15 Jun 2006

Summer Conferrings at University College Cork (UCC), 15 June

Over 400 students graduated today  (15 June 2006) at UCC's 2006 Summer Conferrings.  Students graduated from the College of Medicine and Health in Medicine, BMedSc, BDS, MBS (Health Services Management), BSc Nursing (Psychiatric), BSc Nursing (Intellectual Disability), BSc (Nursing Studies) and BSc Nursing (General).  49 students were awarded doctorates from the Colleges of Science, Engineering and Food Science; Medicine and Health; Business and Law; Arts, Celtic Studies & Social Sciences.  Professor Gerald Fitzgerald, Department of Microbiology, UCC was awarded a DSc degree and a DLitt was awarded to Joe Ruane, Department of Sociology, UCC.  Tony O'Mahony was awarded an Honorary MSc (citation attached).

The Conferring addresses were delivered by Dr Mary McLoughlin, Health Advisor to GOAL's Primary Health Care programmes in the developing world (attached) and Mr Frank Ahern, former Assistant Secretary General, Department of Health and Children (attached).

TEXT OF ADDRESS for the Conferring of Master of Science (honoris causa)  on Mr Tony O'Mahony at University College Cork delivered by Dr Tom Kelly

Tony O'Mahony, the recipient of today's honorary degree, is a legend among his peers-both amateur and professional. He is widely regarded as one of the foremost, if not the foremost, field botanists of his generation in Ireland. What does this mean? It means that he can recognise and identify most of the 900 or so native Irish plant species. To do this he had to master the complex structure and distinctive features of each of the plant species belonging to the Irish flora. For many professional biologists this would be the outcome of a lifetime's work, accomplished after long hours in the laboratory and university library.

But the remarkable character of Tony O'Mahony's achievement is that his unique depth of knowledge and expertise is self-taught. Tony, though a national figure in the pantheon of Irish botany, never had the privilege of a modern secondary or third level education.
Born into a loving family in Cork City in 1949, Tony attended the National School at Strawberry Hill and then the Crawford Technical College, but left formal education at the age of 14. Before this however, at the age of seven, Tony had an experience which set his destiny as a botanist. At Sallybrook, on the banks of the Glashaboy River, the discovery of a chicory plant stimulated a strong interest in medicinal plants and herbs. Many of the most famous drugs used in medicine such as aspirin, quinine and penicillin have been extracted from one type of plant or another. By the age of 12 he had read every book in the City Library dealing with herbs and medicinal plants. At the age of 14, although still deeply fascinated with the medicinal uses of plants, his interests in botany broadened and he began to systematically record the distribution of the flora in his native county.

In 1966, at the age of 17 Tony made an important discovery. His father, a keen fisherman, also delivered goods and took Tony to the town of Macroom. Here he discovered a hawthorn tree which he identified as the Midland Hawthorn Crataegus laevigata. At the time Professor David Webb, of Trinity College Dublin, was the expert on the plants of Ireland, but the Midland Hawthorn was not in his famous book An Irish Flora. Naturally, Tony enquired of Professor Webb why this species was not in the list. And got the reply that there had been no reliable record, though several misidentifications had been reported. Eventually Professor Webb, who must have been dubious of the claims of this callow youth, requested proof, which Tony obtained and sent to Trinity College. He got an immediate and typically generous reply, which read "I apologise; I withdraw; I eat dirt!!" And so, in 1973, T. O'Mahony published his first scientific paper on "the first definite record" of the Midland Hawthorn "for" Ireland. A total of 42 additional scientific papers have been published since then in journals such as Watsonia, Bulletin of the Irish Biogeographical Society, Irish Naturalists'Journal and the Irish Botanical News. Tony has contributed chapters to books and to survey reports including several undertaken by personnel at UCC. He has also drawn up plans for the conservation and management of plant communities in such important sites as the Gearagh, Kilcolman Bog, and Lough Beg in Cork Harbour.

Together these scientific publications represent a major and unique contribution to the documentation of Ireland's plant Biodiversity and its conservation.

