WORLD HEALTH ORGANIZATION
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL
•
ORGANISATION MONDIALE DE LA SANTE
REGIONAL COMMITI:EE
wp/RC7/Min/2 Rev.l 24 September 1956 ORIGDIAL: ENGLISH MINUTES OF THE SECOND MEErDIG
Seventh Session Me.D1la. 7-13 September 1956
Institute of gy~iene Saturday, 8 September 195 at 9:00 a.m. CHAIRMAN: Dr. J. Bierdrager
CONTENTS
1 2
Opening remarks by the Chairman Address of the incoming Chairman Technical Discussions
4 4 4
3
.....
4
Action taken by governments with regard to the implementation of the various resolutions passed during the sixth session of the Regional Committee Acknowledgement by the Chairman of brief reports received from governments on the progress of their health activities ••••••• • • • • Report of the Regional Director
5
5
8
6
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8 15
7
Future organizational studies; regionalization
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WP/RC7/Min/2 Rev.l Page 2 Second Meeting Saturday, 8 September 1956 at 9:00 a.m. PRESENT
I
Representatives of Member States AUSTRALIA
Dr. H. E. Do'Wtles Miss E .. Warren Dr. L. C. Yen Dr. C. H. Yen Dr. Y. T. Kuo Medecin-Colonel R. Augere Medecin-Colonel Aretas Dr. M. Kusu.moto Mr. A. Saita Mr. T. Nakagawa
CHINA (TAIWAN)
FRANCE JAPAN
KOREA
Dr. Mr.
D. S. Chung
c. c.
Lee
LAOS
Dr. C. S. Sayavongs Dr. J. Bierdrager
NEW ZEALAND
Dr. F. S. Maclean Dr. Dr. Dr. Dr.
PHILIPPINES
R. Tumbokon E. Agustin T. Gomez A. C. Regala
PORTUGAL UNITED KINGDOM
Dr. J. de Paiva Martins Dr. Dr. Dr. Dr. Dr. W. Gl.yn Evans
Mohamed Din bin Ahmad M. Doraisingham A. R. Edmonds G. Graham-Cumming
UNITED STATES
Dr. R. K. C. Lee Dr. K. Bain Dr. H. DeLien
VIET NAM
Dr. L. K. Quyen Dr. P. G. Can
wp/RC7/Min/2 Rev.l Page 3 II Representatives of the United UNITED NATIONS III C~ILDREN'S
Nation~ f~d
Specialized Agencies !vir. S. M. Keeny
FUND
Representatives of other Inter-Governmental Organizations SOUTH PACIFIC COMMISSION Dr. Thos. C. lDnie
Representatives of Non-Governmental Organizations in official relations with WHO INTERNATIONAL FEDERATION OF GYNECOLOGY AND OBSTETRICS INTERNATIONAL PAEDIATRIC ASSOCIATION INTERNATIONAL SOCIETY FOR THE WELFARE OF CRIPPLES INTERNATIONAL UNION AGAINST
Dr. Jose Soriano Dr. F. del t.fu.ndo Dr. J. S. Santillan Dr. J. Z. Santa Cruz
CANCER MEDICAL WOMEN'S INTERNATIONAL ASSOCIATION Secretary:
Dr. R. Rivera-Ramirez Dr. I. C. Fang Regional Director
wp/RC7/Min/2 Rev.l Page 4 . 1 OPENING REMARKS BY THE CHAIRMAN The CHAIRMAN welcomed the representatives from China who had not been present at the opening session and expressed regret at the absence of representatives from Cambodia owing to the illness of the chief representative. 2 ADDRESS OF THE INCOMING CHAIRMAN The CHAIRMAN thanked the Committee for the honour done to his country and to him personally by electing him as Chairman. He referred
to the absence of Dr. R. H. Bland (retiring Chairman) and asked the Chief Representative of the United Kingdom to express the thanks of the Committee for the work he had done during his term of office. The CHAIRMAN then referred to the varied situations in the Western Pacific Region which had countries with a high degree of development and at the same time areas where people lived in small, under-developed communities.
