African visitors get medicine without borders at Palomar Medical Center

By: QUINN EASTMAN - Staff Writer | Friday, May 25, 2007 10:14 AM PDT ∞

ESCONDIDO ---- On a tour through Palomar Medical Center's microbiology lab Thursday, a group of Ugandan and Ethiopian health care specialists stopped to examine a piece of equipment that covered a desktop.

By placing a sample of a patient's blood or urine inside a credit-card-sized cartridge, lab workers can identify types of bacteria and perhaps antibiotics to fight them, the lab's medical director Jerry Kolins said.

The five Africans ---- a doctor, a nurse, two demographers who work on preventing infectious disease and a chemical engineer ---- are visiting San Diego County as part of a three-week "study exchange" sponsored by the Rotary International Foundation.

Several in the group said they were familiar with the microbiology equipment but asked how many cartridges Palomar's staff uses every day.

They whistled when a supervisor answered 100 daily.

A box of 20 cartridges costs around $150, according to manufacturer Biomerieux's Web site. A cartridge reader can cost more than $100,000.

Dr. Peter Rukumbira, an obstetrician at Kiboga Hospital in Uganda, said doctors there manage to learn much of the same information with a microscope, a centrifuge and petri dishes, but it takes days rather than hours.

"At the end of the day, you get the result," he said. "But you have to use some ingenuity."

Technology and managing patients' medical information were recurring themes Thursday.

The group visited Palomar Medical Center's emergency and radiology departments and the six-bed neonatal intensive care unit, where they saw an infant that was born almost two months premature.

In the neonatal unit, Rukumbira paused to inquire about a breathing apparatus for premature infants, saying that Kiboga Hospital is in the process of acquiring its first incubators.

The group said AIDS, malaria and complications of childbirth were major concerns in African hospitals, a contrast from motor vehicle accidents, heart disease and cancer, which dominate American hospitals.

They had an energetic running discussion with Kolins, who supervises the hospital's blood supply, about how donated blood is tested for viruses such as hepatitis C and HIV, which causes AIDS.

"We sometimes have to refer people elsewhere when blood is not available," Rukumbira said, adding that he also once lost a patient who refused to accept donated blood.

Messay Teferi, who works in Addis Ababa for a government agency on reproductive health and preventing HIV infection, says he has his work cut out for him back home.

Some estimates of the number of Ethiopian adults who would test positive for HIV run as high as 3.5 percent, he said. For every 100,000 live births in Ethiopia, 673 new mothers die, he said.

The corresponding number in the United States was 17 maternal deaths per 100,000 in 2000, according to the National Institutes of Health.

Not all of the African group's visit is focused on medicine.

The group was scheduled to visit Escondido Mayor Lori Holt Pfeiler's home Thursday afternoon and Stone Brewing Co. that evening. One of the visitors, Ugandan engineer and Rotarian Joel Sekabembe, works in brewing and distilling.

A similarly sized group from North County is visiting East Africa as part of the Rotary exchange, said Trudy Armstrong, a member of the Rancho Bernardo Sunrise Rotary Club that is organizing the Africans' visit.

The Rotary International Foundation pays for the visitors' airfare and local Rotarians host them in their homes.

They've also visited Pomerado Hospital, Sharp Hospital, UC San Diego molecular biology labs and the San Diego Zoo's Wild Animal Park's new veterinary hospital, Armstrong said.

Contact staff writer Quinn Eastman at (760) 740-5412 or qeastman@nctimes.com.