The True Meaning of Technology Transfer
Robert H. Glew
I have had a long-standing interest and experience in developing research collaborations with biomedical scientists in developing countries. In particular, for the past 25 years I have maintained mutually rewarding and beneficial scholarly relationships with many physicians and Ph.D.-basic scientists at several teaching hospitals in Nigeria. All the while I myself have been engaged in these scientific collaborations with academicians in Nigeria I have also been sending teams comprised of 5-10 undergraduate-, graduate- and medical students to that country for periods of two to three months where they receive biomedical research training in various areas related to tropical health.
When most biomedical scientists hear the words "technology transfer", particularly in the context of one or another developing country, the kind of transfer they usually think of involves hardware such as computers, spectrophotometers and fluorimeters for measuring enzymes or quantifying substances like creatinine, ketones or glucose in blood serum, enzyme-linked immunoassays for detecting viruses like HIV, ultrasound instruments for scanning bones or monitoring the unborn fetus, bioelectrical impedance analyzers for determining body composition, spirometers for assessing lung function, a gas chromatograph or HPLC system for separating and quantifying fatty acids or amino acids, and molecular biology paraphernalia for studying and manipulating DNA. In 1977, before I had spent my first sabbatical leave in Nigeria, I, too, thought only in terms of biomedical hardware when I was planning which technology I might carry with me to the teaching hospital where I would be conducting research involving biochemical and nutritional aspects of maternal/child health. It never occurred to me that the fund of knowledge I carried in my head would be more important and valuable to me in Africa than all the scientific instruments and reagents I was packing up to take with me on my sabbatical.
Over the past 25 years, I have been taking my sabbaticals at various teaching hospitals in Nigeria and directing an international biomedical scholar exchange program in that West African country. Early on, I regarded technology transfer largely in terms of capital equipment and the methodologies required to operate and maintain those devices so they might be used properly and productively in support of teaching and research activities that might answer fundamental scientific questions of importance to the people of Nigeria. I am chagrined to confess that during the 20 or so visits I had made to Nigeria during those years, it never occurred to me that there might be an interest or critical need on the part of my Nigerian collaborators for a different kind of technology transfer, that is, something as fundamental as a scientific writing course. My embarrassment is further increased by the fact that for the past five years I, myself, have actually been teaching a course entitled "How to write a scientific paper in the biomedical sciences" to undergraduates and graduate students at the University of New Mexico (UNM).
Why then, during all these years, had I not thought of providing a scientific writing course for the faculty, students and staff of the teaching hospitals in Nigeria where I had been engaged in bi-national collaborative research projects, dozens of which had resulted in published reports in peer-reviewed journals and which were co-authored by Nigerian and UNM investigators? I suppose that the main reason for this is that, for the most part, the task of writing the manuscripts arising from these collaborations was a task I both assumed and executed together with my colleagues and students in the U.S. The main rationalization I gave for so-doing was that our Nigerian collaborators did not have access to the literature one needed in order to adequately compose the introduction and discussion sections of the papers. However, given the universal availability of e-mail, even the least technologically advanced countries now have web access to libraries worldwide, the basis for including one's African colleagues fully in the process of manuscript writing is more compelling than ever.
The impetus to teach a writing course in Nigeria was raised for the first time last year, on the final day of my annual month-long visit to the Federal Medical Centre in Gombe. The Federal Medical Centre is the only tertiary care center, in Gombe State which is located in the hot, arid savannah of northeastern Nigeria. The Medical Centre serves the health needs of about three million persons, mostly of Hausa or Fulani ethnicity. The co-director of the Program, Dr. Dorothy J. VanderJagt and I had just spent the month in Gombe lecturing and planning the collaborative research projects the UNM students in the NIH/Fogarty International Center-sponsored UNM-Nigeria Minority International Research Training (MIRT) Program would carry out a few months later. We then met with the medical staff and the chief medical director (CMD) of the FMC, Dr. Ali-Gombe, to discuss our collaborations and lay out the details and final plans for the soon-to-be-initiated research projects. Toward the end of the meeting we asked the Nigerian doctors if they had any particular needs we might be able to help them with. Fully expecting that with such a question we might be opening ourselves up to a very substantial request and one that would conceivably exceed our modest MIRT budget, we were both surprised and delighted to hear CMD Ali-Gombe respond to the question by saying: "There are two things you could do for us: teach us how you write scientific papers and show us how to do statistical analyses using the computer." Dr. Al-Gombe went on to explain to us what he saw as a major impediment to Nigerian doctors writing up and publishing the results of their investigations. He told us he believed that the doctors at the medical centers, specialist hospitals and teaching hospitals all across Nigeria were very much interested in research and that he saw them accumulating large quantities of data that were relevant to the health of our people and populations elsewhere in sub-Saharan Africa. He added: "Unfortunately, perhaps even tragically, much of that valuable data lies fallow, gathering Saharan dust in filing cabinets because many of the doctors and scientists who collected that information were never taught how to subject their data to the rigorous kind of statistical analyses required by first-line international medical journals, or because they had not been trained to write a scientific paper." Dr. Ali-Gombe concluded his remarks with a plea: "What you can bring these young physicians that would do the most good at this moment in our development would be a short course on statistics and another that would both encourage and teach them how to write a scholarly paper." As soon as the CMD had completed his remarks, collectively, the eleven Nigerian doctors seated around the conference table thanked Dr. Ali-Gombe for his insights and sensitivity with regard to their professional needs and interests. Why had it taken so long for the doctors to express this sentiment regarding a writing class? One of them confided to me after the meeting that, at least for himself, it was the result of a lack of self-confidence, a feeling of inadequacy, and a sense that he simply couldn't produce manuscripts of sufficient quality to be attractive to first-line peer-reviewed journals in Europe or North America.
