The Australian College of Rural and Remote Medicine (ACRRM), in recognition of its leadership and success in championing rural practice, is proud to have been invited by the WONCA Working Party on Rural Practice to host the 14th World Rural Health Conference to be held in Cairns from 29 April – 2 May 2017. This important conference will be held in collaboration with the 14th National Rural Health Conference from 26 – 29 April 2017, as part of A World of Rural Health.
The WONCA 14th World Rural Health Conference is an international event that will see delegates from around the world exchange information on the latest developments and challenges in rural family practice and rural and remote health generally.
The World Organisation of Family Doctors (WONCA) is a not-for-profit organisation with 118 member organisations in 131 countries and territories. The WONCA Working Party on Rural Practice consists of up to 20 members with representatives from each of the world’s regions: Europe, Asia, Africa, North America, South America, Australasia / Pacific.
The WONCA Working Party on Rural Practice vision is health for all rural people around the world.
The conference expects 900+ national and international delegates to attend. These will include rural doctors, researchers and academics, teachers, doctors-in-training, medical students, policy makers and administrators from both the public and private sectors.
The program will feature streams based on themes most relevant to all rural and remote health practitioners. These include Social and environmental determinants of health; Leadership, Education and Workforce; Social Accountability and Social Capital, and Rural Clinical Practices: people and services.
The extensive program will include a wide range of plenary sessions and workshops, and a number of excellent keynote speakers have already been confirmed. It also includes clinical sessions to provide skills development and ongoing professional development opportunities.
The World Summit on Rural Generalist Medicine is to be held as a pre-conference event, and potential delegates are welcome to participate in this important optional event.
Please email firstname.lastname@example.org for any detailed information required relevant to the WONCA 14th World Rural Health Conference in 2017 in Cairns.
A bursary fund exists for medical students, young doctors (in GP training program/Registrars/Resident – in first 5 years of GP practice) and doctors from developing countries, to assist with costs of attendance at the conference.
Salah satu objek wisata yang menjadi andalan di Palangkaraya adalah Sungai Kahayan. Sungai ini adalah salah satu sungai terbesar yang ada di Pulau Borneo. Panjangnya sekitar 250 km dan banyak penduduk yang tinggal di sepanjang sungai ini. Salah satu wisata unik yang tergolong baru khas Palangkaraya yang sedang di gemari saat ini yaitu susur Sungai Kahayan. Anda bisa berwisata susur Sungai Kahayan ini berombongan.
Selama menyusuri sungai, Anda akan disuguhi dengan pemandangan khas hutan-hutan Kalimantan. Di sepanjang perjalanan Anda bisa melihat fauna khas Kalimantan yang tidak bisa ditemukan di tempat lain diantaranya orang utan, uwa-uwa, kera abu-abu dan bekantan. Selain itu, Anda juga bisa mampir ke tempat pemancingan atau situs sejarah dan habitat orang utan di Pulau Kaja. Rute wisata bisa dipilih sendiri sesuai dengan keinginan Anda.
Untuk menikmati wisata eksotis ini, Anda tidak perlu merogoh kocek dalam karena biayanya sangat terjangkau. Satu paket wisata untuk minimal 10 orang dibrandol dengan harga mulai dari Rp 750.000. Harga tersebut sudah termasuk makanan ringan dan fasilitas kapal wisata yang digunakan untuk menyusuri sungai. Kapal ini terbuat dari kayu besi, memiliki kamar tidur, AC, live music dan tempat bersantai.
Bagi Anda wisatawan jauh yang ingin menikmati alam khas Kalimantan ini tidak perlu bingung karena Pemerintah Palangkaraya telah berinisiatif membuat buku panduan wisata untuk para wisatawan.
