I WAS diagnosed with pneumonia and being treated for pneumonia until I got to London where I was told I had cancer of the lungs”. Gani Fawehinmi (1938 – 2009).

These are the words of the Late Chief Fawehinmi, a politician,  social critic, human and civil rights lawyer, and a senior advocate of Nigeria , SAN,on his health conditions before his death. He died on 5 September, 2009 of cancer of the lungs. Had this cancer been detected earlier, given the quality management he had, perhaps, he might have been here with us today. Cancer of the lungs, like most other cancers, are curable or at least, more manageable when detected in their early stages than when detected in their later stages.

Gani’s case was very unfortunate. He sought for quality care from health facilities in Nigeria but these facilities failed in their duty to deliver quality care to him. Although Gani did not mention the facilities he was wrongly diagnosed before his eventual trip abroad, one could easily assume that these facilities had the cosmetic trappings of quality – fine buildings, clean environment, professionally-looking staff, shiny equipment etc. They, however, lacked the basic essence of a medical laboratory which is to provide high quality diagnostic services that meet the needs of patients and the healthcare personnel.

Generally speaking, quality is a measure of excellence or a state of being free from defects, deficiencies and significant variations, brought about by a strict and consistent commitment to certain standards that achieve uniformity of a product in order to satisfy specific or user requirements. In medical diagnostics, quality could be a matter of life and death. This is the reason pathologists get very finicky when issues of quality come up.

One must acknowledge that quality in healthcare is not just a Nigerian problem but a big global medical issue. We were told of how Dora Akunyili, Nigeria’s one-time information minister and a former director-general of the National Food and Drug Administration and Control, NAFDAC, fell victim of misdiagnosis in the United States. While Dora and Gani may just be two of the most celebrated cases of misdiagnosis, a lot of other Nigerian patients, whose cases of misdiagnosis are hardly known, are sent daily to their untimely graves.

I once attended a quality seminar where the facilitator, Janette Wassung, a quality management consultant from South Africa, told a story of a mother of two who was diagnosed with neuroendocrine cancer at the age of 34 and was told she only had months to live. She underwent five surgeries to excise cyst from her gum, remove lower jaw and teeth and face reconstruction with bone taken from her lower leg. This woman was shocked to hear, when another biopsy was done, that she never had cancer in the first place. It was later discovered that the slides from the biopsy of the cyst that was taken from her was contaminated by cells from another patient which led to the unfortunate misdiagnosis.

In healthcare delivery journey, diagnosis is the route that takes the driver (medication/doctor) and the passenger (the patient) to the destination of patient’s recovery. Once the route is wrong, as in cases of misdiagnosis, both the driver and the passenger will never get to their destination. On the contrary, misdiagnosis could lead to number of unpalatable circumstances including death, unnecessary and elongated treatment with the attendant high costs. It could also result in lengthy and costly litigation for the laboratory.

The only panacea to the issue of misdiagnosis is the deployment of a good quality management system (QMS). A good QMS is an end-to-end affair, covering the collection, transportation and reception of samples; reagents, instruments used and personnel who conduct the test; as well as the result format, international unit of measurement used and number of pathologists that interpret the results. To show how important the issue of quality laboratory testing is, the International Standard Organization dedicated a section to medical laboratory quality process, tagged ISO-15189. This standardisation ensures that the issue of misdiagnosis does not even come up at all. In Nigeria unfortunately, only one laboratory has adopted this international benchmark as well as the attendant accreditation as at today.

If as a nation, we are serious about improving our healthcare delivery, we should begin with the enthronement of quality laboratory testing. As a fulcrum on which the entire healthcare delivery system revolves, an efficient laboratory testing eases up the journey towards wellness. To do this, the government should encourage our medical laboratories to adopt the ISO 15189 standards and accreditation. This encouragement may be in the institution of workable timelines for laboratories in Nigerian to seek and get this all-important accreditation.

As the world celebrated the World Quality Day yesterday, a day set aside to create awareness for the important role quality plays in bringing about nations’ prosperity, let us resolve to enthrone a good quality management system in our healthcare delivery.

Mr. Precious Anyiwo, a Medical Laboratory scientist,works with Pathcare Laboratories, Lagos.