Editorial: Evidence Based Medicine: The Foundations of a Good Healthcare System

Author(s): Dr James Ayrton BM, Dr David Attwood BM, BSc

James Ayrton and David Attwood are UK doctors currently working in Juba Teaching Hospital as part of the St Mary's Juba Link - a partnership which seeks to promote continuing professional development, particularly through training in secondary medical care.

We vividly recall on our first days as medical students being told that half of what we were about to learn in our degrees would be obsolete by the time we graduated. Such is the pace of advancement in medical knowledge and practice. A brand new edition of a medical textbook, by the time of publication, is already many months and perhaps years out of date. It is useful to reflect on these facts as we consider the place of peer-reviewed journals, such as the Southern Sudan Medical Journal, in our continuing professional development.

Firstly, medical therapies are constantly evolving; new drugs are being developed and existing treatments re-evaluated by the international medical community. Evidence based medicine has become the cornerstone of the modern medical approach, and it's crucial to have a means of keeping abreast of the latest developments and keep our practice up to date. We owe this to our patients.

Second is the issue of applicability. It is good to read about approaches to medical management in the UK or even Northern Sudan, but the fact is our disease burden is different, our available resources are different, the cultural factors are different, and perhaps even the physiology of our population is different! This highlights the importance of having our own national journal, as the means to discuss and learn from each other about the specific needs and management issues of our population.

Thirdly, the ability to independently publish peer-reviewed studies and clinical audits is extremely important. The first step to making any real improvement in a system is the ability to take an honest look at how things are now and to publicly acknowledge the strengths and deficits. Only then can any meaningful progress be made. To bury one's head in the sand will never result in any improvement, and the published medium of scientific data is a powerful opponent to apathy and denial.

Lastly, it's important to recognise the value in building a national community of medical practitioners. We are all working towards the same goal: the healthcare of the people of Southern Sudan. This journal provides a forum for co-ordinating the discussion and dissemination of ideas, linking individuals, healthcare centres and hospitals, spanning primary and secondary care to help facilitate teamwork.