WONCA News October 2022

WONCAPRESIDENT DRANNASTAVDAL(NORWAY)

EMAIL:PRESIDENT@WONCANET TWITTER:@ASTAVDAL

WONCAIMMEDIATEPAST PRESIDENT DRDONALDLI(HONGKONG)

PRESIDENTELECT ASSOCPROFKARENFLEGG(AUSTRALIA)

EXECUTIVEMEMBERATLARGE& HONORARYTREASURER PROFVALWASS(UK)

EXECUTIVEMEMBERATLARGE DRMARÍAPILARASTIERPEÑA(SPAIN)

EXECUTIVEMEMBERATLARGE PROFSHABIRMOOSA(SOUTHAFRICA)

REGIONALPRESIDENT,WONCAAFRICA DRDANABUBAKAR(NIGERIA)

REGIONALPRESIDENT,WONCAASIAPACIFIC ASSOCPROFMOHAMMADHUSNIJAMAL(MALAYSIA)

REGIONALPRESIDENT,WONCAEAST MEDITERRANEAN

PROFTAGHREEDMOHAMEDFARAHAT(EGYPT)

REGIONALPRESIDENT,WONCAEUROPE PROFSHLOMOVINKER (ISRAEL)

REGIONALPRESIDENT,WONCAIBEROAMERICANA CIMF

ADJ/PROFJACQUELINEPONZO(URUGUAY)

REGIONALPRESIDENT,WONCANORTHAMERICA DRJEFFMARKUNS(USA)

REGIONALPRESIDENT,WONCASOUTHASIA DRTARIQAZIZ(PAKISTAN)

YOUNGDOCTORS'REPRESENTATIVE DRSANKHARANDENIKUMARA(SRILANKA)

WONCACHIEFEXECUTIVEOFFICER DRHARRISLYGIDAKIS

WONCAWORLDSECRETARIAT

WORLDORGANIZATIONOFFAMILYDOCTORS AVENUEDESARTS78

1210BRUSSELS

BELGIUM

EMAIL:SECRETARIAT@WONCANET PHONE:+32(0)23290075

WONCAEDITOR

MARIADOLORESZAVALA

EMAIL:EDITOR@WONCANET

TRANSLATIONS

DRJIEGU

DRHUAYANG

DRJULIENARTIGNY

CONTENT

FROM THE PRESIDENT PAGE 3

WONCA & WHO NEWS PAGE 6

WONCA EXECUTIVE MEMBERS MEET WITH WHO REPRESENTATIVES IN GENEVA

WONCA REGIONS

WONCA EMR INAUGURATES REGIONAL PROFESSIONAL DIPLOMA IN FAMILY MEDICINE

PAGE 9

INTERVIEW: JACQUELINE PONZO TALKS ABOUT THE VIII SUMMIT OF FAMILY AND COMMUNITY MEDICINE IN GUATEMALA WP & SIGS NEWS PAGE 16

AGEING LINES: STORIES FROM CAREGIVERS AND ELDERLY PATIENTS

FEATURED STORIES PAGE 19

WONCA GRANTS ACCREDITATION TO CLINICAL MASTERS IN FM OF THE ARABIAN GULF UNIVERSITY

WORLD MENTAL HEALTH DAY PAGE 20

WONCA CONFERENCES PAGE 24

ANNOUNCEMENTS AND UPDATES PAGE 26

FROM

WHILE ACTION STILL CAN

In our clinical work, Family Doctors are cautious; we don’t raise an alarm until and unless there is good reason to. Experience has honed our sense of timing; we’ve seen how too much focus too soon on risk and potential negative health outcomes may provoke indifference, even hopelessness, in our patients, undermining the veryactionswe’reseekingtohelptrigger.And,we knownottowaittoolong We’recarefultoshout outnecessarywarningswhilethere’sstilltimefor our patients’ actions to mitigate dramatic outcomes.Thatisgoodclinicalriskmanagement.

The world in all its sectors is in a state of imbalance after more than two years of the pandemic. The corona virus has traversed the globeatgreatspeed,amessengerknockingdown everynationaldoor.Ithasputusonnoticethat,if weintendtotransform‘OneHealth’fromamere slogan into a lived reality, we’ll need to take globalaction.

WestandbythepromiseswemadewhenWONCA was founded 50 years ago, and by our unconditional commitment to the UN 2030 Agenda and the Sustainable Development Goals. After cautious consideration as clinical risk management experts, we have reached the conclusiononbehalfofourorganizationthatthe moment for shouting out a global warning has come, while there’s still time to act to avert disaster Thus we’re stating it clearly: Global SolidarityisnowWONCA’SNumber1Priority.

F R O M T H E P R E S I D E N T

YES, GLOBALIZATION. BUT...

We cherish many aspects of globalization. It has shortened the distance between us, making it easier to share science, insights, products, and the arts The Internet is a wonderful tool for advocacy, for spreading our messages broadly, encouragingandenablingpeopletoteamupand exertinfluence,together.

But…

Let’s be honest and acknowledge the inequities thatglobalizationhasexposedandinflamed The huge gap between the rich and the poor persists andisgrowingfarhardertoimpact,ortoignore. We recognize in the exponentially growing epidemicofNon CommunicableDiseases(NCDs), which pre dates COVID, an apt, and awful, case in point of the interconnection between economics and health. NCDs increase inequities in all countries, but they hit the poorer countries thehardest.

