Warrior in the white coat

Back in the battle against infectious disease..

2017 summer found me back in Uganda, and back at the Infectious Disease Institute – Makerere University. This being my second internship at this organization, I had a warm welcome from very familiar faces in a familiar space. But for a single staff change or two, nothing about the laboratory had changed. This time, knowing more about the lab gave me more precision in choosing the nature of work I did.

What was different

Cell pelleting

Prior introduction to several labs at Mulago steered me away from high performance liquid chromatography (Pharmacokinetics lab), towards molecular biology, immunology, and microbiology. Therefore, I spent the entirety of my internship in the translational research lab. It also helped that I was familiar with the staff in this lab and some of the work they were doing, so I spent less time adjusting to the environment. Like my previous internship here, the nature of work available and duration of my internship did not allow me to develop or latch onto a research project for a more holistic research experience. I eased into the routine lab work and fortunately this time I had more experience in the lab from my third-year microbiology lab courses. I was ready to suit up in the white coat and dive deeper into the wet lab than before.

The work.

Drug sensitivity testing(right) with Emmanuel M. (left).

This internship offered fuller days, and more complex tasks. There was a lot to confect and more to practice. I slotted into tasks that were already being conducted by the staff, and two contributions especially stood out for me. Between these major tasks, I did trivial tasks within experiments and assays, processed and stored components of whole blood, and breast milk samples. One of the prominent studies in which I spent ample time supporting the staff was the gonorrhea study. Funded by the Center for Disease Research, the study was aimed at studying the trends of antibiotic resistance and susceptibility at select health centers around Kampala. The work I did included receiving urethral swabs, gram staining and streaking the bacteria on selective media. I also helped subculture, and set drug sensitivity tests and minimum inhibitory concentration test strips. By honing these techniques, I am more equipped to investigate antimicrobial resistance which was one of the targets in my Clinton Global Initiative University (CGIU) commitment to action.

Taking the fight to leukemia

Half way into my placement, the Texas Children’s hospital introduced a project to enhance leukemia diagnosis and treatment using flow cytometry. This was aimed at using fluorescent markers to identify abnormal cell populations that would be targeted during treatment. Work done under this diagnosis felt meaningful to me because it augmented treatment and provided useful data for future cancer research. More importantly for me, this was an unforeseen opportunity to develop a skill I had been fascinated by for a long time.

Far from home, yet far from dismay

Using the FACS canto for flow cytometry.

In the way of luck, the leukemia study gave me an unforeseen opportunity to interact with Mike Cubbage, the lab manager of the Texas Children’s hospital core laboratories. A master of flow cytometry, he possessed a wealth of insight into flow cytometry data analysis. Having done research/diagnosis work around Africa, he was a resource in my efforts to learn more about laboratory-based work done on the continent but instigated from overseas. I learnt that if the capacity to conduct research was available, the costs were similar on and off the continent, for different reasons. Limitations to research in Africa arose from equipment and accessibility to reagents, while limitations to research overseas arose from high wages for complex work.

Setting up PCR (right) with Joshua M. (left).

At about the same time, Megan Neary, a PhD student from the University of Liverpool launched part of her pharmacogenetics project in the lab. Her work was focused on investigating the relationships between genes involved in HIV Antiretroviral drug metabolism and contraceptives in African populations. This was a rich opportunity for me to learn more about PCR. Although I did not seize this opportunity to the extent I did flow cytometry, I had shadowed and conducted each part of the experiment. My conversations with Megan contributed to my understanding of international research. From her, I learnt that collaborations between universities tremendously eased research in Africa. And aside from limitations like unstable electricity supply and reagent shortages, some research was better off done in Africa. This leaves an opportunity for domestic researchers to use the samples for further studies in the future.

Not withstanding challenges like my personal health and interpersonal adjustments, this internship was a success. I appreciate the time that the staff invested in training me in the skills I required, and relish their patience in moments where I was proffered the opportunity to work without supervision. It has left me a lot to ruminate about, and certainly enriched my proficiency in research and the work place. The translational lab has been a place I can learn from enthusiastic colleagues and enjoy diverse conversations with friends. This is an organization I would recommend to scientists who seek involvement in infectious disease research in Africa.