World Federation of Societies of Anaesthesiologists

WFSA - an active player on the world scene

Dr. Jannicke Mellin-Olsen, chairman WFSA Education Committee

Your country pays about $2.50 US dollar for you as an annual membership fee to the WFSA.  Did you know that the WFSA is now an organization with educational activities going on across the world in order to improve anaesthesia services to our patients worldwide, be it in Micronesia, Malawi, Moldova, Mexico or Mongolia?

The 14 training centres across the world are important for this.  For instance, young specialists from Vietnam, Laos, Mongolia, Burma and more go to Bangkok in Thailand to be trained in modern anaesthesia for a year. The programme has been running since 1996, initiated and chaired by Prof. Thara Titrakarn. The 56 fellows that have been there until now have left their (sometimes small) children and friends behind to improve their professionals skills in a foreign country, a real sacrifice. The teachers in the three university hospitals and three other hospitals work together with them all the time - teachers and fellows in a foreign language alike.  Despite this only three have dropped out of the training, and all except two are practicing anaesthesiology in their home countries. In Mongolia, these fellows now have now been able to form a critical mass to become influential in improving anaesthesia services and education in that country.

But Bangkok is not the only training centre in Asia - for years, it has been possible to learn paediatric anaesthesia in Vellore, India, and recently, also in Singapore and in Hong Kong. In the Maldives, for instance, the (until recently) only anaesthesiologist in the country went to Vellore to train under Prof. Rebecca Jacob, and this has meant a major change in how the Maldivian children are being anaesthetised.

In Israel, Prof. Gaby Gurman started a training centre for Eastern Europeans in Beer Sheva. When he retired, the programme was moved to Tel Aviv, and Prof. Tiberiu Ezri took over and opened it to young colleagues from Kenya and Nigeria, as well. Moldovan colleagues can be trained in Romania, as well (by Prof. Yuri Achalowski), and this centre is run in co-operation with the European Society of Anaesthesiology (ESA). In the same way, the WFSA works with the Latin American Regional Section (CLASA) to establish a training centre for regional anaesthesia in Brazil. In Chile, Prof. Silvana Cavallieri runs an excellent training centre for paediatric anaesthesia, and Latin Americans can learn obstetric anaesthesia in Bogotá, Colombia. If you are African, your best bet to learn obstetric anaesthesia would be to go to Tunisia to learn from Prof. Mohamed Benammar or to learn paediatric anaesthesia in Tunisia or in South Africa. Intensive care medicine training programmes are run in India and in Israel.

There have been Fellows learning neuro- and paediatric anaesthesia in Cape Town, and we are in the process of developing a training centre for paediatrics in Nairobi, Kenya. Some of these initiatives are co-sponsored by national societies who wish to contribute more than just membership fees. The typical funding for a Fellow means that the home institution pays their salary, the hosting institution waives fees and the WFSA covers housing expenses and per diem. The Fellows are selected based upon their applications, CVs and recommendations from their home institution and national society. After the training, they will have improved their competence and received a diploma to show that.

In countries where anaesthesiologists are particularly scarce, the WFSA has also supported basic post graduate training, e.g. for a colleague from Zimbabwe and from Congo. WFSA can also support other activities where there are no or very few doctors, like update meetings for clinical officers in Malawi and examination support.

WFSA will also support speakers to national meetings several places in the world, and, for major regional congresses, we now offer WFSA panels. To some countries, we are sending examiners for national exams, and these experts will often combine that with speaking at national congresses.

We are also working with other organizations such as the International Association for the Study of Pain with whom we co-sponsor a training programme for pain specialists in Thailand; Baxter Inc for Fellowships to regional and world congresses and for production of educational CD ROMs in obstetric anaesthesia; the Society for Pediatric Anesthesia (USA) in supporting training Fellowships in paediatric anaesthesia in Vellore, India. Also Drager has been a major sponsor to our programmes, particularly to paediatric anaesthesia in Tunisia and in South Africa.  We expect to work even more closely with other specialty organizations in the future, for instance the obstetricians and the surgeons.

Some of the major organizations that work with WFSA are established by our own colleagues. For instance, the Primary Trauma Course (PTC) programme (www.primarytraumacourse.org) was initiated by Dr. Douglas A Wilkinson and Dr. Marcus Skinner in 1996 with the aim to train surgeons, anaesthesiologists and other health professionals involved in the prevention and early management of severe trauma victims. During a two day course, they are taught the basics of primary and secondary survey and early resuscitation, but within the confines of their time, experience and resources.  The course continues with a teaching module, so that the participants in turn can train others. As an example, four PTC instructors went to Iran early in 2007 and trained 30 people. By the end of that year, 300 more health workers in Iran had undergone the same training. PTC courses have now been held in 46 countries throughout the world and are now a part of the trauma strategy of the WHO.

Another course series that has spread across the world, was initiated in 1986 by Prof. Scherpereel of France and more European colleagues - the  "Foundation for European Education in Anaesthesiology" (FEEA). This is a course series to improve CME/CPD initially in Europe, but from 1995 in Latin America, in 2004 in Africa and in 2006 in Asia.  Impressively today there are course series in 102 centres in 47 countries across the world. The series consists of a cycle of six courses, covering all aspects of our speciality in an interactive programme. Although the topics are the same, the contents will be adapted to local conditions. If the anaesthesiologist completes one course per year, the full cycle will be completed in six years, ready to start again. ESA has taken over the practical organisation of the programme, which has changed its name into the Committee for European Education in Anaesthesiology. The ESA sponsors European centres; the WFSA the rest of the world.  All the educational material can be found on a website sponsored by GE Healthcare, www.euroviane.net.

An extremely important part of education is to facilitate teaching. Not all eminent scientists are naturally gifted teachers, and some tricks of the trade can be learnt. Dr. Gaby Gurman of Israel came up with the idea of establishing the "International School of Instructors in Anaesthesia" (ISIA). The first course involved colleagues from five countries in Eastern Europe, and that was so successful that a new class has started, now in co-operation with ESA. It consists of three weeks of courses, some months apart. The students come from various countries and are supposed to exercise their newly acquired competence in-between courses and then to establish courses in their own countries afterwards. The students have been extremely enthusiastic and have later formed their own networks to train others. There is a great demand for similar courses from other regions, and WFSA expects that training of teachers will be an even more important activity in the future.

The Education Committee is composed of nine members. Currently the members come from Colombia, Israel, Japan, New Zealand, Norway, Russia, Singapore, Tunisia and the USA. Traditionally, there has been a geographical spread with each member responsible for one part of the world. The Committee both starts and facilitates educational activities, in addition to finding partners to finance them.

During 2010, we would like to co-operate even more closely with national societies. Many of those have their own important international activities, sometimes together with WFSA, sometimes on their own. If we could join forces, then we would accomplish even more. What would you like the WFSA to do for you? What do you want to do to share your competence with those who do not have your knowledge base - be it that you come from a high income part of the world with access to all facilities or you have become an excellent clinician because you have little basic equipment and few drugs in your vicinity?

One of my personal experiences after I got involved in the WFSA is that I have learnt much more than I have taught. I have experienced that when I meet colleagues, we always have something in common. That gives us a shortcut to conversations on other aspects of life. I have learnt that no matter what my religion, colour or cultural background is, we anaesthesiologists as human beings mostly share the same aspirations and hopes for our lives, no matter where we live: Food, water, shelter, safe living conditions, love from family and friends,  and interesting working conditions and being able to provide a future for our children. Being involved in WFSA activities makes us better professionals and wiser human beings.