This presentation is based on a personal professional experience in SEA as a Medical Doctor, holding various positions in various organizations, including private sector. None of the views exposed will reflect the official positions of these organizations. Looking backward, I think I have got the necessary distance to get insights on how this collaboration between SEA and Europe has the potential power to boost higher learning in both of these parts of the world, to the benefit of all, taking the example of the higher learning in Health. I will first expose few case studies in SEA countries, about networks and organizations involved in human development, namely the ADB and the ASEAN. I will further provide personal comments on the shift of paradigm, in successful higher learning cooperation between SEA and Europe, and on how a fruitful future could be shaped together under a humanist perspective.
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A Humanist perspective on Higher Learning collaboration between South-East Asia and Europe: the example of Health sector.
1. A Humanist perspective on
Higher Learning collaboration
between South-East Asia and
Europe: the example of Health
sector.
ASAIHL International Conference, Montpellier (France), 10 to
13 June 2014
ASAIHL Conference 2014, Montpellier
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Dr. Jean-Jacques BERNATAS, MD,
MScPH
2. Introduction
The views exposed do not reflect in any way the official
positions of any of the organizations or institutions cited
in this presentation.
It is based on a personal experience alternatively as an
actor and as on observer during 8 years spent in
South-East Asia
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3. Case studies (I): cooperation in
Health sector in Vietnam
Post-graduate training for physicians: from non-
graduating program to PG diplomas. FFI to “DU”
and DFMS/DFMSA (1)
Hoa Sen Lotus Program (2): Hubert Curien
Partnership (PHC) in Vietnam. To promote
scientific partnerships in funding students mobility
in both ways.
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4. Case studies (II-1): an example of
network: Institut Pasteur
International
Network (IPIN)
The IPIN (3): 32 partners around the world. Research/Training/Public Health.
Creation of the Pasteur Institute of Paris in 1888
In Asia:
1891: Pasteur Institute of Saigon - now Ho Chi Minh City – by Albert CALMETTE (1863-
1933);
1895: Laboratory created by Alexandre YERSIN (1863-1943), an became the Institut Pasteur
of Nha Trang in 1905;
1923: Pasteur Institute of Hanoi, now National Institute of Hygiene and Epidemiology (NIHE),
1996: convention between IP and HKU,
2003: Pasteur Institute in Seoul,
2009/2010: Pasteur Institute of Laos.
All are independent and are national-owned institutions, under the direction of their
respective MoH +/- MoEd.
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5. Case studies (II-2): an example of
network: Institut Pasteur
International
Network and SISEA Project (3)
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Type of disbursement Amount (€) %
Equipment ### 12
Personnel & Training ### 38
Goods and services ### 34
Monitoring and evaluation ### 3
Other ### 6
Management fees ### 7
6. ASAIHL Conference 2014, Montpellier
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International Short Course in Biostatistics - REDI centre -
Singapore, November 9-13, 2009.
Capacity
strengthening
• 24 trainees/12 from
SISEA/Lao PDR, Cambodia,
Vietnam, Indonesia,
Singapore, China.
• New ties with professionals
coming from Indonesia, and
Singapore.
• High quality of the
collaboration with REDI and
NUS, who are willing to
develop further collaborations
in training at the regional
level.
7. Case studies (III-1): Higher education and
development, from MDGs to post-2015
agenda
MDGs: “Achieve universal primary education”. From 82% in 1999 to 90%
in 2010. Still 57 millions children of primary school age are out-of-school
(4)
Post-2015: Education and skills for inclusive and sustainable
development (5);
↗ access to primary education → ↗ demand in secondary education → ↗
demand in HE
Inadequate access to HE →knowledge divide, including “e-literacy” gap → ↗
inequality (esp. gender-wise)
HE is to be included in post-2015 development agenda: education as a
continuum, from primary to HE.
The British Council’s Director of Education and Society, Jo Beall
emphasizes on the key role played by higher education in the post 2015-
agenda (http://bit.ly/1tVwuYt )
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8. Case studies (III-2): ADB, a regional
partner in Education and
Development
The Asian Development Bank (ADB, www.adb.org ) analysis
(6) about higher education states that:
HE faces 4 challenges in Asia:
Maintaining/improving quality,
Relevance of curriculum, to be aligned with local labor market,
increasing and better utilizing the financial resources
Continued expansion of access vs. equity and quality.
