The Foundation and Structure of Health and Family Life Education in The Caribbean—An Initiative of The Advanced Training and Research in Fertility Management Unit

Abstract

Introduction The University of the West Indies was opened to students in October 1948 to serve the English-speaking countries of the Caribbean. In addition to the on-site functions and faculties, the University has an established network - The School of Continuing Studies (formerly The Extramural Department) - with facilities in the Member States. It is through these facilities that the Advanced Training and Research in Fertility Management Unit (ATRFMU) was able to launch and deliver its overseas outreach programme. Distance teaching (UWlDEC formerly UWlDITE) via satellite communication has, in the course of twenty years of operation, given greater meaning to the regional character of the institution. As the region faces the imminent realities of an economically more demanding Twenty-first Century, the countries of the Caribbean have found it necessary to collaborate in order to address population problems and the attendant social issues. The Caribbean Community, CARICOM, originally an association of the English-speaking States, now encompasses the wider Caribbean including Suriname and Haiti and has given observer status to the Dominican Republic. As early as 1955, the Department of Obstetrics and Gynaecology in the Faculty of Medicine responded to the needs of the population it served and established the Marriage Guidance Clinic to provide counselling and family planning services. A major turning point came in 1968 when, as a result of a study on tubal ligation (outpatient procedures), the Department was recognized for its research and training in the culdoscopic sterilization technique and later the laparoscopic and mini-laparotomy procedures. The ATRFMU was established in 1972 with three components - Clinical Services, Research and Training. Funding was received from the Pathfinder Fund and the Ford Foundation to support a training programme in culdoscopy tubal ligation offered with the University of Miami. Participants came from Egypt (3), India (11), the Caribbean including Haiti (11) and Panama (1). Other courses were developed and sustained by funding from the United Nations Fund for Population Activities (UNFPA) between 1976 and 1978, and from 1978 to 1983 by the Government of Jamaica in collaboration with the UNFPA, the United States Agency for International Development (USAID) and the Deutsche Gesellschaft fur Technische Zusammenarbeit (GTZ) of the BMZ (Federal Republic of Germany) - through the initiative of Dr Dieter Ehrhardt, the then UNFPA country representative and Dr. Pierre Sevryns, the PAHO representative stationed in Guyana. After 1983, the GTZ became the major funding source of the Unit's programme. The Johns Hopkins Programme for International Education in Gynaecology and Obstetrics (JHPIEGO) also supported The University of the West Indies Distance Teaching Experiment (UWIDITE) programmes. Other organizations assisted the activities of the Unit in specific ways between 1984 and 1998. In 1998 the University took over the financing of the Unit from GTZ on a phased basis. The expansion of the courses offered by the Unit was the result not merely of the generous funding by the external bi-lateral agencies, but also of the ATRFMU's philosophy of responsiveness to the fertility management needs of the Caribbean. In the earlier days, it was seen as an opportunity to address the anxiety of the University caused by the criticism that the University's presence was not felt in the non-campus territories and the view that the University did not reach out to people. It was certainly with some degree of wisdom that the universal problems of population began to be addressed more than thirty years ago. Perhaps it is true to say that attention to these problems is now more desirable, in fact urgent, even after so many years have passed. The ATRFMU has maintained its focus on three components - Clinical Services, Research and Training - modifying and expanding its offerings and activities according to the assessment of need and the development of new interests. …