WONCA News October 2022

VOL 50 | NUMBER 8

NEWS

2022

O C T O B E R

WONCA PRESIDENT DR ANNA STAVDAL (NORWAY) EMAIL: PRESIDENT@WONCA.NET TWITTER: @ASTAVDAL WONCA IMMEDIATE PAST - PRESIDENT DR DONALD LI (HONG KONG) PRESIDENT-ELECT ASSOC PROF KAREN FLEGG (AUSTRALIA) EXECUTIVE MEMBER AT LARGE & HONORARY TREASURER PROF VAL WASS (UK) EXECUTIVE MEMBER AT LARGE DR MARÍA PILAR ASTIER PEÑA (SPAIN) EXECUTIVE MEMBER AT LARGE PROF SHABIR MOOSA (SOUTH AFRICA) REGIONAL PRESIDENT, WONCA AFRICA DR DAN ABUBAKAR (NIGERIA) REGIONAL PRESIDENT, WONCA ASIA PACIFIC ASSOC PROF MOHAMMAD HUSNI JAMAL (MALAYSIA) REGIONAL PRESIDENT, WONCA EAST MEDITERRANEAN PROF TAGHREED MOHAMED FARAHAT (EGYPT) REGIONAL PRESIDENT, WONCA EUROPE PROF SHLOMO VINKER (ISRAEL) REGIONAL PRESIDENT, WONCA IBEROAMERICANACIMF ADJ/PROF JACQUELINE PONZO (URUGUAY) REGIONAL PRESIDENT, WONCA NORTH AMERICA DR JEFF MARKUNS (USA) REGIONAL PRESIDENT, WONCA SOUTH ASIA DR TARIQ AZIZ (PAKISTAN) YOUNG DOCTORS' REPRESENTATIVE DR SANKHA RANDENIKUMARA (SRI LANKA) WONCA CHIEF EXECUTIVE OFFICER DR HARRIS LYGIDAKIS WONCA WORLD SECRETARIAT WORLD ORGANIZATION OF FAMILY DOCTORS AVENUE DES ARTS 7-8 1210 BRUSSELS BELGIUM EMAIL: SECRETARIAT@WONCA.NET PHONE: +32 (0) 2 329 00 75 WONCA EDITOR MARIA DOLORES ZAVALA EMAIL: EDITOR@WONCA.NET TRANSLATIONS DR JIE GU DR HUA YANG DR JULIEN ARTIGNY

CONTENT FROM THE PRESIDENT

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WONCA & WHO NEWS

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WONCA EXECUTIVE MEMBERS MEET WITH WHO REPRESENTATIVES IN GENEVA

WONCA REGIONS

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WONCA EMR INAUGURATES REGIONAL PROFESSIONAL DIPLOMA IN FAMILY MEDICINE INTERVIEW: JACQUELINE PONZO TALKS ABOUT THE VIII SUMMIT OF FAMILY AND COMMUNITY MEDICINE IN GUATEMALA

WP & SIGS NEWS

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AGEING LINES: STORIES FROM CAREGIVERS AND ELDERLY PATIENTS

FEATURED STORIES

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

WORLD MENTAL HEALTH DAY

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WONCA CONFERENCES

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ANNOUNCEMENTS AND UPDATES

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FROM THE PRESIDENT O C T O B E R

2 0 2 2 "Our world is in deep trouble – and so too are the Sustainable Development Goals".

WHILE ACTION STILL CAN MATTER

UN Secretary-General António Guterres at the Health Leader Political Forum, 2022'

F R O M

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 very actions we’re seeking to help trigger. And, we know not to wait too long. We’re careful to shout out necessary warnings while there’s still time for our patients’ actions to mitigate dramatic outcomes. That is good clinical risk management.

T H E

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 globe at great speed, a messenger knocking down every national door. It has put us on notice that, if we intend to transform ‘One Health’ from a mere slogan into a lived reality, we’ll need to take global action.

P R E S I D E N T

We stand by the promises we made when WONCA 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 conclusion on behalf of our organization that the 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 Solidarity is now WONCA’S Number 1 Priority.

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And, make no mistake about it – there are huge differences among us.

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, encouraging and enabling people to team up and exert influence, together.

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 Income Countries (LMIC) are impacted differently.

The smallest member organizations and colleges, who pay less, are located in countries where Primary Care and Family Medicine services are scarce, as are available resources, both financial and human.

