Rural Round Up: WP on Rural Practice annual report

John Wynn-Jones reports:

Progress on the 2016-2019 work plan

Equity, Diversity and Relevance

Progress continues to be made on all fronts. We have developed a scoring system to help provide us with an equitably balanced and diverse council. This will mean positively discriminating with regard to gender, age and geography. We have excellent representation from South Asia and more contacts are being established in Africa and Asia Pacific. Although we work with colleagues in Brazil, it has been difficult to build contacts in the Spanish speaking parts of South America. This will become a priority for 2018. Rural Seeds has helped us connect successfully with young doctors and students around the world.

Conferences

WONCA World Rural Health Conferences

The 14th WONCA World Rural Health Conference in Cairns was a great success with nearly a thousand delegates. We are grateful for the support of ACRRM and send special thanks to Marita Cowie and her team. Similarly, we must thank Raman Kumar, Pratyush Kumar and the team from the Academy of Family Physicians of India for the hard work that they have put into the 15th World Rural Conference in Delhi, reported on below.

Plans for our next conference in 2019 in New Mexico are well underway. Our partners will be the University of New Mexico and The National Rural Health Association. New Mexico has its own unique rural health challenges and the NRHA has been the main advocate for the health of America’s rural population for decades. New Mexico has a major Spanish speaking population and we hope that this link will help connect more with the Spanish speaking countries of Central and South America.

Report on 15th WONCA World Rural Health Conference 2018

Special thanks must go to our Indian hosts, who have worked tirelessly to organise one of our most successful conferences to date. It was uniquely a very Indian conference but at the same time international with over a thousand delegates form over 40 countries.

Our enduring memory will be the engagement with so many young doctors and students from around the world. The conference was a testament to the next generation and their ability to fight for what they believe in and their commitment to change the world around them. Special thanks must go to my good friends Raman Kumar and Pratyush Kumar who have worked so hard over the last 12 months to make it a success.

The timing of the conference was perfect as a result of two important events:

1. The Prime Minister of India, Mr Narendra Modi had just announced the plan to establish 150,000 Wellness Centres around India (yes - the figures are correct!). There is a hope now that those 60% of the rural population of India who have no access to health care will now have some justice.

2. It is 40 years since the declaration of Alma Ata was signed. This was probably the most important statement on the value of Primary Care in the last century. It also acknowledged that health and wellbeing are also dependent on economic and social issues. WHO are currently working on a new declaration and we were asked to comment. We saw an opportunity to view Alma Ata from a rural perspective, and our contribution can be found via the Delhi Declaration. 

I always hope that our conferences leave a lasting legacy in every country that we visit and I have no doubt that this one will. It attracted wide political, professional and media support. We were honoured to welcome the Vice-President of India, the Honourable Venkaiah Naidu and 2 Health Ministers. The Vice-President’s passionate address was the best speech that I have heard at any of our previous conferences from a politician. A national consultation on primary care was held in parallel with the main conference.

The conference produced a number of deliverables in addition to the determination to make a difference by bringing accessible health care to the rural millions of India. These included:
• The Delhi Declaration.
• New policy on Digital Health
• Project SETU A new Indian Student & Young Doctor Group dedicated to reducing the inequity between the rich and the poor in India. They see this initially as an Indian initiative but hope that working with IFMSA and RuralSeeds, it will become an international student project.
• National Consultation on Primary Care in India
• AFPI Rural: A new section of the Indian Academy of Family Physicians of India dedicated to rural health

 
WONCA World conference, Korea 2018

Despite the fact that we already had our council meeting, we intend to have a significant presence in Seoul, Korea. We are committed to at least 10 workshops (either our own or in a joint capacity with other groups). Our final plans will be discussed at council but we intend to use the time to link in and work with other WPs and SIGs.

Working in Partnership

Working together with other groups within WONCA and outside the organisation will have a greater impact than working separately. Rural health is a cross cutting theme. All WONCA’s WPs, SIGs and YDMs represent urban and rural peoples. Current collaboration with: Working parties (Education, Environment, Women & Family Medicine and Mental Health); Special Interest Groups (Point of care testing, Emergency Medicine, Family Violence); Young Doctor Movements (VdGM, Spice Route, Polaris). We have also developed valuable links with NGOs and Organisations outside WONCA. These include: WHO, The Network Towards Unity for Health, Darwin International Institute on Compassion, National Rural Health Association (USA)

Portfolios

All executive members have their own portfolios. They are responsible for developing their specific areas within the WP. These include: Research: Dr Zakiur Rahman (Bangladesh); Developing World: Pratyush Kumar (India); Students and young doctors: Mayara Floss (Brazil) + Veronika Rasic (Croatia and UK); Clinical Practice: Bikash Gauchan (Nepal)
Education + Training: Barb Doty (USA); Publications: Dave Schmitz (USA); Communication: Jo Scott Jones (New Zealand); Policy Development: Role of Past Chairs

Rural Seeds

The Rural Seeds network was established to link aspiring rural health professionals who were students or in the early stages of their training. This growing network links with YDMs and IFMSA but is an integral part of Rural WONCA. The future of Rural Practice lies in their hands. I must take the opportunity to show my gratitude to a number of dedicated individuals who have made this a success. A brief outline of their work include:s
• Rural Family Medicine Café: is a monthly on-line forum with practitioners, young doctors and students from around the world.
• Rural Success Stories: This is a collection of good news stories from rural practice. What worked and why it worked. 
• Mentor Mentee Programme: This is still at an early stage and a small sample is being evaluated. The results will be presented at the conference.
• We are working with Rural Seeds to establish a robust management structure and this will be presented at the conference.

Policies, Statements and Publications

Our policies and statements, including a Values Statement, can be found on the WONCA website.

Communication

The main avenue for discussion remains the Google Group. We have approximately 900 members worldwide. Our reach increases greatly when we add the EURIPA and WoRSA groups. We also run a Facebook page and a Twitter page. The past Rural Family Medicine Café can be viewed on YouTube along with some wonderful videos produced by Dr Mayara Floss

Special initiatives

-Rural Heroes

-Rural Medical Education Guidebook: We are again taking this forward once more. Expressions of interest are being sought to fill some of the gaps currently present in this remarkable resource.

-The WHO link : Following Jim Campbell’s visit to the 14th Conference in Cairns, we were asked to contribute to the 4th Global Forum on Human Resources for Health in Dublin in November 2017. We ran a panel workshop where the response was so good that there was standing room only and we made new valuable contacts (especially from Africa). Through our participation, there was a significant rural presence at the conference and this was reflected in the final Dublin Declaration.

Looking Forward

Coming to the end of our triennium, we must look to the future. A new Chair will take over in 2019 and a fresh work plan will be developed. Possible ideas for the future could include:

• Expand the regional network: Asia Pacific; North America?
• Attend the Africa Region Conference 2019 and promote the WP.
• Promote rural research in LMICs to reduce the 90/10 gap globally in health-related research
• Develop a Multidisciplinary/Cross sectoral focus (+ Community Health Workers)
• Linking student groups/Global health
• Expand the global voice of the WP
• Work with the rural generalist movement to adapt their model to the needs of LMICs
• Compassion in Rural health care

Editor's note: this is an edited report - a complete version was circulated to all google group members