Brian & I returned to work at Kaloleni Clinic today, from a glorious safari weekend (if you ignore the intense sickness, which I will). Finding the clinic pretty deserted of practitioners but ever populated with patients, we made ourselves available to simply pitch in where ever needed. Brian observed and assisted in the HIV counseling area of the Know Your Status project & I worked in the Lab.
Kaloleni’s lab is a picture of adaptation to resource availability. One lab technician in specific was Brian & my best contact, whom we met on our tour and bonded over the sharing of common interests and language. He is the most knowledgeable lab technician I have ever come across in any country. While the majority of my day in the lab was spent logging in patients tests and organizing flow I did get to witness & participate in some sample collection, processing & resulting of samples taken from various patients. This gave me a unique opportunity to view the patients chart, interact with them and then see their results on their way to the patient and provider (& the clinical area that I typically participate in).
Here are some of the things I saw:
– Blood Typing. This was done for pregnant women all day & done the “short-cut” way according to the technicians. 3 drops of blood on a slide are mixed with Anti-A, Anti-B & Anti-D (or Rh status), if the blood clumps in that spot then it’s + if not it’s -. So +, -, + = A+ blood type and so forth.
– Urine Microscopy. Urine is collected by the patient in a glass container then it is placed in a centrifuge and spun down (this makes the heavier elements like cells or bacteria to fall toward the bottom of the sample) then the bottom portion of the sample is viewed under the microscope to provide the result. This was added to a UA strip test that’s done in the doctor’s office. Urine cultures can be done from the remainder of the urine not spun down by placing them in petri dishes and incubating.
– Widd’s Test – Test for Salmonella, a common contaminant of water in the area and cause of Typhoid (we were told that we may have suffered from a bout of this bacteria the week before but Cipro to the rescue when I could hold it down …). This is done by placing drops of blood from a patient onto a piece of paper with anti-typhoid antibodies on it and a reagent that changes color when binding occurs and is compared with a control of binding antibodies. (You might have to see this one while being explained it to get what I’m saying … polle (sorry))
– Blood Smear. Looking for parasites like Malaria.
– TB sputum stain. 1st get sputum from presentation to the lab and then from 1st thing in the morning upon waking. Then take the sputum and spread a thin layer on a slide and heat gently with open flame. Then line up slides on a make-shift rack over a sink. Pour Carbon fixant die on each slide and heat. Wait 5 minutes and wash the slides well with straight sulfuric acid & then water. Pour methylene blue over the slides and wait 5 minutes. Wash the slides with water and set to dry. Make sure you sterilize your tools with phenol. – TB shows up on microscopy as Red Bars on a blue background.
– Blood glucose testing
and lots of other blood draws that were sent out to other laboratories.