Category: global outreach

So what exactly do I do on my international escapades? I work with my laboratory professional association (mostly), American Society of Clinical Pathology (ASCP) who is under contract with the CDC to help improve laboratory capacity, quality, standards and processes in developing nations. Basically, I work with labs around the world to help them establish lab processes and procedures that meet international standards to collect, handle and process and test laboratory specimens safely and with accuracy, so that the results: 1) are the right patient 2) can be counted on for accuracy and 3) provide info to the clinician in a timely manner so he/she can diagnose and initiate treatment if necessary.  And, most of the lab work in these nations are for the “big three” HIV/AIDS, tuberculosis, hepatitis (and in some places, malaria). So…I get called to work closely with international colleagues, review processes and procedures, help mentor lab scientists with quality and process improvement—and do a lot of training, especially in the blood collection part of the process. My last trips over the past several years have included a variety of these things and recently in Central Asia, mostly blood collection training.

The work I get to do is rewarding, engaging, energizing, humbling, and one small way to give back some knowledge and experience to things I am passionate about—but it’s always so good to be home!

Hosh Ohmadet!

-Beverly Sumwalt, MA, DLM, CLS, MT(ASCP) is an ASCP Global Outreach Volunteer Consultant.

I know this is a “lab blog” not a “travel log” but after the long and arduous global outreach visit to Tajikistan, I simply can’t resist.

My last blog introduced our Tajikistan colleagues and the challenges they face with pre-analytical processes and our experiences and time with them. It’s for all those reasons the ASCP Global Outreach Volunteer Consultants endure the not-so-fun rigors of travel, experience countless hours of joy in airline terminals, work/eat/sleep at odd hours because we don’t know what time zone we’re in, and throw our shoulders out carrying our carry-on luggage…because if you don’t, it will definitely get lost. I’m living proof that it can happen even if you ARE carrying it on.

Our complicated itinerary for return flights from Dushanbe to the USA gave me indigestion and guaranteed luggage challenges. However, even my compact and well-packed little rogue suitcase was over full with paperwork and reports that needed returned after our workshops, making it way too full and way too heavy to carry-on back home. I had four plane changes ahead of me and 36 hours of travel, including having to stay overnight in Istanbul. With very little confidence I checked the bag with the Russian-speaking airline agent, who told me to pick it up in Moscow and re-check to Istanbul. At least I thought that’s what she told me. In Moscow (why we were flying to Moscow to get to Istanbul to get to Chicago still puzzles me…) they pulled both Dave and me out of passport control lines, gave us armed escort across the tarmac to another terminal, and with gestures and points told us to re-check into airline transfer. In my mind’s eye, I thought I remembered seeing my name/contact info stripped off the handle when they threw it on the loading belt—well you guessed it, my little rogue suitcase was in for another adventure.

If the suitcase could talk, it might tell us about the intricacies of airline baggage handling, the rough and ready haulers who toss it like a marshmallow into huge cargo holds, the pounding and radiation it gets inside the security checks. I’d also like to think it would tell us about the people it sees, the faces that are going about their business, smiling and frowning, complaining and cajoling, living in the proximity of global travel. I’d like to think it would tell us to watch and listen and experience and absorb the adventures we are privileged to be part of. I’d like to think it would tell us to pack light, stay fit and travel well. I’d like to think it has seen the world from the belly and not the shoulders…and from that point of view, there surely is much to learn and understand about the people I meet and the places I visit. If my little rogue suitcase could talk, I think it might have interesting global wisdom to share.

Late last evening, 10 days after landing in my hometown airport, my rogue suitcase showed up unannounced and unceremoniously on my front porch. It had several numbers and bar codes attached in various places, most of them torn and damaged beyond bar-code-reader recognition, from places like VNO and IST and ORD and a couple I didn’t recognize. Nothing short of amazing, it made its way home once again, traveling around the globe with a mind of its own. I stand in awe and offer my thanks and appreciation to all those involved in tracking and re-directing it back home.

As I close this little travel story, I also think of the global outreach colleagues I work and travel with and our vision and mission to improve and strengthen laboratories around the world. We’ve all lost luggage, missed flights, traveled complicated itineraries, and used a lot of “air time” trying to keep up with our families and friends. But in the end, if our suitcases could talk, they might agree that it’s all worth it.

And…I hope your travels are always safe, on time, uneventful and that you never lose your luggage!

–Beverly Sumwalt, MA, DLM, CLS, MT(ASCP) is an ASCP Global Outreach Volunteer Consultant.

In July 2012 I traveled to Dushanbe, Tajikistan as part of a team that conducted initial site visits and needs assessments at laboratories around the country. Clearly it has been a couple of years since that visit and I must admit that I haven’t done a good job at keeping up on any developments. I am sure there is much we did not see, and did not learn and various items that were lost in translation, and I realize that one visit does not an expert make. All that being said, however, I wanted to share my impressions from that visit, as I was surprised by the differences between the challenges laboratory services face in Tajikistan (and reportedly much of the Central Asia region) and those faced in many countries in Africa. In many African countries, challenges related to laboratory services and infrastructure can be linked to lack of resources, materials, testing supplies, supply chain issues and difficulty for rural patients to access the laboratory.

In Tajikistan, at the time of our visit, there was a severe lack of reagents needed to continue running multiple tests. This was due to a delay in receiving a specific international source of funding dedicated to purchasing these reagents. In general, however, the laboratories we visited appeared to be better supplied and stocked than many I have seen in various African countries.

To me, the most striking observation was how the structure of the laboratory system made it difficult for patients to obtain the appropriate testing and care. There was one lab for TB tests, and one lab for routine CBC’s, and another one for HIV tests, etc. Some of this separation was due to different sources of funding for the labs, which restricted those funds to be used only for specific tests (an issue for sure, but one related more to international aid and funding than the Tajik structure). Another explanation we received was that some of the separation was due to bygone practices from the communist era government where many services were very siloed. No matter the explanation, however, it could be challenging; a patient who needed multiple tests had to traipse around to numerous locations in order to have samples taken for each test.

Imagine what that would be like as a patient. Would you follow through on doctor’s orders if it was going to take all day and multiple stops? I’d like to think I would, but perhaps not if it was too much of a challenge.

-Marie Levy spent over five years working at American Society for Clinical Pathology in the Global Outreach department.