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Foreign Embassy Visits
BJD World Network Conference, Washington DC
On the occasion of the 2009 World Network Conference, BJD international delegates took the opportunity to visit their country Ambassadors based in Washington DC to discuss musculoskeletal issues relevant in their region. The idea was to bring the BJD message to a leader or diplomat who may have previously been unaware of the vast burden of musculoskeletal disease in their country and to ask them to use their position to lend support for increasing awareness and building cooperation with the Ministry of Health. Below are reports of how each country delegation proceeded.
 Australia: Prof Peter Brooks and Mrs Ruth Lilian visited the Ambassador of Australia for one hour on October 22, 2009. The Ambassador, Mr Dennis Richardson, was very aware of the individual burden of musculoskeletal disease, as his wife had just undergone total knee replacement surgery. This knowledge on his part was advantageous for the delegation because he already had a personal understanding of the problems and challenges, and could easily comprehend the need for musculoskeletal health to remain a health priority in Australia. The Ambassador, a ‘career diplomat’, will be returning to Australia next year so he asked that Prof Brookes and Ms Lillian get in touch with him a that time and promised to get on board with the Australian Network and their activities.
 Brazil: Dr Elaine Silva and Dr Eudimia Lima of the Science and Technology Dept at the Brazilian Embassy received the Brazilian delegation, Mr Fernando Diniz and Dr Marcos Musafir on October 24, 2009 for two hours at the Brazilian Embassy.. The delegation explained the role of awareness of road traffic injury, the role of prevention, and the burden of MSD diseases in Brazil in general. The Ambassador asked for a written summary of the BJD Global Network Conference and promised to send it to the Foreign Affairs Ministry in Brazil with recommendations to increase focus on these issues to the Ministry of Health.
 Croatia: The Croatian delegates, Prof Jadranka Morovic-Vergles and Frane Grubisic, visited the Ambassador, Mrs Kolinka Grabar-Kitarovic, on October 22, 2009. They introduced the Ambassador to the BJD, its vision and its goals. They also informed her about the burden of disease in Slovenia from 2004 onwards, and she expressed full comprehension and support of their future projects.
 Denmark: The Danish delegation had a one-hour meeting with the Danish Ambassador on October 21, 2009. They presented the state of musculoskeletal health in Denmark and educated the Ambassador about the facts showing that bone and joint diseases are a heavy burden on society as well as for the individuals living with them. They brought with them papers which document the costs and the burden of disease and presented their political programme listing concrete actions that the Danish Health Ministry could take to improve prevention and treatment of MSDs in Denmark.
 France: The French delegation including Prof Liana Euller-Ziegler and Christian Plumail met with Prof Ducker, the Medical Counselor at the French Embassy on behalf of the Ambassador who was away at the time. Prof Euller-Ziegler was already acquainted with Prof Duker, and therefore he was aware of the BJD and the World Network Conference in Washington DC. Prof Duker listened to the French delegation’s explanation of the burden of musculoskeletal disease in France and the importance of increased awareness, and he promised to take this message to the Health Minister and the President (who had bestowed on Prof Euller- Ziegler his high patronage for the EULAR congress in 2008) along with a comprehensive report on musculoskeletal disease and the BJD. Key points of discussion were: Awareness Raising; Patient Education; Research Funding.
 Hungary: The Hungarian Ambassador was very open to help with BJD Hungarian projects, and asked the Hungarian delegation to send him clear and concentrated messages in a written form very soon. The Hungarian delegation, Kati Dul, promised to do so, as well as to send him a summary of the Global Network Conference and activities in Hungary, for him to forward to the Hungarian Government and Ministry of Foreign Affairs.
 Japan: Prof. Takashi Matsushiti, Chairman of the Steering Committee, Japan BJD NAN and Prof. Shoichi Kokubun, Member of BJD ISC visited the Embassy of Japan one hour on October 22, 2009. Mr. Tadayuki Mizutani, an officer dispatched to the Embassy by the Ministry of Health, Labour and Welfare, received them. They began by explaining what the BJD is and describing the activities initiated by the Japanese NAN since 2000. They continued by asking him to take their report and request to his ministry. The request is to found trauma centers in each major city, especially first in or around Tokyo. He knew the insufficiency of our trauma care unlike in USA and many European countries and agreed to tell our request to his senor officers in the Ministry of Health, Labour and Welfare.
