Pathologists for Malawi (Vol 1, No 1)

We have recently begun an effort to bring volunteer pathologists to Malawi for the next 4 to 5 years in an effort to provide continuous service coverage while the COM and MOH transition to having full time Malawian patholists in place in Blantyre and Lilongwe. Below are the most recent updates for this project.

I have learned from my fantastic colleagues at UNC and KCH in Lilongwe that Dr. George Liomba will be spending a few days every two weeks in Lilongwe to read slides and interpret them. This is an excellent arrangement and I am delighted George is able to move the KCH pathology lab forward! We will be coordinating the Blantyre volunteers with George's schedule so that we maximize coverage in Lilongwe and avoid overlap.

Dr. Kamiza has finalized the process for obtaining a medical license for the visiting pathology volunteers (fee is $250 US). The process will require that the volunteer provide a copy of their CV, a certificate of good standing, copy of professional degree and to complete two online forms which can be found at the following links:

http://medicalcouncil.org/printregistration.htm

http://medicalcouncil.org/declaration.htm

The primary medical council web site is: http://www.medicalcouncil.org/

I have compiled a "Case Log" which shows ~half of the cases that were encountered during one year. This electronic record was created as part of a research project so the diagnoses represent those that my students were collating from the attached appendix. You will note that MOST of what is missing are non-diagnostic or normal biopsies. This gives you an excellent flavor of what we see in Blantyre. Also note that, although the case numbers are deleted, these are IN ORDER as received so you can see how some clinics seed things in batches. One important aspect of pathology service which can be reiterated by our clinicians at QECH is that the pathology service is currently underutilized so that VOLUME of cases may increase dramatically as we improve turn around time with volunteer presence. For example, KCH estimates that only about 5% of patients who NEED biopsies are receiving them.

Pathpedia is a unique forum to discuss pathology including global health and can be found at this link: http://www.pathpedia.com/Default.aspx

Our first two visitors will be Dr. Petr Skapa and Dr. Chris Hansen. There is quite a buzz about potential utilization and possibly training in FNA techniques during our volunteer visits and I think this is an excellent opportunity if QECH can accommodate them. My suggestion to the clinicians is that the pathologists be allowed to work at COM in the mornings (to complete the day's sign out) and then schedule with the clinicians (on the days that make the most sense) to come in the afternoons to work on FNA techniques, etc. The most efficient way to achieve this is an open line of communication between the visitors, Dr. Kamiza, and the clinical teams at QECH. I look forward to this potential improvement and hope it can greatly impact the care of our patients in Blantyre!