EFORT and World Orthopaedic Concern
a joint Effort
Alain Patel - Vice President WOC and Liaison Officer WOC-EFORT
Geoffrey Walker - Past President WOC
Professor Jacques Duparc concluded the first Presidential Address by reminding us of the need for the Federation to concem
itself actively with orthopaedics in the developing world.
WOC was founded some 20 years ago for exactly this reason, and we believe that orthopaedic surgeons are best trained in their own countries, on their own patients and with the facilities available. The orthopaedics of less and of more developed areas have become as dissimilar as chalk
and cheese and many of the sophisticated procedures now regularly perfom ed in developed areas are totally unsuitable
where resources are minimal. Many `old-fashioned disorders' such as bone and joint infections, tuberculosis (often complicated by AIDS),
poliomyelitis, and neglected trauma present commonly in developing countries, and fractures both open and closed arnve late. Surgeons
trained in total joint replacement, spinal surgery, and osteosynthesis for fractures find their experience of little value in these circumstances
and often re-emigrate, if indeed they have ever retumed home after completing training in a sophisticated centre.
WOC strives to avoid this problem by supporting appropriate training schemes in less developed parts of the world. This is often difficult, and there is no common pathway. The founders of WOC originally had the idea of relatively grand intemational efforts, but all of these foundered
more or less completely. Effective schemes usually follow personal contact between a visiting orthopaedic surgeon and a doctor in a developing area who is seeking help. To follow up and develop
these initial contacts WOC has found it more effective to function in regional groups. Thus, we have a US Region (also known as Orthopaedic Overseas),
WOC Canada, UK, Ge§nany, Australia, South- East Asia, India, Holland and others. Alain Patel is currently secretary-general of a
francophone group, supported in part by the French Govemment and using French- speaking volunteers from France and from countries outside the hexagon. We believe that this co-operation at an intemational
level is very important and should be encouraged.
Each region is autonomous, and has to raise its own funds. Training programmes are also custom-made to suit local conditions and to produce
appropriately trained orthopaedic personnel. For example, the
scheme in Bangladesh founded by Dr Ron Garst in 1972 is now totally self-sufficient, and has produced over 150 orthopaedic surgeons,
most of whom work in Bangladesh. Another example is the Malawi scheme, organised some ten years ago by Dr Ed Blair. In a country with a medical
school only recently opened and with very few doctors, Dr Blair has trained very successfully over 50 orthopaedic clinical officers.
They can cope with trauma and with a large proportion of elective orthopaedics. There are now one or two of these excellent orthopaedic officers in all
but one of the regional hospitals of Malawi.
It is very much to be hoped that EFORT will continue to be an outward-looking organisation as well as involving itself in the problems of Europe.
The need for appropriately trained orthopaedic personnel, and appropriate material and books remains enom ous in the less-developed
world. The need is there: can EFORT join with WOC in making a real effort?