在塞拉利昂（Sierra Leone）的马克尼（Makeni）的头两周中，我们的重点非常着重于使埃博拉诊断实验室尽可能快地运作。在该国的该地区，实验室设施在开放治疗中心开放之前，实际上缺乏诊断能力。
With no existing diagnostics facility, all samples were being driven (or sometimes flown on a UN helicopter) to a Center of Disease Control (CDC) lab based in Bo. They were fantastic, but although they had a very quick turnaround time for testing samples, the logistics of physically getting the samples to them meant the process was slowed down significantly. Creating a diagnostic facility in this area was key to speeding up diagnoses.
在我们面对的条件下打开分子诊断实验室并不直接。有很多人在等待交付设备，手工装载套件，然后在营地周围移动盒子。
One of my lasting memories is having to ask the entire team to move a huge tent’s worth of equipment across the building site by hand, because the clinical staff needed the tent to store their personal protective equipment (PPE).
借助高温，湿度和庞大的设备，我们必须在现场建筑工地上移动，这是一个真正的挑战。我没有真正考虑的是，团队的上半场已经卸下了所有相同的在前两天进入第一个帐篷的盒子。
Needless to say they were less than thrilled when we had to relocate them, but after a little discussion, the team did a fantastic job and all the kit got moved. A few days later (after the blisters had healed), this rather surreal situation became a source of amusement for us.
埃博拉治疗中心的转变
当诊断实验室打开时，ROTA设置为交错实验室中的人数，确保我们可以覆盖上午6点至10点的开放时间。团队成员将在上午6点，上午8点，上午11点和下午2点开始轮班，后期轮班一直持续到一切都完成为止。典型的转变持续了大约八个小时。
如果您要早班工作，平均一天将是这样的：
〜5：30 AM：
醒来，勇敢洗澡。尝试寻找早餐的东西（旅馆直到早上7点才提供早餐）。不要忘记服用抗疟疾，服用温度（36.3c）。
~5:45 am:
Wait and hope that the driver remembers to pick you up to take you to the treatment center.
（（物流和运输通常很好，但有时候我们不得不等待运输。）
〜6：00 AM：
到达埃博拉治疗中心（等）。（在大门外，三名外观寒冷的国家等工作人员会向我们打招呼。）
用漂白剂洗手，取得温度并回答问题以检查健康状况。（“你有瘀伤吗？”，“你睡得好吗？”等）。
靴子在进入等。穿过更衣室，Don Scrubs和Wellington靴子（我经常花10分钟的时间尝试，并且通常没有找到合适的两个！）为了进入实验室“绿区”。
（早晨的温度与典型的英国夏季相似，但比当地工作人员习惯的温度要冷得多。他们会发现巧妙的方式保持温暖 - 包括在工业服装干的敞开的门周围挤满了！）
~6:10 am:
到达实验室并解锁它，更换鞋底堵塞，并在实验室周围快速查看，以确保电源仍在，没有泄漏。
穿上布礼服，两双手套和护目镜。是时候弥补漂白剂了 - 扣篮和隔离器的10,000 ppm，其他所有东西的5000 ppm。前一天的拖把地板，拭子长凳和空桶。
检查用于与埃博拉阳性样品一起使用的隔离器，将其清除并设置为未来一天。检查实验室中的所有库存物品 - 我们对各种试剂是否有足够的等分试样？那个巨大的帐篷中的1.5毫升管在哪里？我们有足够的EDTA血管为驾驶员准备吗？
（我不会错过的一件事是氯的强烈气味，我们在实验室中使用的浓度比它们在埃博拉其他地区的其余部分中使用的浓度更高，在狭窄的环境中，氯烟雾变得相当强大。在实验室外的那个氯的气味很大。
~8:00 am:
The second shift arrives. Discuss the results from the previous day – How many positives were there? Did anything go wrong? Did all the reagents behave as they should?
