Regional meeting on teaching of pubic health in medical schools: opening adress, 8-10 December 2009, Bangkok, Thailand.

Opening Address by Dr Samlee Plianbangchang Regional Director, WHO South-East Asia At the Regional Meeting on Teaching of Public Health in Medical Schools 8-10 December 2009 Bangkok, Thailand 1 Regional Meeting on Teaching of Public Health in Medical Schools 8-10 December 2009 Bangkok, Thailand Opening Address by: Dr Samlee Plianbangchang, Regional Director, WHO South-East Asia ------------- Professor Pirom Kamol-ratanakul, President, Chulalongkorn University, Professor Prawase Wasi, Professor Emeritus, Faculty of Medicine, Siriraj Hospital, Mahidol University; Dr Amorn Nondasuta, President, Foundation for Quality of Life, Thailand; Dr Sathaporn Wongjaroen, Deputy Permanent Secretary, distinguished participants; honourable guests; ladies and gentlemen: The WHO Regional Office for South-East Asia is very pleased to organize this regional meeting on “Teaching of Public Health in Medical Schools”. This is with special attention to the teaching at “undergraduate level”. The importance of teaching of public health in medical schools has long been recognized. Such teaching may be in the form of: • preventive and social medicine; or • community medicine; or • community health. In medical schools, there is usually a department devoted to teaching one of these subjects. The main purpose of this meeting is to review the situation and to see whether there is anything in such a teaching that may need further orientation. This is especially in 2 light of the changing paradigm in public health today. We have to ensure that our medical graduates have adequate proficiency in today’s public health. Distinguished participants, During the recent past, there have been significant changes in public health scenarios worldwide. Among others, “macroeconomics principle” is playing an important role in today’s health development. Planning and managing public health programmes are influenced by modern thinking in macroeconomics. Macroeconomics is influencing governments’ decisions; on strategy to achieve “universal coverage” of health care and services; and decisions on strategy to ensure “unlimited access” to such care and services by “all people”. At the same time, “social determinants” are becoming an “essence” for development of public health programmes. The programmes that are needed to attain the level of health that will permit “all people” to lead a “socially and economically” “productive and satisfied” life. The “PHC approach” as we all know well, is the principal tool of public health endeavours towards this goal in health, that is, the goal of HFA. PHC, through public health interventions will help ensure “reaching the hard-to-reach”; or “reaching the unreached”. Ladies and gentlemen, As all are well aware, we are facing a “multitude of problems” in health today. We have the “double burden” of diseases – communicable and noncommunicable. We have to take the “best care” of the sick. We have to devote all our time to prolong the life of “sick people” through the application of medical sciences and technology, and we have to pursue 3 improvement in the quality of life of “those sick people” through “medical rehabilitation”, to enable them to return to normal life, socially and economically. At the same time, the health of the people, who are not sick, must be protected, maintained and even further improved. This health “protection”, “maintenance” and “improvement” must be pursued through “public health interventions”, the interventions that are especially at “primary level” of health care, the interventions that focus on “health promotion” and “disease prevention”, taking into consideration in these processes “health determinants” and “health risks”. Indeed, today’s emerging health challenges stem from various crises, such as: global economic downturn; global food crisis; global warming or climate change; and not the least, the pandemic influenza A(H1N1). These environmental and ecological factors are inter-linked and inter- related, forming vicious cycles in many aspects of human life, including health. We need strong public health systems, we need robust public health programmes for facing these formidable challenges. Among others in this perspective, it is an urgent need to strengthen “public health workforce” in our countries. We have to review, and we have to improve education and training of our public health professionals and practitioners. In this connection, we believe that teaching of public health in medical schools can also take us a long way towards strengthening of “public health workforce” in our countries. We need to ensure that our medical graduates are adequately proficient in public health. We need them to be able to tackle public health problems of the entire community; the problems that stem primarily from environmental and ecological degradation. We would like to see our medical graduates being able to work effectively in the “multisectoral and multidisciplinary environments”. Our medical graduates should join the “public health 4 workforce” in efforts to reduce the “disease burden”, particularly, through “health promotion” and “disease prevention” strategies. Medical graduates need to effectively adapt to the constant change in “health paradigm”, the change that is due to the dynamics of the environment and the ecosystem. “Public health competence” is also needed for those who work in “medical institutions”, the institutions that are also the “referral facilities” for “continuum” of care for people in the community. Public health can help ensure a “reasonable balance” of care, the balance between “preventive” and “curative” services. The role of medical doctors is more than providing “curative care” in institutions. But, they have also to get involved in public health education and research; they have to get involved in training and supervising community-based health workforce. Medical doctors have to support the functioning of “public health facilities”, such as public health laboratory and disease surveillance and many more areas in public health that need the involvement of medical graduates. Medical graduates will have to get involved in health activities, beyond the boundary of medical institutions. Ladies and gentlemen, Responsibility for teaching public health in medical schools should go much beyond the department of preventive and social medicine. This teaching, the teaching of public health in medical schools, is a multi-departmental responsibility, all other departments should also abide by this responsibility. And this teaching should be considered an obligation in today’s medical education. Public health can help medical personnel look at 5 their clients in a more “holistic manner”, help medial staff better understand clients’ life, both before and after institutional care. Public health can help improve interdepartmental collaboration among various specialities in medical schools. Rather than a discipline, public health is a field of multiple disciplines and multiple sectors. Public health programmes need an application of a range of scientific know how in their development and implementation. Ladies and gentlemen, I thank all participants for their interest, and for their valuable time to attend this meeting. We have a diverse group of participants who can express their views on the subjects from different perspectives. We will hear the opinions of people, from both inside and outside medical schools. I hope we would also hear about the expectation of the public, on what medical graduates can effectively contribute to the “total” well-being of people in society. Let me also thank Professor Adisorn Patradul, Dean, Faculty of Medicine, Chulalongkorn University, for agreeing to co-host the meeting. My sincere thanks are extended to Dr Sathaporn Wongjaroen the Deputy Permanent Secretary of Public Health, the Royal Thai Government for agreeing to inaugurate the meeting. I thank Professor Pirom Kamol-ratanakul, President, Chulalongkorn University for graciously welcoming the participants. I most sincerely thank the two internationally known figures for agreeing to deliver keynote speeches – Professor Prawase Wasi and Dr Amorn Nondasuta. We look forward to hearing their inspired and thought-provoking speeches. 6 I hope that this regional meeting would contribute to innovative thinking and new ideas on the subject of Teaching of Public Health in Medical Schools. Ladies and gentlemen, With these words, I wish the meeting all success and a fruitful outcome. I wish all participants interesting and productive deliberations and I wish them all an enjoyable stay in the city of Bangkok.