Wednesday, July 23, 2008

Lab Work

The Walter Reed lab in Kericho began as a makeshift workspace in a rented living room.

"I came out here and took one look at the place and thought I would take off..Kericho is pretty small," said lab director Rukiya Kibaya, remembering her first foray into the new world of scientific support for the AIDS effort in rural Kenya in 2003.

"But the enthusiasm of everybody at the site caught up with me."

The Walter Reed lab is now one of the best in Kenya, the only one in the country to win the prestigious College of American Pathologists (CAP) certification and one of only a handful in Africa with that designation -- which means its procedures and results are on par with the best labs in the world.

This minor miracle -- brought about with a lot of investment from the U.S. military and a lot of hard work by dedicated Kenyan scientists like Kibiya -- now operates from a suite of rooms in the Clinical Research Center at Walter Reed's headquarters in downtown Kericho. Reaching it is like moving through a series of airlocks leading from the developing world to the front lines of science.

Just off Kericho's main drag, where minibus taxis jostle and hawkers congregate selling everything from bananas to cellphone minutes, you walk down a quiet alleyway to a large metal gate. Behind it, the CRC is a freshly-built, stone building surrounded by manicured lawn and "keep off the grass" signs. A reception hall leads to a landscaped inner courtyard that wouldn't look out of place in Silicon Valley. And around it are arrayed quiet, airconditioned offices ranging from IT to pharmacy, and well-equipped laboratories where the exacting work of testing, measuring and reporting the biomedical ravages of HIV in the region are carried out.

Lab workers in blue coats work quietly and quickly, surrounded by the metallic gleam of state-of-the-art machinery enabling them to do everything from basic urinalysis to complicated tests to assess patient HIV viral load -- an increasingly important signpost for AIDS-related illness.

In the cold storage room, a row of locked refrigerators gives way to massive scientific freezers - set at -74 degrees Celsius -- which preserve samples and are backed-up and failsafe-d to keep the both the samples and the data reliable.

While the CRC lab was originally set up in line with Walter Reed's "primary mission" in Kericho -- the thus far fruitless hunt for an AIDS vaccine -- the lab is clearly realigning itself with the new realities and new priorities of PEPFAR, the U.S. AIDS treatment aid program. Much of the work now is devoted to new studies aimed at assessing how and when to intervene with anti-retroviral treatment, and in training lab personnel from other nearby facilities on how to handle the scientific backup required for a program that is enrolling tens of thousands of local Kenyans on AIDS drug treatment.

"We're spreading our risk," Kibaya said.