Divining without Seeds: The Case for Strengthening Laboratory Medicine in Africa (Culture and Politics of Health Care Work)

The lack of laboratory diagnostic capacity in Africa threatens the lives of millions. Iruka N. Okeke's readable expose is a wake-up call. -Keith P. Klugman, William H. Foege Professor of Global Health, The Rollins School of Public Health, Emory University

Well before anyone else was worrying about it, Iruka N. Okeke, through her research, was calling attention to the problems of drug resistance caused by insufficient diagnosis preceding treatment in Nigeria and other parts of Africa. Treatment on the basis of nonexistent diagnosis is like driving a car in the rain without a windshield wiper. It can waste scarce resources of both patients and governments, place unnecessary selection pressure for drug resistance to evolve, and worst of all, deny patients the correct treatment that could cure them and sometimes save their lives. The only reason it is done now is that there are no immediate alternatives. All this has been well recognized by scientific and health system experts, but Okeke's book Divining Without Seeds brings that message to a nonspecialist audience. Health ministers, donor agency operatives, and bureaucrats would do well to read this passionate account of the need for prompt, accurate, and affordable diagnostic facilities. Driving blind may work for a while, but eventually we need to be able to see the road. -Ramanan Laxminarayan, Director of the Center for Disease Dynamics, Economics & Policy and Associate Research Scholar and Lecturer in Economics, Princeton Environmental Institute

Written by an expert in the fields of microbiology and infectious diseases, this book addresses a major problem preventing appropriate health care delivery in Africa, namely, the lack of diagnostic technologies. It is a call to action for attention to an area of medicine that has long gone unrecognized for its importance not only to the healthcare of the patients in developing nations but also those living in more industrialized countries. -Stuart B. Levy, MD, Tufts University School of Medicine

In this beautifully written book Iruka N. Okeke interweaves the problems of Africa, the history of infectious diseases, and her own life experience to make the compelling case that the near-total lack of basic laboratory diagnostic services continues to be a major cause of mortality and morbidity throughout that continent. -Thomas F. O'Brien, MD, Brigham and Women's Hospital and Harvard Medical School