the hiding culprit

Growing up I was a champion hide-and-seek player.  Maybe it was because I was small and could fit into small spaces.  Maybe it was because I had more patience than others.  Often, it was just because I knew where to look.  Lately, this skill has come in useful in the lab onboard the Africa Mercy.

Sometimes a patient will come in and you have no idea what is wrong with them.  The labs don’t make sense, the symptoms don’t make sense and unfortunately we don’t all have House, MD showing up with the answers.


Eventually it clicks – a parasite is found and it all makes sense.  Maybe in Africa this should be my first thought and it certainly is now.  I am seeing things on a daily basis that I only ever saw in textbooks or on “teaching slides” when learning how to identify certain organisms.

Now that we are suspecting parasites the reverse happens as well.  The doctors, nurses and I in the lab will have a pretty good idea of what is going on with a patient but we cannot prove it.  Enlarged spleen, grossly anemic, low platelets, no other explanation – “I bet it is Schistosomiasis” – a disease caused by parasites in the genus Schistosoma.  S. mansoni has been the most common here in Madagascar. 

Schistosoma mansoni

Schistosoma mansoni

But if that is the case than why won’t the little bugger show itself.

It becomes a game of hide-and-seek and I am not a very good looser. The game has multiple players.  Sometimes I’ll find Schisto’s friends…

Ascaris lumbricoides (roundworm) and Trichuris trichiura (whipworm)

Trichuris trichiura (whipworm) and Ascaris lumbricoides (roundworm)

Necator americanus (hookworm)

Necator americanus (hookworm)

but I know they aren’t really the culprit.  Schisto is still hiding and I will not be defeated.  I continue to scan, make concentrations and scan some more.  I use an iodine stain to make things more visible.

Sure it takes a couple hours to do a full ova and parasite workup on a patient (I’ll let your imagination fill in the specifics of where the specimen is coming from) but I love every minute of it.  Finally there it is, Schistosoma mansoni, sometimes by itself and sometimes among friends.

Schistosoma mansoni and Ascaris lumbricoides

Schistosoma mansoni and Ascaris lumbricoides

There is something so satisfying in finally finding the parasite after scanning multiple slides for an hour.  It validates not only my time but my knowledge as a lab tech.


On top of the personal victory in hunting down the darn thing there is victory for the patient who can now receive proper treatment.  According to the CDC, Schistosomasis affects more than 200 million people worldwide and is one of the world’s Neglected Tropical Diseases (NTD).

NTDs are a group of infectious diseases that are the source of tremendous suffering because of their disfiguring, debilitating, and sometimes deadly impact. They are called neglected because they have been largely wiped out in the more developed parts of the world and persist only in the poorest, most marginalized communities and conflict areas – CDC

In finding the parasite (and friends) we can then accurately treat the disease and help bring healing to the patient beyond their surgery.  Mercy Ship’s mission is to “bring hope and healing to the world’s forgotten poor.”  This is healing in every aspect of life – spiritually, mentally and physically.  I am so thankful I can be a part of this healing process.