The scholarship is worth $5,000 and will assist Cameron with costs associated with undertaking trainee intern electives in innovative and challenging overseas situations next year. Cameron will be travelling to Colombo, Sri Lanka and Darwin, Australia.

Cameron is training in Palmerston North following a year of rural immersion in Dannevirke, though his family is based in nearby Ōtaki. He is passionate about equitable access to healthcare in rural settings, reducing barriers to mental healthcare services, and adaptation to reduce the effects of climate change on health.

Cameron Toogood

“The Pat Farry Rural Health Education Trust’s vision is for our work and the experiences that these medical students gain on their electives to ultimately contribute to the quality of rural health services in all regions of New Zealand,” said Mrs Farry.

“My primary goals are to learn about different strategies to overcome barriers in rural healthcare, develop my skills in limited resource environments, and explore the possibility of engaging collaborative international rural community projects in my career.” says Mr Toogood.

Cameron will be starting in Colombo, Sri Lanka at the University of Sri Jayawardenepura where he will be assisting in both general surgery and parasitology. He will then move to Darwin, Australia to a placement at Royal Darwin Hospital where he will be based in the anaesthetics/perioperative unit.

While in Tararua, Cameron discovered an interest in rural medicine and overcoming barriers to access, transport, and health promotion. This prompted him to choose both Darwin and Colombo as two diverse locations that will allow him to study how local healthcare teams respond to such challenges, and what lessons can be brought back and applied to our contexts.

“By visiting areas that service rural communities whilst still being large enough to house theatres, I hope to learn how these triaging and outreach systems work overseas. I am currently organising weekend travel to rural clinics in both countries to be able to follow the patient flow from rural outposts to larger connected centres as I have done this year at Dannevirke and Palmerston North.”

Cameron has been part of the Rural Medical Immersion Programme (RMIP). The RMIP was developed by Dr. Farry in six rural locations around New Zealand and sees around 20 fifth year students a year to learn under the guidance and mentoring of experienced general practitioners, rural hospital generalists, and tertiary hospital specialists.

“RMIP has been a unique opportunity to better understand the world of rural health and improve my fundamental skills. It clearly plays an important role in ensuring healthcare access for our rural kiwis by supporting the training of tomorrow’s rural doctors, and will undoubtedly shape the future direction I go in.”

“Since 2011, 27 medical students have benefited from the Pat Farry Rural Health Education Trust’s scholarship programme. The latest scholarships will bring the total amount awarded by the Trust in scholarships and grants to $105,000,” said Mrs. Farry.

Earlier this year, 2018/2019 Pat Farry Rural Health Education Trust Travelling Scholarship recipients Annabel Merrett and Annelise Brown traveled to Italy and Guatemala. The pair have documented their past experiences via blog on the Pat Farry Rural Health Education Trust’s website and Facebook page.

ENDS

Contact:

Claire Dooney

Pat Farry Rural Health Education Trust

www.PatFarryTrust.co.nz

*protected email*

Tel: 027 632 0821

2018 Recipient Annelise Brown

2018 Recipient Annabel Merrett

“Scholarships offered by the Pat Farry Rural Health Education Trust assist young people to spend valuable time in innovative and challenging overseas situations, to return, and to become the new idea generators here in New Zealand,” said Mr John Farry, Pat Farry Rural Health Education Trust Chairman.

General Practitioner Dr Pat Farry was a tireless advocate and champion of rural health before he passed away in 2009. He devoted much of his career to advocating and lobbying for improvements and funding for rural medicine as well as mentoring and teaching rural healthcare professionals.

The Pat Farry Rural Health Education Trust was established in March 2010 to support the sustainability and quality of health services to rural communities. “One of the ways in which the Trust does this is by providing scholarships for undergraduate medical students and young rural health professionals,” said Mr John Farry.

Since 2011, twenty-six medical students have benefited from the Pat Farry Rural Health Education Trust’s scholarship programme.

While the Trust is based in Dr Farry’s hometown of Queenstown and has links to the University of Otago School of Medicine where he taught, the student’s own home bases and careers are New Zealand wide.

