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We would like to include some newspaper clippings for the coverage of our conference organised on the 7th of July 2001 at Le Grand Gaube Hotel, Mauritius. This page also contains the ABA's Chairman speech and a collaboration work between the ABA, The Central Health Laboratory and the University of Westminster UK.
Article as reported by L'express Dimanche of 8th July 2001 ( Website:http://www.lexpress-net.com/archives/0807/La_une/actu_0107.html)     SANTÉ PUBLIQUE

Les laboratoires s'essoufflent


Le personnel des laboratoires du secteur public veut une refonte totale de ses conditions de travail ainsi qu'un rehaussement de son diplôme.

  Les laboratoires effectuent cinq millions d'analyses par an, et les demandes pour les tests spécifiques sont en hausse.

Un laboratoire central qui date de 1958, des équipements tout aussi vieux, un programme de formation pour des techniciens, élaboré il y a... trente ans ! L'Association des analystes biomédicaux (AAB), a toutes les raisons du monde d'exiger du ministère de la Santé, une réforme totale des services des laboratoires publics à Maurice et à Rodrigues.

Kushen Ramessur, le président de l'association, l'a souligné hier à l'hôtel Le Grand Gaube, lors d'une conférence ayant pour thème les services laborantins à Maurice après 2001.

Il rappelle que les laboratoires effectuent cinq millions d'analyses par an, que les demandes pour des tests spécifiques augmentent et que cela nécessite davantage de compétences. "Or, depuis des années, nos conditions de travail n'ont connu aucune amélioration. Il n'y a aucune structure pour assurer la formation des techniciens de laboratoire", fait-il ressortir.

Une requête toujours rejetée


Ces dernières années, l'AAB a demandé, à plusieurs reprises au ministère de la Santé de convertir l'actuel diplôme de Medical Laboratory Technology en licence en science biomédicale. "La requête a toujours été rejetée puisque cela impliquait aussi une augmentation de salaire", explique Kushen Ramessur. Selon lui, cette conversion a été effectuée dans presque tous les pays développés ou en voie de développement, puisque la formation des techniciens de laboratoires - même si elle doit être modernisée sous certains aspects - équivaut à celle d'un scientifique biomédical.

Kushen Ramessur suggère aussi au gouvernement la création d'un institut biomédical. Malgré le fait que ces techniciens ont bénéficié de plusieurs stages à l'étranger, ils n'ont pas reçu de formation dans de nouveaux secteurs médicaux.

Avec la mise sur pied de cette structure, la formation continue du personnel de laboratoires, l'expansion des services laborantins et les travaux de recherches seraient assurés. L'AAB a déjà soumis un projet de réorganisation des services du laboratoire central au gouvernement. Ashok Jugnauth, ministre de la Santé, présent à cette conférence, a promis de l'étudier. Il estime que leurs demandes sont tout à fait justifiées.

Saphira KALLEE

Cancer : un mal qui gagne du terrain

Cancers du sein, du col de l'utérus, du poumon et de la prostate, et leucémie sont hélas en hausse à Maurice. C'est ce que révèle le Dr Shyam Manraj, "Senior Pahologist" au laboratoire central, qui animait une causerie sur le cancer, lors de la conférence d'hier. Il explique que cette maladie n'augmente pas de décennie en décennie, mais d'année en année. Les causes de cette évolution, l'incidence et la prévalence de cette maladie de 1996 à 2000 font actuellement l'objet d'une étude de sa part. Les conclusions de son enquête seront rendues publiques d'ici décembre. Rappelons que de 1989 à 1996, 7 439 cas de cancer ont été enregistrés à Maurice.

 


Speech by Mr K Ramessur, Chairman of ABA on the occasion of the ABA international Conference

Hon Ashok Jugnauth , Minister of health & Quality of Life
Dr Bisnathsing , Liason office WHO ( Mauritius )
Mrs Veerapen PS Min of Health
Dr Sungkur CMO
Dr Mrs Jeebun , Consultant Pathologist
Members of the Press
Distinguished Guests
Ladies and Gentlemen

Let me first of all welcome you all in the name of the Association of Biomedical Analysts. The theme chosen for this year's ABA conference is " The role of Laboratory Services In Mauritius Beyond The year 2001" .Some of you may be wondering why such a title?

Well, Like all the other departments in the health system, the lab services plays a key role in helping clinicians in confirming their diagnosis , in the monitoring of patients under treatment and has been a major tool in the program for the screening of diseases such as Diabetes, Cancer, AIDS etc.

