Collect my blood, don't screw up ourfield trial!
We started with the collection at 0700, and got assistance from two very skilled nurses.
First of I have to admit that my body is having serious problems with the lack of caffeine, especially in the morning. Sometimes we get up around 0500, and work till 1900. Long days…
Anyway, collection was performed on nine children from one specific area, I helped separating the samples (divide blood, into plasma and the rest) and did some malaria essays to check if the children were infected. This was something I wanted to know because I need this data to know on which samples I will be able to do a infected red blood cell extraction. The remainder of the blood was taken to Korogwe. Hans made the drive and asked if I could join him. Because there were not too many patients in the clinic I decided to join him. Korogwe, has a hospital with a new brand new laboratory, with several research teams from different countries occupying it. There are only females working in the lab, at least that is what I noticed.
They have showers, nice rooms, and actually it is quite nice (especially some of the lady’s, one was wearing a white dress, almost transparent ). We analyzed blood profiles and prepared the plasma for long term storage. The cool thing about Korogwe is that there all the people there are doing incredible research, all in the area of tropical infectious diseases. Hans knows all these people and always introduces me to them (he knows where my interests are pointing to). Today we met someone whom was asked to perform a big vaccination trail (cholera) on behalf of the WHO on Zanzibar. His trials includes only some geographic regions at this moment but might expand to the whole population (1.5mil.). He joked, at least, I think he was, that he was looking for people like me (multidisciplinairy).
I also met Mayke, a PhD. student who offered to help me with establishing a good protocol for isolating and appropriate storing of my infected red blood cells. Afterwards Hans delivered me back to Bondo clinic, but before that we made a stop at a nice restaurant to get a cold coke and had a few nice chats about the Academic world. Which is no different than the real world.
A few challenges are coming up. How am I going to collect the infected red blood cells, hibernate the parasites long enough, and store these goods till I get back in the Netherlands (these kinds of experiments require fancy labs). Well enough stuff to think about this weekend.
To make a long story short, I have been helping in the clinic these last days and will do so until upcoming Sunday. Then Hans and I will go to Moshi, where they have ‘advanced’ lab facilities. The main focus there will lay in the isolation of these white blood cells from blood, which will be collected in the Bondo field hospital and transported to me the same day (almost 750km of travelling a day). Next to that I will do a few other things on which we will come back later.
It is a shame I have to leave on Sunday, because I like the clinical work, but fact is I am not a medic. This way, I can connect clinical work with scientific work, and that is the area I want to end up in. Hans already told me I can come back as soon as the blood collection is completed. And I probably will do so. Maybe I can locate myself in Korogwe for a few weeks, depending on the arrangements Hans can make. This will greatly reduce the traveling time for the blood samples and will improve the quality. I am really glad that I decided to come here. There is no thesis project that could replace the unique experiences I am gaining here and this is an conclusion I already made within the first week. And let’s face it, these fancy lab techniques I can always master them in at least a month after all I am a smart kid
The African or other way of doing a proper job
As I mentioned in previous chapters, the children in our program receive food supplements. It is of utter importance that they get these supplements every day, on a empty stomach. That’s why the supplements are administered by a so called health administrator. This is a guy who has the responsibility within a certain area to administer these medicines and check if the children have any symptoms of fever. In that case, the health administrator directs mother and child to the clinic (the furthest locations are 12.5km from our clinic). They get paid for this job, and according to local standards quite decent as well. We don’t leave the job to the mothers because they might 'neglect' these kinds of routines, and it makes it harder to monitor errors in administration.
To check if the health administrators do their job we perform so called spot checks. We go to a certain spot, unannounced to check if the health administrator is doing his job. Last week we noticed that one health administrator was handing the pills out to the mothers. So we could never confirm if the child actually got the supplements. This could lead to major flaws in the whole study and is therefore unacceptable. That’s why the health administrators have to report in now every day, and have to bring the pill strips. It sounds like a harsh measure but apparently it has to be this way. The downside is, that the team had more administration to comply with and we have to perform more health checks (so get up early…)
Wednesday morning (morning is 0500) we woke up to do a so called spot check, except for the truly beautiful sunset, we say to our great pleasure that our health worker was doing a great job.
Check out the pictures. I will try to update you from fancy Moshi on a more regular bases. I have internet at my disposal at any given moment.
Cheers mates luv ya all,
Oooh, it all sounds so nice! Still hard to imagine what life is like out there in Africa, but that's just because it is probably so different from here.
I assume that the clinic that you work in is also treating the sick children, or is it only for scientific purposes? So I wonder, how is it all financed, and are you able to save most of the children or are there many fatalities, even after/during treatment in your clinic? This must be quite hard, especially because children are involved. How do you cope?