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Is Veganism the Future, or just a passing phase?The Dark Heart of Humanitarian AidInequality and Health
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2015; 87:4
URGO
Is Veganism the future?
...Or just a passing phase?
2
3. Medical News
4. Inequality and Health
6. Is veganism the future?
8. BMA medical student conference
9. The politics of drug research
10. The dark heart of humanitarian aid
12. The lighter heart of humanitarian aid
13. Interview with the Candy Anatomy guy
(Mike McCormick)
14. SHITS - Part 2
16. Letters to the Editor
17. GUGPS Ethics case
CONTENTS
13.
6.
EDITORIAL
So this is it. The last issue of the year. I know its late and that most of you are off enjoying your summer, but one cannot rush some-
thing like Surgo; it needs time, dedication and rigorous peer-reviewing to produce something of such high quality. So now for what is in
store for you: PhD student Louis Nerurkar indulges us with the consequences of health inequality; guest writer Simon Roeder and Arts
Editor Jenna discuss the future of veganism and contributor Jamie gives us the debrief of the riotous BMA medical student conference
2015. Following this, Beth Thomas updates us with the fight against Big Pharma and their unfair pricing of essential treatments and
James Tadjkarimi and myself examine the usefulness of humanitarian aid. If you still want more: Ella Gooner Bennett interviews Mike
McCormick, our very own med school celeb, about his journey to sugar-laden stardom before taking a more downward trajectory where
Daniel Taylor Sweet examines our faecal matter and its relationship to fad diets in the second instalment of Surgos clinical trial (SHITS)
but dont let that stop you...we finish our issue with Letters to the Editor and GUGPS second ethics case. What more could you ask
for?
On a different note, I am stepping down as Surgo editor and enjoying my retirement as the next Med-Chir sponsorship rep. I wish the
best of luck to the next editor David Boyle and the rest of the Surgo committee. Surgo will forever be in my heart. Je suis Surgo.
Regards, Tom Baddeley
10.
Surgeons amputated mans leg with rusty hacksaw
The now famous Ayr Hospital made the news recently when a vas-
cular surgeon allegedly used a rusty hacksaw to amputate a pa-
tients leg when a metal plate was unexpectedly found in the mans
femur. Under recommendations from an orthopod (who I imagine
was joking) a member of the surgical team was sent to B&Q to buy
a new one, but it was closed so they made-do with one found in a
cupboard. The surgeon was not available to comment as its golf
day, and hes not in hospital.
Herpes used to fight melanoma
A genetically modified strain of herpes was used in a phase 3 trial to improve
outcomes in patients with inoperable malignant melanoma. An injection of
T-VEC contains the virus which was made harmless to healthy cells but rep-
licates inside cancer cells and kills them. It also stimulates the immune sys-
tem prompting an exaggerated immune response. Researchers found 16.3%
of patients who received T-VEC were in remission after 6 months, com-
pared to 2.1% of control group. Unfortunately is doesnt work for those
already infected with herpessorry guys.
Vitamin D added to M&S bread
In a bid to make up for our lack of sunlight, M&S have pledged to
add sun exposed yeast to their bread products, naturally raising the
vitamin D content. It is hoped this will reduce the increasing inci-
dence of osteoporosis, rickets and multiple sclerosis. This is not
just bread, this is M&S bread.
Scientists discover key force of human aging
Scientists have found that the genetic mutations underlying Werner
syndrome (adult version of progeria aka Benjamin Button disease)
could lead to methods of preventing and treating age-related diseas-
es. In Werner syndrome the tightly packed DNA bundles of hetero-
chromatin are disrupted and consequently cause accelerated aging,
but scientists believe this process may be reversible opening up the
possibility of a treatment for Alzheimers
MEDICAL NEWS
www.surgoglasgow.com
4
Inequality in the UK and across the developed world is a
growing social problem. Oxfam recently published a report
predicting that by 2016 one percent of the world would own
fifty percent of all wealth. In the UK wealth and income ine-
quality has consistently increased since the 1950s, and due to
recent political reforms we have seen growing divides between
the poorest and richest halves of society. Alongside this, other
social indicators of poverty all point to an increasing state of
deprivation for much of the population with more people than
ever accessing food banks and levels of childhood poverty at a
record high; 3.5 million children now live in poverty in the UK
and Save the Children have predicted that number may rise to
close to 5 million by 2020.
Parallel to economic inequality we see large divides in health
equality; numerous analyses demonstrate the drastically differ-
ent health outcomes observed between those at the top com-
pared to those at the bottom. Excess mortality, defined as
death before the age of 65, more than doubles when you com-
pare managerial workers to unskilled workers, this is matched
by a landscape of increasing premature death as you move
from the relatively affluent South of England to the relatively
deprived North of England and Scotland where the incidence
of premature death is approximately 1.5 times greater. With
life expectancies over 9 years longer and the amount of time
spent in good health, a staggeringly high 18 years longer for
those in the top 10% compared to those in the bottom 10%.
In effect those at the bottom live shorter lives that are dispro-
portionately spent in poor health. Coupled to this idea of
good health, 40% of adults aged 45-64 on below average
incomes have a limiting longstanding illness or disability, com-
pared to fewer than 20% of adults earning over the average
income. It is an undeniable fact that economic inequalities
within our society seem intimately linked to dramatic divides
in health outcomes.
40% of adults aged 45-64 on below aver-
age incomes have a limiting longstanding illness or
disability, compared to fewer than 20% of adults
earning over the average income.
