I would like to congratulate you for the very comprehensive and balanced feature article in the Sunday Magazine of 8 February entitled "Family Medicine practice Important to the Society”. 

It was a very careful description of the role of a Family Physician in communities around the world, and highlighted the most critical elements of that role, such as a close doctor-patient relationship of trust and confidence, continuous care to all members of the family regardless of age or problem, active involvement in the community with their patients. 

As the article pointed out, this speciality forms the core of the very effective health system of the country of Cuba. However, as a specialist in Family Medicine from the University of Colorado Denver (USA) who has been collaborating with the postgraduate medical programs of the National University of Rwanda, I would like to take issue with the opening statement that "Family Medicine is a speciality ...that has not been practiced and promoted in Rwanda and developing countries”. 
The National University of Rwanda Faculty of Medicine has been actively developing a Masters of Medicine program in Family and Community Medicine for the past 2 years.  One of the first acts of the newly appointed Dean of the Faculty of Medicine, Prof. Herbert.

Nsanze, was to create a new Department of Family and Community Medicine (FAMCO) directed by a community medicine specialist, Dr. Longin Barongo. 

This Department has systematically developed an outstanding Masters of Medicin postgraduate program which has been requested, approved and supported by the Ministry of Health, and is now active with 7 postgraduate students since August 2008. 

These students will focus on the various elements mentioned in the article for a total of 4 years, and upon completion of the program should be able to deal effectively and scientifically with most of the common problems that present to a Health Centre or District Hospital, including complicated obstetrics, paediatric problems, emergency surgical issues, and common medical problems. 

In addition, they will be able to apply sound preventive health measures in the community and direct the team of community health workers that now are a major force in rural Rwandan health care. 

80% of their training will take place in one of several district hospitals known for their quality of patient care to better equip them to deal with the most common health issues of a community. 

At the request of the Ministry of Health, the program will progressively increase the number of physicians admitted to the program to a maximum of 20 students/year, to expand this cadre of well-trained generalists as rapidly as possible.

Rwanda is only one of many African countries that are in the process of developing the speciality of Family Medicine - there are well established programs in South Africa, Kenya (Moi University), Uganda (Mbarara and Makerere Universities), and Sudan, and developing programs in the DRC, Tanzania, and many others. 

These programs have banded together for collaboration and interchange in an organization called PrimaFamed, whichwas organized by the Dept. of Family Medicine of Ghent University in Belgium and funded by a grant from the European Union. 

Together, they are developing a consensus on the profile of the African Family Physician, which is distinctly different from Family Physicians on other continents.

It would be very effective to follow up this introductory article on Family Medicine with a more in-depth description of the Family and Community Medicine (FAMCO) program of the National University, and the role that these new specialists will play in improvement of the health status of Rwandans. 

Please, feel free to contact Prof. Herbert Nsanze of the NUR Faculty of Medicine for more details. Thank you again for bringing this important issue to the attention of your readers!

Prof. Calvin Wilson
Associate professor of Family Medicine
Director - USAID Rwanda Medical Training Initiative, with NUR University of Colorado Denver School of Medicine
Denver, Colorado USA