Dear all:

Some of you have mentioned that you don't think it is fair to have as high of standards for the 
IBCLC because it may be difficult for those in other countries to get these qualifications.  Well 
intended thoughts, but (PLEASE DON"T TAKE OFFENSE) also unintentionally patronizing.  

First, I have to say that I have many colleagues in different countries who are exceedingly well 
trained and did so without any compromise in standards.  If I were to need cataract surgery and 
could afford the airfare, I would go to Madurai India to the Aravind Eye hospital because they see a 
volume of patients far greater than any ophthalmic surgeon in Manhattan.  They have great 
training.  Ditto when I think about the Famine Early Warning System in Niger - many excellent 
epidemiologists who could have been interviewed by the news media but weren't.  They would 
have told the news much more about the precipitating causes.

Second, WHO and UNICEF did run a training course on breastfeeding for health care professionals.  
If my memory serves me correctly, that course was for 30 days. Far longer than my 7 days of 
course work for my IBCLC.  Materials already exist that I'm sure could be adapted. 

Third, there are many many excellent organizations that work in developing countries (some of 
them local nongovernmental organizations) that are highly skilled in training. 

With the right mix of collaborating NGOs and interest, it would not be that difficult to set up such 
a training program. It would take, perhaps a few well chosen professions who might follow 
through a training course (I'm thinking Norway rather than the US where we are not as 
sophisticated in supporting breastfeeding).  Then a few grant proposals - and they would be able 
to generate their own programs.  I am sure that this process would teach us much as well one 
always learns from differing perspectives.  

We do not need to water down the standards for other countries.  We do need to look to existing 
structures to build a process for creating opportunities.

Susan E. Burger, MHS, PhD, IBCLC

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