In view of the difficulties which confronted the Organization
in this respect, he felt that the Organization, in collaboration with other agencies, had done valuable work. The importance of countries
appreciating that mutual assistance was the realization and basis of mutual understanding was emphasized. Assistance in itself was unacceptable
unless the assisted territories were aware that at some time their assistance might be called for. (For full text see Annex I)
3
TECHNICAL DISCUSSIONS The Chairman of the Technical Discussions Group announced that the
topic selected for discussion was "The Care of the Child from 1-6" and gave a brief summary of the techniques to be used. She also informed
wp/RC7/Min/2 Rev.l Page 5 the Committee that the following had been selected as group leaders:
Dr. C. H. Yen (China), Dr. Le Khac Quyen (Viet Nam), Dr. A. C. Regala (Philippines) and Dr. K. Bain (USA). Medecin-Colonel ARETAS (France)
proposed that the schedule contained in documents wp/RC7/TDe and
wp/RC 7/TD3
should be adopted; this was seconded by Dr. C. C. LEE (Korea) and unanimously approved.
4
ACTION TAKEN BY GOVERNMENTS WITH REGARD TO THE IMPLEMENTATION OF THE VARIOUS RESOLUTIONS PASSED DURING THE SIXTH SESSION OF THE REGIONAL COMMITTEE (WP/RC7/2) The CHAIRMAN informed the Committee that the replies received from
governments with regard to the implementation of the resolutions adopted at the last session of the Committee were given in document wp/RC7/2 and asked whether any other representatives wished to nuke statenents. There
being no further statements, the CHAIRMAN proposed that the following draft resolution should be considered: I~e
Regional COmmittee,
1.
NOTES the action taken by governments with regard to
resolutions adopted during the sixth session of the Committee; 2. THANKS those governments who have submitted reports and
suggests that this method of reporting be followed at future sessions of the Committee."
Dr. A. C. REGALA. (Philippines) suggested that the follOwing paragraph be added to the resolution: I~JOINS
Member Governments that have not taken any action
on the resolutions to submit at the next regional committee meeting a report on the action taken."
WP/RC7/Min/2 Rev.l Page 6 M6decin-Colonel ARETAS (France) suggested that the proposal of the Philippine dalegation made the resolution mandatory and that he would abstain from voting on the amendment. Dr. C. H. YEN (China) was of the
opinion that the resolution submitted by the Secretariat was sufficient. The fact that countries had not sent in reports did not mean that they were not taking action. Mr. A. SArTA (Japan) asked the Secretary which
resolutions were referred to in paragraph 1 of the draft resolution and what exactly was intended by II
this method of reporting be followed at The SECRETARY replied that there
future meetings of the Committee".
had never been any formal resolution requesting governments to make statements on the implementation of resolutions adopted by the Committee. In
the past, however, oral reports had been given and since this had on some occasions been time-consuming, it had been decided to ask governments whether they wished to present written statements which would then be subm~tted
for information purposes.
He referred in particular to the
resolution on the distribution of project reports; the majority of the governments in the Region had agreed to the distribution of project reports provided these were cleared with the government in advance, and it was felt that it was of interest to all countries in the Region to know what the situation was. Further, if he as Regional Director "Tere at any
time asked about, for example, environmental sru1itation activities in different countries he was now in a position to make a statement based on the information received from certain countries. Mr. SArTA stated that he
fully appreCiated the need for follow-up of resolutions but he did not consider that the submission of reports should be mandatory. He suggested
that the Committee should merely take note of the reports submitted and thank the governments concerned.
wp/RC7/Mln/2 Rev.l Page 7 Dr. W. GLYN EVANS (United Kingdom) proposed the following amendment
to paragraph 2: "THANKS those governments who have submitted reports and is of the opinion that this method of reporting in writing is preferable to the method of submitting oral reports at regional committee meetings." Medecin-Colonel ARETAS asked for the views of the Chairman and the Regional Director on the matter since a decision would have to be taken on the proposal of the Philippine representative. The SECRETARY stated that even in the draft resolution there had been no intention of making the procedure obligatory as the word "suggests II had been used. He felt that the proposal of the United Kingdom representative
seemed to cover the views expressed. Dr. REGALA explained that it was not the desire of his delegation to
include any element of compulsion in its proposal.
It was, however, their
feeling that information on the experiences of Member Countries in the Region should be made available in reports so that they could be of use and benefit to other governments and this had been the basis of the amendment proposed. In view of the discussions which had taken place he wished
to withdraw his proposal.
Dr. R. K. C. lEE (USA) stated that in view of
the explanation given he would like to second the proposal made by the representative of the United Kingdom. Mr. SAITA stated that the amendment
was not satisfactory in its wording, but with the spirit of compromise he would accept it. Medecin-Colonel ARETAS agreed to the proposed amendment.
The amended resolution was then put to the vote and carried unanimously, it being agreed that the Secretariat should re-word the last paragraph.
