To kick off 2018, we headed back to the Land of the men of integrity and resumed our operations where we left off (after being unexpectedly mobilised for a Dengue outbreak in Louga). Located at the very edge of the country, Kédougou and its hilly landscapes, few tarmac roads and scattered and hard to reach villages is the perfect environment for testing our Mobile Lab. Add to this that the Kédougou region, with a diverse and growing population, gold mining areas and tropical climate, has always been high on Institut Pasteur de Dakar’s radar for the (re-)emergence of infectious diseases and tropical fevers as part of routine surveillance programs. The fourteen hour long drive from Dakar reminded us that fast and reliable transportation of people, and, even more so, diagnostic samples is a real challenge.

During the first week, our teams joined hands with the Bandafassi health post where the heroic Chef de Poste, Mansaly, and his right hand man Gérard are running the day-to-day consultations, deliveries and performing blood-film microscopy (which is still the primary method of malaria diagnosis). Despite their very basic infrastructure, a couple of hours of electricity per day and a lack of equipment, they are not sparing any effort to help patients who sometimes traveled for hours in the hope of finding solace.

This time our teams came with a long-expected mission, namely reaching the village of Angoussaka perched on top of the 330 meters high mountain while challenging the vehicle, the on-board equipment and our nerves.  After having cleared the road with the help of a machete, our skilled driver Bidiel was all set for some next level manoeuvring  and – with the mental and practical support from the rest of the team –  braved a steep uphill climb, defying all critics and non-believers. Praesens and IPD had definitely reached a new high in all senses, not only did the vehicle excel at this aptitute and robustness test, but more importantly, many molecular diagnostic tests were smoothly run by our lab technicians in our Mobile Lab, conveniently parked under an epic mango tree.

We were welcomed with the usual Senegalese téranga, by the Chef du Village and his crew and celebrated this memorable day with a shared meal, full of gratitude and some local folklore.

Our Bandafassi duo settled in a hut for the day in front of which long lines formed, while offering free consultations and recruiting patients meeting the case definition for tropical fevers and respiratory viruses. Typically for this time of the year, many patients were diagnosed with respiratory viruses, the usual suspects, ranging from metapneumovirus, picorna and parainfluenza sometimes co-infected with malaria, one of the biggest burdens of the region.

Rural communities like these that are isolated and enclaved and at times completely cut off from the rest of the world during rainy season would benefit immensely from healthcare being directly delivered to them. This made us realize once more how important it is to reach that symbolic last mile.

The potential of the Mobile Lab being an open platform has therefore been highly appreciated by local authorities and our concept evolved towards a mobile, compact and integrated healthcare structure that allows for plenty of applications, even beyond molecular diagnostics. The autonomy, connectivity and modular space allow for adjustment and welcome the future integration of complementary, hybrid technologies and devices on hand (e.g. portable echography, NGS, vaccines, biochemistry etc.), depending on the needs.

Thank you Kédougou, it was great meeting again and congratulations to our teams for this successful endeavour!

We would also like to announce the official launch of our website: praesensfoundation.org

With special thanks to our sponsors: