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Library projects lending order to chaos in Liberia

A conversation with UMass Medical School’s international medical librarians

At any given time of year, there are scores of students, faculty and researchers off campus—some way, way off campus—in the Dominican Republic, Peru, Ghana, Liberia—providing aid, serving fellowships and gaining experience they can apply to their work, and their patients, here at home. As an ongoing, periodic feature on UMassMedNow, we will profile some of these travelers and give you some insight into the impact—both small scale and large—that the people of UMMS are making on our world. 

In March, UMassMedNow reported that a contingent from UMass Medical School was traveling to Liberia to move forward with a number of initiatives aimed at helping the war-torn country rebuild its medical infrastructure. An eight-person delegation, assembled by Associate Provost of Global Health Katherine Luzuriaga, MD, professor of medicine and pediatrics, traveled to Liberia for a week of collaborating with and supporting their Liberian colleagues.

Collaborative projects at the University of Liberia (UL) and its A. M. Dogliotti Medical School and at the Tubman National Institute for Medical Arts (TNIMA) Nursing School included medical training, nursing leadership and—addressing what is a perhaps less obvious but equally vital need—library services for the medical school, nursing school and Liberia’s John F. Kennedy Hospital.

Elaine Martin, DA, director of library services for UMass Medical School’s Lamar Soutter Library, and James Comes, EdD, formerly associate director of library information services, kicked off an initiative to rebuild the main library and the A. M. Dogliotti School of Medicine Library at UL, and the separate library that serves TNIMA and the JFK Hospital staff. Facilities and collections were decimated during years of neglect due to ongoing warfare. Here Dr. Martin and Dr. Comes talk about what they learned during the March visit, and what is next for Liberia’s medical libraries.

 

Liberia library

Elaine Martin, DA, and James Comes, EdD, seen here with a Tubman National Institute for Medical Arts Nursing School library staff member, are helping to improve medical libraries in Liberia.

UMassMedNow: What was the genesis of the Liberia Libraries Projects?

Elaine Martin: As Associate Provost of Global Health Katherine Luzuriaga and collaborators got involved in updating the medical school curriculum at the University of Liberia, it became evident that, in order for the curriculum to be redesigned, the libraries need to be functional. Right now, their condition is what we would have seen in the United States in the 1950s—basic, paper-based libraries without electronic resources. In fact, often without even reliable electricity! There are few books on the shelves dating before 1990, and those are crumbling. So the first thing we learned was that a phased-in approach is needed to achieve what we would consider adequate resources.

Jim Comes: After I spent five weeks in Tanzania working at the country’s largest medical center, a 500-bed hospital that serves more than 13 million people, Dr. Luzuriaga was interested in what I had learned there. Subsequently, she asked Elaine and me to join the group traveling to Liberia. This first trip was simply to assess needs. For example, we quickly realized that providing electronic library resources is not an achievable goal at this time.

UMMN: What are achievable goals for the Liberian libraries, and how will they be achieved?

EM: Our immediate, short-term goal is to have a library set up to support the new curriculum with essential student resources: basic texts, a reserve collection and a collection of core journals, all to be donated. We have formed a U.S. medical schools library consortium comprising UMMS, the National Medical Library, the Walter Reed Army Medical Center, George Washington University and Howard University. Each institution brings with it resources to provide material support, be it books, staffing, supplies or dollars.

JC: We are also encouraging the Liberians to expand their resources, for example, by joining the HINARI Access to Research in Health Programme of the World Health Organization, which provides free or very low cost online access to the major journals in biomedical and related social sciences to local, not-for-profit institutions in developing countries. Once they get access to the Internet, this resource will be invaluable.

UMMN: Besides books and journals, what else is needed?

EM: People’s lives in Liberia are so hard—when we asked library staff what they needed to do their work, the first thing they requested was cold water to drink during the day. You can’t do even basic tasks without thinking five steps back to make sure they have the bare necessities to achieve them. For example, they showed us dried ink pads and dried up markers. There were no supplies, not even pens, paper or labels. They could not catalog the books because they did not have labels and tape.

The physical plants of the libraries are in terrible condition and need to be updated. Everything, from corroded shelving and tattered books to rickety furniture, needs to be fixed or replaced.

We also discovered that there is a huge need for staff training. They have minimal library science and computer skills and even, due to the impact of years of war, limited literacy because of interruptions in their education.

UMMN: What are the next steps?

JC: With the consortium, we are planning a multipronged execution. For example, Howard University will process donations of library materials; George Washington University will contribute staff training; and we will be receiving about 500 medical texts from the Walter Reed Army Medical Center Library, which is closing.

EM: We’re looking at, over a period of three to five years, addressing the physical set-up of the libraries, including adequate, basic school supplies—this time we brought 20 pencils, they could have used a hundred, but were grateful for the 20! We will also set up a simple but reliable manual circulation system. Through the consortium, we are hoping that different individuals can make trips every few months to maintain momentum toward achieving our objectives.

At the July meeting of Health Education and Relief Through Teaching (HEARTT), a not-for-profit corporation providing overall health care and health training to underdeveloped communities and countries, which UMMS is hosting this year, we intend to further crystallize the libraries agenda. We will be hosting a meeting of the library partners in conjunction with the HEARTT meeting. We are beginning to establish achievable goals and tasks, and to assign duties to the partners. Jim and I plan to return to Liberia in July to start putting the plan in place.

UMMN: Jim, you’re retired. Why are you doing this work?

JC: I initially got involved in introducing the information component to the Westborough Rotary’s GEMINI Program to train first responders in Third World countries. Now I’m at the point where I get more than I give. It is rewarding to be able to help.

EM: Jim was always a library ambassador during his 13 years at UMMS. In his independent quest for meaningful post-retirement work, Jim became the one who really got our institution involved with the Liberia libraries. We are so grateful to have him on board.

UMMN: Anything else you’d like to add?

JC: We are committed to taking small steps in a long-term process. We can see where the Liberians need to go. Now they need to embrace the vision in order to realize it.

EM: It is rewarding to know you can make a difference, even in small ways. In turn, doing this work expands our own awareness of the importance of providing access to medical information. Now that Liberia is at peace, its people are optimistic, open and welcoming. They want to learn, and keep asking when we are coming back.

View the slideshow for an inside look into what the UMMS team found in the libraries at the University of Liberia and its A. M. Dogliotti School of Medicine and TNIMA Nursing School.