Bridging the eye health information gap through the internet

Sally Parsley
E-communications Manager, International Centre for Eye Health (Resources), London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.

Keywords: Education; Teaching Materials; Access to Information, Databases; Internet

The internet connects millions of computers around the world. Once connected, the eye health worker can use internet services to:

access the most up-to-date information at a fraction of the traditional cost of journal subscription via the new Open Access publishing model
communicate with colleagues, reducing the sense of professional isolation which comes from geographical separation
engage in a two way process of communication between health information providers and users
publish locally appropriate material more easily.

However, if this technology is to play a major part in providing health information, some key problems must be acknowledged and addressed.¹

A serious concern is with the ‘digital divide’ - the gap between those with and those without internet access. Only about one in eight people in the world can connect to the internet and most of these are in high income countries.^2,3 This ‘digital divide’ is at its most extreme in Africa where it is estimated only one in 70 are able to access the internet³ and most of those in South Africa.⁴

Some publishers bridge this gap by finding alternative ways to distribute information. The International Centre for Eye Health (ICEH) for example, has adopted an approach to sharing information which combines print and electronic materials and new technology such as the internet, email and CD-ROM to provide information in easily accessible formats and to facilitate local production and adaptation.

We can expect internet access to improve and become more affordable in the future (See Table 1). Potential users should not be put off by a lack of experience - the rest of this article gives help and advice on how to use the internet to access reliable and free eye health information.

Table 1. Use of the internet throughout the world

World region	Internet Useage	User Growth (2000-2004) (2004 or latest data)
Africa	1.4 %	183.2 %
Asia	7.1 %	124.4 %
Europe	30.7 %	117.7 %
Middle East	6.5 %	218.7 %
North America	68.6 %	106.3 %
Latin America/Caribbean	9.4 %	180.9 %
Oceania	48.5 %	107.2 %

From Internet World Stats www.internetworldstats.com/stats.htm

How to find the information you want

First, be clear about what you want to achieve (Table 2).

Table 2. Different types of health information and how to access it

What do you want to achieve?	How to find information
Explore a health topic generally or look for some specific health information	Browse health web sites - this can be time consuming Use a search engine - see ‘Tips for searching the web’ Visit information gateway and bibliographic database web sites - these web sites and pages collect links to documents on a specific topic
Find out about an organisation	Visit its web site If you don’t know the web site address use a search engine
Keep abreast of current research and practice in the health field	Visit electronic journal web sites Visit information gateway and bibliographic database web sites Subscribe to email updates and alert services
Access free journals on line	Visit Open Access web sites for up-to-date research
Participate in discussion with a group of others	Subscribe to email lists - read and participate in discussions via email Visit discussion boards - read and participate in discussions via a web site
Communicate with colleagues around the world	Use email Use Instant Messenger computer programs Visit individuals’ web sites

Tips for searching the web

Some examples of popular search engines are:

Think carefully about how you will enter the search terms you want to use.

are there alternative spellings?
which language will you use?
is the plural term often used as well?
are there terms with similar meaning?

Use Boolean terms such as:

OR
Web pages found containing either term will get a higher placing. Note: OR is used by default in many search engines.
For example, open-angle OR glaucoma
AND / +
Web pages found must contain both terms.
For example, open-angle AND glaucoma
NOT / -
Web pages found must not contain the terms preceded by NOT.
For example, glaucoma NOT open-angle
“ ”
Web pages found must contain the exact search term between the quotation marks
For example, “open-angle glaucoma”
Read the help pages provided by many search engines. The symbols used for AND/OR/NOT differ and not all search engines support all the Boolean features.

Evaluating information

Anyone can publish anything on the internet, and inevitably some of what is published is inaccurate or undesirable. Things to consider include:³

Author
Do you recognise and trust the author’s name and affiliation?
Publisher
Try to assess the publisher’s role and authority
Point of view or bias
Because it is easy to publish on the internet, the variety of points of view and bias will be the widest possible
References
References allow you to evaluate an author’s knowledge
Accuracy
Can the information be verified?
Up-to-Date
When was the information published?

Glossary of terms
Bookmark - also called Favourite - a way to save in your browser direct links to web sites you want to see again.
Boolean searches - a way to improve searchers using ‘operatives’ such as AND, OR, and NOT.
Browser - a computer programme that lets you view the World Wide Web. For example, Internet Explorer. Browsing is the act of clicking on a link in one web document and opening another one.
Discussion Boards - popular, fun, alternative places for discussion. They are accessed and viewed on the web through a browser.
Email - a way to send messages to other internet users.
Email Lists - services to which you subscribe to receive and participate in discussions via email.
Email Alerts - subscription services which send you emails when web sites have new content.
Instant Messengers - computer programs that let you send a message that immediately pops up on an online contact’s screen. Two free examples are ICQ and AOL Instant Messenger.
Hypertext Links - text, buttons or graphics that, when clicked with a mouse button, open another page.
Open Access Publishing - a new model for financing scholarly publication. Instead of users paying to subscribe to a journal, articles are made available electronically for free and the cost is paid by the authors or institutions.
URL (Uniform Resource Locator) - a web site address. For example, the URL for the Community Eye Health Journal web site is www.cehjournal.org To visit this web page type the URL into the address bar of the browser.

References

1 Tan-Torres Edejer T. Disseminating health information in developing countries: the role of the internet. BMJ. 2000; 321:797-800. Available from: bmj.bmjjournals.com/cgi/content/full/321/7264/797
2 International Telecommunications Union. Internet indicators: Hosts, users and number of PCs 2003. Available from: www.itu.int/ITU-D/ict/statistics/at_glance/Internet03.pdf
3 Internet World Stats. World internet users and population stats. Available from: www.internetworldstats.com/stats.htm
4 Manji F, Drew R, Jensen M. Healthcare training and internet connectivity in Sub-Saharan Africa. (Monograph on the Internet), Oxford: Fahamu; 2002. Available from: tall.conted.ox.ac.uk/globalhealthprogramme/report/Nuffieldwebreport.pdf
5 Kirk E. Evaluating information found on the internet. The Sheridan Libraries of The John Hopkins University 1996 (updated 5 June 2002). Available from: www.library.jhu.edu/researchhelp/general/evaluating/index.html

All web links were accessed on 24 September 2004.