Wonca News - June 2006

From the Wonca President:

Health Professionals Unite on

Patient Safety

From the CEO’s Desk

Gender Equity in Wonca

From the Editor

Examining the Roles of Women Family

Doctors

FEATURE STORIES

•Working Party Seeks to Enhance Role of Women Family Doctors

in Wonca and Health Systems

•Working Party Releases First of a Series: Women in Organizational

Medicine

Wonca REGIONAL NEWS

•Wonca Europe Region to Convene in Florence

•1st Wonca Iberoamerican-CIMF Regional Conference to Meet in

Buenos Aires

•El Primer Congreso Regional de Wonca-CIMF Iberoamericano Realizara

en Buenos Aires

•Come to Bangkok for the Asia Pacific Regional Conference

HEALTH AND HEALTH SYSTEM NEWS

•Wonca Representatives Attend the World Health Assembly

•Wonca Mourns the Death of WHO Director General, Dr LEE Jong-wook

MEMBER AND ORGANIZATIONAL NEWS

•Register for the 7

Wonca World Rural Health Conference in Seattle

•Tomlin Paul - Wonca Global Family Doctor for May 2006

RESOURCES FOR THE FAMILY DOCTOR

•The World Health Report 2006: Working Together for Health

•Lifting the Smoke-screen - 10 Reasons for a Smoke-free Europe

•Call for Papers Issued by Education for Health Editors

WONCA CONFERENCES 2006-2011 AT A GLANCE

GLOBAL MEETINGS FOR THE FAMILY DOCTOR

VOLUME 32

NUMBER 3

JUNE 2006

CONTENTS

Wonca website:

http://www.GlobalFamilyDoctor.com

Wonca President

Prof Bruce Sparks, South Africa

2 Cruden Bay Road

Greenside

Johannesburg 2193

South Africa

Tel: 27 11 646 2140

Fax: 27 11 717 2558

Email: brucespa@global.co.za

Wonca Chief Executive Officer

Dr Alfred W T Loh

Wonca Administrative Manager

Ms Yvonne Chung

World Organization of Family Doctors

College of Medicine Building

16 College Road # 01-02

Singapore 169854

Tel: 65 6224 2886

Fax: 65 6324 2029

Email: admin@wonca.com.sg

Wonca President-Elect

Prof Chris van Weel, Netherlands

Wonca Immediate Past President

Dr Michael Boland, Ireland

Honorary Treasurer

Richard Roberts, MD, USA

Wonca Regional Presidents

Dr Abra T Fransch, Africa

Warren A Heffron, MD, Americas

A/Prof Goh Lee Gan, Asia Pacific

Prof Igor Svab, Europe

Dr Shatendra K Gupta, Middle East

South Asia

Dr Adolfo Rubinstein,

Iberoamericana-CIMF

Wonca Executive Members at Large

Dr Javier Dominguez del Olmo, Mexico

Prof Michael Kidd, Australia

Richard Roberts, MD, USA

Chair, Bylaws and Regulations

Dan Ostergaard, MD, USA

Chair, Publications & Communications

Dr Geoffrey D Martin, Australia

Editor, Wonca News and Editorial Office

Marc L Rivo, MD

4566 Prairie Avenue

Miami Beach, Florida 33140, USA

Tel: 305 671 7327

Fax: 305 674 8839

Email: marcrivo@aol.com

WONCA GLOBAL SPONSORS

FROM THE WONCA

PRESIDENT:

HEALTH PROFESSIONALS

UNITE ON PATIENT

SAFETY

“Health workers are a positive

asset, not a cost item”

Dr Tim Evans

Assistant Director-General

Evidence & Information for Policy,

WHO

Geneva, May 2006

I had the pleasure of attending,

as an observer, the World Health

Professions Alliance (WHPA) Leaders

Forum: Working Together for Safe

Health Care in Geneva from 20 – 21

May 2006. The main theme of the

meeting related to patient safety,

but the global shortage of health

personnel was also addressed. The

WHPA is an alliance of nurses,

pharmacists, physicians and dentists

represented by their respective

organisations, namely the

International Council of Nurses,

International Pharmaceutical

Federation, World Medical

Association, and the World Dental

Federation. These organisations thus

represent millions of health

professionals globally, seated jointly

in country delegation clusters.

The unfortunate and sudden

collapse and death of the Director-

General of WHO, Dr LEE Jong wook

that weekend placed a major pall

over the later proceedings of the

meeting. His major contributions to

polio eradication, access to

medication, support for treatment of

HIV/AIDS patients globally, health

human resource development and

preparation for a possible avian flu

pandemic were acknowledged and

praised.

WONCA

News

FROM THE WONCA PRESIDENT

Despite the sad news about Dr

Lee, the gathering of world leaders

contributed actively to discussions

around patient safety, combating

counterfeit medicine and materials,

developing inter-professional teams

for safer health, and the crisis in

health professional resources

globally. What impressed me was

the collaborative and mutual respect

demonstrated by the representatives

of the four major professions to

each other. There were some

statements about turf issues,

especially the concern from

pharmacists about their limited

clinical roles in patient care.

Dr Yoram Blacher, a WMA

executive member from Israel set

the scene on patient safety and

medical errors. He indicated that it

is estimated that 10% of the world’s

population who receive health care

have had their health affected by

errors. This figure pales in the wake

of the number of ‘near misses’. The

usual response is unfortunately to

find the guilty parties rather than

attempts to improve the system. He

indicated that studies had shown

that many health professionals were

pushed out of medicine altogether,

or into ‘safer’ professions and

disciplines. Defensive medicine

practices were often a natural

response to threatened litigation.

While defensive medicine has

negative consequences such as

reluctance to manage high-risk

populations and domains,

unnecessary over-investigation, and

allegiance to legal considerations

rather than necessary clinical

decisions, there can also be positive

spin-offs for patients. These include

increased adherence to clinical

guidelines and screening protocols,

improved record keeping, and also

more frequent consideration of

patient consent.

The delegates concluded that

there was a need for a blame-free

responsible healthcare environment,

which would encourage confidential

self-reporting of near misses. There

were also calls for system and

working environment changes, and

the nurturing of a culture of safety

to replace the culture of blame.

My concern with these broad

statements of intent was that self-

reporting would probably not be

acceptable to our medical protection

insurers and could possibility even

result in increased litigation, unless

reporting is protected by legislation

such as the Patient Safety and

Quality Improvement Act in the USA.

Reporting such errors in some

countries could jeopardise the

practitioner’s employment and

possible safety. But in Geneva, of

greater concern to me was that

there was the limited stress placed

on preventing health-worker errors.

As professionals, we should take

steps to pre-empt such mistakes,

and aim to improve the quality of

patient care through enhanced

clinical competence & expertise. In

family practice, this can be

encouraged through programmes of

self-audit, chart review, self-

reflection, observed consultations

and formal morbidity and mortality

discussions. The challenge would be

how to attract the doctors who

really need such programmes - a

problem faced by all voluntary

educational programmes.

How often have we heard the

statement, “In medicine mistakes

happen - doctors are only human?”

A 1999 report, To Err is Human,

revealed that one million people in

the United States suffer from

preventable medical injuries with

estimates from 44,000 to 98,000

deaths from them every year. Some

Wonca Member Organisations have

developed initiatives and

programmes on patient safety, and

have stressed the importance of

minimising doctor-initiated errors.

Such initiatives usually involve

WONCA

News

FROM THE WONCA PRESIDENT / FROM THE CEO’S DESK

FROM THE CEO’S DESK:

GENDER EQUITY IN WONCA

At its first meeting following World Council elections in Orlando in

October 2004, members of the new Wonca Executive noted the gender

imbalance in the Executive Committee. Only one woman, Regional President

of Wonca Africa Dr Abra Fransch, was represented. In addition to Dr Fransch,

the previous Executive Committee was represented by Member at Large and

immediate past WHO-Wonca Liaison Person, Dr Ilse Hellemann.

Gender imbalance did not escape the notice of members of the Wonca

Working Party on Women and Family Medicine (WWPWFM). At the meeting I

had with the WWPWFM President, Dr Cheryl Levitt, in Vancouver in late 2005

on the occasion of the First Regional Council Meeting of Wonca Region North

America, this issue was extensively discussed. Dr Levitt indicated to me then

that her Working Party was keen to help address this situation. I welcomed

the idea and initiative. I felt that proposals from the Working Party would

help Wonca Executive in its deliberations on this issue at its future

meetings.

A quick review of the data and documents available in the Wonca World

Secretariat showed that gender imbalance in this world organization is

significant and initiating constructive actions is long overdue. At the member

organizational level, a quick count revealed that only 15 (17%) out of 89

current Presidents of Wonca Member Organizations are women.

At the global level, a quick look at the compositions of Wonca World

Councils revealed that female Council Members in the various past Councils

were also very small in numbers. The 1998 World Council had 8 (17%)

female representatives out of 47 total Council Members. In 2001, 7 (14%)

out of 49, and, in 2004, 15 (21%) of

69 were women.

So it could be safely concluded

that the issue of gender imbalance

needs to be addressed at both

national and global levels

At the Core Executive Meeting in

Singapore in February 2006, this

issue of gender imbalance in Wonca

was discussed at length. Core

Executive agreed then that there

needed to be increased female

representation and better gender

balance or equity in Wonca.

