JDN-NEWSLETTER-ISSUE-07-2015

1
JDN
The World Medical Association, Inc.
L’association Medicale Mondiale, Inc.
Associación Médica Mundial, Inc.
Newsletter
JUNIOR DOCTORS NETWORK
ISSN- 2312-220X
JDN Newsletter 7
Issue 7-2015 June – 2015
Next meeting
Trade+Health:
A Call to Action
2 3
JDN JDN
The WMA-JDN had elections in
Durban in October, 2014. We wel-
come DrAhmet Murt from, Istanbul,
Turkey as the new JDN chair. The
new team comes from different re-
gions including Africa, Asia-Pacific,
Eastern Mediterranean, Europe,
North-America and Latin America.
This issue includes:
– Ahmet Murt, MD makes his first
chair address for the new term.
– Ayako Shibata,MD highlights
community medicine for su-
per elderly population in 2025.
– Ricardo Correa reports on
his journey on medical editor.
– Arthur H. Danila discuss
about Social Media Summit
Editorial
JDN has started the year with a vi-
sionary governing team that has a
wide geographic representation.
Preparing to celebrate the 5th year
after its foundation, JDN is well
aware of the needs of junior doctors
as well as of the medical profession.
ThesewillbeguidingtheJDNtomeet
the requirements of the junior doc-
tors and of the medical profession.
While JDN is composed of personal
members who are associate mem-
bers of WMA, many of them are
already representatives of their lo-
cal, national and/or regional junior
doctor organizations. JDN now con-
centrates on aligning the personal
membership with these organiza-
tional representations. That is why
we call the year as a reforming year.
Dr. Wunna Tun
Communication
Director
JDN, WMA
Editor in Chief,
JDN Newsletter,
WMA
at the International Conference
on Residency Education in 2014.
– Elizabeth Wiley, MD share about the
IFMSA meeting in Taiwan and Trade
and Health working group –
Pasqualina Coffey and
James Churchill presents CDT
guideline on clinical images. –
Zeinab Osman share the plight of
an African Mother suffering from
Female Genital Mutilation. I am
sure you will enjoy the sto-ries in
this new year issue .
This journey is planned to be an ongo-
ing communicative process between
many stakeholders. We kindly ask all
medical associations across the world
tobesupportivetowardsjuniors’efforts
while they are working hard to institu-
tionalize the representation of junior
doctors in their regions or countries.
Another key factor to be successful
in the journey is cooperation. This is
between the junior and the senior or-
ganizations as well as between the
organizations from different countries.
This cooperation will help junior doc-
tors worldwide to recognize the skills
of 21st century doctors that gener-
ally can not be gained by just their
own. When planned carefully, an ef-
fective cooperative framework will
help not only for learning from each
WMA JDN OFFICERS 2014/2015
Written by Dr.
Ahmet Murt
Chair , WMA
JDN
4 5
JDN JDN
Editors:
Dr. Wunna Tun
(Communication Director)
Dr. Ricardo Correa
(Publication Director)
oficcers
Presidentes e diretores
(Lista)
Join the group of
Junior Doctor Network of
World Medial Association
Contact: jdn@wma.net
White Paper
Social media and medical professionalism
Relevant Junior Doctor Policy
Ethical Implications of Collective Action by
Physicians
Current projects
Doctors’ health and wellbeing
Global health training and its ethical impli-
cations
Quality in postgraduate medical education
and training
Diagramação
Logo – Suport
AMB – Associação Médica Brasileira
* The JDN is an initiative of individual Associate
Members of the WMA. The information and opinions
expressed in this newsletter represent the opinions
of the authors and do not necessarily reflect those
of the WMA. WMA and WMAJDN assumes no legal
liability or responsibility for the accuracy, complete-
ness, or usefulness of any information presented
Written by: Ayako Shibata,MD :
OBGNY senior resident:Osaka Japan
JDN is respectful towards the diversities of
junior doctors from different regions of the
world and encourages them to share their
cultures while trying to formulate a glob-
al approach to health. Although not old in
age, the dense experience of the network
showed us that, the greater the diversity
among members, the higher is the new
knowledge generation. The JDN will work
harder not only for scientific and profes-
sional interactions but also for social and
cultural interactions among junior doctors.
