Looking back to maintain our forward trajectory

Declarations at the end of a TUFH annual meeting are hard to write and easy to forget. It’s easy to forget what came the year before – we are often so focused on creating anew that we don’t look back at what we declared after previous conferences.  We are trying to do better.  The declaration that emerged from the Ubuntu 2024 conference which brought TUFH and Rural WONCA together continues the theme of community wellness through attention to people, place, and policies.  Community remains a consistent throughline from previous declarations – working with, working in, and working for.  Thanks to the joint conference sponsorship with Rural WONCA, we continued the focus on rural communities that started with the Thunder Bay meeting in 2012, an emphasis that was reinforced in the Vancouver declaration that came out in 2022 and was amplified in the Sharjah declaration that emerged last year.

The goals presented in Thunder Bay 2012, Vancouver 2022, Sharjah 2023, and Ubuntu 2024 have been consistent:

1. Community engagement: Communities must be part of generating solutions to their own health care needs and enabled to be actively involved in implementing these solutions. Developing community capacity to engage with policy development through supporting locally led social innovation in health initiatives and continuous learning processes is essential.  
2. Equity in rural health: Based on the principle of equity, we need to prioritize rural issues as we restructure the health system towards realizing health for all. We should aim to produce practitioners likely to work in underserved communities by assisting students in these communities to obtain sufficient primary and secondary education to be able to enter health professional training.
3. Educate the health workforce in context: recruit students from underserved communities and train them in generalist practice and primary health care. Deliver health services by locally based health care teams wherever possible.
4. Create social and health policies for the public good: Accreditation should include measurement of responsiveness of institutions to the needs of their communities. Universal coverage can strengthen health systems and lead to improved access.  And community-led approaches can co-create policies and solutions that reflect the needs of marginalized communities, including women, rural populations, migrants, indigenous peoples and disabled people.

Many of the papers in this issue support these themes: impact of rural placements, models of education in the community, workplace education of pharmacy students in Nepal, community immersion of dental students, impact of covid on vulnerable populations, and a theoretical perspective on teamwork.  Several other articles are indirectly related: the use of virtual reality in education of dental students, of caregivers of patients with dementia, and as an adjunct to other simulation tools.  Also in this issue are papers on professional development of Japanese women in medicine, professional identify of underrepresented students, and academic support of students.

I suggest we revisit the Ubuntu declaration and the others that preceded it throughout the year and hold ourselves accountable for the lofty ideas they present.  As stated in the conclusion of the Ubuntu declaration, we challenge readers to work with The Network: TUFH and Rural WONCA individually and through their local organizations to align education, policy and systems innovations with these key goals.  Then analyze the evidence, draw your inferences and disseminate the knowledge through publication in this and other journals.  Let’s not forget the goals we wrote in years past so we can maintain our forward trajectory.

Bill Burdick

Co-Editor