Executive felt however that the issue

needed focused discussions and

also input from the Working Party

on Women and Family Medicine, as

well as input from Wonca Member

Organizations. Core Executive felt

that Member Organizations should

be encouraged to send more female

representatives to Wonca meetings.

Executive also felt it necessary that

there be changes in the Wonca

Bylaws and Regulations to promote

gender balance or equity as

otherwise there may be no

significant change within the world

organization. For example, under the

section on the Election of Members

at Large, the Bylaws could specify

that at least one Member at Large

should be a female member. In the

section on the creation of

Committees and Working Parties, a

clause on gender balance /

representation could be added.

It was also suggested that there

should perhaps be mechanisms

such as mentorship and leadership

development programs in Wonca

Member Organizations to promote

gender equity at Wonca events and

in the various Wonca-office

positions. Arising from these

discussions, Core Executive decided

that there would be a specific item

on gender balance on the agenda of

the Full Executive Committee

Meeting in Buenos Aires in October

2006.

voluntary reporting, creating an environment of safety, protected

confidentiality, a system for comprehensive analysis of errors to identify

actions that would minimize the risk that reported events recur, the sharing

of patient safety information among healthcare organisations and fostering

confidential collaboration with other healthcare reporting systems.

However, the challenge to many practitioners in developing areas of the

world where systems and organisational structures do not exist for such

programmes is “how do I ensure the safety and optimal care of my

patients”. We need to continually ask ourselves, “Am I doing the best I can

for my patient, using the best available evidence and most effective

measures at my disposal, and am I being honest about what I can and

cannot do.”

Professor Bruce Sparks

President

World Organization of Family Doctors

FEATURE STORIES

WORKING PARTY SEEKS TO ENHANCE ROLE OF

WOMEN FAMILY DOCTORS IN WONCA AND HEALTH

SYSTEMS

Increasing numbers of women are entering family medicine and general

practice around the world. In some countries (for instance, Russia or the

Philippines) women became the major providers of general practice and

family medicine during the 20th century; in some (e.g., Canada and the

United States), women have increased in numbers recently; and in others

(parts of Asia, Africa and the Middle East) still only a few women are family

physicians. Although women family physicians play an increasing role in

both developing and developed countries, they frequently face societal,

cultural and institutional barriers, including limitations on their scope of

practice.

FROM THE EDITOR:

EXAMINING THE ROLES

OF WOMEN FAMILY

DOCTORS

This issue of Wonca News

contains the first of a series of six

significant articles to be published

by the Wonca Working Party on

Women and Family Medicine

(WWPWFM) examining the role of

women physicians and family

doctors in Wonca and throughout

the world. The articles are excepted

from a monograph coauthored by

WWPWFM Chair Cheryl Levitt, Lucy

Candib, Barbara Lent, and Michelle

Howard. The first article, published

in this issue, examines the role of

women in organized medicine.

Subsequent articles will examine

women in training, practice and

academia, as well as women

physicians caring for patients and

themselves.

WONCA

News

FROM THE CEO’S DESK / FROM THE EDITOR / FEATURE STORES

Members of the WWPWFM are

currently holding extensive

discussions among themselves on

how best to correct the gender

imbalance in Wonca. The Working

Party will shortly be submitting a

set of recommendations to Wonca

Executive for its consideration. This

will hopefully in time lead to

changes in the Wonca Bylaws and

Regulations that will promote

gender equity.

The process may be a long one

but then any journey must start with

the first step.

Dr Alfred Loh

Chief Executive Officer

World Organization of Family

Doctors

In their introduction to this important series, the authors state that,

when the role of women family doctors is optimized in all of these settings,

then the health of the people are optimized. Readers are encouraged to

contribute their knowledge and perspectives to the coauthors in the

WWPWFM, particularly from Wonca member organizations where published

information on the role of women family doctors is limited.

This issue also reports on relevant news to Wonca Member Organizations

and Direct Members regarding the World Health Organization. Wonca

Executive member, Michael Kidd, reports on the 58th World Health Assembly

in Geneva, Switzerland. The World Health Report 2006: Working Together for

Health is reviewed in the Resources for the Family Doctor section. The vital

global work of the WHO took second stage as Wonca joined many

organizations around the world in mourning the sudden death of WHO

Director General, LEE Jong-wook, also reported in this issue.

Finally, this issue reports on the upcoming World Rural Health Conference

and Wonca Regional Conferences in Florence, Buenos Aires and Bangkok

which are rapidly approaching. As we move towards the final year of the

Triennium leading up to the Wonca World Conference in Singapore in July,

2007, I welcome reports from Wonca’s Working Parties, Task Forces and

Special Interest Groups and Member Organizations that examine and

promote the role of Wonca and its family doctors around the world.

Marc L. Rivo, M.D, M.P.H.

Editor, Wonca News

marcrivo@aol.com

4566 Prairie Avenue

Miami Beach, FL 33140 USA

1-305-674-8839 (fax)

WONCA

News

FEATURE STORIES

The health of a population depends, among other

things, on the ability of the healthcare workforce to

deliver the best possible care. Barriers preventing

women physicians from meeting their full potential

occur in training, in practice, in organizational medicine

and in academia. When women form a part of the

workforce but are limited in how they contribute, the

whole society loses out. All medical organizations

around the world that are committed to the highest

quality family medicine should endeavour to remove

institutionalized gender barriers that limit the full

participation and contribution of women members.

Women physicians’ enormous contributions to the

profession have benefited both physicians and their

communities. They bring a variety of life experiences,

work in many different practice settings, both urban and

rural, and participate in academic and medical

organizations. Women physicians have been leaders in

advocating for all aspects of women’s health: for

appropriate use of power within the doctor-patient

relationship, for research in areas of importance to

women, for reproductive health and choice, and for

recognizing the importance of gender as a determinant

of health for both men and women. Women integrate an

understanding of women’s lives into their professional

work. They have been leaders in stressing the

importance of a balance between career and family - an

issue that is of importance to both men and women in

medicine. Women physicians have highlighted the need

for enhanced interpersonal skills for all practitioners,

including non-hierarchical relationships with patients

and peers.

From R to L - Cheryl Levitt, Barbara Lent, Lucy Candib, meeting at

Langdon Hall in Ontario, Canada, in February 2002 to develop the

Working Document on Women and Family Medicine

Wonca provides a forum for exchange of knowledge

and information between member organizations of

general practitioners/family physicians. Wonca also

represents the interests and promotes the educational,

research and service activities of general practitioners/

family physicians at other world organizations

concerned with health and medical care. Decisions

adopted by Wonca have a large symbolic and potentially

practical influence on family medicine and general

practice in all parts of the world. Wonca formally

endorsed the Beijing Declaration and Platform for Action

from the Fourth World Conference on Women in 2001

and 2002, with its far reaching vision of women’s rights

to all aspects of health including reproductive freedom.

Women family physicians have worked within the Wonca

member organizations around the world to develop

approaches to the systematic discrimination against

women and to promote the full development and

wellbeing of women as patients and doctors. Initially

informally, and later formally, women physicians have

organized working parties, standing committees, and

sometimes separate organizations, nationally and

internationally, to address cultural and structural barriers

to their full professional development, and to working

with and on behalf of their patients. At the 16th

International Conference of Wonca in Durban, in 2001, a

group of women participants established the Wonca

Working Party for Women and Family Medicine

(WWPWFM).

As one of the activities of the WWPWFM, we

undertook an international literature review to collect

evidence, documentation, reports, and media coverage

about the barriers facing women family physicians. We

developed a monograph to provide this material in a

variety of formats, including a point-form summary, a

narrative descriptive report and an annotated

bibliography, all available on our website at

www.womenandfamilymedicine.com. Briefly the chapters

are:

Women in Organizational Medicine-Covers issues of

under-representation of women and barriers,

importance of women’s contributions, and examples

of women’s caucuses and projects.

Women Family Physicians In The Doctor-Patient

Relationship-Discusses women’s practice patterns,

the medical encounter, communication style, patient

satisfaction, gender differences in activity levels, and

a feminist perspective of the medical encounter.

Women Family Doctors Caring For Themselves And

Their Families-Discusses physical and mental health,

stress and burnout, depression and substance

abuse, and the need for flexible practice for women.

WONCA

News

FEATURE STORIES

Women In Training (Medical School And Post-

Graduate Training)-Covers issues of gender and

racial/cultural discrimination, sexual harassment,

decisions about marriage and parenting, choice of

specialty and gender bias in medical education.

Women In Practice-Covering issues of sexual

stereotypes in practice, personal and professional

role pressures, attitudes, policies and practices

pertaining to women physicians, sexual orientation,

challenges in rural practice, and relationships with

nurses.

Women In Academia-Covering issues of promotion

and tenure, gender differences in compensation,

gender bias in competitive evaluations, role models

and mentorship, research career and tokenism.

Not surprisingly, culture, language and geographic

origin limit the scope of the literature. The experiences

of women physicians from many parts of the world have

not yet reached the published international literature. In

other regions, some of the literature reflects educational

and practice environments that have subsequently

undergone significant change. The world of women

family physicians is in a period of rapid transition.

