The Rape of Medical Laboratory Science Profession: The Bane of Modern Healthcare Delivery in Nigeria

Rape according to Oxford Advanced Learners Dictionary is (1) “to force somebody to have sex with you when he/she does not want to, by threatening him or her using violence” or (2) “the act of destroying or spoiling an area in a way that seems unnecessary”. It is further defined by online dictionary to mean “to abuse an object in an extreme manner or to dominate in a contest”. By extension therefore a forceful encroachment into a profession or field of practice by non-professionals is tantamount to rape.

A profession on the other hand is a type of occupation or job that needs special training or skill especially one that needs a high level of education. Every profession is established by law and there are rules and regulation guiding its practice.

Among the healthcare professions, one of the most abused is Medical Laboratory Science. In a hospital setting or any other healthcare institution the medical doctors are employed for clinical services, the nurses also are taken for their services but that cannot be said of the medical laboratory scientists. Other professionals are allowed to practice exclusively but for the medical laboratory, various persons are allowed to encroach into it. If it is not the doctor, it is the nurse or even ward-maids. Many other persons may be employed and designated “lab man”.

Therefore it is important for me to define the medical laboratory science profession, for us to know who the medical laboratory scientist is. It is “the practice involving the analysis of human and animal tissues, body fluids, excretions, production of biologicals, design and fabrication of
equipment for the purpose of medical laboratory diagnosis, treatment and research”… (Medical Laboratory Science Council of Nigeria Act, 2003 No 11 Sect. 29). And a Medical Laboratory Scientist (the scientist) therefore, is a person who has undergone an approved educational training and obtained a degree in a council approved institution, is subsequently registered and duly licensed by the council to practice (Section 18). And the law further said; no person not fully registered shall be entitled to practice the profession.

Therefore the engagement of any person by self, government or institution is illegal and amounts to a rape of medical laboratory science profession.

LEVELS OF RAPE OF MEDICAL LABORATORY SCIENCE
1.EMPLOYMENT OF QUACKS
The employment of quacks or non-professionals to manage and render medical laboratory services is a common place in Nigeria. It is done at various levels in both public and private sector.

(A) THE GOVERNMENT.
The State and local governments are the most common culprits. They engage quacks and post them to work in our medical laboratories when there are many scientists either unemployed or under employed. This is worrisome because the supposed implementers and executors of the
laws and regulations of the land are the worst violators. If government (the leadership) does this, what do they expect of the private sector? This official employment of quacks appears to be directed particularly at medical laboratory science in the health sector. Otherwise, where have
you seen a non -medical doctor posted to consult patients in government hospitals in Nigeria? Even under emergency, when there are no doctors the patients are left unattended. If the doctor does not come eventually, nothing happens and heavens do not fall. This act of quackery is about playing out again.

In a recently advertised recruitment exercise by Imo State government, the position of medical laboratory scientist is not advertised. This is in a situation where there are not enough scientists in the existing general hospitals. And the government is building 27 new ones who are going to work in the medical laboratories?

(B) PRIVATE HOSPITALS AND CLINICS
All private hospitals and clinics in Nigeria show on their signposts the offering of laboratory services, among others. But more than 90% of them have no Scientists. Who then runs the laboratory tests? Or are the tests not done? The society needs answers to these questions. It is important we know who handles our biological specimens and how. And the patients are entitled to know the result of their laboratory test(s) and have it. The private clinics can have laboratories attached to their centres, but they need to employ the appropriate manpower and equipment and be prepared to subject them to scrutiny by the regulatory body. If not they are going foul of the law. Alternatively, they can go into collaboration with registered and licensed laboratories to cover them. This is the global best practice. A hospital is not authorized to render laboratory and even pharmacy services unless it has the complementary workforce.

C) PHARMACY SHOPS
Almost all pharmacy shops now render medical laboratory services. This is the most recent level of rape of medical laboratory science profession. And it has become a common place since the advent of “point of care kits. The Pharmacists have joined in the rape whereas they cry wolf against the patent medicine vendors and guard jealously the opening of pharmacies.

There is need to state here that the sales and dispensing of drugs are not too difficult. Before now it was in the hands of non-pharmacists. As they have seen the need and are working to protect and preserve their profession, they should not join in raping medical laboratory science.

