National medical associations to focus on Vitamin D deficiency and its prevention

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Vitamin D deficiency is highly prevalent in India. The reasons for this widespread deficiency include a predominantly vegetarian diet, sedentary lifestyle characterized by long hours spent in indoor spaces, sun-shy behavior of individuals and over-dependence on technology as modes of recreation and entertainment. Majority of the population remains unaware that it is in fact Vitamin D deficiency which is the cause of their vague aches and pains and long-term deterioration of over-all health and well-being.

Seeing the current scenario, the WMA urged National medical associations to support continued research and education on the topic of vitamin D insufficiency during its recent General Assembly. The leaders were of the opinion that vitamin D deficiency is not a country-centric issue, but has global significance given a series of studies that show that deficiency of vitamin D deficiency can also be linked to impaired growth and development of diseases such as osteoporosis, type 2 diabetes, cardiovascular ailments, cancer, among several others.

Adopting preventive actions in high-risk populations at risk may help to control the rising prevalence of vitamin D deficiency that should include large scale awareness campaigns of both doctors and patients. These preventive actions are particularly important in high risk groups – young children, the elderly and pregnant women. In many cases, sun exposure is generally not recommended because it can increase the risk of skin cancer.

World Medical Association recommends the following for all national medical associations:

• Support continued research in vitamin D and its metabolites

• Invest in educating physicians about innovations in vitamin D and its impact on an individual’s health

• Encourage physicians to consider measuring the serum levels of 25-hydroxyvitamin D in patients at risk of vitamin D deficiency

• Monitor development of dietary recommendations for vitamin D

Riot Control Agents: The usage and implications of suppressing riots with lethal weapons

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The World Medical Association (WMA) during its recent meeting held in Moscow urged all the governments to consider the fatal results that might occur post the usage of chemical agents often used to control riots. Governments across the world should understand that stockpiling and usage of such agents be done in a manner, which minimizes the chances of morbidity and mortality.

History has been a witness to political uprisings or riots in many parts of the world, some more severe than the other. The outcomes of these political and social feuds are an innumerable casualties, destruction and a simmering distrust or conflict between the two parties. In the past, various means were used for law enforcement in the event of such uprisings or riots. The use of poison gas during the First World War is one such example. This ultimately led to a call from the International Committee of the Red Cross (ICRC) in February 1918 for the cessation of its use. This led to the Geneva Protocol of 1925, the Biological and Toxin Weapons Convention of 1972 (BTWC) and the Chemical Weapons Convention of 1993 (CWC).

• These conventions prohibit the development, production and stockpiling of chemical weapons in addition to their usage in warfare and call for measures to decommission or destroy existing stores

• The CWC allows the use of specific chemicals in domestic law enforcement including riot control situations, which means that governments might hold stockpiles of certain agents and use only in domestic or national jurisdictions

• Although there is academic and military interest in what is often called non-lethal weapons, the incidence of morbidity and mortality caused by weapons are not criteria used in prohibition. A tiered approach based on degrees of lethality of specific weapons is contrary to the ethos of both conventions

• The use of riot control agents in situations of widespread public unrest and political or other uprisings may give rise to specific medical, legal and ethical challenges, despite not being in conflict with the principles of CWC

Riot control agents are still being used despite the long-standing concern regarding their safety and associated health hazards.

These riot control agents are not expected to directly cause any injuries or deaths. But they might impact the population based on determinants of age and health.

Release of chemical agents such as tear gas in a small enclosed space exposes individuals to concentrations far higher than those expected in normal deployment in riot situations, causing higher levels of serious morbidity and potentially death.

Their misuse can cause serious harm to the demonstrators and even death. Using chemical weapons for oppressing non-violent peaceful demonstrations, may lead to a breach of the human rights of the individuals concerned, in particular the right to life (Article 3), the right to freedom of expression (Article 19) and of peaceful assembly (Article 20) of the Universal Declaration of Human Rights.

WMA recommendations

• The decision of deploying such riot control agents be taken carefully as their inappropriate use endangers the lives of those targeted and exposes people around, amounting to a potential breach of human rights standards, in particular the right to life, the right to freedom of expression and of peaceful assembly as stated in the Universal Declaration of Human Rights.

• Riot control agents, if used, should be done in a manner designed to minimize the risk of serious harm to individuals, and to prohibit its use in the presence of vulnerable populations, such as children, older people or pregnant women.

• The riot control agents should never be used in enclosed spaces where chemical concentrations may reach dangerous levels, and where people cannot move away from areas with high concentrations of the agent.

• Police and other security forces should be trained in the safe and legal use of riot control agents to minimize the risk of harm when they are deployed such as rapid evacuation of any individual who is apparently suffering from a high level of exposure, not aiming people, and avoiding excessive use of the agent.

• States should penalize individuals who misuse riot control agents and who deliberately endanger human life and safety by using the agents.

• The governments should provide for unrestricted and protected access of healthcare personnel to allow them to fulfill their duty of attending to the injured as outlined in the “WMA Declaration on the protection of healthcare workers in situations of violence.”

• Above all, their use in any circumstances should be refrained, considering risks to health and life associated with the use of such riot control agents.

Doctors for Social Responsibility: Fight against Nuclear Weapons

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The terrible aftermath of the atomic bombings on Hiroshima and Nagasaki 70 years ago has not been forgotten even today. These bombings devastated these cities and killed several thousands of people and the horrifying after effects in the form of cancers, radiation injuries and suffering are still being studied today. After the bombings, the land became absolutely ravaged and there wasn’t anything left that could be used for sustenance further.

These bombings and the tremendous destruction that they left behind have changed the perception about nuclear bombs.

Lamenting the circumstances, way back then, doctors had warned the world against the devastating effects of nuclear weapons. And since then, doctors from across the world have stood steadfast and united against all kinds of nuclear tests and other such activities.

The recent WMA Declarations of Geneva, Helsinki and Tokyo have shed light on how doctors from all across the globe have stood up for humanity and social responsibility. As the nations are proceeding towards development, doctors are being encouraged to act on their responsibilities beyond curing their patients. Given the importance and status that doctors are accorded in our society, they are being called to serve the world for the cause of humanity. The WMA recognizes its duty towards working for elimination of nuclear weapons.

The WMA took the declaration forward by:

  • Agreeing that the world together should condemn the development, testing, production, stockpiling, transfer, deployment, threat and use of nuclear weapons
  • Requesting all the respective governments to refrain from the development, testing, production, stockpiling, transfer, deployment, threat and use of nuclear weapons and to work in good faith towards the elimination of nuclear weapons;
  • Advising all governments that even a limited nuclear war would bring about immense human suffering and substantial death toll together with catastrophic effects on the earth’s ecosystem, which could subsequently decrease the worlds food supply and would put a significant portion of the world’s population at risk of famine
  • Requesting that all National Medical Associations join the WMA in supporting this Declaration, use available educational resources to educate the general public and to urge their respective governments to work towards the elimination of nuclear weapons
  • Inviting all National Medical Associations to join the WMA in supporting this Declaration and to urge their respective governments to work to ban and eliminate nuclear weapons
The world needs a strong support system of doctors to ensure the universal slogan of peace across the globe.
Nuclear weapons are highly destructive in nature and pose an existential threat to humanity. If used, they can kill several millions of people and destroy the ability of the planet to sustain life.
It’s time we react before all is gone!

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