There have sometimes been observed dif-
ferences among different regions. This situ-
ation directs us to initiate regional meet-
ings and also to build close relations with
already founded regional representative
organiza- tions. To give some examples;
there have been two meetings organized
in Eastern Mediterranean, along with meet-
ings in Latin American, Africa and the Asian
region in the previous two years. The JDN
also tries to keep the close partnership
with Permanent Working Group of Euro-
pean Junior Doctors in European Region.
The journey will not always go on a smooth
path, the changing patterns of learning and
working environment of junior doctors in dif-
ferent parts of the world will need a dynamic
strategy which can be adaptable to different
situations. JDN will be in the service of junior
doctors worldwide, with sometimes shallow
but generally deep policies and with some-
times narrow but generally broad horizons.
Looking forward to a more successful era,
with reforms while protecting the tradition.
Japan is getting into the
super-elderly society for
the first time in the world.
In 2012, 24.1% of the Japa-
nese population was over
the age of 65. By 2050, 39%
of the Japanese population will
be over the age of 65 (OECD
Historical Population Data and
Projections Database, 2013).
As limitations of the current sys-
temhasappearedhereandthere,
the need to think about the “new
form of medical care, welfare,
and care” has been increasing.
We organized a workshop
to think about “Community
medicine for the year 2025”,
by inviting Dr. Yoshihiro Takay-
ama, a physician from the Minis-
tryofHealth,LabourandWelfare.
Planning
future community health care system for
the super-elderly society
In 2000,Japan has introduced
a Long-Term Care Insurance
(LTCI) programme, with 45% of
the funding comes from taxes,
45% from social contributions,
and 10% from service users.
One of the characteristics of LTC is
a “single-entry system”,where case
managers have the responsibility
for creating care plans and monitor-
ing conditions of the users from as-
sessmenttoreferralandendofcare.
The percentage of home care
is high compared with insti-
tutions(12.6% vs 2.8%) in
Japan(OECD average 7.9%).
At the workshop,40 participants
were multi-disciplinary from the
medical students to the pharma-
cists as well as young doctors.
6 7
JDN JDN
After Dr. Takayama
showed us the real case
scenarios,the participants
discussed the plan to sup-
ports patients’end of life
time and their wishes.
Japanese JDN will con-
tinue to make learning
opportunities concerning
public health and health
policy for young doctors.
R e f e r e n c e
Social Securi-
ty in Japan 2014
National Institute of
Population and So-
cial Security Research
http://www.ipss.go.jp/s-
info/e/ssj2014/005.html
OECD A Good Life in
Old Age- Japan 2013
http://www.oecd.org/
els/health-systems/Ja-
pan-OECD-EC-Good-
Time-in-Old-Age.pdf
Long-term Care Insur-
ance in Japan Minis-
try of Health,Labour
and Welfare 2002
http://www.mhlw.go.jp/
e n g l i s h / t o p i c s / e l –
derly/care/index.html
JDN @ IFMSA
August Meeting 2014,
Taipei, Taiwan
Written by
Elizabeth Wiley, Social Medical
Affair Of
ficer, WMAJDN
Written by
Ricardo Correa MD, Es.D
, Clinical Fellow, Endocrinology
NICHD/NIH, USA, Publication
officer JDN
August 5-11, 2014. The
AM2014 theme was
“Sustainable De-velopment
for the New Era.”
Plenary sessions at AM2014
focused on “IFMSA reform”
with more than 200 proposed
bylaws changes. The effort to
reform IFMSA was a result of
a campaign to identify ways to
achieve the “IFMSA We Want.”
