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To the Editor:

The basis of everything is personal friendship: an international, intercultural friendship, lasting for many years, and carried on by mutual respect for the culture of the others. One day in October 2002, on our way to the 8th Meeting of the Middle East Society of Organ Transplantation in Muscat, Oman, we all met in the transit lounge of the Airport in Bahrain. We talked, joked, and discussed recent developments in medicine, politics, and society. At one point, we focused on the need for medical education in developing countries. No one can remember who actually came up with the idea. It was somehow as if we all had it all together at the same time. Why should we not use our friendship, which already was so fruitful in research projects, for promoting medical education in developing countries?

We became quite enthusiastic with this idea and even had a tentative name for ourselves: the Bahrain Group. A few days later, we already had the seed of thought for our first project: the Performance of First Kidney Transplantations in Aden, Republic of Yemen.

After a few months and a lot of organizational work, while war was waging in Iraq, an international team gathered in Aden and performed 5 successful kidney donations [1,2]. While fighting the many obstacles we faced in achieving this project, we were even more impressed by the enthusiasm and empathy of young students that helped us in every possible way in treating the patients. Their interest in learning from us led them to surround us almost all the time, asking questions and seeking advice. Far from being disturbed by them, we enjoyed their willingness to learn as well as their excellence in executing our recommendations and advice.

The performance of the transplants also was accompanied by the group organizing an International Conference on Kidney Diseases and Transplantation, Aden University medical students played an active part in organizing this conference.

Our experiences in Aden helped us to focus and crystallize the thoughts and determination of the Bahrain Group in pursuing its aims and objectives.

As an interesting and eye-opening extra effect of this project, it was gratifying to observe that the whole venture has fired the imagination and hopes of the medical students and doctors in Aden with regard to their “hidden” talents and capabilities. Indeed, following the formation of the Bahrain Group, many of the medical students did several interesting research projects and studies that they would have not thought possible prior to their experience with the Conference and looking after the transplant patients. Additionally, this project was accompanied with the establishment of a new journal, now produced by Aden University, called the Journal of Tropical Nephrology and Urology. This gave further impetus to our wish to continue education for medical needs in Arab countries.

Following our return, we started to develop organizational ideas and exchange them by e-mail. Along the way, we changed the name of the organization to the “Vienna Initiative” and finally decided on the name, “Arab-European Foundation of Medical Doctors.”

Finally, one of us, Faissal AM Shaheen, was awarded a high Austrian medal of honor in recognition of his important role in developing medical cooperation between Austria and the Arab world. In his response to the Austrian Minister of Health, he announced that we would found the Arab-European Foundation of Medical Doctors. He himself supplied the basic funding to allow us to establish the organization based in Austria. FAM Shaheen was elected the first President of the Foundation; Robert D Fitzgerald, Hans Dill, and Abdulla Ahmed Al-Khader were elected as Vice-Presidents; Abdullah Bin-Mahfood became Treasurer; and Annelies Fitzgerald was elected Secretary of the Foundation. In a second step, we established subcommittees. Many prominent persons from the European and Arab medical community declared their interest and participated in these committees. These are listed in Table 1. This structure should allow us to concentrate on several topics, which should all merge in the common task: supplying medical education to those in need, or, as Abdulla Ahmed Al-Khader said: “Poverty should not be a barrier to medical education.”

While we started to organize the Foundation, the tsunami catastrophe got us working, even at that early point. In cooperation with the Austrian Sri Lanka Friendship Association, we collected money and medical supplies for the victims of this catastrophe in Sri Lanka. We were very content that all of these items would be transferred to those in need, without any collateral costs diminishing the value of our collection. The success was great, as we were able to finance the building of a preschool in a Sri Lanka village with the surplus money going to an SOS-children care village.

However, this campaign did not distract us from our goal of supplying medical education to those in need. Discussing and calculating costs, we soon realized that contrary to the more often exercised practice to bring students to European institutions—where many funds are used for housing, visa, and travel costs—a much greater benefit could be realized if the meetings were held in the countries themselves. In a meeting of the Foundation in Vienna in 2005, we formulated projects that promised great benefit for our cause.

Firstly, the Focus: Praxis program: 
Basically, a so-called best-practice program, this project does not seek to transfer knowledge and technologies from European to Arab countries. Instead, it seeks to select successful solutions/practices for specific problems that were developed in these regions [3]. These solutions could be shared and used successfully in many hospitals with similar settings. Focus:Praxis programs should guarantee quality of patient treatment and care, as well as advancing the organization and enhancing of interdisciplinary work 
- If you share money, it will become less - If you share ideas, they will become more.

Secondly, the COPe Program for healthcare professionals in the transplant sector: 
COPe stands for Communicational, Organizational, and Personal factors influencing the transplant process and the number of donor reports. The goal of COPe is to enhance professional communication in the field of transplantation through basic training of transplant coordinators. This will guarantee sensibile communication so we can develop concepts for the organization and the work with personal attitudes and values, not only with skills and tools. This is the basis for increasing the transplant rates and the available organs for transplantation [4].

Led by the great distances between our homes, our hospitals, and the places where those live who should profit from our work are, we developed a Web site, including an active forum for discussion and exchange of ideas, at http://www.aef.at.

Other ideas are ready to launch, but like all good things, they cannot live on their own. They need input from others, funding, and cooperation. As we all work in the field of transplantation, it is natural that this should be the first field, where our ideas should become real. We hope to be able to present our program at international meetings; obtain some of you as national, regional, or even local representatives; and along with the help of all of you—to acquire sponsorship.

Look at our Web site, and give us your ideas and help. With this already accomplished, the ideas once born in the transit lounge of the Bahrain airport will be able to make a difference.

References:

1. Fitzgerald RD, Fitzgerald A, Hakim NS. Aden kidney transplantation International Surgery 2004; 89: 164-165
2. Fitzgerald RD, Stockenhuber F, Fitzgerald A. Dealing with the uncertain and the unexpected: a report on the first kidney transplantations in Aden, Republic of Yemen. Annals of Transplantation 2005; 10(1): 46-49
3. Fitzgerald A, Thurnher H, Fitzgerald RD Best Practice Hospital – A Model for the Cooperative Exchange of Information Saudi Journal of Kidney Diseases and Transplantation 2000; 11 (1): 64-71
4. Fitzgerald A, Mayrhofer-Reinhartshuber D, Fitzgerald RD. The COPe™ concept for the training of communication in highly emotional situations. Annals of Transplantation 2004; 9 (1): 36-38