Recipients to date have originally come from Thames, Paraparaumu, Tauranga, Ngatea, Nelson, Matamata, Fielding, Darfield, Christchurch, Invercargill, Blenheim and Auckland before studying at the University of Otago School of Medicine campuses in Dunedin, Christchurch and Wellington or on RMIP (Rural Medical Immersion Programme) placement in Dannevirke, Blenheim, Greymouth, Queenstown, Balclutha and Masterton.

“The Pat Farry Rural Health Education Trust’s vision is for our work and the experiences that these students and young health professionals gain to ultimately contribute to the quality of rural health services in all regions of New Zealand,” said Mr John Farry.

Application forms can be downloaded here and close on 24 September 2019. Finalist applicants will be advised mid-October with the scholarship recipient(s) announced late October/early November 2019.

For further information:
• Applications open for the 2019 Pat Farry Rural Health Education Trust Travelling Scholarship on 16 August 2019. Download an application form.
• See a full list of past scholarship and grant recipients.
• Follow blogs by Pat Farry Rural Health Education scholarship and grant recipients.
• The Pat Farry Rural Health Education Trust is a registered charitable trust and donations are tax deductible. Donating to support the Trust’s work is simple. We accept donations via online banking, cheque, direct debit authority or credit card (using Givealittle by the Telecom Foundation). Donate now.

ENDS

Contact:
Claire Dooney
Pat Farry Rural Health Education Trust
www.PatFarryTrust.co.nz
Tel: 027 632 0821

Regional competition

The presentations vary from a basic cold to a high fever and last week I had to suture up a toe cut by a machete. Many infectious diseases such as malaria, dengue and chikungunya must be in the differential diagnosis. The centre takes care of all the basic needs of the community, including following pregnant women as well as monitoring growth and health of the children. Family planning is an important part of the medical provision here as many families consist of 12 children or more, and girls marry as young as 12 years of age. Once a year, there is a team of a gynaecologist and supporting staff to provide alternative measures of contraception including surgery, jadelle subcutaneous implants and intrauterine implants. This year, this fell in April and I had the privilege of assisting. The most common method used regularly however, are hormonal injections.

There are no doctors here; the service is provided only by nurses, and treatment is generally regimented according to local guidelines. It makes sense and is important to have such guidelines, but at times, they can be frustrating and restrict alternative treatment that would otherwise be more useful. However, more than the limited knowledge of the local staff, the limited resources here are even more restricting.

A typical home, housing 3-4 generations

Some days I accompany a nurse on home visits, travelling with the nurse by motorbike to the homes of postpartum women. This involves removal of sutures, general check up of the neonate and the mother, as well as provision of vitamins and general advice. Some women choose to birth at home, while others have been rushed to nearby Fray Hospital for an emergency Caesarean section. Many have not sought medical attention after birth and therefore vaccinations and other follow up care of the neonate are required. A typical home here consists of a single room, with a thatched roof and a dirt floor. There is a fire in the centre where the cooking is done, and beds, or hammocks line the walls. The toilet is a hole in the ground outside in a small ‘hut’. There are a number of health risks to the mother and baby. This includes the health danger of an open fire within the home, which means the neonate is breathing in smoky air as well as the danger associated with the baby swaddled in blankets in a hot climate, lying in a hammock, where the head is not lying flat. On top of this is the lack of hygiene. There is no free access to clean water and therefore gastrointestinal disease and parasites are rampant. There are animals wandering around the home; a large family of ducks or chickens, and dogs that come and go as they please. There are pigs wandering in the backyard and the road beside the home lifts dust, entering the lungs of the inhabitants.

There is a great vaccination programme here and all the children born here are documented with a local register of the vaccinations that have already been provided. If a family does not bring in their child to be vaccinated, they are visited in their home to provide these accordingly. There has also been a programme established for deparasitation. Parasites are a major problem here and preventative treatment at a young age can help prevent much disease. This is included in the home visits.