WP/RC7/M1n/2 Rev.l Page 8 5 ACKNOWLEIGEMENT BY THE CHAIRMAN OF BRIEF REPORTS RECEIVED FROM GOVERNME!NTS ON THE PROGRESS OF THEIR HEALTH ACTIVITIES The
CHAIRMAN
acknowledged the receipt of reports from the Governments
of China, the Federation of Malaya, Fiji, Japan, Netherlands New Guinea and Viet Nam. 6 REPORT OF THE REGIONAL DIRECTOR (WP/RC7/3) The REGIONAL DIRECTOR requested the Committee to examine Parts I and II of the Annual Report in detail and referred briefly to some of the major happenings during the period under review. A survey had been carried out
of the technical and administrative procedures in the office, as a result of Which it had proved possible to adhere to the approved staffing pattern and no new posts had, therefore, been provided for in the proposed programme and budget. He informed the Committee of the appointment of the three area
representatives and the arrangements made Whereby the medical officer in charge of the Singapore Epidemiological Intelligence Station had also taken over this function, the expenses for the Regional Office being limited to duty travel and minor expenditure directly associated with regional activities. Considerable progress had been achieved in the field of malaria control and in the Pacific Island territories the anti-yaws campaigns had been considerably expanded. IncreaSing emphasis had been placed on education and
training activities and
44%
of the fellowships awarded (126) had been for
training within the Region; in the period 1954-1955 only 33% had been placed in the Region. The Regional Director informed the Committee that he would The CHAIRMAN then asked for general
be glad to answer any questions raised. comments on the report.
Dr. H. E. DOWNES (Australia) stated that in his opinion the report was better than any previous one and congratulated the Regional Director and his
wp/RC7/Mln/2 Rev.l Page 9 staff on the amount of work Which had obviously gone into its preparation. There being no further general comments, the CHAIRMAN suggested that the report be considered page by page. Regional Office, section 3, Page 4 Mr. A. SAITA (Japan) referred to the administrative manageltlent survey
carried out and stated that his delegation welcomed the information that the Regional Director was striving to operate the Regional Office as efficiently and economically as possible. He hoped that the staffing
pattern would be reviewed periodically in order to ensure that it was strictly in accordance with the actual needs of the office. Accommodation, section 3.2, page
5
Mr. SAITA felt that the report on the latest negotiations with the Host Government with regard to accommodation for the Regional Office was most encouraging and suggested that the Committee should thank the Host Government, for its co-operation. The assistance given by the Department
of Health in the negotiations should be particularly noted and it should be congratulated on obtaining such a considerate and generous offer. Organizational structure, section 3.3, page 5
Mr. SAlTA referred to the appointment of the three area representatives and felt that the Regional Director should be congratulated on being able to fill the posts with experienced men. He suggested, however, that
a periodic review of the need for area representatives should be carried out and if the Regional Director found that there was no need for maintaining a post he should be courageous enough to suppress the post. The dangers of
bureaucracy should not be overlooked and he was not conversant with the workings of the Regional Office nor What the channels of communication
wp/RC7/Min/2 Rev.l Page 10 were f'rom the top level to the f'ield. He referred to the programme and
budget and comparing the amounts allocated to field activities and that required f'or the Regional Of'fice pointed out that in 1957 more than $300 000 would be used to support f'ield activities costing $550 000. The REGIONAL DIRECTOR assured Mr. Saita that all the points mentioned would be borne in mind but suggested that the last point on the regional office expenditure should be deferred until the report of the sub-committee was ready.
Dr. R. K. C. LEE (USA) stated that he wished that Mr. Saita had been a member of the sub-committee and he hoped When the report was issued that he would study it critically. He too was not clear about
the lines of communication and supervision of' staf'f from the Regional Director to the Director of Health Services, the public-health administrators, area representatives, etc. He asked Whether a manual had been
developed covering this matter in order that governments might know to whom to ref'er on particular points. The objective of WHO was to make
the maximum use of f'unds and personnel available and not to develop an organizational structure just because it had been established in other regions. He wondered Whether the growth had not been too much on adminis-
trative structure and not sufficiently on the field and service staf'f •. Dr. W. GLYN EVANS (United Kingdom) asked whether it would be possible to have some comparative figures showing the expenses in other regions and the proportions spent in the office and in the f'ield. The REGIONAL DIRECTOR agreed to prepare a statement of this kind for the Committee.
