AFPHM eBulletin – 6 April 2018

Two months in Mongolia

As a part of my public health training, I had the great opportunity to undertake a short-term placement from November 2016 to February 2017 as a volunteer with the Hepatitis and Sexually Transmitted Infections (HSI) unit at the Western Pacific Regional Office (WPRO) of the World Health Organization (WHO). This included a few weeks of orientation with the HSI unit at the WPRO in Manila, two months in the WHO Country Office in Mongolia, then a week to wrap up and handover to my supervisors back in Manila. 

Viral hepatitis is now recognised as a significant public health problem globally. The Western Pacific Region carries 40 per cent of the global mortality burden associated with viral hepatitis. The Western Pacific Regional Action Plan for viral hepatitis outlines a public health approach, with five priority areas for awareness, surveillance, prevention and treatment of viral hepatitis in the region. Priority area five includes accessible and effective treatment cascades, with monitoring and evaluation of country-specific viral hepatitis treatments cascades a key action area. 

Whilst I was in Mongolia, I worked together with the WHO Country Office staff to support the collation of aggregate data from private and public viral hepatitis treatment providers to help build their first treatment cascade (also referred to as a 'cascade of care') for viral hepatitis C, B and B-D co-infection for 2016. 

In my initial reading about the context in Mongolia, I was very surprised by the high prevalence of viral hepatitis, with hepatitis C estimated to effect 6.8 per cent of the general population (>20 per cent in those aged 40 and over) and hepatitis B around 10 per cent of the population aged 19 and over. There are also high rates of hepatitis B-D co-infection. The key risk factors in Mongolia (dental procedures, tattoos, surgery and being a healthcare worker), are quite different to those in our Australian context, and stigma is reported to be low. Many Mongolians have friends and family affected by the sequelae of viral hepatitis, with the incidence and mortality from liver cancer (>90 per cent attributed to viral hepatitis) in Mongolia the highest in the world. The Mongolian Government have a strong commitment to work towards elimination of viral hepatitis as a public health issue in Mongolia, and have rolled out a national ‘Healthy Liver Program’. This includes subsidies under national health insurance for direct acting antivirals for hepatitis C. The collation of numbers requiring, and numbers on, treatment as part of the treatment cascade is a tool used to support upscaling and targeting ongoing national treatment programs.

For me, this placement was a great opportunity to learn firsthand about WHO as an organisation, including how regional and country offices work at a practical level. The Mongolian Country Office in Ulaanbaatar (UB) is co-located with the Mongolian Ministry of Health (MoH) offices.

The two months that I was in UB happen to be the coldest months of the year, with many Mongolians asking me incredulously “Did you choose to come to Mongolia at this time of the year?” when I first met them. Temperatures were frequently between -20 and -25 degrees Celsius during my 20 minute walking commute to the Country Office. There were mornings that I arrived at work with icicles on my eyelashes. 

These cold months are also the worst for air pollution, a result of a combination of coal burnt by the many families living in gers (nomadic tents) around the more established buildings in the city centre, car fumes and the unique geography of the capital in a valley. I found living with the air pollution a significant challenge, and learnt about advocacy happening in this area through colleagues in the country office.

I also had opportunities to get outside of UB and experience some of the beautiful Mongolian countryside in winter – including some walks in the mountains surrounding the capital, with confronting views of the air pollution sitting over the valley city. Another highlight was seeing very fluffy camels in snow, a contrast to the usual view of camels on the beach here in Broome. 

For public health trainees interested in similar opportunities with the WPRO, more information is available on the WHO website

Dr Sally Singleton
AFPHM ​trainee, WA

A message from your President

AFPHM has developed a fantastic program for the RACP Congress in May, ‘Disruption for healthy futures’; I outline this below. The topic is extremely timely given the findings reported in the World Meteorological Organisation WMO Statement on the state of the global climate in 2017. Last year the global mean temperatures were 1.1 degree Celsius ± 0.1 above preindustrial levels; there is a demonstrated increased risk from heat-related illness, the effects of extreme weather events and the massive internal displacements of populations resulting from drought and food insecurity.

