Yesterday (Wednesday, June 16), we met with the Matron of the hospital to show and demonstrate all of our technologies. It looks like we will be shifting the attention of our microenterprise project towards HIV support groups instead of the community health workers, especially given the hospital’s current efforts to boost the financial stability of HIV patients by providing seedings for crops and livestock, which is especially applicable given the region’s focus on agriculture. Tomorrow, we will identify promising support groups that will be able to especially benefit from the microenterprise project and impart knowledge gained from our program to other support groups.

It also looks like “Malawi Sally,” our hand-held centrifuge developed for hematocrit detection without power is going to be a BIG hit here. I can’t emphasize enough the need for accurate anemia detection, especially given local health problems such as malnutrition, HIV, and malaria. These conditions all can cause anemia, which can lead to dizziness, heart palpitations, overall fatigue, and possibly even serious cardiovascular complications. For pediatric patients with severe anemia secondary to malaria, it is crucial to monitor recovery in these patients by assessing either hemoglobin or hematocrit. Rapid blood loss during childbirth may be fatal for anemic mothers, especially if anemia is not properly assessed beforehand.

Portable hemoglobin/hematocrit assessment technologies currently exist, but they are extremely expensive for application in low-resource areas. St. Gabriel’s has received a HemoCue device designed to assess hemoglobin levels. However, because the single-use, plastic cuvettes are so incredibly expensive ($0.70 each for 10,000 patients is at least $1000 in recurring costs), the hospital does not dare to use it except for extremely dire situations. Instead, the hospital rely on less accurate, clinical signs such as checking the inner membrane of the eyelid (conjunctivae) and paleness and sometimes a Full Blood Count (FBC) machine, which is very overused and often breaks down.

“Malawi Sally,” our hand-held centrifuge for hematocrit detection, is a solution to this problem with anemia diagnosis, as it is affordable (<$30 in cost), accurate (within 10% of results from regular laboratory centrifuges), and fast (as many as 30 samples in 10 minutes). Today, we tested 40 patients in the antenatal clinic, and the majority of mothers were mildly anemic, which the matron said was normal with these pregnant women. Moderately anemic patients that were assessed by “Sally” were submitted for further and more conclusive hemoglobin/hematocrit testing in the lab. I’m glad that these patients will be monitored more closely to possibly prevent any further complications due to anemia in the future. The nurse we were working with was delighted by the “Sally” centrifuge, especially with the ease-of-use and affordability of the device. Tomorrow, we will continue testing of “Malawi Sally” in the pediatric ward, and I already have a feeling that “Sally” will be very popular with the pediatric nurses, as well!