Work Update.. Making ISO standards FUN!

It’s been almost two years I’ve been in Tanzania. Quite unbelievable that amount of time has passed.  Before I left the UK during one of the pre-departure training courses some ex-volunteers talked to our group.  I remember one of them saying that “your worklife as a volunteer fluctuates –sometimes you are busy at work, sometimes you have nothing to do, sometimes you will have success, sometimes failures and sometimes it feels like you are not achieving anything, changing anything or helping anyone!  But in the last few months of your placement things will finally start happening but time will also speed up and you will feel that there is not enough time to do everything.. why didn’t all this happen 2 years ago?!”

Well, they were right! I’ve had all of the above, and now with only a few months to go before the end of my volunteer placement, work is super busy, but things are finally falling into place! here’s a update on what I’ve been doing.(I apologise if it’s a bit geeky and dull… but that’s my job!) 

In November last year, our laboratory was accepted (after some campaigning on my part) onto the SLMTA/SLIPTA programmes. SLMTA stands for Strengthening Laboratory Management Towards Accreditation and SLIPTA stands for Stepwise Quality Improvement Toward Laboratory Accreditation.  The programmes are devised by the World Health Organisation to improve the management and Quality Systems of laboratories in developing countries and it has been used in many African countries including Tanzania with good success.  The SLIPTA program aims to make laboratories compliant with international standards for the management and running of the laboratory (the ISO 15189 Standards for Medical Laboratories - For geeks, this is like ISO 9001/2 but for laboratories instead of companies).  This is a big step, as even the UK laboratories are only just adopting the ISO 15189 standards, so Nyangao hospital has a chance of being ahead of the UK, and accredited to an international level!

The ISO standards cover all aspects of a laboratory such as Management, Staffing, Equipment, Safety, Quality control, Documentation, Communication, Auditing, Reporting etc, and the aim is to improve quality and make every aspect of work and management traceable, justified and accountable.  

So, for the past 12 months or so I have been working with the laboratory management team to make sure we meet all these rigorous standards.  This has meant devising a complete Quality Management System and document control system; writing or updating over one hundred policies, procedures, forms and documents and training staff in these new systems.  It’s been hard work getting everything written, and sometimes even harder work getting the staff to adopt the new systems.  ISO standards are a pretty dull subject, and quite a foreign concept to many people, Tanzanians and Non-Tanzanians alike! 

And then James made a filing system.. and he was pleased.

It may seem like just creating a lot of paperwork and a little detached from actually helping patients, but when followed correctly, a Quality Management System helps reduce and prevent laboratory errors, reduce loss of service due to equipment failures or reagent stock outs, improve quality control, improve staff training and overall improves the quality of the laboratory so it can provide accurate, reliable and timely results for the patients we serve.

The SLMTA program also gives training courses to the laboratory management team as well as providing a mentor to come to the lab for a fortnight, three times a year to assist with the introduction of the Quality Management System.  We have just recieved our mentor visit which has meant even more work in the last few weeks implementing her suggestions.

  Inspections are performed every four to six months, and the lab is rated on a 5 star system according to how well we meet the ISO standards.  Our first inspection scored us zero stars, which was expected as it was the baseline assessment.  We have done a huge amount of work since then, and still have a huge amount to do before  the next inspection which will be in May, literally weeks before I am due to leave! It will be rewarding for all of the laboratory staff to receive at least one star, if not four or five!!

  What was it the ex-volunteer said?? …In the last few months of your placement things will finally start happening but time will also speed up and you will feel that there is not enough time to do everything.. why didn’t all this happen 2 years ago?!  ….. So true! And I just hope there is enough time left!

my office ( I need a notice board)

In other news…… finally, after 18 months of campaigning, pestering and begging, we’ve had air conditioning fitted in the lab!  My office is no longer like a sauna and I can sit at my desk and not be in a puddle of my own sweat just from moving the mouse. 

Now, where did I put that piece of paper?  What was the document number?  What version is it??

African Tour Part 2 - Zambia

Part 2 – Zambia

We spent our first night in Zambia in a nice backpacker hostel in Lusaka, the capital city.. to be honest we didn’t see much of the city as we were tired from our rude awakening on the train, and we had an early start the next morning to get the bus to Livingstone. 

After spending 18 months using the crowded, dirty and often downright dangerous public transport in Tanzania, the bus to Livingstone was quite overwhelming.. A luxury coach, with air conditioning, comfy seats, leg room, no people standing, no chickens, clean, and it even smelt nice!  I’ve only taken a long distance bus once in the UK, but this one beat it hands down!  It made the seven hour journey to Livingstone very pleasant, and before we knew it we had arrived.

Livingstone is a great place and reminded me of the towns in New Zealand.  It is clear that a lot of money is made from tourism in Livingstone as it is a clean and green place, full of good restaurants and accommodation. We stayed in the superbly named Faulty Towers, although somewhat disappointingly, there was no Manuel or Basil!