Family Medicine and Primary Care are key in tackling NCDs. We have the skills to handle clinical complexity and to offer tailormade care. Yet, inequities are here too: our services are in shortestsupplyinpreciselythosecountrieswhere theneedforthemisgreatest.

WONCA`S VISION: ‘HEALTH FOR ALL AND A FAMILY DOCTOR FOR EVERY FAMILY’

We are 131 member organizations spread over 111countriesinsevenglobalregions

Another global trend is emerging, however, this one in countries where Primary Care has traditionally been strong Our services are being underfunded, especially as compared to hospital care. Family Doctors’ practices are increasingly overloaded while the recruitment of doctors to theFamilyMedicineSpecialtyisindecline

And, make no mistake about it there are huge differencesamongus.

WONCA`s fee structure is determined by the number of members in the area’s national colleges and associations. Consequently, High Income Countries (HIC) and Low and Middle IncomeCountries(LMIC)areimpacteddifferently. Thesmallestmemberorganizationsandcolleges, who pay less, are located in countries where Primary Care and Family Medicine services are scarce, as are available resources, both financial andhuman.

HIC member organizations contribute more to WONCA’s financial sustainability, based on their size. Yet they too have suffered during these last years, and the consequences for them keep coming Apredictablereactiontohardtimesisto turninward,totakecareofone’sownneedsfirst. Thus, when revenues sink during a “conference drought”andfinancialaccountsarelookingbad, the larger HIC members may well resist subsidizing those member groups with fewer resources,andlowerfees.

The smaller, LMIC colleges might protest that timesofcrisisarepreciselywhensmallergroups’ internalbusinessneedsaremoredirethanthose oftheHICgroups,obligatingtheorganizationasa whole to allocate a larger share of the resources tothem.

We are in it together Wherever we’re situated along the continuum, the challenges we face are the results of the same global trends, and the solutions we can design will serve us all. Health care inequity is dangerous, associated with political instability and an increased risk of conflict Big gaps between rich and poor spark rage, crime, wars, streams of refugees… Like the virus,inequityembroilsusall.

‘US VS. THEM’ RESPONSES ARE COUNTERPRODUCTIVE

E

O M T H E P R E S I D E N T

As more of us have now seen first hand, good public health does indeed depend on stable economic and ecological systems It’s probably neither pure altruism nor the desire to see themselves as nice people that motivates the more privileged among us to stress equity. Healthy populations are more likely to generate stablesocieties Thepandemicexposedtheclear andsimpletruth:‘Nooneissafeuntileveryoneis safe.’Solidarityservesusall.

Thatputsequityatourcore,asamutual,shared responsibility. It makes Global Solidarity our top priority

WONCA's voice supports coordinated, global action to strengthen Primary Care and promote Family Medicine. The stronger our unity, the strongerourvoice

F

WONCA PRESIDENT

DR ANNA STAVDAL

WONCA EXECUTIVE MEMBERS MEET WITH WHO REPRESENTATIVES IN GENEVA

In a short but fruitful stay in the Swiss city, President Stavdal began her agenda meeting Dr Bente Mikkelsen, director of the division of Noncommunicable Diseases of the WHO. Also presentatthemeetingwereDrTemoWaganivalu, and Dr Slim Slama, unit leaders at the NCDs DepartmentattheWHO

During the meeting, Dr Stavdal highlighted the mission of WONCA and the crucial role of family doctors and Primary Care professionals in global advocacy to improve the lives of people with NCDs.

WONCA President, Dr Anna Stavdal, WONCA CEO, Harris Lygidakis, and Professor Val Wass, Executive Member at Large and WHO Liaison, led key meetings with representatives of the World Health Organization at the organisation’s headquarters in Geneva, Switzerland.

Dr Temo Waganivalu, Dr Slim Slama, WONCA President Anna Stavdal, Dr Bente Mikkelsen, WONCA CEO, Harris Lygidakis, and Professor Val Wass at the WHO headquarters in Geneva

WONCA representatives also met with Prof Bettina Borisch, Executive Director of the World FederationofPublicHealthAssociations,andHoi Shan Fokeladeh, Policy Advisor at the International Council of Nurses (ICN), to brainstorm upcoming efforts to promote and advocateforuniversalhealth.

Professor Val Wass, WONCA President Anna Stavdal, Prof Bettina Borisch (World Federation of Public Health Associations, Hoi Shan Fokeladeh ICN) and WONCA CEO, Harris Lygidakis

WONCA President, Dr Anna Stavdal, WONCA CEO, Harris Lygidakis, and Professor Val Wass, Executive Member at Large and WHO Liaison

W O N C A & W H O N E W S

On the second day, WONCA Executive members firstheldameetingwithWHOrepresentativesDr Denis Porignon (Policy Advisor), Dr Teri Reynolds (Clinical Services and Systems Lead), Dr John Fogarty (Senior Technical Advisor), and Dr TheadoraSwiftKoller(SeniorTechnicalAdvisorin Equity).

WONCA executives also met with Maria Neira, Director of the Department of Environment, Climate Change and Health; Heather Adair Rohani, technical officer on energy and health; and Dr Anshu Banerjee, Director for the Department of Maternal, Newborn, Child and AdolescentHealthandAgeingoftheWHO.

WONCA at the WHO Headquarters: Heather Adair Rohani, WONCA President Anna Stavdal, Prof Val Wass, Maria Neira, and Dr Harris Lygidakis

Dr John Fogarty and D r Teri Reynolds with WONCA representatives, Prof Val Wass, WONCA President Anna Stavdal, and WONCA CEO, Harris Lygidakis.

