By Carrie Loewenthal Massey

Special Correspondent

New York — As Pakistan recovers from the devastating floods that struck the country in late July, a unique collaboration between the U.S. National Library of Medicine (NLM) and medical publishers is helping doctors in the flooded areas to tackle new diseases and navigate unfamiliar health conditions.

The library’s Emergency Access Initiative (EAI) grants medical relief workers free access to the full articles from 240 medical journals, 69 medical textbooks and the online databases Uptodate and DynaMed, which normally require subscription fees, plus the NLM’s MedLine/PubMed free digital database. Thus, medical staff responding to a disaster can continue to access vital information even if the medical libraries on the ground have been affected.

“We know from experience with past disasters that health workers have a great need for information to treat those in affected areas and to deal with the public health issues that occur,” said Becky Lyon, NLM’s deputy associate director for library operations.

Indeed, NLM opened the EAI for use in Pakistan in part as a result of direct requests from aid workers in the flood territories. On August 26, a cancer hospital in Lahore contacted the World Health Organization (WHO) for information to help with their research on health issues suffered by flood victims.

“They wanted to see what medications might be available and what diseases might crop up. … That prompted me to ask whether NLM was planning to open up EAI,” said Kimberly Parker, the WHO program manager for the Programme for Access to Health Research. The WHO inquiry, along with a request from one of the publishers providing content to NLM, led the medical library to open the emergency initiative.

The NLM, which is a part of the U.S. National Institutes of Health (NIH) and is the largest medical library in the world, has partnered with the WHO to spread the word about the emergency initiative’s availability.

The WHO’s Eastern Mediterranean regional office coordinates with the Ministry of Health in Pakistan and sends messages through WHO contacts that include the Eastern Mediterranean Association of Medical Editors and the Virtual Health Sciences Library, Parker said. WHO field workers in Pakistan also communicate with health care professionals they meet on the ground in the afflicted region. The NIH’s Fogarty International Center conducts outreach in Pakistan as well, according to Lyon.

The emergency initiative, opened September 9 for use related to the Pakistan flooding, will remain open until October 9. At the end of that initial four-week period, NLM staff will assess the emergency initiative’s use and study news reports from the flood region to determine whether the service should be extended, Lyon said.

Though she has not received official usage reports yet, Parker said she believes the health community in Pakistan values the EAI, and she has already heard of an extension request from a WHO affiliate.

“I would expect anyone receiving word of this is using it frantically as much as they can,” she said.

A CRITICAL RESOURCE WHEN DISASTER STRIKES

The NLM set in motion plans for an emergency information-access system in the aftermath of Hurricane Katrina, which ravaged the Gulf Coast of the United States in August 2005. The system was subsequently launched in early 2009.

“We learned from Katrina that health professionals called to respond to the disaster didn’t have experience with the things they were seeing in the disaster area,” Lyon said. “They were seeing very different kinds of diseases and having to figure out interesting ways of providing health care with very limited resources.”

Originally negotiated for use only in the United States for domestic disaster-response efforts, the EAI has in fact served as an international resource: the NLM first activated the initiative in January to help those working in Haiti with the earthquake relief effort.

“When the Haiti quake occurred, so many Americans were involved in the response, including the military, so we went to the publishers and asked if they’d be willing to extend [the EAI] for the Haiti disaster,” Lyon said. After the initial four-week open period, the publishers agreed to longer EAI access in Haiti.

The Pakistan floods mark the resource’s second activation period. According to Lyon, the NLM considers the floods a special occurrence that warranted opening the EAI, especially when the WHO offered to use their communication network to spread word of the resource. The NLM has a network of 5,000 U.S. libraries to which it can send information, but it relies on the WHO to extend its connections abroad to Pakistan.

With the WHO partnership, the EAI has the potential to reach critical areas of the flood region and make a difference in peoples’ health.

“It is our hope that providing EAI to Pakistan will help them meet the health challenges their people face now and in the months to come,” said Lyon.

Publishers participating in EAI include the American Academy of Pediatrics, American Association for the Advancement of Science, American Chemical Society, American College of Physicians, American Medical Association, American Society of Health-Systems Pharmacists, ASM Press, B.C. Decker, BMJ, Elsevier, FA Davis, Mary Ann Liebert, Massachusetts Medical Society, McGraw-Hill, Merck Publishing, Oxford University Press, People’s Medical Publishing House, Springer, University of Chicago Press, Wiley, and Wolters Kluwer.

Learn more about the Emergency Access Initiative ( http://eai.nlm.nih.gov/docs/captcha/test.pl?url= ) on the NIH website.

(This is a product of the Bureau of International Information Programs, U.S. Department of State.  Web site: http://www.america.gov)