The General Medical Council have agreed that part of a letter which they wrote to a member of the College containing their current policy on confidentiality can be published in the Psychiatric Bulletin. This letter was written in response to a specific enquiry.

There are only 130 psychiatrists in Pakistan for a population of 95 million and they are stationed at major cities where only 15% of the population of the country resides. The foreign trained psychiatrists, mostly in the UK, are attached to the departments of psychiatry of medical schools in major cities and are not willing to go to rural areas where 85% of the population lives. Thus there is an acute shortage of psychiatrists at district headquarter hospitals (DHQ) in rural areas.

I would like to raise Issues about tape-recorded interviews by way of describing the recent admission to hospital of a man who began recording staff and patients.

Rwanda was the most densely populated country in Africa. It is two-thirds the size of Switzerland but contained a larger population (9 million people), growing by almost 40% every two years. Few square inches are left uncultivated. The Tutsi people (never more than 14% of the population) are said to have arrived in the 14th century ad, bringing with them a feudal and totalitarian system of government. There was significant intermarriage with the result that today the Hutu and Tutsi people share the same language, cultural beliefs and religions (predominantly Catholic). In reality the terms Hutu and Tutsi now more accurately describe caste than ethnicity (Delcros, 1994).