Among the reforms adopted
at AM2014 were a significant
change to IFMSA’s alumni
strategy including a phased-
in elimination of the Alumni-
Director (Alumni-D) position
on the Team of Officials. In
2015, the IFMSA will assume
primary responsibility for main-
taining contact with alumni.
Alex Papadopoulos, 2013-
2014 JDN Membership Officer,
served on the AM2014 plenary
team as Vice Chair. Elizabeth
Wiley, 2013-2015 JDN Socio-
Medical Affairs Officer and
IFMSA Supervising Council
Member, attended the AM2014
Team of Officials Meeting.
The next IFMSA General As-
sembly will be held in Turkey,
March 3-9, 2015 with an IFM-
SA Alumni Meeting tentatively
planned for March 5-8, 2015.
In this occasion, I will tell you
my experience as a junior doc-
tor involve in the medical edit-
ing area. I hope that you will
consider getting more involved
in the area of medical edit-
ing once you learn a little from
my experiences thus far. As a
new physician, this has been
a fun and intellectually chal-
lenging experience for me.
Six years ago, I was invited by
LATINDEX to participate in a
course titled “How to be an Edi-
tor”. At first, I was reluctant to
participate because I was re-
ally busy working as a recently
graduated clinician and was
also doing a research fellow-
ship focus on public health. My
mentor, however, told me that if
I wanted to improve my country
scientific publication besides
doing papers I should get in-
volved in editorial process. This
recommendation led me to par-
ticipate in the fellowship/course.
The course had a lot of group
and individual homework, pres-
entations, and finally a personal
meeting with an editorial board
to discuss everything about
editorial process and appraise/
analyze/edit an article. After
several months, I accomplished
my goal and finished this in-
tense but valuable course.
JDN @ IFMSA
August Meeting 2014,
Taipei, Taiwan
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JDN JDN
The perspective how I see the entire sci-
entific process is different. Prior to the
course, every time that one of my arti-
cles was rejected, I usually critized
the editors. I thought that be-
cause I was not an important
scientist, they did not read
my work. After this expe-
rience, I realize that the
editorial board is made
up of people who work
because they have
passion for science and
want to contribute to it.
It was at this point I de-
cided to start my career
as a Medical Editor, I can
personally tell you that this
pathway has been very difficult.
At the beginning, nobody was paying
attention to me, probably because I was
a young with some training but not a lot
of real publications. However, I kept at it.
My first experience was in a Spanish jour-
nal entitled: “Archivos de Medicina” . This
journal gave me the opportunity to start ap-
plying what I had learned in initial course
I took. I started as a junior editor, which
was little frustrating because I felt I was do-
ing basically secretarial work. Then after a
couple of months, I was promoted to full
editor and the real work started. I worked
at least 3 hours per night. Given my other
responsibilities, there were some points
that for my love of publications I would
have quit due to exhaustion, however, this
did not happen. During my tenure with
Archivos de Medicina, I learned a lot from
THE COURSE ENDED UP BEING
A LIFE CHANGE EVENT.
my mentor and decided to continue the jour-
ney and get involved in International Journals.
Meanwhile, in Panama, the medi-
cal journals quality was de-
creasing so I decided
to make a change. I
had a meeting with
all the Senior Edi-
tors of the Pana-
manian Journals
and presented a
project to make
there journals
more effective.
That was one of
the most frightening
moments of my life.
Can you imagine been
in front of all your profes-
sor and telling them what they
need to do? At the end of that meet-
ing, they agreed with all my recommendations
and decided to implement them. As a result,
we founded the Panamanian Association of
Medical Editors (PAME), an organization to
this day has saved seven journals in the region
VAs a result of PAME, I was invited to work
on a project to create the Central American
Association of Medical Editors (CAME). Finally
in 2009, the CAME project became a reality
and we had our first meeting in Honduras.
Being the youngest and most energetic
in the group gave me the opportunity to
assume a lot of responsibilities and to quickly
learn about the participating organizations
and further about ethics in publication.