The well established vaccination schedule

All medical treatment in Guatemala is provided for free, so cost is not a barrier to access health care. This includes the home visits as well as vaccination programmes. However, although cost is not an major issue, I have recognised that a major barrier to health care is the lack of health literacy. The importance of health education in the prevention of disease is striking. There have been a number of afternoons I have spent at the medical centre here feeling somewhat frustrated by my limitation in the ability to help. I spend much of my day dealing with secondary problems, and with the medical provisions we have, I can only offer temporary symptomatic relief. What is really needed is education on how to prevent such diseases. This is a benefit of the home visits as it provides a great opportunity to provide education.

Hanging posters at the local school

Before I arrived, I was asked in advance to provide a first aid presentation to the girls at the school. My initial thought was that this consisted of education around CPR, dealing with burns and other acute emergencies. However I have quickly realised that more importantly, this presentation needs to consist of information on the importance of more basic principles of health such as washing hands, cleaning teeth and diet. Many people here don’t understand the importance of personal hygiene. The presentation of this lack of hygiene has been at times, extreme. One Monday morning, I arrived to the medical centre to find a mother with her baby already there. She had travelled a long way from her home town and her baby, only 3 months, was completely covered in bites, scratches and crawling insects and flies were buzzing around the head. We sent her and her child immediately to the hospital, while providing the rest of the family with treatment for scabies and skin infections and provided some education on the importance of washing. Dental hygiene is also significantly lacking. Young children already have rotting teeth and many young adults have very few teeth, if any, remaining. I could not say how many might even own a toothbrush here, but it is certainly not a priority. The diet of fizzy drinks and sugary snacks doesn’t help. ‘Agua’ here refers to any type of fizzy drink or sweet drink; if you want water, you must specify ‘agua pura’.

A day at the local market

During my time here, I have begun to develop ideas on how to help. I have been working with the girls at the school to produce educational posters to display at the school and the medical centre, translated in both Q’eqch’í and Spanish. Along with the help of a friend who studied design, and the girls at the school to help translate into the local language, I have been able to create posters, as well as laminated educational pamphlets about how to wash hands, body and teeth. Alongside this, I have purchased and supplied the centre with several hygiene supplies including toothbrushes, toothpaste, soap and shampoo. I have also recognised a number of gaps in the medical resources here including a foetal Doppler ultrasound, which was raised as a need by the local staff. Thanks to the provision of the Pat Farry Scholarship I was able to fund and provide these. Additionally I have been kindly donated a couple of glucometers to supply the medical centre.

Educational poster hanging in the medical centre waiting room

I am really pleased that I allocated my whole elective to this village.  My decision to do this was to allow time to form relationships, learn the culture and the language, and hopefully make long lasting connections. The longer I spend here, the more needs I recognise, and the greater my desire to contribute and make a difference. However a lot of these things take time; it takes time to identify the needs, to develop ideas and to test these ideas. In addition it takes time to form trust and develop respect from those in the community.

I am enjoying the fact that I have had time to invest and contribute to the community. It is a challenging environment and I hope I will leave some positive changes behind. However, just as importantly, I have learnt yet again to appreciate the privileges we have in New Zealand and hopefully return with a new perspective on our medical system.

I am living at ‘Centro de Promoción Feminina de Ratz’um K’iche’, a school which promotes the education for young indigenous girls. Many families do not value the importance of education of young women and this area is known to have the highest rates of illiteracy in Central America. The initiative was established 20 years ago and has been supported by Vitamundi, an association based in Spain, which in addition to educational volunteering, provides health volunteers to provide free medical assistance in the area.

Evening antics at the school

‘¿Hablas español?’. That is the first question I have to ask before I start each consultation. Yes, that does mean, ‘Do you speak Spanish?’. And no, that wasn’t an error. I have quickly learnt that there is no hope that anyone will speak English here, and I have soon become adapted to this. However, if this was not challenging enough, Spanish isn’t even the first language of many of the people here. Q’eqch’í is the native tongue of the indigenous Mayan people who inhabit this area. And not all have learnt Spanish. As if speaking Spanish all day wasn’t tiring enough; try listening to the nurse speak in q’eqch’í, before turning to you and translating in Spanish. I was mentally exhausted by the end of the first day.

