Dr Parvina Gunter is a lab worker at a health centre in Dushanbe, Tajikistan

"As a lab worker, I am involved with investigation of patients through clinical, biochemical and therapeutic analysis. I am also a member of the Urban Association of Laboratory Workers. I conduct training and workshops, as well as give lectures about particular diseases. The last lecture I did was about Avian Influenza and its threat to Tajikistan. Avian Influenza is a relevant issue in Tajikistan, as Tajikistan is a transfer zone.

One of the best things in my job is working with the new equipment when we get it. Nowadays technology is a great joy! The greatest challenges here are the seasonal changes and lack of financial resources. It can be difficult to work without good conditions. Last winter was extremely cold, we faced a lack of water, heating and electricity, and everyone was badly affected. In summer it is the opposite! We lack air conditioners or fans. Also it becomes a challenge to treat patients when they are stressed due to small salaries, economic instability and constraints.

I think we do a good job however. Patients’ expectations are very high, as our health centre is recognized as one of the best. People know that hygiene rules are observed in our clinic, such as single-use syringes and disinfection measures. Patients expect to recover as soon as possible.

To me a health system is a complex of all supporting services (US scanning, EKG, laboratory together with outpatient and inpatient services). It is a unified system of diagnosis and treatment of patients by applying international standards. I have experience of seeing the health systems in other countries, particularly in Germany, and I think the health system in Tajikistan leaves something to be desired.

An example in my area: at the moment we have to refer patients somewhere else if they need separate blood tests on HIV/AIDS and hepatitis. If it was possible I would improve our service by having that capacity here, and having a comprehensive analysis system to monitor the entire investigation. This would be more efficient."