he World Federation of Societies of Anaesthesiologists (WFSA) was established at the first World Congress of Anaesthesia in the Netherlands in 1955. There were 28 member societies. Currently there are more than 104 from all over the world. ASA is the largest, and many Americans have made significant contributions over the years. Several have held high office, including past WFSA presidents Francis Foldes, M.D., and John J. Bonica, M.D. At present John R. Moyers, M.D., is Secretary, H. Jerrel Fontenot, M.D., is Chair of the Finance Committee and Charles J. Coté, M.D., is a member of the Executive Committee, having previously been chair of the Pediatric Committee.

The main aim of the Federation is to improve the standard of anesthesiology worldwide. The major thrust of its activity is educational. Our Education Committee runs refresher courses in many developing countries. Recently, training centers have been established to provide basic training in anesthesia for physicians so that they can eventually form a core of anesthesiologists who train others in their countries. One of these, in Bangkok, Thailand, is helping to train people from Indo-China, particularly Cambodia, Laos, Mongolia and Myanmar. So far they have trained about 30 anesthesiologists over the past seven years. The course in Ghana, Africa, is partly supported by ASA, which is a very important and much appreciated contribution. It provides basic training for Ghanaians, but also must take someone each year from surrounding English-speaking countries such as Sierra Leone and Gambia where properly trained people are almost nonexistent. Formerly ASA has supported programs in Tanzania and Ethiopia. These programs have been very important in countries where there is only a handful of trained anesthesiologists for large populations of 30 million or more. Individual ASA members have generously given their time to teach in these centers. There is also a pediatric anesthesiology training position in Santiago, Chile, and more specialty centers are planned. Dr. Coté has been instrumental in establishing these.

Overall more than 60 nations have been helped with teachers coming from more 25 countries. So it is a great international effort carried out on a relatively small budget.

Other societies have been involved very actively in similar programs. Australia, with help from New Zealand, has developed teaching and training in the South Pacific so that it now has its own Master’s program. Anesthesiology was the first postgraduate medical qualification in the region. Other programs in Africa are supported by France, Belgium and the Netherlands. Israel helps in Eastern Europe, Italy helps Albania, and now a center is being established by Egypt to help other sub-Saharan countries.

The WFSA Publications Committee produces Update in Anaesthesia, edited by Ian Wilson, M.B., which is now available in five languages and is on the Internet in English and Russian <www.nda.ox.ac.uk/wfsa/>. This committee also distributes books to less affluent departments when money is available, and it coordinates journal distribution from anesthesiologists who are willing to send theirs on to needy people or departments. There is a list of hopeful recipients if you wish to contribute.

The Federation also has produced a document to guide people about appropriate donations of equipment. All over the less affluent world, one can see sophisticated donated equipment that is not in use because of irregular electricity supply, no gases, no maintenance or even training on how to use the equipment. Sometimes there are parts that have to be replaced periodically, which the recipients cannot afford. This sophisticated equipment has been sent to countries that have a health budget of as little as $5 per citizen. The WFSA Equipment Donation Guidelines are attempting to remedy this.

The economic problems in recent times have created some difficulties for the Federation. Because most of our funds are in the United States, we have had decreasing returns on our investments. Our aim has been to keep up the educational programs and severely trim other costs. Society dues per member ($1.25) were not increased for 20 years. For the past two years, some societies voluntarily paid an extra $.25 per member. At the WFSA World Congress in Paris, France, last April, the General Assembly approved, almost unanimously, to increase this number to $2 and in two years to $2.50. There was little opposition after the president pointed out that this was equivalent to one or two cups of coffee for most people. Also at the Congress, a review of the constitution was undertaken to make the organization more efficient and economical. Several changes were approved in Paris.

We hope this conveys something about the Federation of which your Society is an important member. Encourage its active participation. Individuals also can contribute through educational activities, donations to our Foundation or in other ways mentioned. Some of you may have immigrated from a less affluent country and would like to help your old homeland. Paying their Society dues may be a significant help to them. It may only be a few hundred dollars, if that. Helping those who are not well off can be very satisfying. Maybe one spinoff could be saving some of the thousands of mothers who still die in childbirth each year through lack of adequate obstetric and anesthesia care.

Many of you came to the World Congress in Paris in April and met some of these interesting people from other lands. One of the great aspects of our specialty is that anesthesiologists can have friends of any nationality, color or creed. Perhaps you can help them in simple ways, even arrange to visit them or do something else practical to help.

Kester Brown, M.D., is an anesthesiologist at Royal Children’s Hospital Melbourne, Victoria, Australia.