From the President: May 2017

Photo: President Howe and Palestinian colleagues including new president Mohammad Raba’l holding the WONCA shield

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Prioritising people’s needs – four thoughts on equity from this month’s WONCA business

A busy month in April / early May – I attended a conference as a keynote speaker, in Tunisia run by the ‘Towards Unity for Health’ (TUFH) network; then went to Palestine to the first conference of their new family medicine association; closely followed by the Rural Working Party conference in Cairns, Australia.

The Tunisia conference was about ‘Improving the Social accountability of Educational Institutions’. It focused on how to ensure that universities and other key providers of health workforce training focus their work on the needs of populations – rather than sources of income, or less applied areas of research. Social accountability was defined by WHO in 2010 as “the obligation to direct education, research and service of activities towards addressing the priority health concerns of the community, region and/or nation that they have a mandate to serve”. I gave a keynote on embedding the values and ‘competencies’ of social accountability through the educational process. This was an excellent chance to emphasise the role of family medicine in making learners aware of the causes and consequences of people’s ill health, as well as inspiring a person centred view and encouraging others to work outside the hospital setting.

WONCA’s profile at the meeting was enhanced by contributions from Prof Amanda Barnard (WONCA Working Party on Women in Family Medicine), and Mayara Floss (WONCA Working Party on Rural Practice- WWPRP), who won one of the student prizes! Other allies included Prof Jan de Maeseneer, and Katherine Rouleau of the Canada Besrour Center – accompanied by its benefactor Dr Sadok Besrour, who is Tunisian, and is a key supporter of family medicine development. This was an excellent conference, and I would encourage you to review the outputs on the TUFH website.

Then on to Palestine, where I was invited to be a keynote speaker at the first conference of the newly formed Palestinian Association of Family Medicine (PAFM). This invite was supported by some of my UK colleagues in academic family medicine, who have been working for almost five years in a ‘twinning’ project to support developments in family medicine. They have been partnering with early leaders in the country such as Dr Mohammad Raba’I (first president of PAFM), Dr Samar Musmar and Dr Lubna Al-Saudi (leading the new academic FM unit at Al Najah University, who have already joined WONCA!); and jointly securing support from the Ministry of Health, WHO and various funders.

Photo: President Howe and Dr Lubna Al-Saudi at her office in Al-Najah University

It was a profound learning experience to see the challenges in the West Bank, but also to experience the excitement of the GPs and first generation of FM residents at the 200+ person conference. I also visited some of the first accredited training sites, the university, and supported evidence and discussion at meeting with MoH and WHO. The equity issue here is the need to prioritise new members, especially in zones of political conflict, and to use our skills and relationships at personal and country to country level to try to support development over time. I know that our WONCA regional President is keen to welcome the PAFM and to add to the developments in Palestine at this early and promising – but fragile, stage.

Next, Cairns – I cannot write about what happened there yet (as I write before I attend this conference). We know the WONCA Working Party on Rural Practice have organised an excellent programme, with tours to remote and needy communities, a shared summit on the issue of rural medical generalists (family doctors? others? – we shall discuss…), and the overall thrust on the equity issue of securing and strengthening the rural and remote FM workforce. I look forward to seeing old friends, meeting new friends, being worked hard, and learning much!

Finally, we shall celebrate World Family Doctor Day on 19 May –and this year are picking up the theme of mental health, which is a key issue in everyone’s life. Patients with serious mental health illnesses, or those who have been psychologically damaged by personal traumas, have particular challenges to meet. As family doctors, we have a need to ensure their care is as good as that of other patients, who are sometimes more able to ask for help; that our systems enable them to access our care; and that we ourselves are sufficiently supported and skilled to meet the needs of what can be a challenging and needy group of people. Fortunately, our WONCA Working Party on Mental Health is doing wonderful work to help our members to access the latest evidence on what we can do as family doctors to help both prevent and make better people’s mental health problems.

So – different equity challenges – for family medicine in education; countries who are new to family medicine; rural workforce; mental health. All focusing on the best outcomes for the most needy.
I am also concerned to sustain our members to meet these challenges, so – as always – please make sure you care for yourselves as well as others in this demanding work. If you want help please ask a colleague – ask WONCA! – and sustain yourself so that you can deliver for others. Keep well!

Amanda Howe