World Congress on Health Information and Libraries

The theme of the 9th International Congress on Medical Librarianship (or World Congress on Health Information and Libraries, as I've also seen it referred to) is Commitment to Equity.  I am struck by how every seriously this concept is taken by many of the delegates here.  In the plenary sessions I've seen a number of presentations that describe what is happening at a national level in a number of countries that are working very hard to develop healthcare systems that ensure an adequate level of care for eveyone.  Accurate and timely information management is taken for granted as a part of that mission.

Makes me feel like I come from a backward nation.  At lunch yesterday, discussing this with a couple of friends from the UK, Lynn quoted Jocelyn Elders from her talk at MLA last spring:  "In the United States we don't have a healthcare system; we have a sick-care system."  Our friends are baffled at why the richest and most powerful nation in the history of the planet doesn't fix this problem.  The problem is obvious and the resources are at hand.  It is incomprehensible to observers from other countries.  I doubt that I do a very good job in trying to explain.

I was moved by the mayor of Cotacachi, Ecuador, who described the efforts in his area to develop the local health system.  He spoke with great pride of how low the infant mortality rate is (much lower than the US), and how they've developed a sophisticated system for prenatal care that leverages the knowledge and abilities and talents of women throughout the community.  I wonder if we could get him as a consultant to Alabama.

Iain Chalmers gave a brief, pointed, and extremely lucid presentation on what he considers the "scandalous" failure of contemporary science and scientific journals to do a barely adequate job of "cumulating" knowledge scientifically, rather than simply continuing to do, and to publish, isolated studies.  He presents shocking data on the numbers of deaths in a variety of areas that could have been prevented if scientists and editors insisted on doing a better job of putting their work in context systematically.  I touched on this same theme in regard to the literature of librarianship in my April editorial earlier this year, but Sir Iain's presentation was far more elegant, persuasive and sobering.  He sees a tiny ray of light on the horizon, however, with a new policy announced by the Lancet, in which they will insist that articles that they publish must do an adequate job of reviewing the literature and putting each new study into the appropriate context (Young C, Horton R. "Putting clinical trials into context." The Lancet 2005 Jul 9-15:366(9480):107-8).  It's something that the new editor of the JMLA may well want to consider.  We may not be killing people by failing to heed Sir Iain's advice, but we're not helping them much, either.

Anca Dumitrescu, from the WHO Regional Office for Europe, reported on what sounds like a very interesting project -- systematic reviews directed towards public health policy makers, rather than health care professionals.  I haven't had a chance to look yet, but the website is public.  Imagine, political decision makers developing policy based on evidence and facts.  Obviously a fool's errand, but noble nonetheless.

Discussions of open access are everywhere, of course.  Even the director of PAHO, in her videoed remarks at the opening session on Tuesday evening, talked about the importance of the open access movement for the developing world.  I'll be in the thick of that tomorrow, since my paper is being included within the open access track.

I marvel at the complexity of putting on a meeting like this.  For those of us from the US, who are used to the very tightly scripted, by-the-clock, MLA annual, section and chapter meetings, it can be agonizing if you don't let yourself just go with it.    The first of yesterday's morning plenaries, for example, was supposed to end at 10:15.  I arrived about 10:00 (since I'd spent the previous 90 minutes in a fruitless quest to get my own registration sorted out), to find that the first of the four speakers was just finishing.  The 2nd panel was supposed to start at 11:00, but it was already after that when the first finally ended.  If this was the US, the organizer, at that point pulling out his or her hair and screaming profanities at the assistants, would have announced a five minute break to try to get the damned thing back on schedule.  But here in Salvador it was time for the brilliant Sons of Gandhi to put on a drum show that led everyone out of the hall and into the exhibits.  It was marvelous, with dancing and singing and beads being thrown around and aromatic essences fizzed into the air and even a little dead ringer of the Mahatma himself tottering along behind the troop.  I think the 2nd panel started around noon, and I'm not quite sure what time it ended.

But it'd be petty to fuss too much about that.  We've got a thousand interesting people here, all (more or less) dedicated to the importance of effective information management for improving the health of the world.  It's good to be together.  I think that tonight we're all going out dancing.