But… Let’s be honest and acknowledge the inequities that globalization has exposed and inflamed. The huge gap between the rich and the poor persists and is growing far harder to impact, or to ignore.

We recognize in the exponentially growing epidemic of Non-Communicable Diseases (NCDs), which pre-dates COVID, an apt, and awful, casein-point of the interconnection between economics and health. NCDs increase inequities in all countries, but they hit the poorer countries the hardest.

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 shortest supply in precisely those countries where the need for them is greatest.

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

‘US VS. THEM’ RESPONSES ARE COUNTERPRODUCTIVE

We are 131 member organizations spread over 111 countries in seven global regions.

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 the Family Medicine Specialty is in decline.

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P R E S I D E N T

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, inequity embroils us all.

T H E

The smaller, LMIC colleges might protest that times of crisis are precisely when smaller groups’ internal business needs are more dire than those of the HIC groups, obligating the organization as a whole to allocate a larger share of the resources to them.

F R O M

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. A predictable reaction to hard times is to turn inward, to take care of one’s own needs first.

Thus, when revenues sink during a “conference drought” and financial accounts are looking bad, the larger HIC members may well resist subsidizing those member groups with fewer resources, and lower fees.

WONCA NEWS

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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 stable societies. The pandemic exposed the clear and simple truth: ‘No one is safe until everyone is safe.’ Solidarity serves us all.

That puts equity at our core, as a mutual, 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 stronger our voice.

DR ANNA STAVDAL WONCA PRESIDENT

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

Also available in: Français Español

中文

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WONCA EXECUTIVE MEMBERS MEET WITH WHO REPRESENTATIVES IN GENEVA WONCA President, Dr Anna Stavdal, WONCA CEO, Harris Lygidakis, and Professor Val Wass, Executive Member-atLarge and WHO Liaison, led key meetings with representatives of the World Health Organization at the organisation’s headquarters in Geneva, Switzerland.

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 present at the meeting were Dr Temo Waganivalu, and Dr Slim Slama, unit leaders at the NCDs Department at the WHO. 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.

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

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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 representatives also met with Prof Bettina Borisch, Executive Director of the World Federation of Public Health Associations, and Hoi Shan Fokeladeh, Policy Advisor at the International Council of Nurses (ICN), to brainstorm upcoming efforts to promote and advocate for universal health.

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

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On the second day, WONCA Executive members first held a meeting with WHO representatives Dr Denis Porignon (Policy Advisor), Dr Teri Reynolds (Clinical Services and Systems Lead), Dr John Fogarty (Senior Technical Advisor), and Dr Theadora Swift Koller (Senior Technical Advisor in Equity).

WONCA executives also met with Maria Neira, Director of the Department of Environment, Climate Change and Health; Heather AdairRohani, technical officer on energy and health; and Dr Anshu Banerjee, Director for the Department of Maternal, Newborn, Child and Adolescent Health and Ageing of the WHO. WONCA at the WHO Headquarters: Heather AdairRohani, 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.

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WONCA EMR INAUGURATES REGIONAL PROFESSIONAL DIPLOMA IN FAMILY MEDICINE The Regional Professional Diploma In Family Medicine (RPDFM) is a two-year diploma. RPDFFM 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 Nations Children's Fund (UNICEF).

The RPDFM is a bridging programme aims at equipping general practitioners (GPs), who do not 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 individuals and families. The training is delivered in a blended format using a mix of online (selfdirected, instructions, discussions) and face-toface (teaching, discussions) clinical training with both academic and clinical supervisory support.

The training programme spans over a period of 24 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 composed of 16 blocks with each block spanning 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. Also 35 tutors were selected initially to take this educational journey forward.

WONCA REGIONS

The inaguration event took place on Sunday, 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 (Regional Director,WHO EMRO), Dr Omar Al Rawas (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 WONCA EMR for their advocacy to family medicine and declared this diploma as a victory to WONCA as it will secure an adequate number of family physicians to allow WONCA to achieve its Mission and subsequently achieve SDG3 “Health for All”.

Then the Implementation overview of the Regional Professional Diploma in Family Medicine was presented by Dr Elsheikh Badr (Chairperson, Strategy Office, ABHS) and Dr Mona Osman (Head, Training Committee, Family Medicine Council, ABHS) to describe the executive eb=vent and the Gantt chart for the process.

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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 Organization of Family Doctors, (WONCA) gave the first talk highlighting family practice core values and accentuating that now, more than ever, 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 family practice in the community.

