From the President: Family Medicine in the Asia Pacific & SDGs

Residents and staff of the Family Medicine Residency Training Program at the Ramathibodi Hospital of Mahidol University in Bangkok, Thailand, with WONCA president and WONCA president-elect


Dr Saipin Hathirat is program director of the Department of Family Medicine at the Ramathipodi Hospital of Mahidol University in Bangkok in Thailand. Earlier this year I visited Saipin and the academic staff and residents of the Ramathipodi Family Medicine Residency Training Program. It was a privilege to hear from these enthusiastic young doctors about the challenges they face and the joys of their daily work. President-elect, Amanda Howe, and I also had the opportunity to visit the impressive training facilities within the clinical services of the Department of Family Medicine.

Photo: Typical family medicine consultation room in the Ramathipodi Hospital Department of Family Medicine in Bangkok

Although based within a hospital, the Department of Family Medicine clinic is on the ground floor, and all patients attending the hospital are seen in the clinic and managed there and then, or referred to other specialist clinics upstairs.

Exciting developments like this are taking place all across the Asia Pacific Region. In March the members of the Taiwan Association of Family Medicine hosted our 2015 WONCA Asia Pacific Regional Conference, bringing together family medicine colleagues from Chinese Taipei, from across the Asia Pacific Region and from around the world.

One of the highlights of the conference was the vocal presence of the young family doctors of the Asia Pacific, members of WONCA’s Rajakumar Movement, led by the irrepressible Dr Shin Yoshida from Japan. Our young doctors are supporting each other to prepare for meeting the future health care challenges facing our world.

Photo: Shin Yoshida and Rajakumar members from the Taipei conference

2015 is a landmark year in global health as the Millennium Development Goals come to an end. The United Nation has developed the Sustainable Development Goals and targets, or SDGs, which will guide the global development agenda post-2015. In his inspiring address to the United Nations General Assembly last December, Secretary-General Ban-Ki Moon, discussed “The road to dignity by 2030: ending poverty, transforming all lives, and protecting the planet.”

The United Nations Secretary-General made a call to action to transform our world beyond 2015. In his words “we are at a historic crossroads... With our globalized economy and sophisticated technology, we can decide to end the age-old ills of extreme poverty and hunger. Or we can continue to degrade our planet and allow intolerable inequalities to sow bitterness and despair. Our ambition is to achieve sustainable development for all.”

He goes on to state that the 1.8 billion young people on the planet “are the torchbearers for the next sustainable development agenda through 2030. We must ensure this transition, while protecting the planet, leaves no one behind.”

Photo: Wat Arun temple on the west bank of Bangkok’s Chao Phraya River

The United Nations has adopted 17 Sustainable Development Goals. There is only one health specific goal, number 3: “Ensure healthy lives and promote well-being for all at all ages.” But each of the 17 new goals has an impact on global health and the health of individuals.

The Secretary-General advised that, “Millions of people, especially women and children, have been left behind in the wake of unfinished work of the Millennium Development Goals. We must ensure that women and also youth and children have access to the full range of health services. We must ensure zero tolerance of violence against or exploitation of women and girls … The agenda must address universal health-care coverage, access and affordability; end preventable maternal and child deaths and malnutrition; ensure the availability of essential medicines; realize women’s sexual and reproductive health and reproductive rights; ensure immunization coverage; eradicate malaria and realize the vision of a future free of AIDS and tuberculosis; reduce the burden of non-communicable diseases, including mental illness, and of nervous system injuries and road accidents; and promote healthy behaviours, including those related to water, sanitation and hygiene.”

These are bold ambitions, and as global citizens, family doctors must play our part. People-centred care is a core component of universal health coverage, and there will be an increasing role for family medicine over the coming years in many countries to ensure this happens. We need to support the focus on the social determinants of health and work to ensure marginalized populations, those groups of people in our communities most at risk of poor health, are not excluded from health care.

Each nation needs a strong system of primary care, and strengthening primary care must continue to be addressed beyond 2015. WONCA needs to ensure the clear voice of family medicine is heard on behalf of our patients and communities. 
We need to be clear about our role as family doctors in working with our patients and communities to increase life expectancy and achieve equitable health outcomes. 

Earthquake in Nepal

The global community has been saddened by the tragic consequences of the earthquake, and the subsequent aftershocks and avalanches, in Nepal. Our thoughts are with all the people in Nepal and surrounding nations affected by this tragedy, including all our colleagues who are members of the General Practitioners' Association of Nepal, our WONCA member organisation. This tragedy will have touched the lives of everyone in Nepal and are thoughts are with all our colleagues at this sad time, including our WONCA Regional President for South Asia, Professor Pratp Prasad and his family in Kathmandu, and our many family medicine colleagues based in Kathmandu and in other affected urban, rural and remote locations across the country. Soon after the earthquake we started to receive reports of how our colleagues in Nepal are reaching out to assist and support all those who have been affected by this tragic event.

At times of terrible tragedy, those of us based in other parts of the world often wish we could make a difference and reach out and provide assistance. In the early stages following such an event, the best advice is to provide financial support to a trusted and experienced non-government organization (NGO) involved in the local relief efforts. This includes organisations such as Red Cross/Red Crescent, MSF (Doctors Without Borders), World Vision and Oxfam. Please make a donation today and also encourage your national government to provide much needed financial support to Nepal.

Once the immediate needs of the people of Nepal have been met, our colleagues in Nepal will be able to advise us about practical ways we can provide direct support, as individuals and through our own member organisations, to assist our colleagues and their health services and communities to recover their capacity as they rebuild in the aftermath of this tragic event. Our colleagues in Nepal will need our support over the months and years ahead.

World Family Doctor Day 2015

As doctors we can be proud of our profession. Each of us has a set of values and principles that determine how we behave as ethical medical practitioners. Each of us has the potential to be a role model for future doctors, and to contribute our own lasting legacy through the examples that we set in the way that we live our lives and the way we practise medicine.

The challenges we face also test our own resilience. While we continue to innovate within our practices and within our communities to ensure that our patients receive the highest possible standards of care, it is critical that we also continue to innovate to find ways to support each other as well.

Many family doctors work under very difficult conditions, often without the resources needed to do our jobs. We work long hours with arduous demands on our time. Our resilience is tested regularly, and many of us feel unappreciated. And we don't often hear the words thank you.

This is why WONCA has established World Family Doctor Day, held on May 19 each year, to acknowledge the important work you do. World Family Doctor Day allows us to say thank you for your commitment every day to providing health care to the people of your communities.

On May 19, on behalf of the billions of people around the world who benefited during the past year from your care and support, and from the care and support of our family doctor colleagues, we say thank you. Thank you for your commitment to being a wonderful family doctor. Thank you for the great and important work you do. And thank you for the health care you provide each day to the people who trust you for their care and advice.

Michael Kidd
WONCA President