I received a request from a physician in Iran for current texts in my field. 
His plea was touching: 

> I know that , as  a junior physician, I have no right to bother  a senior 
> surgeon, but asking for your kind help was my last chance. I practice in a 
> remote area of W.Azarbaijan , Iran , close to  Iran - Iraq border zone . As 
> the sole medical facility in region , we have to practice all branches of  
> surgery here . A majority of our patients are oculofacial reconstructive and 
> oculoplastics  cases .   Most of our patients are poor and unable to pay even 
> our  negligible visit fee .  
> 
> Also I am far from medical colleges , libraries and professors in Iran, my 
> sole consultants are my books and journals  . On the  other hand ,  my low 
> income and embargo on Iranian Banks as a result of nuclear dispute does not 
> allow me to buy  all my needed books. 


I can send him some of the books he has asked for, but that does not solve the 
underlying problem, which is duplicated all around the world.  Although the 
number of "open access" journals and books is increasing, they still are 
inadequate for specialized needs such as this. All publishing throughout the 
world is done digitally, and this knowledge is already in digital format. Can 
anyone think of how we can get that information to people like this, and still 
preserve the profit motive that is necessary for publishers to continue to 
operate?? 

The problem is not one of hardware or internet access.  It is not one of lack 
of digitization of the information.  The problem is how to devise a new 
business plan that looks at information as the means, and not the end.  Steven 
Denning recounts his efforts at the World Bank to give away information as an 
expendable.  Information, at least in medicine, is still looked at as power.  
In reality, the ability to "situate a network" is where the power is heading.  
Publishing houses and journals need to turn a profit on some other item of 
value, but how to make the network something of value when now it is not even 
appreciated?

Russ Gonnering  ("Russ #3)

Russell Gonnering, MD, MMM, FACS, CPHQ
[email protected]
www.emergenthealth.net

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