Supporting training programmes in Pathology to increase capacity and improve service delivery.

There are only four qualified Pathologists in Zambian, serving a population of over 13 million people. Currently, the only training institution for medical specialists in the country, the University of Zambia (UNZA) School of Medicine (SoM), is unable to train pathology specialist due to a lack of trainers.

Through partnership with THET, the UNZA SoM and Ministry of Health (MOH) established and launched MMED training programmes in 2010 to train more specialists. Volunteers from the UK and elsewhere deliver and support the training courses. Trainees are also able to go on international clinical placements in order to get hands-on experience. In 2014, THET sent two pathology trainees to Toronto, Canada for clinical placement for five months.

According to trainees, the clinical placement in Canada was beneficial because it improved their ‘diagnostic skills’, which are now being used at University Teaching Hospital (UTH). See picture above. The experience in Canada exposed trainees to new ways of diagnosing disease using advanced technology particularly with respect to Medical Kidney and Brain Pathology, which are conspicuously absent at UTH. Trainees also observed that pathology practice in Toronto is different from the way it is done at UTH because “it is very specialized” within histopathology while forensic pathology is equally separate as opposed to UTH’s general pathology.

The Service

Since the start of pathology training at the SoM, the number of students taking up the course has been increasing. As such there is increased staff helping to improve service delivery. More importantly, ‘turnaround time has improved from 6 months to just within 7-14 days for about 80% of all cases received at the Pathology Department,’ said one of the pathology trainees. This improved performance has translated into growing confidence about what the department can do and therefore more health facilities around the country are sending their lab tests. The better turnaround time does not just mean improved patient care but also cuts down on hospital costs since patients will not be spending long periods of time in hospital waiting for their results.

Future leaders

Following clinical placement experience in Canada, both trainees were positive that the current momentum around service developments in the department will be sustained particularly because of increasing numbers of staff. Before THET support, ‘we were crawling, now we are walking, and I hope very soon we will be running.’ said one trainee.