|Year : 2009 | Volume
| Issue : 2 | Page : 377
Making a Difference: An Interview with Pauline Vluggen
Associate Editor, Education for Health
|Date of Submission||18-Jul-2009|
|Date of Web Publication||28-Jul-2009|
Associate Editor, Education for Health
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Vluggen P. Making a Difference: An Interview with Pauline Vluggen. Educ Health 2009;22:377
Pauline Vluggen is often seen as ‘the mother of The Network: Towards Unity for Health‘. Pauline has been involved in The Network since longer than anybody (including herself) can remember. As early as 1981 she attended the Network conference at Bellagio, Italy. Since then she developed the Network Office, based at Maastricht University, the Netherlands. When The Network grew into the full professional organisation it is nowadays, she assumed the responsibility of Executive Director. For these reasons Education for Health saw it fit to ask Pauline to be interviewed. She has made a difference!
This interview was conducted in Dutch on 18 June 2009. It was translated, edited, abridged and then reviewed by the interviewee.
Jan van Dalen
Associate Editor Education for Health
How did you become involved with The Network?
I was the secretary of Co Greep, the Dean at Maastricht University's Medical Faculty in 1977. He was also the Secretary General of The Network, and Ine Kuppen was the Network’s secretary then. The first conference I attended was at Bellagio in 1981. There were some 20 participants! Then I was away from the University for three to four years. When I returned I shared an office with Ine and became a colleague of Gerard Majoor. Way back in the 1980s Gerard, who later was to become Associate Secretary General and Secretary General of The Network, and I set up various ‘internationalisation’ activities within the medical school, among which were student exchange programmes. It happens that the Network Office at that time was housed in the same office as ours. Consequently, Gerard and I also became increasingly involved in the Network Office, and when Ine moved on in 1990, I became the Network’s secretary.
It was like a family at that time. The conferences took place once every two years. The first conference I organised was in Pattaya, Thailand in 1987. I was not able to attend that one. Two years later, in 1989, I organised and attended the conference at Kerkrade, the Netherlands. From then on I was involved in all conferences until I had to miss the latest one in Colombia last year, because of health reasons.
The Network is a truly international organisation, so we needed to be able to communicate effectively with people in all parts of the world. Compared to the incredible communication resources we have today, communication at that time was an enormous challenge. Most was done by mail, which obviously took much time. We had to send a programme book to the conference site weeks in advance of the conference. Changes in the schedule had to be handed out at the beginning of the conference, which inevitably led to some confusion.
In between conferences, communication was kept up by means of The Network Newsletter, which has been in existence since 1982. Later the journal Education for Health was founded. This became the forum for the dissemination of more scientific information that The Network had to share. We did not have our own telex but we could use the University’s machine. Even when the first fax was installed at Maastricht University this was an enormous improvement!
Fortunately, Vic Neufeld and Beth Alger, Network members from Canada and the United States were already involved in electronic communication. They helped us begin using the most modern means of communication at The Network. Obviously, the ease of communication was also influenced by the facilities at the other ends.
The Network was founded with Tamas Fülöp’s vision that education for the health professions should be adapted so that it would better serve the local needs. Most curricula in developing countries were copied from the English (medical) curricula. These curricula were not necessarily designed to address local healthcare problems.
I think that the conferences and the journal are the two most important means by which The Network contributes to helping schools shape their curricula to the local needs. The conference provides a real platform for the exchange and sharing of ideas, formats, research and wild plans. All over the world, in the early years of The Network, there were individuals with a strong mission to redirect health professions education. However, these individuals were quite alone in their own institutions. The Network conference provided a forum where they could meet and team up with likeminded individuals from all over the world. Work and material was exchanged and many eyes were opened to the way others had been doing things. Two innovations in medical education were prominently discussed and further developed: problem-based learning and community-based education.