Need for:
Enhanced capacity of university leaders
more effective national and institutional-level policies
greater attention to partnerships, including those with the private
sector, to improve quality and ensure sustainable financing of
higher education.
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9. Case studies (III-3): ASEAN, a
strategic regional support to Higher
Learning
(7) Human Development/Advancing and prioritizing
education:
To develop an exchange program for teaching staff to
improve the quality and adaptability of education,
Education networking for teaching and research with the
Southeast Asia Ministers of Education Organization
(SEAMEO) and the ASEAN University Network (AUN);
Courses on ASEAN studies, including at higher education
levels;
Promote the options of university placements in an institution
of higher learning in a second ASEAN Member State
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10. Change of paradigm in
cooperation (and) in Higher
Education
From vertical to flat management: paternalistic vs.
collaborative model.
From arborescence to network: the best comes out from
teamwork and sharing – not distilling –knowledge. Feedback
will guarantee continuous improvement.
From local to global: the world is our classroom, as well as
our village and our laboratory.
From “for a few” to “for all”: Confucius vs. MOOC
From face-to-face to distance-based
From quality to quantity …? And back to quality again.
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11. Conditionality for success
To accept the unavoidable changes
HE can only grow on a solid secondary and primary
education
HE makes sense only if in line with the local and the
regional labor market
Exchange of experience, knowledge sharing: networking
and cooperation (regional and global)
Budget: funding must be secured first and foremost.
No place for corruption
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12. What makes South-East
Asia/Europe partnership in HE so
special?
The long-lasting shared history, sometimes conflicting,
may be the ground of a bright shared future, fruitful for
each partner.
We may face issues that the other partners faced
already, and for which experience has been gained and
could be shared (infectious/chronic diseases)
Different cultural backgrounds will bring different views
on questions of research.
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13. Expected outcomes of SEA/EU
collaboration in HE
Sustainable development of LIC and MIC in SEA
New markets for both SEA and European
countries
Mutual fostering in research and education
HE is aiming at fostering imagination, creativity,
open-mindedness, citizenship
Strong options given to SEA university besides
North America and Australia
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14. Tracks for the future
Developing regional networks and connecting them at a
“meta-network” level
Facilitating by all mean the mobility of the students and
of the teachers:
legal framework for supporting visa requests and for
facilitating travels for teachers and students;
Administrative support to manage mobility;
Sustainability funding
Public-Private Partnerships
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15. Conclusion (I): “L’un vers
l’Autre”
Victor Segalen and F. Cheng (8):
Two poets, 60 years apart having had a journey one from
Europe to Asia, and one from Asia to Europe;
A cross-view on the best of both traditions will enrich our vision
of the world.
“exote”, the traveler who immerses himself in another culture,
while keeping his origin, to the best of both cultures.
Giáo sư Bác sĩ Tôn Thất Tùng, who developed an
innovative technique of liver surgery (9) (10), in the 60’s, and
taught it to the French surgeons.
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16. Conclusion (II): Humanist vision of
the goal of Education
F. Rabelais in his “Gargantua” (11):
“In all their rule and strictest tie of their order there was but
this one clause to be observed,
Do What Thou Wilt
because men that are free, well-born, well-bred, and
conversant in honest companies, have naturally an instinct
and spur that prompteth them unto virtuous actions, and
withdraws them from vice, which is called honour.”
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17. It is also about investing in the
future …
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18. Acknowledgements
University of Montpellier 2, with a special mention to Dr.
Roger Frutos;
Institut Pasteur International Network and its Asian
members: NIHE, IPHCMC, IPNT, IPC, IPL;
The Embassy of France in Vietnam and the French Ministry
of Foreign Affairs;
All my colleagues in Vietnam, Lao PDR, Cambodia,
Indonesia, Singapore, Philippines (ADB);
The ADB, especially the members of the Health Community
of Practice.
To my Master, Pr. René Baylet
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19. References
(1) : Ministère de l'Enseignement supérieur et de la Recherche. Bulletin Officiel N° 48 DU 24 DÉCEMBRE 2009. Circulaire
n° 2009-1035 du 30-11-2009.
