From the President: Family medicine in the Middle East

Photo: WONCA Eastern Mediterranean Region President, Mohammed Tarawneh, and Honorary Treasurer Oraib Alsmadi, with representatives of the Al Razi Young Doctor Movement and representatives of the International Federation of Medical Students Associations (IFMSA)

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Dr Khawla Alsawaf is a family doctor working at the Al Hamraa Primary Care Centre in Jeddah in the Kingdom of Saudi Arabia. Khawla works with a team of health professionals delivering comprehensive primary health care services to the members of her community.

Photo : Dr Khawla Alsawaf, family doctor, at the Al Hamraa Primary Care Centre, Jeddah, Saudi Arabia

I recently visited Saudi Arabia as a member of a World Health Organization mission. We had been invited to review primary health care across the country. This visit allowed me to witness the changes underway in a country that has firmly adopted a policy of strengthening primary health care through a family practice model.

Following governmental commitment to the Declaration of Alma Ata in 1980, the health system in Saudi Arabia has been reformed to deliver comprehensive, cost-effective primary care services to all members of the community.

Photo: Dr Hayel, at the Khaled Primary Health Care Centre, Jeddah, Saudi Arabia

Family Medicine was introduced as an academic discipline at the College of Medicine at King Faisal University in 1980, and at King Saud University in 1982, and postgraduate training in Family Medicine was introduced in 1983. In recent years that there has been strong government-level commitment to the role of the family physician in leading the delivery of primary health care services in Saudi Arabia.

The primary health care services provided by the Saudi Ministry of Health are delivered through an extensive national network of 2,500 primary care centres, based in both urban and rural communities. Other providers of primary care services in Saudi Arabia include university hospitals, the military, the National Guard, and the private sector.

Saudi Arabia is one of many nations in the Middle East taking the role of family medicine very seriously. Family medicine is seen as the solution to ensuring universal health coverage, health care for all people. This was highlighted at the recent WONCA Eastern Mediterranean Region Conference, held in Dubai in March, in the United Arab Emirates.

WONCA’s Eastern Mediterranean Region runs from Morocco in the west through to Afghanistan in the east. The regional conference saw the welcoming of new WONCA member organisations from Afghanistan, Algeria, Kuwait and Morocco, and the Department of Family and Community Medicine at the University of Gezira in Sudan was welcomed as a new academic member. The WONCA Eastern Mediterranean Region also includes Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria and the United Arab Emirates, with a number of other countries in the region, including Iran and Tunisia, currently in the process of seeking membership of our global organisation.

One of the highlights of our Eastern Mediterranean Region Conference was a special panel session hosted by leaders from the World Health Organization’s Eastern Mediterranean Regional Office (WHO EMRO), including Sameen Siddiqi, Hassan Salah and Mohammad Assai. This session highlighted many of the challenges facing family medicine development in nations of the region, including lack of government-level support, inadequate investment in facilities and support for primary health care, and severe shortages of trained family physicians and other primary health care professionals.

 Photo: WONCA Africa region president, Matie Obazee, and other delegates participate in the 3rd WONCA Eastern Mediterranean Region 2016 Family Medicine Conference

These are, of course, challenges that affect many countries around the world. But the WHO EMRO has a plan to scale up family practice in all nations of the region, including high, middle and low-income nations, and nations affected by serious crises. With support from WONCA, the WHO EMRO is working with each country’s Ministry of Health to gain political support and strengthen capacity in family practice. Programs have been established to introduce and scale up the training of specialist family physicians, and to support further training of general practitioners without postgraduate qualifications. Our family medicine colleagues from the American University of Beirut in Lebanon, and from Kuwait, among others, have been actively involved in working with WHO EMRO in supporting the training of colleagues from across the region.

It is impossible to visit the Eastern Mediterranean Region and not be aware of the crises affecting the people of several nations and especially the plight of the many people who are refugees fleeing violence in their home countries.

I commend to you the Istanbul Statement, released by WONCA Europe last October, calling for all people who are refugees to have access to equitable, affordable and high-quality health care.

WONCA’s global special interest groups (SIGs) are also active in this area, including our SIG on Migrant Care, International Health & Travel Medicine, led by Maria van den Muijsenbergh from the Netherlands, and our SIG on Conflict & Catastrophe Medicine, led by Prof Rich Withnall from the United Kingdom.

Several of our member organisations have produced resources to support family doctors working with migrants, refugees and people seeking asylum, including these guidelines from the Royal Australian College of General Practitioners.

We judge the nature of a community by the way it treats its most vulnerable and marginalized members. We are being judged as a global community by the way we respond to refugee crises around the world. As family doctors we play a role in ensuring health care for all people in our local communities. By working together we have a powerful voice as effective advocates for ensuring access to health care for all people.

Michael Kidd
World Organization of Family Doctors (WONCA)