A number of factors explain gaps in health between the rich
and the poor including differences in diet, nutrition and smok-
ing. Obesity prevalence decreases as level of education increas-
es, and childhood obesity is twice as high when comparing the
bottom decile to the top. Interestingly, data taken from Scot-
tish schools have suggested that a contributing factor in the
obesity relationship may be that those in the most disadvan-
taged areas have similar absolute body weights but reduced
height due to growth limitation, indicating that the relation-
ship may also be linked to poor childhood nutrition rather
than just overeating. Smok-
ing also shows a clear gradi-
ent with rates up to four
times higher when compar-
ing the most disadvantaged
to the most affluent. This
relationship between socio-
economic status and negative
health behaviours is seen
again and again as diabetes,
low levels of physical activity
and alcohol and drug intake
have all been shown to be
linked with increased depri-
vation.
Alongside physical factors
impacting on health it has
also been suggested that the
ability of the well educated
Inequality and Health
Louis Nerurkar looks at the impact of health inequality
and affluent to advocate for access to healthcare may influence
health outcomes. For example, socioeconomic status is linked
to access to cancer care trials with the most deprived having
the lowest levels of access. In addition the ability to engage
with private healthcare services may be out of reach for many
lower down the socioeconomic scale. That is not to say that
we should not advocate for our own health as best we can but
simply that we should not ignore the vulnerable because they
do not have the time, education or economic means to ensure
an equality of access to healthcare.
Those in the most disadvantaged areas have
similar absolute body weights but reduced height
due to growth limitation...linked to poor childhood
nutrition.
One of the most recent and insightful findings in this area is
that inequality alone is shown to be bad for the health of soci-
eties as a whole. Countries with higher rates of inequality have
increased rates of child mortality and lower life expectancies
when compared to their more equal counterparts. This does
not just affect those at the bottom as these negative outcomes
associated with increased inequality exist across the whole of
the social spectrum. Work carried out by Richard Wilkinson
and others has shown that this extends to many measures of
both health and societal wellbeing, including but not limited
to, the UNICEF index of child wellbeing, mental illness, trust
of others within your society, violent crime and social mobili-
ty. They conclude that in the modern developed world it is not
just individual levels of wealth that decide healthcare out-
comes, but also the equality of the society that you live in.
A variety of factors seem to influence divisive health outcomes
seen between the most disadvantaged and the most affluent;
these include but are not limited to poorer health behaviours
including increased rates of obesity, smoking and alcohol and
drug intake alongside reduced intake of fruit and vegetables
and lower levels of physical activity. In addition, lower educa-
tional status, access to healthcare and support services and
reduced advocacy likely contribute to both health behaviours
and healthcare outcomes as a whole. Alongside differences in
healthcare behaviours, inequality is increasingly shown to be
bad for societies and to have negative impacts on health across
the whole social spectrum. As we move forward into the 21st
century and away from the austerity of the financial crisis we
must attempt to support the most vulnerable and provide
them not just with the education and support systems they
require to have better health but also with the financial means
to manage this. In reducing the economic and educational di-
vides in our society we will not just make life better for the
most disadvantaged but for all of us, regardless of our income
or wealth. It is therefore in everyones best interests to reduce
inequality and to provide the support and services required to
improve health from the bottom to the top.
Louis Nerurkar is a current PhD student in
Neuroimmunology
www.surgoglasgow.com
6
Veganism is defined by the Vegan Society as a way of living that
excludes, as far as possible and practicable, all forms of exploita-
tion of, and cruelty to, animals for food, clothing and other pur-
pose. Veganism is on the rise; this can be seen in the increase in
media awareness of veganism and the increasingly easy access to
vegan products in supermarkets. But are people staying vegan?
I think the most important area to look at is the reasons as to why
people become vegan, as this has the largest impact upon their
commitment to the lifestyle. The principles of veganism are estab-
lished parts of many cultures and religions, following from the
principle of non-harm found in faiths such as Sikhism, and Hin-
duism and as such have already proven to be more than a passing
phase.
Looking at those in the West who change their lifestyle and
become vegan, there are three main reasons that people go ve-
gan: ethical, environmental and health.
Looking at environmental first, we see an issue that is only just
coming to light. the majority of major environmental agencies are
not addressing it clearly or at all yet, but as peoples awareness of
the facts grow, they may make lifestyle changes to suit their new
understanding.
Animal agriculture accounts for 51% of worldwide green-
house gas emissions.
2500 gallons of water are required to produce 453g (1lb) of
beef.
Animal agriculture uses 20-33% of all fresh water con-
sumption in the world.
Animal agriculture is responsible for 91% of Amazon de-
forestation.
50% of the grain produced is fed to livestock.
These are just a few facts that indicate the massive damage that
consuming animal products does to the environment. However,
I do not believe that environmental issues alone are enough to
maintain veganism. If environmental reasons are your primary
motivation it becomes easy to simply cut down your animal in-
take rather than cut it out completely. Environmentally-minded
people are already aware of a myriad of methods to reduce their
environmental impact, but most do not entirely drop environ-
mentally-damaging habits such as driving alone. They simply
reduce them, and we can extrapolate a similar pat-
tern for animal-use.
Environmental concern is likely to increase (as
climate change becomes for evident) and people
may start reducing their animal use, but whether they become
vegan or not depends on the level of research they do into other
benefits to the lifestyle. The environmental need to drastically
reduce animal consumption is undeniably pressing, and may pro-
vide a segway into a fully vegan lifestyle for some.
Looking at health-motivated veganism: this is a controversial issue
because there is very little unbiased research, as its either financed
by meat/diary companies or by vegan organisations.
Nonetheless, people do cut animal products out of their diet for
health reasons. In some ways this can help strengthen resolve,
because they are more likely to eat a healthy diet and therefore not
suffer any health problems and they would put this down to ve-
ganism. Also, diets are socially understood and so they will likely
face less stigma, which causes a lot of vegans to revert to an om-
nivorous lifestyle (roughly 25%).