(D) THE NGOS
The NGOs are falling over themselves to render healthcare services. That is good. To render these services, they employ doctors and nurses, for their services, but for laboratory services, they employ “anybody”. And you need to see how this laboratory services are rendered. No interest is shown for the accuracy or reliability of the results produced. No precautions whatsoever are taken, particularly of safety. The question again here is, why “anybody” but not the scientist for laboratory services, while the right personnel are employed for other professions.

(E) PRIVATE LABORATORY
This is another area where you find a chunk of quacks. Many non-professionals open and manage laboratories. This level of rape is chronic and needs to be eliminated. It requires the concerted efforts of all the medical laboratory scientists, government at all levels and the populace/patients. The patient should ascertain the qualification of whom you are patronizing. The consequences of the employment of quacks include production of inaccurate, unreliable and non-reproducible results. This in turn means misdiagnosis and then mistreatment. In turn clinician will resort to guess work in managing patients. A non professional with the resources can set up a lab but has to employ the appropriate manpower to run it.

The use of quacks is of dare consequences – wastage of resources and eventual wastage of life. We need to discourage it.

2. DEARTH OF MEDICAL LABORATORY SCIENTISTS IN IMO STATE PUBLIC SERVICE.
It is a truism that laboratory services are essential components of health care delivery. There are only about twenty medical laboratory scientists in the employment of Imo State government and non in the local governments. This is about an average of one scientist to a functional general hospital, except the specialist hospital, where we may have up to 4. The situation arose because scientists retire and no new ones are employed.

It is important to bring to our notice here that before now the specialist hospital, then general hospital Owerri, had accreditation to train both students of medical laboratory science and Interns. But it has lost the accreditation due to poor situation in its laboratory services department.

The implication is that our students do not get the adequate training and the graduates have to look outside the State for placement if they are not taken by FMC, Owerri. This is improper and should be corrected.

Recently, due to the accreditation being sort by Imo School of Nursing and Health Sciences, the Medical Laboratory Science Council of Nigeria visited the specialist hospital. The hospital is one of those cited by the school as one of its training centers. Behold the laboratory facilities and manpower therein are below expectation. And unless the laboratory facilities and manpower are upgraded securing the reaccreditation may be difficult.

To be contd.

Igwebuike Charles
Chairman
Assoc. of Medical Laboratory Scientistsof Nigeria Imo State
Phone No.: 08033826056, 08095450675.

what sayest thou?

Successful treatment of any disease begins with accurate diagnosis. If precise diagnosis can not be guaranteed, no matter the genuineness of drugs administered on the patient, it can not be efficacious. Nigeria should get it right from the roots.

Who has time to read this long story when you have nothing to offer.

idealsico:
Successful treatment of any disease begins with accurate diagnosis. If precise diagnosis can not be guaranteed, no matter the genuineness of drugs administered on the patient, it can not be efficacious. Nigeria should get it right from the roots.

Diagnosis starts before the lab. Not in, or after the lab.

Secondly, a pathologist is always in charge of laboratories anywhere in the world. It is not encroachment, it is how things ought to be. Until Medical Laboratory Scientists in Nigeria learn to humble themselves and work in conjunction with the pathologists, they will always feel cheated and raped.

Know your position in a place and gladly and proudly occupy it. That's the best way to gain pride and recognition for your profession.

nobilis:


Diagnosis starts before the lab. Not in, or after the lab.

Secondly, a pathologist is always in charge of laboratories anywhere in the world. It is not encroachment, it is how things ought to be. Until Medical Laboratory Scientists in Nigeria learn to humble themselves and work in conjunction with the pathologists, they will always feel cheated and raped.

Know your position in a place and gladly and proudly occupy it. That's the best way to gain pride and recognition for your profession.

Do not make too much noise here, go to Abuja and repeal the Med lab laws. The average Nigerian now knows who actually runs those tests that promotes and saves their lives in our hospitals. Mr pathologist go consult with your physician-friends on clinical disease management and leave the lab for those who have spent all 5 university years +1year internship learning how to run it-The Medical Lab Scientist.

Sctests:


Do not make too much noise here, go to Abuja and repeal the Med lab laws.

Hmmm. I'm not making noise o.
There is nothing I said here that goes against the Med Lab laws.