Thus, the monograph is a ‘work-in-progress’. We hope

to keep it updated by the international literature and by

the ongoing research being undertaken by the

WWPWFM.

This monograph will be summarized in a series of six

articles that will be published by Wonca News over the

next year, beginning with this June issue’s summary of

the chapter entitled, Women in Organizational Medicine.

We encourage readers to write to us with comments

and suggestions. Readers can find further information

about the WWPWFM at the group’s website at

www.womenandfamilymedicine.com, where we post the

group’s Working Document and descriptions of other

activities and reports. We encourage those interested in

subscribing to the listserve to send a message to

Dr. Lucy Candib, the listserve coordinator at

lcandib@massmed.org.

Cheryl Levitt MBBCh

Lucy Candib MD

Barbara Lent MD

Michelle Howard MSc

Wonca Working Party on Women and Family Medicine

Working Party Releases First of a Series: Women

in Organizational Medicine

Although the number of women doctors in family

medicine is increasing, many women continue to face

major barriers at the personal, professional and

structural levels limiting their full participation in

organizational leadership and reducing their impact on

clinical, organizational and social policies. Innovative

strategies to promote equitable participation of women

in leadership positions would result in a strengthened

family medicine workforce

This article on women in organizational medicine

represents a summary of our review of the reported

experiences from peer reviewed and grey literature

(unpublished reports and news-items mostly found on

the internet) of authors from Western and English-

speaking countries and ideas shared with women from

the Caribbean and Europe. Further details, including an

annotated bibliography can be found at

www.womenandfamilymedicine.com.

Women often have a distinct style of practicing

medicine that is likely to carry over to their involvement

in organizational medicine as well. Although, at times,

women face restrictions in their scope of practice, they

also contribute substantially to clinical care by their

particular focus on the health issues facing women and

children. Women physicians have been leaders in

advocating for improved women’s health, safety and

reproductive rights internationally. When they are in

positions of power in public office, they bring more

attention to the issues of women and children. Women

physicians are more likely to practice obstetrics,

preventative care, and counseling than men. They are

also more likely to do research in women’s health and

to draw attention to health issues affecting women and

children. These contributions can potentially be even

greater in less developed countries where women and

girls are more disadvantaged in society.

A primary reason for the disparity between the

involvement of men and women in organizational

medicine is the pressure of balancing career and family

responsibilities, as well as traditional gender imbalances

in domestic and child-rearing responsibilities. Women

report difficulties in taking on the extra responsibilities

involved in being a part of a medical organization, while

maintaining their home lives as well. For instance, most

organizational meetings take place after hours, further

extending the workday and conflicting with women’s

involvement with their children’s lives. Often women in

leadership positions strive to develop policy around

lifestyle and balance beneficial to all individuals.

Lack of mentoring and opportunities for skills

development are often cited as barriers to women’s

involvement in leadership in Western and English-

speaking countries. In the last decade, several medical

organizations in Canada and the United States have

developed specific leadership programs for junior, mid-

career and executive women, while other organizations

have made deliberate efforts to encourage senior

women physicians to mentor more junior women.

Women physicians in senior positions in academic,

clinical and research organizations are important role

models for women medical students and residents, and

can highlight medical leadership as a valuable career

path. Medical organizations need to ensure that their

leadership represents the needs of the members and

reflects inclusive interpersonal styles, so that women

will make a professional commitment to participate in

this important arena.

Organizational bodies need to take responsibility to

ensure equitable representation. Policies and

procedures, bylaws and structures should all be

examined to identify the barriers to women’s

participation and revised to ensure and monitor

equitable participation. Women entering organized

medicine have encountered informal hurdles,

discrimination and sexism resulting in a failure to be

included and/or welcomed into organizational medicine.

This ‘old boy’s network’ mentality can be extremely

destructive and counterproductive. Appointment of a

few isolated women to formal committee positions is

often viewed as a gesture of ‘tokenism’, where women’s

inclusion fulfills appearances of gender equality in

representation but does not recognize or encourage

their distinct and full contributions. Organizations can

undertake to expunge these discriminatory behaviors

through a culture of open and safe discussion,

avoidance of tokenism and through the active

promotion of inclusive and protective policies and

practices.

A preoccupation about the image of the profession

may limit the advancement of women. Some physicians

have expressed concern that if women become visible in

organizational leadership, society might view the whole

profession as “women’s work”, resulting in a loss of

prestige, income and authority. Instead, the increasing

numbers of women in medicine, including family

medicine, offer an opportunity both to draw from a

wider pool of candidates and to bring women’s

strengths to medicine, rather than serving as a problem

for the practice of medicine. As well, women have

significant potential to improve rather than diminish the

image of the profession by demystifying medical skills

and knowledge and practicing in a more collaborative

and less hierarchical manner.

In some countries, although no published English

literature documents the status of women in

organizational leadership, we know anecdotally that

disciplines dominated by women, like family medicine,

have lower perceived status than other specialties. For

example in Latvia, nearly all family physicians are

women; in some South American countries, women

dominate family and community medicine. In contrast,

in the Caribbean, while women family physicians are

prominent in family and community medicine, they still

feel valued and powerful in relation to men and each

other. Caribbean women physicians strongly advocate

for women’s and children’s health and social justice for

the marginalized. They feel an advantage in being

perceived as similar to nurses in their emphasis on

caring. Nevertheless, they acknowledge tensions

between men and women regarding access to powerful

positions.

In many countries, women physicians established

their own medical organizations to serve as their voice.

The Medical Women’s International Association (MWIA)

is an association of medical women representing women

doctors from 70 countries in all five continents. Formed

in 1919, when women were hardly a presence in

medicine, the MIWA still today actively pursues its

goals: to promote the cooperation of medical women in

different countries and to work against gender-related

inequities in the medical profession including bias in

career development and financial rewards. The MWIA

website [http://www.mwia.net/] lists a number of

countries with medical women’s associations active in

addressing these concerns.

Around the world, leaders in organizational medicine

are becoming increasingly aware that the promotion of

equity and gender will have profound benefits to all.

Both men and women of good conscience have

advocated for promoting more inclusive organizations.

In some countries, conventional medical associations,

universities and colleges have established committees

to begin to address the challenges of gender and equity.

In 2002, a group of women within Wonca established

the Wonca Working Party on Women and Family

Medicine (WWPWFM) to work through Wonca to improve

the health of women by enabling family doctors

worldwide to meet their full potential as health care

providers to their communities. The WWPWFM is

determined to remove institutionalized gender barriers,

WONCA

News

FEATURE STORIES

WONCA REGIONAL NEWS

WONCA EUROPE REGION TO CONVENE IN FLORENCE -

AUGUST 27-30

It is our pleasure to invite you to the 12th Wonca Europe Regional

Conference that will be held in Florence, Italy on August 27-30, 2006. The

aim of the organizing committee is to prepare in Florence 2006 an event to

be remembered as one of the most important offered by WONCA Europe to

its members and all those caring for General Practice/Family Medicine.

WONCA Europe has more than 30 member organizations and represents

more than 45,000 family physicians in Europe. The society is the academic

and scientific society of general practitioners in Europe. The aim of the

society is to improve standards of care in General Practice/Family Medicine;

stimulate networking among GPs with an interest in professional develop-

ment, research, education and quality improvement.

The conference theme “Towards a Medical Renaissance: Bridging the Gap

Between Biology and Humanities” seeks to bridge the gap between biology

and the humanities. Illness, disease and sickness, three words full of

meanings for one very specific human biological condition, to be

understood, needs to be observed from many different points of view.

That is precisely the exciting underlying thread of the 12th WONCA Europe

Conference; a thread that will conduct participants through six main topics:

1) biology and humanities, 2) caring for the world, 3) family practice

research, 4) quality, 5) education, and 6) risk and safety.

These themes will allow doctors, while easily surfing through their

preferred conference sessions presenting, discussing and facing their own

everyday real problems, to be exposed to new ideas, state of art knowledge

and reliable guidelines. Every moment of the conference will be an occasion

to “think globally” in a rigorous scientific manner and to “act back locally”

in a highly professional way.

Each one of these topics will have a dedicated chairman that will follow

the works during the three days of the conference and will summarize the

State of the Art in the last plenary session. So participants may follow the

lectures and sessions of their main interest but, before leaving the

conference, will be informed about what of relevance has been told in all

the other ones. Everyone will be able to bring back home a clear idea about

the important ideas which emerged during the ongoing process of the

conference.

With such relevant philosophical and scientific inheritance, with its

beautiful Mediterranean climate, good and healthy food, and great

shopping, Florence is the ideal place for the 12th Conference of WONCA

Europe ESGP/FM. Florence is one of the most beloved cities in the world,

an open sky museum famous worldwide. In the fifteenth-century Florence, a

self-governed, independent city-state with a population of 60,000 became

with its writers, painters, architects and philosophers the cradle of

Renaissance culture; Renaissance shifted mankind into the centre of the

WONCA

News

FEATURE STORIES / REGIONAL NEWS

change gender-based values and

habits that support systematic

discrimination in the profession, and

focus attention in Wonca on

women’s and girls’ health. Members

of the WWPWFM believe that

institutional transformation of

Wonca and its member

organizations, as well as personal

change through the empowerment

of our members, can act as catalysts

to wider systemic changes in home

countries. By the next triennial

meeting in Singapore, in 2007, the

WWPWFM will prepare a position

paper with recommendations to

enhance the contribution of women

family doctors to the organization

and the profession.