(2): http://www.campusfrance.org/fr/lotus, accessed on 04 June 2014.
(3): J.-J. Bernatas: "Surveillance and capacity building in South-East Asia: SISEA project and the International Pasteur
Institutes Network“. International Congress of the Société de Pathologie Exotique, Vientiane, Lao PDR, 25-28 janvier 2010.
(4): http://www.un.org/millenniumgoals/education.shtml accessed on 04 June 2014.
(5): UNESCO: Education and skills for inclusive and sustainable development beyond 2015. Thematic Think Piece, May
2012.
(6) Higher education across Asia: an overview of issues and strategies. Mandaluyong City, Philippines: Asian Development
Bank, 2011.
(7) ASEAN Socio-Cultural Community Blueprint. Jakarta: ASEAN Secretariat, June 2009
(8): F. Cheng: L’un Vers l’Autre. Albin Michel, 2008. ISBN 978-2-226-18853-3
(9) Ton That Tung, Nguyen Duong Quang. A new technique for operating the liver. Lancet Jan 26, 1963; 281:192-193
(10) Tung TT, Les résections majeures du foie, Paris : Masson, 1979
(11): F. Rabelais: Gargantua and Pantagruel, Book I. Five Books Of The Lives, Heroic Deeds And Sayings Of Gargantua
And His Son Pantagruel. Chap. 57. Gutenberg Project, accessible online at http://www.gutenberg.org/files/8166/8166-
h/8166-h.htm#2HCH0057
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Notes de l'éditeur
Dear guests, Dear … M. Dear Colleagues, Dear Alumni of the University of Montpellier, It is an honor for me to be here, in this auditorium of the Botany Institute, where I have spent hours in learning the basics of parasitology. I will hereby expose personal insights on higher learning collaborations between South East Asia and Europe, mainly France, if you don’t mind, and of course about health education, for which I may have accumulated some experience in both continents.
This presentation is based on a personal professional experience in SEA as a MD, holding various positions in various organizations, including private sector. None of the views exposed will reflect the official positions of these organizations. Looking backward, I think I have got the necessary distance to get insights on how this collaboration between SEA and Europe has the potential power to boost HL in both of these parts of the world, to the benefit of all, taking the example of the HL in Health. I will first expose few case studies in SEA countries, about networks and organizations involved in human development, namely the ADB and the ASEAN. I will further provide personal comments on the shift of paradigm, in successful HL cooperation between SEA and Europe, and on how a fruitful future could be shaped together under a humanist perspective.
As Attaché of Health at the French Embassy in Hanoi, I had mainly to manage locally a big change in the historical collaboration in health education, since the national regulation for receiving medical students in France for post-graduate training changed, from a ground level based on acquaintances between physicians in both countries, to a regulated system at the national levels. The main strategy was to keep the best curricula organized locally in Vietnam with a double graduation (post-graduate diplomas recognized in Vietnam by the national authorities, delivered by the French universities but not recognized to practice medicine in France), and to comply with the new system aiming at sending physicians to France in the University hospitals, and delivering a post-graduate diploma recognized in France as well. These diplomas are named DFMS and DFMSA (diplomas), replacing the previous AFMS/AFMSA ("attestation", which is just a certification of attendance). As the quota of foreign medical students is determined by country of origin on yearly basis, it has been pointed out that the new system has reduced the accessibility to this training, but it was perhaps one of the objective at the administrative or political level, while on the ground physicians, professors and students felt themselves deceived or even mislead. The Hoa Sen Lotus is the Vietnamese form of the French PHC program, which only supports the mobility of students to get a master degree or a PhD. Supported by the French Ministry of Education and Ministry of Foreign Affairs, it is focused on research and capacity strengthening, providing further specialized knowledge to the students, as well as an individual experience of a being a student abroad, on a long-term basis (at least 1 year).
The Institut Pasteur International Network is a global partnership between research and public health Institutes that has its roots in the shared history between France and its former colonies. Although this ‘H”istory (with a capital “H”) has been sometimes marked by strong, even armed conflicts, the scientific collaboration in Health, and between the members of this network was not too much affected, and the physicians continued to share their works, looking beyond their political and cultural differences.