And you, instead of making noise here, go to Abuja and lament the rape of Medical Laboratory Science.

nobilis:


Hmmm. I'm not making noise o.
There is nothing I said here that goes against the Med Lab laws.

And you, instead of making noise here, go to Abuja and lament the rape of Medical Laboratory Science.

We are already doing that, that's why you are jittery.

Sctests:


We are already doing that, that's why you are jittery.

Jittery??
In what sense am I jittery?

Isn't it paradoxical that the people who always clamor for "international best practices" just want to abandon the same international best practices just to further their own selfish gains and purposes?
This behaviour is only expected of worshippers of the god, Janus.

Ok! From my own perspective, I believe the issue of quackery is actually the fault of mlscn and amlsn. They have unwittingly created the enabling environment for such things to become prevalent in nigeria.

First thing they should do is to stop discriminating against bsc holders in the biological sciences (microbiology and biochemistry) and create an avenue for them to be properly trained, registered and licensed for clinical laboratory work. You would be surprised that most of the individuals being referred to as quacks are actually bsc holders in microbiology and biochemistry who insist on practising the medical aspect of their fields. I appeal to mlscn and amlsn to drop this policy of exclusion against them because it has aggravated the problem.

Secondly, mlscn should establish a firm grip on the importation of diagnostic kits into nigeria. I have been made to understand that they are actually listed as pharmaceutical products & medical devices and some of them can be sold directly to consumers without them even visiting the lab e.g pregnancy test kit. Strong regulations should be put in place to stop pharmacists from infringing.

Thirdly, nigeria is a corrupt country! The direct solution to all that plagues the medical laboratory is to solve the endemic corruption that has eaten deep into every fabric of our society.

We need to go back to the drawing board as regards the issue of diagnosis of disease in nigeria. From the little info I got from my contacts in the united states, clinical pathologists and clinical laboratory professionals exist side by side and render the same quality healthcare services to the public. I see no reason why such cannot be done here. The battle for dominance is unnecessary and I believe the exclusive powers mlscn was given in their enabling ACT should be amended in such a way as not to exclude/prevent the pathologist from performing his function of diagnosis of diseases.

nobilis:


Jittery??
In what sense am I jittery?

Isn't it paradoxical that the people who always clamor for "international best practices" just want to abandon the same international best practices just to further their own selfish gains and purposes?
This behaviour is only expected of worshippers of the god, Janus.

International best practices is good when it favours you wardmen. There a tons of stuffs the MLSCN can ask for if you wanna travel the IBP lane.

D.mls/D.cls is also international best practices. Many clueless physicians(pathologists inclusive) besiege sites like labtestsonline.com asking loads of questions about certain lab tests due to the fear of malpractice. It is the Clinical Lab Scientists that always come their rescue. Our Nigerian butchers like won't let that happen. My Director here in the U.S is not a Pathologist. He is a CLS with an M.Sc.
Direct access testing/ Consumer-ordered test is becoming embraced by peeps who have decided to take their own health into their hands. Some people no longer take frequent trips to the physicians office before they can order tests. When they need a follow up, they simply work into the lab for their blood work. That's international best practice. Will you embrace it?.

In the U.K Medical groups have warned Pathologists not to sign jobs they didn't do.
Consultant Biomedical Scientist(equivalent of Medical lab. Scientists in Nigeria) in the U.K have their job roles in the NHS without encroachment from the pathologist. That's IBP, have you embraced that too?.

A pathologist's job is purely clinical, he is an expert on disease study not on Medical laboratory principles, methods and management. Professionally they are 2 different things.

coollabman:
Ok! From my own perspective, I believe the issue of quackery is actually the fault of mlscn and amlsn. They have unwittingly created the enabling environment for such things to become prevalent in nigeria.

First thing they should do is to stop discriminating against bsc holders in the biological sciences (microbiology and biochemistry) and create an avenue for them to be properly trained, registered and licensed for clinical laboratory work. You would be surprised that most of the individuals being referred to as quacks are actually bsc holders in microbiology and biochemistry who insist on practising the medical aspect of their fields. I appeal to mlscn and amlsn to drop this policy of exclusion against them because it has aggravated the problem.