Please see

www.womenandfamilymedicine.com

for the full Monograph, Summary

and Annotated Bibliography on

Women in Organizational Medicine.

We hope this article and the series

will encourage women to write to us

about their experiences around the

world and help inform our future

work.

Cheryl Levitt MBBCh

Lucy Candib MD

Barbara Lent MD

Michelle Howard MSc

Wonca Working Party on Women

and Family Medicine

WONCA

News

REGIONAL NEWS

known cosmos ad man became its

measure.

Since the thirteenth century

travelers praised the warmth and

comfort of Florentine hospitality. The

tradition is carried on today by a

highly organized service totalling

more than 350 hotels and pensions

of different categories, able to

accommodate more than 20,000

guests. Most hotels are in the city

centre near the Congress Centre

Fortezza da Basso. Special rates

have been negotiated for congress

participants.

To register and for additional

information, please contact us via

phone (39 055 50351), email

(info@woncaeurope2006.org) or the

web (www.woncaeurope2006.org)

We surely want you to have a

marvelous stay and no doubt

Florence will be able to marvel you;

but we do not want for you only a

beautiful show. We would like you

to go back home pleased by the

certainty to have lived a very

exciting and scientifically relevant

experience in being where important

topics, for general practitioners

from all over Europe and the

Mediterranean area, were stated and

discussed.

We strongly want Florence 2006

to become another important step

for all GPs attending, on the way

toward a thriving General Practice

both for Italy and Europe. We are

lucky enough to have at our

disposal Leonardo’s land: the best

place to build a new Renaissance

for Family Medicine.

Dr. Giorgio Visintin

Chairman, Organizing Committee

Dr. Massimo Tombesi

Chairman, Scientific Committee

Professor Igor Svab

President, Wonca Europe

Professor Chris van Weel

President-elect, Wonca World

1st Wonca Iberoamerican-CIMF

Regional Conference to Meet in

Buenos Aires - October 11-14.

It is a great honour for me to

announce the 1st Iberoamerican

Wonca-CIMF Regional Congress that

will be held in Buenos Aires from

October 11th to October 14th, 2006.

The whole city is getting ready to

welcome the family physician

community for four days.

We have prepared an extensive

scientific program with plenary

sessions, round table discussions,

workshops, and satellite symposia.

Also, participants will have a chance

to get new and updated

information, participate in expert

debates and breakfast sessions,

scientific presentations, skill

assessment stations and the option

to take the specialist certification

exam. In addition to the opportunity

of enjoying the meeting with peers

and friends from around the world,

several social and tourist activities

have been scheduled. More than

forty eminent personalities from

well-known academic institutions

will be among the guests. They will

include most family medicine’s areas

of interest.

Buenos Aires, the city of Borges,

Cortazar, Maradona and Gardel and

capital of the Argentine Republic, is

a city of culture, fashion,

gastronomy, art and music. It is also

known as the city of tango, good

beef and soccer. Before or after the

Congress, you will be able to visit

some of the top tourist spots in

Argentina, such as the Iguazu Falls,

Bariloche and the Patagonia

glaciers.

We are getting ready for your

visit. We want you to enjoy a warm

stop in our city and to get the most

out of this high-level scientific

conference that will contribute to

the development of better

professionals and a healthier

population.

To learn more about our exciting

conference and to register, please

visit our website at:

www.woncacimfcongreso2006.com/

We are looking forward to seeing

you all in October 2006.

Greetings,

Dr. Sergio Solmesky MD

Chairman

famfyg@aamf.org.ar

El Primer Congreso Regional de

Wonca-CIMF Iberoamericano

Realizara en Buenos Aires de 11

al 14 de Octubre

Como coordinador del Comité

Científico es para mi un gran honor

invitarlos anunciar el I Congreso

Regional de Wonca-CIMF

Iberoamericano que realizaremos en

Buenos Aires del 11 al 14 de Octubre

de 2006 e introducirlos en lo que

será sin lugar a dudas un evento

académico formidable. Estamos

orgullosos de estar preparando un

programa científico tan diverso e

interesante, las posibilidades de

formación son muy variadas y se

encuentran distribuidas a través de

ejes temáticos dominados por los

principios de nuestra especialidad.

En este sentido encontrarán

desde simposios, mesas redondas,

talleres, cursos, presentación de

trabajos orales y posters, hasta una

serie de novedosas actividades

como las sesiones de video, las

actualizaciones en medicina

centrada en el paciente, y los

talleres interactivos.

Nuestros invitados extranjeros

prometen entregarnos unas

HEALTH AND HEALTH

SYSTEM NEWS

WONCA

REPRESENTATIVES

ATTEND THE WORLD

HEALTH ASSEMBLY

In May I was honoured to be

invited to be one of the two

delegates of Wonca, along with

Professor Deborah Saltman, to

attend the annual World Health

Assembly of the World Health

Organisation (WHO).

The WHO is 60 years old in July

2006. Wonca is recognised as a

“Nongovernmental Organisation in

official relations with the World

Health Organisation”. This is

prestigious recognition of the

importance to global health of

family medicine. I found that many

of the delegates knew about Wonca.

The size of the meeting was

initially overwhelming. The meeting

is held in the United Nations Palace

of Nations which is enormous.

Meeting rooms are scattered across

several floors and signage is

minimal. Security was tight and very

visible so there was always

WONCA

News

REGIONAL NEWS / HEALTH AND HEALTH SYSTEM NEWS

plenarias colmadas de

conocimientos y reflexiones que

puedan ser de utilidad para la

práctica de la Medicina Familiar en

toda Iberoamérica. Se hará especial

énfasis en temas que reflejen los

distintos roles que hoy ocupa el

Medico de Familia y que pueden

favorecer la construcción de un

sistema de salud centrado en la

Atención Primaria.

Esperamos sinceramente que

este congreso sea una gran

oportunidad para compartir

experiencias y ampliar nuestros

horizontes, encontrar viejos amigos

o hacer nuevos, y escuchar

novedosas investigaciones e ideas

que puedan servir para mejorar la

salud de nuestros pacientes, así son

los Congresos de Wonca.

Estamos sorprendidos por la

cantidad de propuestas de

actividades recibidas hasta el

momento, provenientes de toda

Iberoamerica. Si todavía no han

enviado las suyas, también los

invito a ser parte de este Congreso

mediante el envio de sus trabajos

científicos. Navegando en este sitio

encontraran la información necesaria

para hacerlo.

Finalmente me gustaría

aprovechar la oportunidad para

agradecerles a todos los miembros

del Comité Científico por su

colaboración y por el trabajo que

realizan día a día.

Dr. Ezequiel López

Coordinador del Comité Científico

famfyg@aamf.org.ar

Come to Bangkok for the Asia

Pacific Regional Conference -

November 5-9

The 15th Wonca Asia Pacific

Regional Conference will be held for

the first time in Bangkok, Thailand

during 5-9 November, 2006. The

conference will be hosted by the

General Practitioners/ Family

Physicians Association, Thailand and

the Royal College of Family

Physicians of Thailand, under the

auspices of the World Organization

of Family Doctors (Wonca - World

Organization of National Colleges,

Academies and Academic

Associations of General

Practitioners/Family Physicians).

The theme of this meeting is

“Happy and Healthy Family”. We,

the family doctors, along with

physicians, dentists, nurses,

pharmacists, public health personnel

and all health-care workers, have to

work closely together for taking

proper care of the illness, prevent

and control diseases, and promote

health for all. These are challenging

goal for us to achieve in an era with

a rapid growth of new technology,

industrialization, and population

mobility.

The meeting will provide us

opportunities to bring together

family doctor teams in urban and

rural areas, sharing their

experiences and learning from

experts as well as fostering

partnerships in the region.

Thailand has been the site of

numerous international meetings,

and Bangkok is the gateway of the

region. The country’s rich heritages,

beautiful scenic seaside and

mountain views as well as our

unique Thai hospitality will make

your visit truly memorable.

For further information and to

conference website at

www.wonca2006.org

We look forward to welcoming

you to Bangkok in 2006.

Sawasdee.

Kachit Choopanya, MD., MPH. & TM.

Chairperson of the Organizing

Committee

Prasong Tuchinda, MD.

Honorary Chaiperson

WONCA

News

HEALTH AND HEALTH SYSTEM NEWS

someone to point you in the right

direction.

The main United Nations

assembly hall is enormous. The

delegations from each of the 192

countries which are members of the

WHO are situated at tables on the

main floor. Representatives from

other organisations and the media

sit in the tiers of balconies. NGOs in

official relations have our own

balcony high above the proceedings

which provides the opportunity to

meet with other NGOs and talk

about the policies being developed,

and the work of our own

organisations.

The sad death of

Dr LEE Jong-wook

The meeting was of course

overshadowed by the sudden death

of WHO Director General Dr LEE

Jong-wook on the day before the

World Health Assembly began.

Many tributes were made to the

man and his leadership and his

remarkable contributions to the

health of the people of the world.

Dr Lee’s prepared address was

shared with the members on the

opening day of the conference. It

was a wonderful speech and is

available on the web.