This network was born in South-East Asia, in Vietnam, and is still growing nowadays, with its latest member in Lao PDR. All these institutes are independent structures, under the responsibility of their own MoH and Ministries of Education (and Training).
Training is one of the three pillars of the vision Louis Pasteur and his disciples shared to build up this network: research for improving people’s health (public health), and training to improving scientific skills and capacity. All the IP still continue to adhere to these founding precepts, in accepting master degrees, PhD and post-PhD students, organizing workshops and seminars under the numerous projects they implement in collaboration with their international partners over the 5 continents.
An example of partnership with SEA countries involving IPIN was the SISEA project. Its aim was to contribute to improving the detection and the treatment of epidemic episodes in South-East Asia, and had 2 specific objectives:
To establish a program for epidemiological surveillance and investigation of epidemics caused by emerging viruses
To establish a network of laboratories and develop regional coordination in these fields, in association with WHO.
It had 3 components:
C1: Strengthening the reference laboratories and establishing a network among them.
C2: Improving the epidemic alert on emerging viruses in each country
C3: Strengthening the epidemic response network at national and regional levels.
In terms of training, the project funded specialized training on Quality control (IPP) , biostatistics and field epidemiology (NUS, ECDC, IPP, REDI Center), infection control in healthcare facilities (WHO, REDI center).
It was more hands-on, not graduating, short-term training.
This project also established a collaboration with UM2 and regional partners in Thailand, in sending students for master degrees, and supporting PhD students.
Higher learning plays a major role in fostering development of LIC and MIC, including those in SEA. This region has country members at different levels of economic and human development, and higher education should be seen under each country’s angle. Focusing on EFA (Education For All) in LIC doesn’t mean that there is no need for higher education, and higher education in upper MIC has to face a growing number of students who completed secondary education. In LIC, there is an issue with local accessibility to tertiary education, and regional cooperation makes even more sense for their students, while in upper MIC there is a concern with quality assurance in education. Regional HIC will play a major role to drive the region ahead, if they not only try to collaborate with the most famous universities worldwide, but also take the regional lead to promote high quality of accessible tertiary education.
The European countries may play a key role in sharing their own experiences in training and education, especially in quality assurance, mobility, accessibility, and public-private partnerships.
As the time of the final assessment of the MDGs is coming, discussions between partners to set up the post-2015 agenda are of utmost importance for the future of our world. Even though it is unlikely MDG #2 will be achieved, higher education must be considered as an important asset to buid a more inclusive and sustainable development. Regarding higher education it is more and more about quality, inclusiveness and accessibility, considering the education as a continuum from primary (for all) to tertiary education for the greatest number of secondary level graduated students, addressing also the question of gender inequity.
The British Council’s Director Education and Society, Jo Beall, said, in a blog about post-2015 agenda:
“Emerging economies are investing in higher education precisely because they recognise the link with economic development and prosperity. Higher education has a key role in achieving a world of post-aid development where the playing fields are level and the players share responsibility. If we miss this chance, we will fail to eliminate extreme poverty through education, and lose the opportunity to make the world a safer and more prosperous place.”
The Asian Development Bank is the major regional partner in Asia supporting a sustainable development with the goal to eradicate poverty by 2020. Education is one of the topics of interest, and the analysis provided by ADB’s experts highlights the main challenges and needs for an enhanced higher education in Asia. ADB is an International Finance Institution (IFI) as WB, AfDB and EBRD are. They provide technical assistance and funding to governments, and are also think tanks where partners can get inspiration to design new tools for a sustainable development.
The ASEAN, association of South-East Nations, plays a major political role to foster the regional cooperation in South-East Asia, among its 10 member states. The ASEAN sets up the political agenda and issues recommendations that applies to all its members. Besides funding, having a strong political agenda an support at the level of the Governments is a necessary prerequisite to implement a regional collaboration, including in higher education. Education, as well as Health is under the ASEAN socio-cultural community.