So, without further discussion, it was agreed: During our next visit to Gombe, Dr. VanderJagt would teach a computer-based statistics course and I would teach a course on manuscript writing. Since I had been teaching a formal writing course at UNM for several years and had developed a comprehensive syllabus for the course, little in the way of preparation was needed for me to get ready to repeat my writing class in Gombe. In fact, all I had to do was run off a dozen copies of the syllabus. However, there was one significant problem, and that was how to compress the course from four months into two weeks: whereas in Albuquerque I had 16 sessions and about 40 hours of class time in which to teach the course, in Gombe I would have only eight sessions and only 15-20 hours to teach the same material to the medical staff of the Federal Medical Centre.
Twelve months later Dr. VanderJagt and I were back in Gombe, this time for a two-week visit. In the mornings she taught her statistics course to 20-30 physicians, technicians and nurses, while in the afternoons I taught my writing class to 10 physicians and one head nurse. For reasons unbeknownst to me, nearly all the doctors who participated in the writing course were pediatricians, internists, and pathologists.
At the start of the first session I probed the group to learn their attitudes about writing and to determine what they hoped to gain from the classes. For the most part, their responses weren't very different from the answers I usually get from undergraduate and graduate students in Albuquerque: "I want to learn how to get myself organized to write a paper and to identify strategies I might use to approach the task and break it down into discrete steps"; "I want to learn how to analyze and critique a scientific paper"; "I want to learn what each of the different sections of the manuscript should contain and what they should accomplish". There was also one frequent response that I had not heard from my students in the U.S. It was stated most succinctly and in transparent language by a young pediatrician: "I have little confidence in my writing skills. Until I went to public school at age six, I spoke only my native language, Hausa. Though I did study English in primary school and all the way through high school and university, there were few opportunities for me to write and have my work critiqued. Furthermore, most of the novels and other books I read were written by Europeans or North Americans, and nearly all of the scientific papers I consulted during my professional studies were authored by Americans. To be truthful, though I love science and want to do research and ultimately see my work published, I have this inferiority complex. When I get my data consolidated into the form of tables and figures and I sit down to do the actual writing, my confidence leaves me. I think that I have no business writing a scientific paper. And so I put the data away in a drawer."
With regard to the question of why they might want to write a scientific paper, a pathologist in the group answered: "I want to inform the world of what is happening in Africa. I want to document the diseases that are causing so much suffering among my people. I enjoy the process of research. But, I want to report my findings to the global scientific community. I am not happy drawing from the world's fund of knowledge, from books and publications written by European or North American scientists; I want to contribute to it, and I want to see my work and my ideas validated by the scientists outside Nigeria who will review and critique my papers." Another doctor, an internist, said he wanted to publish his findings in peer-reviewed "European journals", as he called them, so that young people in Nigeria, medical students in particular, could see that their teachers were capable of doing quality, world-class research. He said he wanted his students to avoid acquiring the inferiority complex that infected and paralyzed so many young people in Nigeria and prevented them from expressing themselves in writing and publishing their work.
And so the course began. Over the next two weeks, we deconstructed the scientific manuscript into its universal components - the title page, abstract, introduction, methods and results sections, discussion and bibliography - and discussed in detail and with examples what the content of each should be. We also discussed the sensitive issue of the responsibilities, criteria and ethics of authorship. Much of the very enjoyable last session was devoted to a discussion of ways to promote an atmosphere conducive to writing: How to avoid writer's block? How to create a community of writers at the Federal Medical Centre? How to establish a habit of writing?
Two days after the last session convened, two of the doctors and the senior nurse brought me copies of manuscripts they had either just written or revised as a result of the writing class and asked me to edit and critique them. These manuscripts were subsequently revised by their authors and soon thereafter submitted for publication to respected journals. The nurse volunteered the comment to me that the class did as much to increase her confidence in the significance of her research as it did in teaching her how to write a scientific paper. As for the two doctors, they resolved not to allow useful data pertinent to the health of Nigerian people to lie fallow in a desk drawer. Collectively, the doctors and the nurse expressed the sentiment that they had a renewed conviction that each of them had something significant and worthwhile to contribute to the scientific literature.
Did the writing class
accomplish its goals? It is too soon to tell. We shall have to wait
another year or two to see how many of those who participated in the
writing course at the Federal Medical Centre dusted off those files
of data and actually wrote manuscripts. We would need to know if those
manuscripts were submitted for publication to respected peer-reviewed
international journals and how many of those papers were ultimately
accepted for publication. If only one or two of the ten doctors who
sat for the writing class at Gombe were to publish the papers they wrote
as a result of the class, then it would support my contention that there
should be more to technology transfer from the scientifically and economically
advanced nations to the less developed countries than the delivery of
capital equipment, books and training manuals from the former to the
latter. The experience of sharing what I have learned about writing
a scientific paper with my colleagues and collaborators in research
has convinced me that when it comes to international collaboration and
cooperation between American and Nigerian scholars, there are no substitutes
for flesh-and-blood, face-to-face interaction and communication. I also
learned that it was essential that we strive to understand and address
the needs of our Nigerian colleagues as they themselves express them,
rather than as we in the more technologically advanced countries perceive
them to be.
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