A local family

The first week was a challenge on a number of levels. After just arriving in Boloncó, which reaches a humid 35 degrees celsius during the day and where no one speaks a single word of English; it was all rather daunting and overwhelming. It however hasn’t taken long before I have started to feel more competent, and with this, I have been thoroughly enjoying the interactions with locals. Being a small village, many of the patients I see during the day, I will often see later in the street. Sometimes I am invited into their home; other evenings, I find myself playing football with the kids in the street. I wave hello to the man in the shop as I walk to work as he asks me each day if I have been for my run yet. I have been asked several times why I am running, and it is not uncommon that people think I am in fact running from something. The concept of running for exercise is somewhat of a foreign idea. I am becoming accustomed to life here. I am forming relationships with locals, I am playing football with a local women’s football team and my language is improving progressively.

Sports day at the school

At the medical centre, I am also beginning to feel more competent. My days at the ‘Puesto de Salud’ begin at 8am. Usually I am involved in taking consultations, and the distribution of the basic medications that are available here. We do not have the facilities to do laboratory tests or imaging, and anything complicated or requiring emergent treatment is sent to Fray, where the closest hospital is located. Much of the basic equipment that is normally available in a GP in NZ is also not available here. I believe my time in RMIP (rural medical immersion programme) last year has helped to equip me for this ability to cope with uncertainty and to learn how to use clinical impression to manage and treat patients.

A welcome delivery of fresh coconuts on a hot afternoon at the medical centre

Each day brings new challenges, both with communication and with medicine. However, it is also extremely rewarding and I truly appreciate the relationships and connections I have been forming with my patients and with the people in the community

Some of the local wild life

I soon became introduced to the reality of Guatemalan roads; a supposedly nine-hour trip took fourteen hours after a demonstration closed the main road, forcing the bus to take a back road. As if nine hours wasn’t long enough for what was only a 400km journey. That same journey encountered narrow cobbled city streets, a minor accident with another car requiring negotiation, and a small payout to repay the damage, and then after an already long day, another road blockage. This time, roadworks, with a predicted 1.5-2 hour waiting time. Once traffic finally got moving, the bus was unable to, requiring passengers to pile out and help push the bus along again. It was an exhausting first day in Guatemala, but one that was highly rewarding; an authentic and realistic impression of this country. I knew I was in for a treat.

I spent the first week of my elective making my way towards the medical center in rural Guatemala, a destination not easily reached. Transport in Guatemala consists of “chicken buses”, a journey I am quite fond of, but something many people dread. If you’re after a smooth journey and perhaps a short nap, the chicken bus isn’t for you. However, despite its discomfort and danger, public transport here is remarkably effective. I have never had difficulty finding the bus I need; with numerous helpful and friendly locals, alongside the persistent yelling of the bus driver, there is no mistaking the direction you need to go. It is only when you start swinging around the corners at full speed along some narrow winding mountain roads, and you notice the sign above the drivers that says ‘adicto a peligro’ (addicted to danger) that you begin to question your willingness to survive the next few months.

This opportunity to see a bit of Guatemala on route to the medical center was a real privilege and a great way to gain perspective of the country I will be in for the next few months. Seeing Volcan Feugo erupt at night (an eruption last year in June killed 2500 people which left much of the road and village devastated) from the top of Volcan Acatenango under a starry sky, has to be one of the most incredible things I have ever seen, and yet the most memorable and important memories so far have been interactions with locals.

Volcan Fuego with activity

Transitioning from locations that fall on a tourist route, where foreigners are plentiful and local interactions are few, and moving progressively more rural until I finally became immersed into an indigenous community; the contrast was marked. I became more aware of the reason I love traveling; that is, the people. Traveling as a backpacker has made me truly respect and value the experience of living in a community. I can appreciate the real privilege we have been given as medical personnel, to enter into and be accepted into a community because of the skills we have. And it is opportunities like these, I travel for. Opportunities to get to know the people, to learn their culture, daily routines, perspectives and understand the unique challenges faced in their society.

