagrin, several documentaries on the genocide include footage of her disastrous performance, unforgivingly immortalizing her forever.) The difference between this pathetic moment and subsequent American reactions to Darfur under President Bush could hardly have been more glaring. And indeed, Clinton's position that there was no full-blown genocide in Rwanda

unwittingly provided the glimmer of hope out of an act of unsurpassed political opportunism. If Rwanda was "not quite" a genocide, and therefore intervention was not obligatory, it surely followed logically that if a genocide were declared in future, would it not mean that intervention was mandatory, inescapable? That logic, combined with the prospect that if a disaster was well-enough publicized, the world would have little choice but to move in, offered some real hope that the "next Rwanda" would not be betrayed and abandoned as the original Rwanda had been. The next Rwanda Then came Darfur. Less than a decade after Hutu Power was defeated, the world had found its "next Rwanda". It is irrelevant to my argument that serious genocide authorities disagree about whether the conflict is a genocide or not. All agree that it had many of the dimensions of a genocide, that it is an appalling catastrophe, and that robust intervention is demanded. As we know, no such intervention has occurred, and as this is written early in 2006, the situation seems to have deteriorated substantially and become even more complex - the almost inevitable consequence of the world's meagre response to date. From the point of view of the hopes raised by two of the optimistic lessons from Rwanda, the response of the "international community" to the crisis in Darfur can only be considered a giant, tragic set-back. It is not too much to say that Darfur shows that only the first despairing lesson - the bottomless cynicism and self-interest of the major powers - -remains valid, while the hopes have been largely destroyed. After all, by the middle of 2004, at the very latest, everyone who counts knew that an overwhelming political and humanitarian man-made disaster had befallen western Sudan. On April 7, when he rightly should have been in Kigali for the commemoration of the tenth anniversary of the Rwandan genocide, Kofi Annan was instead in Geneva unveiling a new five-point plan for genocide prevention and announcing that the world must not permit Darfur to become "another Rwanda". Everyone who counts soon either visited Khartoum to plead with the Government of Sudan that was orchestrating the crisis, or popped in at a displaced persons or refugee camp in Darfur or across the border in Chad. When Annan and Colin Powell make a stop somewhere, you know that it's already a major story. Itmay not have competed with the Michael Jackson trial, but even in the mainstream media, Darfur stories, features and opinion pieces were remarkably common

for a crisis so remote and complex. The crisis in Darfur, in other words, was fairly big news. This was unlike Rwanda. Clinton and Annan knew all about Rwanda, but media coverage for many weeks was both minimal and distorted ("tribal savagery") so the public remained largely uninformed. Yet despite Darfur's profile, the Security Council was effectively paralyzed by the conflicting interests of the veto-casting P5. This time China, thirsty for Sudan's oil, and Russia, anxious to sell arms to a genocidal government, also played spoiler roles. The Council passed a series of powder-puff resolutions each threatening the killers in Khartoum that if they did not rein in their Janjaweed forces, they would be forcefully confronted with - yet another resolution. Perhaps not since a representative of Rwanda's genocidaire government retained his position on the Security Council through the entire 1994 genocide has the Security Council appeared to be more of a joke than over Darfur. The role of the United States Yet there was another reason for hope. Pushed by an unlikely coalition of domestic pressure groups, the US Congress and Executive publicly declared that Darfur constituted a genuine genocide under the 1948 Convention. Such a radical and dramatic step was unprecedented in American history. Both chambers of Congress hastily and unanimously passed their own resolutions declaring Darfur to be a genocide with barely an explanation, let alone debate, and President Bush and Secretary of State Colin Powell each eventually followed with their own concurring declarations. To the genocide prevention community, this seemed the moment they had so long dreamed of and planned for. What would be the point of making this declaration unless significant action was being planned? It was true the Bush government, and others, were modestly generous in providing humanitarian aid to the displaced and the refugees as well as funding for the Africa Union Mission to Darfur. But now, surely, with these declarations, was the long-awaited moment of qualitative escalation. Now we would see the kind of forceful intervention denied Rwanda and that was crucial if the travesty in Sudan was to be ended. In fact, all that was needed was to pay heed to the second part of Colin Powell's statement before the US Senate Foreign Relations Committee. Yes, the US had decided, upon looking at evidence it had specifically commissioned - the exact opposite of Rwanda - that a genocide was taking place before the eyes of the world. Powell had no doubt what the