However, our population is fast expanding and the demand for better health care is ever more present; the pressure on laboratory services is rising exponentially as there is now
1. more and more analysis that are being sent to the laboratory Around 5 millions tests are done every year
2. a larger panel of laboratory tests is being requested
3. a very high demand for highly specific tests is being asked
4. a more in-depth knowledge is required for the tests that are being done
5. greater skill and know how is now required to perform and assess comprehensively the newly implemented techniques

As we are now moving in full fledge into the Third Millenium, we must absolutely see to it that we are not outpaced by events and lag behind helplessly as the World moves forward beyond year 2001.

Our laboratory service was first established in 1894 , when a small bacteriology lab was set up at Civil Hospital . In 1908 the Lab moved into a new building at Reduit and in 1958 the Central health Laboratory opened its door at victoria Hos in Candos . So as you can see the our Present Main Lab is going to celebrate its Golden Jubilee very soon . Today we are working in the same old building in more or less the same condition that we used to work decades ago . So , ABA consider that it is high time that the MOH should undertake a full reform of our lab service . A reform is not a negative thing in itself because it will help us to correct our weaknesses . It will eventually enable us to offer a better laboratory service to the population and receive an ISO 9002 award very soon . The ABA has already submitted a copy of our proposal for the reorganisation of the laboratory services in Mauritius and Rodrigues to the consultant Pathologist for due consideration .

But one must also bear in mind that a modern lab equipped with the most sophisticated apparatus will give an optimum yield if a properly trained staff is not available . Let us now have a look at the training program for laboratory Technicians . It was designed some 30 years ago and has remained almost static since then .

As you all know in many countries, continuous professional training is usually provided by a recognised institutions, like the IBMS, in England, where its members get the opportunity to be in touch with up to date diagnostic technology. They can also share their acquired experience with their colleagues throughout the country and the world via seminars, CPD Courses and a biomedical journal.

However, no such institution exists in Mauritius and there is no proper structure to cater for the continuous professional development of lab technician .The ABA was thus founded in 1995 with a principal objective of providing a professional image of our members and the biomedical community in Mauritius. We therefore encourage continuous Professional development through further Education, Seminars, conferences, writing scientific papers , journal based learning and case studies. But Still we suggest that the government should set up a biomedical institute to cater to the professional development of technicians .

Up to now one of the major achievement of ABA is the publication of a 100 page report on the importance of upgrading the present diploma in Medical laboratory technology into a BSc ( Hons ) . Most of you have already had a look at the report and have expressed their views and opinion on this subject " C'est un rêve que nous les techniciens consideront comme étant trés chères et que nous voulons realiser le plus tôt possible" .

There is a whole range of reasons for asking for such an upgrading and I would like to point out that in the past this demand was each and every time rejected because it was thought that the only change that an upgrading will bring will be an increase in salary and nothing more . But , is it not legitimate for some one to aspire to a better professional status and salary in his career ? Who will deny this ?

However , this is not the sole reason why we are asking for a BSc Course , For the past ten years there has been numerous development in the field of pathology. Many new technologies such as HLA typing, Endocrine and Tumour Markers by Immunoassays (RIA , EIA), Gel electrophoresis , Polymerase Chain Reaction have been introduced in the laboratory services.

Despite various scholarships that have benefited some Medical Laboratory Technicians, the majority of technicians have received no specialized training in new fields.

The rapidly expanding laboratory services and the introduction of new technologies will require a highly specialised training for the Medical Laboratory Technicians . The conversion of the Diploma course to a Bsc (honours) course will certainly mark the turning point in the next Millenium and will better prepare the future technologists to meet their increasing challenges .

New world trend: Throughout the world the new trend is towards upgrading in the department of Biomedical Sciences . In almost all developed and developing up countries the diploma course in medical laboratory technology has been converted into a Bsc course in Biomedical Science and medical laboratory technicians are hence called Biomedical scientists or technologists.

However ,the main entry requirement for the post of Medical Laboratory Technologists in U.K is a Bsc course in Biomedical Science and candidate must be State Registered Biomedical Scientist (SRBS).

Holders of a degree course can integrate the Institute of Biomedical Scientists and thus can participate in various workshops and research works. The IBMS gathers information from various members and publishes them in its monthly journal thus providing a means of communication between all laboratories throughout the world. No such institute exists in Mauritius as the laboratory Technicians are holders of only a Diploma in Medical Laboratory Technology. Thus with the absence of an Institute of Biomedical Sciences (IBMS) the medical laboratory technicians working in private laboratories are not registered and therefore cannot communicate with those working for the M.O.H. This situation prevents the expansion of laboratory services and hinders research.

