At Hôpital Albert Schweitzer, we aim to deliver quality health care, even in the midst of challenging circumstances, with limited resources and a large and growing volume of patients. HAS operates a high functioning microbiology laboratory in rural Haiti, and we often must come up with creative solutions to ensure that we can offer the best services under difficult circumstances. The microbiology laboratory allows us to ensure that our patients are being diagnosed and given life-saving treatment accurately. When patients present with certain conditions, such as a urinary tract infection or septicemia (where bacteria is in the blood), we often need to extract and grow these disease-causing bacteria on a test plate in order to identify them and test the efficacy of different antibiotics. The information that laboratory technicians find after growing bacteria on an agar plate helps us to know what the patient is suffering from, and find exactly which antibiotics they will respond to, enabling us to help them recover as quickly as possible.
When patients present with certain conditions, such as a urinary tract infection or septicemia (where bacteria is in the blood), we often need to extract and grow these disease-causing bacteria on a test plate in order to identify them and test the efficacy of different antibiotics. The information that laboratory technicians find after growing bacteria on an agar plate helps us to know what the patient is suffering from, and find exactly which antibiotics they will respond to, enabling us to help them recover as quickly as possible. Bacteria need culture media (broth in petri dishes) to grow, and one of the most common media is called Columbia sheep blood agar. Most laboratories in the United States purchase pre-prepared agar plates, but for several reasons, this is very difficult for a laboratory in rural Haiti. The agar plates are expensive, require a cold supply chain, and, even with a perfect supply chain, will only remain stable for around six weeks.
In November 2011, former Microbiology Laboratory Supervisor Birgit Gast came from Germany to HAS to initiate a microbiology lab. When she realized how difficult it was to procure this agar, she remembered that when she first started working in 1989, her laboratory in Germany had sheep in their backyard thatthey would occasionally draw blood from. With the support of the Swiss Partnership, former Medical Direct Dr. Silvia Ernst, and the help of long-term veterinary volunteer Dr. Keith Flanagan (who has since passed away), HAS’s laboratory was able to purchase sheep and provide them with appropriate grazing and living space on the campus grounds.
Madam Mouton (Mrs. Sheep in Kreyol), as the great matriarch of our sheep family is affectionately called, is watched over, along with her three male sons, with great care by HAS staff. The sheep are well fed and given ample space to roam. Drawing blood from the sheep is extremely safe and does not hurt them, similar to the process of humans donating blood. Each sheep gives about 30 – 50 ml blood every three months, which does not affect their health or comfort in any way. Though it usually takes about three to four trained laboratory staff to make sure the sheep does not move too much in the process, it is always done gently, and under very clean circumstances, so the sheep are very accepting of the procedure.
When asked if she was afraid to be so close to the sheep’s teeth, Eda Sam, the head of the HAS laboratory, said, “I am never afraid to approach the sheep, because I know they won’t bite or kick me. Sheep are the calmest animals!” Once the blood is drawn from the sheep, we need only agar powder, petri dishes, sterile water, and an autoclave. After cooking the agar, we pour it into petri dishes, let them cool, do quality control, and then use them to help find the causes of infectious diseases.