Local children playing

I am already beginning to notice real health needs. I am becoming aware of the existence of the ‘double burden’ of disease. The coexisting burden of malnutrition and infectious disease, with an emerging burden of chronic disease as obesity and heart disease have become more common with the influence of western society. Poor dental health is particularly noticeable, and hardly surprising considering the cheap and easy access to sugary food.

I know I won’t be able to make a huge difference in my time here but becoming involved in an indigenous culture that lacks so many of the basic needs we take for granted, will be rewarding and challenging.

I am very lucky to be able to stay with a Peruvian family here in Trujillo, which not only means I get to eat delicious, authentic Peruvian food three meals a day, but it also allows for extra Spanish practice, as the family does not know any English. Thanks to this method of full immersion, my Spanish has improved 10-fold in just a few weeks. After a day of thinking, listening and speaking in Spanish, my brain is truly fatigued, however, it is incredibly satisfying.

In the morning, I go to work in the Emergency Department at Trujillo Regional Hospital. Then, after a short siesta in the afternoon, I go to the Medical Spanish Language school for Medical Spanish lessons. These classes teach me, as well as other medical students, doctors, nurses and other medical professionals from around the world, medical terminology in Spanish and important cultural nuances that we need to be aware of when interacting with Hispanic patients.

On Fridays, we have a different itinerary, and we go to an under-resourced area of town and provide free health care. The location varies each week – from a school to a prison, to a park. In Peru in 2009, a law was introduced making health insurance mandatory for everyone, and with this law, everyone living in extreme poverty was automatically registered under government-provided health insurance. However, up to 20% of Peruvians, despite this law change, have fallen through the cracks and still do not have any form of health insurance. Therefore, these weekly health campaigns aim to provide health care to those who do not have health insurance and cannot afford health care. Under the supervision of a Peruvian doctor, I get to consult one-on-one with the patients, which is challenging but very rewarding. The patients are incredibly understanding and patient with my broken Spanish and make an effort to speak slowly and simply so that I can understand.

All of the medical team at a school in the outskirts of Trujillo for the most recent Friday health campaign. The team included medical professionals and students from the United States, Australia, Sweden, Peru and New Zealand.

Several patients that I have met through these campaigns, and the emergency department, have left a strong mark on me, however, one lady from the most recent health campaign, stands out in particular. She had traveled three hours that morning to make it to the school where we were providing the health clinic. Immediately she burst into tears and began to undress showing me the patches of her psoriasis over her body. Her belief was that her disease meant imminent death. I quickly turned to my native-Spanish-speaking superior for help as it was important to reassure her, and I feared my lack of fluency may be misinterpreted and cause more harm. However, it was an excellent learning experience that people not only need access to health care for treatment but also for reassurance. Time needs to be taken to allow patients to understand their illness, as a lack of understanding can cause great harm, as was the case for this woman. I am grateful that we could meet her that day and extinguish her fears.

Being here in Peru has allowed me to learn more about diseases that I rarely see in New Zealand. It also means that while in Peru, my differential list of possible diagnoses for patients has completely changed order. For example: when a patient complains of diarrhea and abdominal pain, the most likely diagnosis is worms, not a tummy bug; when a patient has a cough for two weeks, it is more likely to be tuberculosis and not a viral infection; and itchy skin is less likely to be due to allergies and more likely to be scabies or ringworm. Access to investigations is also limited, especially at the health campaigns, and therefore history and examination are usually the only tools the doctor has for the guidance of diagnosis and treatment. While it is certainly not ideal, this allows for very thoughtful and skilled medicine.

It truly has been an informative two weeks and I thoroughly look forward to what the next four weeks in Peru will bring me…

A Private Film Screening ‘She Shears’ | 5 April 2019 | ASB Theatre

Click here to book! 

Please join us along with family and friends for DINNER THEATRE at the ASB Theatre, Blenheim for a fundraising event hosted by the Pat Farry Rural Health Education Trust.