Even third world countries like cameroon , Peru and Ecuador are now running conversion courses for the lab technicians . This is certainly a way to provide the country with a whole pool of Scientists who are going to consider thrive for the well being of the whole community. We must not forget how essential the department of Biomedical Science is and that the many surveys that have till date been carried out for non communicable diseases(NCD) and for cancer have been made possible only with collaboration of the Laboratory staff. The laboratory desires to have a well trained batch of professionals to cater for their needs.

Specialisation : It is becoming more and more important for technicians to specialise in a specific laboratory field where they will be able to cope with the new units which are actually operational eg Cardiac Surgery, Organ transplant, Neonatal unit and plastic Surgery.

Scholarships: For past ten years many senior medical laboratory technicians , Clinical Scientists and pathologists have benefited from scholarships and this have contributed in the introduction of new technologies such as Radio Immuno-Assay, Human Leucocytes Antigen typing , Hormone assays. However these scholarships though very efficient do not cater for the majority of technicians who are required to cope with these new trends. Thus development in the laboratory especially in the branch laboratory is very slow and more time is required to adopt the newly introduced technique . With the present situation specialised training in certain fields is confined only to a group of technicians working with the new methodologies. Hence we find that there is really a lack of specialised training for all technicians which result in the delay of development of the laboratory services .

Also , today some technicians have waited for more than 20 years before getting a refresher course abroad . This is considered more as a lifetime achievement award because very often as soon as the he return back he is promoted to the grade of Principal laboratory Technician and is posted to a branch lab and he is thus unable to pass the knowledge during that training session to his junior staff .

Reference laboratory: The Ministry of Health will no doubt be proud if one day, the laboratory service in Mauritius proves to become a reference at least in the Indian Ocean. To keep pace with other developed countries where long before the course has been upgraded to a Bsc hons course in Bio Medical Sciences, it is high time for Mauritius also to go in the same direction. In this context an upgrading of the existing personnel will not only give a better "respectability" to the laboratory findings but will also open a broader horizon and give new impetus to the world of Science as it is in our small island. The group of Bsc holders that will be formed each year will provide a considerable thinktank to the Scientific population of our small island and will contribute hopefully to put our island in the limelight once again in this field.

There are also several reports to sustain what I have said above . For example :

Late Professor T. Baker, Head of the Department of Biomedical Sciences, Bradford University and external examiner for medical laboratory technology has always rated very highly the course in his reports and has always been in favour of upgrading .

Prescod report
In 1973 the expertise of Mr. J. M. Prescod from Bromley College of Technology was offered by the Overseas Development Administration to advise Government (MOH) on the establishment of a training course for Medical laboratory Technician .Following his recommendation the four year Diploma in Medical Laboratory Technology Course was opened at the University of Mauritius. Mr. Prescod also recommended a fifth year with subject content similar to the fellowship in Medical Laboratory Science of U.K. Nowadays in UK another alternative qualification to the fellowship examination is M.Sc in the appropriate field. The establishment of a Mauritian Institute of Medical Laboratory Technology to govern the professional status of technologist together with the state registration of the profession were also strongly recommended.

Professor Osuntokun report
In 1983, upon the request of Government, the W.H.O provided Professor Osuntokun to advise in the setting up of an institute of Health Sciences. Concerning pathological laboratory Services, the professor made the recommendation to explore the possibility to run BSc courses for Medical Laboratory Technologists. He further advised Medical labotatory technologists to go on to higher degree programmes such as MSc , M. Phil and PhD.

Chesworth report
In 1987 the salaries Commissioner, Late Mr. Donald Chesworth O.B.E, recommended a three year full time degree course in Medical Laboratory Science . For existing diploma holders , a further one year full time course leading to the conferment of a degree. He also states that Medical Laboratory Science is a field in which the rate of new development is fast, and where there is a great need for refresher courses.
So Ladies and Gentlemen as you can see , it is high time that a full reform of the laboratory service is undertaken just as reforms is being carried out in the field of IT , Education , Postal Services and Financial Services . All this will eventually benefits the country and we will be able to provide a better service to the nation .

Last but not least , I would like express my deepest gratitude to all those who have helped us in the organisation of this event .

