October 2011

A monthly means to inform and inspire our TEAM

October 2011
Vol. 2, No. 10

Photo of a candle with scrabble letters EMBLEM

Scrabble by Candlelight


A few years ago while I was working in a medical office in Indiana, the power went off during a storm.  That had not happened there for years.  I was astonished to have to put up with such a thing in the USA.  No backup was available.  Someone was sent to a local camping store to buy gas lanterns. 

In Africa we keep all our backup systems in order.  Possibilites for dealing with darkness when the “mains” hydroelectricity goes off are;  diesel generator, solar lights, kerosene lanterns, candles, torches (aka flashlights), laptop computer or cell phone screens, striking matches repeatedly, waiting for intermittent flashes from lightning, or going to bed early and waiting for dawn or the end of rationing, whichever comes first.

To heat up water for bathing or to cook food, we use an electric stove or hot plate, gas cylinder stove, kerosene burner, charcoal stove, wood fire, or just bathe in cold water, and eat raw food for a while.

Dealing with heat is another matter.  Refrigerators and freezers have traditionally been run either by electricity, kerosene, or gas cylinder.  When the power goes off, we pray it is restored before meltdown, and until then do not open the door!

EMBLEM research freezers need reliable and complete backup. They need to keep specimens at -80 degrees Celcius within a very slim margin of temperature variation.  Therefore, EMBLEM freezers have a modern way of keeping themselves cold for up to 72 hours in face of power outage, using internal carbon dioxide transfer.  Temperature is monitored closely to document the safety of the specimens. 
 Dr. Esther Kawira, Editor

Lab equipment arrives at Homa-Bay

Lab equipment arrives at Homa-Bay


Case Spotting and Enrollment

The Laboratory equipment for the Homa-Bay study site arrived on 22nd September 2011. Pamela, Constance, Peter and the medical superintendent were there to receive it. Setting up the equipment is currently in process.

Reviewing the EMBLEM SOPs is also in process and expected to be completed by mid-October.

The EMBLEM interviews for the positions of Data Manager, Data Assistants, Laboratory Technologists and Nursing Officers were successfully conducted and the new staff will be coming on board soon. Meanwhile, Community Advisory Board members have been appointed and their letters are ready.


Technicians operating the Safety hood

Technicians operating the Safety hood


A total of 113 cases have been spotted at Lacor, 58 cases (41 males and 17 females) were eligible and were enrolled. Non-enrollment was due to cases originating from outside the study area (29), not having a diagnosis of BL (15), declining participation (3), clinically unstable (2), and died shortly after spotting (2).  A second meeting with the Community Advisory Board was held on September 14th, 2011 as part of our effort to increase BL-literacy in the community. Mr. Martin Ogwang, PI at Lacor, visited several health centers in the districts of Lira, Otuke and Aleptong, where many of the cases have been enrolled, to tell them about the EMBLEM Study and encourage referral. Dr. Kinyera (EMBLEM Study Coordinator) and Mr. Mbaziira (EMBLEM Study manager) made similar visits to health centers in Arua, Koboko, Yumbe and Maracha districts.


Census for the 12 Pilot Villages has been completed and the households for Pilot Population Controls and HCII units to enroll HCII Pilot Controls have been selected. Control enrollment is scheduled to begin on October 18th. 

Laboratory setup

The EMBLEM BSL2 bio-safety hoods at Lacor and Kuluva were inspected and certified by technicians from South Africa. Training in freezer failure management SOPs was conducted. Daily posting of freezer temperature to the EMBLEM portal has been instituted. A liquid CO2 BUS (BackUp System) system was connected to the freezers.

EMBLEM Tanzania

 Appropriate laboratory space was firmly identified at Bugando Medical Center, for EMBLEM study.  Renovation cost estimates were completed for the space.  Meanwhile, delays in clearing of lab equipment by customs meant that the equipment will likely arrive not much before the end of October. Tentative plans were also made for Datafax installation and training by a team from Uganda.                                                                                              

EMBLEM Newsletter is a monthly on-line publication based on contributions of the EMBLEM Study staff.
Editor: Dr. Esther Kawira
Reporters: EMBLEM Uganda – Mike Mbaziira; EMBLEM Kenya – Pam Akinyi Were; EMBLEM Tanzania – Josiah Magatti