Thanks Lynn (from South Africa) for your comments about the
"international" relevance of the IBLCE exam.  It is a subject about
which I feel passionately, and constantly strive to address in my
capacity as the IBLCE Regional Administrator serving Asia and the
South Pacific (including Australia). IBLCE is very conscious of
international issues and they are covered well in the Organisational
Goals and Strategic Plan. Lynn, I will respond to you privately at
more length, but I will briefly address here a few issues you have
raised. Those interested in this topic may also like to read the
article I wrote for IBLCE News in JHL June 1995 - The "I" in the
IBLCE.

The exam questions and slides/photos are contributed by IBCLCs from
all over the world. The Exam Committee each year has at least two
non-Nth American members, and the exam is checked the IBLCE Board,
which also has delegates from Australia, Europe and the UK. In
addition, the draft exam goes through various editing (and
translation) processes by non-US subject matter experts. Part of
this process is to remove bias for candidates in non-western or
developing countries. Where necessary, a culturally adapted version
of the exam is offered, but the degree of difficulty is the same.

Yes, candidates isolated from access to quality up-to-date
knowledge, and those working in places where outmoded practices are
still the norm, are at a disadvantage. But mothers deserve the best,
so IBLCE will not compromise standards by producing an easier exam
for the disadvantaged.

In my region, Hong Kong and Singapore have been very active in
recent years, and interest is growing in Japan. In all these places,
it is usually one person's crusade to improve lactation management
and education that has got the ball rolling - There are certainly
some unsung heroes out there! Once there is a group of IBCLCs they
tend to support each other, but while numbers are small it is much
harder.

Australia has about 1100 IBCLCs (1 per 237 babies born each year -
the highest ratio in the world). A further 283 candidates sat this
year, including 24 recerts. ALCA (full membership open only to
IBCLCs) is the main professional support group, with several smaller
Colleges of LCs opened more recently.

Ros Escott
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