Dr David Pencheon, founder and Director of the NHS Sustainable Development Unit and Public Health Physician (PHP), will open Congress. Health care systems around the world face multiple, often interconnected challenges and opportunities – climate change is one of these challenges. Transition toward a sustainable, resilient health and care system is possible as part of a whole of system response. David will highlight how, between 2007 and 2015, the NHS reduced its carbon emissions by 11 per cent despite increasing activity by 18 per cent.  This presentation will be immediately followed by the Redfern Oration and distinguished PHP and epidemiologist Professor Alistair Woodward is our Redfern Orator. Alistair will continue the theme looking at the risks to human health and set the scene for the sessions that follow examining how the health sector is responding and the role that PHPs are playing. The sessions are:

  • Is the health sector taking climate change seriously? – with a focus on the NSW health system, speakers will examine how Local Health Districts, clinical practice, procurement and how we work intersectorally to shape the urban environment, is making a difference.
  • Disasters and mental health – climate change will make extreme weather events more frequent, intense, longer-lasting and more unpredictable. This session will examine the mental health impacts of flooding, in particular the recent flooding around Lismore in NSW following Cyclone Debbie. To close the session Professor Tilman Ruff will describe the consequences of nuclear conflict, the other great existential threat to civilisation. In addition to the direct loss of life, the particulate matter released into the atmosphere will exponentially exacerbate disruption to the climate.
  • Integrated care and whole of system change – will examine how integrated care can be a mechanism to improve the health of populations. It will examine links to ‘wiser health care’ and ‘sustainable health care’ and the potential impact of these on future health systems.
  • Climate change and its impact on the Pacific - Dr Colin Tukiotonga, Director General of the South Pacific Commission has agreed to speak in this session. Pacific Island countries are among the most vulnerable to the impacts of climate change, due to their geographic, demographic and socioeconomic risk factors, small populations and scarce resources. While contributing the least to the causes of climate change, they are experiencing some of the most severe impacts.

Congress provides an opportunity for a call to action. Health professionals have an essential role to play in addressing climate change and it is time to ramp up the response; to date the responses from Australia and New Zealand have been slow. As part of this call, a themed issue on Planetary Health is being produced by the MJA to coincide with Congress and free copies will be available to registrants. AFPHM Fellows Professors Nick Talley and Tony Capon have taken lead roles in producing this issue.

David Pencheon and Alistair Woodward are both presenting at the National Training Days that immediately precede Congress. David will also be participating in meetings in Sydney, Canberra, Melbourne and Hobart as part of a five week visit to Australia. AFPHM Fellows are helping to set up events so please take advantage of these when they are advertised locally.

If you are looking for a quick update I commend the NASA website, Vital Signs of the Planet, which clearly presents the evidence for rapid climate change: NASA Global Climate Change Vital Signs of the Planet.

AFPHM will draw upon its recent PHP workforce reports, The Unique Contribution of Public Health Physicians to the Public Health Workforce, 2010 and Planned and unplanned futures for the Public Health Physician Workforce, 2017  when it meets with the National Medical Training Advisory Network (NMTAN) to discuss current and future challenges that face the AFPHM workforce. We are currently waiting to be advised of the time of our meeting which is being coordinated by the College.

AFPHM Council identified the need to build on these reports with a workforce strategy at its planning session last year. Meanwhile I commend to you the recently released Faculty of Public Health (UK) document, FPH Workforce Strategy and Standards document. The strategy has four main components to:

  • champion the unique value of public health specialists and to work with employers and other stakeholders to understand that the role is understood and valued
  • ensure that a flexible public health specialist workforce is trained and available to meet population health needs
  • ensure that appropriate workforce date is available and that appropriate workforce planning is undertaken
  • work in partnership with the public health community to ensure an effective workforce that is appropriately supported is able to deliver improvements to public health.

Workforce issues, the STP program and the outcomes of the recent nomination process for regional AFPHM Committees, featured in my meeting this week with the Chairs of the Regional AFPHM Committees for the ACT (Dr Tony Gill and Dr Bronwyn Harvey), Queensland (Dr Jacki Mein) and WA (Dr Tina Bertilone). I have enjoyed these teleconferences immensely over the past two years and thank all the Chairs for their essential contribution to ensuring a vibrant and engaged membership.