Education for Health is the other medium by which the good work is made known. It is not sufficient to exchange findings among those who happen to be present at a conference; research findings must be shared with a broader audience. I think that Education for Health is in many ways unique in pursuing the Network’s mission. There is no other journal that addresses health professions education with the mission of providing more appropriate, tailor-made healthcare to those in need. Education for Health publishes articles about modest attempts to improve health professions education and healthcare and articles in which the impact of these efforts is evaluated. Education for Health has always carried contributions from authors from all over the world, which is another unique characteristic. Many of the authors of important work from developing countries have very little experience in writing for publication in an international scientific journal, so Education for Health has always put much effort into guiding and assisting relatively inexperienced authors towards writing publishable papers.
The Network has always had its secretarial Office at Maastricht University. This would have been an easy opportunity to put Maastricht in the spotlight. How did you feel about that?
It has been the policy of the Network leadership to have a stable Office at one institution, instead of rotating that responsibility between various members’ institutions. Since Maastricht volunteered to provide the Office, this offer was gladly accepted.
We have kept the Network Office strictly neutral. I can say with full confidence that we have worked hard to avoid favouring Maastricht. We have listened to our members and to the people who shape the organisation. Maastricht policy makers have not been part of the Office. There have not been an exceptionally large number of Maastricht speakers at our conferences nor special sessions about ‘how things are done in Maastricht’.
How did the work at the Office influence you?
The fact that I was able to run the Office for so long has had a deep personal impact on me. I joined the Office as a relatively young, inexperienced secretary in her twenties. My only international experience at that time had been going on holidays to Spain with my mother. Of course I was aware of the inequality of resources in the world, and I knew, theoretically, that I was privileged just by being born in The Netherlands. I had always had the urge to go out and do something in order to alleviate the troublesome circumstances in other places. At The Network I actually met people who made a difference, who did something. When I travelled on behalf of The Network, I could really experience the differences in circumstances in the world. I could not help but feel how unjust this is. Network members ‘have their heart in the right place’. They go out of their way to help change inequality. This has had a big impact on my life.
A popular part of every conference are the site visits during which participants have an opportunity to visit local clinics, schools…. By the site visits the local organisers can give a true inside view into the local healthcare and educational circumstances in their country; something that we are not often able to really understand if we are from abroad. An annual highlight for me is preparing for these site visits. About six years ago when my husband, René, and I were in Uganda exploring opportunities for site visits, we were touched by the limited opportunities that schoolchildren in Uganda had, compared to our part of the world. We asked a friend to explore possibilities to ‘adopt’ a school with especially limited resources. Our friend was involved in a small hospital in Villa Maria, a village in the south of Uganda, and she pointed out a school in the neighbourhood. René and I have taken that opportunity and ‘adopted’ this primary girl-school in Villa Maria, where we hope to contribute a little in our own way. We help the school acquire teaching material and organise trips, so that these young Ugandan children can see elephants for the first time in their lives! So far we have sponsored 18 girls to continue their education at a good secondary school that will prepare them for an academic or professional career. The first girl, who will complete secondary school in one and one-half years, has indicated that she would like to become a medical doctor. Sounds good to me! Our work in Uganda has no doubt been strongly influenced by my work for The Network.
You have run the Network Office for the vast majority of the 30 years that it has been based at Maastricht. I know you don’t like this question, but what do you think you have contributed to the development of The Network?
Indeed I don’t like this question… I have always seen the Office as supportive and serving. I think I have contributed enthusiasm and stability to the organisation. I have served as the organisation’s memory. I think the atmosphere at the conference is one of the positive features of our organisation. People tell us they feel welcome, and they return to the next conferences. That gives me some confidence that their experience has been pleasant and worthwhile for them. I think the basic attitude of positivism and encouragement is fairly unique in our conferences. I have tried to contribute to that. We have not been ‘conference-robots’. When people come back to subsequent conferences, I know them and I can welcome them personally. I have seen the pleasant atmosphere contribute to many friendships and bilateral collaborations. I also have always encouraged the participation of students at the conferences. The next generation should carry the torch after us.
