From the President Family Medicine developments in South Asia

Photo: WONCA South Asia Regional Council with WONCA president, president-elect and CEO

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WONCA brings the family doctors of the world together to share our experiences in clinical practice, education and research in each of our countries. Our WONCA South Asia Region held its annual conference in Colombo in Sri Lanka in February. Over 600 family doctors from Sri Lanka, India, Pakistan, Bangladesh, Bhutan and the Maldives, joined together with colleagues from many other nations around the world, to share experiences in clinical care, education and training, and research.

Our host was the College of General Practitioners of Sri Lanka. College president, Antoinette Perera, Scientific Program Chair, Shyamale Samaranayaka, and former WONCA South Asia Regional President, Preethi Wijegoonewardene, led the team from the college in organizing the conference and its scientific program.

The College of General Practitioners of Sri Lanka was established in 1974, just two years after the establishment of WONCA, and was quick to become part of the WONCA family. The current college membership represents the diversity of family doctors in rural and urban Sri Lanka, with many enthusiastic young doctors working alongside senior members, including founding members and past presidents, Professor Leela Karunaratne and Professor Denis Aloysius. The college’s motto, “Arogya Parama Labha”, translates as, “The greatest of all gains is good health”. The college has a strong and well-established commitment to education, working with the national Postgraduate Institute of Medicine to offer a Diploma in Family Medicine, and an MD in Family Medicine by clinical training and assessment, for those seeking specialist recognition by the national Ministry of Health.

I have been a regular visitor to Sri Lanka over the past 20 years and have had the opportunity to visit many of our colleagues in their clinics in Colombo and in rural areas around Kandy and Galle, and to take part in the college’s education programs and rigorous assessment activities. I have always been impressed by the warmth, dedication and commitment of the family doctors of Sri Lanka, no more so than in the aftermath of the terrible 2004 Boxing Day tsunami when over 35,000 people lost their lives in Sri Lanka, and over 500,000 people lost their loved ones, homes and livelihoods. Our colleagues in the college, many themselves bereaved, immediately joined the relief efforts to assist the people of their nation, providing emergency health care and counseling services, and assisting to rebuild health clinics and homes in many affected areas. Our WONCA colleagues in many nations also banded together to raise funds and send much needed equipment to support our colleagues in Sri Lanka.

Over 25% of the people of the world live in South Asia, many in dire poverty with limited or no access to health care, and WONCA is committed to supporting developments throughout this region. This was my fifth visit to South Asia since becoming WONCA president and each time I visit I am impressed by the progress that is being made to strengthen family medicine in each country and to tackle the incredible challenges in working towards ensuring that all people have access to the health care they need.

Sri Lanka, with a population of 20,000,000, is no exception with dual serious challenges of both communicable and non-communicable diseases, and the challenge of an increasing population of elderly people, often with multiple comorbidities and many needing home-based care. The conference allowed family doctors from across the region to share solutions to the challenges that each nation is facing in strengthening primary health care through family medicine to meet these challenges and ensure universal health coverage.

Among the highlights of the conference was the program of events organized by the members of the Spice Route Movement, WONCA’s active organization for young family doctors in South Asia, founded by WONCA executive member, Dr Raman Kumar, and now led by Dr Bhavna Matta from India, and the launch of the new WONCA Rural South Asia (WoRSA) health group, an initiative led by young family doctor, Pratyush Kumar, from India, and dedicated to improving health care for the majority of people in the countries of South Asia who live in rural areas.

Photo: Members of the Spice Route Movement, WONCA’s organization for young family doctors in South Asia

I was also pleased to meet Dr Ali Shareef, our first WONCA direct member from the Maldives, the remote island nation in the Indian Ocean. Ali and his colleagues are planning to establish their own national family doctor association to advance the training of family doctors and to ensure the standards of primary health care delivery in their country.

My time in Colombo included a special personal event. 20 years ago, on my first visit to Colombo, I agreed to supervise the MD thesis of a young Sri Lankan family doctor, Kumara Mendis. Since that time Kumara has become a close friend and has been very active in WONCA, especially with our ehealth working party, sharing his experiences of the challenges of introducing electronic medical records in low- and middle-income nations. When I first met Kumara in Sri Lanka he took me to his home to meet his wife, Ramani, and his two small daughters. 20 years later and I was invited on this visit to attend the marriage of Ramani and Kumara’s eldest daughter, Radhika, in a Poruwa ceremony, the traditional Sinhalese wedding ceremony held on a beautifully decorated wooden platform and accompanied by drummers and singers. It was a joyous reminder of my privileged membership of our global family of family doctors.

Michael Kidd
WONCA President