Pathology Support

Project Advocate: John Benziger, MD

Outline of Project: This project is aimed at bringing pathology services to Puerto Cabezas by

improving facilities, donating appropriate equipment, and teaching strategies to improve and

augment testing options.

Accomplishments of Project August 2007-2008:

This project, largely funded by a humanitarian grant from the College of American

Pathology Foundation, started with construction a new lab building adjacent to the existing

Hospital Nuevo Amanecer in Puerto Cabezas. Construction began in October 2005 and was

completed in April 2006. The new lab is a functional, attractive and well-built structure.

Donated, used histology equipment and materials were brought to the lab, and Javier, the

head technologist, has also trained in histotechnology.

As a part of the development of pathology services I visited the pathology training

program in León on two occasions. This outreach resulted in the successful recruitment of Dr.

Janine Tenorio, who finished her pathology residency training and started working at the lab in

April 2007. A computer and printer for the lab introduced a database system to manage data

and print out reports. The Cytotechnologist, Justo, who was formerly housed at the Puerto

Cabezas Polyclinic has moved to the new building where he has increased space and

oversight from Dr. Tenorio.

Mary and I were in Puerto Cabezas preparing for the new pathology service

inauguration when Hurricane Felix struck on September 4, 2007. The whole area, including the

hospital, suffered extensive damage. Fortunately the well-built pathology building sustained

only minor damage. We returned in February 2008 and were heartened to see that many

repairs and improvements had been made, and the vegetation was regrowing vigorously. The

lab building was repainted and looked great. The inauguration took place with gratifying praise

and support pledged by the hospital, the mayor and leaders of the regional and national health

ministry. The pathology lab staff now includes a pathologist, cytotech, histotech and secretary,

The pathology service is now fully functional and providing timely services to patients in Puerto

Cabezas and in other parts of RAAN.

The chemistry testing program has made slow, but definite progress. The labs in Puerto

Cabezas, Rosita, Bonanza, & Siuna all have new small desktop chemistry analyzers. The first

order of chemistry reagents has arrived and is being stored in a new refrigerator in the

Pathology Lab. These reagents will allow testing for ten of the most commonly needed tests.

Technologist Javier Carcamo has begun teaching techs at the outlying small hospitals how to

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use the equipment and perform the tests. He will be spending two weeks in September getting

the labs in Rosita and Bonanza up and running.

Goals for the next year: The goals for the coming year is to continue to improve procedures

and to further develope and integrate the computer database system to generate reports and

facilitate tracking of patients with abnormal pap smears. I am also working to develop

specialized, simplified and inexpensive equipment for use in processing tissue biopsies.

Should these ventures prove successful, they could make it much easier to start up pathology

services in other remote locations in Nicaragua.

We hope to work to expand this chemistry program to other sites and to reach a point

where this capability will be sustained into the future.

Funding: $30,000 CAP Foundation Humanitarian Award; Equipment donations

Volunteer Visits: September 2007 and February 2008

Next Visit: March 2009