W OR L D HEALTH ORGANIZATION

REGIONAL OFFICE FOR THE

EASTERN MEDITERRANEAN

.j,:l\..l' ~, 4!;y'

~..v' .r,' V/J ~ ..v' ~I

ORGANISATION MONDIALE DE LA SANTE

BUREAU REGIONAL DE LA MEDITERRANEE ORIENT ALE

REG roNAL COMMITrEE FOR THE EASTERN MEDITERRANEAN

EM/RCl4A/Min.l December 1964

y?~rteenth Session ORIGINAL: ENGLISH

SUB-COMMITI'EE A

MIN1lTES OF THE FIRST MEETING

Held at the BUilding of the Nursing Insitute, Sula5?1khat, Kuwait

on Saturday, 3 October 1964, at 10 a.m.

CHAIRMAN: Dr. V. VASSILOPOULOS (Cyprus)

Later Mr. Y. :JtSS!M HIJJI (Kuwait)

CONTENTS

1. Opening of the Session

2. Address by the Minister of Health of Kuwait

3. Election of Chairman

4. Address by the Chairman

5. Election of Vice-Chairmen

6. Addresses by the Regional Director and the Representative of the Director-General

7. Proposal by the Representative of Iraq

8. Address by the Director of Medical Services of Kuwait

page

4

4

4

5

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5

8

8

EH!RCl4A!Hin.l page 2

Representattves of Member States

Government

CYPRUS

ETHIOPIA

FRANCE

IRAN

IRAQ

JORDAN

KOllArT

IEBANON

LIBYA

PAKISTAN

SAUDI ARABIA

SOWILIA

SUDAN

SYRIAN ARJlB REPUBLIC

TllHSIA

UNITED ARA.B REPUBLIC

UilITED KIi'iGDOH OF GREAT ERI Tfilll AIID NORTHERN IRELAND

YEJVIEN

Representati ve I Alternate or Adviser

Dr. V. Vassilopoulos

Ato Hailu Sebsebie

Hedecin Lieutenant-Colonel Constant

Dr. A.H. Samii Er. Z. Davidian

Dr. Sabih Al-lvahbi Dr. Salman Taj-al-Din

Dr. Khaled El Shami

fir. Youssef Jassim Hijji Dr. A.Kamal El Borai Dr. Yehia Shaker Dr. N. Abdulkader Dr. Aly Onsi Dr. Nabih Farhat

Dr. Jamil Anouti

Dr. Abdul lIegid Abdel Hadi

Colonel il.F .M. Eorhanuddin Dr. S. Mahfuz Ali Dr. Hamid Ali Khan

H.E. Mr. Abdullahi lsila l10hammud l'lr. Adan Farah Abrar

Dr. Zein El Abdin Ibrahim

Dr. N.T. Hachicha

Dr. Nohammed Abdell,Jahab Shukri Dr. Sayed Svreilim Dr. Hashem Hahmoud El Kadi Dr. Abdul Azim Hussein El GholJni Dr. Abu El Fotouh Shaheen Dr. Imam Zaghloul El Sayed

Dr. C.R. Jones

Representatives of Associate Member States

QATAR Dr. Mahmoud El Nishad

\-Jorld Health Organization

Secretary to the Sub-Committee

Representative of the Director­General

Deputy-Secretary to the Sub-Committee

United Nations and Specialized Agencies

UNITED NATIONS and TECHNICAL ASSISTANCE BOARD (U.:T[J3)

UNI'illD NATIONS CHILDREN'S rum (mlICEF)

mll'rED NATIONS P.ELIEF AND HORKS .AGENCY FOR PAIESTINE REFUGEES (1.n'IRHA)

EH!ItCllWHin.l page 3

Dr. A.H. Taba, Regional Director

Dr. P .11. Kaul, Assistant Director­Gernral

Dr. A.il. El Halawani, Deputy Regional Director

Nr. S. Kar

Mr.Werner G.F. Middelmann

Dr. M. Sharif

~~tatives and Observers of International Non-Governmental, Inter-Governmental and National Organizations

IEAGUE OF ARAB STATES

IllTERlIATIONAL !~SOCIATION FOR THE PREVENTION OF BLHlDNESS

mTERNI,TIONAL DENTAL FEDERATION

IEl,GUE OF RED CROSS SOCIETIES

US NAVAL }lEDICAL RESElti~CH milT NO.3 (US llJlMRU 3)

Dr.