world expected next, and said so explicitly: "Mr. Chairman, some seem to have been waiting for this determination of genocide to take action. In fact, however, no new action is dictated by this determination. We have been doing everything we can to get the Sudanese government to act responsibly. So let us not be preoccupied with this designation of genocide. These people are in desperate need and we must help them. Call it a civil war. Call it ethnic cleansing. Call it genocide. Call it 'none of the above'. The reality is the same: there are people in Darfur who desperately need our help." (US Department of State, "The Crisis In Darfur," Written remarks before the Senate FRC, Washington, DC, September 9, 2004). How was this possible? Had the historic declaration of genocide been nothing more than an opportunistic political ploy by the Bush administration to assuage some domestic pressure groups? Could even the Bush neocons be so cynical as to play politics with genocide? If not, how could this wholly unanticipated development be explained? How could the esteemed Colin Powell participate in this destructive exercise which has done so much to debase the currency of the Genocide Convention? Within mere months of the American government's determination of genocide in Darfur, a new Bush administration betrayal of Darfur was exposed. First came the revelation that the CIA had sent a plane to Khartoum to ferry the head of Sudanese intelligence, General Salah Abdallah Gosh, to Washington for discussions with his American peers on the "war against terror". Sudan, it appears, had become "a crucial intelligence asset to the CIA." (Suzanne Goldenberg, "Ostracized Sudan emerges as key American ally in 'war on terror'," Guardian Weekly, May 6-12, 2005.) Never mind that General Gosh's name is widely assumed to be among the 51 leading Sudanese officials named by the UN-appointed International Commission of Inquiry on Darfur. The "war on terrorism" obviously trumps genocide. Later we learned just how close this tie really was. In October 2005, Guardian reporter Jonathan Steele reported the following: "Question: When do Bush administration officials cuddle up to leaders of states that the US describes as sponsors of international terrorism? Answer: When they are in Khartoum. I know because I saw it the other day…. We were attending the closing dinner of a 2-day conference of African counter-terrorism officials, to which the US and UK were invited as observers. The western spooks were less than happy to have the western press on hand, especially as their names were called out. But loss of

anonymity was a small price for the excellent cooperation both agencies believe Sudan is giving to keep tabs on Somali, Saudi and other Arab fundamentalists who pass through its territory…. [The dinner] was in the garden of the headquarters of Sudan's intelligence service, not far from the Nile. Up stepped a senior CIA agent. In full view of the assembled company, he gave General Salah Abdallah Gosh, Sudan's intelligence chief, a bear hug. The general responded by handing over a goody-bag, wrapped in shiny green paper. Next up was the [British] M16 official, with the same effusive routine." (Jonathan Steele, "Darfur wasn't genocide and Sudan is not a terrorist," Guardian, October 7, 2005.) There are still Darfur activists who believe that despite close working relationships between the Bush administration and precisely those Sudanese leaders against whom the International Criminal Court intends to issue warrants, the US can still be relied on as an ally in pressuring Khartoum to end its war against the Fur and other Africans. I wish I could agree. The Khartoum government is as canny as it is treacherous, and blithely uses its leverage to continue getting away with murder in Darfur. It now has trump cards with the Americans, the Chinese and the Russians. Those of us who urge intervention on strictly humanitarian grounds have no comparable influence whatever. The result is virtually pre-ordained: the death and rape and suffering in western Sudan will continue. Are there now lessons from Darfur, having seen that the only lesson from Rwanda that proved relevant was the most despairing one? It is almost too disheartening even to ask. But for those committed to genocide prevention or to interventions on strictly humanitarian grounds, tough questions must again be asked, creative new directions and mechanisms sought. The alternative is too ghastly to contemplate. * Gerald Caplan has a Ph.D. in African history from the School of Oriental and African Studies, University of London. He is author of Rwanda: The Preventable Genocide, the report of the International Panel of Eminent Personalities appointed by the Organization of African Unity to investigate the Rwandan genocide; founder of "Remembering Rwanda"; and co-editor with Eric Markusen of a special edition of the Journal of Genocide Research devoted to the 10th anniversary of the Rwandan genocide. He teaches a course on the genocide to Rwandans in Rwanda. * Please send comments to editor@pambazuka.org

