Health and disease among Somali primary school children in Hargeisa

Background and objective: Limited data exist on health conditions of school children in Somaliland. School Health Intervention Pilot Program (SHIPP) was conducted through Edna Adan University Hospital to screen children and offer interventions. We present the results of the general health screening of the school children, and also describe the association between nutritional status and other variables.

Methods: In this cross-sectional study children from two public primary schools in Hargeisa were assessed for general health by nursing students. Nutritional status was assessed by BMI-for-age z-scores and visual acuity by Paediatric Snellen Chart.

Results: We screened 2,093 children aged 4–19 years; 58% were boys. Very low BMI-for-age (z-score < −3) was detected in 10%; 6% had visual acuity below 0.7; 26% had dental caries. Children reported low exposure to health services: 33% reported no prior vaccination; 46% reported they had never visited a health clinic or hospital.

Conclusion: A significant number of children were malnourished, had reduced visual acuity or treatable infections which could impact their ability to learn. Public schools are a feasible entry point for public health action including screening, treatment, and referral in fragile countries.

Medical students' attitudes towards conscientious objection: a survey

OBJECTIVE

To examine medical students' views on conscientious objection and controversial medical procedures.

METHODS

Questionnaire study among Norwegian 5th and 6th year medical students.

RESULTS

Five hundred and thirty-one of 893 students (59%) responded. Respondents object to a range of procedures not limited to abortion (up to 19%)-notably euthanasia (62%), ritual circumcision for boys (52%), assisted reproduction for same-sex couples (9.7%) and ultrasound in the setting of prenatal diagnosis (5.0%). A small minority (4.9%) would object to referrals for abortion. In the case of abortion, up to 55% would tolerate conscientious refusals, whereas 42% would not. Higher proportions would tolerate refusals for euthanasia (89%) or ritual circumcision for boys (72%).

DISCUSSION

A majority of Norwegian medical students would object to participation in euthanasia or ritual circumcision for boys. However, in most settings, many medical students think doctors should not be able to refuse participation on grounds of conscience. A minority would accept conscientious refusals for procedures they themselves do not object to personally. Most students would not accept conscientious refusals for referrals.

CONCLUSIONS

Conscientious objection remains a live issue in the context of several medical procedures not limited to abortion. Although most would want a right to object to participation in euthanasia, tolerance towards conscientious objectors in general was moderate or low.

[Medical students' attitudes towards legalisation of euthanasia and physician-assisted suicide]

BACKGROUND

We wished to investigate prevailing attitudes among future doctors regarding legalisation of euthanasia and physician-assisted suicide. This issue is important, since any legalisation of these practices would confer a completely new role on doctors.

MATERIAL AND METHOD

Attitudes were identified with the aid of a questionnaire-based survey among medical students in their 5th and 6th year of study in the four Norwegian medical schools.

RESULTS

Altogether 531 students responded (59.5% of all students in these cohorts). Of these, 102 (19%) were of the opinion that euthanasia should be legalised in the case of terminal illness, 164 (31%) responded that physician-assisted suicide should be permitted for this indication, while 145 (28%) did not know. A minority of the respondents would permit euthanasia and physician-assisted suicide in other situations. Women and those who reported that religion was important to them were less positive than men to permitting euthanasia or physician-assisted suicide.

INTERPRETATION

In most of the situations described, the majority of the students in this survey rejected legalisation. Opinions are more divided in the case of terminal illness, since a larger proportion is in favour of legalisation and more respondents are undecided.