•
WORLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANTE
REGIONAL OFFICE FOR
THE WESTERN
PACIFIC
BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL
REGIONAL CCf.lMITl'EE Nineteenth Session Manila 1-8 October 1967 Provisional agenda item 13
WPR/RCl9/5 19 July 1968 ORIGINAL: ENGLISH
THE ESTABLISHMENT OF A WHO MEDICAL SCHOOL IN THE WESTERN PACIFIC REGION Report by the Regional Director DITRODUOl'ION In compliance with resolution WPR/RC18.Fq' adopted by the Regional COIIIDittee at its eighteenth seSSion, the Regional Director has the honour to submit a report on medical education in the Region and the type of assistance being provided by WHO. The report is composed as follows: 1. Data concerning medical educational facilities in countries of the Region • 2.
•
Outline of the form of WHO assistance being given in the field of medical education. Comments of governments on the proposal of the f.1alaysian Government to establish a WHO medical sohool in the Western Paoific Region.
3.
Annex 1 - Statistical data concerning countries in the Region \dth medical schools. Annex 2 - Statistical data concerning countries in the Region \'11thout medical schools. Annex 3 - Comments of governments on the proposal of the f.1alaysian Government to establish a \iHO medical school in the Western Pacific Region. /1 MEDICAL •••
WPR/RC19/5 page 2
1 1.1
MEDICAL EDUCATIONAL FACILITIES IN COUNTRIES OF THE REGION
The World Directory of t-Iedical Schools, third edition, 1963, is However, as a number of new
the most comprehensive source of information available on medical educational facilities in the Region. schoolS have been established and important developments have taken place in existing schools since the 1963 Directory was published, questionnaires were distributed to all countries and territories in the Region in March 1968, for the purpose of collecting up-to-date information on the subject. The response to the questionnaire was good and a great deal of valuable information was received. Relevant narrative sections of the
•
1963 Directory covering administration of medical schools, conditions of admission, curricula, examinations, etc. were brought up-to-date and although it has not been possible to incorporate the revised narrative sections in this report, amendments provided by governments have been noted for record purposes. Of greater import are up-to-date statistical data Which are included in this report (Annex 1), together with brief relevant comments submitted by Member countries and territories. 1.2 In 1951, when the WHO Regional Office for the Western Pacific came
into existence, there were sixty-eight medical schools in the Region. Two of these, the Fiji School of Medicine and the Health Officers School
in Cambodia, were for the training of assistant medical officers. to 95 000 in Cambodia.
At
that time the populationVphysician ratio varied from 725 in New Zealand At the present time there are in the Region 98 medical schools of which:
85 are graduating students
13 are not yet graduating students Three of the schools graduating students, namely those in Fiji, Laos, Papua and the Trust Territory of New Guinea, do not offer degree courses. /The population •••
wPR/RC19/5 page ,
The population/physician ratio in the Region based on the most recent statistics available now ranges from 632 in New Zealand to 26 213 in laos. The population/physician ratio can be a useful index used by health administrations and health. planners in referring to standardS and availability of health services. Comparison of the ratios quoted in the 1963 World Directory with those currently quoted in Annexes 1 and 2 indicate that over the last few years there has been some improve-
ment in most countries as far as the physician supply situation is con-
...
cerned.
Using the population/physician ratios of Annexes 1 and 2
it is convenient to place countries and territories in the Region in three main groups Group I - Population/physician ratio below 2000 This includes Australia, China (Taiwan), Japan, New Zealand, the Philippines and Singapore. this group include: Islands and territories in American Samoa, Gilbert and Ellice
Islands, New CaledOnia, Tol<elau Islands and Trust Territory of the Pacific Islands. Group II - Population/physician ratio between 2000 and 5000 This intermediate group includes Fiji, Hong Kong, the
•
Republic of Korea and West Malaysia. tories include:
Islands and terri-
Brunei, Guam, Ryukyus and Tonga.
Group III - Population/physician ratio above 5000 Included in this group are Cambodia, Iaos, East Malaysia (Sarawak) and Viet-Name Islands and territories include the British Solomon Islands, Cook Islands, Niue, Papua and
the Trust Territory of New Guinea. 1.3 Although different countries and territories will have their own particular views on the adequacy or otherwise of their supply of physicians, it would seem reasonable to state that in countries in Group I, the supply of physiCians appears relatively satisfactory. However, it is recognized that with rising living standards and increasing populations, medical manpower needs are also increasing and no doubt further medical educational facilities will be required
lin these countries •••
WPR/RC19/5 page 4 in these countries in the near future. countries. As far as territories and islands in Group I are concerned, the relatively favourable ratios can be misleading. taken into consideration in each case. In countries in Group II, there may be a relative shortage of On a comparative basis, this
group has a similar ratio to European (around 1000) and North American
Important factors
such as distances, isolation and population distribution need to be
physicians.
