Domhnall MacAuley on Dubai writing and education workshops

Domhnall MacauleyOne of the last arrivals before the Icelandic volcanic dust closed European airspace, planes were parked bumper to bumper on the tarmac with thousands crowded into the airport terminal. As part of the BMJ outreach and partnership programme, I had just arrived back from Dubai where, together with Jenny Lewis and Mark Tracey, we shared a conference on clinical writing, Best Practice and BMJ Learning at the Dubai Health Authority.

Dubai is an extraordinary place. Disneyland for architects. Hotels of unprecedented luxury, man made islands to outshine the natural world, racecourses in the desert, ski slopes in shopping centres, huge moon tickling cathedrals of glass. This is a land where everything is possible.

The demographics are extraordinary. The population age profile has a huge bulge in the 20-45 year old age group of whom 80% are male, made up largely by the labour force. This is also reflected in greatly increased mortality rates in the 35-45 year old age groups, predominantly among the non national workforce. Trauma is a major problem and, overall, comprises 11% of all deaths. In marked contrast, the local population mortality graph rises gradually. There are about 1200 physicians and 50% are female. Obstetricians, of whom there are 40, are exclusively women and surgeons almost exclusively men. About two thirds of the 10k Dubai Health Authority workforce are expatriates.

Dr. Alaa-Elddin Eldemerdash, from the Dubai Health Authority emphasised the huge challenge of moving from habit and tradition to evidence and research. He was keen to look at international guidelines and how they could be adapted locally.  His medical colleagues, in the workshop on publishing research, were equally enthusiastic but, there is a poorly developed research infrastructure and little history of research. Bright, enthusiastic and committed doctors, they were keen to publish but not sure how to start.

We discussed different strategies. Researching aspects of health care of local relevance is important and we agreed that this might be best suited to a local journal. This was their first problem: when sent for peer review it was usually assessed by reviewers outside the local environment who often lacked local understanding. But, they also wanted to go beyond local journals and aim for the international literature. We discussed entry level publication in the BMJ and what they might target. The first step might be a Rapid Response and a good topical response with data is an important part of post publication peer review. The BMJ doesn’t publish case reports other than as a “Lesson of the Week” or a “10 minute Consultation”- although there is a separate BMJ Case Reports Journal. So, we focused on how they might target the “Practice” section of the BMJ. We decided the best strategy in finding a topic for a “Lesson of the Week” or a “10 Minute Consultation” would be to identify a local topic of global importance. One possible area might be women’s health in an Islamic population- a field where they would clearly be experts and their experience would have resonance throughout the world. Similarly, in searching for a research topic, the unprecedented levels of trauma at Al Rashid Hospital offer another field of unique experience.

But what I learned most in my short stay was the narrowness of my own preconceived views and, in particular, of women in this part of the world. I had expected them to be slightly inhibited and reserved. Most workshop participants were women and they were very bright, articulate, and extravert professionals of considerable elegance and sophistication. Our discussions were dynamic, lively, and engaging. They are clearly ambitious, committed, very able and will lead future developments in health care. As in many countries, the future of medicine is female and, looking at what has already been created in this country, the potential is limitless.

Domhnall MacAuley is primary care editor, BMJ