However, this is unlikely to cause a lifelong commitment to the
vegan lifestyle; it is likely to only influence ones diet (making one
a plant-based dieter, rather than vegan), and even there one may
feel justified in eating the occasional animal product as a treat
Finally, people go vegan for ethical reasons. This, I think, is the
fundamental reason veganism is unlikely to be a passing phase and
will continue to increase in popularity.
I think the idea that any form of activism that seeks to portray an
oppressed group as a passing phase is ridiculous. Where there is
oppression there will always be people seeking to end it and not
contribute to it. The ethical argument is also, I feel, the strongest
in that it does not allow for cheat days or exceptions. Animals
are alive, feel pain, feel happiness, and have cognition. Once peo-
ple make the connection between the food/product in front of
them and the oppression and torture of animals necessary for its
production, they become aware of their complicity in the process,
and many will determine that their convenience or pleasure is nev-
er worth that. This connection is becoming easier to make with
animal right activists having more presence in social media and
finding it easier to spread the message.
Being vegan is getting easier and easier and if you are able to live a
healthy, happy life without causing harm to others why would you
not?
eganism the Is
future? Simon Roeder tells us why veganism is
the way forward
Veganism is an odd one. Whereas vegetarianism can be traced
back to Ancient Greece, veganism is a newer term (coined 1944).
However, vegetarians throughout history who also refrained from
eating dairy or eggs were termed strict vegetarians. There have
been several attempts to form communities that aimed to follow
strict vegetarian codes, some involving a ban on using animals for
any purpose whatsoever, even farming. The book Go Vegan! is
a truly fascinating and thoroughly enraging read. Let me just make
this clear before I start: I have no issue whatsoever with vegetari-
anism.
People try out veganism for a multitude of different reasons but
only a few adventure in to the whole lifestyle, which takes in to
consideration not only what they eat, but also what clothes they
wear and how they interact with the world. This is not a new con-
cept by any means and Im not even talking about religious beliefs
or 60s hippies. Im talking about your average conscientious Joe:
reusing his carrier bags; putting on a jumper instead of the heating
when it gets cold; eating local cheddar instead of gruyere; etc. etc.
There is no doubt that the worlds population needs to take re-
sponsibility for what it uses and disposes of. However, we cannot
deny things like the hundreds of years of selective breeding that
have have led to sheeps wool growing far longer and fluffier than
the sheep themselves need. It grows so much that if they are not
sheared, they will overheat in summer. Therefore the farmers
shearing, and subsequent processing and selling of wool products
on the market is a symbiotic relationship. It is a similar story with
cows milk and honey. It may come as a surprise to some funda-
mental vegans that it is possible to exist symbiotically with animals
and in no way mistreat them. The argument that animals are tor-
tured is ridiculous in Scotland, where there are strict and tightly
regulated laws regarding animal welfare and farmers are well edu-
cated with regards to these.
Eating local produce is a great idea and as Scotland has plentiful
land for grazing and huge amounts of hillsides for hill sheep farm-
ing, this is a perfectly achievable idea. Our famous highland cattle
are fantastic at living off the harsh highland terrain with little inter-
ference from humans. And as we all know, Scotland is the
grateful receiver of millions of gallons of water (sometimes
over a very short time frame) so there is never a risk of
drought harming livestock. My point? Economically and
environmentally, livestock farming in Scotland makes
sense. I should make a small point that unfortunately not
all countries have both such high standards of animal wel-
fare, but Ill come back to that.
As for health, thats a whole different matter; it is some-
thing that troubles many of us and will be a major part of
all of our lives as doctors. We all know the detrimental
effects that a typical Western diet can have on a persons health.
You only need to look at the startling fact that if a Japanese person
(who you would expect to have a very low risk of CHD) moves to
the UK and adopts a traditional Western diet, will, in no time at
all, have the same risk of CHD as someone with British ancestry.
So how can we mortals combat this? There is an option to cut out
all the things in our diets and lifestyle that could possibly cause us
harm. Another option is to become more moderate: eat fewer
fatty treats; learn how to cook delicious vegetables instead of just
boiled broccoli (we could learn a lot from a Mediterranean recipe
book); cycle or walk to work regularly. Ill admit that this is a
harder way of improving your health, not least because there is no
money to be made in an industry peddling common sense! There
are no handy books entitled, Living in a Moderate Way to Stay
Healthy but then thats the trouble we all face. We have too
much time on our hands or we feel unimportant so having a
change of lifestyle that we can then brag about and Instagram to
high heaven is just what a slightly underappreciated soul needs.
With veganism on the rise (strangely enough this is only the case
in societies where people have more income than they need), the
question I pose is that of sustainability. Is a strict vegan lifestyle
compatible with the world? Can you honestly afford everything
you need for a vegan life on the same student loan as the rest of
us. Theres no doubt that there are many more products specifi-
cally marked as vegan than there were even five years ago, but they
are infallibly more expensive than many other food options. Now,
I love a couscous salad and I have many (unintentional) vegan
meals without feeling the need to Instagram myself saving the poor
animals from a milking. I dont need to take supplements to re-
main healthy though. I eat meat, or milk, or cheese, eggs, fish,
honey! To get the amount of protein an average 70kg person
needs you have to eat 600 grams of boiled lentils! Or a healthy,
balanced diet.
We have evolved as part of the world and despite our technologies
we are not above the rest of the flora and fauna. There are many
things that we, the population of Earth, have a duty to improve in.
It will take hard work and massive changes in industry and in the
way we think, but the hurdles hold the opportunity for us to be-
come better. My opinion: veganism is a cop out.
...or just a
passing phase? Arts Editor Jenna tells us her point of view
www.surgoglasgow.com
8
Medical Student Conference 2015
Social Time!
A contingent of Glasgow medical students attended this
years BMA Medical Student Conference. Jamie Henderson
gives us a review.