Dr Lee’s strongest focus in his

speech was on the fight against HIV

and the need to keep up the

pressure to get prevention,

treatment and care linked and

working. His aim was for no one on

the planet to die because they can’t

get access to antiretroviral drugs,

for no one to miss being tested,

diagnosed and treated because

there are no clinics, for HIV positive

mothers not to unwittingly transmit

HIV to their babies, and for parents

with HIV to live and look after their

children rather than leave behind

AIDS orphans. This was the aim

behind the WHO “3 by 5” program

which was an attempt to get

3,000,000 people in developing

nations onto antiretrovirals by 2005.

The program succeeded in getting

around 1.3m people on drugs which

is still a major achievement

especially as the program has

helped to build foundations for

continuing efforts in prevention,

treatment and care in so many

countries. However the battle of

course continues as there are still

over 6m people in urgent need of

antiretroviral treatment for HIV, as

well as many more in urgent need

of treatment for TB and malaria. Dr

Lee provided examples in his

speech of WHO leadership in the

control of malaria and TB and the

enormous challenges remaining in

the combat of these two killer

diseases.

Dr Lee advised that polio is now

only endemic in four countries -

India and Pakistan, which are both

on track to complete eradication by

the end of 2006, Afghanistan where

conflict stands in the way of some

children and the polio vaccine, and

Nigeria where up to half the children

in the northern states are still

missing out on vaccination and

which is the last uncontrolled

reservoir of polio in the world.

Dr Lee spoke about avian

influenza and the role of the WHO.

H5N1 has now been reported in wild

and domestic birds in over 50

countries and in humans in 10

countries, including the recent

cluster of human cases in Indonesia

which was being investigated at the

time of the World Health Assembly.

He spoke of the death and

destruction of over 200 million birds

and the huge loss of livelihood and

essential nutrition which this

represents. He spoke of the need

for continuing vigilance and

preparedness which is essential for

all member nations.

Dr Lee addressed the World

Health Report 2006 which described

the growing global health workforce

crisis, again an issue of concern to

Wonca’s member organisations.

WHO and its partners have launched

the Global Health Workforce

Alliance.

Dr Lee spoke about the new

global report Preventing Chronic

Diseases which he stated analyses

for the first time the scale of the

damage from diseases such as

cancer, diabetes and cardiovascular

disease (all core business for family

medicine). The WHO has proposed

a goal of reducing chronic disease

deaths by a further 2% annually

until 2015. This initiative would

prevent 36 million premature deaths

worldwide.

Finally Dr Lee spoke about his

accountability framework for the

WHO which provided an insight into

the mind of the man. He stressed

that WHO reports were to detail the

results of what the WHO sought to

achieve. So instead of the annual TB

report detailing how many

consultations and meetings were

held in the past year, it said that in

the previous year 4.8 million people

with TB globally were treated under

the DOTS strategy and that 80% of

these people were now cured. The

outcomes focus is refreshing and, in

this era of electronic data collection,

possible on this scale for the first

time.

The boy from Kenya and the

Prince of Wales

There were two major

presentations to the whole

assembly.

The first presentation was by a

19 year old man from Kenya,

Johnson Mwakazi, who was invited

by Dr Lee to speak on behalf of the

40 million people with HIV. He

delivered a brief but moving poem

WONCA

News

HEALTH AND HEALTH SYSTEM NEWS

based on his experiences. I later heard how he

described with great humility how he was “just dust”

compared to the gathered dignitaries at the assembly

and how his eyes opened wide when he was told that

he is just as important as any other person at this

meeting and any other person on the planet.

The second presentation was by the Prince of Wales

and this was reported widely in the international media.

The main message of Prince Charles’ speech was that

health professionals and health officials should not

ignore the lessons about health which may be learned

from traditional sources in each of our countries and

that we should see if we can blend traditional lore with

new science. He spoke about treating the whole person,

the impact of the environment on health, and the

impact on a nation’s health from many areas of

government policy in addition to specific health policy.

Prince Charles also spoke about some of the

evidence-based benefits of alternative health care, such

as the use of St John’s wort and acupuncture for chronic

pain. This of course grabbed the attention of the media

who did a great job of reinterpreting his meaning. He

did make the only reference to family doctors that I

heard in the whole week when he stated that “50% of

UK general practitioners refer their patients for

complementary therapies”. I am not sure where His

Royal Highness gained his information from but perhaps

the Royal College of General Practitioners might also

need to educate him a little on the many other

important roles of general practitioners and family

doctors in ensuring that the people of his nation have

access to high quality primary care services.

Prince Charles did finish with a plea that the nations

of the world each develop their own plan for integrated

health, reflecting each nation’s traditional health

wisdom, and support the health of their environment,

and balance their investment in prevention as well as

cure. Seems like a reasonable message to me but then

I am not a tabloid journalist.

The World Health Assembly Agenda

The agenda of topics discussed (and more

importantly the resolutions passed) at the assembly was

broad and much is of interest to the core business of

Wonca and our member nations.

The agenda included:

*Pandemic influenza preparedness and response

*Eradication of poliomyelitis

*HIV/AIDS prevention, treatment and care

*Sickle cell anaemia

*Smallpox eradication - destruction of virus stocks

*A draft global strategy on prevention and control of

sexually transmitted infections

*Prevention of avoidable blindness and visual

impairment

*The WHO Framework Convention on Tobacco Control

*Nutrition of infants and young children

*Child and adolescent health and development

*International trade and health

*Intellectual property rights (mainly discussing generic

medications)

*International migration of health personnel and the

challenge this poses for health systems in many

developing countries

*The role of the WHO in health research

*Emergency preparedness and response - including

responses to natural disasters and the health

consequences of armed conflicts and the dreadful

impact especially on women and children

*Health promotion in a globalised world

*Patient safety

*A new global strategy on diet, physical activity and

health

*Control of African trypanosomiasis

*Reproductive health

*Sustainable health financing, including universal

health coverage and social health insurance

*The role of contracts in improving the performance of

health systems

*Strategies to strengthen nursing and midwifery

It was impossible to be across the discussion on

each topic. However each morning the papers for

discussion that day were distributed in hard copy. All

the resolutions are available on the WHO website at

http://www.who.int/mediacentre/events/2005/wha58/en/

Professor Michael Kidd

President of The Royal Australian College of General

Practitioners

and WONCA Executive Member

Wonca Mourns the Death of WHO Director

General, Dr LEE Jong-wook

More than 1000 people packed into the Basilique

Notre-Dame in Geneva to attend the funeral of WHO

Director General Dr LEE Jong-wook and to hear tributes

to his life and work. Dr Lee died on May 22, 2006. He

was 61.

WONCA

News

HEALTH AND HEALTH SYSTEM NEWS / MEMBER AND ORGANIZATIONAL NEWS

Dr Lee became Director-General of the World Health

Organization on 21 July, 2003. Before that, he had

worked for more than 20 years for the Organization, first

battling leprosy in the South Pacific islands, then

tackling vaccine preventable diseases including polio. At

WHO Headquarters in Geneva, he pioneered new ways

for people to gain access to tuberculosis medicines.

“Dr Lee’s work defined and exemplified the very best

of WHO,” said Rhyu Si-min, Minister of Health and

Welfare of the Republic of Korea, who spoke on behalf

of the international health community. “He wanted

change to take place on the ground. He travelled great

distances, to more than 60 countries in three years. And

he would never hesitate to travel the distance across

the floor to take the hand of a child who was sick. His

work has touched millions, and has made their lives

better.”

Expressions of deep sympathy and tributes to Dr

Lee’s leaders were sent in around the world including

from ordinary people, ministers, non-governmental

organizations, and heads of state. On behalf of Wonca,

CEO Dr Alfred Loh sent the following expression of

sympathy:

The World Organization of Family Doctors (Wonca)

extends its sincere condolences to the family of Dr Lee

Jong-Wook, Director-General of the World Health

Organization.

On behalf of the Wonca World President, the

Executive Committee and World Council, I would like to

express our deepest sympathy to Dr Lee’s immediate

family and to the WHO. We are deeply saddened by the

news of his sudden death.

Wonca, an international NGO of general practitioners/

family physicians devoted to improving the quality of

life of the peoples of the world through fostering and

maintaining high standards of care and education, has

worked with WHO via a number of joint projects with

the shared vision of improving the health of individuals

and communities globally.

The congruence of the mission of Wonca through the

training and orientation of family doctors and the efforts

of WHO to assure all of the world’s citizens a level of

health that will permit them to lead socially and

economically productive lives, creates a natural synergy

ideally suited to providing high quality essential care

that is equitable, relevant, and cost-effective.

MEMBER AND ORGANIZATIONAL NEWS

WORLD RURAL HEALTH CONFERENCE

IN SEATTLE - ANCHORAGE

SEPTEMBER 8-13

It is a great pleasure for me, on behalf of the Wonca

Working Party on Rural Practice, the University of

Washington School of Medicine’s Department of Family

Medicine and WWAMI program, the American Academy

of Family Physicians, and our State Academies, to invite

you to participate in the exciting experience of the 7th

WONCA World Rural Health Conference. This meeting

will be held in Seattle, Washington, USA from

September 8-13, 2006.

