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EDITORIALS: Donald M Berwick A learning world for the Global Fund BMJ 2002; 325: 55-56 [Full text]

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Global health before global wealth

Richard P Fitton, Glossop Derbyshire SK13 1HZ   (13 July 2002)

"Global health - to laugh often and much"

Richard P Fitton, Hadfield, Glossop, Derbyshire SK13 1HZ   (13 July 2002)

Support Local Learning Organisations in DC

Arun N Patel   (16 July 2002)

Global health before global wealth 13 July 2002
Richard P Fitton, GP hadfieldMedical centre 82 Brosscroft Hafdield, Glossop Derbyshire SK13 1HZ Send response to journal: Re: Global health before global wealth	Health is a creative process that improves mental, social and spiritual well being as well as physical and fiscal. It depends on positive, humorous relationships between individuals, communities and countries. It is not passive and delivered as a Christmas present by governments, drug companies, doctors and nurses. It involves work, learning, wisdom, management of failure and disappointments and the support of the disabled, infirm and aged. Economies and nations that don wealth as their mantra inevitably become unhealthy. Governments would do well to make health rather than wealth central to their policies. Health is created by hard work and effort by individuals and communities. It involves an acceptance that other "unhealthy" people will reduce every one else's health. The internet and availablilty of fashioned artificial intelligence seems an opportunity for transcendence for nations. The BMJ's donation of their clinical data bases to the hundred poorest countries in the world seems to be a great start. Perhaps the developing world can donate other IT developments before they have been exploited commercially and become unaffordable to the Third World.
"Global health - to laugh often and much" 13 July 2002
Richard P Fitton, Single handed GP Hadfield Medical Centre, 82 Brosscroft, Hadfield, Glossop, Derbyshire SK13 1HZ Send response to journal: Re: "Global health - to laugh often and much"	I have worked closely with patients in a "Patient-Centred Medical Centre for nine years. Successes and failures and a deal of fun and irony have been generated. The success we have enjoyed has stemmed from the patients wishes, views and needs. Failures, duplications, changes of direction and misconceptions have abounded but discussion, humour and tolerance have always been the means of overcoming them. A statement by Ralph Waldo Emerson, a nineteenth century American poet, might well adorn the walls of offices, waiting rooms and "heartsinks"' living rooms around the global health community (that includes all citizens):- "To laugh often and much, to win the respect of intelligent people and the affection of children: to earn the appreciation of honest critics and endure the betrayal of false friends, to appreciate beauty, to find the best in others, to leave the world a bit better, whether by a healthy child, a garden patch, or a redeemed social condition: to know even one life has breathed easier becuase you have lived. This is to have succeeded." We think we have one or two successes and hope to have more and a lot more fun.
Support Local Learning Organisations in DC 16 July 2002
Arun N Patel, Specialist Registrar in PHM North Nottinghamshire Public Health Community, Mansfield. NG21 0ER Send response to journal: Re: Support Local Learning Organisations in DC	Since early 80s Developing Countries have developed huge local capacity in learning/teaching (i.e. primary care, community development etc). Still increasing amount of resources (funds and material) are spent on trying to "implant" teaching from the developed world. Journals, Books, Computers and now web-based learning is being fast tracked to developing countries as if they were "magic bullets" to solve health problems in developing countries. For example for the past 30 years in East Africa an organisation named African Medical Education & Research Foundation (AMREF) provides most appropriate local training of all caders of health workers. They produce locally illustrated and suitable text books and learning material at a cost which can be afforded locally. Yet universities in UK dump volumes of western books (old editions as gift) in East Africa and spend millions bringing people to be trained in UK universities (needless to say those trained in the west contribute very little in improving the health of population in developing countries). Besides good will and compassion to help developing countries we need "common sense" and go out in full support to strengthen local organisations and groups rather than duplicate and creat competition with them.