Fun Times at the BMA Student Conference
What is the BMA student conference I hear you ask, hopefully I can answer that I mean I will try. During the conference us, the stu-
dents, debate what policy the BMA will pursue on behalf of the student membership. What sounds more exciting than debating policy
for two days with medics from around the UK, I cant think of anything either. We managed to muster a group of four of us to travel
down to BMA house in London to propose policy for the year ahead.
We kicked off with a fantastic speech discussing medical
careers with Professor Jane Dacre, the current President
of the Royal College of Physicians. With a long and illus-
trious career she gave us her top 10 tips for having a suc-
cessful career in medicine. Low and behold she highlight-
ed location as the most essential thing when having a suc-
cessful career, where you do your foundation years does
really matter. She also made the point that women need
more self-belief chastising the medical profession for al-
lowing its leaders to continue to be pale, male and stale.
and challenged the female students in the room to step
up to the plate. She didnt leave men completely off the
hook, encouraging all of us to strive for a more diverse
leadership, as it will benefit the whole profession.
But we werent there to be spectators; Glasgow stepped
up to the plate and attempted to move the date of the SJT
to the penultimate year of study. We faced massive oppo-
sition from the Universities who sit their finals in their
forth year, slackers, and ultimately it was defeated on
these grounds. Although we had this initial disappoint-
ment we fought on and ended with two motions passed;
blowing the rest of Scotland out the water.
With our unrivalled success we are heading out to the
BMA annual meeting, to spread the Glasgow love to real
doctors from throughout the UK. So look out for us hit-
ting the shores of Liverpool. Serious policy discussions with the previous Surgo Editor
At the University of Glasgow, research is taking place which
everyday brings us closer to finally finding a vaccination to pre-
vent malaria, to understanding the pathophysiology of sleeping
sickness and to understanding the interactions between hepatitis
viruses and liver cells in hepatocellular carcinoma. If this re-
search brings us tangible outcomes, millions of lives could be
affected worldwide by the amazing work of the academics at our
institution. But sadly, the way our university sells its work to
pharmaceutical companies at the moment means many of the
world's poorest and most in need will be priced out of accessing
these potentially life saving compounds.
Let's first have a quick forage into drug discovery. If we imagine
a potential malaria vaccine, public institutions such as the Uni-
versity of Glasgow conduct research into potentially useful com-
pounds and highlight laboratory find is which show promise.
These compounds are then taken up by pharmaceutical compa-
nies to create the actual vaccine (e.g. a stable, cheap product that
is safe for human use) and then test this safety and efficacy in
clinical trials. This part of the drug development process is done
by private pharmaceutical companies because it is so expensive,
and a public institution could not foot the bill if the drug does
not come to market, for whatever reason. So in summary, the
university finds potentially useful compounds, and sells that in-
formation to pharma to make those compounds into safe and
effective drugs to tackle the problem.
At Harvard University in the States, a group of students discov-
ered that their university was selling information discovered
about potential treatments for HIV to pharmaceutical compa-
nies, and then these companies were producing drugs using
these compounds which were much too expensive to be used in
the places were they were most needed, for example in sub Sa-
haran Africa. These students thought that it was wrong that in-
formation produced by their public university could be used in
this way, so they came up with the Global Access Licensing
Framework. This framework stipulated that any compound dis-
covered by the Harvard University that was sold to a pharma-
ceutical company must be made available to patients who needed
it in low income countries.
Since this action, over 100 institutions all over the world have
signed up to GALF, including the University of Edinburgh and
the University of Dundee. Medsin Glasgow have been trying to
meet with our technology transfer officer to discuss taking up
GALF at the University of Glasgow for over 4 months, and
have had little success so far. We believe that the University of
Glasgow has the potential to sign up to this successful frame-
work which has improved access to many new drugs all over the
world. Although not perfect, this framework is a big improve-
ment in the short term on the imperfections produced by our
current pharmaceutical production system. If you would like to
be involved in this campaign, or would like some more infor-
mation, please get in touch at [email protected] or
Glasgow has a drug problem, it's time to work at a solution.
GLOBAL ACCESS LICENSING FRAMEWORK:
Every university-developed technology with potential for further
development into a drug, vaccine, or medical diagnostic should
be licensed with a to make affordable versions available in re-
source-limited countries for medical care .
www.surgoglasgow.com
We have a drugs problem...
Beth Thomas outlines the unfair way universities sell
their research of new medications
10
The Dark Heart of
James Tadjkarimi reports on the side to
humanitarian aid they dont want us to know
about...
Often on the street were approached by what I like to call
charity muggers, who ask in their bubbliest way whether youd
like to donate a few pounds a month to the aid organisation
theyre working for that day. However much or little you do-
nate is down to you, but if you do decide to, the buck really
stops there. You walk away with a sense that youve done
something selfless (which you have) occasionally getting an
email with updates, or a phone call asking whether youd like
to increase the amount you give.
We all assume these organisations are in the best position to
decide how and where their resources should be distributed,
whether thats in the form of life saving healthcare, or essential
food and water for those in need. More often than not, count-
less lives have been saved from situations that we could never
even imagine, but there is room for error. Sometimes these
aid agencies dont always get it right, so much so in fact that
you have to ask if theyve done more harm than good in a number
of situations.
The Birth of Humanitarian Aid
In 1967, a south eastern state called Biafra tried to become an in-
dependent nation apart from Nigeria. Its inhabitants were mainly
Igbo people, who held different cultural, ethnic and religious val-
ues to those of the Nigerian people. Unfortunately, their cessation
was not recognized by Nigeria and resulted in a bloody 3 year civil
war. The Biafran rebels were heavily outnumbered and outgunned
by the British backed Nigerian Federal army and after 10 months
of fighting, were reduced to a tiny enclave. Wanting to end the
civil war, the Nigerians imposed a blockade on the Biafran prov-
ince resulting in widespread famine.
