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    PROJECT FOR A TECHNICAL AND

    METHODOLOGICAL ASSISTANCE TO IMPROVE

    THE KNOWLEDGE AND ANALYSIS OF MEDICAL

    DISEASES IN YEMEN

    Association Mdicale Franco-Ymnite

    January 1999

    Association Mdicale Franco-Ymnite (AMFY)

    57 Av Paul Doumer 75016 Paris

    Tel 33-1-45 04 47 72

    e-mail : [email protected]

    Prsident : Dr Y. Viallard

    Vice-Prsident : Dr J.F. Hiance

    secrtariat : Dr J.L. Georges Fax 33-1-39 63 95 12

    PROJET AMFY 99 version du : 30/03/99 JFH/JLG

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    1. HISTORY OF THE FRENCH-YEMENI MEDICAL ASSOCIATION

    (AMFY)

    The french medical assistance in yemen began 50 years ago (Dr Fvrier COLLARD,

    1948). The French Medical Mission of Taiz (MMF) has been created in 1961 by Dr Yvette

    VIALLARD, and officially recognized in 1968. More than 80 french physicians, biologists,

    nurses, technicians in radiology, arabist administrative assistants have worked in this mission.

    It developed in the Republican Hospital of Taiz into six medical specialities : radiology,

    ophtalmology, pneumology, cardiology, internal medicine and infectious diseases, and

    pathology laboratory. Concurrently, several yemeni physicians and paramedics have been

    recruited and turned out, and some of them have completed their specialization in France.

    The French-Yemeni-Medical Association (AMFY) has been created in 1990, just before

    the definitive closure of the French Medical Mission, in order to continue a close medical

    collaboration, contribute to a better knowledge of the medical problems in Yemen, and keep

    and use all the friendship that had been gathered over 30 years of common work. The creation

    of AMFY was encouraged and sponsored by Mr Travers et Mr Calvet, respectively vice-

    director of scientific and technic cooperation, and director of the Middle-East area in the

    french foreign office (Ministre des Affaires Etrangres).

    The association maintained close contacts between french and yemeni doctors of Taiz,Sanaa and Aden. It organized medical meetings in Yemen (the "rencontres mdicales franco-

    ymnites"), during which many important medical problems in Yemen were interactively

    discussed and analysed : endocarditis (1994), traditional pharmacology (1994), new trends in

    tuberculosis (1996), rheumatic heart disease (1996), radiology and ultrasound in medicine

    (1994, 1996), prevention and care of cerebral vascular accidents (1998).

    AMFY also contribute in:

    - helping yemeni physicians/paramedics for their post-university training courses in

    France, reception and lodging (Dr Viallard)

    - mailing and dispatching medical journals and publications in Yemen

    - collecting donations of medications and medical equipment for the Republican

    Hospital of Taiz.

    Until now, the AMFY has been financed by a grant of the french governement, private

    donations, and suscriptions of the members. Its actions were supported by the service culturel

    et de coopration scientifique of the French embassy in Sanaa, and by the Yemen embassy in

    Paris.

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    2. PURPOSE OF THE PROJECT

    The purpose of this project is to bring medical informations and large technical and

    methodological assistance, following specific requests of yemeni health professionals, for a

    better knowledge and an improvement of care of medical pathologies in Yemen.

    3. BACKGROUND AND RATIONALE

    During the 10 years following the closure of the French Medical Mission, medicine in

    Yemen has deeply changed : medical schools and university hospitals have been created or

    developped, vaccination program have been planed, highly qualified yemeni specialists have

    been recruited, and hospital medical equipments have been improved. Concurrently, the need

    of substitutive medicine has decreased, and the request of yemeni health professional have

    changed to a greater assistance in methodological aspects, analysis of process and

    organization, and post graduate educational programs.

    Because the French Yemeni Medical Association has gathered a network of medical and

    academic experts, all being aware of the specificities of the medical yemeni practice, it

    appears useful and necessary to work out a new project for a common work, taking into

    consideration the changes in medicine in Yemen and the new requests of our yemenicolleagues and members.

    This project will concern public institutions in Yemen (hospitals, universities) and will

    be non-profit making. French experts will volunteer working on this project.

    4. METHODS

    The methods will associate post graduate educational programs, in Yemen and in France,

    and setting up of simple structures allowing a better transmission of medical informations

    between France and Yemen.