I look forward to seeing you at Congress and in particular at the Faculty Dinner on the Sunday evening. The dinner is being held in the beautiful Royal Botanic Gardens overlooking the Harbour. Till then,

Yours in Fellowship
Lynne

Professor Lynne Madden
President, AFPHM

Webinar #3 2018: Public health and sexual health

Many sexual health concepts require a public health framework to assist in their understanding. In this webinar we will cover the Anderson and May equation in sexual health, and how it assists in working out why certain, completely treatable infections persist in populations. We look at which variables are amenable to intervention, and which interventions may potentially make a difference to prevalence.  We will also look at the cervical screening guidelines and how explanation of the changes requires a public health understanding and perspective.

Dr Jacki Mein is a public health and sexual health physician working currently as the Director of Medical Services, Wuchopperen, which is a large Aboriginal medical service based in Cairns. She has worked across the north of Australia from Broome, Darwin and Cairns over the last two decades in both capacities and has a lifelong interest in remote, women’s and Indigenous health.

Date:  Thursday, 26 April 2018
Time:  1pm to 2pm AEST

For information on how to join this webinar, visit the RACP website.

To watch previous webinars, go to our Youtube playlist
If you are interested in presenting a future webinar, please contact AFPHM@racp.edu.au.

AFPHM National Training Days – REGISTER NOW

The highly anticipated 2018 AFPHM National Training Days will be held on Saturday, 12 and Sunday, 13 May 2018 at the RACP Sydney office. Visit the website to register.

Registration cost: $105 (includes tea and coffee, and light lunch). More information regarding the registration fee may be found in a letter from the NTD Working Group.

The AFPHM NTD Working Group has developed another engaging and invigorating program of public health topics and speakers this year, including two internationally renowned speakers covering the following topics:

  • Dr David Pencheon (Director, NHS Sustainable Development Unit, UK)
    Sustainable Development: establishment in the UK, strategy setting, and lessons for trainees on influencing the decision-making process.
  • Professor Alistair Woodward (Head of Epidemiology and Biostatistics, University of Auckland)
    Epidemiological approaches to public health problems.

The program will also include topical presentations from the following Australian public health experts (noting that titles are preliminary, and all content is subject to change):

  • Medicinal cannabis - Dr Tony Gill and Dr Jan Fizzell
  • Building better health – Professor Leena Gupta
  • Environmental health risk assessment - Dr Ben Scalley
  • Aboriginal and Torres Strait Islander health – Dr Tamara Mackean
  • Obesity – Dr Michelle Cretikos
  • Public health careers (expert panel, to be confirmed)
For full details and to reserve your place at this important public health training event visit the website.

RACP Congress 2018 – ​five weeks to go

RACP Congress 2018 will take place at the International Convention Centre, Sydney, from 14 to 16 May 2018. With only five weeks to go make sure you register now for the pre-eminent event for all physicians in Australia and New Zealand.

The RACP Congress program will pose challenges, share the latest clinical and research updates and encourage delegates to think differently with sessions such as, 'Sustainable, healthy urban development: health working with and influencing other sectors to support health protecting environments' with Professor Peter Sainsbury.

For more information on the RACP Congress program and speakers visit the Congress website www.racpcongress.com.au.

History of Medicine Session – RACP Congress

Do you have an interest in the early days of the College? Would you like to share your research?

An opportunity exists to speak at the RACP Congress, 2018 in the History of Medicine Session.

You are invited to submit a short abstract (200 words max) for consideration. We look forward to hearing from our historians.

We invite you to submit your abstracts to Library.Heritage.Committee@racp.edu.au by Sunday, 22 April 2018.

Updated Physician Readiness for Expert Practice (PREP) Program Requirement Handbooks now available

The new PREP Program Requirements are now available on the relevant Basic Training and Advanced Training specialty web pages.

Basic Training
The 2019 Basic Training Program Requirements apply to all trainees registered in a PREP Basic Training program in 2019. Program requirements for 2020 will be released in line with the revised Basic Training Curricula.

Advanced Training
The 2019–20 Advanced Training Program Requirements are available on the new Advanced Training specialty web pages. The 2019–20 Requirements apply to all trainees registered in a PREP program in 2019 and/or 2020.

PREP trainees and their supervisors should familiarise themselves with the updated program requirements for their specialty. It is the responsibility of the trainee to ensure that they are following the correct guidelines for each training year.

Trainees' Day 2018 – reduced registration rate

RACP Trainees’ Day and Trainees' Dinner is an opportunity for Basic and Advanced Trainees to network and discuss professional critical topics and training pathways. 

We are pleased to advise that due to the generous contribution from our sponsors Trainees' Day registration rate is now AUD $50. 

