2013-05-09 / Front Page

Mary Nagel helps Haiti improve labs, tests

By Terri Lang


Mary Nagel is an independent medical laboratory consultant working with several organizations and the people of Haiti to improve the quality of laboratories and laboratory test results. Above, she meets with Haitian officials. Mary Nagel is an independent medical laboratory consultant working with several organizations and the people of Haiti to improve the quality of laboratories and laboratory test results. Above, she meets with Haitian officials. She has another family in Haiti, and for Mary Nagel, it is difficult leaving that family when she travels back to her family in North Dakota.

“It is not always easy being such a distance away from my family here, but I have family there also,” Nagel said. “Haiti is my home, it is reality for me and it is where I need to be for now.”

Mary is the daughter of Edwin and Delores Nagel of Linton and is the third oldest of Nagel’s nine children.

“I was a very shy child,” she said. “Yet, I was always considered to be a leader even as a young child.”

Mary’s mom agreed.

“But, she got over her shyness while in high school and being active in sports. Plus, having six brothers to compete with helped also,” Delores said.


Mary’s mother, Delores Nagel, and older brother, Gary, appreciate having the time they can share with Mary during the holidays. Mary’s mother, Delores Nagel, and older brother, Gary, appreciate having the time they can share with Mary during the holidays. Edwin and Delores recall Mary being their adventurous child, and she was very hard working and determined.

“Mary always worked hard at whatever she did,” Delores said. “At age 10, she was already taking care of her younger siblings and the home.”

The Nagels are proud of their daughter’s accomplishments, and they have supported her in whatever she has chosen to do, as they have with all of their children.

“I brought her up to make her own decisions,” Delores said. “Although it is tough that she is so far away, we continue to support her choices.”

Nagel’s role in Haiti


Nagel gets back to the United States two to three times a year and enjoys spending time with her family in North Dakota. Nagel gets back to the United States two to three times a year and enjoys spending time with her family in North Dakota. For Nagel, she knew Haiti was the place she needed to be the minute she stepped on Haiti ground.

“There is a reason I am down there,” Nagel said. “My agenda is to support my colleagues and guide them in making decisions regarding laboratory science and management.”

In Haiti, Nagel is an independent medical laboratory consultant working with several organizations and the people of Haiti to improve the quality of laboratories and laboratory test results.

They set the stage in moving labs through improvement projects that will someday lead them to accreditation.


These are typical homes in Port-au-Prince, Haiti. These are typical homes in Port-au-Prince, Haiti. Nagel is responsible for coordinating projects, writing documents to set guidelines for clinical laboratories for the country and helping in the process of building those clinical labs.

“In Haiti, there are no guidelines for starting a lab,” she said. “Anybody can still start a lab.”

Prior to 1988, that is what it was like in the United States, Nagel said. The U.S. Food and Drug Administration has guidelines called Clinical Laboratory Improvement Amendments (CLIA). Congress passed the CLIA in 1988, establishing quality standards for all laboratory testing to ensure the accuracy, reliability and timeliness of patient test results regardless of where the test was performed.

Nagel has been working with the United Nations Peacekeeping Operations, a branch of the United Nations that deals with the infrastructure in underdeveloped countries. She meets with various branches of the Ministry of Health. The Ministry of Health are Haitians who hold offices similar to the U.S. Congress. Nagel and her colleagues are currently waiting for final approval of the minimum requirements document they have been working on from that group.


Nagel is currently working on two regional labs in Haiti, one that was newly built and one that was renovated. They are proposing to build six more labs and renovate one lab so every department in Haiti has an accredited clinical lab. Nagel is currently working on two regional labs in Haiti, one that was newly built and one that was renovated. They are proposing to build six more labs and renovate one lab so every department in Haiti has an accredited clinical lab. “Projects and undertakings in Haiti process and develop very slowly,” Nagel said. “What takes two months in the U.S. could take several years in Haiti.”

That is partly due to the complexity of the country. For reasons of administration, Haiti has been divided into 10 departments, similar to states.

“The government is very complex in Haiti,” she said. “Therefore, everything becomes quite an undertaking when dealing with the several departments.”


In Port-au-Prince, Haiti, Nagel lives in the upper part of her home, and there is an office in the lower part. In Port-au-Prince, Haiti, Nagel lives in the upper part of her home, and there is an office in the lower part. Nagel is currently working on two regional labs in Haiti, one that was newly built and one that was renovated. She has traveled to seven of the 10 departments assessing the labs.

“From the three documents that I have assisted in writing, we are working with those labs in implementing the proper guidelines and standards and getting together a standardized equipment list,” Nagel said.

In cooperation with the United Nations Offices for Project Services (UNOPS) and a French organization, they are working on obtaining funds to build six more labs and renovate one so that every department in Haiti has improved labs with stable electricity and equipment to perform laboratory testing. Nagel’s job then is to get those labs accredited. In May, she will begin training with a U.S. organization to provide the training needed to improve laboratory functions.


Nagel has traveled to seven of the 10 departments assessing the labs. This is what a typical lab looked like prior to the newly built or remodeled labs. Nagel has traveled to seven of the 10 departments assessing the labs. This is what a typical lab looked like prior to the newly built or remodeled labs. In her current profession in Haiti, Nagel is able to use all the skills and training she acquired in her previous jobs in the U.S. She enjoys her work in Haiti but said it is very challenging.

