President's message

Keith MacLellan, MD
Shawville, Que.
President, Society of Rural Physicians of Canada

Can J Rural Med 1996; 1 (2): 58

Rural medicine is a global issue. This statement may sound contradictory because, after all, rural medicine is very much community based. Decentralization of decisions, training and care are at the core of our discipline. Yet, while politics, history and economics fragment our world, geographic realities can unite us, particularly with the strong, shared experiences of rural doctors. This possibility was highlighted at the First International Conference on Rural Medicine, held in Shanghai between May 21 and 28, 1996, a meeting where rural doctors from many countries exchanged ideas, skills, stories and entertainment. Many themes were familiar to Canadian doctors: isolation, heavy workloads, high levels of responsibility and skills, poor political representation at the regional and national levels, inadequate training programs and underfinancing. Combine these with a love of the countryside or the bush and a commitment to rural people and the challenges their health care creates, and you'll find a rural doctor from almost any country.

Three events were, to my mind, the salient points of the conference. The first was the overwhelming interest in an acknowledgement of China's barefoot doctors -- those who staff the front lines of the Chinese medical system. This acknowledgement was repeated over and over as doctors from around the world visited villages and looked into the barefoot doctors' black bags, visited their clinics and viewed their patients.

Another high point was a talk by Dr. Roger Strasser, one of the world's few professors of rural medicine, in which he described why he believed his discipline to be distinct, with its own literature, research and clinical characteristics. His presentation of the rural training policy of WONCA (the World Organization of Family Doctors) is available to anyone wishing to make representation to governments or health bodies.[1]

Finally, the Rural Doctors Association of Australia and the Society of Rural Physicians of Canada (SRPC), with help from many countries, convened the World Organization of Rural Doctors (WORD), devoted to improving health care to rural residents globally and helping in the formation of national and regional rural doctors' associations. The premise is that in order to create effective change in rural health care, contributions must come not only from government and collegial academic levels, but also from the field workers themselves -- those "toiling at the coal face." WORD should be fully established by September 1997, in time for the Second International Conference on Rural Medicine, in Durban, South Africa. Contact us through the SRPC if you would like to help.

So you see? You are not alone, even though isolation is such a big factor (sometimes good, sometimes bad) in most rural doctors' lives. Give us your support, tell us what's in your black bag, join the SRPC. There is lots of work to do, both for your town and for the world.

Reference

WONCA Working Party on Training for Rural Practice. Policy on training for rural practice. Can Fam Physician 1996;42:1181-3.

Table of contents: Can J Rural Med vol 1 (2)