That was followed by question and answer then closing remarks from Dr Jawad El Sharif (Deputy Secretary general, ABHS), Dr Rana Hajjeh (Director, Programme Management, WHO EMRO), 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 PRESIDENT – WONCA EMR

Report written by Dr Nagwa Nashat Hegazy

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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 that still does not have the specialty and that the VIII Summit will be the architect and engine of sowing the first seed for a future full of family/family doctors.

Dr Jacqueline Ponzo, president of the IberoAmerican Confederation of Family Medicine reviews her feelings about the most important event of recent times. Guatemala has placed its trust in CIMF, and after the enormous gesture, the organization made its entire structure available to contribute to this founding process.

WHAT EXPECTATIONS ARE PLACED ON THE VIII IBERO-AMERICAN SUMMIT?

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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 remotely in very difficult times. Although it seems that Covid-19 is being left behind, the consequences of the health emergency still persist in each one of us, in our organizations and in our countries. CIMF remained strong and active during all this time, but meeting and embracing is 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 probably for this reason, they are very creative. As in the medical consultation, what is programmed is as important as what is unscheduled, what is spontaneous.

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Sometimes, the second can be the most relevant 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, from the political point of view, the event is of immense relevance. We are co-organizing the VIII Summit with the highest health authorities of Guatemala, the Ministry of Public Health and Social Assistance and the Guatemalan Institute of Social Security, and with the Pan American Health Organization. Guatemala does not yet have a specialization in Family and Community Medicine, 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 produce documents of great relevance and value for ICMF, for regional (and even global) family medicine / family and community medicine, and for each of its associations, for the development of the specialty.

WHAT IS THE IMPACT THAT THIS COULD PROVIDE IN GUATEMALA AND IN THE REGION? The first of the slogans, definition of the specialist 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 main expected impact is that from the summit it is possible to articulate a curriculum for postgraduate training that supports family and community medicine residency capable of producing competent professionals. This means: specialists capable of taking on the health care of people of all ages and the resolution of the most frequent health problems through a bond sustained over time, with a family approach and community orientation.

Guatemala is a country with more than 17 million inhabitants, a young population (only 5 to 6% 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 live births, a quarter of those over 15 years of age lack literacy, and just over half of the population has access to safe sanitation (53% ) and only 61% have access to drinking water.

At the same time, it has a great wealth and cultural diversity in a territory that is also diverse.

In Guatemala there are numerous native peoples and ethnic groups. At least 24 languages are spoken in addition to Spanish. All these characteristics represent enormous challenges for any health system. But this is not a problem for the advancement of our specialty; On the contrary, we are certain that only with family and community medicine can adequate and quality care be offered to the needs of the population with these characteristics. Of course, medical care 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 that it be up to the people and their needs. . Then, WHAT DOES IT MEAN THAT GUATEMALAN POLITICS HAS BEEN INTERESTED IN CIMF TO INSTALL THE SPECIALTY IN THEIR COUNTRY? It is a recognition that fills us with pride and also with responsibility, which requires us greatly.

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CIMF is an organization based on the voluntary work of its members. It does not have paid positions and is financed with the contributions of its member associations and profits generated in 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) and because of the economic situation 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, That CIMF has been identified by the government institutions of Guatemala, with whom we had no contact until receiving their call in June 2021 as the most appropriate reference for their objective of installing the specialty in the country, tells us that CIMF, that WONCA Ibero-American is occupying its rightful place, as a regional benchmark in the matter. This does not mean that we can trust and rest, on the contrary, it means more work, more study, more cooperation, to play that role properly.

It will leave us with growth expressed in the consolidation of groups, in the updating of topics 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, Costa Rica and Panama, HOW DO YOU THINK THE FUTURE OF MF IN LATIN AMERICA WILL BE? This question is difficult, because it requires imagining the future at a time of uncertainty and rapid change. Imagine medicine, the region and, in that context, think about the MF of the future in Latin America and Ibero-America, because our

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, including more than 20 young people and a special committee made up of former presidents of the seven previous summits

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region includes Iberia. To a large extent, everything will depend on the paths that the region travels in the coming decades.

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.

Not to replace care for illnesses, but to make that care even better, specializing in people who suffer from these health problems, in each person, in each family. At the same time, assume a form of medicine capable of encompassing the historicalterritorial dimension in the clinical process.

It is necessary to overcome the dichotomous view 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, in their community dimension. That is what we mean when we say of 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 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 the planetary dimension of health in the practice 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 community medicine". In some way this includes, 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 the planetary dimension of health in the practice 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 community medicine". In some way this includes, 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.

