Committee Reports

Update and New Initiatives from the Electronic Communications Committee

The Electronic Communications Committee (ECC) provides over sight for two major ISTM activities, the TravelMed listserv and the ISTM website.

The TravelMed listserv is a closed list electronic discussion forum which provides private discussion space for ISTM members. It allows members to discuss interesting or troublesome clinical cases and new research and clinical developments, and to identify travel medicine resources on a global basis. The 450 current subscribers are in more than 40 countries and the discussions are lively and informative.  One or more subscriber always seems to have the requisite expertise needed or lives in or is experienced with a locale under question. 

Two major enhancements are in store for the listserv in the coming months.  First, ECC member Phil Scappatura has collated into archive files all listserv discussions since 2001, and has sorted them by topic. These files will be available shortly for download on the new "Members Only" section of the ISTM website (see below).  This will lend a permanence to some very high level discussions on hot topics in travel medicine and will act as an ongoing resource.  Secondly, the signup and change of e-mail addresses for signing on to listserv will be dramatically simplified by the end of the year. Signup will merely involve checking a box on each member's listing in the online membership form in the Members Only section of the website.  In the meanwhile, for those who want to join listserv the instructions are found on the TravelMed tab on the current ISTM website. We invite members to join.

Our ISTM website continues to be a tremendous success.  There are more than 20,000 total visitors and 15,000 unique visitors a month, 8,000 of them visiting the Clinic Directory. Our success is even more remarkable because unlike many larger societies or societies that charge far higher dues, ISTM has no full-time staff devoted to maintaining our website. We depend on committee volunteers.

Furthermore, we are pleased to announce that by November a completely new website will be in place. An allocation from the ISTM annual budget is enabling us to finance some contract programming and a graphical overhaul to develop a state of the art SQL server web-enabled data base. This is in the final stages of development. The website project is under the supervision of web-site editor Karl Neumann and the database is being overseen by the ECC directly.

The new database will take over all administrative functions of the ISTM and will be directly accessible to all members.  The October membership renewal mailing will contain a login/password that will allow each member to access a Member's Only section.  This section will contain the online Journal of Travel Medicine, the TravelMed listserv archives, and a searchable ISTM membership directory. Members will be able to renew online as well as change information in their membership listing and any ISTM Travel Clinic Directory listing that they have elected to post, as often as they wish. (The ISTM Travel Clinic Directory will remain open to the public as it is now.) Listings will show committee memberships, CTH certification and will allow options to join TravelMed listerv and to receive a printed version of NewsShare. Because the whole system is database driven each member will be able to use only one e-mail address for all ISTM functions.  Existing listserv subscribers have already had their TravelMed e-mail addresses matched to their e-mail addresses in the membership database (a slightly painful process for some).  We have compared the functionalities that ISTM will offer to that offered by other societies and, we believe, we will be at the leading edge.

Over the years, a number of ISTM members have suggested various ideas for "commercialization" of the ISTM website as a potential revenue stream. The issue was once again discussed by the ECC in New York. No satisfactory model that would benefit ISTM emerged, mainly because of the desire to maintain ISTM's status, stature, and image as a non-profit scientific and academic society remains paramount. The major strategies for commercialization proposed have involved co-branding with a major industry sponsor and the concept of offering a "shopping mall" with links or advertisement space rented to ISTM members and non-members engaged in various entrepreneurial activities. However, the revenues from a "shopping mall" would not be substantial and would likely be offset by having to pay a staff person to administer the space.  Issues such as checking legitimacy of businesses, assigning positions of links and dealing with ensuing disputes, billing, and legal issues (an ISTM member denied a listing, for example) are very time consuming. Major sponsorship would likely come with some strings attached and would likely dilute revenue already coming to ISTM for sponsorships during the ISTM conferences. Also, one of the major reasons for the high volume of traffic on our website and on the Clinic Directory is because of direct hyperlinks from such high profile, high volume authoritative websites such as the American CDC's Travel Home page. We would likely lose these links if our website was felt to be commercial in nature.

The ECC will present a report to the mid-term Executive Board meeting in February 2004 on the feasibility and cost of using a service such as elections.com for online balloting for the next ISTM elections.

The ECC welcomes feedback and suggestions from any ISTM member at any time.

David O. Freedman, MD for the ECC

Report of the ISTM Publication Committee

The Publications Committee (PC) is charged with keeping an eye on all written communication using the logo of ISTM. The PC also collaborates with the Electronic Communications committee. A number of possible initiatives have been proposed by Brian Decker, our publisher, and other ideas have been generated out of the recent Executive Board meeting:

Guidelines for the practice of travel medicine. These guidelines would be published in JTM. The Executive Board believes it is time for ISTM to stand forward and be fully recognized as the authoritative body that it is. Clinical Infectious Diseases is already developing such guidelines.  National differences in practices can be accommodated in guidelines that are flexible enough to recognize the commonalities while accommodating the differences. The Professional Education Committee is considering this charge, and a member of the PC will with this committee.