We would like to thank our sponsors Westpac, Avant Mutual, Novartis, Professional Transcription Solutions and the NSW Government for making this reduced rate possible. 

Trainees who have already registered will be contacted and will receive a refund equivalent to the difference in the registration rates.

Register and view the program on the Congress website

Evolve posters at RACP Congress 

Evolve will be at RACP Congress to share and promote effective strategies that help implement the Evolve recommendations into everyday clinical practice. To stimulate ideas, discussions and action, there is an opportunity for you to showcase your work on Evolve to your colleagues. There will be no formal Congress selection process or presentation on these posters. If you are interested in being a part of this event, please contact evolve@racp.edu.au and we’d be happy to support you in developing a poster for display.

Evolve resources
For the latest Evolve resources to help implement the recommendations in your daily work, visit evolve.edu.au/resources.  

Interested in being featured in Women's Agenda?

Women’s Agenda is an online publication for career-minded women that’s looking to feature more women in medicine, and cover issues relevant to women pursuing careers in health. They regularly run Q&As and profiles on a wide range of different women. If you’re interested in potentially being featured, you can contact the Marketing and Communications team at media@racp.edu.au. You can check out the publication online: www.womensagenda.com.au

Faculty 2018 examination dates available online

The Faculty 2018 examination dates are now available on the RACP website. Candidates will be advised when exam application forms are available on the website. This will be prior to registrations opening in 2018.  For more information contact the Examinations Unit at examinations@racp.edu.au or phone 1300 MY RACP (1300 697 227) or +61 2 9256 5444.
 

CPD credits registration date

Due to a technical issue with the MyCPD platform a small number of Fellows were unable to register their CPD credits before the due date – 31 March 2018.

​Impacted Fellows have been individually contacted and have been given an extension until Monday, 9 April to complete their 2017 MyCPD record.

If you have any questions the CPD team can be contacted using the following details.
Australia - MyCPD@racp.edu.au, +61 2 8247 6201
New Zealand - MyCPD@racp.org.nz, +64 4 460 8122

AMA Public Health Awards 2018 – call for nominations 

The AMA is seeking nominations of people or groups who have made an extraordinary contribution to health care and public health. Recipients will be invited to attend the 2018 AMA National Conference in Canberra in May 2018, where the awards will be presented. In the year following the presentation of the awards, recipients will have the opportunity to participate in interviews with interested media, and engage in AMA supported activities promoting their work in their field of expertise. 

Nominations are sought in the following categories: 

  • AMA Excellence in Healthcare Award
  • AMA Woman in Medicine Award.

More information regarding the awards and the nomination process may be found on the AMA website. Nominations close COB Monday, 23 ​April 2018.

Expressions of Interest

Check the RACP Expressions of Interest page at any time, to find out if there are any opportunities that are of benefit to you.

Public Health Expert, National Blood Authority (NBA) Board
The NBA is a statutory agency within the Australian Government Health portfolio that manages and coordinates arrangements for the supply of blood and products and services on behalf of the Australian and state and territory governments. More information may be found on their website.
If you are interested in this position, please contact Ms Kim DeLacy, Director, Blood Policy and Programs section, no later than 19 April 2018.
 

Conferences and events

The Royal Australasian College of Physicians publishes notices of events and courses as a service to members. Such publication does not constitute endorsement or mandating of any such events or courses.

Missioncraft 2018 – Leadership in Disaster Relief

Go to the RACP events list at any time to see what events are coming up.

AFPHM contact details

AFPHM Faculty enquiries (including Council and committees):
Kerri Clarke, Executive Officer, AFPHM
Phone: +61 2 9256 9622
Email: afphm@racp.edu.au

AFPHM Education and Training enquiries:
Lia Iliou, Education Officer
Phone: +61 2 8247 6286
Email: publichealth@racp.edu.au

AFPHM Oral Examination enquiries:
Caroline Greenaway, Examination Coordinator, Assessment and Selection Unit
Phone: +61 2 9256 9681
Email: examinations@racp.edu.au

AFPHM training site accreditation inquiries:
Site Accreditation Unit

Phone: +61 2 9256 9674
Email: accreditation@racp.edu.au

AFPHM CPD enquiries:
Office of the Dean (CPD)
Phone: +61 2 8247 6285
Email: mycpd@racp.edu.au
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