Valerie Walker, director of the UCLA Medical Alumni Association, cites the domino effect in the children's book "If You Give a Mouse a Cookie" to explain how a 25-word e-mail request for some donated textbooks from a UCLA medical school graduate stationed in Iraq turned into an international movement of giving in only 18 months.
During her 2006–07 Iraqi deployment, Army Maj. Laura Pacha learned that the Iraqi government had sealed off the country from new medical textbooks since 1994. Pacha, a physician who graduated from UCLA's medical school in 1998, sent a request to the UCLA Medical Alumni Association for medical textbook donations to bring the medical libraries up to date.
Walker says she wanted to help, and she knew it was possible. After all, eight years ago, she guided her daughter through the logistics of shipping and distributing 3,000 pounds of humanitarian aid collected for Polish orphanages, which earned Walker's only child a Girl Scout Silver Award.
But she had no idea her efforts this time would spread like a virus, evolving into the project Operation Medical Libraries
(OML), which harnesses the goodwill of people from all over the world.
Walker organized what she thought was a one-time textbook donation drive, e-mailing UCLA medical alumni asking them to drop off medical textbooks they weren't using to a designated location on campus. More than 2,000 textbooks poured in, and she shipped them off to Iraq. Capt. Marcus Pecora, a UCLA School of Nursing alumnus, received the donations on Pacha's behalf and delivered them to numerous facilities in the provinces of Tikrit and Salah el Din.
"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."
The book drive then took on a life of its own, according to Walker.
The donations kept pouring in, and at the same time, Walker began receiving requests from other U.S. medical corps representatives serving in Iraq — and Afghanistan.
While on military duty, these physicians were seeing firsthand the scarcity of resources for their medical counterparts in developing and war-torn parts of the world. Internet resources in these areas are less accessible due to a lack of electricity and limited infrastructure, so doctors and nurses rely heavily on a limited supply of textbooks for formal and continuing education.
Under the Taliban, all illustrations of the human body were forbidden in Afghanistan, and books with anatomical descriptions were confiscated and burned, according to Navy Lt. Cmdr. Bruce Deschere, who advised medical staff at the Afghan National Army hospital during his deployment.
Through e-mail, Walker has rapidly connected those in need with those willing to give.
With medically trained Bruins and other Americans mentoring Iraqi and Afghan doctors, the donated books are saving lives.
"A typical doctor can have 200,000 patients over his or her career," Deschere said. "Do the math, and the (lack of up-to-date) medical textbooks can literally impact the care of millions."
In one case, the chair of pediatrics at a major hospital in Iraq had been relying on a 1993 photocopy of the Nelson Textbook of Pediatrics. He told an Army captain, "I just want this one book." When a pediatrician at the University of California, San Diego, heard the story from Operation Medical Libraries, she bought him an updated edition and other books.
In each case, the books were sent from the U.S. to the Army Post Office (APO) address of military personnel, who then delivered the textbooks to the medical schools, doctors or hospitals in need. Using the APO system allows shipping costs to be calculated on the domestic rate and eliminates the excessive paperwork and delays that come with foreign government customs inspections, as well as the typical gift tax levied on the recipient.
OML has added Malawi, Mozambique, Morocco, Uganda, Peru and the Solomon Islands to its list of recipient countries.
In addition to textbooks, OML has received requests for needed medical supplies, including microscopes, scrubs and stethoscopes.
Walker is quick to cite statistics from the Clinton Global Initiative indicating that more than 7,000 tons of usable medical materials and supplies are discarded every day in American hospitals and clinics — most of which are incinerated or deposited in a landfill.
"There's no reason all these resources should go to waste when there is such a dire need globally," she said.
Since the project's happenstance beginning, Walker has facilitated the shipment of more than 32,000 pounds of textbooks and has established a collaboration among more than 20 partners from across the country, including publishers, authors, university medical schools, hospital libraries and other organizations.
Physicians have been inspired to give because there's an immediate impact, and they feel a kinship toward their foreign medical professionals, Walker said.
Many U.S. physicians rely on the Internet to get updated journal articles and medical information, and their textbooks and physical libraries languish, according to physician Lawrence Maldonado, a 1980 UCLA graduate who is medical director of the intensive care unit at Cedars–Sinai Medical Center. Maldonado organized donations from Cedars.
"It makes so much sense," he 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."
Walker has also engaged some high profile individuals to publicly support the program, including U.S. Rep. Henry Waxman of Los Angeles and Khaled Hosseini, an Afghan native and the author of the acclaimed novel "The Kite Runner," who attended medical school at UC San Diego, and completed his residency in Los Angeles.
While 12 medical schools nationwide are partners in the project, Walker is especially proud of having recruited all five UC health sciences campuses to participate.
"We're always talking about the 'power of 10' with the 10 UC campuses, that we are stronger when we come together," she said. "I believe this is true. When it comes to alumni relations, the campuses aren't competing, which lends itself to collaborating and sharing best practices. Now that all five campuses are involved, we stand united on the mission to enhance medical education and improve health care for people we will never meet."
Walker recently facilitated a partnership between Canadian physicians living in Toronto and members of the Canadian military serving in the Afghan province of Kandahar. As a result, textbooks from Canadians will be included in OML libraries.
It is difficult to assess the scope of the OML project; because all the information anyone needs to donate is on the OML website, individuals can send donations on their own, without the knowledge of those who started the project.
Recently, Walker received an e-mail from an Army nurse stationed in Afghanistan. The nurse gave Walker the name of a physician who had sent her several boxes of books and asked Walker to e-mail him and thank him.
"Since he found out about OML through its website, I don't know who he is or how to contact him. I am certain other physicians have sent books without my knowledge," Walker said.
"OML's story continues to expand, with no ending in sight," she said.
And for the beneficiaries, the extent of OML's generosity goes far beyond the books themselves.
Shane Granger works with a nonprofit organization serving Isabel Province, one of the least developed areas of the Solomon Islands, where a poorly funded local doctor and his staff care for more than 40,000 residents spread over a 4,800-square-kilometer area. When the doctor received a much needed shipment of medical books and training manuals, Granger e-mailed Walker to thank her.
"We can do no better for these people than sending them knowledge to do their jobs more professionally, knowledge that builds their own self-esteem and will be there long after we have gone," he wrote. "You are not sending tools, but the knowledge to use the tools. That is the most important gift we can ever make."
Granger recalled the head nurse crying when she opened the first OML shipment and then pinning to the wall a line from the accompanying dedication letter. It read: "You have not been forgotten."
To be a part of the movement, visit the OML website
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