The Editor
COA Bulletin
Canadian Orthopaedic Association
4150 Ste Catherine St. West, #360
Montreal, QC  H3Z 2Y5

Dear Sir:

I was pleased to read that Dr. Myles Clough is enthusiastic about donating time to orthopaedics in the developing world and I enjoyed reading his article (Surgical Implant Generation Network, in COA Bulletin no. 72, pp 10-11). 

There is one point, however, that requires clarification.  Dr. Lew Zirkle did not train the first cadre of orthopaedicc surgeons in Indonesia in the 1980s.  Dr. Alan McKelvie and Orthopaedics Overseas, Washington D.C., started an orthopaedic training programme in Djakarta during the 1960s.  The government of Indonesia assigned trained general surgeons from various cities such as Surabaya, Solo and Bandung to this programme and these trainees formed the nucleus of orthopaedic and trauma practice on their return to their own hospitals.  Dr. McKelvie, a clinical professor at George Washington University, continued this training programme through the 1970s and 1980s.  With the help of Dr. Ron Beetham of Australia, he sent many volunteer orthopaedic surgeons from North America and Australia for several weeks at a time with a planned curriculum.  The candidates were examined by outside examiners in conjunction with the Ministry at the end of their training.

To a lesser extent World Orthopaedic Concern was also involved in Indonesia during the late 1970's and 1980s.  I myself spent several weeks in Malaysia and Java during 1989.

Sincerely,

John V. Fowles, O.C., MB.BS, (Lond), FRCSC
West Bolton, Quebec

Dear Editor,

I mentioned Dr. Fowles' comment to Dr. Zirkle and got the following response: "I was in the Army in 1973 when I traveled to Indonesia to teach orthopaedics.with Care Medico. There was one trained orthopaedist at the time in the entire country - Dr. Soelarto.

Four trainees were in the first class as described by Dr. Fowles.  These were the next trained group of trained orthopaedists. Dr. Subroto, who has just retired, was in this class. I returned many times. In l980 Paul Spray of Orthopaedic Overseas asked me to be the programme chairman. Dr. Fowles is correct in that many orthopaedists from the US, Canada and Australia participated in this training programme. All of them contributed to this effort."

Many thanks,

Myles Clough, M.D., FRCSC
Kamloops, BC