World Federation of Associations of Pediatric Surgeons: An historical overview 1974-2007
As part of the WOFAPS History of Pediatric Surgery series, we are proud to share a collection of articles, lectures, presentations, videos, and historical archives that celebrate the pioneers, milestones, and evolution of our specialty.
Through preserving and sharing the history of pediatric surgery, we honor those whose vision and dedication laid the foundations for modern pediatric surgical care while inspiring future generations of surgeons around the world.
Join us as we explore the remarkable journey of pediatric surgery through stories, historical lectures, rare presentations, and educational resources from across the global pediatric surgical community.
The following is a lecture by Jay L. Grosfeld, MD and Jose Boix-Ochoa, MD titled “World Federation of Associations of Pediatric Surgeons: An historical overview 1974-2007”
The development of pediatric surgery as a distinct specialty was slow in its acceptance. Following World War II, it became apparent that techniques of care and procedures that were used in adults did not always apply to children, particularly the newly born. The advent of antibiotics, vaccines, and newborn intensive care facilities allowed survival of pediatric patients that previously perished many of whom that would subsequently require the expertise of surgeons experienced in the care of infants and children.
Progress in the field was influenced by the availability of new technologies including ventilators for babies and that permitted survival of premature infants that prior to that time would ultimately die prenatal ultrasound that improved the early recognition of abnormalities. Organizations representing children’s surgeons arose in a few developed countries with advanced medical care including UK, US, Canada, France and Germany.
However, there was no specific international organization that could provide leadership and a voice of support for children’s surgeons and develop educational and scientific guidelines for children’s care throughout the world. The British Association of Paediatric Surgeons (BAPS) had been in place in the UK since 1953 and included overseas members. The Canadians developed their own organization (CAPS) in 1967.
Although the Surgery Section of the American Academy of Pediatrics had been established in 1948, it was controlled by the pediatricians and was not a separate surgical organization. The American Pediatric Surgical Association (APSA) was finally established in 1971 to fill this void in the US. Interest in children’s surgery expanded to many places in the world and it became apparent that an international group representing the various fledgling pediatric surgical associations and societies would be of great value. In 1970, Jesus
Lozoya of Mexico and Virgilio Carvalho-Pinto of Brazil raised the interest of a few of the pediatric surgical groups in both developed and developing countries to establish an international organization for pediatric surgeons. James Lister of Liverpool, UK joined the discussion and served as an organizing catalyst. Others including Harvey Beardmore, Montreal, Canada, Julio Monereo, Madrid, Spain, Keijiro Suruga, Tokyo, Japan, Durham Smith, Melbourne, Australia, Jose Pinus, Sao Paulo, Brazil, Jose Santiago Piñeiro, Buenos Aires, Argentina, and Andrew Wilkinson, London UK also became involved.
Discussions were held at the BAPS meetings in Glasgow in 1972 and London in 1973. Andrew Wilkinson of London, UK was the President of the BAPS in 1971- 1972. In early discussions, it was suggested that Mr. Wilkinson might serve as the first President of this potentially new international group to assure that the BAPS would choose to become a member organization. Drs. Lozoya and Carvahlo-Pinto were responsible for putting together a preliminary constitution and the World Federation of Associations of Pediatric Surgeons (WOFAPS) became a reality.
The Constitution specified that membership to WOFAPS involved national associations and societies and not individual members. WOFAPS was established as an international body representing its various constituent associations and societies “organized exclusively for charitable, religious, educational and scientific purposes to improve the care of children throughout the world.
The first meeting was held October 15, 1974 in Sao Paulo, Brazil. Dr. Carvahlo-Pinto was the host. After a spirited and heated debate surrounded by considerable political intrigue, Dr. Harvey Beardmore was elected the first President and Mr. James Lister was elected Secretary-General.
It was determined that the Presidential term would be three years. Andrew Wilkinson who had flown to Sao Paulo expecting to be the first President was incensed by the outcome of the election and left the meeting abruptly to return to London.