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IFMSA-Africa Newsletter January/February 2006 Page 9

Forum: Chronic Diseases This year’s theme for SCOPH Dear SCOPHians! As some of you already know….Chronic Diseases is this year’s theme for SCOPH-IFMSA! Early into our term, we realised that we do not only want to ‘manage’ SCOPH for the coming year, but also to add to the muscle that makes up our International SCOPH Family. Given the importance of the problem of Chronic Diseases, and the fact that it has been side-lined or ignored by many of the international organisations for so long, we decided to target this issue in particular. Under Chronic Diseases there is a very wide range of Risk Factors (smoking, lifestyle, obesity, etc.) and SCOPH activities already exist that target these. That said, this does not mean we shall only be working on this only! In fact, all issues we work on (VCP, TB, Malaria, Teddy Bear Hospital/Children Activities, Organ Donation, etc.) are just as important! And we shall continue working hard as an international team to continue strengthening each of these! Since we already work on Chronic Diseases, we have decided to add a more organised and structured support for this. More to follow on this later! One goal shall be to increase awareness of the international impact of Chronic Diseases among SCOPHians…on the server, GA, nationally and locally. We will be uploading a few very interesting articles on Chronic Diseases to the files section on the SCOPH server (published in Lancet October ’05). We strongly recommend you to check them out! If you are interested in the rest of the articles in this series (focus on India, China), please contact us! Let us know what you think!!! Feel free to post on the server, or to scophd@ifmsa.org Huge Hugs! 2006…The Year of SCOPH…The Year of IFMSA!!! Jade Khalife & Karina Larsen SCOPH Directors 2005-2006

The neglected epidemic!!! Opening discussion…! Hello all, Hope you read this article (Published online 5 Oct 2005 DOI:10.1016/S0140-6736(05) 67354-5) and can’t wait to read your inputs!!! The reduction of chronic disease is not a Millennium Development Goal (MDG). While the political fashions have embraced some diseases – HIV/AIDS, malaria, and tuberculosis, in particular – many other common conditions remain marginal to the mainstream of global action on health. Chronic diseases are among these neglected conditions. Chronic Diseases represent a huge proportion of human illness. They include: Cardiovascular disease (30% of project total worldwide deaths in 2005), Cancer (13%), Chronic respiratory diseases (7%) and diabetes (2%). Two risk factors underlying these conditions are key to any population – wide strategy of control – tobacco use and obesity. These risks and the disease they engender are not the exclusive preserve of rich nations. Quite the contrary.1 Chronic diseases are a larger problem in low-income settings. Research into chronic diseases in resource-poor nations remains embryonic. But what evidence there is 2,3 shows just how critical it will be to intervene early in the epidemic’s course. There is an unusual opportunity before us to act now to prevent the needless deaths of millions. Do we have the insight and resolve to respond? With a new series of articles 4-7 for which we thank the superb efforts of Robert Beaglehole, The Lancet aims to fill a gap in the global dialogue about disease. It is a surprising and important gap, one that health workers and policymakers can no longer afford to ignore. The call by Kathleen Strong and colleagues4 for the world to set a target to reduce deaths from chronic diseases by 2% annually – to prevent 36 million deaths by 2015 – deserves to be added to the existing eight Millennium Development Goals. Without concerted and coordinated political action, the gains achieved in reducing the burden of infectious disease will be washed away as a new wave of preventable illness engulfs those least able to protect themselves. Let this series be part of a new international commitment to deny that outcome. Richard Horton

1. Yusuf S, Hawken S, Öunpuu S. Effect of

potentially modifiable risk factors associated with myocardial infaction in 52 countries (the INTERHEART Study). The Lancet 2004: 364:937-52