In conjunction with the National Rural Health Conference, and as a fundraiser for the Pat Farry Rural Health Trust, we will be hosting a private screening of the She Shears Film with a Q+A session with guest speaker Jack Nicol (Film Director).

Proudly supported by New Zealand Rural Women, the film follows the journey of five women shearers, and also shines a light on the many women who live and work hard in rural New Zealand.

We would love for you to join us and support rural health in Aotearoa by forwarding this email to your network and contacts inviting them to help make it a night to remember!

Click here to book! 

If you have any questions, please do not hesitate to get in touch.

We will also have two of our PFT scholarship recipients, Mark Owen-Cooper and Natasha Austin speaking at the conference. Mark and Natasha will be presenting at the National Rural Health Conference at 1.30pm on the Saturday 6th April, on their experience as a part of being awarded the PFT Travelling Scholarship.

About the Pat Farry Rural Health Education Trust
Visionary leader, highly respected teacher, healer, mentor, tireless advocate and champion of rural health, Dr. Pat Farry was unmatched in his efforts and contribution to Rural Medicine and General Practice education. Pat’s vision of sustainable and quality health services for rural communities and small towns of New Zealand was through education.
The Pat Farry Rural Health Education Trust was established in March 2010, with the purpose of continuing this legacy. The objectives of the Trust are to support the sustainability and quality of health services to rural communities. More than $100,000 has been granted in scholarships to support students interested in a career in rural health.

The Trust looks forward to having your support to continue this legacy by joining us on FRIDAY 5TH APRIL.

Warm regards,

Sue Farry and the Pat Farry Trust Trustees

Practising using Virtual Reality via the Microsoft Halolens.

This is marketed by a company called Wekit (website: wekit.eu), which is funded by the European Union, which has a goal to enhance the use of technology in different industries, including medicine. The aim of the ultrasound technology is to allow a doctor without any experience in ultrasound to become an ‘expert’ in order to serve the best on-the-spot-care to the patient.

The virtual reality technology uses the Microsoft HaloLens to produce a 3D image to be seen only be the wearer, and this image can be interacted with using hand gestures. The Halolens gives visual and auditory instructions, as well as interactive images, of what should be seen on the ultrasound monitor as the doctor assesses the patient. The intention is for the doctor to produce an image on the ultrasound monitor that is similar to the virtual 3D image, and then use that ultrasound image to look for pathology in the patient.

Applying the virtual reality Halolens to perform an ultrasound examination of a patient’s submandibular glands.

This technology could also be very useful in rural areas of New Zealand which are under-resourced with specialist doctors. It could allow rural doctors to carry out investigations or even interventions without the need for the patients to travel to larger centres. Using the virtual reality was thrilling and it excited me for what further technology will be brought into medicine to enhance our skills and improve our treatment of patients.

My daily walk to the hospital through the countryside of Pisa.

Overall, my experience in Italy has been about learning some of the important principles of medicine; such as, ensuring I am wise in the interventions and treatment I deliver to my patients, and dealing with frustration when a diagnosis or cure cannot be found. I am sure my time in the Emergency department of Peru will be extremely different and filled with its own distinct challenges, and I am excited for the contrast. No more white coat and Italian shoes; only scrubs and sneakers for the next 6 weeks!

Marilynn with her Te Waka Toi award. As feautured in the ODT Monday November 7th

The Pat Farry Rural Health Education trust is delighted to announce that a major component of their fundraising drive in 2019 will feature the auctioning of several original Marilynn Webb prints.

A former Francis Hodgkin Fellow and Officer of the New Zealand Order of Merit, Marilynn Webb is widely considered to be one of New Zealand’s most distinguished and influential artists.

Her work has often been described as an open discussion of the social and political issues that we face as a nation. It has always been politically charged, socially and environmentally conscious, and is perhaps best characterised as a voice of ‘quiet dissent’.

