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| Cepheid GeneXpert |
Then some days it seems like all the pieces are falling into place.
Last Sunday morning I did my run then Pierre and I Skype’d with France. After brunch I took a chance and followed up on a contact I had at UCLA (someone who had done a medical mission last spring to test women in Petit Goave for STIs). I wanted to ask about the GeneXpert, an instrument I plan to use to diagnose Chlamydia and gonorrhea. I have been trying for several months now to convince Cepheid, the manufacturer, to donate or loan a couple of GeneXperts for my project. I sent the email. My contact replied a couple of hours later and asked me to call him at home to talk about my project. We had about a 15-minute Skype call while his kids waited for him to take them somewhere. It turns out that he knows someone at Cepheid and he promised to talk to this person about my project on Tuesday. The week was off to a good start. We’ll see where this lead goes.
Sunday night, Josh Udovich, the Carl Zeiss Microscopy Account Manager for USUHS, emailed to tell me that his manager approved my request for donation of a Primostar iLED microscope. This is a very nice, rugged microscope with a battery pack that was developed for use in developing countries.
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| Zeiss Primostar iLED Microscope |
Tuesday, we had a visit from David Fitter from the CDC. David was passing through on his way back to PauP and asked if he could stop by and see the lab. David arrived with four Toyota Land Cruisers. Security rules for Embassy personnel, including the CDC people, require them to travel with at least two vehicles when going outside PauP. We had a very good visit. David works on TB so he was very interested in seeing the BSL3 lab that is almost finished here. That is where the TB work will be done once the BSL3 lab is commissioned later this month. UF will also train technicians from the LNSP (Laboratoire National de la Santé Publique).
Wednesday morning, Jeff Deal and his wife Hart arrived. Jeff is the Director of Research for Water Missions International (http://www.watermissions.org/). Water Missions provides sustainable safe water and sanitation systems for people in developing countries and disaster areas. Jeff is interested in determining the impact that the Water Missions systems have on public health on a broad scale. Basically Jeff wants to study two groups. One group which has the Water Missions safe water and sanitation system. The other group with no water and sanitation system but which is in line to get them from Water Missions in the future. Thus, the idea is to monitor water borne diarrheal disease pathogens before and after installation of the Water Missions systems. Jeff came to pick our brains and see if we could collaborate. This is a great opportunity and Water Missions can prove to be a tremendous resource for our projects here. It is well established and present in many regions in Haiti as well as in Central America and Africa. As if that wasn’t enough, Water Missions even has a project in Baradères. We are in an ideal position to work with them in Baradères since that is where I will be setting up the new UF lab. The timing is perfect and so is the partner. Coincidence?
We had some great discussions with Jeff and Hart. They both spent quite a bit of time in Africa, most recently in South Sudan. Since Jeff is also a tropical medicine doctor, he spent time working with Kevin, the UF student who is looking for schistosomiasis in Haiti. Jeff is also an anthropologist. He has done a lot of work in Africa. I have been convinced for a long time now that it would be a really good idea to get an anthropologist involved in the survey component of my STI project. Jeff agreed to help out and look at our survey questionnaire.
Thursday morning, Madsen (who arrived late Wednesday) and I drove over to meet Dr. Celestin, the head of the Centre de Santé, Gressier, one of the sites where I plan to do my STI study. We talked (in French) about the logistics and how the study will be set up. I explained the project’s goals (being careful to call it a project and not a program; in the Haitian mindset programs are long term with more money) and how we would be testing men and women and getting same day results for immediate treatment of the patients who test positive. I let Madsen talk about salaries and whether we might hire the same staff that did the pilot study at Dr. Celestin’s clinic last summer. Space is a concern but Madsen thinks Dr. Celestin will find the space we need. The meeting went very well. Madsen and I were very satisfied.
As soon as we returned to Christianville, we met up with Andy Camilli, a friend and colleague from Tufts University in Boston. Andy was in PauP for a few days to meet with Dr. Boncy, the head of the LNSP. One of our goals is to promote the UF-EPI Haiti lab and its work and when Andy emailed me that he would be in PauP, I immediately asked him to come out to visit the lab. Since Andy could not arrange a ride, Meer sent Makendy and Pierre into PauP to pick him up. Andy is a cholera investigator so his first question to Meer after getting out of the Everest was, “Is Vibrio cholerae entrenched in the environment in Haiti?” This question is a very hotly debated one right now. Some groups don’t believe that cholera has established itself in environmental reservoirs in Haiti. Meer’s recently published data say otherwise (http://wwwnc.cdc.gov/eid/article/20/3/13-1293_article.htm). So Meer invited Andy to take a look at his data. Now Andy is a believer. We gave Andy a tour of the lab and a tour of Christianville after lunch. Andy was blown away by the UF-EPI lab and the projects going on here. He also was amazed at Christianville and all its activities.
Thursday evening, Madsen, Pierre, and I got a ride over to the Haiti Health Ministry (HHM) compound. HHM is the other site I want to use for my STI study. Our meeting with Sandy, the HHM Administrator, went very well. HHM is going to one of our study sites. Sandy took us on a tour of the new clinic building which is almost complete. We met a Tibetan carpenter who was finishing up cabinets for the new clinic (you meet people from all over the world here). I also almost bumped into a cow on the road as we walked back to Christianville in the dark.
Thursday night, I got an email back from my colleague at UCLA. He said to expect to hear from Cepheid about my GeneXpert donation request.
Friday morning, Madsen, Meer, and I drove into PauP for a meeting at the LNSP. La Direction d’Epidémiologie, de Laboratoire et de Recherches, the epidemiology, laboratory and research branch of the Ministry of Public Health and Population, holds monthly meetings to teach and inform about the newest research findings. Meer’s talk on the presence of Vibrio cholerae in the aquatic environment in Haiti was a big hit and had a huge impact. The timing was perfect. He got about 15 minutes of questions (for a 15 minute talk) and handled them all brilliantly. I was especially impressed with how Meer responded to the questions about how his research findings might influence the national cholera elimination efforts. Such questions are really policy questions and Meer very nicely deflected them saying that they are really questions for people higher up in the national policy chain. It was a good thing that I already had seen Meer’s slides and knew his data since Madsen told me about a half hour before Meer’s talk that he wanted me to interpret for Meer. I told Madsen that he should do it, not me. Madsen insisted. So I ended up interpreting Meer’s talk and the question and answer period as well. Believe me, being an interpreter is not an easy task. It is not like translating where you have plenty of time and can think and write and re-write the translation. It was a little stressful. But at least the LNSP people now know me: I’m the blan who speaks French with a Philadelphia accent.
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| Kevin Talbot at the Ocean Grill |
Meer, Curtis, Solomon, Pierre, Kevin and me climbed into the red Nissan and Solomon drove us down to Léogâne. Jacques (the owner and chef) greeted us outside. We introduced him to Pierre and Kevin who were dining at Ocean Grill for the first time.
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| Pierre Maurelli at Ocean Grill |
I got back to the lab and found an email from Cepheid. They will give me a loaner GeneXpert and reduced pricing on the instrument as well.
All of the pieces are falling into place. It was a crazy busy week.
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