strike

Last month I not only did a lot of travelling on planes but also trains. Sometimes the trains ran smoothly, according to schedules. Other times they stopped altogether, because of strikes, train journeys flashing on boards but never to run. During strikes travellers are reminded of the invisible human work that goes into getting them from A to B, C and D.

There is also of course much invisible human labour that either gets displaced by, or is involved in, the operating of pneumatic tubes. And in times of revolt (just as in times of breakdown), this invisible work also becomes more visible.

Several weeks ago, hospital workers in Malta took action against their working conditions during a strike. The Union Haddiema Maghqudin issued directives to laboratory technicians of the Mater Dei hospital in Malta to refuse to process essential and urgent blood tests. They were to do this by not accepting blood samples through the pneumatic tube system.

This meant that no blood results were issued and nurses and midwives were forced, according to Malta Today, to "abandon their wards" and take the samples physically to the laboratory, where they could "beg" technicians to perform the tests. The hospitals encouraged their staff to counteract the strike by continuing to send samples through the tubes, and if returned, to keep sending them in hope that the technicians accept the blood samples eventually.

It was a battle conducted through the tubes, with blood literally, flying back and forth. The hospital and newspapers both declared this a matter of life and death. The issue not only highlighted how integral the infrastructure is to patient care, but also the kinds of work both entailed in keeping it running, as well as the kind of work it replaced, nurses work on wards for example. In this case an infrastructure of connection become central to, and highlighted the disconnections between hospitals, governments and staff in which it was embedded.

Image my own.

invisible tubes

It is amazing how well pneumatic tube systems can be camouflaged: they are the embossed wallpaper of hospital ceilings and walls, there only if you look for them. I have spent three and a half months now in a hospital in Melbourne doing fieldwork about listening and sounds in medicine (see more details here). It seems I have had my ears out more than my eyes! For it has only be recently that I've spotted evidence of the hospitals' pneumatic tube system, in the emergency department.

A few emails later and I am being taken on a tour of the system by Scott, Operations Manager in the Pathology department. Scott takes me into the central pathology lab first, the hub of the system, where specimens are delivered and processed. As we talk a few capsules come flying in from ED. That is one point-to-point track in the system, the other heading to ICU and the private hospital. Someone is there nearby to organise the capsules, empty their contents and send back the tubes to where they came from. This system is all about pathology - no medical records or pharmaceutical items are transported.

The tour continues and we visit the plant room, walk corridors with tubes overhead, and visit the outpatients' department and the haematology department. In the haematology department, blood products, requests, visitors and capsules whizz by. As a trauma hospital, this lab works 24/7, the capsules arriving day and night, needing urgent attention. The outpatients' pathology department is less frenetic but no less busy - as many as 150 - 200 blood samples can be taken here a day.

We walk back to Scott's office and talk over some plans for future pneumatic tube systems in the new pathology department in the hospital, and the challenges of integrating systems from different hospitals, some quite some distance away. The plans are at the concept phase, the system one of possibility at the moment. I leave the pathology department and follow the corridors back to the main entrance. This time the sounds I pay attention to are not the coughs and beeps, but rather the rumble of pneumatic tube capsules overhead.

Photos are my own.