Dr.

Dr.

Dr.

Dr.

Ghaith el Zerikly

TOufic Turk

George Soudah

Sabih Al-vJahbi

J.D. Northway

EE/RclWl/Hi.n. 1 oage 4

1. OPElJING OF THE ~ESSION Iten 1 of the Provisional Agenda

Dr. VASSILOPOULOS (Cyprus), Vice-Chairr,oan at the Thirteenth Session and Acting

Chairman in the absence of the Chairman of that Session, in declaring the meeting

opened, expressed the gratitude of all members of the Suo-Committee for the

hospitality shmm to them from the first mOlClent they had landed in :Cu,'mit.

2. ADDRESS BY THE HINISTER OF HEALTH OF K'J1,AIT

H.E. Hr. ABDUL LA'rIF AL-THUNBJJ, Hinister of Health of I\uwait, welcomed

representatives on behalf of h'is Government and wished them a pleasant stay in the

country. He was looking forcmrd to participating in an exchange of vie .. s .. hich

would be all the more fruitful for the friendly atmosphere in >rhich it ~JOuld be

conducted.

He commended the stIBnuous and effective efforts being exerted by the Regional

Office in many countries of the Region and referred in particular to the valuable

assistance his = Hinistry "as receiving, and .. ould, he hoped, continue to receive.

,Ihile thanking HHO for its "ork in the health field he also ,-rished to pay

tribute to UIJICEF, TAB; FAO, UNESCO, and the; other United Nations bodies for the

assistance theY.Jere providing to all cou,,-cries ~li thout distinction of race, and

more particularly to the developing countries, .. hose needs .. ere the greatest.

KUl'ait Has keen to cooperate closely l1i th all international organizations devoted

to promo-c,ing h1llnan ,T8lfa~o8, and looked tmards the future with confidence and

o;?tir.lismCl

After expressing the hope that his C,overml1ent l s excellent relations ,lith llHO

Hould be further developed and strengthened, he >Jished the Suh-Committee success

in its fine humanital'i.:;n e:'ldeai;-ours ..

3, :,LECTIO!: 0:;;' CHAIRl1AN; Item 2 of the Provisional Agenda

::'he ACTlilG CH!'JBYlA;! invitee'- nominations for the post of Chairman.

Dr. ABlliL HPJJI (Ie_by,,), p.-oeosed lIr. Jassim Hijji (Ku .. ait).

Decision: )1:'. JASSLH H.-JJI Has elected by acclamation and took the Chair.

4.. ADDRESS BY THE CF.AIRl1AN

E}!/RCl.4A/Hil'l. 1 page 5

The CHAIRHAN, after emressing a')Prcciation of the honour done to h:iJnself and

to his country by his appointment, thanked Dr. Kaul, the Assistant Director-General,

for attending the session as renresentative of the Director-General, to whom he

requested him to convey sincere good wishes. He also thanked the Eegional Director

and his staff for all they had done to organize the holding of the session in

Kuwaj_t, and expressed his confidence that the discussions .10uld be fruitful and

of benefit to the health of the Region.

He congratulated the Emirate of Qatar on its accession to associate membership

and welcomed its representative to the session. He hoped it would soon be possible

to hail the entry of other emirates of -the Arabian Gulf to the Organization.

In conclusion, he conveyed to the Sub-Committee the best vlishes of his Govern­

ment for the success of the meeting nm, being held in his country.

5. EIECTIOll OF VICE-CHAIRllEN: Item 2 of the Previsional Agenda

The CHAImltlN called for nominations for the posts of ttro Vioo-ChzI.i.n:lcn.

Dr. EL BORJ..I (Ku1fait), proposed Dr. Anouti (Lebanon).

Decision: Dr. Anouti was unani!l1OUsly Glected Vice-Chainnan.

The CHAIRl1AN invited nominations for the second post of Vice-Chairman.

Dr. EL SH1\1{I (Jordan) proposed H.E. l!r. Abdullahi Issa HohanmIud (Somalia).

