Why Nigeria’s Medical labs bring out spurious reports: A critical review

January 10th, 2019

Dr Samuel Ureme

A few weeks ago, Dr Kenneth Iroegbu, a medical doctor and a specialist in Pathology took a swipe on Medical Laboratories in Nigeria for furnishing laboratory results which he described as “spurious”.  He chose to launch his tirade on the platform of International Pathology Day in Abuja possibly for maximum effect.

According to the reports as published by The AUTHORITY Newspaper of 15th November, 2018, the renowned physician elaborated bile and derision on medical laboratory which is the hub, pivot and pace maker of Medicine in particular and Sciences generally.

 It was not the first time he exhibited this intemperate and belligerent disposition towards Medical Laboratory.  In his previous media appearances, he generously poured invectives, darts and aggressive rhetorics on every medical laboratory scientists to the extent that the public may think that the only problem of health sector lies in Medical Laboratory.

It is difficult to understand why an experienced and cerebral professional frittered away valuable time and space on real hate speech as distinct from the manner of politicians of Nigeria.

In the opinion of Dr. Kenneth Iroegbu, the primary reason why the Laboratories are not delivering today is because of the “agitation for control and they will not deliver until that agitation ends”.

It was obvious that he referred to the jostle for control of laboratories between medical laboratory scientists and medical doctors.  There is nothing intrinsically wrong with healthy competition among professional groups provided it is pursued within the ambit of the law and does not disrupt service delivery.

It is disturbing that Dr Kenneth Iroegbu who is a globally acclaimed pathologist (as he trumpeted) chose the Media to tell the world that medical services in Nigeria have performed very poorly because of spurious results furnished by medical laboratory scientist-controlled laboratories.

This is a serious allegation that should be taken up by Federal Ministry of Health, Association of Medical Laboratory Scientists of Nigeria and Medical Laboratory Science Council of Nigeria (MLSCN).

He should be compelled to prove his case beyond doubt or dispute.  Failure to do this shall be deemed a high professional misconduct which is a classical case of reps ipsa loquitor. It appears that Dr Kenneth Iroegbu needs basic instruction on many factors that affect accuracy, reliability and reproducibility of laboratory results.  Quality control of laboratory results and Corrective Action and Preventive Action (CAPA) are institution-wide structures for monitoring and evaluation that goes beyond professional agitation.

It is not for emotional outburst, hasty decision, tantrums and polemics.  I absolutely agree with Dr Kenneth Iroegbu that the laboratory process control is very vital and should be resolved without delay.  At same time, I want to remind him that in energy metabolic pathways, it is the enzymes at critical points or committed steps that are targets of process control in line with the principle of the tests.  Not politics, not agitation, not arguments.

Another worrisome aspect of Dr Iroegbu ‘s International Pathology Day Press address was where he stated that medical laboratory scientists do not appear in Court.  His thought here is rather hazy or unclear.  I discern that he may be referring to appearance as Expert Witnesses.  If my interpretation is right, then his figures did not add up.  Medical Laboratory Scientists have performed this role as contained in Scheme of Service of Federal Republic of Nigeria.  The role of appearing in Law Court to provide scientific evidence necessary for judicial decision is also captured in Act II of 2003 which is a potent irritation to pathologists.

In pursuit of full implementation, MLSCN registers all Medical Laboratory Science students in all Nigerian Universities as part of professional monitoring and evaluation.  After graduation, they are inducted and licensed to practice as full-fledged professionals.  These are bare facts which can be verified easily.  The licence empowered Medical Laboratory Scientists to function within their jurisdiction including Forensic Pathology and Historiography.

Dr Iroegbu poignantly stated that the Laboratory is the “home” of pathologists.  My take on it is that his position is warped or bogus.  The Laboratory is a public facility open to all scientists definitely not a home for any group.  The history of science is replete with exploits of philosophers, physicists, mathematicians, physicians, biochemists, physiologists, medical laboratory scientists and others that cannot be accommodated here.

These leading lights of Sciences or “Fathers of Science” worked individually and in groups to illuminate the cosmos to transform and transit from Dark to Modern Age.  It was because of harmony between them that Dr Fred Banting (a physician) worked with George Best and Prof Macleoid(core scientists)  to discover insulin which gave them Nobel Prize in 1931.

Dr Iroegbu claimed to have spent 98% of his time in the Laboratory and ipso factoknows it inside out.  I put to him that his opinion is grossly exaggerated in an attempt to win some points. The Laboratory is a mysterious facility that is only revealed in bits snippets and units after a controlled experiment by qualified and cognitive practitioners.

Nobody can know the Laboratory up to 1% in a life time.  I urge Pathologist Kenneth Iroegbu to tone down the rhetorics, climb down from his high horse to learn the paradoxical humility of greatness of the Laboratory.

