By Jamie Tereposky

When people think of a hospital, they think of doctors and nurses. They don’t always think of scientists in lab coats. But we are always there, hidden in the background, providing those doctors and nurses with critical patient information to guide their diagnosis and treatment decisions. 
Jamie in field labI am one of those unseen scientists. I have worked as a medical laboratory technologist at hospitals across Canada, but in October, for the first time, I traded my white coat for a red vest and left my air-conditioned lab for a field of rubber trees near Cox's Bazar, Bangladesh.
You may wonder what role a laboratory could play in a Red Cross field hospital.

Although my test menu was more limited than I am used to, I was still able to do my work with the simple equipment I had available.
I provided a positive hepatitis result for a little girl who was so jaundiced that her eyes glowed bright yellow - this meant she was able to be referred to a local treatment program.
I documented and monitored electrolyte and blood sugar levels. I held the little hands of children warm with fever and took a drop of blood from their fingers to check for malaria. I scanned water samples from the camps under a microscope looking for parasitic organisms so they would know if it was safe to drink.  Where blood transfusion would mean the difference between life and death, I tested and provided blood for transfusion. 
One of those cases was especially challenging.
It was around dusk when the outpatient department was closing for the evening and I was about to leave my lab tent after a long, hot and busy day, when I was told that a patient was being transferred from a nearby clinic. She was pregnant, and suffering from placenta previa, a serious and potentially life-threatening complication of pregnancy. She was bleeding severely. 
When she arrived she was whisked into surgery for a C-section. I had prepared early by sprinting down a gravel road to the medical warehouse where our blood fridge was stored and brought two units of O negative (the universal donor) to the operating theatre to be transfused.
After collecting blood samples, I ran back to the lab to determine her blood group and hemoglobin level. Her low hemoglobin result indicated she was in a dire condition and had already lost a lot of blood. Armed with this information, I ran back to the fridge to retrieve more donor units to prepare for transfusion. 
I ran this loop several times, from the lab to the operating theatre, to the medical warehouse and back to the lab; grabbing blood from the fridge, testing it, then delivering it to the operating theatre, where they would immediately ask for more.
When the surgery was complete, the obstetrician was concerned that the patient might continue to bleed and asked that I monitor her hemoglobin throughout the night to ensure it was stable. Until midnight I went back every hour to repeat her tests. Then again at 3 am, and then 6 am. As the sun came up, we celebrated that she had made it through the night.
I saw the patient again several days later, awake and recovering. She looked mildly irritated to see me, as people often do when I come to poke them with needles. I didn’t mind, though. She didn’t know I’d been sprinting up and down that gravel road in the dark, bringing bags of blood to keep her alive, or that I stayed up all night to check on her while she slept.
Providing laboratory services in humanitarian settings is challenging, but it is also essential. It felt good to show my value in these difficult conditions. The morning after the C-section, the anaesthesiologist thanked me for everything I had done and emphasized how critical my test results and blood products had been to this patient’s survival. There, on the field hospital team, my unique skills and contributions were no longer hidden in the background.

Jamie Tereposky is a medical laboratory technologist at Alberta Health Services in Edmonton.