Mobile Lab

Dear all,

I was recently asked to give a little more detailed update on the progress of the clinic and mobile lab. Since there are so many of you who have given money, sent supplies, purchased equipment and/or lifted up prayers, I thought I'd share yet another newsy message with you all with specific information regarding the lab.

CONASPEH and the people of Haiti have a lot of friends in you. We are amazed at how often people gather a few of their resources together and share them with people here. Such actions are a beautiful witness of a global community. I've seen a church soup supper purchase enough medications to run our little clinic for 4 months. Letters from Sunday school classes have reached us and it warms Patrick's and my heart to know that even our youngest of friends have the people of Haiti in mind. Church fund drives from across the country have helped CONASPEH purchase land. There are a lot of people to thank.

I just want to send out a universal thank you to everyone who has thought about Haiti, read a book, kept up with recent news events, followed this blog, sent school supplies, collected medical supplies, donated money, or planned and participated on a trip here. Every effort, no matter how large or small, makes a huge difference. And we, representing CONAPSEH and the people of Haiti we work with, thank you.

With that, greetings from Port-au-Prince! The school year has started, and activities jumped once again into full swing at the busy school and CONASPEH headquarters where Patrick and I work. Its nice to have the echo of the voices of children reverberating off the walls again. The air is charged with energy renewed.

I'm writing to also give you an update about the mobile lab that many helped purchase with their offerings. We received the lab in June when a group coming to visit Haiti was able to carry it over and deliver it directly to us. The lab is really something, capable of a lot and quite mobile, set up to run on solar and battery-powered energy no matter where the clinic is located. Since a lot of the mobile labs we have run are held in dusty dark corners of concrete churches sans any modern convenience, freedom from a wall outlet is really a blessing.

I don't know how many of you are familiar with the kind of work the clinic is doing. So I'll be brief. Essentially I arrived to Haiti and set up shop as the only doctor in a largely non-medical organization that recognizes health care education and outreach as vital in order to attend to the dire needs of the Haitian people. Upon arriving to Haiti, the "clinic" was a barren and empty room without much more than a box of Band-Aids. It was functioning largely as a first aid station for the children at the CONASPEH school. After several really frustrating months of clinic visits that entailed making a lot of recommendations to patients who had neither the means nor motivation to follow up, we realized that in order to provide affordable and safe health care in Haiti, a fully stocked and capable clinic needs to be in place if any difference is to be made the the health of the patients who come for evaluations. There is just not a broad enough medical infrastructure here that can meet the needs of the sick and impoverished.

Currently our clinics (Port-au-Prince, Carrefour and Artibonite) see patients ages 0 to 104 (that's the current age to beat) years in age with complaints covering every organ system. The clinics have no running water (yet) and only one with spotty electricity (currently MUCH improved), but we make do surprisingly well. Despite an overwhelmingly high number of clinics in Port-au-Prince, most are not able to offer prices affordable enough for the average poor person living in the city. Therefore our clinics receives people who suffer ailments largely from their low economic status: problems of hunger and malnutrition, poor sanitary conditions, and chronic lack of access to care. Services are not always free, but for the equivalent of a US dollar, patients get evaluated and sent home with the medications they need. If the price is too steep for the extremely poor and ill, the price is waved. Students and staff at CONASPEH are not required to pay.

With the help of friends and donors, we've been able to keep the pharmacy stocked with basic medications that at least cure things like ear and lung infections and other basic, easily treatable illnesses that should not lead to significant morbidity and mortality (but do in cases of lack of access to care). Then, with the help of several individuals and churches, we were able to purchase a mobile lab.

Not being trained in lab sciences, I used most of July to read the lab manuals, discuss with my team the logistics in toting a lab around to mobile clinic sites and to other stationary clinics, and how we would handle stocking and restock of supplies needed to keep the lab consistently functioning. Because our clinic staff now consists of myself and one nurse, I've had to choose to either be a lab technician or a doctor. So as a compromise, I've selected the most quick and user-friendly tests in the pack that can be done in the space of an office visit and can influence treatment planning.

For example, I can quickly and easily utilize urine chemistry and microscopy, blood glucose and finger-stick hemoglobins that have helped me rule in or out urinary tract infections, diabetes and anemia. Through the urine analysis, I was able to council a young man that his conglomeration of symptoms was likely due to an acute hepatitis (that otherwise I would not have been able to be very certain about) and was able to council him accordingly. This was a potentially life-saving discovery from a simple urine exam.

The lab is capable of so much more. It is capable of malaria and rapid TB screening, blood chemistries, and early infection identification. However these labs require staining and a more involved process of both blood draws, sample preparation, and careful evaluation by a trained eye.

We've started the search for a lab technician that can work alongside us and turn a lab that is partially functioning into one that is fully functional and efficient. We interviewed two people Tuesday who seem very promising and have a work day planned with them tomorrow to further evaluate their flexibility, availability, skills and willingness to work along side us. I pray that whomever we find will have patience and a secondary income since they likely will have to initially start working for pennies and out of the goodness of their heart as CONASPEH has little to no money to pay much of a salary.

The nursing school starts in October, and the nursing director and I have been discussing the formation of some practical learning labs to teach the nursing students through the use of the lab. Up until we received the mobile lab, the school had a single working microscope (thanks to another donation!). Now we have another beautiful new one. You might imagine how much more punch a lecture about microbes and pathogens in the water can deliver when students can look for themselves at what swims in a sample under the microscope.

So the use of the laboratory is evolving slowly and thoughtfully. It has already changed my own ability to deliver health care, and has the capability to provide an even broader spectrum in months and years ahead. My current goals now are to continue training myself in the skills of laboratory diagnosis in my spare moments in case a lab technician is harder to find (in that case I'd dedicate an afternoon or a day a week to be "lab day" and just process the samples myself), to begin a science and learning lab for the nursing students, and find a helper for our clinic system to broaden our outreach and services.

Thank you for the gifts of your consistent support and your prayers. It makes projects possible, outreach more meaningful, and a ties of partnership strong.