E-newsletter Issue 50 | October 2006
Letter Home, Olivia Yacoub – lab technician, Chiradzulu, Malawi
| Olivia Yacoub is a Lab Technician from Houghton in South Australia. Olivia's has recently completed her first mission with Médecins Sans Frontières (MSF) in Chiradzulu, Malawi. She has justed arrived in Liberia to commence her second MSF mission. |
Malawi is indeed the warm heart of Africa, albeit refreshingly cold at times!! I spent 3 months in total in Malawi, Chiradzulu district as laboratory technician under the supervision of a national staff member. It was a valuable experience working under the national staff member which is uncommon in MSF missions. My role was to assist in management tasks and perform routine work as part of the team. There are 2 national MSF staff members and 4 Ministry of Health workers in total in the lab. Chiradzulu is an amazing place, resource poor but there is an overwhelming feeling of warmth and smiles and people living for their families. I never tired of observing the Malawian village life, people ‘living’ carrying water, food etc (usually on their head which is a skill I have not yet mastered!!) and mostly growing their own food in the stunning picturesque mountainous area.
I was very impressed with the appearance of the hospital, it is actually better aesthetically than the hospital where I work in Australia, there is a huge difference in laboratory equipment however (or lack there-of). The hospital was built and donated by the European Union and has approximately 700 admissions per month. The main objective of the long term mission is to provide counseling, testing and ARV treatment to those living with HIV with focus also on those co-infected with TB. The project also involves a decentralisation team who service 10 health centres in the surrounding Chiradzulu mountain district where the HIV prevalence is approximately 20%.
We ran basic testing in the laboratory including CD4 counts on the Partec machine (approx 700/ month), manual white blood cell counts and manual differentials using one step fixing and staining with Giemsa stain, malarial parasite diagnosis on thick films and haemoglobin using the Haemocue system. The ‘biochemistry’ section runs ALT as a marker of liver function and creatinine for renal function. In Australia it is standard to order anywhere from 8-20 tests for basic biochemistry - is this a form of ‘consumerism’ or necessity or is there a fine line? There is also a microbiology section including TB diagnosis by microscope and testing of other body fluids.
My time in Malawi was very rewarding, although challenging at times as the Malawian slow pace is very different to what I am accustomed to. MSF supported and integrated in the laboratory very well and it was a very good working environment. After I left, I didn’t have an international staff member replace me as the national staff are managing the laboratory quite well. I now have a solid understanding of working in resource poor settings and knowledge of the way MSF operates which is valuable for my next mission in Liberia.