Medical doctors all over the world are both respectable and respected.  Throughout human history, they enjoyed and still enjoy high reputation and regard.  Many of them have won Nobel Prizes in Sciences.  Anybody that loves achievements or accomplishments must appreciate them. I have many close friends among them that I profusely cherish.  My own nephew is one of them and I know his intellectual fecundity.  Some of them were instrumental to the life of Medical Laboratory Science all over the world.  In Nigeria, Prof Ben Chike Edozien, the Asagba of Asaba almost single-handedly planted B.Sc. in Medical Laboratory Technology at University of Ibadan in mid 1960s.

The Association of Medical Laboratory Scientists of Nigeria, under the Presidency of Dr Godswill Okara, an ebullient and vivacious medical laboratory scientist honoured him prestigiously.  The new breed of medical doctors don’t seem to be like their progenitors and predecessors who were both humanists and core scientists.  That is why I am deeply shocked by the verbiage of Dr Kenneth Iroegbu.  He even stepped into the domain of the Judiciary.  To publicly assert that the Court and Judges do not know Civil Service Regulation is strange, bearing in mind that Medical Council Regulation he operates with, is a creation of the Law.

I know that the Judiciary is strong enough to react or respond appropriately.  To posit and strongly too, that a Judge cannot tell him what to do is bureaucratic rascality that can lead to anarchy.  Such comments must be avoided.

It is obvious that Dr Kenneth Iroegbu holds medical laboratory scientists in disdain.  There are many other doctors who share this propensity.  I admonish them to change their mindset, discard caustic and acerbic remarks in order to bring harmony to the health sector.

Many of such uncouth languages have appeared in both traditional and social media and these have embarrassed clients, the pivot of our advocacy.  A crucial aspect of professionalism is decent and polite communication which drive pre and post test counseling of clients.  When professionals descend to low ebb in order to run others down leaves much to be desired.  Indeed, any country whose professionals are unprofessional in words and actions is in deep trouble.

It is interesting and worthy of cogitation to read the conclusion of Dr Iroegbu’s presentation.  He called for synergy and close collaboration between medical laboratory scientists and pathologists.  I am with him and wish that it shall be more strident and persistent.  Nigerian has lost a lot because of rivalry between these two scientific elites.  The duo is adept in medical research and certainly collaboration shall be a veritable platform to break fallow grounds that may fetch awards.

As a student of Medical Laboratory Sciences in mid 1970s at University College Hospital Ibadan, I witnessed some beautiful collaborative researches consisting of scientists across professions united by desire to extend the frontiers of knowledge. This group, it was that provided environment-friendly normal values for interpretation of Laboratory test results.  What is available currently are scientists who only work to become professors or wealthy without any other legacy.

The health indices of Nigeria are very poor and shameful.  It is an obnoxious or contumacious commentary on all of us particularly the health professionals. I share Dr Iroegbu’s passion for harmony and synergy no matter how fragmentary and peripheral.  A strand of it can be nurtured to the size of Cedar of Lebanon.  This can happen only if we eschew rancour and bitterness and have respect for each other.  The obvious thing is that we need each other.  The two professions are united by medical services and so shall it remain till the crack of doom.

If a Laboratory furnishes spurious result, the decent response is not to rush into Media Trial as exemplified by Dr Kenneth Iroegbu.  There are globally accepted protocols for monitoring and evaluation.  MLSCN is passionate about result quality and will enthusiastically support every effort to achieve and sustain it.

The Chief Executive Officer Mr. Tosan Erabor has stressed this in all public appearances of the Council. If Dr Iroegbu is serious about his “spurious result theory”, he should take the right steps in search of remedy.  His rendition of medical laboratory scientists as “our own allied health professional component” is laughable.  This depicts pathologists as “phagocytes ”or “macrophages” on foray for perceived invaders.  The time for predator mentality is over for good.

Sometime ago, one jaundiced hatchet writer named Azoma Chikwe painted medical laboratory scientists in horrible and lurid colours in an article published in Daily Sun Newspaper of Thursday, March 30:2017.  Although his or her profession was not clear, but what is obvious is that it was written by an insider in a medical facility.

In the said article, he/she traced the historical locus of medical laboratory science as an appendage of a pathologist clinic.  The writer described medical laboratory scientists as blood vampires of Blood Banks.  Such belligerent, bellicose and garrulous utterances are not features of medical professionals that swore to professional oath.  Synergy and harmony are essential for functional unity in medical facilities.

Let all haughty scientists learn from Sir Joseph Lister, the celebrated English Surgeon that humbly “bowed” to Louis Pasteur, the great French Chemist that published the Germ Theory of putrefaction.

It will be an absurdity for any pathologist to ignore obvious scientific innovation from other scientists. Superiority complex is a worse configuration of inferiority complex.  The sorry state of medical education and services in Nigeria should worry health professions not rivalry which Prof Lambo a former Health Minister aptly defined as “beauty contest”.

I heartily thank Dr Kenneth Iroegbu for his services to Pathology and all its Professionals.  There is more to learn and do and we should face what is facing us.  That is the way to go.  If we pursue knowledge development and propagation, we shall not have time to pursue each other.

Dr Ureme, a Medical Laboratory Scientist, writes from University of Nigeria Enugu Campus.  

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