Decision : H.E, Hr. fibdullahi Issa llohammud was unanimously elected Vice-Chairman

6. ADDRESSE:S BY THE REGIOllAL DIRECTOR 11ill THE REPRESENTATIVE OF THE DIRECTCJR..QENSr:.,'.c,

The rr;GIOllAL DIRECTOR_, on behalf of \lHO, iVelcomed the reprcsentativm to the

Fourteenth Session of the Regional Commi-ttee and ex;nessed thanks and deep apprecia­

tion to 'ohe Government of KU>Jai t and to H.E. It--. Abdul' Latif ll-Thuninn, Einistcr of

Public Health, for their kind invitation and generous hospitality.

KUWait, so wisely using its oil,realth to contribute to public health, set a

particularly inspiring example of rapid social and general proe;ress with its up-to­

dato medical and public health institutions, at a time when cOlh~tries of the

Region Here actively shaping their future. The impressive distillation plants to

EH!RC1WMin.'l page 6

change sea llater into drinking "later, the "lOde 1 network of hosni tals and health

centres, and the free medical care system, run on a health budget nearing a

quarter of the national budget, HCr:e maj or contributions to health "rog-ress and

achievements worthy Q-f careful attention.

He )J81c.omed the renresentative of the Director-General, Dr.' .E. Kaul, Assistant

Director-General, and also the representative of the State of Qatar, "hose recent

admission as Associat3 lL:c_'cc:' brought I,JRO regional membership to tnenty, against a

membership of vNclve "hen the Regional Office had been established fifteen years

befoI'EJ. It was also gratifying to note the increasing recognition by Governments

of the true nature and purpose of 'JHO.

The Regional Di::'ector's annual reoort, dealing mainly "ith the work accomplist.­

ed during the previous year, also endeavoured briefly to assess the achievements,

shortcomings and experience gained during the :,ast fifteen years" and although muct

still remained to be done, they could rightfully look back with satisfaction on

their j oint contribution to heal'~h progress.

,lIe then referred to the encouraging results obtained from the all-out malaria

eradication drive '.hich had already orotected some 25% of the Region1s Dopulstion

at risk, the smaD_pox eradication cam,)aigns, the number of notified cases in the

ICegion during 1963 havin1, been the IGHest ever, the mass campaigns against trachona

bringing about So 50% d':'op )_'1 its prevalence in Hide areas, and the bilharziasis

controJ. pilo';-, pr')je-:ts "Hhich f'hm-I-cd steady experimental advances. H01Orever, ne1-.T

health prob le",s loomed in the teeming netropoli ta:l areas, such as the increasing

prevalence of ,cccrdiov2,scu12.r di seas3s, ca,_'cinomas, mental dis orders, occupational

diseases, radiation "d~2.rds and accidenGs. A significant trend was the ['~owing

de!1land for skilled uo"'~ker.3 in res8a::~h al!d tra'_ning activities resulting in a

tHofold incroase Si;C~3 1961 'C:l the ""nual number of such fellowships awarded by elHO.

A hiGh priority tGs!;:, accomt5.ng fa;: a large share of ,mo I s regional programme,

"as t'le htiildirg 1.Cp o!' a grmJinE', eadre Oi' doctors and health workers. Increased

assistance ''''.5 be'_n:; s'_ven by the Organization through advisory assistance to

medical facul +,je: '" ',;11'0'-,;:0 iy,'.er-countl'Y meetings and much \fas being done by

individua.:L ccunt.r'"es of the Eegio;l to produce more doctors: the number of medical

schools had 'nc""'lsed frc," 12 to 33 during the past fifteen years while medical

=pmoer, still cri +'i~ally i:lsu~ficient in \fide areas, would have increased 100%

'jn five years I """,me, Dee;oite all the efforts being Ir_ade, however, the challenge

was far from be:'-n.g leGe, "nd "'YLle all ,Jere aware of the magnitude of the task ahead,

EN/RC1Wl'Iin.1 page 7

he hoped they shared his feelinc that, IIi th the closo collaboration existing

between the Governments and the Organization, it ;Iould be possible to meet their

ever-l'fidening commitments and achieve greater accamplishrosnts in the years to

come.

He had already referred in his al1D11£1 I":mort to thc death of his distinguished

::>rodecessor Dr. Shousha, whose loss Has, he was sure, deeply fElt by all.

Dr. Shousha had not only been the first. Eegional Director arld ryrincipal founder

of the ccegional Office, but a pers anal fr\cmo. to himself and to many of those nm,

present. He therefore proposed that in Dr. Shousha1s memor"J the Sub-Comnittee

should observe one minute t s silence.