Up until this point, Biafra had appealed to world leaders and gov-
ernments for military assistance. They used every trick in the book
and even had a propaganda unit to attract international attention.
They tried to sell the fact that Nigerian wanted Biafra for its oil
reserves, and that its people had been subjected to religious massa-
cre amongst other things. No nation answered their pleas; but
everything changed once the blockade took place. The mass star-
vation going on gave them a new weapon for publicity: Kwashior-
kor. Images of children with Kwashiorkor (a severe form of mal-
nutrition in children caused by a lack of protein) began to leak,
and people in the western world were waking up to stark photos
of hundreds of Biafran children in desperate need. We started to
pay attention very quickly, and although many governments re-
mained loyal to Nigeria it kick-started a cause clbre that gave
rise to the birth of the aidworker; a left leaning generation of indi-
viduals independent of government, determined to help prevent
the Biafran crisis from every happening again. Mdecins San Fron-
tires (MSF) was once such organisation that came into being
from the resultant situation.
To many, the situation seemed clear cut. Nigeria was seen as ty-
rannical in its treatment of Biafra and it stopped at nothing to re-
duce the state and its people to dust. However, what people didnt
realise until a few years later was that Biafra had been using dirty
tactics too. It had hired a PR company based in Switzerland with
the sole aim of promoting their cause. No one was listening to
their political message so they relied on hunger as a weapon of
propaganda, and used its people as victims. This system was so
well orchestrated that the PR company would send photographers
over to Biafra and with ease, take photos of children kept in a
state of perpetual hunger in Biafras own dedicated starvation unit.
Humanitarian Aid
With the release of every subsequent image came vast donations
in the form of money and relief aid. This influx of aid from the
rest of the world allowed for the smuggling of arms into the coun-
try to help the Biafran cause and unknowingly to rest of the world,
prolonged fighting by eighteen months leading to further blood-
shed.
Oversimplifying the message
Fast-forward to 1984, where Ethiopia was in a famine of biblical
proportion. At the time the country was under the command of a
Marxist government loyal to Soviet Russia which made Reagan
and Thatcher reluctant to help some 400,000 people in plight.
What followed was an unprecedented surge in public outcry and
support not seen since Biafra- something largely due to Bob Gel-
dof. Say what you will about his white saviour complex, Geldof
and co managed to turn a lot of heads with their charity single Do
they know its Christmas and Live Aid. No one can fault that, but
many accused them of oversimplifying the message; by donating
your money you can ensure that food gets to those that a truly
need it. You dont need to be a humanitarian to feel compassion
like that, but like many of conflicts that weve had over the past 50
years, the causes can be many and beyond the control of any
aid agency.
What we were presented with on global TV networks and by
aid agencies was that Ethiopia had fallen into famine due to
drought. This was a cause, but not the sole one. In actual fact
what transpired was a situation not unlike Biafra. The Ethio-
pian government was again embroiled in a civil war against the
north, using deliberate starvation, crop burning and preven-
tion of local trading as weapons of choice. Aid being deliv-
ered by agencies did a tremendous amount of good in refugee
camps and helped alleviate one of the worst food crises weve
seen but once again, the cash influx that was earmarked for
those in need ended up in the hands of far worse men. The
government began by levying a tax on anything that came in,
so they could feed and arm their own troops and subsequently
used feeding centres set up by aid agencies as bait traps, draw-
ing them in and rounding them up in order to resettle vulnera-
ble people in purpose built villages dotted about the country.
This forced relocation was billed as a way to relieve population
pressure, but in reality it allowed them to thin opposition in
the northern highlands and resulted in further deaths to the
resettled community due poor execution and understanding of
basic needs like housing, water seeds and tools. MSF estimat-
ed that a further 300,000 people lost their lives in the resettle-
ment and for speaking out about it, were immediately expelled
from the country. As demonstrated, issues often stretch far
further than solely feeding the hungry and it really raises ques-
tions about what the right approach to these situations is.
The future of humanitarian aid
What some of these case studies show is that even with the
best of intentions, things can go awry with often dire conse-
quences. By their own admission, MSF, Oxfam and Save The
Children agree that simply rushing into a humanitarian crisis with-
out any understanding of the underlying geopolitical and social
causes can further cripple a country. Our modern definition of
humanitarian aid is still in its infancy, and with only fifty years in
the field it has been on a slow and steep learning curve in under-
standing morally what is right and wrong to do, where it can make
an impact with independence, and truly gage how it can minimise
detrimental knock on effects whilst remaining accountable. What
these charities would really like to see is a shift towards local insti-
tutions and agencies providing relief, allowing them to place a
greater emphasis on development, making its people less vulnera-
ble and therefore more prepared for when a crisis happens.
So the next time you decide to donate, (and regardless of the tone
of this article please do) ask yourself why youre doing so. The
limits of humanitarian relief aid are many and situations are often
messy and highly complicated moral dilemmas. Really analyse the
situation thats playing out on the ground as best you can and un-
derstand that you wont be able to save the world, but you may be
able to save lives.
www.surgoglasgow.com
12
Humanitarian aid is the rapid assistance given to people in imme-
diate distress. Sometimes, it is this assistance that prevents the
loss of many lives due to preventable causes like malnutrition or
disease. In all the examples James has used above, it was the first
response of aid organisations that prevented widespread starva-
tion and stopped the progression of diseases like cholera in its
tracks.
Aid organisations such as MSF try to keep their neutral stance
despite the complexity of modern conflicts. It is true that since
9/11 many aid organisations
direct their care with western
political agendas. In Afghanistan
some organisations were too
closely linked with military pow-
ers, mostly for safety reasons,
and now need to disassociate
themselves from them to be able
to access the people in need.
Therefore it is important for aid
organisations to keep their neu-
trality to help everybody affected
by the crisis more effectively.