A booklet for the education of travelers.  Dr. Steffen published such a booklet on behalf of ISTM in the past.  While the art work was debated, the content of the booklet was very well received.  The Industry Liaison and the Public Education Committee have responsibility for this booklet.  Our nurses have expressed a strong desire to take the lead on this project.  It should be a notable membership benefit when completed.

Oversight for content and appearance of our journal.   The PC will be mindful of the advertisements in our journal and whether they are ethical and appropriate in their claims and whether our authors have fully disclosed conflicts of interest.  With the change in editorship of JTM, consideration should be given to changing the appearance of our journal.  Likewise, the idea of a name change to the Journal of Travel and Migration Medicine should be seriously debated.

The Membership Committee needs to have written products (brochures, banners, etc.) that support the solicitation of new members.  Improving membership is a major concern of our new president.

Anyone wishing to participate on the Publications Committee and assume some responsibility for helping us achieve these goals should please contact me.

Charles D. Ericsson, MD
Chair, Publications Committee
charles.d.ericsson@uth.tmc.edu

ISTM Migration Health Committee

A meeting was held during on May 7, 2003 in New York. Present were: Brian Gushulak (Canada), Christoph Hatz (Germany), Louis Loutan (Switzerland), Anne McCarthy (Canada), Rogelio Lopez-Velez (Spain), Elizabeth Barnett (USA), Francesco Castelli (Italy), Doug MacPherson (Canada).

Review of Activities: The meeting took place during CISTM8, a dynamic undertaking marked by several sessions, workshops, presentations and activities that reflected the increasing interest and importance of the health migrants and other mobile populations. The sessions and workshops on issues of migrant health were well attended and the quality of the presentations was impressive.

During the past year the Committee has had difficulty in completing many of the tasks it set for itself. The generation of publications and reference documents has been difficult for Committee members given their respective workloads. Reviewing the pressures of time and external commitments, some members suggested that these goals were perhaps too ambitious and the Committee should consider less complex undertakings.

It was almost universally accepted that health issues in migrant populations continue to be an area of growth and increasing interest both with ISTM and in the broader medical community. Those interests extend from issues of screening for disease in practitioners' offices to the public health principles of population mobility. Surveys of academic literature demonstrate that the amount of published material dealing with migration health is expanding, reflecting the growing number of providers, researchers and policy makers who are now involved in the subject.

Considerable discussion focused on appropriate methods of trying to meet the diverse challenges within the capacity of the Committee.

Challenges: Discussion reinforced the need for simple clear guidelines and instructions for practitioners who deal with migrants. It was noted that the relevance of health issues in migrants continues to increase, particularly for those who deal with refugees and asylum seekers.

Challenges inherent in the field are created by the significant differences and variation in migrant populations between providers and national locations. The political and social factors that affect and stimulate migration are diverse and the resulting population movements are correspondingly diverse. This makes the generation of standard reference material a complex task. For example, the screening instructions designed for a group of asylum seekers or illegal migrants from rural tropical Africa would not be totally appropriate for similar migrants from Eastern Europe. It was noted that Committee membership might need to be expanded or altered to expand capacity and perspective.

Issues for Action: The issue of the role and mandate of the Committee: continued to generate comment and it was suggested that the Terms of Reference initially drafted in Innsbruck be re-circulated for consideration and comment. Following that process the Terms will be proposed for formal adoption by the subcommittee and referred to the Executive Board.

Committee Products: After some consideration the subcommittee agreed to work towards a modular approach to migration health issues for ISTM. The modular approach was felt to have several advantages:

(a) It allows committee members to work within their direct sphere of knowledge.

(b) The products are of a size that may be easier for committee members to produce.

(c) The concept allows for continuous integrated growth of what could become a complete syllabus or reference manual on the subject.

(d) The concept allows for natural use of electronic media and easy distance learning opportunities and extension into the less developed world.

Action Plan:

It was agreed that members would, within three months, develop draft presentations. The presentations will be in PowerPoint format. They will be from 10 to 20 slides and will include no more than the relevant references. The individual modules will be authored by one individual but will require the approval and adoption of a majority of the subcommittee before being considered for external use.

Following completion, each draft will be circulated to the full subcommittee for comment and adoption as a committee module. Adopted modules will be presented to the Publications and Electronic Communications Committee for consideration as web-based components of the ISTM web site. The authors and the subjects of the initial modules:

Christoph Hatz: The Migrant Medical History
Louis Loutan: The Use of Interpreters in Clinical Situations
Elizabeth Barnett: Immunization in Migrants
Anne McCarthy: Screening for Infectious Disease
Brian Gushulak: The Phases of Migration

The process will be reviewed in one year to assess its success.

Other Business:

New Members: The Committee welcomed Dr. Rogelio Lopez-Velez from Spain and Dr. Anne McCarthy from Canada to the group.

Next Meeting: Subcommittee members will look for a potential venue at another event attended by several members as a site for a meeting in 2004, to try and avoid the 2-year hiatus between ISTM Conferences.