Diagnosis and quality of healthcare: A Response to The Guardian

Without doubt, The Guardian remains one of the celebrated and reputable media outfits in Nigeria, a feat it has achieved owing to its in-depth analysis and qualitative reporting. It is also the launching pad of some of Nigeria’s finest writers like Sonala, Levi and the world famous Dr. Abati. It is, however, disheartening that it was under the watchful eyes of Dr. Abati, the chairman of The Guardian’s board of editors, that the erroneous editorial of 29th September, 2009 that left several followers and playmakers of the medical field in doubt of the acclaimed credibility of The Guardian, got published. This article is meant to clarify the issues raised, and to enlighten the editor that wrote it, and the general public that read the editorial on the real situation in the diagnosis sections of our health institutions.

Unlike what the editorial claimed, medical laboratories are manned by medical laboratory scientists (and not technologists) as clearly stated in the Medical Laboratory Science Council of Nigeria (MLSCN) Act of 2003. They are responsible for running tests on body samples, conducting laboratory investigations, making diagnosis, and monitoring patients. These roles are however not played exclusively by the scientists as other members of the health team also make inputs at various levels.

It is worthy to note that laboratory tests are requested by the consulting physician who sees the patient. He (or she) is the one that refers a patient or sample to the laboratory for desired investigations. This stage has a major impact on the diagnosis, its relevance and timeliness.

Sometimes, wrong tests are requested by the physician. In suspected cases of infection for instance, when a patient comes to the hospital with myriads of symptoms, it takes an experienced physician to discern and determine which of the symptoms would be of diagnostic importance, and which ones are less suggestive of the underlying causative agent(s). When the doctor fails to figure this out, wrong samples are sent to the laboratory resulting in the inability of laboratory personnel to establish diagnosis. To make things clearer, let’s look at Chief Fawehinmi’s case.

Lung cancers, like other cancers, are usually diagnosed in the pathology department following the submission of the right tissue samples to the laboratory.

Firstly, selected parts of the organ are cut at surgery and sent to the laboratory. At the early stage of cancer, few cells in the tissue are affected, which then spreads to other locations within and outside the tissue. If the surgeon is able to pinpoint the affected tissue parts, cuts accurately and promptly sends such to the laboratory, diagnosis could be made, and the patient will be saved. This is an ideal picture of what should happen. But like life, things sometimes go wrong.

The chief’s doctors suspected pneumonia and not lung cancer although the late activist’s travails in the hands of past governments that led to his incarceration in some cancer-friendly cells should have told the doctors that he might have inhaled some carcinogenic agents. They however failed at this and continued their pneumonia suspicion which the cancer slowly advanced. Same went for the late Sonny Okosun as both were mentioned by the editorial.

The Nigerian health system, no thanks to the unfair advantage given to physicians by various governments and express access to press that doctors have more than other health professionals, majorly recognize and fraternize with doctors while pushing other playmakers to the background, only mentioning them in cases when things go wrong, and of course in derogatory editorials like that of The Guardian.

It remains entirely ludicrous and utterly absurd that in the Nigerian context, when people hears news of hospitals, the only thing that comes to mind is the beautiful depiction of doctors with sparkling stethoscopes which they flaunt at any given opportunity- in pharmaceutical adverts, health talk shows, on their automobile dashboards, and even at dinners!

The government also polishes their egos which have made them sideline their basic duty of being members of the team that cares for patients. Instead, they’ve become the self made playmakers who want to have their bite of every parts of the hospital, including the laboratories. They are at the helm of affairs at all ministries of health- federal, state and local; they’ve even invaded WHO Nigeria, UNICEF, and several local agencies that would have helped ensure credibility and fair play. Literarily, they are having a field day while the other professionals have either of two options: siddon look or jet out to countries where things are done right.

The United Kingdom is one of the countries of the world where rules are obeyed, and medical staff sees themselves as members of a working team that ensures the overall wellbeing of the patients. Every team has representatives from the different professions under the health umbrella that brings to the table unique views of the professions they represent. Suggestions are made, contributions are noted, and the patient is treated based on the overall presentations and views of the various health professionals, and everyone is fulfilled. The reverse is the case in Nigeria.

It’s also worthy to inform the editor that wrote that publication that schools of health technology are no longer responsible for the training of medical laboratory scientists. Those institutions have been outlawed since 2001! Training is now the sole duty of the departments of medical laboratory science of NUC and MLSCN accredited universities and at the last count, over 15 of such exist in the country, information that escaped the dutifully watchful eyes of the editors.

The Nigerian health system is a potential landmine that has remained at peace owing to the forbearance, longsuffering, patience, and the hopes of the unsung, but highly criticized members of the health sector that one day, eyes will be opened and they will come to the limelight. They include the medical laboratory scientists, the radiographers, the physiotherapists, the nutritionists, and others whose immense contributions to the sector are being overshadowed and sometimes hijacked by the doctors while the regulatory bodies keep mum owing to their affiliation, from the federal minister to the state commissioners of health, to the physicians’ profession.

The Guardian of Nigeria is the country’s version of The Guardian UK, an establishment that is reputable for its high standards and in-depth researches. It remains a force to reckon with in UK politics and international affairs. Its success is not in the fame of individual writers but the credibility, openness, and critical natures of published articles; these are standards that The Guardian’s 29th September, 2009 failed to meet.

The growth of a nation is not the sole responsibility of the government, it’s all encompassing. The government must create an enabling environment for all, the doctors must promptly request for the right tests, medical laboratory scientists must be prompt in their laboratory investigations, results must be promptly sent via dispatch portals to the clinic, and the consulting physicians must be knowledgeable enough to decipher results and take proper actions. The media should be thorough in their researches prior to publication and not be one-sided or shortsighted in their reporting.

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