Another project that I started during that time, with the knowl-
edge that I gained editing was to write a book for medi-
cal students. Finally in 2010, my first book titled “Ca-
sos Clinicos: Semiologia y Publicacion” was published.
I believe that science should be available to everyone and the
Open Journal System (OJS) is one of the ways to obtain that
objective. Believing this, in 2011 I decided to train on OJS.
With this new training and knowledge, I have the idea of cre-
ating the first open access junior doctor journal. The main
objective will be to stimulate publication among our peers.
Every day I am learning more about this fascinating area,
medical editing. I can tell all of you that even thought this
journey had its difficult and busy periods, I don’t regret it.
Being a junior medical editor has allowed me behind the
scenes in scientific publication and forwarded my knowledge
base as to how articles get published and why some do not.
“I AM SO
PROUD OF MY
ENVOLVEMENT
IN CAME”
I am so proud of my involvement in CAME. CAME is now
helping a lot of regional journals and every day more of them
are been indexed to MEDLINE, ISI, EMBASE and others.
In 2010, the World Association of Medical Editors (WAME)
and the Cooperation for Ethics in Publication (COPE) invited
me to become part of their organization. Being part of them,
has increase my knowledge and my loved for medical editing.
Due to my experiences and the relationships formed from them, I
have found a couple of mentors that like my enthusiasm and have
offered me training positions on their editorial boards. The Journal
of Infectious Disease in Developing Countries and International
Archives of Medicine, were the two journals where I had my first
non-Spanish editorial experience. From these experiences, I
learned the methodology
of approaching different
papers, how to evalu-
ate double publication,
how to use certain edito-
rial computer programs
and how to analyze and
integrate the peer re-
viewers commentaries
and recommendations.
learn a lot and you will
make a contribution
to the scientific world.
10 11
JDN JDN
Over the last five years, a new genera-
tion of “mega” trade agreement negotia-
tions have emerged globally. The size,
scope and lack of transparency of these
negotiations is unparalleled. Launched
in 2010, Trans Pacific Partnership (TPP)
include twelve negotiating parties: Aus-
tralia, Brunei, Canada, Chile, Japan,
Malaysia, Mexico, New Zealand, Peru,
Singapore, United States and Vietnam.
The Transatlantic Trade & Investment
Partnership (TTIP) negotiations include
the European Union and United States.
The Comprehensive Economic and Trade
Agreement (CETA) is being negotiated
between the European Union and Can-
ada. Between the TPP, TTIP and CETA,
forty countries representing more than
60% of the global gross domestic product
(GDP) are involved in these negotiations.
Moreover, these agreements seek to es-
tablish a new global framework for trade
governance and are designed to serve as
a model for all future trade agreements.
But why do these trade agreement ne-
gotiations matter to junior doctors?
If successful, these agreements could
significantly reshape the environ-
ment in which we serve patients and
practice medicine. On a truly global
scale, these agreements may affect:
● health care services;
● access to medicines for patients;
● drug safety and research in-
cluding clinical trial data transparency;
● prevention and control of non-
communicable diseases including
regulation of tobacco and alcohol;
● treatmentofcommunicablediseases;
● environmental protection;
● food safety and supply;
● environmental and oc-
cupational health; and
● medical education and the
supply of health professionals.
Unfortunately, these trade agreement ne-
gotiations are conducted largely in secret
with disparate access to draft texts and ne-
gotiators afforded to industry. Of particular
concern is the possible inclusion of a broad
investor-state dispute settlement (ISDS)
Trade+Health: A Call to Action
Written by
Socio Medical Affairs Officer, Eliza-
beth Wiley
The role and make up of medi-
cal editors is changing. In the
past, you became an editor only
if you published many articles.
Nowadays, beside publication
you need training in editorial pro-
cess. I remembered that the edi-
tor in Chief of JAMA in a meeting
told me “if I knew that I would be-
come the senior editor of JAMA,
I would start my training since
I was a resident 30 years ago.”
