Where there's will, there's a wayBMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7187.883 (Published 27 March 1999) Cite this as: BMJ 1999;318:883
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DEVELOPING COUNTRIES NEED RESOURCES TO PERFORM RESEARCH.
We acknowledge Dr Lede’s enthusiasm and efforts in conducting
research for years under difficult financial situations(1). However, this
voluntaristic approach to research in developing countries is neither
effective nor reflects the reality. Specifically in reference to the
centre he is describing, the institution is CREP, the Centro Rosarino de
Estudios Perinatales, Rosario, Argentina of which we are the current (GC)
and the former (JB) directors. We would like to clarify the sources of
founding for the episiotomy trial: although it is true that this trial was
not supported by a specific grant, CREP, as a free standing institution,
received support for institutional development that covered salaries,
infrastructure, computer resources, travel expenses for external
consultants , support to attend meetings and grants for research training.
This allowed us to implement trials of national priority, such as the
episiotomy trial, without the need for a specific research-linked grant.
This does not mean that trials such as this one do not have large costs
which are in many cases covered by national or international donors. The
progress of the episiotomy trial was systematically documented in our
yearly reports to WHO’s Special Programme of Research, Development and
Research Training in Human Reproduction which has provided yearly capacity
building grants to our centre for the past 7 years. Therefore, though some
of the costs that Dr Lede refers to were covered by individuals, the
largest components of this study were supported by institutions whose
contributions we clearly acknowledge in the publication of the trial:
International Development Research Centre, Ottawa, Canada and the Special
Programme of Research, Development and Research Training in Human
Reproduction, World Health Organization, Geneva, Switzerland (2). Given
Dr Lede’s mainly technical responsibilities within the trial, he may have
been unaware of the funding mechanisms of CREP. It is important that the
international community understands that despite all our willingness and
enthusiasm, scientists in developing countries have the same needs for
funding of our trials and projects as our colleagues from more advanced
research institutions in the developed world. Their help to secure more
funds for our work is greatly appreciated.
Guillermo Carroli, Director
Centro Rosarino de Estudios Perinatales, Pueyrredon 985, Rosario 2000,
Argentina, E-mail: email@example.com
José Belizán, Director
Centro Latinoamericano de Perinatologia (PAHO/WHO), Hospital de Clinicas,
Piso 16, 11600, Montevideo, Uruguay, E-mail: firstname.lastname@example.org
1. Lede R. Where there`s a will, there`s a way. BMJ 1999;318:883.
2. Argentine Episiotomy Trial Collaborative Group. Routine vs selective
episiotomy: a randomised controlled trial.Lancet 1993;342:1517-18.
Competing interests: No competing interests
My own experience learned me that RCT's are completly ignored in
Belgium. Obstetrics in hospitals keep on performing routine episiotomy
even though RCT's strongly recommend to abandone this harmfull procedure.
Patients with dyspareunie and other consequences of episiotomy are not
taken seriously. They are always placed under the wrong diagnose of
psycho-somatic diseases. The word psycho-somatic is abused to often. This
is a fine way for hospitals to continue there malpractice and for
pharmaceutical industries it increases the sale of anti-depressiva. It is
my believe that pharmaceutical industries have to much input in hospital
Obstetrics should be obligated to follow courses that are based on RCT's.
If they don't attend those courses there permit should be taken away.
This is in Belgium and perhaps in other country's the only way to insure a
better ans less expensive health care. Hospital policy should also be
based on those RCT's.
Competing interests: No competing interests