2. Sorensen G, Gupta PC, Pednekar MS. Social disparities in tobacco use in Mumbat, India: the roles of occupation, education, and gender. AM J Public Health 2005:95:1003-08

3. Pampel FC. Patterns of tobacco use in the early epidemic stages: Malawi and Zambia, 2000-2002. AM J Public Health 2005:95:1009-15

4. Strong K, Mathers C, Leeder S, Beaglehole R, Preventing chronic diseases: how many lives can we save? Lancet 2005: published online Oct 5. DOI:10.1016/S0140-6736(05) 67341-2

5. Epping-Jordan JE, Galea G, Tukultonga C, Beaglehole R, Preventing chronic diseases: taking stepwise action. Lancet 2005: published online Oct 5. DOI:10.1016/S0140-6736(05) 67342-4

6. Readdy KS, Shah B, Varghese C, Ramadoss A, Responding to the threat of chronic diseases in India. Lancet 2005: published online Oct 5. DOI:10.1016/S0140-6736(05) 67343-6

7. Wang L, Kong L, Wu F, Bal Y, Burton R. Preventing chronic diseases in China. Lancet 2005: published online Oct 5. DOI:10.1016/S0140-6736(05) 67344-8

Thanks for reading that, hope you get benefit. Let’s discuss. Hossam Hamad, SCOPH Regional Assistant for Africa

Atherosclerosis Photo: www.medlib.med.utah.edu

Prevention is better than cure Hello all, It is really true; Prevention is better than Cure. Please read the data below and see how we could serve humanity. 35 million people will die in 2005 from heart disease, stroke, cancer, and other chronic diseases. Only 20% of these deaths will be in high-income countries - while 80% will occur in low-income and middle-income countries. The death rates from these potentially preventable diseases are higher in low-income countries, especially among adults

Chronic Diseases in Ghana This is a very interesting topic. I have been coming across this same issue for some time now...Down here in Ghana, the acting Provost of the College of Health Sciences, Prof. Amoah in his Inaugural Lecture dwelled on the increasing significance of these "lifestyle diseases" in Ghana and the developing world in general. I think I agree with Richard Horton of The Lancet, that WHO should include this nascent menace in their MDGs...these non-communicable diseases are becoming very important in the developing countries....in line with the shift in eating habits and lifestyle of these people towards a more western-oriented one, as is reflected in the pattern of disease now being observed in these parts of the world. These diseases are actually preventable, may be more so than their infectious counterparts, as all it takes really is, to stick to a healthy lifestyles as many studies have shown. The WHO really should consider this. The IFMSA may have to also play a role in this regard. Sulyman Olanrewaju

IFMSA-Africa Newsletter January/February 2006 Page 10

aged 39-69 years. The impact on men and women is similar. We propose a new goal for reducing deaths from chronic disease to focus prevention and control efforts among those concerned about international health. This goal - to reduce chronic disease death rates by an additional 2% annually – would avert 36 million deaths by 2015. An additional benefit. Will be a gain of about 500 million years of life over the 10 years from 2006 to 2015. Most of these averted deaths and life-years gained will be in low-income and middle-income countries, and just under half will be in people younger than 70 years. We base the global goal on worldwide projections of deaths by cause for 2005 and 2015. The data are presented for the world, selected countries, and World Bank income groups. Strong K, Mathers C, Leeder S, Beaglehole R, Preventing chronic diseases: how many lives can we save? Lancet 2005: published online Oct 5. DOI:10.1016/S0140-6736(05) 67341-2 Hossam Hamad, SCOPH Regional Assistant for Africa

Retina defects in a patient with diabetes. Photo: www.diabetes.nl

SCORE-AfricaThe Standing committee on Research Exchange (SCORE) is frequently referred as SCOPE’s little sister. Although both are in exchange business, this comparison fails to capture the main aspect of SCORE which makes it a unique and special entity… The fact that it deals with research that have been gaining in importance recently in African Countries . SCORE provides medical students with a unique chance to experience an exceptionally rewarding and affordable clinical or pre-clinical research in a foreign country. SCORE in our region is still growing and struggling to find its way in many NMOs accompanied by the general developmental process for many NMOs within the IFMSA. I would like to use the great opportunity of the newsletter to ask you all for more participation and

I and surely you have a lot of dreams for SCORE, but it is well known that working for a dream is what turns it into reality. So do not miss the chance to join our team and SCORE the world from our beloved continent Africa. Let us make SCORE together the Cherry on the top of the cake!...