In 1971 Professor Webb put Tony in contact with Dr John Cullinane of the Department of Botany in UCC. As a result Tony was given a microscope which proved to be essential to the continuation of his studies now ever more detailed, intricate and meticulous.
Tony also makes excellent drawings of plants and in an invited series entitled "Our Wildlife Heritage" he illustrated 24 wildflower articles in the Cork Examiner, which were published in 1986. As a writer his style is interesting and simple which is so vital in making science available to the wider public.

For example, he is outstanding at depicting the excitement of discovery. In June 1969 he rediscovered a plant species known as Little Robin Geranium purpureum which was first found in Ireland in 1832 but had not been recorded in this country since 1882. Tony found this species at three separate locations in one week !! leading to its re-instatement on the Irish list. Writing about the visit of two Cork botanists (Isaac Carroll and the Rev Thomas Allin)  to Kilcolman Bog in 1870 and their discovery of two very rare plant species (golden dock and red goosefoot) he states "One can well imagine their thrill at finding the nationally rare golden dock, a highly distinctive plant with very narrow grass-like leaves, which turn golden brown at the fruit stage in the autumn. He goes on to say that Kilcolman is also "the only inland Cork station of the grotty looking red goosefoot, which otherwise is confined to a very few coastal pools in the county". His most recent paper, on the addition of another new species to the Irish list of plants, is a perfect blend of technically dense material and a simple but exciting account of the find !!
Although Tony O'Mahony's publications are examples of excellent natural science, he himself does not fit neatly into the definition of a scientist. In a book entitled the "Limitations of Science" (1984) the late Sir Peter Medawar, a Nobel laureate in Immunology wrote about how the Humanities, as he put it, "avenge themselves on scientists for being so busily and to all appearances so happily employed and for getting a big cut of the governmental grant- for are they not the nouveaux riches of the campus, these half-educated and barely articulate tradesmen with coarse or unawakened sensibilities with whom conversation at table is such an ordeal?"

Well it is entirely true to say that Tony O' Mahony never got a cut of the "governmental grant" and no one would accuse him of being uninteresting in conversation. Quite the contrary, he has very wide interests and in particular is fascinated by psychic phenomena and the paranormal. Tony is also a gifted musician who has performed in public on many occasions.

But his greatest contribution so far is in the documentation of Ireland's floral biodiversity based on his own mastery of the intricacies of plant taxonomy (the science of identification and classification). He is deeply concerned at the demise of taxonomy which he describes as a cinderella science, but one which critically underpins all serious research into biodiversity and how it is responding to, for example, climate change.
Over 150 years ago, when the world was a much quieter place, William Wordsworth wrote in his poem The Excursion the lines
 "Strongest minds /are often those of whom the noisy world/hears least"
Today, a very strong, gifted and determined mind has been heard.


CONFERRING ADDRESS by Dr Mary McLoughlin, Health Advisor to GOAL's Primary Health Care programmes in the developing world

Introduction

When graduating in 1981 I little thought that I would be addressing newly qualified doctors at a ceremony like this. I was not a grade A student, (mostly scraped pass results), and did not have an interest in research so did not think that UCC Medical School would ever have a reason to give me an award. My great interest at the time was traveling, meeting people of other cultures and studying their way of life. In fact, when I requested permission from the then Dean of Medicine to take a year off between 4th and final Med to travel around the world, he told me I would "end up pushing trolleys". This interest in other cultures formed the background to the humanitarian assistance work that has qualified me for this award today. I'm very happy that UCC Medical College can see merit in diverse achievements rather than solely in archenemy greatness. This broadens the scope for acknowledgement of the achievements that all of you will make during your coming medical careers.

My work in Humanitarian Assistance

Inequalities in Health Provision Between the Developed and Developing world
Let me give you a few facts about the inequalities in health provision between the developed and developing world before I talk about the different ways in doctors can contribute to reducing morbidity and mortality in developing countries.
Statistics speak eloquently of these inequalities.
* Thanks to effective drugs and vaccines, infectious disease account for only 10% of deaths in Developed Countries. They account for 60% of deaths in Developing Countries and, according to WHO, 50% of these could be prevented.
* In Africa, a mere 1.3% of the world's health workers struggle to care for people suffering 25% of global disease burden. Large parts of sub-Saharan Africa have effectively no health care at all. The "brain drain" of health workers from Developing to Developed Countries is fueling this health worker crisis.
* The Global Forum for Health Research records $70 billion spent worldwide on health research every year and only 10% is spent on research into 90% of the world's health problems, (the so-called 10/90 Gap).

