MEAMA meeting - first session

First session of the first MEAMA course

Inviting people to participate in a course and transferring EAMA methods to another area in the world is a challenge for participants and organizers. Twice the first session had to be postponed, first in the autumn of 2002 after the ‘11^th  of September’ and the second time in the spring of 2003, because of the war in Iraq. In October 2003  we could start the first session. A small number of 16 persons participated, half of them women and men and with a good mixture of the three invited disciplines.

The first teachers’ state of the art lectures focused on demographic aspects in the Middle-East area ³. Life expectancy at birth has been presented in table 1. The range is between 68.3 years in Egypt to 76.3 years in Kuwait. Comparing these figures with some European and other areas in the world, we see for Europe a range from 75.9 years in Portugal to 79.9 years in Sweden. In the USA it is 76.9 years and the highest score is in Japan with 81.3 years. Most Middle-East countries have a lower life expectancy than most of the member countries of the European Union. Like in nearly all countries the composition of the population will change from the pyramidal shape to the cone shape, with a decrease in the potential support ratio, the number of persons aged between 15 and 65 years of age per one older person aged >65 years of age. The problems the Middle-East area faces are similar to these in the European Union and North America.

The participants presented lectures about the situation in their own countries. Differences were observed between the countries, although in most countries the problems in older people have been recognized and initiatives have been started. During the discussions questions were raised about which services are needed and how to estimate the quality of the services? How to influence the process of input and output variables and how to build up a system with quality indicators? What is the best way to meet older patients’ health related problems, to build new nursing homes or to propagate the formation of home care teams?

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Medical subjects also received attention, like the increasing number of patients with heart failure, diabetes mellitus, osteoporosis, dementia, depression and  behavioural disturbances. Special awareness was given to the position and the essential role of nurses in the services for the health related problems in older people. One of the interesting observations in the discussions was the recognition of the high impact of the role of nurses in all countries.

The last presentation made a comparison between the Middle-East area and the European Union ⁴. The patient related problems in the two parts of the world are the same, although the quantity of the services showed great differences. For example in the Middle-East countries the number of general practitioners diverged from country to country and the curriculum for medical students and nurses students seldom includes the health care problems in older people. Some countries have home care teams, others just have nursing homes with a high percentage of socially indicated admittances. In the Middle-East area the services for health related problems in older people is community oriented and general practitioners are the concerned physicians. In the European Union geriatric medicine is a recognized specialty in most member states, with specialists for community services and for hospital services. A great difference exists between the national and international structures for the development and the stimulation of the care for health related problems in older people. The European Union has a well developed system of organizations which contribute to the control and improvement of the quality of services, education and training of physicians. For nurses the first steps have been made to set up a European structure.  In the Middle-East area this has to be started and needs the support of the international organizations, like the geriatric medicine oriented societies in the European Union. In the discussions it was suggested to start for the development of the structure for the Middle-East area with bringing together interested persons at the national level to start national societies. Before these national societies present measures needed at the national level it was recommended to co-operate with societies in neighbouring countries to try to harmonize the development of services, education and training. During the session it was an advantage to have the speakers from the Middle East all days and from the European countries nearly always with us. It contributed to the high quality level of the discussions.