When you talk to top public health laboratory professionals about the work they do, an interesting thing happens. Even if you’ve never thought about laboratories, even if the word “phlebotomy” makes you hazy–even if you’ve actually tried hard to forget about the times you’ve needed them–you start feeling glad they exist.
Really glad. Public health laboratories around the world serve our communities in dozens of ways. They help doctors and nurses make crucial decisions about our health and the health of our families, support our leaders to monitor disease and respond to outbreaks, and keep our food safer. If our cows or horses or the crows in our yards start getting sick, we turn to laboratories to tell us what’s going on.
Still, not all laboratories are able to deliver reliable and efficient services. Quality laboratory work requires strong systems and ample resources, a foundation that laboratory leaders in many resource-limited countries are still working to build. As one way to support these efforts, the US Centers for Disease Control and Prevention (CDC) and the American Society for Microbiology (ASM), together with I-TECH, have begun a new fellowship program. Through onsite study tours of US public health laboratories, and by building lasting relationships between global colleagues, the program supports Fellows’ efforts to strengthen their local and national laboratory systems.
This June, one of the first groups of Fellows, all senior Kenyan laboratory professionals, arrived at the University of Washington (UW), in Seattle. There, they began an intensive, six-week tour of public health laboratories in Washington State, Indiana, and at the CDC, in Atlanta, Georgia.
“The CDC/ASM Fellowship isn’t designed to teach leaders laboratory skills or new diagnostic procedures,” explained Dr. Robert Martin, Director of Laboratory Programs at I-TECH and a professor in the University of Washington Department of Global Health. “Rather, it provides an opportunity for the Fellows to gather best practices and lessons learned; information that can help them strengthen the management, communication, and quality assurance functions that allow laboratories to provide quality services.”
As part of the program, the Fellows learn how private sector and local and state government laboratories in the United States communicate in times of need–for example, how multiple laboratories work together to respond to disease outbreaks. They also focus on how US laboratories are managed, what laws and regulations govern the practice of laboratory medicine, how laboratory scientists are educated, and how quality testing is assured. Because most laboratories use multiple electronic information systems, the fellows also learn about the effective use and integration of these systems. “My focus is on strengthening [all] of our laboratory systems,” said Fellow Waqo Bora, Director of Kenya’s Central Provincial Laboratory. He noted that Kenyan laboratories are responsible for a wide range of surveillance, detection, and disease response, and that they “need the competencies . . . to implement electronic laboratory information systems.”
During the first three weeks of the tour, the group visited laboratories throughout Washington. In Seattle, they met with Dr. Sean Murphy and Dr. Wes van Voorhis, of the UW Department of Laboratory Medicine, and Drs. Jeffrey Duchin and Tao Kwan-Gett, of the King County Health Department. At the Washington State Public Health Laboratory, they spoke with laboratory director Dr. Romesh Gautom and quality assurance and biosafety officer Mr. Steve LaCroix, and met staff responsible for managing the laboratory’s various departments.
During a trip east, to the Washington Animal Diseases Laboratory, in Pullman, the Fellows spoke with Dr. Terry McElwain and his staff about the concept of “One World/One Health.” One Health suggests that linkages between animal health, human health, and the environment are key to the majority of emerging diseases affecting humans, and advocates closer working relationships between human and animal health laboratorians and epidemiologists.
The group also discussed the value of relationship-building and communication among laboratories, doctors, and the local community, a concept that resonated with Dr. Jane Siminyu, Director of Kenya’s National Public Health Laboratory Services: “Public health laboratories in Kenya often ‘bump in’ to one another,” explained Dr. Siminyu. “One of the main aims of coming here was to see how [the laboratories] relate to one another. How do you negotiate and still serve the population without one laboratory interfering with another?”
Overall, the Fellows agreed that the study tour, which will continue in Indiana this month, has provided a unique opportunity to gather expertise and lessons learned at US facilities–and could even be longer. Although laboratories in the two countries face different challenges, “I don’t believe in reinventing the wheel,” said Fellow Dr. Joseph Oundo, a laboratory quality manager at the Kenya Medical Research Institute. “During the tour, I was looking at the systems, [asking] what thought processes they’d used, how systems were implemented, what were the challenges and minefields–so that we don’t have to go through the same minefields again.”
At the conclusion of the visit, the CDC and ASM will gather insights and experiences from the three Fellows and their hosts. They’ll use their feedback to continue to develop and structure the program and a curriculum for future participants.
Learn more about I-TECH’s work to strengthen laboratory systems.
Watch an online e-learning module by I-TECH/UW Professor Robert Martin on Developing Sustainable Laboratory Capacity in Resource Limited Settings.
Learn more about the “One World/One Health” approach.