However, over the period 1954 to 1968, a good degree of Countries in this group are now more or less in
improvement has occurred in countries in this group - Hong Kong, Republic of Korea. line with South American and several Middle East countries. In Group III countries, the position of medical manpower is acute and most serious. African States. 1.4 In the context of medical manpower, the much publicized "brain draintl warrants brief consideration. is a universal phenomenon. in the developing countries. In the present day and age, this
....
•
This group has rates comparable to
many
of the new
The affluent countries suffer less - in The Philippines, China (Taiwan), Hong-
fact many benefit therefrom, while the most serious effects are felt Kong and Republic of Korea are countries particularly affected by the "brain drain" - a sizable percentage of their medical graduates leave to take up more or less permanent residence abroad. The "brain drain" The affects other health workers as well as doctors, and in the countries mentioned nurses, for example, also emigrate at a high rate. "internal brain drain" in many countries is also a real problem with the flocking of the professionals to the cities leaving the rural areas sadly neglected as far as health services are concerned. 2 2.1 OUTLINE OF THE FORM OF WHO ASSISTANCE BEING GIVEN IN THE FIEID OF MEDICAL EDUCATION In rendering assistance to countries in the field of medical /establishment •••
education, as in other fields, the Organization places emphasis on the
WPR/RC19/5 page 5 establishment and s':'rengthening of the countries I own institutions and resources, and in particular the training of teachers. needs of the community is strongly supported. Direct assistance by WHO to medical education, at the request of governments, may consist of: (a) the granting of fellowships for: (i) graduate and post-graduate specialized studies abroad and - in special circumstances - undergraduate professional studies; (ii) (iii)
The present
world-wide trend to orient medical education more towards the actual
attendance at training courses and seminars; special training in teaching;
(b)
the assigning of visiting professors and teaching staff to medical teaching institutions in connexion with: (i) (ii) (iii) planning and organizing of new departments; planning curricula; introducing new teaching strengthening research programmes;
methods;
.. -;;.
(c)
assistance to governments in surveying the need for and planning of new medical schools and developing existing institutions;
Cd)
the provision of teaching equipment and books. allowance is included in fellol'lShip awards.
A book
Indirect assistance and other activities may consist of: Ca) the organizing of meetings on medical educational topiCS, such as: (i) inter-regional and regional conferences, expert committees. study groups; support given to national conferences and to international conferences convened by other bodies; (11) international and inter-regional training courses, symposia and seminars, including travelling seminars;
feb)
the collection
...
WPR/RCl9/5 page 6 (b)
the collection, collation and dissemination of information, publications and comments bearing on: (i) reports of meetings under (a) above; surveys of health legislation on education and
(1i)
training of medical, paramedical and health auxiliary personnel; (iii) (iv) (c) bibliographies on medical education; world directories of schools of medicine, schools
of public health; studies on education and training problems, including those referring to teaching methods, examinations, educational standards, etc. 2.2 WHO collaborates closely with the United Nations (including UNICEF) and several of its specialized agencies (u}T.8SCO, ILO, FAO). Such collaboration is based upon agreements between WHO and the other agencies and consists of representation at meetings of mutual interest and the convening of joint meetings, exchange of information and, generally, co-operation and
,..,.
•
consultation in all fields of common concern.
For
instance, while scientific education is a concern of U}T.8SCO, medical and public health education and training (i.e., preparation of all professions engaged in the health field) are of primary interest to and the responsibility of WHO.
2.3 Assistance in the Western Pacific Region Assistance in medical education in the Region actually commenced in 1953 with the awarding of fellowships to faculty members of medical schools for the purpose of their studying abroad. In this way, it was
•
aimed to raise the standard of teaching in the schools. schools with an average of around twelve awards per year.
Fellowships
of this nature are still being awarded to staff members of medical The first major programme of assistance in medical education was given to Cambodia, commencing in 1953. 'lhrough this project, which provided consultant lecturers and fellowships for teacher training, the teaching standards were sufficiently raised in the school to /enable it to •••
-School of Medicine in 1963. able to the School. in Cambodia.
WPR/RC19/5 page
7
enable it to be upgraded and to produce fully-qualified medical graduates. The first group of fully-qualified physicians graduated from the Royal Equipment and supplies were also made availby
The teaching programme of the School has been further
assisted through the g1ving of lecturEls to students
WHO staff stationed
For the 1970 programme and budget a recollDl1endation has been
made to assist the School in the form of consultant lecturers, fellowships, supplies and equipment. Assistance to the Fiji School of Medicine began in 1955. to train faculty members. aVailable. Visiting lecturers in basic medical sciences were provided as well as fellowships Teaching equipment and supplies were made The standard of the School has continuously risen and for Indirect support is also given by WHO An average of ten WHO fellow-
many years now it has served as a major training centre for health personnel in the South Pacific. through the awarding of fellowships to students from surrounding territovies to study medicine in the School. ships are enrolled for studies in any one year at the Fiji School. A major programme of assistance was cOllDl1enced in 1964 to the Faculty of Medicine, University of Jl1alaya, Kuala Illmpur, with the offering of a number of fellowships for staff training abroad.
