Alumni save lives of Iraqis, Afghans with donated medical books
It's hard to learn and practice medicine when the government has sealed off the country from new medical textbooks and banned all drawings of the human form, even for surgeons' anatomy lessons.
That's the history that Bruin medical graduates stationed in Iraq and Afghanistan encountered when they tried to help local doctors improve healthcare. When Army Major Laura Pacha, a physician who graduated in 1998, sent a plea a year ago to the UCLA Medical Alumni Association requesting textbook donations, she hoped to make a dent in the problem.
No one expected the tidal wave of contributions that has garnered national attention.
"I'm perpetually flabbergasted," Pacha said.
Valerie Walker, director of the UCLA Medical Alumni Association, heeded Pacha's call and organized a one-time donation drive a year ago that collected 5,000 pounds, about two and a half tons, of books. But after the drive ended, donations kept flowing in.
"It was a good idea that just took on a life of its own," said Walker, who never expected to head up a nationwide grass-roots movement. Operation Medical Libraries (OML) has now collected 13 tons of books without any publicity and sent them to two dozen hospitals and medical schools in Afghanistan and Iraq. "Other UCs are holding book drives. I'm getting calls from Florida, Colorado, North Carolina. The National Institutes of Health want to get involved."
With medically trained Bruins and other Americans mentoring Iraqi and Afghan doctors, the books are saving lives, Walker said.
"I'm hearing that often, unless they have a book to prove, 'This is how to do it,' the locals don't want to listen," Walker said. "Without things like pharmacology books, they're over-prescribing medicine, and bad things are happening. …When you pick up your prescription, you don't get it in a bottle. It comes in a napkin. Your name's not on it, and there's no medical information on it, just hash marks to show how many pills to take in a day."
The military is also providing training — and OML books — on emergency medicine, which is vitally needed because of the injuries caused by frequent suicide bombings, Walker said.
People have been inspired to give because there's an immediate impact, and it's easy for American doctors to donate, Walker added. Many U.S. physicians rely on the Internet to get updated journal articles and medical information, and their textbooks and physical libraries languish, agreed physician Lawrence Maldonado, a 1980 UCLA graduate who is the medical director for the intensive care unit at Cedars-Sinai Medical Center. Maldonado organized donations from Cedars.
"It makes so much sense," Maldonado said. "Let's get these books over to someone who's going to use them, who doesn't have the electronic resources, as opposed to those of us who will get the same information off the Internet."
The reasons donations are needed in Iraq and Afghanistan are different, Walker said.
"Iraq has books up to 1994 because Saddam stopped letting new items in," she said. "At one hospital, the chair of the pediatrics department — the chair! — relied on a 1993 photocopy of Nelson's Book of Pediatrics. He told an army captain, 'I just want this one book.' " When a pediatrician at UC San Diego heard the story from OML, she bought him an updated edition and other books.
Medical information is even scarcer in Afghanistan, partly because of more than three decades of coups and wars, said Naval Lt. Cmdr. Bruce Deschere, who just returned from a year advising medical staff at the Afghan National Army hospital.
"Another major reason is the Taliban tenet of forbidding any illustration of the human body as vulgar," Deschere said in an e-mail. "They confiscated and burned any text with any anatomic description. They even monitored lectures in the medical schools to make sure no chalkboard drawings were made. One physician told me they were lectured only verbally and had to memorize on the spot; no note-taking was allowed. [It is] extremely difficult to absorb hundreds of thousands of facts this way."
A typical doctor can have 200,000 patients over his or her career, Deschere added. "Do the math, and the [lack of up-to-date] medical textbooks can literally impact the care of millions," he said. "OML is a godsend."
Even delivering books can be dangerous, said Army Capt. Marcus Pecora, a nurse who graduated from UCLA in 2003. Pecora helped distribute books in Iraq, and although he couldn't comment on specific missions, he indicated that even with book deliveries, soldiers faced "sniper fire, hand grenades and improvised explosives." He learned to keep book delivery dates a secret, even from the receiving hospitals. But once he arrived, it was worth it.
"I'd see new doctors and old doctors using the books, and the facility directors were always really thankful for the books," Pecora said. "They feel as if they are out on an island when they don't have the new information, so getting it made them feel connected."
But shipping heavy books can be expensive. UCLA can't do it alone, so OML provides the mailing addresses of its coordinators in Iraq and Afghanistan, and recommends donors send materials media rate to save money.
"I hear from our Army, Navy and Air Force liaisons that the Iraqi and Afghan doctors just can't believe the generosity," Walker said. "It's a noble cause with immediate results."
