APHL Assists Haiti to Rebuild Devastated Lab System

On January 12, 2010 tragedy struck in Haiti. A massive earthquake rocked the tiny national, particularly Port-au-Prince, causing damage and destruction that will take years to repair.

One of the buildings severely damaged in the earthquake was the public health laboratory. Deemed unsafe for use, laboratory operations moved to a tent erected outside of L'Hôpital de l'Université d'État d'Haïti (HUEH). Since the earthquake, the number of patients being treated at HUEH has tripled from 14,000 per month to almost 42,000 thus increasing demands for laboratory testing. Due to extremely high temperatures and no air conditioning in the tent, automated testing requiring cooler temperatures, such as hematology and blood chemistry, are being run manually. The result is that the current testing capacity is only 25% of the daily demand.

Following the earthquake, the Centers for Disease Control and Prevention requested and authorized APHL Senior Technical Consultant and Team Leader for the APHL Haiti Field Laboratory Support Team, Dave Doherty, to assist all of the public health network laboratories in Haiti in getting testing services back up and running to support the enormous demands for medical care and treatment

Upon learning of the dire needs in the tent laboratory, Doherty sought out to find an air conditioner that would help keep the tent at the appropriate temperature. Before he knew it, a casual conversation with a Doctors Without Borders volunteer led him to International Relief Solutions (IRS), a Georgia based company that creates modular buildings in areas of need. The APHL Haiti Field Laboratory Support Team led by Doherty provided technical assistance to IRS in planning and design of a new modular laboratory facility to will replace the temporary tent facility.

The 24’ by 36’ modular laboratory will stand next to HUEH. The facility is designed with infrastructure for work benches, heating, ventilation, plumbing and electrical services. With direct hookup to electrical and water supplies, the laboratory building will have the air conditioning necessary to meet the requirements of the many intricate and delicate tests that the laboratory technicians on scene perform routinely. The lab will arrive with the electrical system and plumbing pre-installed allowing for a quick start-to-finish set up of approximately four days.

Better lab facilities will improve testing services and will enable laboratory technologists to get back to work. According to Doherty, “Many well-trained technologists in Haiti are unable to work and provide testing services because of the loss of laboratory facilities to earthquake damage.”

It could be years before the permanent structures are rebuilt; the new modular lab serves as a long term solution. This initiative was a success due to the collaboration of willing and committed partners, each of whom brought essential resources and expertise to assure an effective solution for meeting a critical need in Haiti. Lives will be saved and illnesses treated effectively because of the efforts of APHL, IRS and CDC. Doherty modestly explains, “We were able to come through. APHL has always come through in Haiti.”

The Power of APHL

by Karen Rogers, senior specialist, communications

The American Society of Association Executives (ASAE) recently interviewed APHL’s executive director, Scott Becker, as part of a new campaign, “The Power of A,” which showcases examples of collaborative problem solving at associations. ASAE is the national association representing trade and professional associations.

During the interview, Becker discussed members’ response to the novel H1N1 virus and their dedication to APHL as well as the urgent need to build national capacity for electronic reporting of laboratory data. The video is available on YouTube and on ASAE’s The Power of A website.

Cross-Border Influenza Preparedness

by Chris Mangal, director of emergency preparedness and response

On August 31-September 1, 2009, in Winnipeg, Canada, APHL's leadership and infectious disease, preparedness and global health staff met with key officials from the Canadian Public Health Laboratory Network (CPHLN) to discuss collaborative activities, such as lessons learned from the recent H1N1 outbreak and planning for a tri-national cross-border preparedness summit. In addition, APHL staff toured the Emergency Operations Center of the National Microbiology Laboratory and learned about their Incident Command Structure used to respond to infectious disease outbreaks.

Following the meeting with CPHLN, APHL staff (Scott Becker, Mary Shaffran, Chris Mangal and Natalia Machuca) attended the first conference of its kind in Canada, “Severe H1N1 Disease: Preventing Cases, Reducing Mortality,” organized by the Public Health Agency of Canada (PHAC).

