Outreach

We decided as part of our project to send one of our members to an African hospital in Malawi, in order to investigate the usefulness of our detection system in a third world hospital lab as well as to increase the awareness of synthetic biology among the Malawian people. This was an opportunity to get up close and personal to investigate the logistic potential and receive feedback regarding our novel method of DNA diagnostics in a developing countries’ hospital laboratory.

Donnchadh spent the month of June in Malawi at Nhkoma Hospital. Nkhoma Mission hospital is a 220-bed facility, with all major departments and a busy eye department. The Hospital's primary catchment area is the surrounding rural 32,000-strong community, but it serves patients from all over Malawi as well as from neighbouring Mozambique. It offers inpatient and outpatient care on site and conducts mobile clinics within its catchment area.

The laboratory is an essential part of patient care at Nkhoma Hospital. It analyses samples from almost every patient that comes to the hospital. The laboratory performs the following analysis; Haemoglobin, Malaria, Full Blood Count, Blood Transfusions, Sickle cell, ESR (Erythrocyte Sedimentation Rate), Urine & Stool Analysis, Pregnancy, HIV, Syphilis, Hepatitis B, Ascites, CSF and pleural fluid analysis, Meningococcal Antigen, Tuberculosis and CD4 analysis. It also has a chemistry machine which can perform multiple analyses on blood serum for liver function tests, Lactate, Glucose, Sodium, Potassium, Bilirubin, Protein and many other beneficial chemical analyses.

Donnchadh's Work

We constructed a survey for the laboratory staff which explained our project, the detection system and its potential applications. We investigated what knowledge the laboratory staff had regarding synthetic biology and whether they thought that our detection system could be implemented in their laboratory.
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The feedback we received was very positive. As an initial impression it was felt that our project may ‘result in the development or use of highly sensitive and specific methods for detecting pathogens.. The method may also be time efficient’ and ‘It might help us to run tests quickly so our patients have results on time.

Knowledge regarding synthetic biology was diverse. Some saying that it is “using bacteria to make vaccines and drugs” and others explaining that they ‘don’t know anything about synthetic biology’.

There were no concerns regarding the use of synthetic biology except one lab assistant worrying about costs because ‘the use of technology is expensive; especially in developing countries’.
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Everyone surveyed at Nkhoma Hosptial laboratory answered that they would like to use our new DNA detection system and that they felt there was potential for its implementation. Our detection system was seen as helpful because it’s ‘very fast, easy to use, cost efficient’... ’and people will be helped in getting treatment on time’.

Challenges

The Laboratory Manager pointed out potential barriers as he felt ‘it will be difficult to sustain the service’. He felt there would be ‘problems in terms of who to order the reagents’ and for the ’training of personnel on when to order and in what condition’ and also that ‘since it will be a new test, stigma will crop in’. He also felt that the biggest problems were with regard to ‘consumables, educators and training, logistic support, electricity, dust, protocol, and bio-safety’.

One of the laboratory assistants felt that ‘since we don’t have any idea or knowledge how it works, doctors might not be able to accept the results unless they are oriented on how it works. We also need to be trained on the working principle’. She felt that the biggest problems that she could foresee were the ‘lack of educators, inadequate logistic support and insufficient monitoring of test quality’.

Despite the barriers that must be overcome, they felt that ‘this is a good development to our hospital and country since the test will require few reagents’ and that ‘the project is good’ and that there is ‘no need of big storage facilities’.