Academic medicine in areas of conflict: Report on the Middle East regional ICRAM meeting
Sukhera J, Clarfield AM, Abdeen Z, Aboodia M, Chalin C, Noyek A, Vardi N, Wolak A, Zeidan B
Presented by
Javeed Sukhera,
Medical School for International Health, Ben-Gurion University in collaboration with Columbia University Medical Center
Israeli-Palestinian Conflict
• Controversial and emotional issue • Escalation since 2000 • Negative impact on health infrastructure • Negative impact on academic medicine
Academic Medicine in areas of conflict
• Paucity of research • Scattered examples in the literature from South Asia, former Yugoslavia and the Middle East
Organization of AM in the Middle East
Israel
Faculties of medicine Medical school tuition Government support Outside grants 4 $2000 USD Significant +
Palestine
1 $3500 USD Sparse +
ICRAM
• Launched in late 2003 by consortium including BMJ, Lancet and other partners • Working party convened in 2004 to set agenda and analyze evidence for the campaign • Emphasized three components of AM: – Teaching – Research – Service • Acknowledged that AM is failing in many aspects, calling for a global debate on its future
Middle East Regional Meeting
• Regional and stakeholder advisory groups were established as part of ICRAM • Meeting supported and funded by both ICRAM and Canada International Scientific Exchange Program (CISEPO) • Held in Jerusalem on May 15, 2005
Goals
1) Discuss the roles of AM both locally and internationally 2) Analyze the failures of AM to accomplish its goals in the region 3) Develop suggestions for how AM can better accomplish its goals 4) Discuss the future of AM in the region
Findings
• Conflict between teaching responsibilities, research and learning demands experienced by both Palestinian and Israeli academics • The issue of gender provoked heated debate • Health disparities emerged as an important issue
Health Indicators in the Middle East
Israel Total population 6,433,00 Palestine 3,737,895
GDP per capita (USD)
Life expectancy at birth (years)
20,780
m/f – 78/82
896
m/f – 71/74 24
Child mortality (per 1000) M/f – 7/6
Under age 5 mortality (per 1000)
Health expenditure as percentage of GDP
6
9.1
28.5
3.0
Most significant finding
• AM has the responsibility to try to bridge political and geographic divides for the benefit of patients by promoting cross border collaboration on practical projects that benefit both sides. • Suggestion that health professionals have a role in contributing to peace building is well documented.
Overcoming Challenges
• Lack of funding • Political circumstances (including security issues and lack of free movement) • Willingness to cooperate • Inequality in resources • Access to information • Research skills
The future of AM in the region
• AM should take the lead in engaging citizenry • No significant role for industry • Public lacks knowledge for grassroots health-sector reform • Concept of global academic partnership is desirable but difficult to achieve
“AM professionals should leave politics to politicians while working together to build capacity within their respective professional societies”
References
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