Alum Prepares for Opening of Biosafety Level 3 Lab in Haiti.
Rupal Ramesh Shah (SPH’15) is committed to seeing things through.
An avid marathoner, she was one of more than 5,000 runners unable to finish the 2013 Boston Marathon due to the bombing. Determined to receive a finish time, Shah returned in 2014 to successfully complete the race.
Shah will soon cross another finish line. A tuberculosis laboratory and quality improvement consultant, she has spent the last year working to open the Biosafety Level Three (BSL3) laboratory at Hôpital Universitaire de Mirebalais in Haiti. The 16,000-square-foot facility, slated to open next year, will house the first BSL3 lab in Haiti’s Central Plateau and will significantly increase the ability for healthcare workers to diagnose, treat, and respond to disease threats.
“Right now we do basic TB testing for patients, and samples are sent to the national lab or a private lab,” Shah says, adding that the turnaround time for test results can take up to one week. “Once the BSL3 laboratory opens, we will be able to do a lot more testing. We will also be able to process the samples here in the lab and hopefully get results in one or two days.”
In 2013, Partners in Health opened the 300-bed community hospital in response to the country’s vast medical needs following the 2010 earthquake. In partnership with the Haitian Ministry of Public Health and Population, the CDC, and other international and local entities, PIH then began opening sections of the hospital’s reference lab. The BSL3 lab will focus on researching, diagnosing, and treating drug-susceptible and drug-resistant strains of TB, of which Haiti has the highest incidence rate in the Americas, at 188 cases per 100,000 people.
“At the hospital, we see a lot more patients who have drug-susceptible TB, rather than drug-resistant TB,” Shah says. “We conduct TB tests using GeneXpert, a molecular diagnostic system to detect TB on 250 to 350 patients per month, and from those cases, 25 to 45 patients test positive for drug-susceptible TB, and two to three cases test positive for drug-resistant TB.”
She also notes that the impact of TB extends beyond the patient: “If a parent dies, the children and the whole family could be affected.”
This isn’t Shah’s first time working amongst infectious diseases in a highly controlled environment. After graduating with degrees in biology and chemistry from Southern Wesleyan University, Shah obtained a master’s degree in microbiology from Clemson University, then worked for almost five years as a research assistant and laboratory manager in the Department of Immunology and Infectious Diseases at Harvard T.H. Chan School of Public Health, spending many hours in her department’s BSL3 lab.
Shah then enrolled as a full-time student at SPH, during which time she completed two practica, one at a TB hospital and the other at a women’s health clinic in the Kilimanjaro region of Tanzania, where she was born and lived until she was 16.
“I knew early on that I wanted to work abroad,” says Shah, who also took several trips to South Africa while at the Harvard Chan School. “I really appreciated the conversations that I had with my global health professors at SPH. They really taught me how to think outside the box and how to handle situations in areas with limited resources.”
Upon graduating from SPH, Shah began working as a quality improvement specialist at Boston Children’s Hospital. Two years later, a physician at Partners in Health connected Shah to the person who is now her boss in Haiti.
In her current role, Shah develops training manuals and checklists and commissions new lab equipment. Once new staff members are hired, she will be in charge of training them and ensuring laboratory workflows are in place.
“My heart is in the developing world,” says Shah. “This is by far the best job I’ve had in my professional career.”
Once her fulfills her role in Haiti, Shah hopes to return to Tanzania to work in her hometown of Moshi.
“The number-one goal in global health is to train the local community and build local capacities,” says Shah. “I strongly believe in strengthening and empowering local communities, and I’m so glad we have been able to do that here in Mirebalais.”