The initial Executive Committee included those members previously noted that were involved in the organizational process. ( Figure 3)
Initially, only 14 national organizations joined the new group. Mr. Lister remained as Secretary-General for 9 years (1974-1983). The next meeting was held three years later (1977) in Barcelona, Spain. Professor Denis Pellerin of Paris, France was elected President.(Figure 4) Professor R.K.Gandhi, New Delhi, India was elected President at the 1980 meeting held in New Delhi. In 1983, Professor Marcel Bettex, Berne, Switzerland became the fourth President of WOFAPS at a meeting in Belgrade, Yugoslavia. (Figure 5)
During Bettex’s tenure the constitution was amended, Mr. Lister resigned as Secretary-General, and Professor Jose Boix-Ochoa of Barcelona was elected to replace him. Boix-Ochoa has served continuously in that position from 1983-until the current time. Influenced by Boix-Ochoa’s forward thinking, personal energy and continuity in office the WOFAPS began to establish some credibility. (Figure 6)
As new pediatric surgical organizations began to emerge in nations around the world, they sought entry as a member of WOFAPS. The WOFAPS was invited to hold their Executive Council meetings every three years by a member country’s pediatric surgical association. Subsequent meetings were held in Santiago, Chile (1986), Istanbul, Turkey (1989), Hamburg, Germany (1992) and Melbourne, Australia (1995).
Jose Ricardo Piñeiro of Buenos Aires, Argentina, Keith W. Ashcraft, Kansas City, MO (USA) (Figure 7) , Wolfgang Meier of Karlsruhe, Germany and Sid Cywes of Cape Town, South Africa (Figure 8) were the elected Presidents for these respective sites. (Table 1) During these years, the activities of the WOFAPS centered on aiding the establishment of the African Association of Pediatric Surgery; and identifying the right representative Pediatric Surgical Association in some countries especially in India and Portugal where there were 2 rival groups claiming a leadership role and their intent to join WOFAPS. Diplomacy was the order of the day and subsequently a satisfactory arrangement for each of these countries occurred resulting in membership in the WOFAPS.
Through a relationship with WOPSEC, an Italian based group led by Drs. Ghinelli and later Dr. Georgocopolous, WOFAPS assisted underdeveloped countries, particularly those in Africa by providing volunteers and advice to improve children’s surgical care especially for traumatized patients following catastrophic events. Dr. Ashcraft personally hosted visiting surgeons from various developing countries for brief periods in Kansas City in an attempt to expose them to the contemporary pediatric surgical methods of the day. For the first time, regular and frequent WOFAPS news letters were sent to member societies to keep them informed of developments.
Professor Jay L. Grosfeld, Indianapolis, (USA) was elected the 9 th President of WOFAPS at the 1998 meeting in Cape Town, South Africa that was hosted by Dr. Cywes and the South African Association of Pediatric Surgeons. During his tenure Dr. Grosfeld was instrumental in developing the “Declaration of Pediatric Surgery” outlining guidelines for establishment of educational requirements, and providing recommendations for the level of facilities and staffing required to care for ill and injured child and especially the newborn with congenital anomalies. (Figure 9)
By this time, 74 national organizations had joined the ranks of WOFAPS.
The Declaration of Pediatric Surgery was voted on and ratified at the 2001 meeting of WOFAPS held in Kyoto, Japan in conjunction with the Pacific Association of Pediatric Surgeons. (Table 2) The event was attended by the then Crown Prince of Japan (the current Emperor) and Professor Takeshi Miyano of Tokyo was elected the 10 th President of WOFAPS. (Figure 10)
In 2004, the first World Congress of Pediatric Surgery was sponsored by WOFAPS and the Croatian Association of Pediatric Surgeons, in Zagreb, Croatia, hosted by Professor Ivan Fattorini. A large attendance guaranteed the success of the meeting. Professor Arnold G. Coran, Ann Arbor, MI (USA) was elected the 11 th President of WOFAPS. During the next three years, a number of important changes occurred. The constitution was amended, and WOFAPS was formally incorporated in Philadelphia. as a non-profit, tax exempt 501(c) 3 organization by the US Internal Revenue Service approved on January 18, 2007.
Dr. Coran and his son Michael, a Philadelphia lawyer spearheaded the change. (Figure 11) The WOFAPS Foundation was established under the guidance of Dr. Grosfeld as a tax exempt group separate from but embedded within WOFAPS to carry out the charitable, religious, educational, and scientific purposes of the Federation. Dr. Richard Azizkhan, Cincinnati, (USA) was responsible for developing the rules and guidelines for application to and hosting of future Pediatric Surgical World Congresses co-sponsored by WOFAPS.