THERE IS A LOT MORE TO LEARN. HOWEVER, I HOPE
THAT ONE DAY I REACH MY GOAL OF BEING A SENIOR
The JDN has established
an informal working group
on trade and health and is
currently working to draft
a policy statement. Please
contact JDN Socio Medi-
cal Affairs Officer, Eliza-beth
Wiley, at elizabeth
w i l e y. m d @ g m a i l . c o m
if you are interested in
working on these issues.
mechanism in these agreements. ISDS
provides a way for investors to bring claims
against governments and seek compensa-
tion. ISDS cases are generally adjudicated
by panels of private corporate attorneys
with little transparency. When incorporated
into smaller scale trade agreements, these
provisions have been used to challenge
successful, evidence-based public health
initiatives such as cigarette plain-packag-
ing. More than half of ISDS cases are either
settled or decided in favor of the investor.
Moreover, there is concern that the mere
availability of ISDS may deter governments
from adopting policies to protect health,
a phenomenon called “regulatory chill.”
In accordance with the WMA Statement on
Patient Advocacy and Confidentiality, physi-
cians have an ethical duty to advocate “…
for patients, both as a group (such as advo-
cating on public health issues) and as indi-
viduals.” Given the potential implications of
these trade agreements on health and health
care services, it is critical that we, as physi-
cians, advocate to ensure that these agree-
ments advance rather than undermine health.
12 13
JDN JDN
With the ubiquitous smart phone poking
out of nearly every junior doctor’s pocket,
it is not surprising that using our
little electronic friends for
taking photos or videos
during our work has be-
come more and more
common. Images are
frequently taken for doc-
umenting and monitoring
key clinical signs, injuries
or lesions, can help assist with
7) Finally, Centers ought to share intern-
ship reports with the NIC and copies given to
referrals and offsite specialist advice, and are
often used for teaching, training or research.
However, the ease and utility of us-
ing personal mobile devices to
capture clinical images needs to
be tempered by important legal,
professional and ethical bounda-
ries. The Council of Doctors in
Training (CDT) in Australia has re-
alised that many junior doctors and
Guidelines for junior doctors on the use of
mobile devices for taking clinical images
Written by
Dr. Pasqualina Coffey, Northern Territory Representative, CDT.
Dr. James Churchill, Chair Council of Doctors in Training.
medical students do
not fully appreciate
their obligations. Fur-
thermore, local policies
are often not clear or
are non-existent. Also,
numbers of complaints
received by regulatory
agencies regarding
the improper capture
and use of clinical im-
ages are increasing.
Remain up to date
with commonly used
devices, storage and
messaging software
and applications.
CDT will also advo-
cate to improve image
upload and printing
services in hospitals
and hope that the
guidelines will prompt
individual health ser-
vices to consider
their own policies and
staff awareness in this
valuable but potential-
ly risky practice. The
guidelines will be pub-
lished shortly and will
be available from the
CDT section of theAus-
tralian Medical Asso-
ciation’s website www.
ama.com.au/dit. We
look forward to sharing them
with the Junior Doctor Network.
Over 2014 the Council has
developed easy to use guide-
lines aimed at junior doctors
and medical students to help
them make full use of this help-
ful tool, while protecting patient
safety, privacy and autonomy.
The guidelines cover common
pitfalls for junior doctors and
medical students including in-
adequate consent and
documentation;
imagequal-
i t y ;
d e – i d e n t i –
fication; insecure
storage; and inadvertent or
deliberate unloading to cloud
storage or social media. For ex-
ample, one study at an Australi-
an hospital revealed that 65% of
respondents had taken clinical
images, but only 25% obtained
consent. Many kept the images
for later use and only 40% were
aware of a hospital policy. 60%
believed they owned the image.
