WONCA Working Party on Rural Practice report on Dubrovnik

Photo: even those in the 'back stalls" got involved in the Working Party meeting.

The WONCA Working Party on Rural Practice met over two days before the beginning of the WONCA World Rural Health Conference in Dubrovnik in April 2015.

People from all over the world, movers and shakers in rural health education, research and in health service provision, many jobbing doctors, trainees and students took part in two meetings that reviewed the work undertaken thus far and planned for the future of the WONCA Working Party on Rural Practice.

Our chairperson John Wynn Jones (@JohnWynnJones) has had a clear focus on increasing diversity in the working party and the success of this strategy was clearly evident in the people there, however there is more work to do and the Working Party decided on a continued focus on encouraging more women, young people, and people from every WONCA region into the working party and its activities. (John pictured speaking at right)

The purpose of the WWPRP is to provide an identity and connection between rural family doctors, to provide communication and collegiality, disseminate information and provide education and pastoral care to our colleagues. Members of the WWPRP act as a barometer of their communities – the health providers, teachers, researchers, governments and patients in rural places around the world. In high income and low income countries. East, West, North and South.

We want to see Health for All Rural People, and we want to be an effective vehicle for improving the health of all rural communities.
If you are interested it would be ideal if you could come along to working party meetings which happen at each WONCA world and WONCA rural health conference – we will meet in Brazil in 2016, and Australia in 2017. In between meetings you can follow the conversations on twitter by following @ruralwonca, searching #woncarural on social media and on Facebook.

The conference was an opportunity to announce a new social initiative – (www.woncarural.org) – a website which provides links to all the work of the working party and to WONCA world. This is an ideal way for us to share news, the work we do and to link with each other. The WWPRP thrives on the enthusiasm and involvement of its members and anyone who wants to get involved will be welcomed. We want your ideas and your voice. Please link with us.

Many members of the Working Party were involved in the second Rural Generalism summit which had happened in Montreal, Canada just before this meeting. Rural communities around the world need health providers that are able to meet their needs, it is clear that all over the world this means people who are able to undertake extended practice including practical, management and teaching skills.

The scope of practice required is different from community to community, but Rural Generalists are needed in Africa, Australia, Canada, the Pacific Islands, the Philippines and the Caribbean, indeed all over the world. Rural Generalism Movement is a way of promoting the need for special education, support and training for people working in rural health around the world.

Rural Proofing is another movement that can help us to make a difference in our communities. We heard how the application of Rural Proofing tools in the UK and USA has helped to make sure that the needs of rural communities are heard in the planning of services.

This is a movement that we would like to see grow.

The WWPRP runs on the smell of an oily rag and whilst we reviewed the financial situation of the group it is clear the value we bring as members is way beyond the income we generate which comes mainly from conferences with a small stipend from WONCA world.

The success of the Rural Medical Education Guidebook has been phenomenal and we will continue to promote it as a great tool for educators at every level from individual teachers to deans of medical schools. The Guidebook is the third most popular “hit” on the WONCA website which is a clear indication of the interest that it generates.

We had brief updates from regions around the world, fantastic to hear about the development of CIMF – a South American Regional Rural Group which along with EURIPA is the only other regional rural grouping under the WONCA umbrella. We think this is a way forward.

Sarah Strasser told us about extending Family Medicine into the Caribbean country of Guyana and asked for help with educational resources. It was suggested that use of online communities and resources such as #FOAMED (Free Online Access to Medical Education) would be useful for communities like this.

Mental Health outcomes around the world are poor in rural communities and we will develop a strategy in the run up to the next WONCA World conference in Brazil (2016).

We heard the WHO has lost focus on human resources which is clearly a major issue for rural communities and we hope by continued involvement of members of the WWPRP at the highest levels with WHO we can see this back on the agenda.

There is a growing recognition of the need to develop an Agricultural Occupational Health Education Programme - the “One Health” Movement illustrates the links between animal and human health, as well as issues around Climate Change and how they will impact on rural communities.

These will be further discussed in the conference and hopefully added to the Rural Educational Guidebook as chapters.

During the meeting we looked again at the Gramado conference statement which has been published online with the other policies and statements of the WWPRP.

We will work on a new version of the telehealth policy, and it was proposed that a change be made in the wording in the Gramado statement around the role simulation can play in medical education. Simulation is a useful tool, but needs to be tailored to the resources available and needs within rural communities. This was agreed to be a pragmatic and reasonable alteration.

We heard presentations around point of care testing for rural communities and he need for leadership and leadership training in rural people. Leadership is about empowering people to flourish in the face of uncertainty. We all do this day to day with our patients, staff, communities, colleges and for some of us countries. We heard there would be many opportunities for us to develop leadership skills during the Dubrovnik conference, which we also prepared for.

We heard about the continued importance of social responsible medical schools, patient safety initiatives and the complex issue of needing to look at the issues around rural communities.
Once again if this sort of conversation “floats your boat” – link in to the WONCA working party on rural practice on social media, join in the conversation, and help us to move together towards the goal of Health for All Rural People.

Jo Scott-Jones (pictured in a serious moment with Leonardo Vieira Targa)

read about "Rural heroes project" launch in Dubrovnik