Anda bisa menghubungi Dinas Pariwisata setempat untuk konfirmasi wisata susur Sungai Kahayan. Untuk menuju dermaga tempat perahu milik Dinas Pariwisata saat Anda sudah tiba di Palangkaraya, Anda bisa naik bis umum atau mobil sewa menuju Kantor DPRD Provinsi Kalteng, letaknya tak jauh dari situ.
About the President of Wonca
Amanda Howe took office as WONCA president in Rio, in November 2016.
Amanda has been deeply involved with WONCA since 2000, when she facilitated a workshop for their Working Party on Women and Family Medicine. She is on their Executive, chaired the group from 2007-2009, and hosted an international meeting at UEA in 2009. Professor Amanda Howe was elected RCGP Honorary Secretary in 2009. She practises at the Bowthorpe Medical Centre in Norwich, England and has been Professor of Primary Care at the University of East Anglia since 2001. “I wanted to be a GP when I was a medical student, despite influences from tutors to do otherwise”, says Professor Howe. “I’m fascinated by the role that the GP consultation can play in helping patients make sense of their lives, and overcome physical and mental adversity.”
She remains “in awe” of how resilient patients can be. “It’s a privilege to work with people faced by adversity and illness. People are often very courageous and extremely strong, they really do inspire me, that’s why general practice is such a great place to learn”
8 November, 2016
Smoking one pack of cigarettes a day could cause 150 extra genetic mutations in lung cells every year, according to new research.
The study, published in the journal Science, analysed the DNA sequence of cells from more than 5,000 cancers from both smokers and non-smokers.
Overall, the study found cancer cells from smokers tended to have a greater number of mutations within certain mutational signatures than non-smokers.
For example, most lung and throat cancers from smokers had many mutations in signature 4. The researchers went on to describe the other individual mutational signatures where they found differences for smokers versus non-smokers, including signatures 2, 5, 13 and 16. The researchers were able to estimate the number of mutations that would be caused in different types of cells.
The results support the theory that smoking causes cancer by increasing the number of mutations found in the cellular DNA, though the exact mechanism by which this happens isn’t completely clear.
Professor Sir Mike Stratton, joint lead author, said: “This study of smoking tells us that looking in the DNA of cancers can provide provocative new clues to how cancers develop and thus, potentially, how they can be prevented.”
Keeping your hands clean is one of the most important steps you can take to avoid getting sick and spreading germs to the people around you. Many diseases and conditions are spread by not cleaning your hands properly. Here are five important things you might not know about washing your hands and why it matters.
- Soap is key. Washing your hands with soap removes germs much more effectively than using water alone.[i] The compounds, called surfactants, in soap help remove soil and microbes from your skin. You also tend to scrub your hands more thoroughly when you use soap, which also helps to removes germs.[ii]
- It takes longer than you might think. The optimal length of time to wash your hands depends on many factors, including the type and amount of soil on your hands. Evidence suggests that washing your hands for about 15–30 seconds removes more germs than washing for shorter periods.[iii] CDC recommends washing your hands for about 20 seconds, or the time it takes to hum the “Happy Birthday” song twice from beginning to end.
- It’s all about technique. Make sure to clean the spots on your hands that people miss most frequently. Pay particular attention to the backs of your hands, in between your fingers, and under your nails. Lathering and scrubbing your hands creates friction, which helps to remove dirt, grease, and germs from your skin.
- Don’t forget to dry. Germs can be transferred more easily to and from wet hands, so you should dry your hands after washing.[iv] Studies suggest that using a clean towel or letting your hands air dry are the best methods to get your hands dry.[v],[vi],[vii]
- Hand sanitizer is an option. If you can’t get to a sink to wash your hands with soap and water, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Make sure you use enough to cover all surfaces of your hands. Do not rinse or wipe off the hand sanitizer before it is dry.[viii]
Note: Hand sanitizer may not kill all germs, especially if your hands are visibly dirty or greasy,[ix] so it is important to wash hands with soap and water as soon as possible after using hand sanitizer.