• _~
Hospital administration, hospital records, biostatistics, internal medicine, public health nursing and nursing administration are fields covered by WHO advisory assistance. A tutor in laboratory technology As the was also provided to assist in the setting up of a training course for technicians to work in the Faculty and the teaching hospital. school becomes fully established with a permanent faculty it is envisaged that the nature of WHO assistance will change and in the place of long-term advisers, consultants in selected fields will be made aVailable. It is intended that fellowships for staff training will be The first group of graduates from the school will be in 1969. WHO assistance has been given to the Universi ty of Singapore in
continued.
the fom of fello"lSh1ps for the training of faculty members as well as ~
advisory services in several fields, including nutrition, physiology, /medical statistics
WPR/RC19/5 page 8 medical statistics, health education, the setting-up of a school of radiography and the establishment and operation of a cardiovascular laboratory. The services of a visiting lecturer in social and preventive medicine are being made available in 1968. The University of Hue in Viet-Nam was scheduled to receive WHO
advisory services in the teaching of preventive medicine during 1968 but because of prevailing conditions in Viet-Nam it has unfortunately not been possible to date to implement this project. The 'Vmo Regional Office for the Western Pacific has made an important contribution to the develoIJllent of medical education through the holding of a number of educational meetings. medicine. in Manila. In 1957, a study -,..
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•
group was convened to consider the teaching of preventive and social In 1963, a conference of deans of medical schools was held This latter meeting is now being followed-up with a travel-
ling seminar on medical education scheduled to be organized in 1969. In 1967, a multiple seminar on paediatric education was held, with seminars being held in five countries in the Region. Through fellowship awards, many opportunities are also given to medical educators to attend WHO educational meetings held in other regions. In recent years, WHO has fostered the develoIJllent of national
associations of medical colleges,
follo~dng
a trend
~ID1ch
has emerged
in many countries in other regions.
The Organization participated in
discussions which led to the formation of the Association of Philippine Medical Colleges in 1967. in other countries.
•
WHO advisers during field visits have
discussed the possibility of national associations being established As an extension of this idea, during the travelling seminar on medical education to be held in 1969, the feasibility of creating a regional association of medical schools will be examined. WHO assistance to medical education has not been confined to the undergraduate field. Schools of public health and institutes of public health have been given considerable assistance enabling them to develop or strengthen graduate public health programmes. /Special consideration •••
WPR;RC1915
page 9/1.0 Special consideration is also being given by WHO to tile matter of teaching methods in medical schools. '!he first of a series of national workshops on this subject in the Region is expected to be held in Papua and the Trust Territory of New Guinea in 1969, to be followed by a further workshop in the Philippines in 1970. It is anticipated that similar workshops \'rill follow later in other countries. COMr>1ENTS OF GOVERNrIJENTS ON THE PROPOSAL OF THE MAIAYSIAN GOVERNMENT 'ID ESTABLISH A WHO MEDICAL SCHOOL IN THE vJESTERN PACIFIC REGION On 12 March 1968, a letter was sent to governments in the Region
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--
requesting their comments on the proposal to establish a WHO medical school in the Western Pacific Region. Specific replies were received Addi tional informafrom eight MembeI' governments and six territories. and seven territories.
tion was included in the questionnaires returned by four governments Copies of the replies or extracts from the questionnaires received from countries and territories are given in Annex 3.
~
":,,)
f'
~
i MEDICAL fORCE
.1 ~U:'ID ~tlJdenu 8 1 1338000 Hoot
t,
.\ SPECLUroNSIDERATlONIN MEDICAL SCHOOLS NROLlMENT LIMITATIONS
COUNTRIES AND TERRITORIES IN THE WESTERN PACIFIC REGION'WITH MEDICAL SCHOOLS
POPULATION LATEST CF.NSUS f.stlmated , .
MEDICAL SCHOOLS TOTAL OPERATING
AVAILABIliTY OF PHYSICIANS IS CONSIDERED
Country Of lerrit«y Yt'_a[ Jnhabilallu
II mid-year 1968
No, of physicians registered:
PopulatIon pel pbysiciaa
IDade.qu.ate fw Adeqau.le followlJ),B l}'pa
Plam to meet future needs of pb:ysiciaRJ' IAIpply
AJeu afleeted
""u4e:f 8
~U:Y
Ire
lnha.bltantll per Newor mt.dlcaiscbool planning IN8 Itljle
Degrees
AnnUal
conferred
aVUage of grad_In
OllOTA F<2'eigneN br TJ' 2qd Yt acceJUd
Slwtlage of tucbrf*
Auntali,
1966
11550444
12040000
13'150
876 ( 8$0)
Tel
NQne
SOme remote
country wea
il lIadel
Sorne medical schools have plans fIX upaosiun aqd • new school coosidu.t1on It nt!Jdert Uftlvenlty.
