Rural Round-up – the Prince Mahidol Award conference

March, 2014

Dear Colleagues

I was invited to represent you all at the Prince Mahidol Award conference in Thailand two weeks ago and I am keen to feed back my experiences.

This was an impressive and inspiring conference co-sponsored by the Thai Government, WHO, World bank, USAID, Rockefeller Foundation, China Medical Board and Japan International Cooperation Agency.

Prince Mahidol was a royal prince who trained as a doctor in Harvard and returned to his homeland as the father of modern medicine and public health. The conference and award was established in 1992 to honour individuals and explore issues related to medicine and public health from a global perspective. This year’s conference was entitled “Transformative Learning for Health Equity”.

It will come as a surprise to some of you that the importance of the education and training for health professionals has not had the profile that it deserves in many countries.

Things appear to be changing and the WONCA Working Party on Rural Practice (WWPRP ) are engaged in this process.

In 2008-9, a number of us were involved in a programme, run through the Human Resources Section of WHO entitled “Increasing Access to Health Workers in Remote and Rural Areas through improved Retention”. Despite the success of this programme, WHO however restructured soon after and dismantled the Human Resources of Health Directorate . However the die was cast and the Global Health Workforce Alliance (WHO Sponsored) and the Global Consensus on Social Accountability in Medical Education have ensured that Transformative Medical Education is seen as an essential tool in delivering the current goal of achieving Universal Health Coverage in the foreseeable future.

The WWPRP has been a champion of the transformative approach. Those of you who attended the very successful Rendez-vous Conference in Thunder Bay, in 2012, will know how the WWPRP is in the forefront of this movement - through its links with innovative pioneers and rural medical schools such as Memorial University of Newfoundland and the Northern Ontario School of Medicine, in Canada; Flinders & James Cook Universities, in Australia; Ateneo de Zamboanga School of Medicine and the University of Philippines School of Health Sciences, Leyte, in the Philippines; and Walter Sisulu University Medical School, in South Africa.

Special congratulations to Roger Strasser, Ian Couper and Krys Crystobell who were presented with Prince Mahidol Awards for their contribution to medical education. Well deserved!

The Prince Mahidol Award Conference was an impressive conference with some very high profile contributors including the President of the World Bank, Deputy Director General of the WHO, the Dean of the School Public Health at Harvard and many more.

I learnt a lot and had some important take home messages as well as useful contacts for the future, which included
• I was able to connect with the International Federation of Medical Student Associations (IFMSA). We have decided to work together to highlight and promote Rural Practice and I hope that we can have medical student representatives on the WWPRP. We hope to have a group join us in Dubrovnik, in 2015. I will keep you informed.
• We need to involve medical students when we develop innovative curricula. I was inspired by one of Krys Cristobell’s students from Zamboanga who had set up a milk bank for premature babies. Jan de Maeseneer from the Network: Towards Unity for Health (TUFH) emphasised the importance of engaging with students.
• We already have a strong relationship with TUFH and Jan de Maeseneer and I discussed developing a MOU for future collaboration
• Emphasis on new ways of learning using interactive IT solutions. I came across MOOCs (Massive online open courses). These are free university courses up to and including masters level available on the internet. This will open up education opportunities for countless students and professionals who have been unable to access health based education. Great presentation from Julio Frenk, Dean School Public Health Harvard - available here.
• The majority of the delegates were economists, NGO technocrats, or academics. We are not going to change the world without engaging with those working on the shop floor. I think that I came across one other family doctor! The professional organisations and bodies need to be there and up on the podium.
• Made contact with World Medical Association and looked to connections in the future.
• Much discussion of international migration of doctors and nurses. The WHO code has no teeth. There is a place for the professionally based codes such as the Melbourne Manifesto that can take advocacy role and demand changes that WHO can not make politically. We still have a lot to do!
• I met with Professor David Williams from London who is professor of Global Oral Health at St Bartholomews and the London Hospital. I had not thought of Oral Health in such a way before yet it remains an area of health inequality worldwide. We have much in common with our dental colleagues. David is a member of World Dental Federation Vision 2020 Task Group and is going to see how they can link and work with WWPRP.

There are probably many more take home messages. I felt privileged to be part of this conference and am very thankful to the organisers, sponsors and particular Ian and Roger for ensuring that I was invited.

Hope to see you all in Gramado, in April. Our next stop!

Dr John Wynn-Jones
Chair Wonca Working Party on Rural Practice