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Dhaka Day by Day

Pathological Services are a Shambles

By S. Chowdhury
The quality of pathological investigation services available in the country is deteriorating fast because of an acute lack of quality control opined one of the senior most pathologists of our country, Dr. Syed Mukarram All.
Talking to The Dally Star', he said that the state of Pathology was in a mess in our country. According to him there was no common standard Of detection. Anyone who can get a license starts a patliological laboratory.
For this, he said, the Government of our country was to be blamed largely. For a long time now. the Government has been quite in-diflerent to this sector. It gave out licenses at random, without first checking the facilities or the equipment of the laboratory to be set up. As a result, we notice that there is no dearth of such laboratories in our country. As a matter of fact, we notice new ones cropping up at every nook and corner.
In his opinion, the government laboratories were a complete failure’, like for example, those of the Institute of Post-Graduate Medicine and Research (IPGMR) and the Dhaka Medical College Hospital. Since they themselves were inept to perform their jobs, they sent the samples of various tests required by their own patients to private pathological laboratories and sometimes to International Centre for Diarrheal Disease and Research. Bangladesh (ICDDRB) or to Combined Military Hospital (CMH).
However, he said that things were different in the past. Way back in 1966, the government pathological department of the Dhaka Medical College Hospital, was the best in the country. At Csent Ite standard deteriorated very much.
Dr. All said that from the government's point of view, this is happening due to the deficiency of manpower, both in t'-'-ms of doctors as
■t J as technicians.
When asked as to why it often happens
that, for similar teste, different laboratories have different results, he said It was due to the use of old and obsolete, out-dated techniques even now followed In matters of pathological investigation in our country He further said ' ■Our country is far behind tn the modern tech niques practised in the advanced countries of
Talking about research, the veteran pathologist said, some institutions of our country like the Institute of Post-Graduate Medicine and Research (IPGMR). Bangladesh Institute of Research and Rehabilitation in Diabetes. Endo cryme and Metabolic Disorders, are carrying out some research work in this field. But this should be geared more towards day to day problems and relate more to them. There was a general neglect In this field, he added
For example, he said. Tn most of the developed countries, the blood electrolyte tests for diarrhoea is done continuously i.e., 24 hours a day. but in our couptry. ft is done perhaps once or twice a week in the pathological laboratories. It is essential that such a system be started here also.'
Dr. Alt had a number of suggestions for improving this condition. One way of improving it. he said was by practising the method followed in the United Kingdom. There they are phasing out pathology from national Health Service Hospitals to private sectors, in the form of contract, which can be for one year, but at the same time constantly keeping an eye on quality control. Similar method can followed in our country also.”
Another step to be taken here, he said, was to go for full automation where possible in the field of pathological investigation. For. the method followed here at present was manual which could make mistakes, as this system tended to result tn a lot of errors. This was the reason why people have lost confidence in the reports of our local laboratories, and thus have becbme dependent on checkups abroad, he observed.
He said that in the area of Hematology and Chemical Pathology. full automation was possible. Therefore. in these branches of pathology, it should be introduced. He went on to say that either the government itself should set up automation tn each hospital, which is quite expensive or give contract to private companies to bring in the latest and most sophisticated machines to serve the country and people.
Among the modern machines, he mentioned automatic tissue processor, chemical analyser, frozen section service, automatic knifesharpener etc.
He. however, pointed out that it was possible many new laboratories may be having these facilities, but there was a dearth of competent men handling the same
Presently, a Professor of Pathology. In the Bangladesh College of Physicians and Surgeons, he has to give lectures to students of postgraduate level. Expressing his disappointment, he said that the quality and input of the students was quite poor. He went on to say that they now had much more opportunities than their seniors had in their time to get acquaint ed with the latest achievement in the field of medicine. But the students these days hardly made an effort to read the latest medical Jour nals which were ao readily available today. Student*. he said should be more dedicated towards their profession: only then with collective efforts can something be done for the country. Besides, they should be properly guided by their teacher* also
There I* no *hort-cut in achieving any thing: one has to go all the way. he concluded