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Use of malarial prophylaxis amongst a population of expatriate church workers in Northeast Zaire.

In common with much of subSaharan Africa, falciparum malaria is a major cause of mortality and morbidity amongst the indigenous population of northeast Zaire1 although there are some mountainous areas in the east of the region that are relatively free from the parasite. There are a significant number of expatriate church workers (missionaries) in the area who work mainly in the health and development sector or directly with the local church in bible translation, evangelism, etc. The lifestyle of these workers, who tend to live close to the indigenous population, and their length of stay in a malarious region means that they are at high risk of contracting malaria.1 This population has been inadequately studied concerning its use of chemoprophylaxis and other measures necessary to reduce the risk of malaria. Many countries have published guidelines2-4 on the use of chemoprophylaxis for the prevention of malaria in travelers. This study was planned to investigate whether these guidelines were being followed by this group of missionaries. It also enabled the author to investigate who or what influences decisions regarding malaria prophylaxis amongst this population.

Adolescent↗

Critical incident stress debriefing in international aid workers.

Missionaries are well known to suffer the effects of stress. Patricia Miersma relates missionary stress to combat related stress. 1 Development workers too are known to be at increased risk of death whilst overseas-mostly due to traumatic incidents. Relief workers voluntarily enter high stress situations. These overseas workers are at real risk of Post Traumatic Stress Disorder (PTSD). The issue of Critical Incident Stress Debriefing (CISD, or Psychological Debriefing) has been critically examined in an editorial in the British Medical Journal.3 The first randomized, controlled study of CISD that we are aware of (for motor vehicle accident survivors) was published in 1996.4 With 54 intervention subjects, it did not demonstrate effectiveness.

Counseling↗

Vocational training.

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Education, Medical, Graduate↗

Obstetrics in Nazareth.

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Education, Medical, Undergraduate↗

The depressine Syndrome: a follow-up study of 130 professionals working overseas.

A four-year follow-up of professional personnel who had been working overseas indicates that the depressive syndrome was the most common diagnosable psychiatric illness in this population. The study also shows that in this content the syndrome had a good prognosis. It therefore seems reasonable not to exclude persons with diagnosable depression from assignment abroad but, rather, to identify the syndrome and recommend necessary treatment.

Adult↗

Hereditary physicians of the Scottish islands.

With the demise of the delivery of health-care by the Columban missionaries in the Scottish islands, there evolved a system of medical care by clan officers. These highly educated clan-physicians held office through hereditary tenure. Evidence is strongest for the existence of the Beaton physicians, but other families, including the O'Conachers, MacLachlans and MacLeas, held similar appointments. These hereditary physicians declined in importance with the demise of the clan system, when other physicians, holding patronage from the landlords, came to the islands.

Genealogy and Heraldry↗

Scottish women medical pioneers: Manchuria 1894-1912.

In Edwardian Britain, less than 2% of all registered medical practitioners were women. Yet during that era, women played a significant role in providing medical care and education in what were lonely, harrowing and difficult conditions in the Third World. This is the story of how a group of Scottish women doctors brought Western medicine to a remote region of Manchuria between 1894 and 1912.

China↗