From the Editor
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With this issue of the journal we are introducing the the Middle East Primary Care Quality Improvement program (MEQUIP). Our time working on the MEJFM and various regional and global postgraduate medical education projects and strategies have seen standards, policies and institutions in the Middle East and North Africa greatly advance. However this is not the situation in all regional countries and there are still issues that affect all countries of the region.

The needs range from Middle East and North Africa trained doctors finding difficulty obtaining employment in many regional and international organisations, such as Medical schools and hospitals, lack of ongoing postgraduate education (CME/CPD) often required by these organisations and a huge variation in standards and prior education among practising doctors greatly affecting population health in a range of countries. The program will start in Nov 1st 2016. A detail paper on the topic is included.

A paper from Pakistan looked at the need fro primary care in Pakistan. The authors stressed that all over the world, family physicians take pride in their work of providing care at the first point of contact; the concept is very well established and refined in United Kingdom amongst many other developed countries. General practitioners in the UK are often known as the gatekeepers to the National Health Service (NHS). This is because of family physicians being the first point of contact for the patients. Majority of patients are managed in primary care, while a few who require further treatment are referred to the secondary care for further management. It has been known that the access to family physicians has a positive effect on the overall health of the patient. In this paper, the author discussed the disease burden, with brief introduction to the current healthcare provision and conclude with suggestions for implementation of family medicine as a speciality in rescuing the ailing healthcare delivery system of Pakistan.

A paper from the UAE discussed a national model for CME/CPD program for dentistry within primary care. The paper is part of an extensive survey done at the Emirate of Abu Dhabi. Recommendations and conclusions were presented by the author.

A case report from Libya presented a case of Acute hair matting (AHM) which is a rare acquired encountered condition in the medical setting, rarely seen, presenting as an acute sudden solid mass of irreversible matting of scalp hair on the vertex in otherwise healthy individuals due to vigorous shampooing or neglect of hair or parasitic infestations. Subsequently, other factors such as shampoos including herbs, conditioners are claimed to be the culprit as well. It's also called as Plica neuropathica. The condition is with irregular hair twists that severely entangled hairs abruptly formed in the scalp. In this case A 16-year-old otherwise healthy, single Libyan girl from the outskirt of Libya presented with a foul-smelling boggy mass of hair on scalp since few months, which she could not be combed for five days. The patient, who wears a head covering for religious reasons had a distinctive big head due to hair matting, and had not shampooed her hair in 6 days. She indicated that routinely washed her hair once weekly. Physical and laboratory evolution were done. Review of the condition was presented by the author.

A joint paper from Libya and Australia describes workforce characteristics of the only functioning disability rehabilitation service in 2012 Libya. This was the Benghazi Rehabilitation and Handicap Center. The focus of the case study was the physical disability services including amputee care. The study provides an insight into issues affecting disability services and revealed areas for future post-conflict workforce development and opportunities for disability service capacity building particularly in relation to coordinated information systems, qualification upgrades, in-service training, and development of inpatient discharge options including community based rehabilitation and supported accommodation.

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