1
M.B.B,S.
1017
Yea
Yes
Yet
No
Cambodia
1967
6463 9S5
376
11191 (2'1000) 1 36'1 (1500) 2323 (D POO)
Yel
Specialists
Remote veas
Developing medlcUlfaiDiD8
1
6"-3 9S5
None
M.D.
24-
No
No _
Yes
Yes
China
196'1
12 716 252
13 069 914
9 16S
FiJI
1966
4'16000
48324'1!1
206
No
Geueralduty med.lcal ofllcm
Large.rbosplt&1s
......,.-
aDd. oot.,.Uent
IncreuedoutpatIiomMed.lca1 Scbool •
1
NDae
483U'1
Noae
D.S.M.
9
Yell
Tes
Tu
Tes
HQIIg Kong
1966
3 732 400
3 918 400
1 603!/
2 "" (3 100)
No
Geueral
pr~
ButeaUy a small geogrlph1cal area Re.rI'IOU!lIlUI
IDcleued lDtaIGe of medical scbool. ~quotI.of~l.D
1
NoaB
3 h8 400
Noae
M••••• S.
UO
Tes
Tel
Tetl
No
Japan
196.'5
182'14961
101)50'1000
110159
1107 (tao)
No
PIIblicbeallh
'"
NoaB
21MtIM
NGae.
I.S.M.
3215
Ta
Ta
Tes·
No
aDd med1eaJ. re8UrCh
,.,....... b._rural MUS. -
~ 1CboaII.
ImJlrCm' Iennmeradon of
Kwea{RepubUcol)
196'7
29201856
302.52495
12'141
2374 (3 600) 28 213 (45 000)
No
I'byIiclaIII
lmJ6mtlltaticlDofm.anpower IUpPly plan. Tral.Dl.ng of MOl I.a Laos a!let euabllduneDt of lbe (eJevalll .eet1oo(buis of l furwe faculty).
9
S
1111_
"--
M.D.
1'1'5
Y..
Tel
Yes
No
i.a(K •
2 '100 000
103
Yes
1
NOlIe" 100 000
None
Med1eU AIIIICaID
10
Tes
Tet
Tes
Yes
Malaysia (Welt)
195'1
62'18 '163
8300 831
1915
"3340
No
GellUal IKac::tlce
Easte:n region of
West Malaysia.
Re.crultment of doetan from over se~: obuioing men training pkca in medical dIooIs QVel~
1
8300 837
NoDe
M.I.'.S,
Ndait
ret
....
_
...
New Zealand
1966
26'16919
2'1~0'289
4349
632 (100)
No
Speeialtmlllli RuralllUl FDelalpractice
&tabllshmentof.wAuclt1.uw:1 medlca1tcboo1.
1
1
2'160289
1
M.B. 01.8.
100
Tes
Tel
Yes
Tel
Papua and the Tl'lllt Territe.)' of New Guinea
1966
2168300
2 1'18 300
166
13 133
No
All typel
All rurel ueas
~ped Dumbert trained In Cone...
1
None
2118300
None
Dip/Med,
-
Philippines
1960
2'106'1685
35 983 000
23 995
1495
Tel Tes From tbeirMedlc.uSChool.
'1 1
NOlIe
5 126 143 1,-r5OO0
None None
M.D.
1312 100-110
Tes Tu
Tel
Yes No
Tes No
Sillgapore
195'1
1455000
111'15000
1182~/
1682 (2600)
NorIe
M.B.8.S.
Tel
Viel-Nam
1967
1606'1 136
110'1
14 ti14!/ (29 000)
No
General Pfaetice Specialists
2
None
8033568
None
M.D.
200
Yes
Yes
Yet
Yes
----
-
• No official celll\u has been undertaken by the Government.
!/ Mid-yell ert1mate.
lte1. al 31 Decembu 1981.
!! Excludln& 114 providonally ~gistered PfactjuQDerI u ~./ ReglsteJ:o;:d .. at 31 December 196'1.
Y
Baled. on 1961 population csrimare.
i
'W~
"2 •
g~
( ) Figures re~nt population/pby$lcia.n ratio In Wexld MedlcalDirectory (.
""~
f'
t;
f'
!I MEDICAL FORCE
i
eJ
<
,
COUNTRIES AND TERRITORIES IN THE WESTERN PACIFIC REGION WITHOUT MEDICAL SCHOOLS
.' Plans to meet future needs
POPULATION
Countly or territory
LA TEST cENSUS Year
Estimated
at
mid~year
No. of physicians registered
Inhabitants
1968
Population per physician
AvailabWty of physicians is considered adequate No
Inadequate for following types
Areas affected
Where physicians are trained
of physicians' supply
American Samoa
1965
25000
26000
21
1238
Specialists
General
Suva and Hawaii
Training Samoan applicanu in Suva and Hawaii. Increased number to train in Fiji School of Medicine •
British Solomoo Islands Protectorate
145630
25
5825
No
Brunei
1961 1961
84249 18378
150853
. (N.Z.)