I think that we contributed to the increased quality of the conference. Tribute goes to Henk Schmidt who invented the unique format of the Thematic Poster Sessions, where poster presenters have the opportunity to elaborate on their work, respond to questions and learn from the feedback and comments of others. You can see that this format is increasingly copied by other conferences! And we have created a better system of quality assurance of the abstracts. True to the Network’s philosophy we don’t just reject poorer abstracts but we try to mentor the authors so they can improve the quality of their work.
Last year health problems came up in your life, and you had to miss the Colombia conference. How did you feel about that?
Painful! It was a painful process. It had not been my choice. It is still difficult to separate this feeling from the feeling of being ill, which made my life miserable in the first place. I was not worried whether the conference would be run well; I knew that was in good and very capable hands. I missed basking in the warmth of the conference.
Perhaps it also gave you some distance to reflect on The Network?
Yes it did. Between the tears I cried because I couldn’t attend, I could reflect a little on how I saw the organisation.
I have two major loves in my professional life: The Network and Maastricht Faculty of Health, Medicine and Life Sciences. As I grew older, these two loves started to compete. I had been given the responsibility of Head of Educational Affairs, and obviously, I also wanted to do a good job there.
I am not the 20-something-year-old girl anymore. Becoming ill confronted me with the limitations I must face. I cannot do everything anymore. There is an end to my capacity to invest much of my life in both obligations. I had to make a choice. Choosing for The Network would have excluded my work for the faculty, whereas choosing for the faculty would not exclude travelling, meeting with friends and continuing my international work. So I chose to step down from the Network Office. But it took some guts, I can tell you that…
So it was a positive choice for the faculty in Maastricht. Was there not any part of that decision that you felt happy about? In other words, what do you see as threats for the organisation?
Well, when we started, the small organisation was like a family. The leaders (Zohair Nooman, Esmat Ezzat, Vic Neufeld and later also Art Kaufman), had vision. They could inspire others, and they listened well. It was a truly democratic approach. Later The Network developed into a much bigger organisation with different leadership. I think I first noticed the symptoms of that growth when there was an Executive Committee (EC) meeting in New Mexico. That must have been around 1992. For the first time I noticed competing positions in The Network. Did we focus exclusively on education, or did we have to expand our horizon and include the delivery of healthcare itself, as a focus of attention? For the first time people started taking positions rather than listening and debating so that they could democratically come to the best solution.
By the way, an indirect result from this meeting was that Towards Unity for Health was taken up by The Network, in 2002.
We have always been a people’s organisation. The leadership shared their vision and listened to the members. They had a dialogue. Nowadays I see less of that. The EC now issues a ‘declaration’ or a ‘resolution’, and I do think these are important. But these are not comparable to the position papers that we used to produce. Position papers were prepared by dedicated members, and they started a discussion. Every now and then I miss that.
Another threat I see is that we are an organisation of volunteers. We are inspired at the conferences but when we go home our other obligations soon interfere. Many members and leaders are so committed that they spend much of their free time with activities for The Network. Much of the progress in the organisation depends on good will. Especially now that the Network Office is in transition, this makes us very vulnerable. I am convinced that The Network will survive this transition, but currently I see it as a difficulty.
The organisation’s finances are another cause of continuous worry. In the first years of existence the WHO provided financial support and Maastricht University has contributed funds for 30 years. But this funding has come to an end. The Network will need speedy and professional support in order to become financially stable.
If all goes well, what do you think will be the maximum effect of The Network as an organisation?
I think The Network does have influence on the quality of health professions education and (perhaps less so) on the delivery and management of services. I think if all goes well, the Network’s influence in these fields can continue and increase. I think The Network needs professionalisation and a larger membership. I think that many good effects can come from this. To accomplish this I recommend that the leadership listens well to the members, goes out and talks with everybody at the conferences. To the members I recommend that they remain active participants: attend conferences, publish, join task forces and pay the membership fees! The organisation is worth it!
Thank you very much for sharing your thoughts Pauline, and for the priceless work you have done for The Network. We wish you all the best!