Since Seattle and the University of Washington

School of Medicine are the home of the WWAMI medical

education program (Washington, Wyoming, Alaska,

Montana, Idaho), we have established the conference

theme of Transforming Rural Practice Through

Education. Education plays many roles for rural

physicians. From preparing them to practice, to offering

opportunities to teach in their practices, education

permeates our lives and is very important for rural

physicians. The thirty-five year old WWAMI program

allows the University of Washington School of Medicine

to serve as the medical school for five states that

comprise 27% of the land mass of the US, yet contain

only 3% of the population-this is truly a rural region,

and decentralized community based medical education

is at the heart of the WWAMI program. Much of our

educational process is dependant on the participation

of community based volunteer faculty physicians

located throughout our area-education and practice are

inextricably tied to each other.

Until his sudden and untimely death, Dr Lee led

WHO very effectively in its mission to help people attain

the highest possible level of health. The world will

mourn the loss of a dedicated and open-minded global

leader in health care.

Dr Lee’s widow has requested that in lieu of flowers,

donations in memory of Dr Lee should be given to the

project where she works, Socios En Salud in Lima, Peru.

Donations can be given via the sister organization of

Socios En Salud, Partners In Health www.pih.org

WONCA

News

MEMBER AND ORGANIZATIONAL NEWS

The Seattle portion of the

meeting will include two linked

major conferences, one dedicated to

the scientific, health policy, and

medical education aspects of global

rural health, and the other

dedicated to continuing clinical

education for rural physicians. Our

international program and scientific

committee is looking forward to

developing a comprehensive

program of posters and

presentations that will be both

stimulating and interesting.

More information on our

fascinating city can be found at the

website of the Seattle Convention

and Visitors Bureau. In addition to a

very strong scientific and clinical

educational program, we will

provide a cultural and social

experience that will be very

enjoyable. We will focus the cultural

program on the native peoples of

the Northwest and Alaska. Our

social functions will create an

opportunity for you to meet other

rural physicians from around the

world, have some fun, and get to

know our region better.

Seattle is the largest city in the

Pacific Northwest region of the

United States. Founded in 1869, the

City of Seattle is located in the State

of Washington on Puget Sound, 113

miles (182 km) from the U.S.-

Canadian border. It is a beautiful

multi-cultural metropolis located

between Puget Sound and the

Cascade Mountains, interspersed

with large lakes. The city is rich in

history and has long served as a

major port and as the gateway to

the Northwest and Alaska.

Surrounded by mountains and

water, the greater Seattle area

features picture-perfect views and

abundant recreational opportunities

year-round. Room blocks will be

reserved for conference attendees.

Additionally, economical room and

board packages will be available in

dormitory facilities on the University

of Washington campus near the

conference venues. Cuisine in the

Seattle area is famous for fresh

seafood, local farm produce, and

other Northwest specialties. The

areas cultural diversity has produced

a wide variety of ethnic restaurants.

Following the Seattle

conferences, we are very pleased to

offer a post-conference session to

consider actual rural health systems

at Talkeetna Lodge near Denali

National Park in Alaska. The

Talkeetna Alaskan Lodge offers the

premier lodge experience with

spectacular views of Mount McKinley

(Denali as it is known locally),

Denali National Park and the Alaska

Range. The Talkeetna Alaskan Lodge

is Alaska Native owned and

operated, offering a resort style

setting with unique and awe-

inspiring Denali and Alaska Range

views that are simply unmatched.

Located just outside the heart of

Talkeetna, it is easy to treat yourself

to the many local activities,

including favorites like flightseeing -

where you can even land on a

glacier in Denali National Park.

Registration, educational and

scientific program information,

accommodations and sightseeing for

both the main and post-conference

may be found at

www.ruralwonca2006.org.

We hope that you will plan to

join us and be part of our exciting

program.

Tom E. Norris, MD

Chair, Organizing Committee

tnorris@u.washington.edu

Tomlin Paul - Wonca Global

Family Doctor for May

Dr Tomlin Paul was born in 1960

in the small village of Morne Diablo

in Trinidad and Tobago in the

southern Caribbean. After studying

for his medical degree at the

University of the West Indies in

Jamaica, he went on to further his

studies in community health and in

1986 graduated with a Master of

Public Health. He has been working

in Jamaica since, as a family

physician, teacher, researcher and

volunteer.

Dr Paul’s heart has remained in

the community over the years. He

has been a teacher of community

health for the past 20 years and for

the last 3 years has been

responsible for coordinating the

undergraduate programme in his

Department at the University of the

West Indies. He teaches family

medicine and primary care to

medical students and coordinates a

rural experience where students

gain first hand experience in

managing and treating common

problems in the community. In 2002

he developed a course for Family

Medicine residents on Health

promotion and wrote an

accompanying monograph. He is

also the co-developer of a web-

based module in health

management for medical students.

Dr Tomlin Paul,

Wonca Global Family

Doctor for May 2006

In 1993, together with one his

classmates, Dr Paul founded Health

Plus Associates, a medical centre

which delivers family medicine and

specialist services to community

members in Kingston, Jamaica. He

has directed this Centre and worked

on a part time basis as a family

physician over the years, where he

has developed a reputation as a

caring and compassionate family

physician. He has a strong interest

in geriatric family medicine and has

also provided care at a senior

WONCA

News

MEMBER AND ORGANIZATIONAL NEWS / RESOURCES FOR THE FAMILY DOCTOR

citizen nursing home over the last 4

years and has participated in WHO

discussions on the development of

Age Friendly Guidelines for primary

health care centres. He has also

published and presented numerous

papers on areas of family medicine

and community health in the

Caribbean.

Dr Paul has also demonstrated

leadership in the development of

the regional Family Medicine

organization - the Caribbean College

of Family Physicians. He has been a

regional Vice President of this

organization for the past 4 years

and has been involved in its

development of accreditation

process and in the planning and

delivery of its research conferences.

Dr Paul gives of his time widely

to a range of organizations. He is a

founding director of the Whole

Person Resource Centre, a non-

governmental agency involved in

capacity building and whole person

development. He has served on a

number of national and regional

bodies and is currently a member of

the National Family Planning Board

of Jamaica and an executive member

of Hope Estate Educational Partners,

an organization which he co-founded

to develop safer and healthier

environments for children. He has

worked closely with the Pan

American Health organization in

developing health promotion

training in the Caribbean. He also

makes contributions to his local

church through participation as a

family physician in the church clinic

and in delivering talks at

educational seminars.

Dr Paul demonstrates the

balance of a teacher, researcher and

community/family physician and

volunteer and is a deserving winner

of the Wonca Global Family Doctor

of the Month Award for May 2006.

RESOURCES FOR THE

FAMILY DOCTOR

THE WORLD HEALTH

REPORT 2006 - WORKING

TOGETHER FOR HEALTH

The World Health Organization

publishes annually a major global

health report. The World Health

Report 2006 - Working Together for

Health contains an expert

assessment of the current crisis in

the global health workforce and

ambitious proposals to tackle it

over the next ten years, starting

immediately. The report reveals an

estimated shortage of almost 4.3

million doctors, midwives, nurses

and support workers worldwide.

The shortage is most severe in the

poorest countries, especially in sub-

Saharan Africa, where health

workers are most needed. Focusing

on all stages of the health workers’

career lifespan from entry to health

training, to job recruitment through

to retirement, the report lays out a

ten-year action plan in which

countries can build their health

workforces, with the support of

global partners.

The World Health

Report 2006 -

Working Together for

Health

Based on new analyses of

national censuses, labour surveys

and statistical sources, WHO

estimates there to be a total of

59.2 million full-time paid health

workers worldwide (see Table 1).

These workers are in health

enterprises whose primary role is to

improve health (such as health

programmes operated by

(Editor’s note: The “Global

Family Doctor of the Month” Award

is an award to encourage

philanthropy among primary care

practitioners and to honour doctors

giving their time and expertise to

their global colleagues and their

patients. The award is given to

doctors who are recognised by their

colleagues as having contributed

significantly to the community in

which they work by way of their

practice, community involvement,

charity work or other humanitarian

acts.

Each Award winner will receive:

1.A letter of congratulations from

the Wonca CEO

2.An Award certificate signed by

the President of Wonca and the

CEO of Wonca suitable for

framing.

3.A complete office diagnostic set

from Welch Allyn worth

approximately US$400.

Submission Requirements:

1.Title and Full Name of nominee.

2.Photo of nominee. The winner

and his/her photo would be

featured on Wonca’s website

www.GlobalFamilyDoctor.com

3.Postal address of nominee.

4.Reasons for nomination for the

Award.

5.Brief resume or CV of the

nominee

6.Any other relevant information

that would assist Wonca in the

selection process.

Please submit nominations and

accompanying documents via email

for this monthly Award to:

Dr Alfred Loh

CEO

World Organization of Family

Doctors (Wonca)

#01-02 College of Medicine Building

16 College Road

SINGAPORE 169854

Ph +65 6224 2886

Fax +65 6324 2029

Email admin@wonca.com.sg )

government or non-governmental organizations) plus

additional health workers in non-health organizations

(such as nurses staffing a company or school clinic).

Health service providers constitute about two thirds of

the global health workforce, while the remaining third is

composed of health management and support workers.