Why it Matters
Remember, clean hands save lives. Diarrheal diseases and pneumonia are the top two killers of young children around the world, killing 1.8 million children under the age of five every year.[x] Among young children, handwashing with soap prevents 1 out of every 3 diarrheal illnesses [xi] and 1 out of 5 respiratory infections like pneumonia worldwide.[xii],[xiii]
October 15th is Global Handwashing Day
Handwashing is for everyone…everywhere. Global Handwashing Day is an opportunity to support a global and local culture of handwashing with soap and water, shine a spotlight on the state of handwashing in each country, and raise awareness about the benefits of washing your hands with soap. Although people around the world clean their hands with water, very few use soap to wash their hands because soap and water for handwashing might be less accessible in developing countries.
- Organize or participate in a handwashing event in your school or community. Find educational resources and materials and planning tools.
- Celebrate virtually on Twitter and Facebook. Look for and use the hashtag #GlobalHandwashingDay, download pre-drafted educational social media messages, and share CDC’s Global Handwashing Day digital button.
- Make sure you and your family know when and how to wash your hands properly.
- Share the science behind handwashing. (http://blogs.cdc.gov/publichealthmatters/2016/10/global-handwashing-day-2016/)
[i] Burton M, Cobb E, Donachie P, Judah G, Curtis V, Schmidt WP. The effect of handwashing with water or soap on bacterial contamination of hands. Int J Environ Res Public Health. 2011 Jan;8(1):97-104.
[ii] Burton M, Cobb E, Donachie P, Judah G, Curtis V, Schmidt WP. The effect of handwashing with water or soap on bacterial contamination of hands. Int J Environ Res Public Health. 2011 Jan;8(1):97-104.
[iii] Jensen D, Schaffner D, Danyluk M, Harris L. Efficacy of handwashing duration and drying methods. Int Assn Food Prot. 2012 July.
[iv] Patrick DR, Findon G, Miller TE. Residual moisture determines the level of touch-contact-associated bacterial transfer following hand washing. Epidemiol Infect. 1997 Dec;119(3):319-25.
[v] Gustafson DR, Vetter EA, Larson DR, Ilstrup DM, Maker MD, Thompson RL, Cockerill FR 3rd. Effects of 4 hand-drying methods for removing bacteria from washed hands: a randomized trial. Mayo Clin Proc. 2000 Jul;75(7):705-8.
[vi] Huang C, Ma W, Stack S. The hygienic efficacy of different hand-drying methods: a review of the evidence. Mayo Clin Proc. 2012 Aug;87(8):791-8.
[vii] Jensen D, Schaffner D, Danyluk M, Harris L. Efficacy of handwashing duration and drying methods. Int Assn Food Prot Annual Meeting. 2012 July 22-25.
[viii] Widmer, A. F., Dangel, M., & RN. (2007). Introducing alcohol-based hand rub for hand hygiene: the critical need for training. Infection Control and Hospital Epidemiology, 28(1), 50-54.
[ix] Pickering AJ, Davis J, Boehm AB. Efficacy of alcohol-based hand sanitizer on hands soiled with dirt and cooking oil. J Water Health. 2011 Sep;9(3):429-33.
[x] Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Rudan I, Campbell H, Cibulskis R, Li M, Mathers C, Black RE; Child Health Epidemiology Reference Group of WHO and UNICEF. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012 Jun 9;379(9832):2151-61.
[xii] Rabie T and Curtis V. Handwashing and risk of respiratory infections: a quantitative systematic review.Trop Med Int Health. 2006 Mar;11(3):258-67.
[xiii] Aiello AE, Coulborn RM, Perez V, Larson EL. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health. 2008;98(8):1372-81.
Posted on October 14, 2016 by
Since 2014, the Indonesian government has been implementing the National Health Insurance (JKN). Accordingly, the health referral system is crucial because it concerns the sustainability of health care ranging from primary health care in puskesmas up to the tertiary level of health care in the hospital, but moreover, because a referral system is needed to ensure that individuals receive optimal care at the appropriate level of health care.
