It is true that the level of service to the public by government authorities and agencies in this country is very low. Everywhere, you find neglect and you meet carelessness. As one official goes leaving behind failure, another comes to make things worse. The reason often cited is the absence of accountability and a system of checks and balances.

In spite of that, nobody denies the big efforts made by the Minister of Health towards laying down a sound foundation for public health care and medical services in Yemen.
In the Central Health Laboratories (CHL), I was pleasantly surprised with the diligence to make the best out of the least available. The new administration, directed by Dr. Mohammed Bin Boreik, Director General of the CHL, are really serious about their responsibility. All over the place, there is a new feeling.

You can feel that the staff want to prove that CHL can provide the same level of excellence offered by other laboratories in countries in the region.
In the CHL main branch in Sanaa, there are about 165 employees, all Yemenis. Of these, 76 are specialists, 26 medical technicians, and 29 administrators.
There are 4 branches for the CHL in Taiz, Hodeida, Aden, and Hadhramaut.

CHL Sections:
CHL is divided into 3 main sections (Public Health Laboratories, Medical Laboratories, and Training and Research) which are then divided into 13 departments.
The Public Health Laboratories are divided into 5 departments; Microbiology, Food & Water, Virology, Parasitology, and Bacteriology. Nearly 50 employees work in this section, of which 85% are women.

Dr. Khalid Al-Shaibani is the director of this section. He holds an MSc in Viral Hepatitis from Alexandria University, Egypt. "The main thing we do in this department is to check the quality of all foods that are sold in the market and analyze bottled and tap water," he says. "We have good facilities and modern equipment. The only problem is that we sometimes lack chemical reagents," he adds.
The Medical Laboratories administration is divided into 4 departments; Biochemistry, Blood Bank, Hematology, and Histopathology. A minimum of 150 samples are received and diagnozed in these departments daily. About 54 employees work in them, most of them women.

Dr. Nadim Ali Ismael is the director. He holds a BSc in Hematology from Sanaa University. "In these departments, we check blood sugar, liver, heart and renal function, hormones. Lately we started checking cancer markers in blood and tissue samples," Dr. Ismael says.
However, Dr. Ismael complained that the Blood Bank lacks necessary equipment and facilities. "The services are somehow inadequate and need to be done according to much more rigorous scientific methods," he explains.

The Training and Research administration is divided into 4 departments: Post Graduate Training, Intermediate Training, the Library, and Quality Control.
Dr. Ahmed Mohsen Othman is the director of this administration. He holds an MSc in Microbiology from Alexandria University. "What we need is books, training courses and financial support to do more in-depth research," Dr. Othman says. Despite the difficulties, he feels optimistic about the new environment allowing for greater efforts towards upgrading the level of services that CHL offer.

Services:
The CHL provide all public and private hospitals with free blood. Blood transfusion services, including HIV, Hepatitis B checks are offered also free of charge. Other check ups are offered for nominal costs.
CHL arranges free lectures for university students and other trainees from different parts of the country. Medical researchers and hematologists are allowed to do their own researches inside the labs and they are provided with facilities.

Difficulties & Needs:
CHL could do a lot more with additional support. No real budget is allocated for it. The Ministry of Health covers some of CHL's needs from its own budget. But, even this support is not put at the disposal of the people there. It is discharged through the ministry.
Another problem has to do with maintenance. Medical equipment in the labs are not maintained regularly. The World Health Organization supports CHL to upgrade the level of qualification and improve its departments.
All the equipment of the CHL are old. The center needs to be provided with new equipment.
In spite of that, Dr. Bin Boreik hopes that they can do much with the facilities they have.

Recent Activities:
Lately, the new administration signed some protocols for research work on the health situation in the country. Sexually Transmitted Diseases (STD), other Hepatitis markers, Rubella and Measles are to be investigated. The quality-assurance system was introduced lately. Sister shaft process (linking up with other laboratories in the region and outside) is now taking place. I was surprised to see that 90% of the diagnosis made in the CHL were endorsed by the Institute for Standardization and Documentation in the Medical Labs at Free University of Berlin.
Concerning continuous education, CHL organizes weekly lectures hosting university professors and specialized laboratory technicians.

Future Plans:
Dr. Mohammed Bin Boreik summarized future plans, as follows:
"In the coming few weeks, we'll have access to the internet. This will help our self-education approach. We have hopes to equip the labs with new instruments. We hope to open a wholly-equipped section for producing chemical reagents within one year. Another thing that we plan to do is to start producing blood derivatives.
"We are now trying to improve blood transfusion services in the five branches of CHL. By the year 2000, we hope we'll be opening other branches in some governorates."

By: Nadwa Al-Dawsari,
Yemen Time