WP/RC7/Mln/2 Rev.l Page 11 Dr. F. S. MACLEAN (New Zealand) referred to the statement on the
Epidemiological Intelligence Station and asked whether it was being transferred to Manila. This did not appear to be the case from the statement
in the Regional Director's Report but he would like some assurance on this point. The REGIONAL DIRECTOR replied that a transfer of the Station to Manila had never been envisaged, the only change was the added responsibility given to the Medical Officer in Charge now that he was acting as area representative. Dr. C. C. LEE (Korea) expressed appreciation of the increased
geographic distribution of internationally recruited staff. Co-operation with the United Nations and other agencies: section 5, page 8 Dr. R. K. C. LEE (USA) commended the Regional Director on the better
co-ordination and improved working relationships with other international agencies. Public Information: section 7, Page 12 Mr. A. SAITA (Japan) stated that his government was extremely
interested in the activities on public information, and had closely watched activities in this field. He mentioned in particular the WPRO pamphlet on
WHO-assisted activities in the Region which had been of conSiderable value. At last year's meeting his delegation had criticized the way in which material had been supplied to governments and he was glad to state that this had greatly improved. However, in one instance, material required
for World Health Day had arrived too late and he felt that this information should be forwarded to Headquarters in order to avoid any year. co~laints
next
wp/RC7/Min/2 Rev.l Page 12
J" Assistance to overnments in the develo in and stren thening of their health services: scction 1.1, Part II, PagC 1 Dr. F. S. MACLEAN (New Zealand) referred to the statement in the
report on the importance of developing training schools for personnel engaged in public-health work. It was his understanding that when the
Organization awarded fellowships, this invariably involved travel to other countries and in his opinion there was a great disadvantage in health workers being trained in other countries where the training might not be geared to their own countries. He asked the Regional Director whether it
was the intention of the Organization to make more training facilities available in countries where the health personnel would be required to work in the future. The REGIONAL DIRECTOR replied that this was a matter of concern to the Organization also and it was intended that as much training as possible should be done in the appropriate environment. The Regional Connnittee had
on several occasions given him the mandate to develop facilities within the Region and every effort was being made to use regional training centres. He referred to the programme of assistance to the Institute of Hygiene, Manila, which had received support from the Johns Hopkins University, the Rockefeller Foundation and the Organization. Assistance had also been
given to the UniverSity of Malaya and improvements were being made in the Central Medical School, Fiji and the School of Health Officers in PhnomPenh. The Organization had been fortunate in receiving assistance from
universities and teaching institutions within the Region with regard to the placement of fellows from this and other regions.
WP/RC7/M1n/2 Rev.l Page 13 Dr. MACLEAN thanked the Regional Director for his explanation but
stated that when a country is short of trained personnel, probably because of training facilities being limited or because if could not finance training, he would suggest that great advantage could be obtained if the basic training were carried out in the worker's own country as travel abroad might have an unsettling effect. The REGIONAL DmECTOR replied
that the basic policy of the Organization was where possible to assist governments to strengthen their own training facilities, particularly basic training. Fellowships awarded for study outside of the Region were
given on subjects for which facilities could not be found within the Region or for post-graduate courses. ~ South Pacific Commission, section 5.5, Page 11 M6decin-Colonel ARETAS (France) referred to the item on the South Pacific Commission and stated that he had noted that direct contact was made during the South Pacific Conference held in Suva, April/May 1956 with regard to the develop.nent of Joint projects under the Technical Assistance Programme. He asked for further information on the matter.
The CHAIRMAN suggested that Dr. Lonie might be asked to include information on this point when he addressed the Committee. Fellowships, section 2.2, Page 28
Dr. C. C. LEE (Korea) commended the fellowship programme of the Organization from which his country had received much benefit. Travel undertaken during the period under review, Annex VI Mr. A. SAITA (Japan) referred to the Annex prepared on travel and
asked the Regional Director for further details as there appeared to be difficulties in this connection as mentioned on page 16 of the report.
wp/RC7/Min/2 Rev.l Page 14 The REGIONAL DIRECTOR replied that it was not always possible to give long notice of visits of the regional office staff and difficulties had occurred in the case of the Federation of Malaya Where at least two months notice had to be given. With teams working in different countries visits had sometimes
to be arranged on an emergency basis because of problems Which had arisen and as the Regional Office had the responsibility of supervising the field teams it was not always possible to give as much notice as one would want.
