FORT HOOD, Texas, July 1, 2004 — One manifestation of Iraq's lack of a national infrastructure is its antiquated healthcare system. When 4th Infantry Division soldiers discovered the Tikrit Medical College library in May 2003, they found only old journals and no real textbooks.

The library was originally intended to service the nearly 600 students who attended the college. Instead it housed only a few shelves of out-of-date medical journals and photocopies of textbooks that were 10-to-20 years old. There was not a single computer in the entire library.

“When I first toured the library, it was neat and tidy, but had very little recent medical literature,” Dr. (Lt. Col.) Kirk Eggleston, division surgeon, said recently. “Almost all textbooks and journals were bound photocopies of the originals and the students weren't allowed to check out any of the materials.”

Word of the dire state of the library quickly spread among the division physicians and it wasn't long before an e-mail made it back to Fort Hood and Dr. David Gifford, a part-time physician at Darnall Army Community Hospital. Once a medical school professor, Gifford was keenly aware of the importance of training medical students with up-to-date materials and was saddened to hear of the state of the medical library.

“Medical information progresses rapidly enough that if you get a text 10 years out of date, you might as well be reading hieroglyphics,” Gifford said.

The body of knowledge shared by healthcare professionals advances daily as doctors and scientists around the globe discover new and better ways to treat the diseases. From innovative pharmaceuticals, to faster ways to diagnose the world's deadliest diseases, the medical field pays little heed to those who can't keep up.

Even a few months spent away from the mainstream of medical knowledge can leave a physician shaking his or her head in bewilderment. For Iraqi doctors and healthcare professionals, being isolated from the world's medical community for more than 10 years, by a regime intent on limiting all outside influence, means the world's way of practicing medicine in the 21st century is sometimes as alien as if the practices had come from another planet.

A combat support hospital commander during Desert Storm/Desert Shield, the recently retired Gifford said he quickly decided that helping stock the medical school's library with current texts and journals would be his way of helping to rebuild Iraq.

“I had contacted the Army about getting reactivated but they didn't want me. So I started thinking about what I could do to help the effort,” Gifford said. “It seemed to me that I should be able to get donations of text books and send them over to Iraq.”

The project grows its own legs

Since Iraqi medical education is based on a British teaching model, all instruction and accompanying texts and journals are in English. Gifford hoped this fact would make his task easier by allowing him to solicit donations from U.S. companies.

Gifford soon realized the task was easier said than done, as his calls to text book distributors and publishing companies were met with less than enthusiastic responses. After weeks of hearing “we'll get back to you” from the companies, Gifford wondered if his project was ever going to go anywhere. A final attempt placed him in contact with Dr. Susan Yox, the editor for an online international nursing education bulletin board.

“(Yox) said she was interested in helping because she had assisted in getting information out about needs for Afghanistan and had been successful in getting medical support and donations,” Gifford said.

Soon after contacting Gifford, Yox posted an article to her web site, www.medscape.com , outlining the needs of the library at the Tikrit Medical College.

The response to the article was “amazing,” according to Gifford. Donations began flooding in from all around the country. The American Medical Librarians' Association, medical school student organizations and more, collected recent journals and texts and sent them to Army physicians in Tiktit to distribute. Darnall Army Community Hospital donated 500 pounds of books and Yox's own organization, Medscape, donated 1,000 copies each of the basic medical texts “Scientific American Medicine” and “ACS Surgery.” The donations, Gifford said, are valued at more than $429,000.

“The hair on the back of my neck stands up when I think about all of the donations, because I thought I was maybe going to be able to get a little bit of help and the help has been beyond belief,” Gifford said.

As donations began arriving in Iraq, Eggleston, his fellow division soldiers and the staff of the 415th Civil Affairs Battalion lead by Dr. (Maj.) Alex Garza worked feverishly to help the medical school make room for the new materials.

“We received well over 1,500 boxes of recent medical books and current medical journals from nearly every state in the U.S. with the senders donating the postage as well,” Eggleston said. “We were able to provide the medical school in Tikrit with many newer texts covering all areas of medicine, as well as full 2003 sets of many prominent medical journals, including the New England Journal of Medicine, the Journal of the American Medical Association and many specialty journals.”  

Building the Iraqi health system one book at a time

“The Iraqis have been profoundly appreciative,” said Eggleston. ‘The physicians were very much aware that they didn't have the most current information, and they were very open to our help. The generous donations, from all over the country, go a long way to providing these fine docs with up-to-date medical information, and also are the start of a professional link and exchange between the physicians of Iraq and the U.S.”

Gifford sees the rebuilding of the Tikrit Medical College library as an ideal first step to helping Iraq rebuild itself and its infrastructure.

“These donations will dramatically improve the quality of the delivery of health care in Iraq,” Gifford said. “When the knowledge base of physicians increases, when the access to current information is opened, it cannot help but increase the quality of health care and the physician's ability to help patients, make the correct diagnosis, and initiate the proper treatment.”

Because the response to the book drive has been so great, Eggleston said soldiers of the 4th Infantry Division, along with their 1st Armor Division replacements and members of the Iraqi government have been able to distribute duplicate texts and journals to other clinics, medical colleges and hospitals around Iraq.

While status of the Tikrit Medical College library has been greatly improved over the past year, Gifford said he will not give up on the project until the library has more of the specialized journals and texts that doctors commonly use.

“We had no control of the spectrum of the things that were donated so, in many cases, we would get multiple copies of a common text, but didn't have the uncommon texts,” Gifford said. “Yes, the library is full, but not of all the books we know they need are there.”

Nearly a year after Gifford first heard about the library at the Tikrit Medical College, donations of medical texts and journals continue to pour in. With every book, Gifford is amazed at how a project he began to simply “stay engaged with the war effort” has turned into something with a life of its own.

“My hopes were to be able to get a copy or two of new or current medical texts from primary medical publishers and send them to the library at the medical college in Tikrit,” Gifford said. “Ending up with wall upon wall of bookshelves filled with text books and medical journals was beyond my most fevered hallucinations.”

For more information on this project, e-mail Gifford at dgifford@hot.rr.com .