Hany Ezzat, SCORE Regional Assistant for Africa IFMSA SCORE Director EMR Assistant 2005-06 EMSA-Egypt NORE2005 Cell: (+2) 0122879175 Email: dr_hany1@yahoo.com

Sophie Gubbels (the Netherlands) during a research project in Malawi.

cooperation in SCORE-Africa, we all need to be working as one hand, one team in cooperation with SCOPE regarding our common issues and alone regarding the projects and development of SCORE in our region. The doors are wide open to be active in SCORE, which hopefully can be a new column supporting the base of the African NMOs.

IFMSA-Africa Newsletter January /February 2006 Page 11

By Edmond Baganizi Saturday the 14th January 2006, Rwanda-VCP, a student run project, based at the Faculty of Medicine, National University of Rwanda launched some of its activities. Among them, the construction of 6 double VIPs (Ventilated Improved Pits) for 12 vulnerable families in MPUNGWE Village, Huye District in the Southern Province of Rwanda. The construction was accompanied by the interactive educative sessions on hygiene promotion conducted in the village. This activity was done with interactive education sessions on hygiene promotion with the people in the village. The guest of honour was the Rector of the National University of Rwanda (NUR), Prof. KARANGWA Chrisologue. There were also other guests notably, the Academic Vice Rector at NUR, Deans of different faculties at NUR, NUR lecturers, provincial authorities and students from different faculties. The ceremonies started by visiting the constructed latrines. Among the speakers, the beneficiaries’ representative thanked the project for all the accomplished and upcoming project activities that aim at improving the hygiene conditions and health welfare of underprivileged communities in Mpungwe village.

Report: Latrines Construction Project Launching

Photo: RVCP

One of the constructed latrines Photo: RVCP

Prof. KARANGWA Chrisologue, The guest of Honour. Photo: RVCP

To end his speech, the Rector promised to fund the latrine construction project with 4.5 millions frw in order to continue the construction of remaining latrines in Mpungwe village and donated five modern cows to the village that will serve as source of fertilisants for the people and milk for the children to fight against malnutrition in the area. The construction of those accomplished latrines cost about 1.284.000 frw. This amount came from the fundraising done by BVDA (Bristol Volunteers for Development Abroad-UK). This event was also covered by different Medias, notably the National Television (TVR), Salus Radio, and ARBORETUM the student journal. More information: www.rwanda-vcp.org Email: rwanda-vcp@yahoogroups.com bageddy@yahoo.com (Coordinator)

John Baptist NKURANGA, the Rwanda-VCP Coordinator said that the participation of beneficiaries was a great input to the realisation of the launched activities. He added: “Those accomplished activities were implemented with the participation of this population in order to eradicate all diseases related to the lack of hygiene in the village.” In his speech Pr KARANGWA

Chrisologue the Rector of NUR reminded the audience the moto of NUR which is “illuminatio et salus populi” which means students have to be light bearers of the nation. This must be shown through activities that can solve problems Rwandese communities are facing. “These activities seem to be a small realisation but they are very important. This is the beginning, and a good example for other students.” He added. He also raised the idea that Mpungwe Village can be the first NUR target group for different faculties at NUR.