Unfortunately it is possible that
many of the innocent people you
do help in one situation can turn
out the be the perpetrators of a
different conflict; but by keeping
the neutrality it is possible to not
make enemies and be able to
access people in need anywhere. So in future conflicts, it might
only be the aid organisations who can offer humanitarian assis-
tance to those in need, and not military powers.
The 2004 Indian Ocean tsunami and the 2011 tsunami in Japan
showed how even well developed countries can be crippled by
natural disasters. Although world governments provided huge
sums of money and equipment for the humanitarian response,
aid agencies also helped the survivors hugely by providing medi-
cal assistance and reconstruction programmes. Despite being
developed countries, tsunamis and other natural disasters leave
devastating long term effects on the country and they need all the
help possible to help rebuild it.
On a different note, some aid organisations are on the front line
for improving rights for women and children, campaigning
against unjust policies and practices and increasing awareness of
the threat of climate change for at-risk communities. Organisa-
tions such as World Vision encourage the public, governments
and other institutions to change their attitudes on these prob-
lems. World Vision encourages cooperation between govern-
ments, companies like NASA and Google, and local communities
to develop sustainable methods of farming and industry. Some-
times only NGOs like World Vision are capable of advocating
changes like these because they are not swayed by political fac-
tors, and have a more holistic view of things. Despite the meth-
ods aid organisations use to publicise their cause can be irritating
and even extreme (like in the Biafran conflict), it is important
because it brings to light problems that the general public might
not be aware about.
Yes, humanitarian aid has made mistakes; in the Rwandan geno-
cide food and medical attention was offered to every refugee in-
cluding those who had committed the original genocide. This
may sound wrong but what could the aid agencies do at that
time? Some argue that this makes humanitarian aid flawed but it
is the cost of introducing humanity into the inhumanity of war.
We must not forget that humanitarian aid is a relatively new con-
cept and is constantly evolving
and learning from its mistakes.
An example of this is that
Oxfam now provides food indi-
vidually rather than large bags of
grain which can be stolen and
misused. They also now bury
their water pipes to prevent ille-
gal siphoning.
The Daily Mail brigade are
known sceptics of foreign aid
and yes there are plenty of argu-
ments against intervention but
aid is absolutely necessary in
crisis situations where the disas-
ter affects the poor and least
powerfully most directly and aid
groups assist the government to
recover survivors and set up
refugee camps in the early stages.
Furthermore, many aid projects work on human development as
well as disaster relief; employing and training local people thereby
helping the recovery and economy of the country.
Some aid organisations campaign for justice and human rights
around the world and some are first responders to natural disas-
ters and conflicts. Wherever people are in need, aid organisations
are never far away. The aid workers and volunteers work in diffi-
cult and unpredictable situations often with very limited supplies,
doing their best to help people in need and rebuild broken coun-
tries. In our increasingly well-connected earth, I believe it is im-
portant for those most vulnerable to know they have someone
on the other side of the world who wants to help them and if all
that means is donating a few pounds a month to a charity, so be
it. For these reasons, I hope aid organisations have continued
support from governments and the public.
Tom Baddeley gives us his 2 cents...
The Lighter Heart of
Humanitarian Aid
Q. What started candy anatomy?
A. I was in a Ketchup waiting for my food and asked the waitress
for something to colour in; I got a pile of crayons and a pictures of
an ice cream sundae and a burger in return. Instead however, in a
desperate bid to get to grips with medical anatomy I turned them
into annotated glenohumeral joint and L1-L5 lumbar vertebrae. It
just continued from there really.
Q. Other than sweets of course, what resources do you use to
help you make your pictures?
A. I use the internet mainly, and any decent lectures we get., Sci-
ence direct is a great website!
Q. What do you think of anatomy teaching in medical
schools? And in particular at Glasgow with the new course?
A. I think it's pretty good, especially given that we are one of the
few universities to still to proper dissection. That's the good thing
about using sweets for the pictures; candy is much less intimidating
than cadavers!
Q. How much does each picture cost you? And how long do
they take?
A. I've avoided costing the sweets haha. That is definitely some-
thing that's it better not to know! I do re-use all the sweets though.
They don't actually take very long to make, maybe half an hour or
so? But that's because I plan them in my head for ages first.
Q. And what about you? Any big plans?
A. At the moment I'm keen on surgery so hopefully that; and hop-
ing to get through the first year exams unscathed obviously!
Q. Ever considered a candy self-portrait?
A. Haha well I suppose I could give it a go...
This interview is a first for Surgo, a first for Glasgow and a first for me,
why? Because I was interviewing one of our own; first year Mike McCor-
mick who is becoming slowly and quietly a little bit famous. Mike is a
post-graduate in physiology from the University of Edinburgh who's
been at Glasgow for a little under 9 months and has already appeared in
the Student BMJ, on STV News and been interviewed by Stanford Univer-
sity California. And all this thanks simply to love of puns and a keen eye
for candy.
Ella Gooner Bennett
Q. Do you have a favourite picture?
A. Mike refused to choose (So I've chosen some for him).
Q. Any plans to branch out into other food stuffs? Bananato-
my?
A. I have actually done a few savoury ones. I used corn on the cob
as adipose tissue and a bagel as bone, with alphabetti-spaghetti as
labels.
Q. Where do you see candy anatomy in the future? Do you
have a next picture planned?
A. Prof Walters has ask me to do some promo stuff for school
leavers in Glasgow. As for the next picture, I'll just have to see
where the course takes me...maybe the dreaded brachial plexus?
