For all those who are geeky enough to be interested, I thought I'd put some
pictures of the lab and the equipment that I'm using.
 |
| View of the hospital from my house - as you can see, not far to walk in the mornings! |
The work is not too different to that back in the UK- it's a lot quieter
here, we see about 100 patients on a very busy day, but usually about 50. – and
of course there is no GP work to do! There is a problem with supply of
reagents and consumables and the lab often runs out of vital things (on Friday
we ran out of EDTA tubes).
 |
| Phlebotomy area |
|
 |
| Request Form |
The main tests are Hb - done using Haemocue (or the Ebra 7 if we
have run out of haemocue test strips) and thick film for malaria.
Thin films are not done at all, but that’s
something that I wil be working on!
There is an Horiba Micros for FBC - although only approx 5 FBC are done per day - Hb is the most useful parameter, and there is little value in knowing WBC count in patients with known fever as they will be put on antibiotics anyway, or PLT counts when there are no treatments available
 |
| Haemocue for Hb |
|
 |
| Haematology Analyser |
|
 |
| ESR |
Microbiology offers urine and stool microscopy for parasites, AFB for TB diagnosis, and culture and sensitivity.
- not my strongest subject by any means, but I'm learning microscopy pretty rapidly!
 |
| Microbiology Bench |
|
The Biochemistry area has an ebra 7 (a glorified
spectrophotometer) and a new analyser (humastar) both can so basic tests such
as glucose, AST, ALT, Creatinine and bilirubin and there is a BD FACS flow
cytometer for CD4 monitoring.
 |
| Flow cytometer for CD4 |
|
 |
| Biochemistry Bench | |
 |
| The old chemistry analyser |
 |
| The new automated chemistry analyser |
The biggest difference compared to in the UK has to be Blood Bank.
Transfusions are done using Whole blood – not
separated components!
We get some units
from the blood centre in Mtwara, but the supply of these is patchy at best, so
most of the blood we have is collected in the laboratory from the relatives of
patients having operations!
Donors are
bled by lab staff, and samples are sent to mtwara for donor screening for HIV
Hep and Syphilis.
The blood bank itself is
just a domestic fridge (and used for reagent storage as well!)
- as you can imagine there is no CPA or MHRA in
Tanzania, and SR would have a fit if she saw the state of the fridge ;)
 |
| The Blood Bank |
|
When a patient needs blood, the donor unit and patient are group typed using
tile method, (ABO and RhD),
and a Room
Temperature compatibility test done (no IAT at 37C)!
I do find this difficult, having being trained
to ALWAYS do an IAT, there are very few transfusion reactions (there are very
few patients with antibodies… few patients have repeat transfusions, and RhD
immunisation is not a problem as 95% of east Africans are Rh(D) Positive).
 |
| Transfusion Area |
 |
| The Blood Bank! |
|
One of my aims here is to study the use of blood, transfusion triggers,
blood safety, etc etc and see if any of the UK system can be applied in here to
improve the safety and service of blood bank.
It’s going to be a big project, but that why I’m here for 2 years!
Well, hope this has satisfied all you science geeks!
If you want to know more please get in touch,
and I’m sure I will be in touch with a few of my former colleagues to get some
advice at some point (SR, VCV/CT and SG – I’m thinking of you!!)
Peas and love x