The Sub-Committee.stood in silence for one minute

Dr. KAUL, Assistant Director-Gen8ral, conveyed to the Sub-Committee the

Dcrector-General t s regrets at his inability to attend and his best wishes for the

success of its deliberations.

}llIO uas unique ",'nong international organizations for the regional structure

"hich had been "risely provided for by the framers of its Consti tutio."l, among "hom,

incidentally, the late Dr. Shousha had played an active part. The importance of

that regional structure ,ras twofold. In the first Dlace, it made it possible to

bring the problems of a given region into focus and to. concentrate on finding

appropriate solutions in the light of local conditions, concentrating efforts th2t

might become too diffused if exerted on a "Torld-,ride basis. Secondly, it enabled

the staff of the Regional Office to Hor), in close contact wi t.'1. the re')resentatives

of Bember States and to work out the most practical ,-JaYs to meet the requests of

governments. It 'VDuld thus be readily understood why the Director-General always

found it necessary either to atteEd the sessions of the regional conrr;ittees iIl

p3rson or to send one of his assistants.

He took the opportunity to mention "that the host country, Kuuait, though 2,

very young Eember State of HHO, had alread7 begun to playa full part in the life

of the Organization, not only at the regional 13vel but also at the uorld level,

since it had ;,een elected to destgnate one of the members of the HHO Executive

Board, l1hich, as the executive organ of the 1rlorld Health Assembly, contributed

directly to the solution of world health problems.

BE/RC1LA/Hin.l pap 13

F~nally, on behalf of the Director-General, he thanked the C'covenlHe"t. of

Kmmit for the fine modern building and t:le excellent facilities it had placed at

the disposal of the session. He 'i-tas attending ths llegional Commi"ctee for the fi~t

time and expected. himself t8 bencfi t grcatl~r from the experience. Unlike most

developing countries, ,'hich "ere short of all requirements for health proGress,

:,uwait possessed great J1'.aterial :reSOlCrces though it lacked qualified personnel,

and he "as looking fon .. ard to seeing for himself t!1e GOv-ernment's accelerated'

approach to the solution Of its problems.

7. PROPOSjl.L BY THE REPRE.'3ENTATIVE 01' IRAQ

Dr. AL 1'JAHBI (Iraq), after referring to the great loss sustained by all in the

death of Dr. Shousha, said he felt the great services rendered by the deceased to

the cause of world health should be commemorated in some fitting Hay. He there­

fore proposed, firstly, that a telegram of condolences should be A.ddressed in the

name of the Sub-Committee to Dr. Shousha's family, and secondly, that a special

fund should be established to uhich LIenii:>er States in the Region ,muld contribute

and ['Ihich Hould be used to endmI a pri.ze for outstanding achievements in the

field of public health by doctors and research Horkers of the Region, same1mat

on the lines of the :Leon Bernard Foundation.

b. AiJDHESS BY THE DIRECTOR OF liEDICAL SERVICES OF KU\~AIT

Dr. EL BOP.AI (KuHait), on behalf of 1,is delegation thanked all those that

were participating in the Hark of 'c,he Sub-Committee for having honoured

Km~,i.t "lith their presence and exoresoed the wish that their stay "ould be as

long as possible.

He proposed to speak briefly on KUHai'c and its health services, since that

c,'ould enable the members of the Sub-Committee, and eS0ecially those l1ho had not

'1reviously visited the country, to lmoF :Je'oter ",hat ,,,as taking oh'l.Ce there.

The popUlation of K'uTHit >'as about 400,000 and the area 16,000 square

Jrilametrcs. 'l'he traveller comingGG ;cmrai t could not fail to be imYJI'8ssed by

',hat he saH the nen'1Ork of asphalted roads lined Hith trees and Hell lit

2nd the modern city 1'1i th blocks of tall buildings which b are witness to the

~l'odigious ef:forts made 1.lY the Government fer the welfare 0,:' the oopulation

:md of all those ',Tho had taken up r8sidonce in the countr:i. Kuwait had many

')(:autiful buildings, of ,·,hich the Tmm Enll cmd the I1inistry of Infonnation and

EM/RCl4A;Min .1 page '9

Guidance were outstanding examples, and the schools and institutes were remarkably

built and maintained. There were already 160 schools and by 1965 there would be

180, attended by 80,000 pupils. There was a school health service with 35 doctors,

including 6 specialists and 10 dentists.