Victoria falls is only about 10km from Livingstone, and for our first visit we had booked to swim the “Devils pool”.  As we arrived at our pick up point, the rather swanky Royal Livingstone Hotel, our taxi had to take a detour around a giraffe that was stood munching on some trees on the driveway!  The Royal Livingstone hotel is located on the Upper Zambezi river, right at the top of the Falls, and you can see the spray rising from the falls.  A short boat ride took us to Livingstone Island, an island perched right on the edge of the falls and where old Dr Livingstone first saw the falls (after paddling in a dugout canoe to get there).  

Livingstone Island is the dark gren patch of trees in the centre of this picture

Livingstone, I presume?

 We were given quick tour of the island, and peered over the edge to see the view Livingstone would have had.  

Long way down!

Then we changed into our swimming costumes, at which point I realised exactly what I was about to do….. Our guide threw a stone into the water about ten feet upstream “aim for that”, he said as he started swimming and being swept downstream towards the edge of the falls.  I was relieved that the water was actually quite warm, but not so happy about the current and the proximity to certain doom!  Louise lost her shoe which bobbed happily to its own impending doom “Sod the shoe, Save yourself”, I cried!  Thankfully it was masterfully saved by the guide who seemed unconcerned about said impending doom as he swam full strength to the edge of the falls!  We reached the outcrop of rock that we had aimed for and clambered along the rocks to the Devils Pool. 

 The pool is a natural infinity pool, with a submerged rock ledge that you can sit on and peer over the edge – just don’t lean too much! 

 

Yeah, just lounging around on top of Vic Falls :)

 After posing for photos we braved more certain doom to swim back to the island and were treated to an awesome “you’re still alive” breakfast!  

NOM NOM!

That evening we took a sunset cruise along the Zambezi, and sipped on Gin & Tonics whilst watching Hippos and crocodiles in the river.  Very colonial.. wot wot wot!

After having seen the top of the falls, the next day (Christmas eve) we went to see the falls from the bottom.  Even though the falls were not quite at full strength, they were still spectacular - huge, noisy and very wet! We spent a full day walking around the national park looking at the falls, and walking along the bridge which is the border between Zambia and Zimbabwe.  After yesterday's excitment I didn't fancy the Bungee jump from the bridge!

Our Christmas day was somewhat un-traditional, and started with a leisurely canoeing trip along the river a few miles upstream from the falls and getting close up (but not too close, thankyou very much) to Hippos and crocodiles!  My Christmas lunch consisted of a nice juicy burger and chips!  For the evening we returned to the Royal Livingstone Hotel and sat on the decking drinking more G&Ts and watching the sunset over the Falls (jolly good!)

After four fantastic days in Livingstone it was time to return to Lusaka, and this time it was a “business class” coach, complete with reclining seats!  We spent one more night in Lusaka then caught the plane into Lilongwe, Malawi, ready for the next leg of our epic adventure!  ……….

African Tour - Part One

I’m finally getting around to writing a blog about my holiday to Zambia and Malawi.  There is so much to write about that I won’t bore you with all the details, but I’ll let the pictures do the talking!

The first stage of our journey was the train from Dar-es-salaam in TZ to Kapiri Mposhi in Zambia.    It is a 1860 Km journey which should take 48 hours, winding southwest through Tanzania, crossing the border near Mbeya and continuing south through Zambia.  

Dar Es Salaam Train Station (Source: Wikipaedia)

We had booked a first class cabin to ourselves and bought tickets in advance , however that didn’t stop the almost inevitable confusion when we arrived as to which cabin we were actually supposed to be in.  However, after thirty minutes of toing and fro-ing, lots of conversations in kswahili, and me actually pointing out our names on the passenger manifest, we got our cabin!  Surprisingly, the train left exactly on time, and so our hope was restored!

Long Train!

The train journey was lovely, passing through some amazing scenery including the Selous Safari Park (although it was night time, so I didn’t see any wildlife), open plains, mountains and forests.  Although the train was a bit noisy and rickety it was good fun and relaxing.. there was even a bar on board!

 It was all going smoothly until we reached Mbeya, where we had a seven hour stop for “the engine to be serviced”… and then seemed to go very slowly after that all the way through the border and into Zambia.

Mbeya station.. we had some time to kill!

We finally arrived in kapiri mposhi around 12 hours later than scheduled, which meant arriving at the ungodly hour of 3am and turfed off the train into Zambia!  In times gone by, the train used to go all the way to Livingstone near Victoria falls, but now it sonly goes as far as Kapiri-Mposhi a town with few redeeming features apart from being at the end of the line.  We stayed long enough to find a taxi to Lusaka, the capital city of Zambia and on to our next leg of the adventure……….   

Louise, somewhere in Zambia