Helping expedite diagnoses for patients in Kenya

1024 768 Arlyne Simon, PhD | Biochemical Engineer. Author. Inventor. Entrepreneur.

By Arlyne Simon, Ph.D.

“Habari! Habari yako?” That is how I was greeted every morning by each of the 14 lab employees at the Nyamira Country Referral Hospital Lab in Kenya. It means “Hello! How are you?” As my Swahili improved during my three weeks as a BD Labs for Life Fellow, my response went from “Nzuri” (I’m fine) to “Poa, asante sana” (Good, thank you very much).

Within one hour of meeting us, our Kenyan colleagues gave us Kisii names; Lori was called Kerubo and I was named Kemunto (pronounced kay-moon-toe)

Labs for Life is a public-private partnership between Becton Dickison (BD), the U.S. President’s Emergency Plan for Aids Relief (PEPFAR) and the Centers for Disease Control. The goal is to combat the HIV/AIDS pandemic in sub-Saharan Africa by working with local governments to improve their labs’ quality management system so they can become ISO 15189-accredited within 18 months. Every year, BD sends a group of fellows to mentor medical lab technicians in Africa, and this past January, I was privileged to be one of them. My assigned partner was Lori A., a clinical sales consultant in BD Canada. For three weeks, we worked side by side with our Kenyan colleagues as they diagnosed patients with diseases like malaria, HIV and tuberculosis.

During the first few days, we conducted a baseline assessment of the lab and identified key areas for improvement. To promote staff engagement, we formed three lab committees: quality improvement, biosafety and biosecurity, and customer care and conflict resolution. Promptly at 9 a.m., we delivered daily seminar talks, highlighting the need for healthcare worker safety and quality patient care.

Before our arrival, the labs had many gaps in how it operated. There was no quality manual and no formal template for standard operating procedures (SOP). Few lab instruments showed proof of regular calibration and none of the instruments were validated. Access was not restricted, so it was not uncommon to see doctors and couriers freely enter the lab. Chemicals were not properly stored.

Our mentorship empowered the staff to make significant improvements. By week three, the lab’s quality manual was 70% completed, and an SOP template had been created. We provided equipment validation training to the staff, validating the chemistry analyzer. Calibration and preventive maintenance “due date” stickers were placed on each instrument. The lab was locked to prevent unauthorized access. Chemicals were stored appropriately.

We also optimized the lab’s workflow and proposed a layout for lab expansion, which the medical superintendent and Minister of Health fully supported. The customer care committee created a customer feedback form as a quality indicator tracker and Lori (who the staff gave the Kisii name Kerubo) administered phlebotomy competency training.

Without a doubt, this experience has been one of the highlights of my career. It has re-ignited my passion for creating new point-of-care technologies and shaped the way that I will design medical devices for developing countries. With limited space and frequent power outages, developing labs need instruments that are simple, user-friendly, compact and robust. The more rapid the tests, the faster patients can be diagnosed and the earlier critical treatment can be administered.