WONCA EMR INAUGURATES REGIONAL PROFESSIONAL DIPLOMA IN FAMILY MEDICINE

The Regional Professional Diploma In Family Medicine (RPDFM) is a two year diploma. RPDF FM present one of successful collaboration for EMR primary health partners; World Health Organization Regional Office for Eastern Mediterranean (WHO EMRO), Arab Board of Health Specializations (ABHS), World Organization of Family Doctors (WONCA), Joint United Nations Programme on HIV/AIDS (UNAIDS), United Nations Population Fund (UNFPA), Office of the United Nations High Commissioner for Refugees (UNHCR), and United NationsChildren'sFund(UNICEF)

The RPDFM is a bridging programme aims at equippinggeneralpractitioners(GPs),whodonot have additional structured training after medical school, with the knowledge, skills and attitudes that are needed to provide comprehensive, continuous and appropriate health care to individualsandfamilies.Thetrainingisdelivered in a blended format using a mix of online (self directed, instructions, discussions) and face to face (teaching, discussions) clinical training with both academic and clinical supervisory support Thetrainingprogrammespansoveraperiodof24 months, with the first 12 months being fully online and the second 12 months in a blended format The training programme is divided into eight terms, spanning over 104 weeks, and composedof16blockswitheachblockspanning over six week period. Moodle will be used as a Learning Management System (LMS) for the online part of the training Nearly 800 physicians have met the eligibility criteria and were shortlisted for enrollment accordingly. The admission process has been initiated at country level.Also35tutorswereselectedinitiallytotake thiseducationaljourneyforward

TheinagurationeventtookplaceonSunday,2nd of October 2022. From 12:00 to 2:00 PM (Cairo local time) The inauguration started with opening remarks for Dr Ahmed Al Mandhari (RegionalDirector,WHOEMRO),DrOmarAlRawas (Secretary General, ABHS), Dr. Karina Nersesyan (Deputy Regional Director, UNFPA ASRO), Mr Aymen Gharaibeh (Regional Director,UNHCR MENA Bureau), Mr Bertrand Bainvel (Deputy Regional Director UNICEF MENARO) and finally Prof. Taghreed Farahat EMRO President, The World Organization of Family Doctors (WONCA). Prof Taghreed acknowledged the efforts of past and current presidents of WONCA world and WONCAEMRfortheiradvocacytofamilymedicine anddeclaredthisdiplomaasavictorytoWONCA as it will secure an adequate number of family physicianstoallowWONCAtoachieveitsMission andsubsequentlyachieveSDG3“HealthforAll”.

Then the Implementation overview of the RegionalProfessionalDiplomainFamilyMedicine was presented by Dr Elsheikh Badr (Chairperson, StrategyOffice,ABHS)andDrMonaOsman(Head, Training Committee, Family Medicine Council, ABHS) to describe the executive eb=vent and the Ganttchartfortheprocess.

W O N C A R E G I O N S

The first scientific session took place under the title ‘what does it mean to be a family doctor?’ where Dr Anna Stavdal President, The World OrganizationofFamilyDoctors,(WONCA)gavethe first talk highlighting family practice core values andaccentuatingthatnow,morethanever,what the world needs is: high quality Primary care. Dr Ghassan Hamadeh Professor of Family Medicine gave the second talk and emphasized the role of familypracticeinthecommunity

That was followed by question and answer then closingremarksfrom DrJawadElSharif(Deputy Secretary general, ABHS), Dr Rana Hajjeh (Director,ProgrammeManagement,WHOEMRO), and Dr Awad Mataria (Director, UHC/HS, WHO EMRO)

MESSAGE FROM PROF TAGHREED MOHAMED FARAHAT, WONCA EMR REGIONAL PRESIDENT

"In the Name of Allah, the Most Beneficent, the Most Merciful. On behalf of me and my colleagues in WONCA world in general and WONCA EMR particularly, I hardly find the words to express our sincere gratitude to Dr. Ahmed Almandari Regional Director, WHO EMRO and all his team for their continuous help, encouragement, and sincere efforts in leading all collaborators throughout this work I extend our deepest gratitude to Dr Omar Al Rawas Secretary General, Arab Board of Health Specializations for acknowledging and recognizing this diploma.".

All the praises and thanks to Allah for giving us the strength and ability to complete this diploma which was a dream for all of us to fulfil the gap in family physicians and to maintain efficient capacity building of family physicians in EMR region

All the praises and thanks to Allah for giving us the strength and ability to complete this diploma which was a dream for all of us to fulfil the gap in family physicians and to maintain efficient capacity building of family physicians in EMR region

As a family physician and a gatekeeper for the health services, I acknowledge this diploma as a victory to WONCA as it will secure an adequate number of family physicians to allow us to achieve WONCA Mission to improve the quality of life of the peoples of the world through defining and promoting its values, including respect for universal human rights and including gender equity, and by fostering high standards of care in general practice/family medicine which will achieve universal health coverage and subsequently achieve SDG3 “Health for All"

PROF TAGHREED FARAHAT

P R E S I D E N T W O N C A E M R

Report written by Dr Nagwa Nashat Hegazy

INTERVIEW: JACQUELINE PONZO TALKS ABOUT THE VIII SUMMIT OF FAMILY AND COMMUNITY MEDICINE IN GUATEMALA

JACQUELINE PONZO: "THE VIII SUMMIT SEEKS TO CONTRIBUTE EFFECTIVELY TO THIS PROCESS AT A FOUNDATIONAL MOMENT IN GUATEMALA"

The 10th and 11th of November will be the culmination of an immense work that is being carried out in pursuit of installing Family and Community Medicine in Guatemala, a country thatstilldoesnothavethespecialtyandthatthe VIII Summit will be the architect and engine of sowing the first seed for a future full of family/familydoctors.