Dr. Graham Tipples from PHAC served as the Master of Ceremonies, welcoming key public health officials, including the Honorable Leona Aglukkaq, Canada's Minister of Health. The minister noted that this conference was the first of its kind to bring together clinicians, laboratorians and key public policy officials. She mentioned that the conference will help Canada to better prepare for and respond to the upcoming influenza season. The minister also mentioned that continued monitoring and surveillance for H1N1 along with consistent collaborations, information exchange and strong partnerships will be vital to keep the population healthy and prevent and manage the spread of H1N1.

The Manitoba Minister of Health, the Honorable Theresa Oswald, welcomed participants to Winnipeg, but stated, “I really wish you weren't here." This statement is a reflection of the growing concerns about the upcoming flu season and the potential for H1N1 to be more widespread, affecting the general population and overwhelming the healthcare systems globally.

Dr. David Butler-Jones, chief public health officer, PHAC, addressed the dilemma of managing and measuring H1N1. He noted that "you can't manage what you don't measure," but also mentioned that the fluidity of H1N1 cases makes it difficult to measure and as such public health officials must be creative in responding to this pandemic.

Dr. Frank Plummer, chief science advisor, PHAC, further explained the objectives of the conference, noting that he hopes participants leave with a better understanding of epidemiology and severity of the disease, clinical care and management issues, intensive care unit challenges and strategies to manage H1N1 cases. He also encouraged further connections among hospitals, infection control and public health.

Dr. Charles Penn, Global Influenza Programme, World Health Organization (WHO) addressed the current status of the pandemic and WHO efforts to facilitate communications globally, mobilize resources and provide access to vaccines and antivirals. Several additional sessions, including in-depth discussions on modeling scenarios, provided participants with more information on Canada's efforts to prepare for and respond to H1N1.

APHL will continue our collaboration with Canada and look to build stronger linkages with Mexico to ensure that there are robust laboratory systems in place to detect and respond to infectious disease outbreaks globally.

What is Public Health?

by Karen Rogers, senior specialist, communications

This question circulated among of group of public health professionals at the Second Annual Public Health Branding Coalition meeting yesterday. Scott Becker, executive director, Leigh Slayden, director of marketing and member services, and I represented the Association of Public Health Laboratories at the meeting, which was organized by the Association of State and Territorial Health Officials, the American Public Health Association (APHA), the Association of Schools of Public Health (ASPH), the National Association of County and City Health Officials (NACCHO) and the Society for Public Health Education.

The meeting’s goal was to move toward developing a brand for public health. According to participants, branding public health would have a myriad of benefits: inspiring the current and future workforce, increasing recognition, creating demand, improving advocacy and improving public health outcomes.

So what is public health?

Past campaigns have sought to help answer that question.

In 2006, NACCHO developed a national identity for local health departments. The logo they developed touted the theme “Public Health: Prevent. Promote. Protect.”

ASPH launched the “This is Public Health” campaign in 2008. This innovative movement used stickers to “brand” public health by pointing out the many (often unrecognized) ways that public health works to keep up safe and well.

The Alliance to Make US Healthiest created a video as part of its Healthiest Nation campaign. If you work in public health, this video will remind you why you do. If you don’t work in public health, this video may inspire you to learn more.

In 2009, APHA launched “Healthiest Nation in One Generation.” This motivating viral video campaign shows the many ways that public health touches our lives.

What does public health mean to you?

Firearms, Explosives and Bullets -- Oh My!: Public Health Partnerships with the FBI

by Anthony Barkey, specialist, emergency preparedness and response

To quote Moe Sullivan: “Early on, working with the FBI was a different experience, but it doesn’t hit you until you realize your partner is carrying a gun. That's a whole new experience for public health."

On a recent visit to the FBI Laboratory in the Quantico Marine Base, I was privileged to gain insight into the breadth of FBI's role in preparedness and response. Joining me in this experience were APHL staff Chris Mangal, Sikha Singh and Gavin Gollehon. The APHL team met with FBI representatives to discuss the development of chain of custody and moot court trainings for Laboratory Response Network (LRN) laboratorians. During these discussions, we were able to make much progress in developing the curriculum and should have some great training opportunities available in the near future. While at the facility, the APHL team were able to see not only an impressive collection of firearms, but also explosives displays and the famed Hogan’s Alley. Overall, the laboratory and Quantico experience was very eye-opening and strengthened our partnerships with the FBI.