General practitioners and specialists 0
All areas
Fiji
36 3
4190 6984
y" Yes
0
cook Islands.
20954
0
Fiji
Conttactual employment outside state.
From fiji School of Medicine and New Zealand medical school. Training of local persons at Fiji school: retaining expatriate strength at present level. By contract from the Slates and the Philippines.
Gilbert and Ellice Islands
1963
48780
56550
30
1885
No
General practitioners
All areas. particularly outer islands
Guam
1967
67500
85000
36
2361
No
General practitioners, obnetricians. paedia~ tricians
Entire island
U. S.A. and Philippines
Malaysia Sarawak. East Malaysia
1960
744 529
907138
69
13 147
No
General medicine specialists 0
Rural areas and small towns
Singapore and Malaya
From Universities of Singapore and Malaya. From Fiji and New Zealand. 0
Niue New Caledonia New Hebrides (U.K.) Ryukyu Islaods
1966 1965
5194 86519 4025 952000
5260 92000
(N.Z.)
1 63
5260 1460
yO' y., 0
In rural areas and offshore. islands
0 0
1957 1967
965000
408
2365
All specialties
0
No
Japan
Develop and expand medIcal training and researcb programme to attract Ryukyuan medical graduates to return from Japan.
Tokelau Islands Tonga
1966 1966
1900 77429
1883 80000
4
471 3200
y", No
University graduates Rural Fiji School of Medicine graduates General practitiotl£n. speciaUsu
-
Fiji, Papua/New Guinea and Australia
Ex Fiji Medical SchOOl.
2'
Training of nationals in overseas medical schools.
Trust Territory or tbe Pacific Islands
1967
91448
95100
48
1981
No
District hospitals OUtlying islands
fiji and U.S.A.
Recruit foreign physicians while at the same time send -as ma~ stu<lenu as are qualified for medical training abroad. Advanced training for specialists and general practltloners in undergraduate schools under government and foreign assistance.
Western samoa
1966
131377
13'1000
48
2854
No
Specialists and general Rural areas p'actitioners
fiji
'" ><
Z
> Z
~~ '-~ ~
" >: ~'" ~n
" • Mid -year estimate. 1967.
~~
WPR;RC19/5 page
15
ANNEX 3 1. LE'ITERS RECEIVED FROM GOVERNMENTS ON THE PROPOSAL OF THE MAIAYSIAN GOVERNMENT TO ESTABLISH· A WHO l>1EDICAL SCHOOL IN THE WESTERN PACIFIC REGION
GOVERNMENT OF AMERICAN SAMOA
Office of the Governor Pago Pago, American Samoa
•
Ref. GAS!1lA-WHO Serial: 705
27 March 1968
Dear Dr. Dy, I would like to respond to your letter of 12 March 1968, regarding the establishment of a WHO Medical School in the Western Pacific Region. The purpose of this letter is to let you know that at the present time we do not envision sending any students to such a school nor are we able to contribute any funds for the initial capital for the construction, equipping, and yearly operation of the school. Our reasons for this action is simply that the University of Hawaii is planning on extending the growth of their medical school and we have already agreed to support them in their endeavour as much as we possibly can. We do appreciate your bringing this request to our attention, however. Sincerely yours,
a.vEN S. ASPINALL Governor
Dr. FranciSCO J. Dy Regional Director World Health Organization P.O. Box 2932
Manila
WPR/RC19/5 Annex 3 page
16
MINISTRY OF SOCIAL SERVICES
Government Buildings Suva, Fiji Ref. 48;)/92 Dear Sir, Thank you for your letters No. WPRO-79 of
10 April 1968
5 March and (vTP)E2/77/13
of 12 March about the proposed establishment of a WHO Medical School in the Western Pacific Region. 2.
I return herewith, duly completed, the questionnaire sent to me In reply to your letter of 12 March, I am to inform you that the It accordingly does not envisage sending students
•
under cover of your first-mentioned letter.
3.
Fiji Government considers that the Fiji School of Medicine is adequate for its requirements. to the proposed WHO Medical School, nor is it at present willing to contribute to the capital or recurrent costs of the school. Yours faithfully,
(R.W. Baker) Acting Secretary for Social Services
The Regional Director World Health Organization Regional Office for the Western Pacific United Nations Avenue Manila
WiR/PC19/5 Amlex 3
page 17 Territory of Guam OFFICE OF THE GOVERNOR
Agana, Guam U.S.A.