Dr Jacqueline Ponzo, president of the Ibero American Confederation of Family Medicine reviews her feelings about the most important event of recent times Guatemala has placed its trustinCIMF,andaftertheenormousgesture,the organizationmadeitsentirestructureavailableto contributetothisfoundingprocess.

WHAT EXPECTATIONS ARE PLACED ON THE VIII IBERO AMERICAN SUMMIT?

The VIII Ibero American Summit will be a very important event for many reasons. In the first place, because it will be the face to face reunion after the pandemic, of a long time working remotelyinverydifficulttimes.Althoughitseems that Covid 19 is being left behind, the consequences of the health emergency still persistineachoneofus,inourorganizationsand inourcountries CIMFremainedstrongandactive duringallthistime,butmeetingandembracingis very necessary, essential. The meeting allows expressing affection, without which it is difficult to live At the same time, it favors informal meetings, those that take place on the periphery of agendas and programs, based on affinities, intuitions or shared stories. They are meetings that are also nourished by enjoyment and probablyforthisreason,theyareverycreative As inthemedicalconsultation,whatisprogrammed is as important as what is unscheduled, what is spontaneous.

O N C A R E G I O N S

Sometimes,thesecondcanbethemostrelevant of the day. In other words, we have high expectations of what will happen in Guatemala, because of what is scheduled and what is not scheduled, what will surprise us, the joy of the meeting

Then,fromthepoliticalpointofview,theeventis of immense relevance. We are co organizing the VIIISummitwiththehighesthealthauthoritiesof Guatemala, the Ministry of Public Health and SocialAssistanceandtheGuatemalanInstituteof SocialSecurity,andwiththePanAmericanHealth Organization. Guatemala does not yet have a specializationinFamilyandCommunityMedicine, but there is a political decision to install it and advance its incorporation into the health system for its transformation. The VIII Summit seeks to contribute effectively to this process at a key foundational moment.At the same time, it will producedocumentsofgreatrelevanceandvalue for ICMF, for regional (and even global) family medicine / family and community medicine, and for each of its associations, for the development ofthespecialty.

WHAT IS THE IMPACT THAT THIS COULD PROVIDE IN GUATEMALA AND IN THE REGION?

Thefirstoftheslogans,definitionofthespecialist profile in family and community medicine, includes the definition of specific recommendations for Guatemala, with a view to the beginning of higher education for the installation of the specialty in the country The mainexpectedimpactisthatfromthesummititis possible to articulate a curriculum for postgraduate training that supports family and community medicine residency capable of producing competent professionals This means: specialistscapableoftakingonthehealthcareof peopleofallagesandtheresolutionofthemost frequent health problems through a bond sustained over time, with a family approach and communityorientation

Guatemalaisacountrywithmorethan17million inhabitants,ayoungpopulation(only5to6%are over 64 years of age) that has had a remarkable demographic growth in recent decades. Life expectancy is less than 70 years for men and 74 for women, infant mortality is 23 per thousand livebirths,aquarterofthoseover15yearsofage lack literacy, and just over half of the population hasaccesstosafesanitation(53%)andonly61% haveaccesstodrinkingwater

At the same time, it has a great wealth and culturaldiversityinaterritorythatisalsodiverse InGuatemalatherearenumerousnativepeoples and ethnic groups. At least 24 languages are spoken in addition to Spanish. All these characteristicsrepresentenormouschallengesfor any health system But this is not a problem for the advancement of our specialty; On the contrary,wearecertainthatonlywithfamilyand community medicine can adequate and quality care be offered to the needs of the population withthesecharacteristics Ofcourse,medicalcare is not enough and it is necessary to work on the structural, social, economic, and environmental dimensions to reduce the great problems, but medical care is necessary, as it is also necessary thatitbeuptothepeopleandtheirneeds Then,

WHAT DOES IT MEAN THAT GUATEMALAN POLITICS HAS BEEN INTERESTED IN CIMF TO INSTALL THE SPECIALTY IN THEIR COUNTRY?

Itisarecognitionthatfillsuswithprideandalso withresponsibility,whichrequiresusgreatly.

A R E G I O N S

CIMF is an organization based on the voluntary work of its members. It does not have paid positionsandisfinancedwiththecontributionsof itsmemberassociationsandprofitsgeneratedin academic events The budget is scarce, because most of our associations are small (the MF/MFC still has few professionals in most of the countries)andbecauseoftheeconomicsituation of the region in general. Notwithstanding the limitations that this imposes, there is something that is not missing from ICPM Enthusiasm and commitment are always present, they characterize us, as well as the creativity and strength of its youth movement, Waynakay.It is true that all this is required at this time by the responsibility of this call, but the demand assumed, the response is joy and collaborative work.Definitely, ThatCIMFhasbeenidentifiedbythegovernment institutions of Guatemala, with whom we had no contact until receiving their call in June 2021 as themostappropriatereferencefortheirobjective of installing the specialty in the country, tells us that CIMF, that WONCA Ibero American is occupying its rightful place, as a regional benchmarkinthematter.Thisdoesnotmeanthat we can trust and rest, on the contrary, it means more work, more study, more cooperation, to playthatroleproperly.