Age - Senile
Star sign Gemini
Favourite beverage Oreo milkshake
Favourite place in Glasgow - Brel
Preferred mode of transport
Christopher Walken
Most versatile sweet - Smarties
What is your mantra? -
What would #joel do
Edinburgh or Glasgow? - Fickle
The tastiest lymph node I have ever seen
www.surgoglasgow.com
14
SHITS
Part 2: Analysis of Results
Daniel Taylor Sweet1
1University of Glasgow, Glasgow, Scotland
June 2015
Funding: No funding was received or applied for.
Conflicting interests: None
Ethical Approval: Approval granted by the MedChir Ethics
Committee.
Background
Many self conscious, exercise adverse, fatsos will commence
some sort of diet in their lifetimes whatever their motives, be it:
wanting a beach bod, chiselled abs or purely just to increase their
pulling powers on the D floor we dont really care. SHITs Part
2 is purely interested in these peoples poop. SHITs Part 2 aims
to address the effect of commencing a celebrity diet on ones
quality, volume, and frequency of stool and flatus. This is a
unique study and, to our knowledge, is the first of its kind in the
world.
Methods
9 participants were recruited from a local medical school. 3 candi-
dates failed to complete the entire study, giving SHITs Part 2 an
attrition rate of 66.67% [6/9].
Following Taylor-Sweet et als work on SHITs Part 1, 5 popular
diets were selected for study: Gluten free diet, Sugar free diet,
Raw food diet, 5:2 diet and the Paleo diet. The participants
were blinded with the by an external assistant and then allocated
a diet to follow for 7 days. Participants were given a Poop diary
and trained how to use the Bristol Stool Scale [see fig 4]. Partici-
pants were asked to record data, in a form, on the following:
Number of poos per day, a Bristol Stool Scale score for each
poo, number a flatus per day and a time of poo for each deifi-
cation.
Data was analysed using Microsoft Excel and SPSS.
Results
The total number of poops per week was 59, this gave a mean
number of poops per person week of 9.83 [SD=2.23], or a daily
mean of 1.47 [SD=0.66] poops per person per day [see fig 2].
The mean Bristol Stool Scale score [see fig 3] was 3.62
[SD=0.9].
The mean episodes of flatus per day
were 8.56 [SD=4.21].
The mean time of defecation [see fig 1]
was 1:27 pm [range=6:00 am to 11:20
pm].
When the separate diets where further
analysed and compared to the cohort
mean. The 5:2 diet had the highest
mean number of poops per day [n=2,
p=0.854]. The gluten free diet had the
lowest mean number of poops per day
[n=0.69, p=0.559].
The raw food diet produced the high-
est mean Bristol Stool Scale score
[n=4.7, p=0.295] compared to the glu-
Surgos Highly Interesting Toilet
Study
An analysis of the most commonly
occurring celebrity diets on Google.
Figure 1: time of poops for entire cohort
www.surgoglasgow.com
ten free diet that produced the lowest mean Bristol Stool Scale
score [n=2.5, p=0.766].
The 5:2 diet produced the highest mean flatus per day [n=13.1,
p=0.835] compared to the raw food diet that produced the low-
est mean flatus per day [n=3.5, p=0.115].
When analysed there was no difference in distribution of poop
timings between the diets.
Conclusion
The findings of this study conclude with the findings of previous
studies that state bowel movements are between 3 times per day
to once every 3 days1. It also agrees with other work assessing
normal levels of flatus [8-20 per day]2.
It is interesting to see that the 5:2 diet produced both the high-
est mean number of poops per day and the highest flatus per day
one would assume that a diet which involved limiting ones in-
put would also limit output, this finding warrants further investi-
gation.
A novel finding was that the raw food diet produced the highest
mean Bristol Stool Scale score; this is the opposite of how one
would hypothesise. Ordinarily it would be thought that the in-
creased fibre (from raw fruit and vegetables) in the raw food
diet would increase stool hardness (and decrease Bristol Stool
Scale score). Again this warrants further study.
Following this brief study the author is now of the opinion that if
the aforementioned exercise adverse fatsos want to loose weight
they would do best on the 5:2 diet considering that the average
poop weights around 317g3 and the average person poops about
172kg per year, this could lead to some very impressive losses.
The 5:2 diet induces around a 50% increase in pooping, meaning
they could expect to loose an extra 86kg per year. I know what
Id do.
References
1. Normal Bowel Habits and Prevalence of Functional Bow
el Disorders in Singaporean Adults Findings from a
Commu nity Based Study in Bishan. L Y Chen et al.
Singapore Med J 2000 Vol 41(6) : 255-258.
2. Levitt, MD; Furne, J; Aeolus, MR; Suarez, FL (November
1998). "Evaluation of an extremely flatulent patient: case
report and pro posed diagnostic and therapeutic
approach.". The American Journal of Gastroenterology 93
(11): 227681.
3. http://fitterlondon.co.uk/wp-content/uploads/2011/09/
bristol-stool-scale.jpg. Bristol Stool Scale image, ac-
cessed 10 June 2015.
Figure 3: mean Bristol Stool Chart scores
Figure 2: mean number of poops per day
Figure 4: Bristol Stool Scale3
16
LETTERS
TO THE EDITOR
Should attendance be taken in lectures?
Dear Surgo Editor,
Although lectures are an excellent learning method for me, I acknowledge that that fact is not true for each individual.
The simple answer is It doesn't matter if attendance is recorded, as long as absentees reasons are considered individually and fairly,
but nothing is ever so simple. Lectures are a learning method designed to assist and direct us students to learn a topic to the desired
depth of the course. But, lectures are just one method of many, there is of course, PBL, Workshops, Self-study, Labs, and Small-group
working, and yet other methods as well. Each method has its advantages and disadvantages, and each individual will learn better by the
method best suited to them. For instance, lectures can encourage students who are less inclined to engage in self study by providing a
strict allocated time slot that provides nearly all the knowledge expected of a topic in a succinct and focused format. But that doesn't
mean they are ideal for everyone, and to have forced attendance to lectures would not be fair on those individuals who would other-
wise benefit from making their own arrangements for learning during that hour.