This inequality in health is not only claiming lives but is crippling communities and undermining economic growth.

Paths doctors can take to reduce morbidity and mortality in Developing Countries
We all know that there is a shortage of doctors in all developed countries, including Ireland, and that this shortage will be a greater burden to the west as populations age and life expectancy increases. However, this burden is heaviest in developing countries as I have outlined above so I will do a little bit of advocacy for this problem here.
Today a lot more is known about how doctors can assist people in crisis than when I graduated. Hollywood has played a role here and I believe that some recent episodes of ER were shot I Darfur, a situation that the UN classes the world's worst humanitarian crisis. To stimulate your interest in a possible future role in humanitarian assistance, let me outline a few paths that doctors can follow, either full-time or part-time.  

1. Hands-on medical work
This type of work includes surgical work with international orgnaisation like the Red Cross and Mededines Sans Frontieres (MSF) in response to natural disasters such as earthquakes and for the injured in war zones. It also includes work in missionary hospitals where doctors spend some time as part of a national staff teams, concentrating more on training than doing the actual surgery. There is very little need for doctors to be involved in non-surgical hands-on work as this is more cost-effectively and sustainably done by national staff health workers, possibly guided by international public health people. Another cost-effective hands-on role for expatriate doctors is managing hospitals, (usually missionary hospitals as few Ministry of Health Departments will permit expatriate management).    

2. Public Health
The vast majority of expatriate doctors, nurses and other health personnel that work in Developing Countries are engaged in managing and administrating public health programmes during crisis situations, (wars, famines, floods etc). Even in active war zones most deaths are due to illness rather than injury. Prevention and timely effective treatment of infectious illness is what saves most lives. The majority of the estimated 200,000 deaths in Darfur have not been from fighting but from diarrhoea, malaria, respiratory tract infections and malnutrition due to people being displaced from their homes and their usual coping mechanisms.  Expatriate health workers are involved in:
* getting official permissions to set up camps:
* recruiting local staff to do the hands-on medical work;
* the logistics of ordering and funding drugs/medical supplies;
* training local staff and supervising their work;
* writing project proposals/reports to donors to keep the funds flowing.
This is all a lot less exciting than what the ER team was up to when in Darfur but it is the reality on the ground rather than Hollywood. This type of work is what I've spent most of my time at in the last years.

Doctors are often disappointed with the type of work they are involved in when volunteering for public health jobs with International Organisations in Developing Countries. But with time, they realise that correct management of such programmes rather than hands-on work has the greatest impact in reducing morbidity and mortality. In my early days in Africa I was horrified to discover that I would be spending most of the day in an office on a computer rather than in clinics or hospitals but now see how important that is.

3. Capacity Building Ministries of Health staff
      This can be a part-time as well as full time involvement in developing countries. Thus, it is something that is of particular interest to many Irish doctors. It is as diverse as spending a week of ones holidays in a hospital demonstrating new surgical/medical techniques to spending years with WHO or the World Bank working with national Ministries of Health to develop their health structures. 

4.  Advocacy Work
There is the huge area of advocacy work ranging from the world renowned Bono/Geldorf "Drop the Debt" campaigns to something as localized as my appeals to the UN and NATO to stop the shelling of Gorazde when I was trapped in that town during the Bosnian war. There is place for all medics to get involved in either part-time or full-time advocacy work for better health services in Developing Countries, (and better economic situations to support them). You might well say there is place for us to do this for the A&E crisis in our own country, (I believe that some of our casualties were rated "Third World" by an English consultant recently), but the health needs of the poor in Developing Countries are great and they urgently require a great number of voices appealing for them.

That's all.