DOES THIS REVITALIZE THE ICPM HIERARCHY IN A REGION LIKE CENTRAL AMERICA WHERE THERE IS A STRONG NEED TO STRENGTHEN HEALTH SYSTEMS?

We hope that the VIII Summit will revitalize ICPM in all subregions. The work that is being carried out in the pre summit since July, in two virtual phases, with the participation of more than 150 people,includingmorethan20youngpeopleand a special committee made up of former presidentsofthesevenprevioussummits

It will leave us with growth expressed in the consolidationofgroups,intheupdatingoftopics and processes, in the opening of new lines of action and thought. Certainly more strength. For Central America in particular, we think that the Summit will be invigorating We hope that this Guatemalan process spreads and spreads. In Honduras there is still no specialization. El Salvador and Nicaragua have associations that have been working for years with many difficulties,CostaRicaandPanama,

HOW DO YOU THINK THE FUTURE OF MF IN LATIN AMERICA WILL BE?

This question is difficult, because it requires imaginingthefutureatatimeofuncertaintyand rapid change. Imagine medicine, the region and, inthatcontext,thinkabouttheMFofthefuturein LatinAmericaandIbero America,becauseour

region includes Iberia To a large extent, everything will depend on the paths that the regiontravelsinthecomingdecades.

With optimism, I hope that solidarity, equity and care for nature will grow in the region. At the same time, I am confident that family medicine will be consolidated as family and community medicine, that it will be involved in health care with a territorial perspective, from the understanding of people and their problems in their social, community, and territorial context. Nottoreplacecareforillnesses,buttomakethat careevenbetter,specializinginpeoplewhosuffer from these health problems, in each person, in each family. At the same time, assume a form of medicinecapableofencompassingthehistorical territorialdimensionintheclinicalprocess.

Itisnecessarytoovercomethedichotomousview that has tended to separate the clinical from the community. Less and less is it possible to conceive of quality medicine or quality health research if it is not involved with people's daily lives,intheircommunitydimension Thatiswhat we mean when we say of the aspiration that family medicine be consolidated as "family and communitymedicine".Insomewaythisincludes, but it is worth explaining, a planetary and profoundly bioethical perspective of medicine Human health is not possible in isolation, separated from other species and from the biosphere. Covid 19 is the most recent and clear sample we have of this Therefore, incorporating theplanetarydimensionofhealthinthepractice of our specialty is also a necessary note for the future. in its community dimension. That is what we mean when we say of the aspiration that family medicine be consolidated as "family and communitymedicine" Insomewaythisincludes, but it is worth explaining, a planetary and profoundly bioethical perspective of medicine. Human health is not possible in isolation, separated from other species and from the biosphere. Covid 19 is the most recent and clear samplewehaveofthis.

Therefore,incorporatingtheplanetarydimension of health in the practice of our specialty is also a necessary note for the future in its community dimension Thatiswhatwemeanwhenwesayof the aspiration that family medicine be consolidated as "family and community medicine". In some way this includes, but it is worth explaining, a planetary and profoundly bioethicalperspectiveofmedicine Humanhealth is not possible in isolation, separated from other speciesandfromthebiosphere.

O

Covid 19 is the most recent and clear sample we have of this. Therefore, incorporating the planetary dimension of health in the practice of our specialty is also a necessary note for the future Human health is not possible in isolation, separated from other species and from the biosphere. Covid 19 is the most recent and clear sample we have of this. Therefore, incorporating theplanetarydimensionofhealthinthepractice of our specialty is also a necessary note for the future Human health is not possible in isolation, separated from other species and from the biosphere. Covid 19 is the most recent and clear sample we have of this. Therefore, incorporating theplanetarydimensionofhealthinthepractice of our specialty is also a necessary note for the future.

Trainingspecialistsinthesetimesmeanstraining professionals capable of working in uncertainty, solving complex problems and adapting to changes.Itistoseektheintegrationoftheseskills with the ability and skills necessary to solve common health problems MFYC is the medical specialty best positioned to take on the complex health issues of today and tomorrow; problems thathaveasocialcomponent,emergingdiseases, others derived from poverty or environmental conditions, which are intertwined with the chronic and communicable diseases that we already know and that, far from being resolved, continuetogroworreemerge.

WHAT DO YOU IMAGINE FOR THE DAY AFTER THE SUMMIT?

Literally,thedayaftertheSummit,November12, 2022, we are already planning it.We will have meetingsfortheimplementationoftheguidelines that emerge from the VIII Summit, both in Guatemalaandthroughouttheregion.

I imagine a post summit with a lot of work, renewalandalotofjoy.

LEA LA ENTREVISTA EN ESPAÑOL AQUÍ

SIG AGEING

AGEING LINES OCTOBER

STORIES FROM CAREGIVERS AND ELDERLY PATIENTS

Thisisaspacededicatedtocaregiversandelderly patients, created with anonymous collaborations fromtheWONCASpecialInterestGrouponAgeing and Health This section includes inspiring anecdotesforthesimplepurposeofaddingvalue andqualitytoolderpatient’slives.

