There is a lot that I took for granted working as a physician in the United States. For example, labs. I worked as a hospitalist in the states. If I needed or wanted labs on a patient I ordered them on the computer and the results would be available usually within a few hours. I simply had to open the patient’s chart on any of the hundreds of computers in the hospital and could review the labs.
Well, in Haiti, if I feel a patient needs labs for diagnosis, treatment, management, I write a prescription and the patient must go to a lab in Cabaret (40 minutes by moto) or in Port au Prince (at least 2 hours by moto- requires some transfers). These labs are only open on weekdays and typically close early to mid afternoon. The patient has to go back to the lab several days later and retrieve the results. Then the patient brings the results back to Cazale. As you can see, this is time intensive for the patient not to mention that they need to pay for transportation in addition to the labs. And I can not imagine that it is very fun to ride on a motorcycle taxi when you feel terrible. And then there is the $. If a patient in the hospital in the states needs a lab done for whatever reason, it is ordered and done period. The patient’s financial status is not a consideration about whether or not a needed test is ordered. In Haiti, you have to consider this. I only order labs that I feel are absolutely necessary for diagnosis, treatment or management. If someone only makes $5 a day, paying $13 for liver function tests is a big commitment.
Last December, I looked into buying a point of care electrolyte analyzer. I gathered prices from organizations that help non- profit organizations obtain medical equipment. I was directed to Worldwide Lab Improvement. The website looked pretty interesting. Though it looked like this organization helps set up a lab. I know how to order and interpret the labs but nothing about running the labs or the equipment and supplies necessary to do so. I filled out the application to see what this would bring about. And in response I received a quote with what seemed to me, an extensive list of equipment. This list was for equipment and supplies to run serum electrolytes, glucose, creatinine and liver function tests. My awesome husband organized (with family help) the purchase of a point of care hemoglobin machine for Christmas. So with this lab equipment, the basics would be covered and I didn’t have to figure out what we needed- an expert in the field would take care of that. In addition, Worldwide Lab Improvement would send someone to RHFH to set up the equipment and teach us how to use it. When I absorbed all this, I started salivating. I had set out to find something point of care- but serum labs are much more accurate. I didn’t really consider anything but point of care- I thought actually setting up a lab would much too complicated, expensive and I lacked the requisite knowledge to set it up. But with Worldwide Lab making this dream a possibility, all we needed to make it a reality was come up with the money- about $8000. Not too bad, I could fundraise this right? I have not done much fundraising- my father-in-law, husband and wonderfully capable sister-in-laws have done most of this. Well, I was visiting my grandmother during this process and was telling her about the hope of a lab and she told me that she just sold her house and she will pay for it.- all of it.
I was planning on setting up the lab in my little office where I see patients. My contact with World Wide Labs- James- sent some suggested construction recommendations for the lab and space needed. These recommendations suggested an air conditioner, a sink, much more counter space than I had supposed was necessary. Well, we had a room that would have to be completely remodeled that could work. There was a team coming soon that was capable of performing these remodels- electrical work, plumbing, shelves, knocking out walls, filling in all the holes in the wall and ceiling so the air conditioner would be effective, etc. I asked this team 1 week before they arrived if they would perform this remodel. So they completely changed their plans and added another person to the team and did an awesome job. A big, heart-felt thank you to the team from Minnesota led by Corey Robinson. Thank you! And then Denise’s team from Houston came next and painted the lab and made it look nice. Thank you friends!
James from Worldwide Lab Improvement came last week and trained myself and some our staff how to use the equipment. Here we go! Thank you James and thank you Worldwide Lab Improvement!