Yugsiche Alto
On Wednesday of last week we spent the day at a school in Yugische Alto–about a 30 minute drive from Plancha–doing our recycling and hand-washing charlita with the kids as well holding a mini-medical brigade.
The doctors in Planchaloma were hoping to use Sally to screen the kids for anemia, but since it’s not ready for use on patients yet, we suggested using the tools in their lab-in-a-backpack instead. Currently, the health center in Planchaloma lacks a lab technician, so they haven’t been able to use the lab-in-a-backpack as planned, but Amanda and I realized that there are many technologies in the backpack that with a quick training, the doctors and nurses could easily use themselves. One such device is the ZIPocrit (the electrical centrifuge used to find hematocrit and diagnose anemia) that we used many times to evaluate Sally in the lab.
We arrived at the school, and the kids were really excited to see us once Nicolas, the clinic administrator, reassured them that they would not be getting any shots (little did they know that we would be pricking their fingers ). They responded really well to the talk, and it was great to do it in front of the doctors and nurses from the clinic so that we can get their feedback on ways to improve the lesson. After the educational portion of the visit, we went ahead with the plan to screen the kids for anemia using the lab-in-a-backpack. While the process initially seemed straightforward enough, we ran into some problems.
We quickly realized that one finger prick on the small children did not produce enough blood to adequately fill the capillary tubes currently in the lab-in-a-backpack. We went ahead and centrifuged the blood we were able to collect, hoping to use the tape measure to determine packed cell volume, but after five minutes in the ZIPocrit, the blood had not separated, and instead had clotted. We believe that this can be easily fixed by using smaller, heparinized capillary tubes like the ones we brought to use with Sally. That way, we wouldn’t need so much blood and the blood would not clot.
Since we didn’t have the alternate capillary tubes with us, we went ahead and used the WHO Color Scale with the kids, which was much easier to use. It requires much less blood and is ready for interpretation in 30 seconds. We discussed this semester in our independent research class that the flaw in the color scale is that its results are very subjective, which we did find to be true, but it seemed to be the best option given the constraints of the environment.
One big take-away from the trip was that contrary to their preconceptions, doctors, nurses and community health outreach workers can perform many of the tests in the lab-in-a-backpack without the help of a lab-technician. Because lab technicians are unavailable to many clinics, we believe that with a quick training, these medical professionals can diagnose diseases that they currently do not even screen for. This was a theme that would also present itself in Yatzaputzan…