A special thanks to the Hon Ashok Jugnauth for being our chief Guest , To Mrs Veerapen , Dr Sungkur , Mrs Ramrukheea for their help and cooperation . Dr Mrs Jeebun for her constant help and advice Our Lecturers namely , Dr Manraj , Mrs Seetulsing- Ghoorah , Mrs Appadoo , Mr Rughooputh . Our Sponsors , Namely Gamma Civic Special Thanks to Mr Patrick and Carl AH Teck , Hertogs Co Ltd Special Thanks to Mr Benydin Promedica Laboratory Special Thanks to Mr Sheik Yusuf Oregon Trading Special Thans to Mr Hurloll Mr Vikash Lokun , all staff and directors of La Grand Gaube Hotel Without Their help This event would not have been possible

I will end up with a saying of the Mahatma Gandhi "If we have to make progress, we must not repeat history but make new history." Thank you , Ladies and Gentlemen for your attention Long live the association of Biomedical Analysts


Collaborative work between the ABA, The University of Westminster, UK and The Central Health Laboratory, Candos Mauritius As appeared in L'express Dimanche of 15th July 2001 ( Website link:http://www.lexpress-net.com/archives/1507/La_une/actu_0107.html)
    CANCÉROLOGIE

Les maladies vénériennes
mises en cause


Deux cents cas mauriciens sont à l'étude en Grande-Bretagne pour établir un lien entre les MST et le cancer du col de l'utérus.

 

Certaines infections ne peuvent être détectées que par des analyses.

Les maladies sexuellement transmissibles (MST) favoriseraient-elles le cancer du col de l'utérus ? Deux cents prélèvements effectués chez des Mauriciennes atteintes de ce cancer seront analysés par une équipe de chercheurs de l'université de Westminster, en Grande-Bretagne, à laquelle appartient Sanjiv Rughooputh, membre de l'Association des analystes biomédicaux (AAB) de Maurice. Les premiers résultats seront connus dans six mois.

Ces analyses moléculaires, menées en collaboration avec le laboratoire central de Candos et l'AAB, permettront d'établir si les malades ont contracté préalablement une maladie vénérienne et de définir le lien entre les MST et ce cancer. On sait en effet que le papillomavirus est associé au cancer du col de l'utérus. Par ailleurs, d'autres études en Scandinavie, à Taïwan et en Chine ont montré que les chlamydiaes et les trichomonas vaginalis seraient également étroitement impliqués.

Les scientifiques ont déjà démarré leurs études il y a plusieurs mois sur des patientes anglaises. Les tests ont révélé que 40 % d'entre elles avaient effectivement attrapé une MST avant de développer un cancer.

Des infections silencieuses

Sanjiv Raghooputh, qui prépare son doctorat en microbiologie et en biologie moléculaire est actuellement à Maurice. Il accentue ses recherches sur les trichomonas vaginalis, agents de nombreuses MST et les chlamydiaes, bactéries vivant à l'intérieur des cellules et responsables de multiples affections. "Chez les personnes infectées par les trichomonas, il y a un écoulement écumeux et purulent. Chez les femmes, ces bactéries peuvent envahir la muqueuse du col de l'utérus, provoquant des lésions," explique-t-il.

En revanche, 90 % des infections causées par les chlamydiaes sont asymptomatiques, c'est-à-dire que les personnes porteuses (dont 80 % sont des femmes), ne montreront aucun signe d'infection. Ces bactéries croissent à l'intérieur des cellules du col de l'uterus. Ainsi, une femme enceinte porteuse de chlamydiaes, peut contaminer son bébé et provoquer chez ce dernier une infection des yeux, qui, si elle n'est pas soignée, peut entraîner une cécité.

Lorsqu'elles ne sont pas traitées, ces deux infections (trichomonas vaginalis et chlamydiaes) provoquent plusieurs complications : colique, grossesse extra-utérine et stérilité. Elles provoquent également des ulcérations et des lésions du col de l'utérus qui favorisent le cancer. Chaque année, il y a dans le monde 500 000 nouveaux cas de cancers du col de l'utérus. A Maurice, chez les femmes, c'est le deuxième cancer le plus fréquent après celui du sein.

Si les données permettent d'établir qu'il existe également chez la majorité des patientes mauriciennes, un lien entre les MST et le cancer du col de l'utérus, l'AAB cherchera d'autres fonds afin d'approfondir ses recherches.

Saphira KALLEE

AAB : Une association très active

L'Association des analystes biomédicaux a été fondée en 1995 avec un objectif principal : professionnaliser davantage les laborantins à travers des stages de formation, des séminaires et des conférences. La plupart de ses membres travaillent au laboratoire central de Candos. Depuis plusieurs années, l'association travaille sur divers projets scientifiques avec l'université de Westminster. Grâce à cette collaboration, l'AAB a pu négocier un rabais de 20 % sur le coût des études pour deux étudiants mauriciens désirant faire, chaque année, une maîtrise en sciences biomédicales. Ajeet Mathur, membre de l'AAB qui prépare actuellement sa maîtrise, rejoindra l'équipe de chercheurs, ainsi que Safina Kureeman, autre compatriote qui vient d'obtenir une licence en biotechnologie