A August Burns, Ronnie Lovich, Jane Maxwell, Katharine Shapiro
Macmillan Education (for the Hesperian Foundation), £7.25, pp 583 
ISBN 0 333 64933 8
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Rating: ★★★
In the industrialised nations, simplified texts have long been used to educate the public about important medical conditions. Similar reasonably priced publications are now increasingly in demand in developing countries. Of the many subjects pregnancy, birth, and infant care are evergreen favourites.
Concerned about the welfare of millions of women subsisting in areas “where there is no doctor or where health care is not afford-able,” the Hesperian Foundation has extended this concept to conceive a “self-help medical information” monograph. The stated objectives of the book are “to help women care for their own health, and to help community health workers or others meet women’s health needs” by including “information that will be useful for those with no formal training in healthcare skills, and for those who do have some training.”
Apart from reproductive health, including common obstetric emergencies, the monograph provides relevant information on nutrition, medical problems, disabilities, mental health, and social issues confronting women in underprivileged societies. The text makes easy reading with links to additional pertinent information on important topics, and is enhanced by liberal use of expressive drawings (over 1000) and incorporation of key messages.
An innovative feature is the detailed description of illustrative case studies examining the root cause of a problem and feasible solutions. These true life examples will stimulate motivated readers to initiate remedial action, including community mobilisation, in their own setting.
A large proportion of literate women should be able to comprehend the narrative. However, the sections detailing drug descriptions and healthcare skills could prove too complex for the usual target audience and thus risk inappropriate (and occasionally dangerous) application of incomplete knowledge in unsupervised settings. Interestingly, the copyright holders “do not assume liability for the use of information contained in this book.”
Self help medical information is an oversimplified and controversial method for improving the health of women in places where doctors are not available. These are precisely the areas where there is a high degree of poverty, illiteracy, and inadequate access to good health care. All these factors will seriously impede the envisaged use of the monograph even after translation and local adaptation. For example, providing information about expensive antibiotics and techniques for measuring blood pressure (without availability of instruments) seems superfluous in these settings. Future editions should distinguish between the knowledge suitable for lay women and that for paramedics.