CHECKING BLOOD and tissue samples to assist with the diagnosis and prognosis of patient ailments has been the life of Adrian Howard for more than two decades.
Howard, a senior laboratory technologist at the Queen Elizabeth Hospital (QEH), has served in every section of the hospital laboratory, starting in phlebotomy (taking blood samples) and today he is head of the haematology and blood banking section.
Back in 1989, shortly after he finished school, a friend of his parents in the Ministry of Health was going off on leave and it was thought that he could work in the place of that person.
“It just so happens that when I got the interview and just as the interview was finished, the guy got a call that the leave was not approved,” Howard said. “Since I was always into science I decided to come over here by the lab, ask a few questions and it just so happened that there was an opening for some temporary work.”
He has also gone on to further his education with a degree in natural sciences from the University of the West Indies and a diploma in medical technology from the Caribbean Association of Medical Technologists.
Even though Howard is in charge of a division and sometimes acts in the position of chief laboratory technologist, he still enjoys getting hands-on and doing some testing himself.
“It is not something that I would like to give up totally,” he said. “It is something that I love doing but most of the departments are fairly well automated, so it makes the work a little easier. Haematology has some automation but it has a lot of the tests are still very manual so there is a lot of hands-on.”
He underscored the importance of the lab with respect to patient care, as a link between the physician and the patient. “The physician is looking to us to provide good credible results so they can properly manage and diagnose whatever condition their patient has.”
In addition, he said he loved the interaction with the patients. 
He has a special interest in blood banking, the smallest department in the laboratory, but also “maybe the most important”.
As the only blood bank in the country, it has to ensure it tests the blood units after they are collected to not only ensure they are safe, but that the compatibility is precise.
“We try to ensure that whatever blood is given to the patient, that the unit of blood that we are giving them is compatible,” Howard explained. “Also, because the department is so small it needs to be well managed by the technologist there so we cannot issue blood willy-nilly.”
One other reason for close scrutiny is that stocks tend to run low quite often.
The most common blood group in Barbados is O which, Howard said, was both good and not so good.
“Because it is the most common group most of the donations are of that type, but then it is the type that is used up quickly as well for recipients. So as fast as it comes in it goes out.”
Ideally, the bank would like to have at least 60 units on the shelf.
“Sixty units sound like a lot but all we have is maybe a mass casualty incident and that would be used up.” A unit of blood generally lasts 35 days.
Speaking on the types of testing available in Barbados, Howard said most could be done here, some could be developed more and there were some where it was just cheaper to have them done outside.
“It comes down to economies of scale. You may get some tests that it may be cheaper because reagents, the chemicals used to do the test, cost a lot of money, sometimes more than the analyser machines used. We have to make sure that when we are going to do a particular test that we have enough requests for that test because once reconstituted, the shelf life of the reagents is very short. So in some cases you may use a reagent once and if you do not get another request to use it, you have to dump it,” he said.
Nonetheless, Howard said with new analyses coming out for certain conditions, the QEH was working closely with some haematology consultants to research and develop additional testing capabilities.
In order to ensure the QEH was up to scratch, Howard said they had embarked on an accreditation initiative.
“It is going well considering limited resources. But it does help a lot in terms of the quality of the results we put out there in terms of the quality of technologists that we have working. It tells everyone that the QEH is up to standard.”
Howard said that as diseases come and go, he has never had any which caused personal trepidation in terms of having to deal with samples. He said with swine flu and avian flu, because they were fairly new, protocols were put in place and there were dry runs held.
“To be honest, from where I sit, I cannot think of anything that would have caused concern of an outbreak; swine flu would have come the closest. Ebola put a lot of fear in everyone but for actual scare, there was none. Hopefully we would not come to that.”
Because of his dedication to the job, Howard spends a significant amount of time at the hospital and has often remarked that he lives there.
He has been married for the last 17 years and has two children with whom he spends lots of family time when he is away from work.
“In terms of trips I do not go anywhere unless my wife and children are with me, except for work purposes,” he said.
