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US adviser aids Afghan military hospital’s lab staff

By Erika Stetson , U.S. Forces - Afghanistan

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KABUL, Afghanistan (February 23, 2012) — Laboratory staff assigned to the National Military Hospital in Kabul are on track to meet Coalition benchmarks for success, according to a NATO adviser.

U.S. Navy Reserve Lt. Cmdr. Luis Nunez, of Chula Vista, Calif., a medical laboratory mentor with the Medical Training Advisory Group at the New Kabul Compound, predicted the hospital’s lab staff would need “very little Coalition and American intervention by July.”

Nunez works directly with two Afghan colonels and an Afghan captain. Collectively, the three officers oversee 30 staff. Nunez’s work focuses on ensuring the lab facility establishes and follows written guidelines for testing it performs as well as for employee training. Putting such policies in place and adhering to them represents the first tier of a three-tier process. 

“Our goal while we’re here is to ensure the Afghan hospital has achieved tier 1 standards,” he said of the current crop of advisers, which is due to depart in the summer. Future teams of advisers will take the hospital’s staff through subsequent tiers. 

The standards, named the Afghan Tiered Healthcare Standards, were developed by the nonprofit CURE International. CURE drew from several sources in crafting them, including Afghan Ministry of Public Health standards and data from the World Health Organization, Nunez said. 

The key for the lab is putting a comprehensive set of procedures in place, along with a system of documented training, Nunez said.
“Then, when we leave, they can continue that sustainable process,” he said.

Previously, staff members were not working from standardized guidelines.

“They were doing testing, but using memory, not written guidelines,” Nunez said. “So practices could vary, which could affect patient care.”

For example, he noted, false positives could lead doctors to incorrect diagnoses and have dire consequences.

“Drawing the blood correctly will determine how the sample is used to diagnose diseases correctly,” Nunez said. 

Afghan National Army Col. Qadir Shabazkhill, the hospital’s Medical Laboratory Department director, said the international community has essentially overseen the development of the facility from the ground up. 

“In the past we didn’t have anything here – this was not a lab,” he said. “We just had an empty room. Now we have everything here.”
The staff will continue to work to build its capacity and knowledge, he added.

Nunez, when not deployed, works as the Medical Laboratory Technician Program director at Southwestern College in Chula Vista, Calif., a community outside San Diego. He was born in Brooklyn and raised in North Babylon, N.Y.

In addition to advising the military hospital’s lab staff, he also advises lab workers at the Poly clinic, located on the hospital’s grounds, and assists with maintaining the hospital’s blood bank.

As the facility develops tier 2 and 3 standards, the advising will focus more extensively on process improvement and expanded layers of quality control, such as conducting patient satisfaction surveys and determining how comments solicited from clients should be used, Nunez said.

“Tier 2 and 3 standards will come down in future years,” he said.