Secondly, mlscn should establish a firm grip on the importation of diagnostic kits into nigeria. I have been made to understand that they are actually listed as pharmaceutical products & medical devices and some of them can be sold directly to consumers without them even visiting the lab e.g pregnancy test kit. Strong regulations should be put in place to stop pharmacists from infringing.

Thirdly, nigeria is a corrupt country! The direct solution to all that plagues the medical laboratory is to solve the endemic corruption that has eaten deep into every fabric of our society.

We need to go back to the drawing board as regards the issue of diagnosis of disease in nigeria. From the little info I got from my contacts in the united states, clinical pathologists and clinical laboratory professionals exist side by side and render the same quality healthcare services to the public. I see no reason why such cannot be done here. The battle for dominance is unnecessary and I believe the exclusive powers mlscn was given in their enabling ACT should be amended in such a way as not to exclude/prevent the pathologist from performing his function of diagnosis of diseases.

Dear friend, There is no discrimination between a B.MLS and B.Sc.
MLS is a professional degree by international standard while the Chemistry/ Biology degrees are academic/research-based. A degree in pharmacology here and in many parts of the world can get you a research assistant position but you can't practice as a Pharmacist. Pharmacy degrees are professional. That's how it goes. Research positions and Professional positions are both important but are not the same.
www.unb.ca/academics/programs/undergrad/fr/medical/

1. MLS have a lot in their curriculum that B.Sc biology/chemistry does not. Anatomy, Physiology are key basic medical courses that must be learned as you'll need to understand structure and functions of what you studied in school and apply them in the lab Scenario- When you told to explain the collection of endocervical smears at squamo-coloumnar junctions, how do you explain that as a chemist?.

2.There are drugs that interact and alter medical laboratory results giving false-positives or false-nagatives, it is the Lab. Scientist's job to know this and factor it in before signing and releasing lab results. This is one of the many reasons Pharmacology is taught to Lab. Scientists. This course is absent in Biologist's/chemist's curriculum.

We also have medical counseling, medical ethics and jurisprudence. CLS are also sued by patients for malpractice(e.g giving out wrong results that may endanger patient's lives), they also testify in court in rape cases. Is the chemist/biologist equipped with this knowledge. That's why it is regulated and it's practioners licensed. Lives are involved. Those aforementioned courses are missing in Biology and chemistry curriculums.
We need to stop seeing the medical laboratory as an afterthought kitchen where any joe can come in and run medical tests. The Medical Laboratory now plays a central role. Infact the HIV battle was fought and won in the laboratory.

3. Importation of diagnostics by law is supposed to be regulated by Medical Lab profesionals through the MLSCN, but our wardmen in labcoats believe otherwise. CBN have released a circular to that effect in accordance with the law.

Scientists and pathologists can work together but on different frequencies, in different offices towards a better health for the patient but they are distinct professions and none should seek to head the other. Pathologists should head theirs while MLS should also head theirs. That's what the law says.

Sctests:


International best practices is good when it favours you wardmen. There a tons of stuffs the MLSCN can ask for if you wanna travel the IBP lane.

D.mls/D.cls is international best practices. Many clueless phycians(pathologists inclusive) besiege sites like labtestsonline.com asking loads of questions about certain lab tests due to the fear of malpractice. It is the Clinical Lab Scientists that always come their rescue. Nigerian butchers like won't let that happen. My Director here in the U.S is not a Pathologist. He is a CLS with an M.Sc.
Direct access testing/ Consumer-ordered test is becoming embraced by peeps who have decided to take their own health into their hands. Some people no longer take frequent trips before they can order tests. When they need a follow up, they simply work into the lab for their blood work. That's international best practice. Will you embrace it.

In the U.K Medical groups have warned Pathologists not to sign jobs they didn't do.
Consultant Biomedical Scientist(equivalent of Medical lab. Scientists in Nigeria) in the U.K have their job roles in the NHS without encroachment from the pathologist. That's IBP, have embraced that too?.

A pathologist's job is purely clinical, he is an expert on disease study not on Medical laboratory principles/methods and management. Professionally they are 2 different things.

I hope you have heard of automated machines that do most of these tests you guys do in the laboratory.

That's all I have to say.

Tomorrow you guys will also blame doctors for the suspension of the MLS program by NUC.
All your woes are caused by the doctor, SMH. It's pitiable.