In Health sector the main statements by the ASEAN Ministers of Health supported an integrated epidemic diseases control (example: Dengue fever, “YANGON CALL FOR ACTION ON THE PREVENTION AND CONTROL OF DENGUE 15th June 2012, Yangon, Republic of the Union of MYANMAR), access to health care, quality of care …
Regarding higher education, I will not develop very much, since it is not my specialty, but I will underline the key institutional leader role of the ASEAN at the regional level, and the key findings stated in the “ASEAN Socio-Cultural Community Blueprint” established in Jakarta in 2009: exchange, networking, mobility, ASEAN common culture.
These previous examples illustrate the changing paradigm in cooperation at the global level, including in higher education.
The paternalistic model inherited from the ancient time of the colonies is over, and has shifted from a pyramidal hierarchical relations between “under-developed” beneficiaries and “developed” donors, to a new flat model of bilateral or multilateral collaborations between partners for a sustainable development.
The arborescence and the one-way model of dependency have been replaced by a complex interactive network of equal and singular partners, where everyone has a word to say, a decision to take, and an experience to share. Everyone is connected to the global village, where a classroom can be delocalized, and where everyone’s place may be a laboratory for everyone else. With the adequate connection, and the appropriate training, everyone may have access to any kind of highly specialized knowledge. The Confucian relation between the Master and his chosen students is changing to a flat education for all, where the most difficult is to make a choice and to challenge every piece of a huge amount of information.
In Health, for instance, every physician has to set up a new kind of interaction with patients attending a consultation with all medical information already reviewed by “googling” symptoms, diseases or sharing their individual experience in various chats and blogs. The role of the physician is changing, from the one who knows to the one who knows how and what to know, being less a “doctor” and more an educator and an advisor in health.
The MOOC movement is changing the deal as well, offering for free the best courses on various platform (Coursera, NovoEd, FUN, …). It is not a matter of quantity anymore, but a matter of quality: how to chose the most appropriate and the most accurate training? How to get back to the same level of undisputable quality provided by a good face-to-face learning delivered by a passionate and committed professor? How to value every training experience?
There is a new step to take ahead, and it is unavoidable. Instead of opposing the classic face-to-face master-to-students model to the open online delocalized education, we have to consider how we can take away the best of both worlds.
However, there are few necessary but not sufficient conditions to turn this changing higher education into a success story:
To accept the changes brought in by the new paradigm of global interconnections;
HL can only grow on a solid secondary and primary education: this is connecting tertiary education upstream, in the continuation of what has been taught before;
HL makes sense only if it is in line with the local and the regional labor market: this is connecting tertiary education downstream, outside education world, inside the real working life. Once trained, the human resources should be retained in the country or in the region. That would represent a perfect match between the young graduated students and the local labor market. It is not that simple, and I will take an example in health education. The nurses, the medical allies, and medical technicians trained in the Philippines are hunted by foreign hospitals in the English-speaking world and in the Middle-East, because they are well trained, well educated, and have an excellent level of communication. There is a dilemna here, since on the one hand, these professionals are away, not filling the existing gaps in Health care workforce in their home country, but on the other hand, they bring back in the country a huge amount of cash, as OFWs holding an official status in the Philippines. In this case we could also argue that the local market should adapt to its workforce in offering better salaries and benefits than abroad.
Exchange of experience, knowledge sharing: networking and cooperation (regional and global) will provide new insights and solutions to face the growing complexity of the world. In 2003, when the world was struck by the SARS outbreak, the identification of the SARS- CoV was rapidly done in Asia, by a team of IPHK under the lead of Malik Perris, for the benefit of all the affected countries in Europe and North-America as well. Being the most common source of potential pandemic situations, the Asian countries, especially in SEA, have benefitted from a strong technical international support, and are now a cornerstone in the worldwide surveillance system of infectious diseases.
Budget: funding must be secured first and foremost. It is necessary to get onboard as early as at the initial level of project design all possible financial partners, either local or global, either public or private;
No place for corruption: it is not only a matter of morale, but also and mainly of efficiency, as money lost into corruption to get fake degrees is also a waste of human resources.
Relations between SEA and Europe, especially France, have shifted to a mature collaboration although - or because - they are rooted in an old and sometimes conflicting history. The “Extreme Orient” considered long time ago to be at the edge of the ancient world is now just at the corner of the digital street. We know each other well enough to understand what we can get and what we can share for our mutual benefit.