Zl March 1968 Dear Dr. Dy,
•
I recognize the need for additional medical schools in the Western Pacific Region for the training of physioians of high quality. Since. however, exoellent training facilities are already available to us in the United States of whioh we are a part, I cannot foresee the utilization of a WHO medical sohool by Guam students. oial support for the proposed sohool. Sincerely yours, Under the oircumstances, therefore. I regret that I oannot oommit this Government to any finan-
-~
MANUEL F. L. GUERRERO
Governor
Dr. Francisco J. Dy Regional Director World Health Organization United Nations Avenue Manila
WPR,lRC19/S Annex ;< page 18 Colonial Secretariat Lower Albert Road Hong Kong Ref. OR 1/5(J36/68 27 June 1968
Sir, I have the honour to refer to your letter (WP)E2177!l3 dated
12 March 1968, addressed to the Colonial Secretary
and
am directed
to inform you that the Government of Hong Kong regrets being unable to either send students to the proposed medical school or contribute funds owing to the present programme of expansion for the local University Medical School. I have the honour to be,
• .-
Sir, Your obedient Servant,
(J.W. Goodair) for Colonial Secretary
•
Dr. Francisco J. Dy Regional Director World Health Organization Regional Office for the Western Pacific P.O. Box 2932 United Nations Avenue Manila
WPR/RC19/5 Annex 3 page 19 EMBASSY OF JAPAN Manila
29 July 1968 Dear Dr. Dy, With reference to your letter (WP)E2177/13 of 12 March 1968, addressed to the Minister for Foreign Affairs of Japan, concerning your enquiry to my Government on the proposed medical school, I wish to inform you, under instructions of my Government, as follows: (1) Upon the establishment of the proposed medical school~
it is possible that Japanese students are
sent to the school. (2) The Government of Japan is inclined to co-operate in the establishment of the said school, provided that the rest of the countries in the Western Pacific Region will also co-operate in it. However, the Government of Japan is not in a position to commit itself at present to contribute
to the funds for the capital expenditure concerning the establishment of the proposed medical school and its yearly operational expenses. Yours sincerely,
NADYOSHI MAEKAWA Second Secretary Dr. Francisco J. Dy
Regional Director for the Western Pacific World Health Organization United Nations Avenue Manila
WPR/RC19/5 Annex 3 page 20
TRANSIATIGl
MINISTRY OF
FOREIGN AFFAIRS
ROYAL GOVERNMENT OF IAOS
Ref. 737/AE/OIC Sir.
20
May
1968
With reference to your letter (WP)E2!77/l3 of 12 March 1968. I have the honour to inform you that the Royal Government of Laos,
•
because of financial difficulties, will be unable at present to make a contribution to the Malaysian project for the establishment of a WHO medical school in the Western Pacific Region.
Yours very truly.
For the Minister Director of International Organizations and Co-operation
Say VONGSOUTHI The Regional Director World Health Organization P. O. Box 2932 United Nations Avenue Manila
WPR/RC19/5 Annex 3 page 21
British Residency Vila. New Hebrides Ref. F .368/8 Dear Dr. Dy, I refer to your (WP )F2./77113 of 12 March 1968. In this part of the Pacific, we are adequately served by the Fiji
29 March 1968
School of Medicine which has been able to meet all our requirements in the past. With the establishment of the University of the South Pacific in Suva this year, we confidently expect that the Fiji School will
develop still further in the years to come. I am therefore unable to envisage that we shall send students
to the proposed school in Malaysia, nor would we be able to contribute funds. Yours sincerely,
(CoDin H. Allan) Resident Commissioner
Regional Director World Health Organization P.O. Box 2932
Manila
WPR/Rc19/5 Annex 3 page 22
DEPARTMENT OF EXTERNAL AFFAms
Wellington. New Zealand Ref. PM 108/7/46/1 Sir. I have the honour, by direction of the Minister of External
22 March 1968
Affairs. to refer to your letter (HP)E2/77/l3 of 12 March 1968 about resolution WPR/Rc18.R7 entitled liThe Establishment of a WHO Medical School in the Western Pacific Region". I am directed to inform you that the New Zealand Government
does not envisage sending stUdents to the proposed medical school.
In these circumstances New Zealand does not feel able to indicate interest in contributing funds for the initial capital expenditure connected with its construction and equipping, as well as its yearly operational expenses. I have the honour to be.
Sir, Your obedient servant.
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Secretary of External Affairs
The Regional Director World Health Organization Manila cc: The WHO Representative, ~
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WPR;RC19/5 Annex 3 page 23
REPUBLIC OF THE PHILIPPINES DEPARTMENl' OF FOREIGN AFFAIRS
Ref. No. 005.9 WHO Sir :
13 May 1968
With reference to your letter No. (WP)E2/77/13 dated 12 March 1968 requesting comment on WHO Resolution WPR;RC l8.R7 entitled "The Establishment of a WHO Medical School in the Western Pacific", this Department concurs with the following opinion of the Secretary of Health to whom the above-mentioned Resolution was referred: "In this connection, I should like to inform that after
going over the documents, I find the proposal of the Government of Malaysia to be laudable. However, there are legal, administrative, financial and other difficulties which must be conSidered and resolved before such a proposal should be implemented. It is my honest opinion that expansion and improvement of the facHi ties of the medical school of r1alaysia would be a better solution than establishing a regional or international medical school." Very truly yours.