Sctests:


Dear friend, There is no discrimination between a B.MLS and B.Sc.
MLS is a professional degree by international standard while the Chemistry/ Biology degrees are academic/research-based. A degree in pharmacology here and in many parts of the world can get you a research assistant position but you can't practice as a Pharmacist. Pharmacy degree are professional. That's how it goes. Research positions and Professional positions are both important.
www.unb.ca/academics/programs/undergrad/fr/medical/

1. MLS have a lot in their curriculum that B.Sc biology/chemistry does not. Anatomy, Physiology are key basic medical courses that must be learned as you'll need to understand structure and functions of what you studied in school and apply them in the lab. Scenario- When you told to explain the collection of endocervical smears at squamo-coloumnar junction, how do you explain that as a chemist?.

2.There are drugs that interact and alter medical laboratory results giving false-positives or false-nagatives, it is the Lab. Scientist's job to know this and factor it in before signing and releasing lab results. This is one of the many reasons Pharmacology is taught to Lab. Scientists. This course is absent in Biologist's/chemist's curriculum.
We also have medical counselling medical ethics and jurisprudence. CLS are also sued by patients for malpractice(e.g giving out wrong results), they also testify in court in rape cases. Is the chemist/biologist equipped with this knowlege. That's why it is regulated and licensed. Lives are involved. Those aforementioned courses are missing in Biology and chemistry curriculums.
We need to stop seeing the lab as an afterthought kitchen where any joe can come in and run medical tests. The Medical Laboratory now plays a central role. Infact the HIV battle was fought and won in the laboratory.

3. Importation of diagnostics by law is supposed to be regulated by Medical Lab profesionals through the MLSCN, but our wardmen in labcoats believe otherwise. CBN have released a circular to that effect in accordance with the law.

Scientists and pathologists can work together but on different frequencies, in different offices towards a better health for the patient but they are distinct professions and none should seek to head the other. Pathologists should head theirs MLS should also head theirs. That's what the law says.

Its very unfortunate that your response is watery. It is common knowledge that special professional training courses are available for biologists/chemists that want to engage in clinical laboratory practice (like the one the american society for clinical pathology runs in conjunction with the american society for microbiology, check here www.asm.org/index.php/nrcm-cert). even in nearby ghana the biomedical scientists over there accept the biological scientists with open arms after the later have fulfilled some requirements (there is no place in this world where this is not done). The flimsy excuse that the curriculum differs no longer holds water because amendments can be made by further training (for example, the IMLT diploma was used successfully for years to convert bsc holders to med lab personnel before mlscn came on board with the bmls cert) .

MLSCN and ALMSN will never be able to solve this problem of quackery with the current approach. Your desire to dominate what you think is your "turf" at the expense of others, who should be your allies, will lead nowhere. You guys fail to be proactive and refuse to think outside the box to stop quackery. The first point I made in my earlier post is a possible solution. Preventing bsc holders from practising their fields as professionals is DISCRIMINATION. STOP THIS NONESENSE CAREER POLITICS!

Secondly, international best practices as recommended by WHO places the medical laboratory under the jurisdiction of the clinical pathologist. The laws operating here were not thoroughly thought out and I believe amendments should be made for the benefit of all.

By the way, are you the new incarnation of YourHealthlabs?

coollabman:



Its very unfortunate that your response is watery. It is common knowledge that special professional training courses are available for biologists/chemists that want to engage in clinical laboratory practice (like the one the american society for clinical pathology runs in conjunction with the american society for microbiology, check here www.asm.org/index.php/nrcm-cert). even in nearby ghana the biomedical scientists over there accept the biological scientists with open arms after the later have fulfilled some requirements (there is no place in this world where this is not done). The flimsy excuse that the curriculum differs no longer holds water because amendments can be made by further training (for example, the IMLT diploma was used successfully for years to convert bsc holders to med lab personnel before mlscn came on board with the bmls cert) .

MLSCN and ALMSN will never be able to solve this problem of quackery with the current approach. Your desire to dominate what you think is your "turf" at the expense of others, who should be your allies, will lead nowhere. You guys fail to be proactive and refuse to think outside the box to stop quackery. The first point I made in my earlier post is a possible solution. Preventing bsc holders from practising their fields as professionals is DISCRIMINATION. STOP THIS NONESENSE CAREER POLITICS!

