August 2010

Today is the first time that I have blogged since mid-July.  It is hard to believe that 45 days have passed!  Everything is going well, I have just been very focused on trying to implement a few solutions with my Afghan counterparts. 

Since July we have started a Quality Control Program, developed and implemented a Bacteriology database, and we are working on supply contracts, standardized operating procedures, and a laboratory guide for the physicians and nurses.  Also, I was able to program, calibrate, establish QC, and train my counterparts on their biochemistry analyzer.  It has been an extremely busy period and I hope the next 45 days goes back just as fast. 

I am looking forward to returning home to my family.

The lab received new reagents and I had to set the system up for testing

Interesting Week

I realized that the top three priorities, that I will focus on, are Routine Analyzer Maintenance and Quality Control, Training and Competency Assessment, and General Laboratory Safety.  I chose these three fundamental areas because they are critical to patient and laboratory staff safety.  I hope that my counterparts agree.

This week was very interesting to say the least.  We had multple supply deliveries, in-service training, discussions with an NGO on training for the Afghans in advanced lab technoloies (i.e., Polymerase Chain Reaction), and many discussions on what is sustainable and what is not in Afghanistan.  Sustainability is a very tough question.  To sustain something means to give support or relief.  The question is: how do we help the Afghans to sustain their own system?  I wish I knew the answer to this complex question.

Lecture held on the biochemistry analyzer

Afghan soldiers drilling

CO2 Cylinder delivery for anaerobic bacteriology

Independence Day & New Analyzer

This week I celebrated my fourth Independence Day outside of the United States.  The first three were in Italy.  The base held a small ceremony, which was simple and nice.  The resounding words from the ceremony were "...life, liberty, and the pursuit of happiness".  These words are also fitting for our role in Afghanistan.

In the laboratory we began the process of setting up a new hematology analyzer to perform complete blood counts. I was intrigued by the amount of interest in the analyzer. There is a lot of energy surrounding this project. I hope to teach my counterparts how to validate a new analyzer and use the energy to get other things accomplished.

Another Wednesday

The work week in Afghanistan is Saturday through Thursday, with Juma (Friday) off. By the time Monday roles around it feels like Wednesday. So I started this saying that there are three Wednesdays: Monday (the third day of the work week), Tuesday (just because it falls in between the two Wednesdays), and the real Wednesday. You would have to be here to really appreciate what I am saying.  Thank God for Juma!



This week was another uneventful week. I want to say that it was like “Ground Hogs Day”. Everyday seems to be the same, with the exception of Juma. Last Juma I was able to Skype my family and we played Checkers, Chess, and Hangman. It was the most fun that I have had since departing in May. I am looking forward to returning home. December were are you?

I spent time at the Hospital and the Poly Clinic this week. We begin discussing laboratory standards and both teams seem to be receptive. At least I hope. Also, we spent time on developing a proposal to improve microbiology capabilities at the Poly Clinic. At the hospital I began to assess the competencies of the laboratory staff. This has gone okay thus far. Next week I will begin a series of lectures in Coagulation Studies.

What a fun day!  I miss these guys so much.

This photo is from April 2010, while I was at Fort Polk.

Of course I had Chai.  I drink about four cups of Chai each day.  It is good.

Learning My Role

This week was uneventful. I drank plenty of Chai and had several conversations about my family and of course on how I can assist with improving the laboratory services.

After two weeks at the NKC and visiting (mentoring) at the Hospital and Poly Clinic I am finally beginning to understand my role. It seems like I need to assist my counterparts with laboratory lectures to increase their knowledgebase and quality management to improve their systems. However, I spend a lot of my time on supplies and logistics. This is a critical component of delivering laboratory results and is probably their most critical issue. But I am certain that the issue cannot be resolved at my level. I will just say that there are many problems with their logistics and supply systems.

I was able to capture a few neat photos of the various laboratory sections: written and Dari and English and a cup of Chai.  There is a saying in Afghanistan... your host can give you everything that he owns, but if he does not offer you Chai he has not given you anything.

This one is my favorite

Beautiful Flowers

Today I am posting photos of flowers that I have observed around the hospital.  When I return home I plan to spend a lot of time with Stephanie and the children landscaping and taking photos of our flowers.

Check out the size of this dandelion.  It's huge.

Turnover, Meeting my Counterparts, and Chai (Tea)

This week involved turning over with my predecessor, meeting my Afghan Counterparts, and drinking a lot of Chai. Also, I almost forgot, I got to eat some traditional Afghan food: pilal (rice) naan (bread), and chicken kabobs.  We had a luncheon at the Rose Garden on the top floor of the hospital.  The scenic photo, below,  is looking away from the hospital towards Kabul.  The view is very nice.  It was a good week and the food was delicious.



My counterpart from the Hospital

                                                                                   

                                                                                       My counterpart at the Poly Clinic

View from Hospital Rose Garden       

                                 Pilal

Naan