European countries started to face the chronic diseases burden right after WWII, and has a long experience in managing these conditions, while the return of re-emerging diseases in European countries may benefit from various experiences implemented in South-East Asia in terms of prevention and control at the community level. We can foresee the burden of ageing in some Asian countries, burden that European countries are facing for decades already, and that refers also to universal health coverage for which Asian countries may gain experience from models of health insurance financing already implemented in Europe.
And most importantly, our respective different cultures that model our vision of facts will bring a different angle of vision on our respective problems.
Obviously, improving higher learning goes far beyond growing the number of well-educated people, especially under the possible collaboration between SEA and Europe.
As said before, higher education is instrumental to fostering a sustainable development of LIC and MIC towards a status of HIC. In terms of economy, it is a unique opportunity to open each other to new markets, including in higher education. To state the obvious, especially when working together as equal partners, SEA and European countries can improve research and education in facilitating students and professors’ exchanges, which will incidentally boost imagination, creativity, open-mindedness and finally citizenship. Having better educated citizens is the strongest defense against hate, racism and environment destruction.
Finally, the European vision and culture, which may differ significantly from those of other partners, gives to SEA universities other competitive options to move forwards.
We all understand the power of networking in human development, based on knowledge and best practice sharing, but now it becomes urgent to determine how to function at the level of networks of networks. For example, a network of SEA laboratories may work under the ASEAN rules, but would have benefit in working with another network of laboratories outside the ASEAN area.
While the ICT are still changing the way we communicate and study, the human-to-human interaction remains necessary and irreplaceable: facilitating mobility of students, professors, and administrative team as well, will increase the number and the quality of the partnerships and their outcomes.
No long-term partnership is possible without a sustainable financing, where the local and regional partners must be key players. A perfect transparent cooperation between all stakeholders and financers, local regional or global, is key to success. PPP, due to their capacity of funding where sometimes public financing might be a complicated process, should be considered as a serious option.
The purpose of this meeting reminded me two examples of this balacing movement between Asia and Europe, for the benefits of both worlds.
The first one is literary. In his book accurately titled “L’Un vers l’Autre” (“Towards One Another”), Francois CHENG, from Chinese origin but who embraced the French culture to the point of being a member of the French Academy, describes how he re-discovered his own intellectal journey from Asia to Europe, in the work of French poet of the early XXth century, Victor Segalen, who took a symmetrically opposite path from France to Asia. Using the same neologism of “exote”, created by Segalen, and used by Cheng, to describe this kind of traveler, who deeply immerses himself in another culture while keeping his original roots, I would suggest that all university partnerships should be primarily based on sending exotes (I didn’t say exocets …) to get the best, from the inside, of The Other’s knowledge.
The second one is more technical, and of course health-related. It is about how, during tough times, in fact war time, a very famous Vietnamese professor of surgery developed a revolutionary technique of liver dissection, in the 60’s, and taught it to some French surgeons and to the rest of the world.
Finally, our journey will take us back to Montpellier and its old University. The Faculty of Medicine of Montpellier is said to be the oldest one still in operation worldwide, starting to teach medicine and surgery as early as in the 12th century. Later on, during the 16th century, Francois Rabelais, one of the most famous Humanist of his time, has been registered as a regular student of this University from 1530 to 1532 to pass his medical degree. He became one of the best anatomists in France, teaching in Paris and in Lyon. He came back as a professor from 1535 to 1537 again. This is what he wrote in his "Gargantua" about the rules observed in the Abbaye of Thelemes, that he offered to “Frere Jean des Entommeures” in acknowledgement of his support during the war against the greedy and stupid Pichrocole: (reading of the text).
The best of our diverse societies will come from well-educated people, who will have the necessary intellectual and spiritual equipment to live in peace, to set an example to everyone, and thus promote virtue and withdraw people from vice.
Beyond getting a good job and being a significant economic agent making profit, we wish students attending and succeeding in HE to become the wise leaders of the coming global world. The partnerships between South-East Asian and European universities are certainly a unique opportunity to reach this goal.
Thank you.