In the coming years the Government intended to set up the University of Kuwait.

Another achievement of which Kuwait was proud was the Central Mechanized Kitchen,

;,hich would prepare free meals for the pupils.

Kuwait had a giant water distillation works which was in operation day and

night to provide the town with more than 24 million litres of water per day; that

wa.s in addition to a natural wa-Ger Gource which provided half that quantity to the

town and its suburbs.

Five miles from the centre of the town was the health suburb. The Al Sabah

Hospital, which was the largest in the Middle East, was situated there; it had 700

beds and its capacity could be increased bJ another hundred beds if necessary. There

>Tere three chest hospitals, with 800 beds in all, and 20 lung disease specialists

,.orked there. Tuberculosis was KUNait's most important public health problem.

'Ireatment was free of charge to all and at the present time two-thirds of the avail­

able beds werc occupied by non-Kuwaitis.

The health suburb also contained an ultra-modern psychiatric hospital with ~OO

beds and 8 specialists, an osteological su~gery hospital and an ophthalmological

':lospital, with 200 beds and 20 doctors, most of whom were specialists.

2.1so a communicable eye <l.isease hospital 'lith a hundred beds.

There was

Apart from the hospitals in the health suburb there was a 500-bed general

hospite.l (the first established in Kuwait) with 50 doctors, a 150-bed obstetric

hospital staffed by 15 speCialists, an isolation leprosarium for leprosy cases, and

37 dispensaries including eleven combined health centres covering the whole of Kuwait

3,nd staffed by 120 doctors viho provided general medical care for the population.

In short, Kuwait was equipped witll complete preventive medical services and

also curative services, a special health guidance and education section, a maternal

and child health service, a central health laboratory with peripheral laboratories,

~ pharmacy in each trGatment centre, a dental section staffed by 25 dentists, a

radiology section with five speCialists and twenty highly qualified photographers,

and a special radiological and radium treat!",ent centre at the Al Sabah Hospital. In

addition, cobalt treatment was to be started in a special radiation and radio-isotope

u6ntre which would have a capacity of 60 beds. In a fevl months building would start

on another 600-bed hospital sDe miles from the town of Kuwait.

EM!RC14A!Min .1 page 10

Kuwait's health institutions were being set up in accordance with predetermined

plans. Their objectives had been well defined, and the first objective was the

assessment of the health problems. The main problem was tuberculosis, then trachoma,

then the problem resulting from the large number of sick persons coming into the

country, and finally the shortage of qualified staff. The second objective was to

provide the necessary health protection and treatment for all citizens; and the third

and last was the raising of the level of the health and medical services.

Efforts were being intensified to achieve the objectives as quickly as possible.

Under the health registration plan which had been launched in Kuwait two years pre­

viously, every citizen had to have_a health identity card, to be carried on his person,

and had to be registered at the dispensary nearest his place of residence, where a

special file was kept for him and his family. Doctors were appointed to staff the

dispensaries in the proportion of one for every 3,000 population. Upon arrival at

the dispensary every patient was examined and the appropriate treatment prescribed,

or if necessary, he was referred for specialized examination in a hospital and either

hospitalized or placed in the care of his family doctor.

The dispensaries were open for four hours in the morning and two in the after-

noon. For every group of three or four dispensaries there was a combined health

centre open 24 hours a day. The centres performed the same functions as the dis pen-

sary for the regions in which they were located, taking over from the dispensary cases

requiring urgent attention. Each combined health centre had a maternal health centre,

an office of preventive medicine and a dental clinic. The comprehensive health

centres in the outlYing regions were equipped with ophthalmological and gynaecological

clinics. That had made it possible to establish medical services in remote areas

and to provide each combined centre in such areas with ten more beds for delivery.

The organizational structure he had outlined ,.,as constantly being improved but

the essential basis of the project would be finalized within a year or two. He

hoped that members of the Sub-Committee would have the opportunity to visit some of

the dispensaries and combined centres.

The health authorities in Kuwait did not remain satisfied with what had been

achieved, but were constantly trying to do better.

The meeting rose at 11.35 a.m.