Workers are not just individuals but are integral

parts of functioning health teams in which each member

contributes different skills and performs different

functions. Countries demonstrate enormous diversity in

the skill mix of health teams. The ratio of nurses to

doctors ranges from nearly 8:1 in the African Region to

1.5:1 in the Western Pacific Region. Among countries,

there are approximately four nurses per doctor in

Canada and the United States of America, while Chile,

Peru, El Salvador and Mexico have fewer than one nurse

per doctor. The spectrum of essential worker

competencies is characterized by imbalances as seen,

for example, in the dire shortage of public health

specialists and health care managers in many countries.

Typically, more than 70% of doctors are male while

more than 70% of nurses are female - a marked gender

imbalance. About two thirds of the workers are in the

public sector and one third in the private sector.

Workers in health systems around the world are

experiencing increasing stress and insecurity as they

react to a complex array of forces. Demographic and

epidemiological transitions drive changes in population-

based health threats to which the workforce must

respond. Financing policies, technological advances and

consumer expectations can dramatically shift demands

on the workforce in health systems. Workers seek

opportunities and job security in dynamic health labour

markets that are part of the global political economy.

The spreading HIV/AIDS epidemic imposes huge

work burdens, risks and threats. In many countries,

health sector reform under structural adjustment capped

public sector employment and limited investment in

health worker education, thus drying up the supply of

young graduates. Expanding labour markets have

intensified professional concentration in urban areas

and accelerated international migration from the

poorest to the wealthiest countries. The consequent

workforce crisis in many of the poorest countries is

characterized by severe shortages, inappropriate skill

mixes, and gaps in service coverage.

WHO has identified a threshold in workforce density

below which high coverage of essential interventions,

including those necessary to meet the health-related

Millennium Development Goals (MDGs), is very unlikely.

Based on these estimates, there are currently 57

countries with critical shortages equivalent to a global

deficit of 2.4 million doctors, nurses and midwives. The

proportional shortfalls are greatest in sub-Saharan

Africa, although numerical deficits are very large in

South-East Asia because of its population size.

Paradoxically, these insufficiencies often coexist in a

country with large numbers of unemployed health

professionals. Poverty, imperfect private labour markets,

lack of public funds, bureaucratic red tape and political

interference produce this paradox of shortages in the

midst of under utilized talent.

In tackling these world health problems, the

workforce goal is simple - to get the right workers with

the right skills in the right place doing the right things!

- and in so doing, to retain the agility to respond to

crises, to meet current gaps, and to anticipate the

future.

A blueprint approach will not work, as effective

workforce strategies must be matched to a country’s

unique history and situation. Most workforce problems

are deeply embedded in changing contexts, and they

cannot be easily resolved. These problems can be

emotionally charged because of status issues and

politically loaded because of divergent interests. That is

why workforce solutions require stakeholders to be

engaged in both problem diagnosis and problem

solving.

This report lays out a “working lifespan” approach

to the dynamics of the workforce. It does so by

focusing on strategies related to the stage when people

enter the workforce, the period of their lives when they

are part of the workforce, and the point at which they

make their exit from it. The road map of training,

sustaining and retaining the workforce offers a worker

perspective as well as a systems approach to strategy.

Workers are typically concerned about such questions

as: How do I get a job? What kind of education do I

need? How am I treated and how well am I paid? What

are my prospects for promotion or my options for

leaving? From policy and management perspectives, the

framework focuses on modulating the roles of both

labour markets and state action at key decision-making

junctures.

The full report may be downloaded at http://

www.who.int/whr/2006/en/index.html .Copies of this

publication can be ordered from: bookorders@who.int

WONCA

News

RESOURCES FOR THE FAMILY DOCTOR

Lifting the Smoke-screen - 10 Reasons for a

Smoke-free Europe

Scotland became the sixth European country to be

smoke free on March 26, 2006, following the example

of Ireland, Norway, Italy, Malta and Sweden. England

will be smoke free next year after a historic vote in the

Parliament last month. In France the support to become

smoke free is growing after the release of (a 151 pages)

an official report of IGAS, which recommended last

month that the best solution is a complete ban in all

public places in France. http://

www.ladocumentationfrancaise.fr/rapports-publics/

064000239/index.shtml

A recent report was released in the European

Parliament entitled Lifting the Smoke-screen - 10

Reasons for a Smoke-free Europe. Professor Konrad

Jamrozik of the University of Queensland made

estimated that more than 79,000 adults die each year

as a result of passive smoking in the 25 countries of

the EU. A total of just over 19,000 of the deaths are

among non-smokers.

Figures for second-hand smoking-related deaths are

broken down by country (25 European Union countries

plus Iceland, Norway and Switzerland), by age (under

65 years, over 65 years), by site (home, work, including

separate figures for the hospitality industry) and by

condition (lung cancer, ischaemic heart disease, stroke,

chronic non-neoplastic pulmonary disease).

Where smoke free policies have been introduced, at

least three out of every four people support them.

Compliance rates are high. In Norway, 94% of

respondents reported that they were seldom or never

exposed to tobacco smoke in bars and restaurants

following the legislation in December 2004 compared

with 56% the previous year. The policy has become

more popular since its introduction in New York, Ireland,

Norway and New Zealand. In Norway, popularity

increased from 47% before the law was introduced to

58% afterwards. Support has also increased in Italy.

Tobacco companies have always claimed that a

smoking ban in bars and restaurants would have a

negative impact on business and lead to fewer sales

and less employment. Independent and reliable

research on the financial impact of smoke-free policies

in the hospitality industry provides evidence that

counters the tobacco industry’s economic claims.

A review of the literature by Scollo and colleagues of

almost 100 studies, produced before 31 August 2002,

from Canada, UK, USA, Australia, New Zealand, South

Africa, Spain and Hong Kong, failed to find a negative

impact or a positive effect in studies based on objective

and reliable measures. http://tc.bmjjournals.com/cgi/

content/full/12/1/13

Other information on the effect of recent smoking

bans in British Colombia (2002), New York (2003),

Ireland (2004), Norway (2004) and New Zealand (2004)

has not shown a negative impact on business. They

concluded that, “The truth is that there is no country or

state which experienced negative economic impact after

a smoking ban in bars and restaurants”.

The report, Lifting the Smoke-screen - 10 Reasons for

a Smoke-free Europe, may be downloaded on http://

www.ersnet.org/ers/default.aspx?id=4577

Luk Joossens

Advocacy Officer, Association of European Cancer

Leagues

Brussels, Belgium

Member of GLOBALink - The International Tobacco-

Control Community

www.globalink.org

(Editor’s note: Submitted to Wonca News by Professor

Rick Bohtelho, Chair of the Wonca Task Force on

Tobacco Cessation)

Call for Papers Issued by Education for Health

Editors

The editors of Education for Health, the journal of

The Network: Towards Unity for Health, have issued a

call for papers for a special issue entitled, The

Integration of Medicine and Public Health in Practice

Through a Unity of Purpose and Action.

In 1999, WHO held an international conference to

address the current fragmentation of health systems and

to develop a framework for better melding the domains

of medicine and public health in health care delivery.

The resulting framework created, referred to as:

“Towards Unity for Health” (TUFH) addresses the need

for a better coordination of health service delivery

through partnerships among the community, health

service providers, policy makers, health professionals

and academic institutions. As described by one of its

creators, TUFH “endeavors to create a unity of purpose

and action among stakeholders”. The theoretical model

has now been tested explicitly in several field projects

internationally as well as implicitly in a variety of other

sites in developed and developing countries.

WONCA

News

RESOURCES FOR THE FAMILY DOCTOR

The editors of Education for Health, a journal listed

in several databases including Index Medicus, are now

planning a special issue of the journal to showcase this

model. We are seeking manuscripts that of descriptions

and evaluations of programs demonstrating innovative

patterns of service and implement the basic principles

of TUFH. We would like to emphasize that we are

soliciting manuscripts that model these principles; it is

not necessary that the project has any connection to

TUFH. These principles include: consensus building

among stakeholders, community engagement,

leadership training, shared management and resource

development and deployment. Roles of the five

stakeholders - health service providers, health

professionals, the community, policy makers and the

academic community, should be described. Programs

may be at the community, district, state or national

level.

Two types of papers may be submitted:

*Full papers of 3000 words or less. These should

include the initial program objectives, a description

of the partners and their roles, the implications of

WONCA

News

RESOURCES FOR THE FAMILY DOCTOR

the program for the health professions and evidence

of impact.

*Brief communications of less than 1200 words. A full

program evaluation is not required. This format may

be used to describe programs which are in the

process of being implemented but have not yet been

evaluated.

Articles in English, Spanish and French are welcome.

Summaries in these languages will be available for each

article .

Manuscripts are due by July 31, 2006 and should be

submitted via email to “Education for Health” at:

efh@network.unimaas.nl. Routine author guidelines will

be utilized, which are available at: http://www.the-

networktufh.org. If you have specific questions, please

contact either of us via email.

Margaret Gadon, MD, MPH

Michael Glasser, Ph.D.

