BY ACHOR ABIMAJE,
A Professor of Pathology in the Faculty of Medical Sciences University of Jos, Prof. MandongMafila has lamented the low number of practicing Pathologists in the country, pointing out that, with the population of 170 Million people, there exist just about 150 practicing pathologists.
The Professor noted that while the Jos University Teaching Hospital (JUTH) has only seven consultant pathologists, only five are actively practicing at the moment serving a population of about 4 million people in the state.
He also said, “it is extremely difficult for the clinicians to provide disease specific care to the patients with such a deficient number of qualified Pathologists.”
Mafila said that virtually all-practicing Pathologists are clustered in the major cities while most general hospitals and primary health care centres have no Pathology service at all.
He said, it is sad that the role of Pathologist as a diagnostician has been relegated to the background by health policymakers in the country, adding that this has further compounded the problem of having adequate professional manpower.
Prof. Mandong stated this while delivering a lecture titled “ Emperor of all diseases at the 82nd inaugural lecture of the University of Jos.
According to him, 70 to 80 percent of diseases rely on the report from clinical laboratories adding that the practices of medicine now is evidenced based and not speculative or any approach to patient care with multiple care drugs prescription often called poly pharmacy.
“When you mention the word Pathologist, the general belief is that a Pathologist is a doctor of dead people,” he said.
Explaining the role of a Pathologist, the University Don cited that “a patient who has left sided neck swollen who the surgeon diagnosed as having a cancer arising from white blood cells called Lymphoma was not responding to treatment and there, a visiting Pathologist from LUTH was invited to take a biopsy of the swelling whether it is Tuberculosis (TB) or Lymphoma, when the specimen was sent to the laboratory and the Pathologist looked at the specimen and made diagnosis, he said these surgeons are killing the patient with cancer drugs as the diagnosis turns out to be TB and not Lymphoma, according to him, within one week of TB drugs, treatment the swelling melted away.”
Given another episode, Prof. Mandong further explained that the same group of surgeons were managing a swelling foot of a rural famer, again they belief it was a cancer the diagnosis by a Pathologist turned out to be fungal infection. It is only a Pathologist that helped the surgeon to know what they are dealing with.
“Pathologist is a medically trained doctor who has had a formal training in medicine and has undertaking a further training in laboratory medicine.”
He pointed out that Pathology as a discipline has four major division which includes Histopathology, Hematology /blood bank transfusion, Medical Microbiology and Chemical Pathology adding that as an academician and clinician his research are mainly in Surgical pathology, Cytopathology and Autopsy pathology (postmortem examination.)
The Professor of Pathology, speaking further identified negative factors that affect health care delivery in most developing countries including Nigeria.
He listed the factors affect Pathological services as absence of national health insurance scheme at state and local government levels, lack of funding for laboratory medicine and in adequate cum obsolete instrument in laboratories to carry out research, limited opportunity for continual medical education and brain drain as more than 60 percent of Pathologist trained in Nigeria are practicing outside the country.
Speaking on the way forward to improving Pathology practice in the country, Professor Mandong recommended that funding institution that supports research on disease specific entities should incorporate in their funds, support for improving government laboratory services.
He listed others as, instituting national health insurance scheme at all levels of governance stressing that this will reduce the cost of funding for health even for the less privileged, retraining and continuing mandatory professional courses for all cadre of Pathology staff, from the clinician, field Scientist and laboratory staff and maintenance of laboratory infrastructure, availability of laboratory reagents and other consumable amongothers.
In their separate remark governor Simon Lalong of Plateau state represented by the secretary to the state government Hon. Rufus Batureand the Gbong Gwom Da Jecob GyangBuba commended ProfMangdong for his contribution to the growth and development of Tertiary health institutions in the country and West Africa sub-region.
Governor Lalong noted that the rescue administration in the state will ensure that the health Sector is given serious priority it deserves for efficiency service delivery in the state.