7 The Report of 18th Congress of the International Association of Rural Health & Medicine (IARM) in Goa, India The 18th Congress of International Association of Rural Health and Medicine (IARM) had been held at Kala Academy in Goa, India on December 10 - 12, 2012 and been finished with big success. The president of the Congress was Dr. Ashok Patil, the President of IARM. The main theme was “Challenges for Rural Medicine in the Global Village”. About four hundred people gathered from 25 countries in the world. 24 delegates from Japan participated in this congress and presented their thirteen studies. Dr. APJ Abdul Kalam, the former President of India, participated in the inauguration ceremony, and the newspapers reported the congress next day (see Figure 1 below). In the inauguration, Dr. Shintani greeted on behalf of the Japanese association of Rural Medicine (JARM) and showed the films of Great East Japan Earthquake on the next day. IARM Executive Board Meeting and General Assembly were held on Dec.10, and Dec.11, respectively. Details of the Congress are provided in http://ruralhealthgoa2012.org/ and in http://www.iaamrh.org/. Figure 1: The newspaper reported the speech of Dr. APJ Abdul Kalam, the former President of India, in the inauguration ceremony on December 10, 2012. 8 Figure 2: 24 delegates from Japan participated in this Congress. Figure 3: Dr. Patil, President of the Congress, welcomed Dr. APJ Abdul Kalam, the former President of India. 9 The 13 Presentations by Japanese Delegates in The 18th International Conference of Rural Health & Medicine 1. Hiroyuki Ishige. Present status of cases with breast cancer at Saku Central Hospital and assessment of treatment quality. 2. Jyunichi Tazawa. Collaboration between hepatologists and primary care physicians in treating patients with chronic hepatitis C in Japan. 3. Shunji Okae. The role of the CT abdomen in enabling junior residents to accurately diagnose patients with an acute abdomen. 4. Motohiro Shimizu. Analysis of patient background, treatment, and prognosis in women with ovarian cancer. 5. Hitoshi Watanabe. Clinical study of cerebrovascular arterial dissection in Saku Central Hospital. 6. Koji Suzuki. Diagnosis of occult fractures of the ischiopubic rami. 7. Kiyoshi Ohara. Japanese reaction to radioactive pollution occurred by the nuclear power plant accident associated with the Japan huge earthquake. 8. Shin Tsuruoka. Response and agenda of our hospital to great east Japan earthquake. 9. Jung-Nim Kim. The effect of physical and cognitive functions on mortality risk by frail persons in Japan. Results of a four-year cohort study. 10. Kanae Hamano. Related factors concerns the quality of life of the elderly population on a remote island. 11. Yoshiaki Somekawa. Risk factor associated with lumber and femoral bone mineral densities in post-menopausal Japanese woman. 12. Takehiko Okamura. Investigation of age related differences in prophylactic effects of BCG intravesical instillation therapy against non muscle invasive bladder cancer in Japanese rural area. 13. Shuzo Shintani. Efficacy and ethics of artificial nutrition supply in patients with neurologic impairments in home care at the rural setting in Japan. Figure 4: From left to right, Dr. Shintani (Secretary General of IARM, Japan), Dr. Patil (President of IARM), Dr.Kalam (The former President of India), Dr. Kim (Korea), and Prof. Hannich (Vice President of IARM, Germany) in the inauguration of the Congress. 10 Figure 5: Lamp Ceremony in the inauguration, from left to right, Dr. Shintani (Secretary General of IARM, Japan), Dr. Kalam (The former President of India), Dr. Patil (President of IARM), and Dr. Kim (Korea). Figure 6: About four hundred people gathered from 25 countries in the world. 11 Figure 7: Dr. Patil, President of IARM, gave a lecture in the session of “Reforms in Medical Education to Improve Rural Health Care”. Figure 8: Presentations in the session of “Women’s Health & Empowerment” 12 Figure 9: Prof. Hannich, Vice President of IARM, gave a lecture in the Congress. Figure 10: Executive Board Meeting was held on Dec.10, 2012. From left to right, Dr. Hideomi Fujiwara (President of JARM, Japan), Dr. Shintani (Secretary General of IARM, Japan), Prof. Hannich (Vice President of IARM, Germany), Dr. Niu (ILO, Switzerland), Dr. Patil (President of IARM), and Dr. Kim (Korea). 13 Figure 11: Traditional dancing by the natives in the welcome night party at the Congress Figure 12: A stuffed bear was dancing at the top of the march. 