The CDT guidelines for clinical
images and the use of personal
mobile devices will be the first
relevant national professional
guidelines for doctors and medical
students working in the Australian
healthcare system. The guidelines
have been made into an easy to
use brochure, which clearly outline
the key points doctors and medi-
cal students should follow when-
ever they take a clinical image.
In composing these guidelines, CDT
was very aware of the fast pace of
technology. As such, we will be re-
viewing the guidelines in one year to
ensure they are relevant and remain
up to date with commonly used de-
vices, storage and messaging soft-
ware and applications. CDT will also
advocate to improve image upload
and printing services in hos-
pitals and hope that
the guide-
l i n e s
w i l l
prompt indi-
vidual health services
to consider their own policies
and staff awareness in this valuable
but potentially risky practice. The
guidelines will be published shortly
and will be available from the CDT
section of the Australian Medical As-
sociation’s website www.ama.com.
au/dit. We look forward to sharing
them with the Junior Doctor Network.
14 15
JDN JDN
On October 22nd, Toronto was
home to the world’s first Social Me-
dia Summit for Health Professional
Education held prior to the Royal
College of Physician and Surgeons
of Canada’s 2014 International
Conference on Residency Educa-
tion. This one-day summit brought
together over 100 participants from
countries around the world to de-
velop consensus on the best use
for social media in medical educa-
tion. WMA JDN members included
Dr. Ian Pereira (@IanJohnPereira,
Queen’s University, Canada) who
helped organize the sessions.
The Summit was chaired by Dr.
Jonathan Sherbino (@Sherbino,
McMaster University, Canada) and
Dr. Ali Jalali (@ARJalali, University
of Ottawa, Canada), both enthusi-
asts of appropriate and innovative
uses of technology in medicine. Dr.
Sherbino’s initial remarks empha-
sizedthebreakthroughofthismeet-
Written by: Dr Arthur H. Danila (JDN Brazil)
ing as one of the first to engage
an international audience both
within the Allstream Centre and
online through twitter and blogs.
The Opening Plenary featured
world-renowned Dr. Anne Ma-
rie Cunningham (@amcun-
ningham, Cardiff University,
UK)¬ from the “Wishful thinking
in medical education” blog on
“How social media can change
health professional education”.
She highlighted the importance
of an online identity, appropriate
behavior, and a set of values
relevant to the digital age. She
also encouraged those interest-
ed in health professional educa-
tion to consider the potential for
social media for good, such as
its ability to create a truly col-
laborative and supportive envi-
ronment. She also warned us
against stressing widespread
Social Media Summit at the 2014
International Conference on Residency Education
fears of social media in
isolation within consider-
ing its benefits, drawing
on Dr. Jacalyn Duffin’s
concept of “vanilla physi-
cians” – doctors whose
attitudes and core val-
ues become softened
and withdrawn because
of fear for exposure.
Participants then attend-
ed two of four possible
sessions intended to de-
velop consensus guide-
lines on each topic. I had
the opportunity to partici-
pate in one on the “Pro-
fessional use of Social
Media for Health Profes-
sional Education” facili-
tated by Drs. Jalali, Cun-
ningham, and Pereira.
Using the positive lens
of an appreciative inquiry
framework, we identified
Social Media Summit at the 2014 In-
ternational Conference on Residency
Education
Save the date! Upcoming
meetings in 2015
– October 12th – 13th, 2015: WMA JDN
Meeting, Mosocw, Russia
– April 15th, 2015: WMA Junior Doctors
Network Meeting Oslo, Norway
– May 8th – 9th, 2015: EJD Spring Meeting
2015, Vienna, Austria
– May 16th – 17th, 2015 : JDN
Working Meeting in WMA, France
– September 22nd – 24th, 2015 (tentative):
CMAAO meeting, Yangon, Myanmar
what works well in the pro-
fessional use of social media
today, what may work better
in the future, and what we
need to do to design and
implement changes to make
theseimprovementsareality.