The majority of learning responsibility should rest upon the student, whether they choose to learn by their own accord or by the lec-
tures should be their decision.
It would be perfectly fine to have attendance recorded, as long as those students that chose to be absent were not penalised.
It would also be fair to not record attendance. Students should be granted the respect to uphold their responsibility to take charge of
their own learning thus to attend lectures as they require.
But what is not fair is to have attendance recorded then penalise the individual student who chose to be absent if their reason was so
that they could learn the topic on their own terms by utilising a method that is more beneficial to their learning. But of course, their is
the risk that the individual could simply skip the lecture and also not allocate themselves time to learn that particular topic.
With all that said, I am aware the statistical correlation between percentage of attendance and pass/fail rates; also, that the University
has an attendance threshold and they have it for good reason; also that there is the consideration of resources required and practicality
issues. All fair points with varying weight of significance, which is why I conclude with the suggestions that:
It is not fair to force attendance by recording attendance to every lecture;
It is perhaps not advisable to publicise that attendance will NOT be recorded at lectures, because that may encourage abuse by
some students;
Thus, may be best to just keep the attendance protocol as it currently is, whereby attendance is taken on the rare/random occa-
sion thus instilling just enough motivation to continually attend, while allowing students some freedom to engage is some self-
study if they deem it more beneficial while not feeling expressly pressured to have to attend the lectures.
Another alternative would be to record attendance for each lecture but then allow students the opportunity to speak directly to,
and request from the Year Director, the freedom to be absent from the lectures to engage in their own self-study; this freedom
can be dependent upon the students ability to uphold their grade average to an individually-assessed threshold, that if the stu-
dent dropped below the threshold he/she would have to attend the lectures in the hopes of raising their grade again.
Anonymous contributor
Have any burning points of view you want to be heard?
Want to complain about something, but dont want to post on Facebook or Twitter?
Surgo is your vessel. Email [email protected]
Solution to the previous case:
The solution here is quite cut and dry. Chlamydia is one of a set of diseases/infections that is known as notifi-
able. As a doctor it is your responsibility to ensure that the said partner is informed and tested in order to pre-
vent harm. Your options are to inform the partner directly, ask Mr Klozoff to inform his partner but make it
clear that you will do so if it becomes necessary, or to convince him to bring in his wife for an appointment
where you will act as a mediator. This would not change if the wife was not your patient, and it would not mat-
ter if the condition was candida. You cannot bring a patient in under false pretexts and you must inform your
patient of every test performed on them.
The Case: Mrs Smith and Alzheimers Disease
Mrs. Smith is your patient and is an active member of the community. She is on the Com-
munity Health Council and Parochial Church Council and is well loved. She has a fear of
becoming "demented" and one day produces a properly drawn-up Advance Directive to
say that if she develops Dementia she does not want antibiotics for chest infections.
Years pass by... Sadly, Mrs. Smith develops Alzheimer's Disease. She contracts
Pneumonia and is very sick. When asked whether she wants her infection treated, she
has forgotten her previous instructions and says "Yes"
Questions-
1) Do you treat Mrs. Smith?
2) Does it make a difference if her family wishes her to have treatment?
Glasgow University General Practice Society:
ETHICS CASE!
www.surgoglasgow.com
CONTACT GUGPS: Facebook: Glasgow University General Practice Society/ Email: [email protected]
President: Mita Dhullipala
18
As summer begins and the sun finally decides to emerge, our holidays/electives begin. For me it has been a wonderful year, and I hope
the same is true for everyone.
MedChir certainly has had a very successful year. We got off to a flying start this year in September, with the new year of firsties prov-
ing to be a fantastic, sociable group. We obtained a record number of new members, just over 130 this year! With our first couple of
events going very well. We had a very big turnout for the 1st medic families event and the welcome back ceilidh. Our Halloween Beer
Olympic was another resounding success resulting in some spectacular hangovers.
We had a lot of educational events this year, with our inaugural paediatrics and pizza night going very well. We decided to put the pro-
ceeds from these events towards charity and with the Christmas Carol singing, Scrub crawl and Raffle from the ball we managed to raise
just shy of 3000 for our charity this year, Social Bite.
Our premier event of the year, the MedChir Ball was held in the Lighthouse venue in the city centre. Despite, getting stuck in a lift for
an hour with 5 other men, I had a fantastic evening. It is a great opportunity for the students and faculty to socialise outside of the lec-
ture hall.
Either side of the Christmas break, with over half of the Medical school sitting exams at the time, we had our annual meetings with
both the Royal College of GPs and the Royal Medico-Chirurgical Society. We also had our Annual Meeting with the Barbers incorpora-
tion, held this year at the beautiful Trade House in the City Centre.
Our annual Debate with the Dialetics society was a fun affair, with the motion Should all drugs be legalised provoking some passion-
ate speeches on both sides.
Once exams were finished and we ran through our OSCE practice nights, we got to look forward to the Annual Scrub Crawl. In which
this year over 400 people took part and we raised a massive 1600 on the night for charity!
Finally we finished up our year with our Annual Gen-
eral Meeting, where our new President/Chairman
Trung Ton was elected to take the reins for the
2015/16 year, as well as our new committee (details
of which can be found on our website
www.medchir.co.uk)
Our last event of the year, the Inaugural Friends of
MedChir Dinner held in the historic Dining Room of
the Glasgow University Union closed out the year in
a flurry of dining, drinking and dancing.
Personally, I have thoroughly enjoyed the past year,
and Im sure next year will be even better!
I hope everybody has a wonderful summer and see
you all in September!
Keep it real.
Kris McArdle
Outgoing MedChir president
A Brief Summary of the MedChir Year
A few words from retiring MedChir President, Kris McArdle
20