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INTERIEW OF DR SHYAM MANRAJ

Question 1: First of all, congratulations on your nomination as adviser to the Research committee for Africa. Please tell us a little more about your nomination and the type of job that you will be expected to do?

Early this year I have been nominated member of the African Advisory Committee for Health Research and Development (AACHRD) for a period of three years. This committee comprises of 12 medical experts of diverse professional background from various African countries. The annual meeting of the AACHRD was held in Harare in March this year.

The role of the AACHRD is to advise the WHO-AFRO Regional Director on how Health Research in the member states could be better organized to respond to the needs of policy-makers and Health professionals.

As a member of AACHRD, I will be expected to:

  1. Provide guidance and advice on Health Research policies, strategies and activities
  2. and serve as a first-testing audience for any newly developed health regional initiatives, programmes etc.
  3. During the Harare meeting, our main recommendations dealt with:

  4. budget allocation for Health Research in member states
  5. improvement of communication and information flow on contemporary issues on Health Research and Development
  6. creation of National Health Research Councils and
  7. elaboration of Research grant awards and WHO/AFRO prize awards.

 

Question 2 : Everybody in the Laboratory services knows you well. However for the sake of our readers can you please introduce yourself?

I am 44 years old, father of three boys and a great fan of Manchester United. !!!

OK After my secondary school studies at Royal College Curepipe I went to Marseilles where I studied medicine and went on to complete my post-graduate studies in Pathology. I joined Central Laboratory as pathologist in 1986 and since then I have worked in all regional hospitals. In the 1990ís, I followed courses both locally and abroad in Health Systems Research and in Public Health and Epidemiology. With that dual pathologist and Public Health specialist background, I got interested in developing Cancer Control and Cancer Registration on one hand, and computerisation on the other hand.

 

 

 

Question 3 : You are the co-ordinator for the computerization of the laboratory services. Since the first year of computerization till today what in your opinion are the advantages and the shortcomings that the staff have encountered?

This project has given us a great opportunity to work as a team (medical, scientific, technical and I.T. staff). More than 450 000 patient files have been created in the system. However, computer utilization varies a lot from department to department due to various reasons.

A proper Laboratory Computer system can lead to the following benefits:

    1. reliable and accurate record-keeping of test requests and results,
    2. Quick retrieval of test results,
    3. Reduce wastage due to repeat of tests following loss of result slips,
    4. Statistical reports can be generated in less time,
    5. Provide Management with parameters in view of improving the quality of laboratory services and,
    6. Create a powerful database to initiate research work and epidemiological studies on pattern of diseases.

I have to admit that only in Histo-pathology and Cytology Services, Biochemistry and Haematology where computer terminal use is more or less regular can the advantages of the computerisation process be felt in the Central Health Laboratory.

In general, problems that the laboratory staff have encountered deal mainly with :

    1. lack of unique identifier leading to the creation of multiple computer files for the same patient
    2. Insufficient statistical tables
    3. Sluggishness of the system and
    4. Unreasonably high rate of incorrectly and improperly filled-in request forms.

 

 

 

Question 4 : You have done a pioneer work concerning the cancer registry in Mauritius . Can you please tell us more about it and if further work is being done on this project?

I started the work of cancer registration as a project for my Diploma in Public Health. Since then I have pursued the task over a period of eight consecutive years from 1989 to 1996. The findings have been published in a report issued last year giving detailed incidence and mortality rates for each cancer site.

These data have been utilized extensively in the National Burden of Diseases study and by the task force for National Cancer Control Program. Our proposal for the Second Phase of the project has been approved the Ministry of Health & Quality of Life and will be benefiting from financial assistance by W.H.O. for its implementation during the coming years.

 

 

Question 5: As a senior pathologist, in the 10 years to come how do you foresee the department of Histology/cytology ? In my opinion, during the next decade the department of histopathology/cytology will develop both in quantity and quality. In terms of quality we will be striving to give more precise, reliable and timely reports.

Apart from conventional staining, use of monoclonal antibodies for immuno-histochemistry and also immuno-cytochemical staining will become a reality for enhancing the diagnosis and monitoring of cancer cases. A quality assurance program will be in place together with a regular audit system.

Cytology services will expand tremendously with a major national cervical cancer screening program by Pap smears well under way, most probably justifying the setting-up of a separate Cytology department. Fine-needle aspiration cytology is also becoming increasingly popular among Mauritian doctors.

 

 

 

 

Question 6: What are the future projects that you will be working on ?

Apart from designing and implementing the second phase of the computerization and National Cancer Registry programs, I will also be collaborating in a few epidemiological studies on certain types of cancer like cervical cancer and gastric cancer to be carried out by international teams in the coming months in Mauritius.

I sincerely hope that the BSc conversion course for Medical Laboratory Technicians will materialize and that in a near future we will have a whole team of dedicated scientific-minded officers. This critical mass of graduate staff will be vital to bring about quality improvement in the Laboratory Services under the leadership of Dr (Mrs) N. Jeebun, Consultant (Pathology) and at the same time to meet the ever-increasing needs of the entire Health Care Services in Mauritius.