CONFERRING ADDRESS by Mr Frank Ahern, former Assistant Secretary General,  Department of Health and Children

The good news is that I will not detain you too long as you want to get on with the enjoyment of the day. This is a great celebration for you all but I would make a few important points quickly because of the significance of today.
 
First a word to you the new graduates.
 
You can feel very proud of yourselves and your achievements. There is something very special about being the first at anything. No other group will ever be the first to reach degree status so you are the pioneers.  You are the advance guard of tomorrow's modern nursing workforce and others over the years will follow in your footsteps. You have a duty therefore to remain at the top and I know you will rise to that challenge.

You may feel now that you will never ever want to look at a textbook on nursing again but after you have fully enjoyed your achievement and settled back after your travels I expect you to go on to become nurse managers or clinical nurse specialists or advance nurse practitioners. When you have seen all the sunny climates that nurses tend to see today and come back from Australia or wherever else I would like you to take the challenges and opportunities presented by the new career structure in nursing.
 
I would like to say a few words now about the degree programme.

People of my age might be forgiven for talking about the times 20 years ago but back then a degree programme for nursing was regarded as "pie in the sky". We used to congratulate ourselves on having the best  nurses in the world and say how every country wanted Irish nurses. That was true but what wasn't widely known was that while our nurses were highly regarded the quality of our nurse education programme was not as widely admired. In countries like the United States the lack of a 3 rd level qualification was prohibiting them from receiving the top level pay rate in American hospitals and when Geraldine McCarthy explained the position to me it became a wake up call. That is when I began to listen carefully to Geraldine who was now educating me.

The Diploma programme and its development was very important in that it brought nursing into 3 rd level education in a significant way. It also provided for an incremental approach to change which allowed for some time to take the new situation into account and work on from there. It changed the profile of nursing forever and put nurse training on a totally different footing. While mistakes were made in the Diploma programme, for instance it was too front loaded it nevertheless became the next step for the move to the degree programme. 

The Commission on Nursing
It is hard to over emphasise the importance of the work of the Commission on Nursing for nursing in Ireland. Rarely have we seen such a major piece of work which has been implemented with such commitment as this report. During this period it was my privilege to be the Director of Human Resources and while my then colleague Dr Ruth Barrington served on behalf of the department I was the person with the difficult challenge to drive the implementation process sand this became very satisfying work and It is a great treat to come here today to see the finished products.

I could never have accomplished what we set out to do on a number of fronts without the excellent team in the Department of Health and Children.

In particular Bernard Carey who was then the Principal Officer in the Nursing Policy Division, which was set up to implement the commission's report, was the person who worked hardest and longest on this project and should get the praise for doing the business.  

I also want to place on the record the work of Dr Laraine Joyce who was then with the Office for Health Management and Dr Siobhan O Halloran now with the Dundalk Institute of Technology for their work in advancing the programme.

I want to make an important point here at a stage when we have so much criticism of public service management that this project was brought in on time and within the budget with the highest student intake ever for nursing.

For you the parents.

I know how good it feels to attend your child's nursing graduation as it is not so long ago that I attended my own daughter's graduation in nursing. I am very proud of her and the choice she made. I believe that for parents it is very important that nursing has degree status because where a person makes a choice to work on patient care and place patients at the centre of their career the recognition for this study should attract the same level of qualification as that for other disciplines. Nurses have the same right to academic recognition as their brothers, sisters or cousins who chose other career paths. You will also want to be happy that this new qualification has prepared your children well for this particularly difficult career.
    
The Health Service of the Future

You will be working in a different type of health service from that of 20 years ago. In the past individuals were given specific tasks and they carried them out individually. To day the emphasis is on team working and nurses are an essential element of that team. You will be expected to work as part of interdisciplinary team where the different health and social care professionals work with the patient at the centre. This concept ensures that the patient comes first and a holistic approach to the patient and his or her situation is taken at all times.

At its very basic it will stop different health care professionals asking the same question of the patient. At its best it will ensure that the benefit of the knowledge and skills of all the professionals will be brought to bear for the very best treatment that can be provides.
Conclusion

All that remains for me to do now is to wish you well in a great career and wear your UCC badge proudly.

244MMcS