Librarian without Borders
Anne Seymour lends her expertise to countries launching medical schools and other health care projects.
March 25, 2019
Anne Seymour has earned her frequent flyer status. When she was associate director of the biomedical library at the University of Pennsylvania, she was instrumental in helping the country of Botswana improve the delivery of medical information to clinicians and patients. She did similar work in Guatemala. Now, as director of the Welch Medical Library at Johns Hopkins University, she has less time to get directly involved in international collaborations, although in 2017 she was the librarian representative to a team that provided guidance on a new medical school in China.
NEJM LibraryHub sat down with Seymour to talk about her library adventures abroad.
Q: Why would a medical library want to set up partnerships with health care systems in developing countries?
A: People often think this is just something fun and benevolent to do, which is totally true. But as importantly, the projects I have done at Penn and Johns Hopkins have supported the work and missions of these institutions as well as their partner institutions around the world. And anything you can do to boost access to health information for consumers and practitioners improves the health care of the world as well as research capacity, which advances science. These are lofty goals, but they’re true.
It’s fascinating to learn how librarians, researchers, and health care practitioners in other countries do their work, especially in resource-limited settings. There are many ideas and new models you can bring back to your own institution, for example how a new medical library in Botswana, with no tradition of academic medicine or history of print resources, deployed mobile devices. And I can’t tell you how much I have learned in terms of cultural competency.
Q: Tell us about your first project in Botswana.
A: The Perelman School of Medicine at Penn was working with the Botswana Ministry of Health and the University of Botswana (UB) to build a program of HIV treatment and care primarily funded under the U.S. PEPFAR program (President’s Emergency Plan for AIDS Relief). Botswana at that time had the highest HIV rate in the world. Penn was also helping launch the country’s first medical school. My colleagues and I wrote a proposal, with the support of the leadership of the Botswana-UPenn Partnership, to do an information needs assessment focused on practitioners. In 2008, we received funding from The Elsevier Foundation. We learned from the assessment that any information that would be delivered should be on mobile devices because cell phones were becoming ubiquitous and the cellular networks were robust. The other thing we determined is that there needed to be specialized training of librarians to meet the needs of the new medical school. There were no medical librarians in the entire country. Hospitals did have librarians, but those librarians did not have special training.
After we determined the needs, I began working with a colleague who is very involved with the Botswana-UPenn Partnership and mHealth projects, dermatologist Carrie Kovarik, MD. The project was to bring smartphones to residency programs, which they were launching as part of the new University of Botswana medical school program. The residents typically attended medical school outside of Botswana, which the government paid for. The hope was that they would come back to Botswana to work. But because there wasn’t any graduate medical training, there weren’t growth opportunities, so they didn’t always return. As a result, there weren’t a lot of specialists in the country. The new residency program, they hoped, would change that.
These small residency programs — 12 internal medicine residents spread out among four sites — had little to no access to information — no textbooks, nothing. We provided smartphones with free medical apps and partnered with some vendors to provide additional content — drug information, evidence-based medicine content, dosage calculators, etc. And the phones had data plans — to access things like PubMed and app updates. The residents said getting smartphones was a lifeline and a lifesaver for them.
Q: Did the pilot lead to any other projects?
A: We published papers on it. Also, the pilot was expanded. The medical school adopted this idea and with funds from an NIH/Fogarty Institute program, the Medical Education Initiative (MEPI), the school was able to distribute tablets for all of their students loaded with content to support their learning, clinical practice, and research. What was exciting is that the pilot grew into a program that was then fully supported by the University of Botswana Medical School.
Also, with the help of the University of Botswana (UB) Medical School, we were able to fund Dineo Ketshogileng, a UB librarian, to come to Penn in 2010 and do an “attachment” or internship for six months at my library.
Ms. Ketshogileng shadowed librarians, met with people, attended classes they taught, and did a lot of self-learning tutorials on different topics, all part of an immersion in medical librarianship. She attended conferences, including the Medical Library Association annual meeting, and we worked on a plan of action for her when she got back to Botswana. She got very involved in our smartphone pilot and the subsequent program distributing tablets to students.
I just spoke with Ms. Ketshogileng, the other day. We are so proud of her accomplishments and how she’s built a program supporting the UB medical school.
Q: After the Botswana work, which we understand included your helping to create an informatics curriculum, you turned your attention to Guatemala. Can you tell us a little about your collaboration there?
A: We built on our experience in Botswana. The project focused on bringing mobile technology to a small hospital in the Lake Atitlan region of Guatemala. Again, we built off of an existing institutional collaboration,
the Guatemala-Penn Partnership. We worked with medical librarians in the two Guatemalan institutions in the partnership (Universidad de San Carlos de Guatemala and Universidad Francisco Marroquin) to build their
capacity to deliver services to their community. We taught research skills, data management, accessing the literature, managing citations, etc. And we co-taught with the Guatemalan librarians and Penn faculty in a week-long workshop for Guatemalan researchers.
Q: What sorts of international collaborations have you been involved with since you’ve been at Johns Hopkins?
A: My whole team at the Welch Medical Library is engaged globally. Some examples of our work include pre-departure training for students and faculty going abroad for research or practice; week-long, in-country seminars on searching, publishing, and research practices; education and consultation with visiting students and scholars; and presentations at international conferences.
One new area of engagement for me was with Johns Hopkins International (JHI). JHI is a division of Johns Hopkins Medicine that sets up clinical operations in other countries and also consults with countries on practice and
education models. JHI was engaged with a university in China that wanted to establish a new medical school based on the U.S. model of medical education. JHI put together a team of people to do this over several site visits, virtual meetings, and visits from our Chinese colleagues. I went to China as part of one multidisciplinary team that provided consulting services on admissions, IT, library services, and general curriculum. I was there for a week and met with many university leaders, faculty, technology staff, and most importantly, librarians. The university library already had a strong and respected program supporting the existing academic mission but lacked knowledge and expertise on supporting a medical school. We discussed what kinds of resources they should look at, what sorts of staff development they needed to do, what skills were needed, what kinds of partnerships they should look for at the university, and more. We also hosted the university librarian when he came to visit Hopkins and the Welch Library and connected him with many resources and opportunities to grow his team for supporting medical education and research. JHI completed the consultancy and although the new school has not yet launched, we hope to see that happen in the future.
Q: What advice would you give to colleagues who may be interested in getting involved in these types of international collaborations?
A: First, I would recommend partnering with your own institution because you will be fulfilling the broader mission, which will result in any initiatives being sustainable and grounded in your institutional goals.
Take advantage of the existing resources and learn about the work of other medical librarians. There’s a lot going on in this area. The Medical Library Association has an International Cooperation Section where you can learn a lot — such as who you might want to partner within your own institution and what kinds of funding opportunities are out there.
Q: Any final words on your experience with these projects?
A: One of the most important things I do in my work is to build my network — my network at my institution and my global network. This work exponentially expanded my global network. Also, when you’re traveling with the leadership of a medical school to a place like Guatemala, you get to know each other very well and you really get to show the value of having a librarian on your team.