Richard Smith asks: Can we create a global network of mentors?

Richard Smith I’m on a plane flying home from Nigeria, where I’ve been participating in a workshop on writing and publishing in journals, reading scientific papers, and encouraging evidence based practice. I had a wonderful time. The workshop had around 100 participants, and they were exuberant and highly responsive. The debate was intense, and some struggled with the discovery that there were no neat formulas and answers and no substitute for constant thought and study.

Despite the enthusiasm, few had published papers—and many were apprehensive about their chances of doing so. West Africa has very few functioning journals, and international journals seem to have horribly high rejection rates.

Yet all agreed that reading, writing, publishing, and debating are fundamental for the improvement of any system—and certainly a health system. Nigeria’s health system might not unkindly be described as failed.

Joseph Ana, the editor of BMJ West Africa (which organized the workshop), took over as health commissioner in Cross River State, one of the poorest states in Nigeria, five years ago and after visiting every part of the state documented the dire state of the health system. It was failing at every level but especially at the primary care level where facilities were dilapidated and services barely functioning. People had no confidence in the system and went elsewhere to get care and give birth. Maternal mortality was 1%, childhood mortality 20%, immunisation rates under 20%; and there were only 72 doctors for 3 million people.

Enhanced information flow can play an important part in improving the health system. Indeed, a flow of good information and vigorous debate are in themselves an essential part of a well functioning health system.

At the end of the workshop we gathered ideas on how to move forward. Mentorship was the number one suggestion. I agree. You can light a fire and give broad information by running a workshop, but attendance at a workshop will not in itself be enough for people to start writing, publishing, critically appraising, and promoting evidence based practice. One on one mentorship is the way to make a real difference.

But Nigeria—and probably many other low and middle income countries—have few people in a good position to act as mentors. Possible mentors are few and don’t have the time, the inclination, or, it must be said, the skills.

Yet there are plenty of people in developed countries, including Britain, who could act as mentors—and in these days of Skype and email mentorship can be done at a distance and at no cost. My hunch is that there are many people, particularly perhaps retired doctors, who would much enjoy being mentors. (Indeed, I’m a mentor, and I keep feeling that I get more out of it than my mentee. I get rich insights into other worlds, something invaluable.)

So might we create a global network of mentors and mentees? Health Information for All 2015 would be a great organisation to take the lead.

Richard Smith is former Editor, BMJ.