Mr. SAITA stated that his country welcomed visitors and was always happy to assist them in the way of observation tours or interviews. How-
ever, he would like the Regional Director to transmit a complaint to the Director-General. In the past visitors had come from the Director-General's
office for observation tours in particular fields of work, these people had, however, invariably resigned as soon as they got back to Headquarters. was appreciated that nobody could control these circumstances but the Government had done everything possible to provide a clear and accurate picture and it was never known Whether the people concerned had reported to Headquarters at all. The REGIONAL DIRECTOR apologized for any inconveniences caused by such happenings and stated that he would pass the comments on to the DirectorGeneral. It
Dr. R. K. C. LEE (USA) asked Whether there were travel schedules for the staff and What was the relation of the regional ad.isers to the area representatives. The REGIONAL DIRECTOR replied that as the system of area representatives was new to the Region, ways and means would have to be found to make
WP/RC1/M1n/2 Rev.l Page 15 the best use of duty travel. tive ~uld
The present plan was that the area representa-
keep in close touch with the countries within his area and if
during his visit matters on which he was not conversant came up he would request the Regional Office to send a specialist adViser. ~rking
The teams
in a country could also request a visit by a specialist adviser All travel was rigidly controlled and there had
if this seemed necessary.
to be a very good justification before it was approved. Dr. R. K. C. LEE. suggested that the report should now be approved
and that page by page discussion of Part III was perhaps not necessary. This was agreed and it was left to the Chairman and the Rapporteurs to prepare a draft resolution for consideration of the Committee. 1 FUTURE ORGANIZATIONAL STUDIES; REGIONALIZATION (WP/RC1/12) The CHAIRMAN suggested that a ~rking
party should be established to
consider the question of regionalization and designated the following as members of the group: France, Japan, Philippines, New Zealand, United
Kingdom and the United States of America with Dr. F. S. Maclean as Convenor. The group would meet on Tuesday morning and report back to the
Committee on its findings. The meeting rose at 12:30 p.m.
wp/RC7/Min/2 Rev.l ANNEX I ADDRESS OF DR. J. BIERDRAGER
(Incoming Chairman) Honourable Representatives, Observers, Ladies and. Gentlemen : It is a very great honour to my country and to myself to be elected Chairman of the Western Pacific Regional Committee for the cOming year. I am grateful for your confidence and wish to express the hope that you will in every possible way assist me to master not only my language difficulties but the duties which fall on anyone presiding over a committee such as this. I welcome you most heartily to Manila and I am convinced. your presence will contribute greatly to the value of our discussions. I believe I speak in the name of all of you wen I say how much we regret the absence of the retiring Chairman, Dr. Bland, who is unable to attend this meeting. I invite the representative of the United Kingdom to thank Dr. B'land for the very helpful work he has done during the past year as Chairman of the Regional Committee. Furthermore, I should like to express our thanks to the University of the Philippines for making this building available for the COmmittee, as well as to all those who have in any way participated in the extensive preliminary work, to make the discussions profitable and our stay in Manila comfortable. It is not my intention to take up time in this opening address as we have an extensive agend.a, to deal with. It impresses me that every year anew the Regional Director's report gives proof of the expansion and depth of our work. It is my opinion that in the Western Pacific Region one finds more varied situations than in any other region. On one hand, there are countries with a high degree,of development facing problems of mental hygiene, paediatric psychology, agricultural utilization of organic wuRtes, water fluoridation and others. On the other hand, we have to deal with unsophisticated peoples in small communities and living a primitive type of existence mainly confined to agriculture and hunting. This situation confronts the Organization with difficulties to solve which I am aware in past years have been dealt with in a most satisfactory way. The value of the 'WOrk done by the World Health Organization in the field of health, often in collaboration with other internationaJ. agencies, in this and other parts of the 'WOrld cannot therefore be 'overrated. We should, however, be fully aware of the psychological background of our activities. It should be understood that any activity aimed at aSSistance, whether it be in a medical, agricultural or teChnical field calls for reciprocity; and it is only in this way that a balance of mutual understanding, appreciation and esteem can be maintained.
wp/RC1/Min/2 Rev.l Annex I
Page 2 No territory or country in the world can in the long run exist by assistance alone, not even by partial assistance, if there is no hope of mutual assistance. Mutual assistance is the realization and the basis of international understanding. Only people who are in a position to render assistance to others are privileged to enjoy health, freedom and social equilibrium. Our aim therefore should be to make those Who, in these days, still enjoy the questionable profits of assistance, familiar with the idea of mutual assistance, this being the sole basis for a world-wide understanding of the ability to support in normal circumstances and a willingness to co-operate in cases of need. Assistance in itself is unacceptable, unless the assisted territories are aware that some time their assistance may be called for. Only after this call has been answered will the World Health Organization be in a position to consider its main task as fulfilled and to resort to mere co-ordinating activities.