Every physician is a scientist

The physician-scientist is the physician who thinks scientifically about his work. The single most important route to improving medical practice and the health of the population is through clinical research and physician-scientists are vital here. (AU)

Medical Library - then and now

The paper traces the Medical Library's growth, development and its relationship with the Faculty of Medical Sciences (FMS), researchers and other users pursuing their teaching, research and patient care. The information is analyzed, synthesized and organized from the annual reports of the Vice Chancellor, Principal, Libraries, various Departments in the Faculty of Medical Sciences, Office of Planning, Institutional Research, and the Web Pages of the University of the West Indies, Mona, Jamaica (AU)

Development of primary health care in Jamaica

The development of primary health care in Jamaica is explored, tracing its early roots to the abolition of the slave trade, the collapse of estate-based services after emancipation and the subsequent establishment of the Island Medical Services in 1875. Most developments in the health sector occurred after World War I in response to the high infectious disease mortality rates. The Rockefeller Foundation was asked to assist with the control of hookworm, tuberculosis, malaria and yaws. Its recommendation led to the growth of public health programmes (eg environmental health, public health nursing, community midwifery) alongside community-based curative services run by hospitals. The most significant period of development occurred in the 1970s when the various vertical programmes were integrated into the current primary care system. Jamaica was integral in the development of the World Health Organization's Alma Ata Declaration on Primary Health Care, tabling the "Jamaican Perspective on Primary Health Care" which set out its goal that all citizens should be within 10 miles walking distance of a primary health care facility. At the close of the twentieth century, the health reform process led to the development of regional health authorities aimed at integrating the management of primary and secondary care under four Regional Boards of Health. This has led to a change in the role of the central Ministry of Health to one of policy-making, health promotion, setting standards, monitoring and evaluation of the quality of health care. (AU)

From "forest malaria" to "bromeliad malaria": a case-study of scientific controversy and malaria control

The article analyses the evolution of knowledge and rationale of control of a special case of malaria transmission based on Bromelia-Kerteszia complex. Since bromeliaceae function as a 'host of the carrier' and were previously associated with natural forests, the elucidation of bromeliad malaria historically elicited controversies concerning the imputation of Kerteszaie as transmitters as well as over control strategies directed to bromelia eradication (manual removal, herbicides and deforestation), use of insecticides and chemoprophylaxis. Established authority, disciplinary traditions, conceptual premises and contemporary criteria for validating knowledge in the field partly explain the long time gap since Adolpho Lutz announced as the beginning of the century the existence of a new mosquito and breeding site as responsible for a 'forest malaria' epidemic occurring at a high altitude. The article brings attention to how economic, political and institutional determinants played an important role in redefining studies that led both in Trinidad and Brazil to the recognition of the importance of kerteszia transmission, including urban areas, and establishing new approaches to its study, most relevant of all the concurrence of broad ecological research. The article then describes the Brazilian campaign strategies which showed significant short-term results but had to wait four decades to achieve the goal of eradication due to the peculiar characteristics of this pathogenic complex. Finally, it brings attention to the importance of encompassing social values and discourses, in this case, environmental preservation, to understanding historical trends of malaria control programs(AU)

The international yellow fever problem in the Caribbean Islands

A brief historical resume of yellow fever in the western hemisphere is given. The present position in the Caribbean and the dangerous proximity of these teritories to the endemic yellow fever zone have been described. It has been shown that the Caribbean is susceptible to yellow fever and that the mosquito vector, Aedes aegypti, is present; the introduction of the virus would therefore result in epidemics of the disease. The methods of eliminating the danger of urban yellow fever epidemics using DDT, and the costs of these methods are given (AU)

Managing curricular change in the UWI Medical Schools

The ideal operational curriculum is dynamic. It is alive, constantly responding to changes within the social milieu served by its programmes. The medical curriculum of the University of the West Indies (UWI) has not been readily responsive to its catchment society's changing needs. This lack of resilience has created both curricular and administrative problems that have remained unsolved. Now, at the threshold of the twenty-first century, many more fundamental curricular changes are imperative in the UWI medical programme if the Facult of Medical Science (FMS) is to be able to withstand the territoral invasions imminent from the global digital institutions of the new age. The new changes that will place the medical curriculum in line with the demands of the new information age will also remove the obnoxious effects of the `dual curriculum' question and related issues. The change Formula (Ch = V x P x D >C) that has worked the corporate transformations and realignments of the late century is applied to the thoughts of a reformed management of the UWI medical curriculum, and its ability to break down walls of resistance to change and liberate the curriculum to full dynamism is discussed. (AU)