Welcome to this first issue of The Meducator. Over the past few months we have been encouraged to pursue this project as a result of the tremendous support we have received from many of you from all parts of the world who have shared with us the need for such a journal. Our ongoing objective is still to provide an affordable, low cost paper journal, which will be readily available to all medical educators from even the most economically challenged countries. In the meantime, however, we have decided to launch The Meducator on the Internet. We hope that by doing so we can demonstrate that there is enough interest to fulfill this vision. We will therefore have to depend, initially, on those of you who are fortunate enough to have access to the World Wide Web for your continued help.

We are the first to acknowledge that information technology (IT) has done wonderful things for business, education and the transformation of our lives in general but is not widely shared by the great majority of our world population. As Dianne Francis reported from Davos, Switzerland recently, some one billion people in the world live on less than $1.00 a day and have yet to make their first phone call. In this bleak IT environment our western media tell us of the 400 people who die in a plane crash in India but not of the fact that 10 or 100 times that number of children died from health problems at that very moment which could have been prevented.

One of the richest men in the world, who has made his fortune from IT, Bill Gates now recognizes, with the formation of the Bill and Melinda Gates Foundation, that support must be given to education in developing countries with a priority to health care. He is absolutely correct in seeing the world wide economic importance of such a move. Sick workers cannot be productive; they earn less money and buy fewer goods and services. High mortality rates represent an enormous burden to a nation. It is reported that one of the big concerns which is really upsetting Mr. Gates is that such a high proportion of the worlds population is needlessly ill because of the lack of access to clean water or to health care providers or to medicines.

The United Nations has estimated that the cost of providing clean water to the worlds entire population is $40 billion US – less than half Mr. Gate’s net worth. Welcome, Mr. Gate’s to the global village of health educators who have been toiling in the vineyards for these many years when he says " I decided that what counts the most is world health" and says he will give away 95% of his wealth to this cause. If only there were 100 or even 1,000 such people with his conviction, and his money, who were willing to make such a commitment to world health. And yet we see the enormous difficulty in providing AIDS medication to Africa. It is not just the cost of the drugs but the lack of a qualified health care delivery system that can guarantee the supervision, compliance and follow up of a complicated drug regimen with many side effects. Surely the most productive approach would be prevention?

With such increased financial support the world could be transformed in designing and tailoring their educational programs to meet the societal needs of their populations and communities for health care.

In this inaugural issue Dean Christobal has shown what can be done in a new medical school in Zamboanga, on a shoestring budget, in a circumscribed, small part of the world but which, in many ways, epitomizes the problems facing medical schools which feel they need to change. Mindanao, divided as it is by religious beliefs and economically disadvantaged to the extreme has reached out to address the health needs of the surrounding communities. This model of medical education has caught the attention of many other developing countries. Does it need support? A rhetorical question – but from who? When cardiac transplants are being done in Manila at the cost of millions of pesos the people of Mindanao do not have clean water and proper sanitation. Is this a national problem or a global problem. Would money from the Gate’s Foundation go to Manila or Mindanao?

Where does The Meducator fit into this somewhat esoteric discussion? As the founding editors, Kalyani and I do not have the backing of any Foundation, Association or religious affiliation to fund this journal. We are relying on our own perception, and the support of our friends, that there is a grass-roots need for all of us, who have an interest in medical education and health care, to be able to discuss our experiences in an ongoing manner. This journal will only succeed with your participation. We will try and provide the latest ‘news and views’. We hope you will contribute articles in the various categories that will help advance medical education and health care around the world.

In undergraduate medical education there has been a call for curriculum reform and for social responsibility and to this end we have been delighted not only welcome Dr. Charles Boelen onto our International Editorial Board but to include his previously published paper, reprinted from Academic Medicine. His message is clear. "A socially responsible medical school perceives the needs of society and reacts accordingly, and a socially accountable school also consults society about priorities and provides impact of its deeds"

The paper from India puts the governments new health policies at the centre of educational reform. We hope that this will form the basis of discussion in the manner in which medical schools might respond to this challenge in the future.

We welcome your comments and hope you enjoy this first issue of The Meducator.
 
 
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