The Minister of Health regulation (Permenkes) No. 1 Year 2012 on Individual Health Care Referral System article 11 (1) requires each health care provider to refer patients when necessary, unless there is a legitimate reason not to, and approved by the patient or their family.
The East Java Province, with support of the Australia – Indonesia Partnership for Health Systems Strengthening (AIPHSS), has issued guidelines specific to the region as a follow up to the Governor Decree SK no 188/786 / KPTS / 013/2013 governing the referral system.
The Process of Setting Up and Regionalising the Referral System
The setting up of the referral system in East Java was developed based on the results of a case study in the AIPHSS districts in East Java (Sampang, Bangkalan, Situbondo and Bondowoso).
The commitment of the East Java Regional Government- led by the East Java Provincial Health Office- to produce a basic law governing the referral system in East Java province is driven by:
- The standard quality is not met by service providers. The health centers and hospital service quality achievement is less than 20%;
- Not every district/city has a referral system that regulates the procedures and referral mechanism;
- Although there is a governor decree on the referral system, not all of the procedures, workflow, recording and reporting of referral processes are done properly by district/city;
- The absence of continuous guidance and supervision for implementing the referral system;
- The number of non-compliance cases in the referral system which therefore cannot be financed by BPJS.
The new governor decree is enacted following the seven (7) stages of the improvement process and development of the referral system, namely:
- Development of assessment instruments for health clinics and hospitals, including TOT (training of trainers) for Focus Group Discussions (FGD);
- Assessment of health facilities and FGD, including mapping of health facilities, DKT for health centers, hospitals, community and Provincial and District Health Office, as well as the analysis of assessment results;
- Disseminate the results of the assessment and FGD through workshops at the provincial and district / city;
- Development of the referral system model, including the dissemination and finalisation of the referral system model at the provincial and district / city;
- Disseminate the referral system model through workshops at the provincial and district / city;
- Piloting the referral system including monitoring and evaluation, and drafting guidelines of the referral system in provincial and district / city;
- Finalising guidelines of the referral system, including a workshop on the results of the implementation of the referral system.
The Governor’s Decree No. 118/359 / KPTS / 013/2015 determines that the regionalisation of the referral system in East Java is divided into eight (8) regional and tertiary hospitals as follows: 1). RSU Dr. Saiful Anwar, Malang; 2). RSU Haji, Surabaya; 3). Ibn Sina Hospital, Gresik; 4). Sidoarjo Hospital; 5). Jombang Hospital; 6). Iskak Hospital, Tulung Agung; 7). RSU Dr Soedono, Madiun; 8). Dr Soebandi Hospital, Jember. Each hospital serves as a Center of Referral for the surrounding areas.
Learning from East Java, other areas may follow similar steps to develop a referral system in their region using the Governor decree or regional regulation. The process to establish a legal basis for this regulation should involve as many agencies and other relevant stakeholders as possible, as well as community groups, including the private sector and health professional organisations. This can be done through forums, hearings and other similar events according to the local need. These processes are part of the process of improving the understanding of the Health Office and other regional bodies, as well as the process of grounding legislation according to the real need of the people. When the legislation is drafted, these processes should also be applied to members of the Legislature, which upon having a better understanding of health, will provide legislative support to the Governor.
MAINTAINING SUSTAINABILITY OF REGIONAL REFERRAL SYSTEM
To ensure the sustainable implementation of a regional referral system, the local budget commitment should be allocated and improved for:
- Socialisation to the local leaders, staff at health care facilities, and communities;
- Supporting health care facilities in order to meet quality standards, more so following the reduction in state budget support;
- Provision of technical guidance for health care facilities, including district health care facilities, and monitoring and evaluation in an integrated manner;
- Integration of information systems between basic and referral facilities;
- Effective cooperation and coordination with BPJS.