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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 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 the planetary dimension of health in the practice of our specialty is also a necessary note for the future.

WHAT DO YOU IMAGINE FOR THE DAY AFTER THE SUMMIT? Literally, the day after the Summit, November 12, 2022, we are already planning it.We will have meetings for the implementation of the guidelines that emerge from the VIII Summit, both in Guatemala and throughout the region.

I imagine a post-summit with a lot of work, renewal and a lot of joy.

LEA LA ENTREVISTA EN ESPAÑOL AQUÍ

ENTREVISTA CON

JACQUELINE PONZO

Training specialists in these times means training professionals capable of working in uncertainty, solving complex problems and adapting to changes. It is to seek the integration of these skills 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 that have a social component, emerging diseases, 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, continue to grow or reemerge.

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AGEING LINES OCTOBER STORIES FROM CAREGIVERS AND ELDERLY PATIENTS This is a space dedicated to caregivers and elderly patients, created with anonymous collaborations from the WONCA Special Interest Group on Ageing and Health. This section includes inspiring anecdotes for the simple purpose of adding value and quality to older patient’s lives.

Discover below the collaborations from members of WONCA Special Interest Group on Ageing and Health dedicated to International Day of Older Persons, celebrated on 1 October, 2022 under the theme “Resilience of Older Persons in a Changing 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”

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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."

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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

"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

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SIG AGEING & HEALTH 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.

WP & SIGS NEWS

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.

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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”.

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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 Medicine Education.

Despite the pandemic, the curriculum was delivered to all 40 trainees, with effective face-toface clinical training in primary and secondary care. WONCA accreditation experts also conducted a three-day visit to evaluate the CMFM course against WONCA Global Standards for Postgraduate Family Medicine.

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 the learning outcomes.

In 2021, Professor Afif Ben Salah, Chairman of Family and Community Medicine Department, at the Arabian Gulf University, reported the progress of the programme after the first year of training.

“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”.

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Its accreditation process involved a three-day visit on-site that included meetings with staff and students and feedback discussions with the team.

After the assessment, accreditation experts concluded that the Clinical Masters in Family Medicine met all WONCA Postgraduate standards, granting accreditation for five years.

In her report, Professor Val Wass, WONCA Executive Honorary Treasurer and Member at Large stated: “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.”

On behalf of the Accreditation Committee and the Accreditation Experts, we would like to congratulate the Arabian Gulf University on achieving WONCA accreditation for the Clinical Masters in Family Medicine. We encourage you to continue developing your students skills and competencies, looking forward to reviewing the improvement on the recommendations provided.

Now, the second final year of the programme has been successfully delivered and assessed.

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WORLD MENTAL HEALTH DAY 2022

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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 our efforts to protect and improve mental health.

Under the theme “Make mental health & wellbeing for all a global priority”, this year’s campaign represents a perfect opportunity for people with mental health conditions, 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 & WellBeing becomes a Global Priority for all.

“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, the services, skills and funding available for mental health remain in short supply, and fall far below what is needed, especially in low and middle income countries”.

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 depressive disorders at more than 25% during the first year of the pandemic. At the same time, mental health services have been severely disrupted and the treatment gap for mental health conditions has widened.

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. The group aims to contribute to education, research, and the latest mental health developments related to primary care. Find more information HERE.

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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 movement from WONCA South Asia organised the Webinar “Make mental Health and Well-being a Global Priority for All”.

The session, held on the 10 October 2022, was led

by Dr Asitha Koshala from Sri Lanka, Dr Tabinda Ashfaq from Pakistan, and Dr Wangdi Norbu from Bhutan.

The webinar focused on several key points related 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, anxiety and other mental health disorders.

“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 “, noted Dr Ashfaq.

Find more information about the Spice Route Movement HERE.

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WONCA WORLD CONFERENCE

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 share research and discuss best practice, keeping communities healthy on an international level.

• Get creative – Showcase your ability to share your expertise in a dynamic way.

With your help, we look forward to building a robust and varied conference meeting the needs of our diverse profession - in a range of positions, segments, and career stages

BURSARIES

Why you should present at WONCA 2023?

• Gain recognition – Meet the standards of an excellent leader and presenter in the global primary care community.

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

• Advance your profession – Share your findings and build the knowledge and expertise of GP and family physicians.

• Grow your network – Discuss and expand your findings with your peers from around the world.

