AFRO-NETS> Review of Essential Textbooks for Health Professionals in Africa (5)

[Bob Mayes <Mayesb@zimcdc.co.zw>]

Review of Essential Textbooks for Health Professionals in Africa (5)
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Roger Drew wrote:

> This is a very important and interesting question which Bob Mayes and 
> Margaret Anaminyi have raised and I would be interested in hearing 
> views on this as part of the review I am doing.

> A few thoughts that people might like to comment on:

> 1. Changing environment - no doubt the current environment is very 
> different from 40 years ago when ELBS (BookPower's predecessor) was 
> established. The emergence of IT is a key one. How has this affected 
> the need for textbooks in training of health professionals in Africa? 
> A survey carried out by BookPower in 2000/1 was reported as showing 
> that the vast majority of students saw textbooks and a well-stocked 
> library as their main sources of information. What do you think?

In Zimbabwe, and I suspect elsewhere, it is difficult to maintain in-
formation seeking behaviors in health professionals once they com-
plete their formal training and move into practice, particularly in 
the rural areas. This is due, in large part, to inadequate access to 
reference materials from basic textbooks to current journals. Most 
district level hospitals have little in the way of a library and find 
it very difficult to maintain collections given informal borrowing 
practices, and normal wear and tear. Also, most do not have the fa-
cilities to make copies of relevant material for personal use by the 
staff. 

We have found, however, that all of our district hospitals have at 
least one computer and that these all have CD-ROM drives (as do vir-
tually every computer less than 2-3 years old). CDs, or better yet 
DVDs, have tremendous information density and are very, very cheap to 
produce and distribute (and replace, should that become necessary). 
Another possibility, which we are currently working on, is the idea 
of an "electronic branch library". With this model, the reference li-
brary would be located at a single site (in our case the Medical Li-
brary at the College of Medicine) and remote sites would be able to 
request publications via email using an electronic index distributed 
to each site on CD. Document delivery would also be electronic as an 
email attachment. I won't go into details, but would be happy to dis-
cuss this with anyone interested.

I should also mention that the Medical Library itself also has the 
same issues with collection maintenance and is very interested in 
moving as much of its collection to electronic form as possible. 


> 2. Accessibility - there are access issues for both books and elec-
> tronic media. I would be very interested to hear any particular stu-
> dent experiences of these. For students, are books or computers more 
> accessible? Is this changing?

I would agree that printed texts are most useful for day to day stu-
dent activity in a classroom setting. However, for reference materi-
als this may not be the case. Indeed, if the cost of collection ac-
quisition and maintenance is calculated, the cost of computers and 
printers compares favorably.

> 3. Competition or Synergy? - often printed and electronic media are 
> set against each other, as if one is competing with each other. I 
> would be very interested to hear of examples of where printed and 
> electronic media are being used together for training purposes

I see no competition between the various media. The choice needs to 
be driven by an analysis of the particular need.

> 4. Copyright issues - one of the major barriers to the idea put for-
> ward by Bob is that material in books is copyright and publishers get 
> their profits by selling books. Anything which undermines those sales 
> is not going to be supported by publishers. Consequently, they are 
> unlikely to be willing to make copyright material, such as that pub-
> lished in books, available electronically. Views and experiences of 
> this would be most welcome.

This is certainly a major issue, but one which I believe has been 
misconstrued somewhat. While electronic publishing via an open Inter-
net site might cause problems, the type of access outlined above 
would allow a very tight control on who is able to use the material. 
It has already been recognized by several publishers that sub-Saharan 
Africa, at least, is a very small market with very large needs. This 
is evidenced by the very steep discounts offered to institutions in 
these countries. It is also interesting to note the large number of 
journal publishers who are making their materials freely available 
electronically. Often times they restrict this availability to mate-
rial over six months old, but in our context that is not much of a 
downside.

> Currently, I think the view within BookPower would be that it is not 
> planning to work with/through electronic media for a combination of 
> reasons including:
> 
> * the distinctive nature of the scheme and the skills and competen-
>   cies of BookPower
> * others are already involved in the IT field and have skills and
>   competencies in that area
> * the 'fact' that textbooks remain the main source of information for
>   most students in Africa
> * the 'fact' that publishers would not be willing to make copyright
>   material available electronically
> 
> However, I think part of the nature of the review is to critically 
> examine some of these things - so feel free to comment.

We here in Zimbabwe would be very interested in the results of the 
review. 

Cheers,

Bob Mayes
Chief, Health Informatics Section
Zimbabwe CDC AIDS Program
38 Samora Machel Ave., 2nd Floor
Harare, Zimbabwe
Tel: +263-4-796-040
Fax: +263-4-796-032
Cell: +263-11-613-195
mailto:Mayesb@zimcdc.co.zw

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