JOSE D. mGLES
Acting Secretary of Foreign Affairs The Regional Director
WHO Regional Office for the Western Pacific United Nations Avenue l.fanila
WPR/RC19/5 Annex 3 page 24 MINISTRY OF HEALTH Government Offices Palmer Road Singapore 2 Ref. M. of H. (HQ)56/67!Vol.II 19 March 1968
Dear Sir, I refer to your letter (WP)E2/77/13 dated 12 March 1968 concerning the proposal to establish a WHO Medical School in the Western Pacific Region. In reply to the two questions raised by you, I regret to inform
you that my Government's reply is in the negative. Yours faithfully,
(QUEK KIOK CHIANG)
f. Permanent Secretary (Health)/ Director of Medical Services
• -"'
The Regional Director World Health Organization United Nations Avenue Manila cc: The WHO Representative, Kuala Lumpur
WPR/Pt:;19/5 Annex 3 page
25
TRUST TERRITORY OF THE PACIFIC ISLANDS OFFICE OF THE HIGH CCMlUSSIONER Saipan, Mariana Islands 96950 21 March 1968
Dear Dr. Dy, I wish to refer to your letter (WP)E2/77/13 regarding liThe Establishment of a WHO Medical School in the Western Pacific Region". You have asked two questions for our reaction. below: I. Does your government "envisage sending students to the proposed medical school"? Answer: It is difficult for us to envisage the situation that At the moment our needs will exist several years hence. (a) (b)
These are given
for medical people are being taken care of very well at University of Hawaii for the first two years of medical school leading toward M.D. degree; and Fiji School of Medicine, leading to M.O. degree. We realize that the Fiji School of Medicine expects to conve~t
to a school that gives an
M.D., thereby, we should think, bring it into competition or, perhaps coworking relation to the Medical School you propose. We envisage continued need for the physicians with M.O. degree attainment and are somewhat distressed to see this being abandoned in the Pacific •
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Dr. Francisco J. Dy Regional Director World Health Organization P. O. Box 2932 Manila
WPFI/RCl9/5 Annex ;, page 26
II. Is your government "willing to contribute f\mds for the initial capital expenditure connected with its construction and equipment, as well as its yearly operational expenses?" Answer: The Trust Territory will be unable to make such
contributions, at least, under the present circumstances. Sincerely yours,
w.
R. Norwood High Commissioner
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Annex page
wPR/ro19/5 2
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DEPARl'MENT OF STATE Washington, D.C. 20520
Dear Dr. Dy, As a result of your letter, (WP)E2/77/l3), the United States has reviewed the general concept of a WHO Western Pacific Regional Medical School as well as the acceptance, in principle, of contributing towards construction and maintenance. We fully recognize the seriousness of the shortage of physicians in many areas of the Western Pacific Region, and the importance of ameliorating the existing and unfavourably disproportionate physician/ population ratio. The United States agrees that the position that this ratio can best be improved through training qualified personnel of the region and, in fact, has provided considerable assistance in this field. The United States continues to believe, however, that the most effective technique for not only increasing the numbers but also improving the qualifications of the region's physicians is by strength~.
.~.
ening national facilities. Sincerely,
Joseph J. Sisco Assistant Secret8r7 for International Organization Affairs
Dr. Francisco J. Dy Regional Director World Health Organization Regional Office for the Western PacifiC United Nations Avenue Manila
WPR/RC19!5 Annex ~ page 2 'J:RANSIATI<E REPUBLIC OF VIEr-NAM MINIS'I'RY OF HEAIJm
4 MaY' 1968 Sir , With reference to Y'our letter (WP)E2/77/13 of 12 March 1968, I have the honour to inform Y'ou that the Ministry of Health of the Vietnamese Government has taken note of the proposed establishment of a WHO regional medical school in the Western Pacific. We are certain that. if this school is able to meet the necessary requisites for operating to the satisfaction of the participating countries. it will do much to solve the problem of the lack of medioal staff in many oountries of this Region. However, I tbink: I must inform Y'ou that. as a resuJ.t of the Canmun1st aggression in the various oities of South Viet-Nam in February 1968. immense damage has been caused to the Hu.e School of Medioine as well as to various health units of the oountry. the finanoial possibilities of our country at war. The f'unds required to repair and re-equip these buildings are bey-ond
'. '.
As a consequence.
we are not in a position to consider contributing to the initial expenditures for the oonstruction and equipment of the WHO School of Medicine in the present circ~tances.
Yours very trulY'.