IFMSA-Africa Newsletter January/February 2006 Page 12

Colophon Editor in Chief: Jennifer Mbabazi, Rwanda Authors: Edmond Baganizi, Rwanda Gerald Caplan Franklin Cudjoe Hany Ezzat, Egypt Hossam Hamad, Sudan Jade Khalife, Lebanon Karina Larsen, Denmark William Lubeka, Uganda Neema Mgana Serini Murugasen, South-Africa Sulyman Olanrewaju, Ghana Oluwatosin Omole, Nigeria Proof reader: Ahmed Ali, Sudan Lay-out: Sophie Gubbels, the Netherlands If you are organising a project or activity, please share it with us! Also, if you want to ask attention for certain topics, do write them down for our newsletter. You can send your articles to ifmsa-africa-publications@yahoogroups.com Important Addresses/ Websites for NMO’S www.emsa-ethiopia.org (Ethiopia) www.fgmsaghana.org (Ghana) www.nimsanigeria.org (Nigeria) www.medsar.org (Rwanda) www.rmsa.org.rw (Rwanda) www.samedsa.org (South Africa) www.ifmsa.org www.ippnw-students.org/africa ifmsa-africa@yahoogroups.com ifmsa-scora@yahoogroups.com ifmsa-scorp@yahoogroups.com ifmsa-scope@yahoogroups.com rvcp@yahoogroups.com (Rwanda)

The Regional Students’ Conference: Antiretroviral therapy and the Latest Development in HIV/AIDS Care

Ssewankambo (dean of Makerere Medical School), Prof. Elli Katabira, Prof. Harriet Mayanja, Dr. Peter Coakley, Dr. Merry Ceppie (Infectious Disease Institute, Institute of Public Health Makerere) to mention but a few. Students were empowered that even in the advent of free ARV’s there consequences and challenges some of which include: • These drugs are sometimes associated with severe side effects, which need expert medical intervention. • ARVs don’t cure AIDS but reduce the Viral Load thereby improving the quality of PLWAHs but these drugs must be taken for life in order to achieve the effect. • These drugs don’t prevent transmission; therefore there is need for behaviour change. Other conference objectives were:

Creating awareness about antiretroviral drugs and their uses in the management of HIV/AIDS and AIDS related illnesses.

Equipping students with the knowledge that will increase their competence as future health workers, in the use of anti-retroviral drugs.

To teach students about the latest developments from research in the fields of HIV/AIDS and Antiretroviral Therapy.

Challenges arising from the use of anti retroviral drugs, ethical issues arising from the same and management of the various complications that arise from the use of the drugs. Several other issues like PLWAHs who want to get married and have children of their own. Hope of an HIV vaccine in the future and PMTCT were pertinent. The conference targeted the elite of society who would be expected to go back and teach their family members and communities they come from. At the end of the 4 day conference which was sponsored by Ministry of Health Uganda, World Health Organization (WHO) a Regional Students’ Alliance for HIV/AIDS in Sub- Saharan Africa (RSAHS) was formed. It was named Sub-Saharan Students’ Alliance against HIV/AIDS (SSAAH). It vowed to continue the battle against HIV/AIDS as well as taking the information to the grassroots.

by: Lubeka William Every year the Makerere University Medical Students Association (MUMSA) a full member organization of Federation of Uganda Medical Students’ Association (FUMSA) organizes events geared towards promoting Health Care in the community. This year a conference was held on Antiretroviral Therapy (ART) and the latest developments in HIV/AIDS care. The theme was: Experience in the care for people living with HIV/AIDS (PLWAH). It was held at Makerere University in Uganda. Delegates were mostly medical students hailed from Kenya, Tanzania, Rwanda, Burundi and the host country Uganda. The conference targeted mostly medical students from Sub-Saharan Africa. The global AIDS pandemic is among the most devastating events in human history. Over 37 million people are currently infected with HIV, 25 million of these in Sub-Saharan Africa. HIV is one of the leading causes of death in Africa. Life expectancy in the worst AIDS –afflicted countries has dropped by 20 years erasing decades of gain. HIV has moved beyond the province of public health alone and has become a social, economic and security concern in most African countries. The conference was held at a time when most governments in Sub-Saharan Africa have committed themselves to providing free Antiretroviral drugs (ARVs) to People Living With HIV/AIDS (PLWAH) needing them in accordance with the 3 by 5 initiative by the World Health Organization (WHO). One of the major objectives of the conference was to create awareness of ARVs and their uses in the management of HIV/AIDS and other AIDS related illnesses. Several eminent researchers, professors and Doctors presented HIV/AIDS related papers at the conference most notably Professor Francis A. Miro of MU-JHU (Makerere University – John Hopkins Research Collaboration) who presented a paper on Prevention of Mother To Child Transmission (PMTCT), Prof. Nelson