“Working in an underdeveloped country is difficult as things do not run as they do in the U.S.,” she said.

After the earthquake in Haiti in January of 2010, Nagel was contacted by the Director of Labotoire National de Santa Public (LNSP) in Port-au-Prince, a Haiti lab similar to the U.S. Department of Health and Human Services. She was asked to become their lab manager but decided she would not accept the position. Instead, she would find a lab manager for them, consult for them and provide training as a private consultant. LNSP contracted with her to be a consultant to mentor the entire lab staff and management.


Tent camps have become micro-cities of their own after the earthquake. Nagel said the Haitians are a strong, faithful people to endure such a tragedy. Tent camps have become micro-cities of their own after the earthquake. Nagel said the Haitians are a strong, faithful people to endure such a tragedy. Nagel’s first visit to Haiti was in 2006 when she spent two weeks doing volunteer lab work. She also spent part of her career in Africa.

Nagel was the International Technical Specialist with Clinical Laboratories Standards Institute (CLSI), an organization that sets standards internationally for medical and research laboratories. She worked with a laboratory subcontracted by the National Institutes of Health (NIH) in getting it accredited accord ing to CLSI standards.


The streets of Port-au-Prince are very crowded. Recent estimates place the metropolitan area’s population at around 3.7 million, nearly half of the country’s population. The streets of Port-au-Prince are very crowded. Recent estimates place the metropolitan area’s population at around 3.7 million, nearly half of the country’s population. CLSI is located in Wayne, Pa.; however, Nagel worked from her home in Grand Forks. She flew to her job in Bamako, the capital of Mali, Africa. She made that trip seven times a year, and she would be in Africa anywhere from two to five weeks. In Bamako, Nagel assisted a malaria research lab that became accredited under her guidance by anAmerican accreditation agency, the College ofAmerican Pathologists (CAP). That laboratory maintains its accreditation today.

In July of 2009, CLSI asked her to do teaching modules as a job, which would have kept her behind a desk. That is when she decided to leave the organization.

Throughout her career, Nagel has spent many years practicing medical laboratory science. She taught a two-year medical laboratory technician and laboratory management program for nine years at the Northwest Technical and Community College in East Grand Forks. She also taught a medical laboratory scientist program at South Dakota State University in Brookings. Even though she liked teaching, she knew she would not be satisfied with doing that for the remainder of her employment years.


The Tap Tap is a mode of transportation people use in Haiti. They are privately owned and beautifully decorated. They follow fixed routes but won’t leave until filled with passengers. Riders can disembark at any point in the journey. Grace Infinie and El Olam are two areas within the city of Port-au-Prince. The Tap Tap is a mode of transportation people use in Haiti. They are privately owned and beautifully decorated. They follow fixed routes but won’t leave until filled with passengers. Riders can disembark at any point in the journey. Grace Infinie and El Olam are two areas within the city of Port-au-Prince. “Haiti is where I want and need to be right now,” Nagel said. “It is not always easy living here, but this is my life.”

Nagel said it may not be the safest place to live but knows there are many places even in the U.S. which are less safe.


A Tap Tap truck is used to transport people from one area to another in Haiti. Visitors to Haiti are warned by the U.S. and Canadian governments not to travel in Tap Taps as doing so is unsafe. A Tap Tap truck is used to transport people from one area to another in Haiti. Visitors to Haiti are warned by the U.S. and Canadian governments not to travel in Tap Taps as doing so is unsafe. “There are armed guards standing outside my door, but I do not believe I would ever see a gunman come in and gun down children,” she said, referring to the tragedy in New Town, Conn.

In Haiti, there are basically two classes of people—upper and lower. Many of the poor still live in tents, some have plywood homes and many family members live in one house.

Nagel lives in a two-story home in Port-au-Prince and she has utilities. In many parts of the country, there is no electricity. There are times that Nagel is without electricity from a week to a month; however, she has a generator and inverter that can give her 10 hours of electrical power.

The first obstacle in building in Haiti is finding stable land for a foundation.

“When it rains, it floods out everything in the lower parts,” she said.

That creates a problem with transportation as streets flood, and people are unable to get to their homes and work when they have a rain storm.

It is very expensive to build a home in Haiti, and only Haitians can own a home there. A one-bedroom apartment runs anywhere from $1,000 to $2,000 per month, and a two-bedroom is $1,800 to $2,500.

Everything is quite costly in Haiti. Food prices are higher as most of their food is imported. Gas is over $5 per gallon.

Nagel said Haiti is a very Christian country, and they know there is a God. She said the people have very positive attitudes, and they just know their God will take care of them. “I have never seen such strong, faithful people,” Nagel said. “That is part of what draws me there and keeps me there.”

Education

Nagel attended Linton Public School through eighth grade and Emmons Central High School from ninth through twelfth grade. After graduating from Emmons Central in 1977, she attended Jamestown College and graduated in 1981 with a Biology Major and a Chemistry Minor. She attended St. Alexius Medical Technology School in Bismarck, receiving her Medical Laboratory Science Degree in 1982. Nagel has a Master of Education Degree from Bemidji State University in Minnesota.

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