Dr. TRAN-LU-Y Minister of Health The Regional Director World Health Organization Manila
WPR/RC19/5
Annex 3 page 29/30 GOVERNMENT OF WF..sTERN SAMOA PRIME MINISTER I S DEPAR'IMENT
APIA, WESTERN SAMOA Ref. E.32/2/l 21 June 1968
Dear Sir, I refer to your letter (WP)E2/77/l3 of 12 March 1968 requiring our views regarding a proposed WHO Medical School in the \tlestem Pacific Region. I regret to advise that at this stage, I do not foresee any likelihood of our making use of this school. A:s you are no doubt aware, the Central Furthemore, as Medical School in Suva, Fiji, and the l\'ledical School at otago University continue to provide adequate facilities for our needs. most of our medical students are financed by overseas scholarships we are required to a certain extent to comply with the requirements of the awarding country. including place of study.
You \'1111 also be aware of our
financial difficulties generally and will therefore appreciate that we are unable to contribute towards the establishment of this school. I regret that I am unable to advance a more favourable reply. no doubt however that you will appreciate our difficulties. Yours faithfully, I have
(Karanita L. Enari) A/SECRETARY TO GOVERNMENT
The Regional Director World Health Organization Manila Philippines cc: Director of Health, Apia Minister of Health, Apia High Commissioner for New Zealand, Apia Inspector-General, South Pacific Health Service. Suva WHO Representative, Suva WHO Country Liaison Officer. Apia
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WPRjRCl9/5 Annex 3 page 31
2.
EX'mACTS FROM THE QUESTIONNAIRES RECEIVED
FROM COUNTRIES AND TERRITORIES Australia The Australian Government, in the questionnaire returned on 21 May
1968, stated that the concept of establishing a regional medioal school is not supported. British Solomon Islands Proteotorate The Government, in the questionnaire returned on 16 July 1968,
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stated that it has no particular views on the concept of a regional medical school and that the Fiji school is adequate for its present needs. Brunei In the questionnaire returned on 22 June 1968, the views of the Director of Medical Services are given as follows: "Whilst I therefore like the progressive and advanced international conception of a Medical School for the Western Pacific Region (which I think would be of most advantage if conducted in the English language), I feel that to produce rapid results the following suggestions could be put into effect: (a) That existing Medical Schools (e.g. Singapore and Kuala Lumpur) should have International Seotions added to them, financed by 'vIHO and assisted by addi tional professional appointments and also constructural additions. (b) That for a 11mi ted period of time, more rapid and slightly contraoted licentiate courses, should be made available, in order to produoe a more rapid turnover of medical students; but that these lioentiate oourses, although contraoted, should have the same basic medical science background, as for ordinary /degree students •••
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• WpWRC19/5 Annex 3 page 32 degree students, so that in the fullness of time,
these licentiates could return to take a complete degree qualification. (c) In this manner the international sections of the well established Medical Schools of the Western Pacifio Region could fUnotion more specifically for the countries in their immediate proximity. (d) The International Seotions will admit stUdents exclusively from territories EXTERNAL to that in which the university exists. 1I Cambodia The Government, in the questionnaire returned on 8 June 1968, stated that the organization of a regional medical school is not supported. Cook Islands In the questionnaire returned on 4 April 1968, it is stated that: "Graduates of the Fiji School of Medicine are satisfactory and future developments indicate that the School will achieve University status in the near future. Conditions in Fij i are sim1lar to that in the Cooks. There is, therefore, no great interest in a school in Malaysia. II
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Gllbert and Ellice IslandS In the questiomaire returned on 5 April 1968, the view of the Chief Medical Officer is given as fo11o\'lS: "As regards basic medical training, the needs of the Colony are fully met by the Fiji School of Medicine. /A regional
...
WPR/RC19/5 Annex 3 page 33 A regional medical training centre particularly for postgraduate training would be valuable."
Malaysia West r."JB.laysia The Government, in the questionnaire returned on 21 March 1968, stated that the views of the Malaysian Government had been expressed at the third plenary meeting of the eighteenth session of the Regional Committee held in Taipei last year. East JI'lalaysia (Sarawak) In the questionnaire returned on 18 April 1968, it is stated: "Will have to depend more on Universities of Singapore and Malaya.
Singapore Medical School will soon be over Suggest easy
producing doctors for Singapore's own needs.
for East and West Malaysia to utilize the Singapore College." Ne\,l Caledonia In the questionnaire returned on
4 April 1968, it is stated that
New Caledonia is not interested in the establishment of a regional medical school. Papua and the Trust Territory of New Guinea In the questionnaire returned on 2 July 1968, it is stated that Papua and the Trust Territory of New Guinea would prefer to have its own medical school because of the peculiar problems of New Guinea. /Republic of Korea •••
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• WPR/RCl9/5 Annex 3 page 34
Republic of Korea The Government, in the questionnaire returned on 24 May 1968, stated that the proposal to establish a regional medical school was under review by the Government.
TOnga In the questionnaire returned on 4 April 1968, it is stated: "The concept is worthwhile further investigation because it could be a solution to the problem of acute shortage of physicians in some countries of the Western Pacific Region. II
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