Discoverbelowthecollaborationsfrommembers of WONCA Special Interest Group on Ageing and Health dedicated to International Day of Older Persons,celebratedon1October,2022underthe theme“ResilienceofOlderPersonsinaChanging World.

"THROUGH HER EYES, YOU COULD SENSE AND ADMIRE A SPIRIT OF RESILIENCE"

A woman in her late seventies visits my clinic during my morning shift at a suburban primary healthcare center, which serves an impoverished population of many nationalities, including Lebanese, Palestinians, and Syrian refugees "How can I help you, ma'am," I asked with a smile. She could barely raise a smile back. You could feel the intense suffering and adversity she has endured She was an older Syrian refugee who arrived in Lebanon one month ago with her older husband Her green eyes were the only distinguishing feature of her appearance, which comprised a black veil and a traditional abaya The eyes are said to be the windows of the soul Through her eyes, you could sense and admire a spirit of resilience, the resiliency of an older Syrian woman.

“Since I have recurrent blood clots in my leg, I've been taking a blood thinner for the past few years

Three months ago, I stopped taking the blood thinner", she added, "There are no remaining medications in our community." This woman could have easily gotten a clot or, worse, a stroke, and may have died "Did you seek out the medication in Lebanon?"

I asked Suddenly, she was in floods of tears and struggling to find the right words to answer “Doctor, I don't have any money. My husband is unemployed and unable to find work. They told him that he was too old to work and that it would be impossible for him to find a job My only son was killed in the war, and we no longer have any financial support. Could you please help us”

SIG AGEING & HEALTH AGEING LINES

She added In essence, this older lady represents many older women and men in our region who continue to face years of armed conflicts and a greater threat of poverty, discrimination, and erosion of traditional support systems with no access to basic social and healthcare services Never before in my life have I experienced such a circumstance, and it is in such moments that you realize your responsibility as a physician extends beyond medical care to encompass the social needs of your patients Is her blood thinner a higher priority than the dinner on the table?

As healthcare providers, we often have our list of priorities, while our patients have their own, which highlights the importance of effective listening and communication skills to better understand our patients' priorities. This older woman's top priority was food, not medication. With no food, survival is at stake. Malnutrition, low immunity, and the complications of infectious diseases in the cold season can be fatal After a few seconds of silence, I reassured her that I will do everything in my capacity to assist her with all the available resources at the center Every older patient has a hidden agenda and a list of priorities and challenges, and every older refugee has a story of perpetual struggle for survival, which we as primary care physicians should uncover in order to better address their needs "

"SHE HAS FOREVER CHANGED MY ATTITUDE"

There are many stories of older women who have made major contributions once their family responsibilities have been resolved I have a patient like this She was a high school teacher for many decades, but when she retired in 2001 she was able to pursue her lifelong interest in frogs. I

In fact she completed a PhD on frogs in her retirement. She would see me intermittently between field trips, some of which involved camping for many weeks in the desert beside anthills known to shelter frog eggs, waiting for the rains to come so she could document their emergence. In other fieldtrips, she found some frogs not previously described Her publications on frogs run from 1974 right through to 2018 I was amazed at her resilience. As I spoke to her about this passion, so very distant from my experience, I started to realise how important frogs are as a sign of the health of our natural environment, and to welcome their croaking at night in my back garden She has forever changed my attitude to this important species in our environment

AGEING LINES

OUR ELDERS, A PILLAR OF STRENGTH FOR THE SOCIETY.

I remember my patient who is an active community worker at the age of 85. He is a known hypertensive and hypothyroid for many years and is controlled on medication His devotion towards his community and neighbourhood is commendable. Daily he pulls out his small car and gathers a list of items people have communicated and brings all the stuff and delivers it, simultaneously providing pick and drop service for many in between He knows people by name, their issues and the problems they are facing. People seek his guidance in matters which are difficult and he would go a long way to help them

When it comes to charity he not only donates but also collects it to help those in need. He has been doing this service free of charge for the last many years and will continue When I see him im lost for words!

OUR ELDERS, A PILLAR OF STRENGTH FOR THE SOCIETY.

She is a 76 years lady that I have known for the past 26 years. She had hyperlipidemia and trying to manage going through menopause. She had one son who was getting ready to go to the United States for higher education She was keeping herself busy by volunteering in several non governmental organizations who take care of sick children, especially those affected by cancer. She went into depression few years after her son departed when her husband died suddenly and refused to take medications or go for psychotherapy. About 5 years later, she came in for check up and seemed to have recovered. She talked with great enthusiasm about an activity she has been engaging in for the past few months whereby she goes visiting older women living by themselves whose children left either to work or study. She would read them stories or converse with them and keep each company for one or two hours a day Women were enjoying her visits and asking her to visit their friends too. As she is feeling the need growing, she was trying to recruit other women to help out. After I expressed my admiration for this community initiative, she explained that she was inspired by the words of an actress in a movie she was watching. The actress was an older woman who was having, in the movie, a rough relation with her daughter and told her “if I am alone and you are alone then we should not be feeling lonely” This phrase triggered some reflection in my patient that made her go out and seek other women in similar situations for reciprocal support.

SIG AGEING & HEALTH AGEING LINES

The last time I saw her was eight months ago when she came in to have a resume of her medical record. She was getting ready to leave and join her son who have settled in the United states.

