Developing the Model: A Perspective from the Developed World

Abstract

Thirty years ago, as a second-year medical student, I spent a summer working with WHO in an isolated Indian community in Guatemala. I soon realised that not only was I ignorant, but misdirected. The main issues there were not medical care, but primary and public health; the lack of clean water or adequate sanitation, no immunisation programmes or contraception and inadequate nutrition. I decided to train in family medicine and public health and went to Seattle to ioin a new programme callcd VAMI, which hoped to address the problems of under-served rural populations in the vast rural areas of the nofthwestern United States.