BSP travel award Sabrina Lamour

My Field Trip in Côte d’Ivoire (October 2013)

Read Sabina Lamour's field report from Côte d’Ivoire, funded by a BSP International Training and Fieldwork Award

Following minor hiccups on the first few days of my stay (including multiple flight delays and “digestive adjustments” to the local food), I spent the first week participating at the “EcoHealth Africa 2013 Conference” in Grand Bassam, organised by CSRS. I was intrigued and interested at the different perspectives and approaches presented by African researchers. Research here appeared to be strongly driven by local public’s concerns, often directly engaging with communities, health workers and sanitation engineers, during project planning and implementation of interventions. There was a strong focus on working collectively across different disciplines in order to ultimately ameliorate human health as well as that of animals and the environment – highlighted in their conference declaration (which I helped translate into English), available online at : http://www.csrs.ch/actualites.php?id=113

Furthermore, there was a great interest in using endogenous public knowledge, especially with regards to medical plants and herbs, in the quest to find alternative treatments for infectious diseases of people as well as of livestock.

After briefly visiting the research facilities at the CSRS in Adipo Doume (outside of Abidjan city), I spent the majority of my stay working at the Methodist Hospital of Dabou town, around 40 minutes drive west from the CSRS. Following introductory visits to the different departments, I assisted staff at the clinical laboratory where I performed multiple diagnostic tests, including microscopic examination of stool samples for gastro-intestinal parasitic cysts, eggs and worm detection, various biochemical analyses (e.g. measuring fasting glucose levels in serum) and performing immunological tests, e.g. testing for presence of anti-Salmonella typhi antibodies for typhoid fever diagnosis. Although the laboratory had malaria rapid diagnostic test strips available, the workers preferred relying on blood smear tests (which I spent a lot of my time doing whilst working there, shown in photo) as they thought this method was more reliable, was able to give a measure of parasitic burden (as opposed to simply presence/absence of Plasmodia infection), and was much cheaper (especially as they could re-use glass slides). I also performed HIV tests, full blood counts and tested patient blood types (as well as my own which I never knew until then!). This was the first time that I was able to experience the day-to-day activity of what goes on in a hospital lab that deals with patients having tropical diseases – notably HIV, malaria, TB, and typhoid which represented the large bulk of infectious diseases – that I’ve learnt much about at university but never got to see face-to-face: it was a highly rewarding experience.

In addition to working in a town hospital, I was able to visit and assist in a more rural setting, in the clinical lab of Taabo General Hospital (about 2 hours drive further inland from Abidjan city). Here I was immediately struck by the much more limited resources of both the hospital and the local community, which consisted of the small town of Taabo surrounded by neighbouring villages. Poverty and illiteracy were serious issues that limited many of the locals to access health care services. The clinical tests available at Taabo laboratory were similar to that of Dabou hopsital, though on a much smaller scale. Furthermore, the few patients that arrived at the hospital often presented with serious inflictions (e.g. systemic organ problems linked to malnourishment) which to me appeared completely novel but unfortunately for the hospital staff, were in fact quite common. Taabo was definitely much more of an eye-opener to the many problems faced by rural communities in low-income countries such as Côte d’Ivoire.

Upon my return, I have since written a short observational report on clinical diagnostics in Côte d’Ivoire, using both Dabou and Taabo hospitals as case studies. This is now publicly available on my Imperial College Blog site at: http://wwwf.imperial.ac.uk/blog/sabrinalamour/2013/11/11/clinical-diagnostics-report/

When I wasn’t cooped up working in the labs or at the conference I did my best to explore the area, e.g. travelling in crammed mini-buses with locals, shopping at the vibrant markets, eating street-food (whilst trying my best to turn a blind-eye to some of the sanitary conditions of the food preparation), visiting some of the nearby beaches on the weekends (absolutely beautiful!), and conversing with fellow students about life in Ivory Coast, under the trees with random lizards and goats passing by…