The Covid pandemic and the economic deterioration in Lebanon thereafter (with electricity cuts, poor internet and high transport costs) made it difficult for her to continue with the socializing visits. She was getting tired going on feet or going upstairs as elevators were nonfunctioning. Her son asked her to help him babysit his children and that made her feel useful again “ I am keeping contact with them ( women she was visiting) by watsApp and will be back again, she said, to visit them when the situation get better in Lebanon. They gave my life a purpose”.

WONCA GRANTS ACCREDITATION TO CLINICAL MASTERS IN FM OF THE ARABIAN GULF UNIVERSITY

The Arabian Gulf University (AGU), supported by the Bahrain Government and the Supreme Council of Health (SCH), successfully completed the two year Clinical Masters in Family Medicine (CMFM). The programme has also been granted WONCA accreditation after meeting WONCA’s Global Standards for Postgraduate Family MedicineEducation

Despite the pandemic, the curriculum was deliveredtoall40trainees,witheffectiveface to face clinical training in primary and secondary care WONCA accreditation experts also conductedathree dayvisittoevaluatetheCMFM course against WONCA Global Standards for PostgraduateFamilyMedicine.

The Arabian Gulf University launched the clinical Master's Programme in family medicine in April 2019. With the COVID 19 outbreak, the academic programme committee found ways to adapt the implementation process without compromising thelearningoutcomes.

In 2021, Professor Afif Ben Salah, Chairman of Family and Community Medicine Department, at theArabianGulfUniversity,reportedtheprogress oftheprogrammeafterthefirstyearoftraining

“We have just successfully finished the first year of training and assessment A time to reflect on progress against WONCA standards As the academic committee evaluates the first year experience further consultation from the WONCA experts is planned in May to prepare the ground for better performance and full accreditation in March 2022”

Now,thesecondfinalyearoftheprogrammehas beensuccessfullydeliveredandassessed.

Itsaccreditationprocessinvolvedathree dayvisit on site that included meetings with staff and studentsandfeedbackdiscussionswiththeteam After the assessment, accreditation experts concluded that the Clinical Masters in Family MedicinemetallWONCAPostgraduatestandards, grantingaccreditationforfiveyears

In her report, Professor Val Wass, WONCA Executive Honorary Treasurer and Member at Largestated:

“We congratulate Professor Afif Bin Salih and his extraordinarily committed team: Dr Basheer Makarem, Dr Fatima Habbash, Professor Mohamed Hary Shehta, and Zadok Chlif Given the challenges of the pandemic, the successful launch, implementation, and graduation of the first cohort of the AGU Clinical Masters in Family Medicine (FM) are most impressive ”

OnbehalfoftheAccreditationCommitteeandthe Accreditation Experts, we would like to congratulate the Arabian Gulf University on achieving WONCA accreditation for the Clinical MastersinFamilyMedicine.Weencourageyouto continue developing your students skills and competencies, looking forward to reviewing the improvementontherecommendationsprovided.

WORLD MENTAL HEALTH DAY 2022

WORLD MENTAL HEALTH DAY 2022

With information of World Health Organization (WHO)

WONCA joined the celebrations of World Mental Health Day 2022, an important date to re kindle oureffortstoprotectandimprovementalhealth.

Under the theme “Make mental health & well being for all a global priority”, this year’s campaign represents a perfect opportunity for peoplewithmentalhealthconditions,advocates, governments, employers, employees and other stakeholders to come together to recognize progress in this field and to be vocal about what we need to do to ensure Mental Health & Well BeingbecomesaGlobalPriorityforall

“Many aspects of mental health have been challenged; and already before the pandemic in 2019 an estimated one in eight people globally were living with a mental disorder. At the same time,theservices,skillsandfundingavailablefor mentalhealthremaininshortsupply,andfallfar below what is needed, especially in low and middleincomecountries”

According to the WHO, the COVID 19 pandemic has created a global crisis for mental health, fuelling short and long term stresses and undermining the mental health of millions. Estimates put the rise in both anxiety and depressivedisordersatmorethan25%duringthe first year of the pandemic. At the same time, mental health services have been severely disrupted and the treatment gap for mental healthconditionshaswidened

As family doctors, we join the call of the World Health Organization, to value, promote and protect, not only our patients mental health, but also the mental health of primary care professionals and healthcare workers around the globe.

“We must strengthen mental health care so that the full spectrum of mental health needs is met through a community based network of accessible, affordable and quality services and supports”

Read the complete release on World Mental Health Day and discover this year’s campaign HERE

We invite you to discover our Working Party on Mental Health, chaired by Professor Christos Lionis.Thegroupaimstocontributetoeducation, research, and the latest mental health developmentsrelatedtoprimarycare Findmore informationHERE

Make mental health & well-being for all a global priority

THE SPICE ROUTE MOVEMENT CELEBRATES WMHD WITH A WEBINAR

On the occasion of World Mental Health Day, the Spice Route Movement, a young doctors movementfromWONCASouthAsiaorganisedthe Webinar “Make mental Health and Well being a GlobalPriorityforAll”.

Thesession,heldonthe10October2022,wasled by Dr Asitha Koshala from Sri Lanka, Dr Tabinda AshfaqfromPakistan,andDrWangdiNorbufrom Bhutan.

Thewebinarfocusedonseveralkeypointsrelated to mental health y primary care, including the most common mental health problems among family physicians and health care workers, who frequently encounter burnout, depression, anxietyandothermentalhealthdisorders.

