It has been another busy couple of weeks on my PULSE assignment to Ghana. I have spent several days at the Millenium Villages Project TLI laboratory. MVP sponsored a continuing education course for the midwives in the cluster clinics yesterday. I didn’t have to do much but move chairs, as my colleague Frances (a med tech) and the director of the district hospital (a gynecologist) gave the seminars in a mixture of English and Twi. The midwives and nurses learned what positive test results from the TLI laboratory mean and how to treat patients when they occur. There are no doctors at the 7 clinics the lab services. They send the lab their samples for a variety of tests. The lab has diagnosed over 90 cases of hepatitis and sickle cell disease each this year and several hundred cases of malaria, and I have been part of many of those diagnoses in the last month while here. Fortunately, Frances and Atta have been very patient with my learning curve. This week I saw my first case of human tuberculosis (from a sputum sample AFB stain). It is amazing what you can do with a microscope, a few reagent strips and some glass slides. The majority of patient samples are positive for malaria, which is both sad and alarming. As with many other PULSE volunteers, much of my time is spent problem solving, and experience with GSK project teams has been very helpful. This has ranged from trying to facilitate generator purchase and installation to overcome power outages to looking into medical waste disposal, and identifying logistical difficulties in courier services and communication. If I do nothing else while here, the installation of a generator for the lab will be a crowning achievement and one that hopefully will save lives. I am now trying to find sources of sonography training for our staff, a situation which seems much easier than it actually is in practice, in a country with few teaching hospitals, and very rare ultrasound machines. In a couple weeks I will meet the regional director of the Ghana Health Insurance scheme and hope to plead our case for laboratory reimbursement. Its a long road ahead but the future looks bright for the lab to be a sustainable asset for the rural villages of the Amansie West district. The picture above is of Frances, giving one of his outstanding lectures to the local health workers. Until next time, Nante Yi.