Secondly, international best practices as recommended by WHO places the medical laboratory under the jurisdiction of the clinical pathologist. The laws operating here were not thoroughly thought out and I believe amendments should be made for the benefit of all.

By the way, are you the new incarnation of YourHealthlabs?

Go back to the link you posted and peruse it
carefully, your asm-ascp website does not say it confers on
you "Medical laboratory Scientist" competencies. Let me quote an excerpt from your source

"Those who pass the exam are certified as a
Technologist in Microbiology (M) or Specialist in Microbiology (SM) by the ASCP and
are issued a certificate with both organizations' names on it."-----http://www.asm.org/index.php/nrcm-cert

Did you notice they were careful not have added the word "Medical"
in front of the "Technologist"? The medico-legal issues surrounding the practice can not
be wished away in countries where they are serious about this practice. Do non-biomedcal scientists(BMS)
in the UK work with patient's samples to achieve results aimed at diagnosis. Do you know that the title "BMS" is a protected title
in the U.K?

Again on your website let's take a look at the functions of a Registered Microbiologist and Specialist Microbiologist.
Is there any job description there with any semblance of working in a Medical laboratory for diagnostic purpose?

You guys have your fields, how many Medical lab Scientists are employed as Food microbiologists, industrial chemists, Environmental biologist and so on?
Do we run the environmental testing laboratories too?. You need to stop seeing the Medical lab Scientist as an ordinary 'Operator' not eligible to differentiate between a hyperglycemic sample caused by DM and a contaminated sample.


Listen the physician's here will click likes and applaud you, but if have any sense of history you will understand
that during the days of biologist/chemist in IMLT, almost every clueless physician will point to the lab and blame it when they butcher a patient.

The lab guys were the fall guys in those days. When a patient dies, it's the lab that delayed results. They prescribe the wrong
antibiotics- "oh that numbskull in the lab didn't run the AST effectively".

Well those "lab guys" have taken responsibility, built capacity, and equipped themselves with enhanced knowledge,
now regulate the laboratory with the full backing of the law. Why should that be a problem? Our national/state hospitals now have very few cases of misdiagnosis traceable to the laboratory. Nowadays, we no longer get frequent finger-pointings for giving bad results and endangering patients as it was in the 70's and 80's, Now we only get finger-pointing for asking to head the medical laboratories we developed-OUR PRIMARY CONSTITUENCIES in accordance with the law. It is a positive turn-around if you ask me.

Wide consultations were made before that ACT was passed as Law, people who thought the "kitchen"/labs should be thrown to the
backyard and blamed it for all their malpractice misfortunes are the ones crying foul today. Our Medical laboratories are getting strengthened,
the Medical Lab.Scientists will keep building capacities through enhanced knowledge and application of same and the patients can only be the greatest winner.

If you are looking to get us back to that age where the "Lab guy" is the fall guy for everyone else and is expected to gladly accept that, then i'm sorry the Law disagrees with you.

In the 50s' and 60's we had medical assistants treating patients because we didn't have enough Physicians, today we have more than ?40,000 physicians.
In the 70's we didn't have enough MLS/Biomedical Scientists. The biologists/chemists without basic knowledge in medical science were drafted in. These were all stop-gap complementary efforts.
Today Nigeria has at least 8,000 Medical Laboratory Scientists. Why go back to the inglorious era?

I am new on this forum, been reading as a guest for months, attracted by lots of misinformation about the MLS profession
and not a reincarnation of anyone. I will also like to meet fellow MLS on these forum. They seem to be very few on this website.

Ok

APC - - - - - change
That's all

Isn't rape a bit of a controversial word? Tone it down abeg.

i gat nofin to say

Which profession is not raped currently?

NWANICHODE:
Who has time to read this long story when you have nothing to offer.

ask him oo. op summarize

Cùrrently working on my studio album. Join you guys soon



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1

Must you open a Thread from a drinking palour?

Na wa ooooo. Its just as if u guys are speaking in tongues here..... *just passing by sha* wey my fellow accountants and bankers?

Rape isn't the best word to use there

Are you guys tired of striking? I hear NUC has issues with this course which ought to have been purely HND/OND paroles. Water will always find its level.

K

clueless

Cry me a river