The 2 nd World Congress of Pediatric Surgery and WOFAPS Executive Council was held in Buenos Aires, Argentina, September 9-13, 2007.(Figure 12) The Pediatric Surgery associations of the Southern Cone Countries of South America (CIPESUR- representing Argentina, Chile, Brazil, Uruguay, Paraguay and Bolivia) were the co-sponsors and Professor Juan Puigdevall was the host. (Figure 13) The IPEG (International Pediatric Endoscopy Group) held their meeting in conjunction with the 2 nd World Congress with more than 1,500 pediatric surgeons in attendance. The 2007 WOFAPS Executive Council Meeting in Buenos Aires was of note and resulted in approval of the new constitution, the rules regarding hosting a World Congress of Pediatric Surgery, and the establishment of the WOFAPS Foundation.
The Council approved the addition of representatives of organizations from countries in the Middle East and Africa to the executive council to assure better worldwide-representation. Professor Boix-Ochoa reported that there were now 92 member associations in WOFAPS. This represents 98% of all children’s surgical associations worldwide. Professor Grosfeld was elected the first President of the newly formed WOFAPS Foundation with the Board of Directors comprised of Drs. A. Coran, T. Miyano, M. Hollwarth, T. Wester, and J. Boix-Ochoa. Professor Prem Puri, Dublin, Ireland was elected the 12 th President of WOFAPS and the site of the next world congress and Executive Council meeting in 2010 was awarded to New Delhi, India-(Indian Association of Pediatric Surgeons- Professor Devendra Gupta-host).
WOFAPS has represented Pediatric Surgery at-large at the International level. Through the efforts of Professor Boix-Ochoa, WOFAPS has developed a relationship with the World Health Organization (WHO) in accordance with their goal to improve the care of children and serves in an advisory capacity concerning WHO publications concerning children’s surgical care.
WOFAPS has also established itself as the organization recognized as representing children’s surgery in the International Pediatric Association (IPA). Initially, WOFAPS was acknowledged as a nonvoting member of the Executive Council of the IPA in 1983. Through the unrelenting efforts of Dr. Boix-Ochoa, in 2001 at the IPA meeting in Beijing, China, constitutional changes were proposed that would assure WOFAPS voting stature on the Standing Committee of the Executive Council of the IPA. This was ratified in 2004 in Cancun, Mexico when WOFAPS was given a permanent seat on the Executive Council of the IPA as a voting member.
Since 1985, WOFAPS has been a participating society in the Societe de Chirurgie Internationale-International Surgical Society (ISS-SIC) sponsored International Surgical Week (ISW) Congresses. These meetings occur every other year and are attended by 1,500 – 2,000 surgeons representing many different surgical specialties from all over the world. This allows Pediatric Surgeons to participate in the scientific program and be recognized internationally by their adult colleagues.
Dr. Grosfeld has served as the WOFAPS liaison and program chairman for these events for the past 22 years. Children’s surgeons from various continents join with the local Pediatric Surgical Association in the country hosting ISW to establish the Pediatric Surgical scientific program. These meetings have been held in Paris (1985), Sydney (1987), Toronto (1989), Stockholm (1991), Hong Kong (1993), Lisbon (1995), Acapulco (1997), Vienna (1999), Brussels (2001), Bangkok (2003-cancelled), Durban (2005) and most recently in Montreal (2007). The 2009 meeting is scheduled for September 2009 in Adelaide, Australia. The Australasian Association of Pediatric Surgeons will serve as the host organization.
The WOFAPS objectives are to improve and maintain the standards of pediatric surgery and promote and integrate these standards throughout the world. The WOFAPS serves as a center for cooperation and interchange of information among pediatric surgical associations, societies and organizations approved by the Federation. The Federation encourages and hopes to maintain high standards of care, ethical practice, education, training, and research in pediatric surgery and its allied sciences worldwide. During the past 33 years, the WOFAPS has matured as an organization that represents the international body of pediatric surgeons.
It is recognized as a formidable group that provides support to the goals and objectives of its member organizations, educational, scientific and clinical recommendations, and an international forum that allows exchange of ideas and exposure to contemporary techniques and methodologies at its world congresses. The newly established WOFAPS Foundation will hopefully provide support in other ways not possible in the past.