 Lebanon: The Lebanese delegation including Prof Prof Ghassan Maalouf and Mr Ali Jaber met the Ambassador of Lebanon, Mr Antoine Chédide, and then the Consulate of Lebanon, Ms Cavela Fazzar, on October 22, 2009 – each visit lasted a half hour. Both dignitaries were very interested to learn about the BJD global activities and especially national activities of the organization in Lebanon. They received the BJD Annual Report and listened to explanation about the burden of disease. The Ambassador then invited the BJD Lebanese delegation to join him for dinner with the Lebanese Minister of Commerce that evening. He promised to write to the Minister of Health and provide him with a summary of their meeting, the mission of the BJD, and the importance of prioitising musculoskeletal conditions in Lebanon.
 New Zealand: The New Zealand delegation comprising Mrs Sandra Kirby (CEO Arthritis NZ), Mrs Dianne Armstrong (Patient Advocate), Mr Kim Miles (CEO BJD NZ) and Dr Chris Bossley (NAN Coordinator NZ), met with the New Zealand Deputy Chief of Mission a the Embassy on October 22, 2009. Ms Jane Coombs, the Deputy Chief, gave them a 45 minute reception, showed a very high interest in the work they have been doing, and asked perceptive questions about the NZ situation and the BJD organization there, they report.
 Norway: The Norwegian Ambassador, Mr Werner Stromman, was very well informed about the BJD as he was previously employed at the WHO and had been exposed to BJD work at that time. He was also aware of musculoskeletal disorders and the consequences for people, the government and the economy. For example, he spoke about the so-called ‘snow birds’ – older Norwegians who travel south during the winter months to escape the cold weather of the north. He was interested to look into research on the health care and rehabilitations implications of this. The Norwegian Ambassador said he would follow up with the Norwegian delegation, comprising Jakob Lothe and Jack Skolsvik, and that he would appreciate to receive more information about the BJD and MSD conditions.
 Portugal: The Portuguese NAN, Dr Pedro Cantista, along with the rest of the Portuguese delegation, met with the Portuguese Ambassador Mr Joao de Vallera for an hour and a quarter on October 22, 2009. The Ambassador was actually already aware of the BJD, its goals, and its programmes, as he had read the material previously sent to him and as a result of earlier discussions with the Portuguese NAN. During the recent meeting, they expressed to him their main concerns and objectives they wish to achieve back home in Portugal. They left with him a missive containing a list of 10 main points which mainly focus on improving clinical care, education and research, burden awareness in the population and education and information about musculoskeletal health for the public to be sent by him to the Health Minister.
 Romania: The Romanian delegation visited the Ambassador of Romania, Mr Cristian Gaginsky, at the Embassy on the afternoon of October 22, 2009. The visit was preceded by the Ambassador’s participation in our Advocacy Day Programme on Capitol Hill. During the afternoon visit, the Romanian delegation, including Nicolae Vlad Popa, (president of the Romanian Association of Patients) and the NAN Coordinator Mihai Berteanu gave the Ambassador the BJD Annual Report and explained to him the vision and the goals of the organization. They went to discuss the prevalence and societal and economic costs of musculoskeletal diseases in Romania and presented arguments in favour of supporting increased funding for research, prevention and rehabilitation. The Ambassador was very interested to help the Romanian NAN, and the Romanian Association of Patients to succeed in realizing the goals of improved prevention, earlier diagnosis and optimal treatment in musculoskeletal conditions in Romania.
On the evening of October 22, the Ambassador also joined the BJD event at the Canadian Embassy and had engaging conversations with Ms Amye Leong, and with Mr Colin Carrie, Canadian Parliamentary Secretary for Health, and with Dr Pedro Cantista from Portugal.
 Slovenia: On October 23, 2009 the Slovenian Embassy held its 4th Annual Global Health Forum, which the Slovenian delegation including Prof R Yothadina, was able to attend. This year’s theme was “Local is Global”, with collaboration with the Embassy of Italy. The panel discussion at this event addressed global health care issues and innovations in primary care technology, telemedicine, and health diplomacy. One of the topics was sustainable political solutions to health care reform facing the US and Slovenian situation. The Ambassador, Mr Roman Kirn, then welcomed the Slovenian delegation. He stressed that the Slovenian Government fully supports the mission of the BJD and the goals of the organization.
