Geneva, Switzerland - Jamaica's report on progress towards the Millennium Development Goals and news about telemedicine in Africa highlighted the second day of the UN Economic and Social Council Annual Ministerial Review in Geneva.

JAMAICA

The national report offered by Jamaica was highly informative. First, the country is doing rather well in the field of health. Second, the report was a model of good communication. Third, the discussion that followed was skillfully moderated. Fourth, comments by several national delegations added value to the report.

The breakthroughs in Jamaica were well explained in the PowerPoint presentation by Dr. Sheila Campbell-Forrester. The report shows why Jamaica is doing well and how it can serve as a model for other nations. It clarifies where Jamaica has been able to achieve the MDG, where it is on the track, and where it is lagging behind or even far behind.

The report ofers glimpses of the good practices of this country. Jamaica has created a national health fund and is the first country to have such an innovative health fund. It provides benefits to individuals, presently subsidized or low-cost medicine for chronic illnesses. It also funds responses to public health emergencies, strengthens local institutions such as clinics and ambulances, and grants money to health-related NGOs. [Download Jamaica's Presentation (PDF) 9MB]

This illustrates the leadership qualities of the nation and its capacity to find innovative ways to create a good health system for the people. Jamaica is promoting health of the people and by the people. “Your health is your responsibility,” says one poster. The government tries to educate the citizens to have a healthy lifestyle and promote self esteem. Concerning AIDS prevention, Jamaica is not shy about promoting abstinence ("Abstinence mek sense," says a poster in Creole) even though it is also trying other approaches.

It is noteworthy that Jamaica's success is not just due to technical factors but reflects a desire for good governance and accountability at many levels of society, even though the informal sector remains strong and violence is a real threat in the slums. Moreover, Jamaica has a balanced approached to health as both a right and a personal responsibility. While showing compassion, the authorities emphasize the people's moral compass. Certainly, nations of the same region (the Caribbean) or of the same category (middle-income nations) can learn from its best practices and try to implement similar policies.

Hero, doctor and mother

The person behind the report deserves a special attention. Chief medical officer Dr. Sheila Campbell-Forrester did not offer a merely technical report. Her presentation was highly professional and well documented. Her impact on the audience, however, came from her attitude on stage. One could feel a moral dimension and even love in her address to participants. Some people have a public position and a strong voice, but she has more — a peaceful charisma that creates an atmosphere of respect and trust. She was once portrayed as “a quiet hero and public servant, a medical doctor and a mother" by Mrs. Petrina Francis, a staff reporter of the Jamaica Gleaner. Dr. Campbell-Forrester once said, "If you had a childhood dream that one day you'd become chief medical officer and then you got there, it has to be a great feeling. I feel happy about my achievements and I believe that all through my life, God has been my planner."

Her belief in the living God, her strong sense of family values, her taste for public life, and her emphasis on a good balance between spiritual and physical happiness are all values which the Universal Peace Federation is advocating worldwide (see our 5 principles), and when people with such values are in leadership positions in any country, that nation can make a difference.

When the moderator is a catalyst

The third element which made the Jamaica report so special was the excellent moderating of the session by Mr. Michael Marmot. He managed to highlight the very best of the presentation, and the discussion that followed was exceptionally interesting, dynamic and educational. Instead of just passing the floor to the next person, he sparked a lively discussion among the audience, and many points of the Jamaican case became even more clear as delegates expressed their views. Mr. Marmot was a catalyst for the best comments and observations

Namibia’s cogent observations

Among the comments offered by national delegations, the ambassador of Namibia to the UN said that many middle-income nations like Namibia can learn a lot from Jamaica. But he also warned that Jamaica and middle-income countries may also be punished for their success. Because they are not “poor countries” any more and are being more successful than others in achieving the MDGs, there is a risk that this good fortune can become a disadvantage.

He also stressed that the brain drain is a real tragedy for Jamaica. The nation is training many nurses because this profession is highly valued as a role model for women. But many Jamaican nurses are attracted to countries where the salaries are much better. As a result, Jamaica, which has a rather good leadership, is a victim of its lack of financial resources. The ambassador of Namibia also stressed that natural risks are high in Jamaica because of tropical storms and climate change. Moreover, the country is facing issues that are specific to small island nations. In a few minutes of comments, the Namibian delegate addressed several points which Jamaica shares with many different countries, and which make her success right now even more remarkable.

CHINA

The national report of China was also very interesting, even though it did not have the moral dimension and charisma that once could sense from the Jamaicans. Many delegates expressed great admiration for China’s progress in the last three decades. What we found most interesting in the report and the discussion that followed is China's desire to balance Western medicine and traditional medicine. The delegates of Egypt and Malaysia noted that this may make China a sort of moral leader in health fields for many developing nations. Though Mr. Chen Zhu, Minister of Health of China, had not mentioned this in his presentation, he did make interesting and balanced comments after other delegations (Cuba, Russia, Singapore, and Indonesia) had offered their observations.

He said that reliance on traditional medicine is more prevalent in the rural areas of China, where more training and infrastructure are needed. The government will try to preserve traditional medicine and help it modernize. A directory of essential traditional drugs will soon be available, and their cost will be covered by insurance. The government will guarantee the safety of these products and establish standards of excellence while promoting more research and scientific methods. Yet, he added, “to be frank, there is a crisis in traditional medicine. It is efficient and low-cost, but it faces challenges in the market economy. We are trying to create three types of medical teams: traditional medicine, western medicine, and, most of all, combined medicine, which will probably be the Chinese way in the future.

This report from China may indicate a revolution in health care in the 21st century, not just for China, but for the whole world.

TELEMEDICINE IN RURAL AFRICA

Our attention was caught by the report by Dr. Antoine Geissbuhler of the RAFT network. (RAFT is the Acronym for Réseau Africain Francophone de Telemedicine, meaning French-Speaking African Telemedicine Network.) Dr. Geissbuhler, based at the Geneva University Hospital, was accompanied by Dr. Cheikh Oumar Bagayoko from Mali. They gave a fascinating report about the breakthroughs of NGOs in French-speaking Africa. Continuing education of healthcare professionals is key to ensuring the quality and efficiency of a healthcare system. In developing countries, this activity is usually limited to people in capital cities, and professionals living far from the capital do not have access to such opportunities or teaching material adapted to their needs. This limits their abilities to provide health care.

Telemedicine enables medical information to be shared in electronic form and thus facilitate access to remote expertise. A physician located far from a research center can consult colleagues remotely in order to resolve a difficult case, follow a continuing education course over the Internet, and access medical information from digital libraries and knowledge bases. These same tools can also facilitate exchanges between centers of medical expertise within the same country as well as across natinoal borders.

Since 2000, the Geneva University Hospital has been coordinating the development of a telemedicine network in Africa, first in Mali and now extending to ten French-speaking African countries.

The core activity of RAFT is the webcasting of interactive courses. These sessions emphasize knowledge-sharing among healthcare professionals, usually in the form of presentations and dialogues between experts in different countries. The webcasting technology works even with a slow (25 kbs/second) Internet connection. [For more information about RAFT, click here.]

Such a wealth of knowledge needs to be shared in ways that respect each partner’s identity and culture. Collaborations with UNESCO and the World Health Organization have been initiated to address these challenges.

The four reports of this ECOSOC annual meeting are posted here. To watch videos of the presentations, click here.