“Depression is one of the huge challenges associated with this profession Too many patients, high expectations, lack of work/life balance, administrative tasks, and the extreme work load causes stress in the medical field. We have a major role dealing with multiple issues at one time and that affects our mental health “ , notedDrAshfaq

Find more information about the Spice Route MovementHERE

WONCA SYDNEY CALL FOR SUBMISSIONS IS NOW OPEN!

SYDNEY, AUSTRALIA | 26 OCT 29 OCT , 2023

WONCA will bring together family doctors, GPs and primary healthcare specialists from around the world so don’t miss your chance to be involved the largest global gathering of primary care professionals. The conference program will shareresearchanddiscussbestpractice,keeping communitieshealthyonaninternationallevel.

With your help, we look forward to building a robust and varied conference meeting the needs ofourdiverseprofession inarangeofpositions, segments,andcareerstages

WhyyoushouldpresentatWONCA2023?

• Gain recognition Meet the standards of an excellent leader and presenter in the global primarycarecommunity

• Achieve visibility Grow your professional brand and get direct access to an engaged audience

• Advanceyourprofession Shareyourfindings andbuildtheknowledgeandexpertiseofGPand familyphysicians.

• Get creative Showcase your ability to share yourexpertiseinadynamicway.

•Growyournetwork Discussandexpandyour findingswithyourpeersfromaroundtheworld.

IF THIS SOUNDS LIKE YOU, APPLY NOW HERE!

BURSARIES

The RACGP has established a fund to provide bursaries for the WONCA 2023 World Conference inSydney.Theaimsofthebursariesare:

•toadvancefamilymedicineworldwide,

• to provide opportunities for family medicine doctors who would otherwise not be able to attend,and

• to support the development of outstanding futureleadersinternationally

Donationswillassistbursaryrecipientsattending WONCA 2023, providing them with valuable networking and learning opportunities Bursary recipients will be selected based on their responsesthroughaformalapplicationprocess

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& U P D A T E S

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HEALTHY LUNG MASTERCLASS ASIA WEBINAR BRIDGING THE DOCTOR PATIENT GAP TO IMPROVE ASTHMA CARE

The Healthy Lung Masterclass Asia (HLMA) webinar series will conclude, with its final webinaron27October2022(19:00 20:25UTC+8) entitled “Bridging the doctor patient gap to improve asthma care” The session will be chairedbyDrSriWahyuTaher(Malaysia)andwill featuretwospeakers.

DWelookforwardtoseeingyouthere!

r Leilanie Nicodemus (Philippines) will talk about optimising asthma care through effective communication and Dr Suhas J Bardapurkar (India)willdiscussstrategiesonhowtoempower patientsinthemanagementofasthma

HLMA is an educational programme focused on asthma care, developed especially for primary carephysiciansacrossAsiaincollaborationwith WONCA

Thursday,27October2022 19:00 20:25(UTC+8)

REGISTERNOW

N C E M E N T S & U P D A T E S

EDUCATION FOR PRIMARY CARE, VOLUME 33, NOW AVAILABLE ONLINE!

Prof Val Wass, Chair WONCA Working Party on Education,writesonthelatestopenaccessitems inEducationforPrimaryCare.

EducationforPrimaryCare,Vol 33,No 5,03Sep 2022"isnowavailableonlineonTaylor&Francis Onlinewithsomeinterestarticles.

An open access systematic review offers strong evidencethatrolemodellinginprimarycarehas acrucialimpactonthefutureGPworkforce,with the potential to shape perceptions, to attract and deter individuals from the career, and to supporttheirdevelopmentasprofessionals

It is so important we open our doors and maximise opportunities to positively role model our values and work in the education and trainingofalldoctors.

The impact of role modelling on the future general practitioner workforce: a systematic review . Elizabeth Lamb, Bryan Burford & Hugh Alberti

WONCA YDM-WP/SIG COLLABORATIVE WEBINAR SERIES

Did you miss the webinar “The Young Family Doctor and Environmental Challenges”?Thesession,organisedby MovimientoWaynakayincollaboration with the Working Party on the Environment,isnowavailableonline

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LSHTM WEBINAR SERIERS: PRIMARY HEALTH CARE: THE HEART OF EVERY HEALTH SYSTEM

The London School of Hygiene & Tropical Medicine (LSHTM) invites you to a ten part seminarseriesthatwillrunfromOctober2022to July2023

The series provides an overview of the key features and functions of PHC, the potential of PHCinallhealthsystemsanditsroleinachieving universal health coverage Sessions draw on examplesacrossdifferentsettings.

For more details and joining instructions follow links"with"Formoredetails,joininginstructions andrecordingsofpreviouseventsfollowlinks:

12.45 13.45,Wed5Oct2022:PanelDiscussion.PrimaryHealthCare:Theheartofeveryhealthsystem?

12.45 13.45,Wed2Nov2022,WhatisPrimaryHealthCare?

12.45 13.45,Wed7Dec2020,AchievingPrimaryHealthCarethroughMultisectoralActionandPolicy

12.45 13.45,WedJan2023,EmpoweringPeopleandCommunities

Feb2023,IntegratingPrimaryCareandPublicHealth

Mar2023,FinancingPrimaryCare

Apr2023,GettingthePrimaryCareWorkforceright

May2023,Holdingittogether:PrimaryCareInfrastructure

Jun2023,Measuring,regulating,andimprovingPrimaryCare

Jul23,PanelDiscussion:PrimaryHealthCareattheheartofeveryhealthsystem anachievabledream?