 South Africa: The South African Delegation including Prof Girish Mody visited the South African Embassy and had an excellent reception with the Ambassador and his health attachés. The discussion was very productive, they report, and it ended with an offer of support to promote musculoskeletal conditions, even in the face of pressing health issues such as the high prevalence of HIV/Aids.
 South Korea: Prof Yeong-Wook Song, NAN Coordinator of South Korea, visited the South Korean Embassy on October 22, 2009 for a meeting with the Ambassador, Mr Han. He explained to him the current state of care of patients with musculoskeletal disease in the country and provided him with selection of educational material describing preventative measures and some media about various programmes the NAN has initiated in South Korea. Not only did the Ambassador agree with the importance of improving public education, prevention and increasing research, he actually decided to join our Advocacy Day programme on Capitol Hill.
 Sweden: The Swedish Embassy welcomed the BJD delegation consisting of Ann Carlsson and Kerstin Källander, the Swedish Rheuma Association, and Professors Lidgren and Åkesson. They were greeted by the Deputy Ambassador Anna-Karin Olofsdotter and the Science and Technology Attaché Martin Wikström and spent about 45 minutes discussing muscular skeletal health care in Sweden. The Ambassador Jonas Hafström greeted the delegation while he was unable to attend the full meeting.
The representatives from the Embassy were very interested in the work from the Bone and Joint Decade and the issues raised. In Sweden, additional money has been given to prioritized research areas during 2008. However, muscular skeletal conditions were not on the list. Professors from Sweden and the Rheuma Association have written several letters to the appropriate ministers, however without receiving any reply. Hence, we forwarded the document describing the situation and asking the Embassy to forward our cause asking for a reply.
The Embassy is organizing a series of seminars each spring and fall. During fall 2009, which coincides with the Swedish Presidency of the European Union, the topic is Climate changes. The focus for spring 2010 will be Health. We were invited to submit topics. Furthermore, we learnt that the Science and Technology Attachés in Washington are collaborating and we hope that collaborative seminars can be arranged with other delegations. The Science and Technology Attaché Mr Wikström also attended the reception at the Canadian Embassy.
 Tunisia: The Tunisian delegation met the Ambassador on Washington DC. The meeting involved a comprehensive discussion of musculoskeletal health care in the country, research and the burden of road traffic injury. The second visit the Ambassador joined the Advocacy Day programme on Capitol Hill.
 United Kingdom: The UK delegation including Prof Anthony Woolf and Ms Ros Meek, visited the Embassy of the United Kingdom on October 22, 2009 and were welcomed by Mr Brian Farrar, the Science and Innovation Attaché for a meeting which lasted just over an hour. They explained the mission of the Decade and the importance of improving raising the profile of MSDs on the government’s health priority. The Embassy representative was very interested in the BJD’s work and suggested that the Embassy would be keen to help build partnerships and opportunities here in the States for UK groups working with musculoskeletal science. He particularly suggested partnering on Best Practice Seminars and Workshops on Research. However, this effort on their part would be contingent on musculoskeletal disorders being viewed as a health priority area back in the UK.
World Bank: Patient Advocate Robert Johnstone and ISC member Marcos Musafir visited the World Bank on October 23, 2009.After a brief explanation of the Decade’s objectives, goals and successful history, they asked what are the World Bank’s needs and requests in this area.
Dr Mukesh Chawla pointed to three major areas of World Bank interest: 1. The Aging Population; 2. Disability and Social Protection; 3. How to Reduce Poverty after a Disaster Occurs. The World Bank focuses its efforts on low-income countries. There is a concern to improve the care of chronic conditions which reduce work capacity, quality of life and income. “Is there a low-cost clinical solution coming?” is what they wanted to know. If yes, they are looking to engage in sustainable projects on a global level with an official organization taking the lead (such as the WHO). Their major challenge at this time is disability because, “frankly speaking, disability is more costly to countries than death, and it becomes a slow killer with the complications”. The World Bank is looking for an economic definition – numbers, data, lost income – caused by disability. They would be keen to see this type of study and would suggest beginning with 3 countries for a start. They also want to see what the possible sustainable solutions are to reduce the suffering – how, and when? They recommend that the BJD together with the WHO initiate this discussion by sending an official letter.
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