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Nearly all of the biomedical professionals I encountered during my fieldwork spent extended research stays in Paris to obtain higher medical training in hematology, genetics, and pediatrics. These fields are key to sickle cell disease management. When Senegalese professionals return to Dakar, however, a certain realization sets in. The disease looks different in Senegal, they all seemed to agree, while the technologies they mastered in Paris quickly faded into skills learned for training purposes with limited local application. Quite simply, techniques without toolssur placecome to mean very little. Blood transfusions, neonatal screening, prenatal diagnoses, protein analyses of disorders