14 The Speech of Dr. Shintani in the inauguration on behalf of the Japanese Association of Rural Medicine I am Shuzo Shintani from Japan. I am a Board Member of the Japanese Association of Rural Medicine (JARM). First of all, on behalf of the Association of my country, I would like to extend my sincere congratulations for holding the 18th Congress of IARM in Goa. We have now 24 delegates from Japan in this Congress. Japanese association of Rural Medicine (JARM) was established 60 years ago by Dr. Wakatsuki and his colleagues, and now our association consists of 4,510 physicians and researchers involved in rural health and medicine. I am afraid that recently the substantial works for the field of rural health and medicine seems to be carried out in a few countries. I hope that IARM will encourage and support such works in each country, and build a worldwide network for colleagues involved in works of rural health and medicine. Now, on behalf of the Japanese People, I thank you deeply for your warm thoughts and expressions of sympathy for our tragedy. As you know, we have experienced tremendous earthquake followed by enormous tsunamis on March 11, last year. The number of casualties by now is 15,870, and 2,814 people are still missing. Furthermore, we have been experiencing another disaster caused by the earthquake and tsunamis, which is not visible but more terrible. The radiation being released from the affected nuclear power plants located in Fukushima Prefecture has now been the center of attention in Japan. Our Japanese delegates will present these matters at this Congress. IARM is an independent association for agricultural and rural health professionals. I am now a Secretary General of IARM. I would like to do my best in contributing to the development of rural medicine and this association. GOA DECLARATION The participants of the 18th International Conference of Rural Health & Medicine held at Panaji, Goa, India from 10th to 12th Dec. 2012, collectively affirm & adopt the following declaration: 1. The Challenges for Health have crossed man made geographical boundaries and ‘Your health, My health, Our health’ has become a reality. 2. That we are all governed by the same principles of economics and thus there is a dire need to reaffirm our faith in Human Rights and Health for sustainable Development. 15 3. That Sustainable Development refers to human development in which resources used meet human needs while preserving the environment so that needs can be met not only of the present generation, but also for the generations to come. EVERY HUMAN BEING IS CREATED EQUAL AND HAS A RIGHT TO DECENT LIVING, WHICH INCLUDES ACCESS TO HEALTH CARE SERVICES, CLEAN & POTABLE DRINKING WATER, SANITATION, EDUCATION AND NUTRITION. 4. We reaffirm the relation between health, human rights, and economic growth. Healthy workers are, for example, good for both governments and business. Our commitment to sustainable development needs to ensure that we are creating more healthy societies and improving the living conditions for people. 5. Health is more than a medical issue and there is a need for a new global vision for health that will build on the MDGs and connect to future development goals. Health would entail a ‘continuum of care’ across sectors, hence global & national health policies should encourage multi-sectoral approach. The vision, based on countries’ needs, should be translated into clear goals, expected results, and guiding principles for its implementation. 6. We commit towards evolving Universal Access to Essential Health Care & Medicines, so that the disparities in access to health care and its affordability, particularly those faced by disadvantaged and underserved segments of population, are corrected. 7. Women’s and children’s health is a human rights issue and closely interlinked with the empowerment of women and girls resulting in gender equality. 8. Health must be brought out of isolation. The impact of issues such as climate change and the direct effects it has on people’s health NEEDS discussion. Health is an important indicator for how well we are managing the climate, water resources, food and energy production. Global warming is one of the most serious risks for future generations in the world. We must continue to assess the health risks of global warming. 9. Health education must be introduced at the primary school level to raise awareness and knowledge about health issues. The latest DALYs (Disability Adjusted Life Years) reports have confirmed that the overall patterns and trends in disease burden of the Developed and Developing economies are beginning to converge with. 10. A Growing Geriatric population leading to increase in Dementia and Alzheimer’s and subsequent funding required from governments to increase social security, aged pensions and healthcare for the aged. An increase Trauma and Accidents causing a huge burden in terms of disability and morbidity. 16 11. An increase in the global burden of cancer, psychiatric problems, depression and cardio-vascular diseases and metabolic syndrome risk factors. 12. Evidence of occupational hazards through chemicals and machinery used in unorganized sector particularly in agriculture, fishery, horticulture etc. is on rise. 13. Infant Mortality Rate & Maternal Mortality Rates that need to be reviewed in most developing countries – India alone accounts for 19% of world’s total maternal deaths and is not on target to address the MDGs 4 and 54 .