Philanthropy: The Essence of Pathology Global Health

Clinical Assistant Professor of Pathology, University of British Columbia (UBC)
Director of Cytopathology, Royal Columbian Hospital (RCH)
Medical Lead, Pre- and Post-Analytic (PPA), Royal Columbian Hospital (RCH)
Medical Director, Laboratory Medicine Program, Chilliwack General Hospital (CGH)

It was mid-July 2015 when I came across an ad in the Arch Pathol Lab Med (posted by my colleague Dr. Drucilla Roberts from Massachusetts General Hospital) looking for pathologists interested in Global Health. Four months later I was en route to Gaborone, the capital of Botswana, from Vancouver, Canada (24 hours flights time plus more). Botswana is in sub-Saharan Africa, a politically stable country with a population of two million. The country was among the hardest hit by the HIV/AIDS epidemic, having the third-highest rate of HIV/AIDS worldwide.

I spent one week at the National Health Laboratory in Gaborone, which has three pathologists and four residents, providing pathology services to a large portion of the country. My daily work would have started with a lecture on a given subject followed by grossing sessions with the trainees and the technical staff. This was later continued by clinical sign-outs with the residents in the afternoon. At the end of the day, we would have gathered as a “family” to review my teaching slides, which later at the request of the residents left them in the country. This was all very well coordinated by my colleague and friend, Dr. Alphonse Kayembe, the head of the Laboratory.

Botswana has many gifts including amazingly friendly people such as the laboratory/hospital staff. During my short stay, I was privileged to observe and honored to interact with the laboratory staff, clinical colleagues and university administrations. As expected in any under-resourced country, the practice of pathology in Botswana faces its own challenges. Primarily, the so-called Second Wave of AIDS threatens the country’s public health by a surge in number of cancers related to immune suppression populations. This in combination with shortage of pathologists and other medical laboratory professionals have resulted in a backlog of cases. The need for education and training along with lack of necessary infrastructure and resourcing has also unfavourably impacted pathology services in the country. Quality and practice standards are other areas that need attention and improvement.

It is important to recognize that there are not simple solutions to these issues or that only providing funding would make them disappeared. As a surgical pathologist and a clinical epidemiologist, I believe that knowing “the problem and its scope” would be the first step in addressing the issue. Collecting epidemiologic data along with developing locally sounded building-capacity modules are of paramount importance. Demonstrating unity and empathy along with the ability to understand and share the feelings of others would certainly be fundamental to building-capacity and creating motivations. On my last day lecture, after answering all the questions, one of the technical staff from the audience raised his hand and said “I have a question! When are you coming back?” That was then when I realized that my presence, no matter how small or how seemingly insignificant may have been, made a difference in my fellow colleagues in Botswana. This was later followed by one of my colleagues, Dr. Peter Zetler (retired) from Vancouver, who spent 4 weeks in Gaborone providing clinical services and training to the National Health Laboratory.

Pathology is global, and philanthropy is the essence of “Pathology Global Health” programs. We as pathologists, along with other medical disciplines, should play a major role in leading the humanitarian sectors. As a UBC clinical faculty, who was privileged enough to independently take a “baby step” in this direction, I would encourage all my fellow colleagues to support Global Health through philanthropy. And this reminds me of one of the most beautiful poem by William Shakespeare:
“The quality of mercy is not strain'd,
It droppeth as the gentle rain from heaven
Upon the place beneath: it is twice blest;
It blesseth him that gives and him that takes”.