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Outside the Lab Training and education

Making a Difference, One Laboratory at a Time

This past fall, several colleagues and I traveled to Tanzania to attend ribbon-cutting ceremonies at Muhimbili Hospital in Dar es Salaam and at Kilimanjaro Christian Medical Center in Moshi. These proceedings represented over a year of planning, coordination with other organizations, partnerships with industry, and the dedication of dozens of staff members all working toward the same goal: improving cancer diagnostics in Africa.

Currently, cancer rates are increasing in sub-Saharan Africa. Around 650,000 people develop cancer there each year, and over half a million people die annually from the disease. More than a third of these deaths can be attributed to cancers that are preventable and/or treatable if detected early. It’s the “early detection” part of the equation that the ASCP, along with the American Cancer Society and our partners in industry, are working to solve.

In the United States, there are 5.7 pathologists per 100,000 people (1); in Tanzania, those numbers are closer to one pathologist per 1.3 million people (2). Although equipment is needed, it is useless without vital experts to interpret the slides and provide a diagnosis.

Both facilities combine to serve an area that is home to over 10 million people; however, each hospital only has a handful of pathologists on staff.

When we conducted site visits at these laboratories in December 2017, we saw the need firsthand. Both facilities combine to serve an area that is home to over 10 million people; however, each hospital only has a handful of pathologists on staff. We concluded that both hospitals would benefit from primary diagnostics and immunohistochemical services – but, without the addition of telepathology capacity, neither would be effective at meeting the needs of millions of patients.

Telepathology serves other purposes as well: training, access to whole slide imaging archives, and consultation on difficult cases. We determined that both pieces – diagnostics and telepathology – were vital to achieving mutual goals. To make that happen, memoranda of understanding had to be negotiated and signed by all parties; ASCP worked with the telepathology vendors to get the equipment ready before shipping; and teams from both entities traveled to Tanzania for onsite installation and training.

But the story didn’t end with the provision of equipment, training, and additional personnel. We also worked closely with their staff to provide vital downstream leadership education through our ASCP Leadership Institute; the program, which was developed specifically for pathologists and laboratory professionals, had to be fine-tuned so that it was culturally appropriate within Tanzania.

When the ASCP committed itself to the lofty goal of “providing access to cancer diagnostics in Africa,” we knew it would entail an enormous amount of effort by thousands of people for a decade to come. What we didn’t fully realize was how gratifying it would be to see all our work come to fruition. Together, we look forward to seeing what 2019 – and beyond – will bring. The heart of our membership has never been stronger.

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  1. SJ Robboy et al., “Pathologist workforce in the United States: I. Development of a predictive model to examine factors influencing supply”, Arch Pathol Lab Med, 137, 1723–1732 (2013). PMID: 23738764.
  2. Universal Health 2030, “More lab physicians needed for quality medical care in region, say experts” (2016). Available at: https://bit.ly/2UCXjWv. Accessed December 12, 2018.

About the Author

E. Blair Holladay

E. Blair Holladay is CEO of the American Society for Clinical Pathology

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