Co-Editors Education for Health

Email: efh@network.unimaas.nl

SAVE

THE

DATE

WONCA Rural Health Conference

2006

Transforming Rural Practice

Through Education

September 8-15, 2006

Seattle, WA, USA

www.ruralwonca2006.org

www.ruralwonca2006.com

www.ruralwonca2006.net

WONCA Rural Conference

September 8-10, 2006

University of Washington campus

Clinical Conference

September 11-13, 2006

Annual Advances in Family Practice and Primary Care

University of Washington campus

Post Conference

September 13-15, 2006

Talkeetna Alaskan Lodge — Anchorage, Alaska

WONCA

News

CONFERENCES 2006 – 2011

WONCA CONFERENCES 2006 – 2011 AT A GLANCE

**Wonca Direct Members enjoy lower conference registration fees

See Wonca Website www.GlobalFamilyDoctor.com for upates & membership information

2006

Region

Venue

Theme

27 – 30 Aug

European

Florence

ITALY

Towards Medical Renaissance:

Regional Conference

Bridging the Gap Between Biology

and Humanities

8 – 16 Sept

World Rural

Seattle

Transforming Rural Practice

Health Conference,

Washington

Through Education

USA

Clinical Conference,

& Post Conference

Anchorage,

Alaska, USA

11 – 14 Oct

Iberoamericana -

Buenos Aires

Building a Primary Care-Based Health

CIMF Regional

ARGENTINA

System: the Role of the Family Doctor

Conference

5 – 9 Nov

Asia Pacific

Bangkok

THAILAND

Happy and Healthy Family

Regional Conference

2007

24 – 27 July

18th WONCA

SINGAPORE

Genomics and Family Medicine

WORLD CONFERENCE

17 – 21 Oct

European

Paris

Re-Thinking Primary Care in the European

Regional

FRANCE

Context: A New Challenge for General

Conference

Practice

2008

1 – 5 Oct

Asia Pacific

Melbourne

A Celebration of Diversity

Regional

AUSTRALIA

Conference

2009

5 – 8 June

Asia Pacific

Hong Kong

Building Bridges

Regional

Conference

2010

19 – 23 May

WONCA

Cancun

Millennium Development Goals:

World Conference

MEXICO

the Contribution of Family Medicine

2011

February 2011

Cebu

Paradigms of Family Medicine:

Regional

Asia Pacific

PHILIPPINES

Bridging Old Traditions with

Conference

New Concepts

Information correct as of January 2006.

May be subject to change.

WONCA

News

GLOBAL MEETINGS FOR THE FAMILY DOCTOR

GLOBAL MEETINGS FOR THE

FAMILY DOCTOR

WONCA WORLD AND

REGIONAL CONFERENCE

CALENDAR

Wonca Europe Regional Conference,

Florence 2006

Host:CSERMEG

Theme:Towards Medical

Renaissance

Date:27-30 August, 2006

Venue:Florence, Italy

Contact:OICsrl

Viale Matteotti 7

50121 Florence, Italy

Tel:+39 0555 0351

Fax:+39 0555 001912

Email:wonca2006@oic.it

Web:http://

www.woncaeurope2006.org

Wonca 7th Rural Health Conference,

Seattle-Anchorage 2006

Host:Wonca Rural Health

Working Party

Theme:Transforming Rural Practice

Through Education

Date:8-15 September, 2006

Venue:8 -10 September – Wonca

Rural Conference

University of Washington

campus

11-13 September, 34th

Annual Advances in Family

Practice

University of Washington

campus

13-15 September, Post

Conference

Talkeetna Alaskan Lodge

Anchorage, Alaska

Contact:Tom E Norris, MD

Chair, Host Organizing

Committee

Department of Family

Medicine

University of Washington

School of Medicine

Box 356390

Seattle, WA 98195-6390,

USA

Fax:206-543-3101

Email:tnorris@u.washington.edu

Web:http://

www.ruralwonca2006.org/

Wonca Iberoamericana-CIMF Region,

Buenos Aires, 2006

Host:Federacion Argentina De

Medicina Familiar y General

Theme:Pursing Equity and

Efficiency in Healthcare:

The Role of the Family

Doctor

Date:11-14 October, 2006

Venue:Sheraton Hotel, Buenos

Aires

Contact:Federacion Argentina De

Medicina Familiar y General

Tel:54 11 4958 5079

Email:famfyg@aamf.org.ar

Web:www.famfyg.org.ar

15th Wonca Asia Pacific Regional

Conference, Bangkok 2006

Host:General Practitioners/Family

Physicians Association of

Thailand

College of Family

Physicians of Thailand

Theme:Happy and Healthy Family

Date:5-9 November, 2006

Venue:The Royal Golden Jubilee

Building

Contact:Dr Kachit Choopanya,

Chairman, Host Organizing

Committee

11th Floor, Royal Golden

Jubilee Building

2 Soi Soonvijai, New

Petchaburi Road

Bangkok, Thailand 10320

Tel:66(0) 2716 6651

Fax:66(0) 2716 6653

Web:www.wonca2006.org

18th Wonca World Conference,

Singapore 2007

Host:College of Family

Physicians, Singapore

Theme:Genomics and Family

Medicine

Date:24-27 July, 2007

Venue:Singapore International

Convention and Exhibition

Centre

Contact:Dr Tan See Leng,

Chairman,

Host Organizing Committee

College of Family

Physicians, Singapore

College of Medicine

Building

16 College Road #01-02

Singapore 169854

Tel:65 6223 0606

Fax:65 6222 0204

Email:contact@cfps.org.sg

Web:www.wonca2007.com

ONLINE REGISTRATION NOW OPEN

Wonca Europe Regional Conference,

Paris, 2007

Host:French National College of

Teachers in General

Practice

Theme:Rethinking Primary Care in

the European Context

Date:17-21 October, 2007

Venue:Palais des Congres

Paris, France

Contact:French National College of

Teachers in General

Practice

6 rue des Deux Communes

94300 Vincennes, France

Tel:33-153 669 180

Emailcnge@cnge.fr

Web:www.cnge.fr

WONCA

News

GLOBAL MEETINGS FOR THE FAMILY DOCTOR

19th Wonca World Conference, Cancun 2010

Host:Mexican College of Family Medicine

Theme:Millennium Develop Goals:

The Contribution of Family Medicine

Date:26-30 May, 2010

Venue:Cancun Conventions and Exhibition Center,

Cancun Mexico

Contact:Mexican College of Family Medicine

Anahuac #60

Colonia Roma Sur

06760 Mexico, D.F.

Tel:52-55 5574

Fax:52-55 5387

Email:javier.dominguez@unfpa.org.mx

MEMBER ORGANIZATION AND RELATED MEETINGS

Congresso de Medicina de Família e Comunidade (8th

Brazilian Meeting of Family and Community Medicine),

Sao Paulo 2006

Theme:Comprehensive Health Care in Brazil: The

Contribution of Family and Community

Medicine - Making Medical Practice More

Relevant to People’s Needs

Host:Brazilian Society of Family and Community

Medicine

Date:15-18 June 2006

Venue:São Paulo, Brazil

Host:Brazilian Society of Family and Community

Medicine

Contact:Rua Marquês de Itu, 408 Cj 34/35

Vila Buarque

São Paulo - SP

Brazil - Cep: 01223-000

Phone:55 11 83636868

Fax:55 11 33613089

Email:sbmfc@sbmfc.org.br

Web:www.sbmfc.org.br/congresso2006

13th World Conference on Smoking or Health,

Washington, DC 2006

Theme:Building Capacity for a Tobacco-Free World

Date:12-15 July, 2006

Venue:Renaissance DC Hotel

Washington, D.C., USA

Contact:John Seffrin, PhD

Chief Executive Officer

American Cancer Society

Email:secretariat2006@cancer.org

Web:http://www.2006conferences.org/

American Academy of Family Physicians (AAFP)

Annual Scientific Assembly, Washington, DC 2006

Date:27 Sept - 1 October, 2006

Venue:Washington DC Convention Center

Contact:AAFP

11400 Tomahawk Creek Parkway

Leawood, Kansas 66211-2672, USA

Tel:1 913 906 6000

Fax:1 913 906 6075

Email: international@aafp.org

Web:http://www.aafp.org

The Royal Australian College of General Practitioners

48th Annual Scientific Conference, Brisbane 2006

Date:5-8 Oct, 2006

Theme:Be the Future

Venue:Brisbane Convention and Exhibition Centre

Contact:Michaela Fox

Email:michaela.fox@racgp.org.au

Web:http://www.racgp.org.au/asc2006/

International Society for Quality in Health Care

23rd International Conference, London 2006

Date:22-25 October, 2006

Venue:London, United Kingdom

Contact:ISQua Secretariat

212 Clarendon Street

East Melbourne 3002 AUSTRALIA

Phone: +61 3 9417 6971 ..

Fax: +61 3 9417 6851

Email:isqua@isqua.org

Web: http://www.isqua.org

College of Family Physicians of Canada (CFPC)

Family Medicine Forum, Manitoba 2006

Date: November 2 - 4, 2006

Venue:Quebec City Convention Centre

Quebec City, Quebec

Contact:Joanne Langevin; Meetings Manager

Cheryl Selig, Registration Coordinator

2630 Skymark Avenue

Mississauga, Ontario, Canada L4W 5A4

Tel:(905) 629-0900 / 1-800-387-6197

Fax:(905) 629-0893

Email:info@cfpc.ca

Web:www.cfpc.ca