The second session was on
“BestpracticesforSocialMedia
platforms” led by Dr. Michelle
Lin, an Emergency Physician
and founder of the “Academic
Life in Emergency Medicine
(ALiEM)” blog (@M_Lin,
University of California). This
session used interactive poll-
ing to reach consensus on best
practices and develop quality
indicators that could be used
to evaluate the impact of this
technology. Other concurrent
sessions were on “How edu-
cation theory should inform
Social Media” by Dr. Jalali
and Dr. Leslie Flynn (@flynnlv,
Queen’s University, Canada)
and on “Defining and evalu-
ating Social Media education
scholarship” by Dr. Sherbino.
The second plenary was “How
health professions educa-
tors should use Social Me-
dia” and presented by Dr.
Lin, whose motto was “there
is no greater job than being
an educator.” She stressed
that we want to make a differ-
ence where the learners are
as a part of a global commu-
nity and delivered a thorough
review of how social media
can shift the academic value
for the traditional role of the
clinician-educator to the dig-
ital-innovator-educator. The
plenary concluded with sug-
gestions on how each one of
us could develop our own digi-
tal identity as a medical educator.
It was a consensus from the at-
tendees that this meeting em-
powered participants to partici-
pate in good discussions and take
home practical advice on the use
of social media in medical edu-
cation. It also engaged a wider
audience through social media
(including Facebook, Twitter, and
the conference blog). What now
challenges us is to encourage
our institutions to join these dis-
cussions on the use of social me-
dia and consider its use where
appropriate for better health
professional education. To help,
next steps from the conference
organizers will be to build on this
day to develop consensus guide-
lines on the use of social media
for health professional educa-
tion. I look forward to these pub-
lications, and the role they may
18 JDN
The pain and she
had already grown up
Together they nev-
er attempted to stop
Seeking for some-
thing to separate them
they never gave up
* * * * * * * * * * * *
At some point of her life
she asked her self why?
All the eyes are on her
it makes her want to cry
* * * * * * * * * * * * * *
They want her to be tough
Pass this habit to her kids
Teach them to be rough
let them feel what she felt
* * * * * * * * * * * * * *
But what if it’s wrong?
And it has be wrong!
It doesn’t make her feel strong
* * * * * * * * * * * * *
This is a story
that no one wants to hear
it’s only her destiny
to end this life with fear
* * * * * * * * * * *
she was only five years old
when she started to realize
those girls are born to be cold
just like a useless device
* * * * * * * * * * *
It’s not their right to complain
As a matter of fact,
they should withstand all emotions
Now she takes one second
and wonder why people
always put her second?
Why not first?
Why it’s always about
what they want out of her?
No one is considering
No one even bother to care
* * * * * * * * * * * *
She struggle hard not to cry
while remembering the
worst scenario of her life
that brought tears to her eyes
And unfolded the hid-
den memories in her mind
* * * * * * * * * * *
When she had urine retention
andneededamedicalattention
but first they want-
ed a permission
from those who nev-
er changed their vision
* * * * * * * * * * *
To cut her up
to leave her with no choice
but to give up
* * * * * * * * * * *
I guess, they nev-
er cared about
her deep emotion
or they would em-
pathize know-
ing the sensation
inside her was a tre-
mendous commotion
she was lost in an in-
visible and painful ocean
* * * * * * * * * * * * *
She is a girl
Like any other Somali girl
FGM is the only night mare
Looking forward
to the golden age
Where it all will vanish
Can’t wait the golden age
To come and end
this punishment
Written by Dr
Zeinab Osman,
Medical Officer
from Somalia
including physical pain
* * * * * * * * * * * *
She heard one of her friends
became a hero
because she went un-
der a procedure
that makes her so
* * * * * * * * * * * *
She knew her day
will come in any way
because she had no options
it was compulsory
* * * * * * * * * * * *
She had to bite her lips
Hold the tears in her eyes
Because if she cries
they will inform other kids
that she was a coward
and will never move
one step forward