（热量和灰尘会对设备和试剂产生各种影响。缺乏可靠的互联网连接也意味着我们无法访问故障排除指南，因此在很大程度上依赖团队成员的经验和创造力来解决任何问题。）
~8:30-11:00 am:
当天的第一组样品出现了。'主要的'（（probably not his real name)驱动他们。
（Major是当地雇用的工作人员，在埃博拉疫情过程中做了一份英勇的工作。直到Makeni Lab开放之前，他每天都开车去BO，大约五个小时，这是一个巨大的奉献精神当地人控制流行病。所有塞拉利昂莱昂尼亚的工作人员都为能够以任何方式提供帮助而感到自豪。）
Don additional plastic aprons and face shields for handing and sorting incoming samples. The paperwork is brought into the lab and wiped down with bleach. Samples are put into the large isolator（命名为“ BFG”）打开。其中一个团队在隔离器中打开样品锅并检查袋子而没有碰到内部的任何东西 - 有什么泄漏的吗？那里有尖锐的。
（（我们被警告说，在流行病样品的早期阶段，各种容器都会出现，有时仍在袋子里。幸运的是，我们从未经历过。）
计算样本总数，并与收到的样本请求表相比。一一小心地将每个样品从包装中删除，然后用漂白剂在隔离器内部擦拭。根据样本请求表格检查样本的详细信息。
标记具有唯一实验室标识符的样品，并排列成批次进行处理。将样品包裹在两个单独密封的袋子中，用漂白剂擦拭，10分钟后，它们可以移至第二个隔离器，在该隔离器中提取核酸。
~11:00am-1:00pm:
在第二个隔离器内部（我们有两个名为“凯特”和“遗嘱”），carefully extract nucleic acid from an aliquot of the patient’s blood or swab. Run malaria tests if required.（这项工作是在伙伴的帮助下完成的，以检查每个步骤的执行正确，并在样本记录表上记录各个步骤。
Once the samples have been inactivated with extraction buffer and ethanol, wipe down the tubes with bleach and wait ten minutes before bringing them out.
（（Working in the isolators is a skill on its own as due to the two pairs of gloves, one of which is similar to dishwashing gloves, you lose a lot of dexterity. Despite the fact that most of us had no experience working in an isolator, the team did a fantastic job and picked it up quickly.)
〜1：00 PM-2：00pm：
将灭活的样品从隔离器中带出来，并进行最终检查，以确保灭活时间正确。将核酸在长凳上提取。
从样品中存在的其他事物中纯化病毒RNA基因组。这个过程需要约40分钟，最终产物是少量纯化的核酸。
与其他团队成员进行协调，以设置包含策划者的管子，以便在提取物准备就绪后立即准备就绪。
〜2：00-4：00pm：
提取物准备就绪后，在单独的房间中添加到策划者中，然后将样品带入PCR室。使用三个PCR机器之一的聚合酶链反应（PCR）分析样品（称为“ Alvin”，“ Simon”和“ Theodore”）。
The PCR takes just under two hours to complete, after which the results are analyzed and checked by two members of the team. Complete the paperwork and enter the results into a database.
（（Depending on where the samples had come from, the results would either be reported later that night or immediately phoned through to clinical staff. The typical turnaround times were 4-5 hours from sample reception to results, which – given the critical safety steps that had to be followed – was pretty quick.)
〜8：30pm：
一位团队负责人将当天的报告发送给所涉及的各个机构。
（（This ‘simply’ entailed sending an email – yet it was one of many challenges we faced during a typical day. We had satellite based internet but it was somewhat temperamental and very slow. We also had mobile internet “dongles” but reception at the treatment center was somewhere between poor and non-existent. I did, after an hour of snooping around, find a single spot in one tent where I could get a single bar 3G signal.) One particular evening it took almost two hours to send the report out due to these connectivity problems.)
~9:00-10:00 pm:
The late shift team (2pm onwards) close down the lab at the end of the day (~10pm), cleaning out all the isolators (‘BFG’, ‘Kate’ and ‘Wills’), discarding all the waste, swabbing down the benches with bleach and generally trying to prepare the lab for the team in the morning.
~10:00pm:
一天结束时，在酒店（Makama Lodge）的餐厅结束同事聊天和饮料。
（这些时期非常重要，不仅对于播出白天出现的任何问题（实用或个人），而且对于团队的整体士气。be quite stressful (kind of a lab-based ‘Big Brother’ experience) so its essential the team has rest time together.)
我们都累了，想念我们的家人，许多人由于肠胃炎而生病。尽管士气总是很高。“笑声是最好的药”的说法。“ Makeni Team One”是一群很棒的人，他们总是在那里互相支持。成为团队的一员真是一种荣幸。
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