What I've Discovered in the Hospital...

I must say that I absolutely love the people I work with in the hospital!! They are so much fun and have made me feel so welcome even though I still have a lot of problems with the language. The first day I was there, my amazing new coworker Maria paraded me around the hospital introducing me to everyone, just to make me feel welcome! The MT's, blood bank specialists, RN's, cooks, cleaners, admin, even doctors and police have all stopped to listen to Maria while she introduces me as the Yankee MT that is going to find her a sugar daddy in the States. It's marvelous! My first day I was so nervous, for the first second because I didn't know Spanish, but Maria slowed everything down, and made me feel like I knew Spanish just as well as her... What a patient lady, I think she's going to go right to heaven for this... sugar daddy or not!

So there are some major differences between a public hospital laboratory in a poor provence of Argentina and any type of hospital laboratory or clinic laboratory in the states.

• When you step in the lab, you don't see large instruments. Instead, it kinda looks like a an older Chem lab.
• They aren't wasteful at all. They reuse their pipette tips, test tubes, slides, everything except syringes and needles.
• Therefore, there is no need for a biohazard bag because everything is washed and reused. The tip of the needles are melted then thrown in the trash.
• When a person with TB comes in, there isn't a special room for them with the air circulating out of the room... This is because most everyone has the TB vaccine, especially people that work at the hospital. Yes, I've decided I should ask a doc about this, because I don't have the vaccine (neither do you I'm sure because it's virtually impossible to get in the states).
• Gloves are available but uncommonly used (they always save the gloves and use them as tourniquets), and on occasion mouth pipetting is practiced
• You have to add your own anticoagulant to the tubes, so after you're done drawing, you have to hurry back to the lab to put the syringe draw in some tubes with the proper dilution of anticoagulant.
• There is no hematology instrument, they do a hematocrit (always), hemoglobin (sometimes), WBC estimate (always), and manual differential (if ordered)
• Manual differentials are done with a pencil and paper. There isn't any type of fancy button pusher here. You just tally up 100 cells with a pen and paper.
• They use a spectrophotometer machine to do their glucose, ggt, hemoglobin, urea, and cholesterol testing
• They run ESRs, wash the tubes and reuse them
• Lancets are not used, instead, a needle is used for a heel poke.
• There isn't a computer in the laboratory. Everything is done with pencil and paper.

My view of the laboratory is just that they aren't as advanced because of lack of funding. It is exactly like a laboratory used to be like in the states, but they don't have the funding to move forward and get newer instruments.

Now, I'm only talking about a public hospital (it's free), in a poor provence in Argentina. I've been in private laboratories in this provence, and it's just like the states. Really good instruments and tools are available if you have money. In Cordoba there is a very large Clinic (clinics are private here, hospitals are public) that has a lot of the same instruments I worked with at Mayo. Bottom line, amazing healthcare is available if you can afford health insurance, which here is $50 a month, and everything is covered. Plus, there's no gimmicks (oh, we won't cover that because you have a "pre-existing condition") they cover it all...

I really am enjoying my experience. It's really eye-opening to work with the poor and see interesting things in the laboratory. Today, there was a sputum with TB in it... and some stool with cysts of Giardia! Life is great!! I really wish I would have brought my parasitology book, I can actually use it here!