    4.1. Post-graduate medical educational programs in Yemen

    4.1.1. Medical meetings

    They will continue the "Rencontres Mdicales Franco-Ymnites". The basis of the

    organization will be almost similar, with some distinctive features as follows :

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    - The medical meeting will focus on the comparison of different experiences concerning

    a major health problem in Yemen, chosen by the yemeni organizers

    - It will require the active participation of both yemeni and french speakers

    - A member of the AMFY will coordinate the meeting, organize the sessions in

    collaboration to the yemeni staff, prepare the following actions of AMFY, and write a report

    for AMFY and sponsors.

    - The medical meeting will essentially deal with the theoretical aspects of the medical

    problem, and will be completed by the other actions of formation (workshops, training

    courses), which are detailed below

    - Periodicity : 1 2 by year

    - Unique place (turnround between Sanaa, Aden, Taiz)

    - Duration : 3 days

    - French team members : 2 to 3 (1 yo 2 experts and one AMFY's board member)

    4.1.2. Workshops of medical techniques

    - The topics will be the same that those chosen for the medical meeting, or be different

    and open on further common works.

    - Medical techniques involved : ultrasound/echography, diagnostic or interventional

    radiology , CT-scan, laboratory techniques, etc

    - Duration : up to 8 days, eventually associated with a medical meeting

    - French team :1 or 2 people

    4.1.3. Clinical management

    - Clinical management sessions will be organized on a specific request of the yemeni

    physicians, and be authorized by the yemeni health authorities.

    - They will consist in clinical discussion of selected medical cases and/or examination

    of selected patients. The cases should be representative of frequent or difficult medical

    problems in Yemen, or have a large didactic interest for physicians, fellows, or students.

    - They should necessarily be associated to a scientific presentation (medical meeting,

    workshop of medical techniques).

    4.1.4. Methodological post graduate educational courses

    - Principle : formation of yemeni health care professionals by an expert in a specific

    topic dealing with methodology and organization : statistics, epidemiology, health care

    processes, organization of out-patient clinics, laboratories, in-patient hospitalization, etc..

    - Formation of formatives : in this way, "formatives' formation sessions" intended to

    teachers, researchers, paramedical or technical officers, could be organized in order to give

    them a pedagogical formation.

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    - Periodicity : 1 to 2 by year

    - Unique place (turnround between Sanaa, Aden, Taiz)

    - Duration : 7 to 15 days

    - French team members : 1 expert

    4.2. Post- graduate medical educational programs in France

    - The AMFY will continue its participation to training courses (Stages Scientifiques de

    Haut Niveau) offered to the yemeni physicians who have previously received a grant from the

    French Government for their specialization . AMFY will help to the recruitment of applicants,

    the selection of university hospital departements providing the training course, the reception

    of the applicant and supporting during the course, and if necessary the search for a lodging.

    - The AMFY may also organize training courses in France, in a wider framework,

    intended to doctors, administrative agents, paramedics, medical / radiology / laboratory

    technicians, in relationship with the university members of the Association.

    4.3. Diffusion of the medical information

    - Distribution of medical journals, subscription for hospital and university libraries

    - Reply to yemeni requests of medical bibliography and references

    - Creation of a bibliographic database dealing with medicine in Yemen, available for

    yemeni health professionels.- Creation of an Internet adress and/or site, providing :

    - the possibility of transmission of the aforementioned informations

    - the ability to present and discus diagnostic and/or therapeutic clinical cases,

    - the ability to transfer medical images (telemedicine)

    - a permanent contact between yemeni and french members of the Association,

    - a link which may facilitate the preparation of the different actions of AMFY

    (medical meetings, workshops, training courses, etc..).

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    5.Articulation of this project and calendar

    In conclusion, this project is a wide framework, which has to be discussed with our

    yemeni colleagues, the yemeni and french authorities and sponsors. The presentation of this

    project will be done during a mission in Yemen by Dr Viallard (president of AMFY) and Dr

    Hiance (vice-president of AMFY) in february, 1999. During this mission, they will have

    - to choose the next medical topic. Propositions are pediatrics, congenital cardiopathies,

    infectous liver diseases (hepatitis, hepatoma)

    - to discuss about the date of the next medical meeting in 1999

    - to try to set internet connexions between yemeni institutions and AMFY

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