IF THIS SOUNDS LIKE YOU, APPLY NOW HERE!

The RACGP has established a fund to provide bursaries for the WONCA 2023 World Conference in Sydney. The aims of the bursaries are: • to advance family medicine worldwide, • to provide opportunities for family medicine doctors who would otherwise not be able to attend, and • to support the development of outstanding future leaders internationally.

Donations will assist bursary recipients attending WONCA 2023, providing them with valuable networking and learning opportunities. Bursary recipients will be selected based on their responses through a formal application process CLICK HERE TO DONATE

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SAVE THE DATE FOR THE WONCA CONFERENCES!

28TH WONCA EUROPE CONFERENCE 2023 BRUSSELS, BELGIUM | 07 JUN - 10 JUN , 2023 WWW.WONCAEUROPE2023.ORG

VIII CUMBRE IBEROAMERICANA DE MEDICINA FAMILIAR Y COMUNITARIA

7TH WONCA AFRICA REGION CONFERENCE 2022

GUATEMALA, GUATEMALA | 10- 11 NOVEMBER

ABUJA, NIGERIA | 24 - 26 NOVEMBER 2022

HWWW.CIMFWONCA.ORG

WWW.WONCAAFRICAABUJA2022.ORG

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SAVE THE DATE FOR THE WONCA CONFERENCES!

WONCA ASIA PACIFIC REGIONAL CONFERENCE BALI, INDONESIA | 5 - 7 DECEMBER WWW.WONCAAPRC2022.ORG

WONCA WORLD SYDNEY 2023 SYDNEY, AUSTRALIA | 26 OCT - 29 OCT , 2023 WWW. WONCA.RACGP.ORG.AU/WONCA-2023

7TH WONCA EMR REGIONAL CONFERENCE MUSCAT, OMAN 10 -12 NOVEMBER 2022 WWW.WONCAEMR2022.COM

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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 webinar on 27 October 2022 (19:00–20:25 UTC+8) entitled “Bridging the doctor-patient gap to improve asthma care”. The session will be chaired by Dr Sri Wahyu Taher (Malaysia) and will feature two speakers.

Dr Leilanie Nicodemus (Philippines) will talk about optimising asthma care through effective communication and Dr Suhas J Bardapurkar (India) will discuss strategies on how to empower patients in the management of asthma.

We look forward to seeing you there!

HLMA is an educational programme focused on asthma care, developed especially for primary care physicians across Asia in collaboration with WONCA.

REGISTER NOW

Thursday, 27 October 2022 19:00–20:25 (UTC+8)

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EDUCATION FOR PRIMARY CARE, VOLUME 33, NOW AVAILABLE ONLINE! Prof Val Wass, Chair WONCA Working Party on Education, writes on the latest open access items in Education for Primary Care.

Education for Primary Care, Vol. 33, No. 5, 03 Sep 2022" is now available online on Taylor & Francis Online with some interest articles.

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

An open access systematic review offers strong evidence that role modelling in primary care has a crucial impact on the future GP workforce, with the potential to shape perceptions, to attract and deter individuals from the career, and to support their development as professionals.

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

WONCA YDM-WP/SIG COLLABORATIVE WEBINAR SERIES Did you miss the webinar “The Young Family Doctor and Environmental Challenges”? The session, organised by Movimiento Waynakay in collaboration with the Working Party on the Environment, is now available online.

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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 seminar series that will run from October 2022 to July 2023.

The series provides an overview of the key features and functions of PHC, the potential of PHC in all health systems and its role in achieving universal health coverage. Sessions draw on examples across different settings.

For more details and joining instructions follow links" with "For more details, joining instructions and recordings of previous events follow links: 12.45 – 13.45, Wed 5 Oct 2022: Panel Discussion. Primary Health Care: The heart of every health system?

12.45 – 13.45, Wed 2 Nov 2022, What is Primary Health Care?

12.45 – 13.45, Wed 7 Dec 2020, Achieving Primary Health Care through Multisectoral Action and Policy 12.45 – 13.45, Wed Jan 2023, Empowering People and Communities Feb 2023, Integrating Primary Care and Public Health Mar 2023, Financing Primary Care Apr 2023, Getting the Primary Care Workforce right May 2023, Holding it together: Primary Care Infrastructure Jun 2023, Measuring, regulating, and improving Primary Care Jul 23, Panel Discussion: Primary Health Care at the heart of every health system - an achievable dream?

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