Throughout her career, she has explored concepts of land ownership, women in art and Māori and post-colonial history but it is the motif of the destruction of New Zealand’s fragile environment that she is most consistently drawn back to. The prints donated to the Trust, Waiotapu Surprise, Mining Crumble, High Country Flambé  and Picnic Pie are wonderful examples of this dark humour and quiet fury that are irrecusably linked Marilyn’s personality.

Dunedin based, Marilyn has represented New Zealand at significant print and graphic arts biennales and her work has been exhibited extensively throughout New Zealand and internationally in Australia, United States, India, Japan, Yugoslavia, Germany, Italy, Norway, Spain and the United Kingdom.

In 2010, the University of Otago conferred the honorary degree of Doctor of Laws to Marilynn. Most recently she was crowned supreme winner at the nation’s Maori art awards Te Waka Toi.

The Artwork will be auctioned online in the New Year. To register your interest please contact Claire Dooney on *protected email* or telephone 0276320821.

The auction will close at 7pm on Saturday the 6th of April 2019, with the successful bidders announced shortly after.

“Cured yesterday of my disease, I died last night of my physician” – Matthew Prior, The Remedy Worse Than the Disease (1714).

Buongiorno from Italy!

After finishing the hard slog of 5th-year exams, and the relief that came with passing, I was ready to throw myself into learning the culture and health system of Italy whilst improving my radio diagnostic skills. Italy is known to have one of the best healthcare systems in the world. The World Health Organisation (WHO) ranked it second in the world behind France for overall efficiency in a report published in 2000. In contrastPeru (my second elective placement) is ranked 129th. (For interest New Zealand is 41st, unfortunately losing to Australia by 9 places). I was curious to experience first-hand the efficiency of an Italian hospital.

Annabel outside the refurbished building called MuseodegliStrumenti per Calcolo, where the Fair Saturday was held.

Day one: I met with Professor Davide Caramella, my supervisor for the next 5 weeks. He was inspirational, filled with metaphors, and passionate about limiting tests, interventions, and treatments for patients in order to minimise harm. He gave me the assignment of presenting at the upcoming Fair Saturday. For those of you who have not heard of Fair Saturday, it is a not-for-profit organisation registered in 2015, which creates a global cultural movement to enhance art and culture throughout the world. Fair Saturday is held in cities all over the world on the last Saturday of November, the day following Black Friday. It aims to positively respond to Black Friday, an infamous day of shopping deals, which began in the United States and seems to have spread throughout the world. Fair Saturday is an anti-consumerism movement to encourage “to be” instead of “to have”. This is a principle dear to my heart as I aim to live as minimalist as possible.

The topic of my assigned presentation was “Fair Imaging” – the idea that doctors should limit radiology referrals in order to limit harm from radiation. A metaphor that Professor Caramella used for this was the mythological story of Odysseus, who took 10 years to get home, which is akin to medicine taking the long route (and ordering excessive tests) to find a simple conclusion. Throughout my medical training so far, I have learned the importance of accepting uncertainty and acknowledging that in some cases doctors are not able to cure a patient, which can lead to frustration and the temptation to do further testing and intervention.

Poster for the One Size Does Not Fit All Campaign.

My presentation discussed the idea that in medicine, more testing, interventions, and treatments are not always better and can cause harm to patients, generate excess costs, and defy patient’s wishes. In other words, keep as ‘minimalist’ as possible in our use of medicine. This is in keeping with the Less is More movement, which encourages the use of lower cost approaches, clinical thought in the care of patients, and evidence-based practice. The primary goal of the Less is More movement is avoiding harm (‘primum non nocere’), and it is not simply about cost-cutting. This movement has gained traction over the last two decades with campaigns such as Slow Medicine and Choosing Wisely.

I also discussed the Image Gently campaign which has a goal to limit imaging of paediatric patients, and in particular the“One Size Does Not Fit All” campaign (poster shown) which aims to limit harm caused by paediatric CT’s.

Not only did I thoroughly enjoy researching this topic, I learnt a lot from other exhibitions and I am glad to now know of the existence of Fair Saturday as I am sure it will be something I get involved in the future.

Please visit the Fair Saturday website if you would like to know more about Fair Saturday.