August 14 - Succeed We MUST

On this day, we went to Mbarara University of Science and Technology (MUST), which is one of the top institutions for education and medical care in Western Uganda. MUST is adjacent to the Mbarara Regional Referral Hospital, and the pathology team sits at the intersection and serves the Western Uganda region.

MUST is Dan's alma mater, therefore we had an easy time navigating the grounds of the hospital and pathology lab. At MUST, we met with Dr. Mitala Yekosani, senior pathologist and co-PI on our Institutional Review Board (IRB) agreement. We were introduced to Dr. Raymond (pathology department head), Dr. Francis, and Dr. Benon - who all support the MUST pathology department. We shared the progress on the Ekyaalo technology with the whole team and discussed the pathology landscape at length. Some notable points from our conversation include:

"There’s too much on the plate of doctors at HCIVs. It would be good for people who are dedicated to lab work at HCIVs to operate this intervention." 

• Lab technologists at HCIVs could be trained to perform FNAC.

• Lab technologists' other responsibilities include reviewing blood and malaria smears 

  • They know general pathology (they have a Bachelors degree) 

• They can stain and fix slides

• Very few Regional Referral Hospitals have pathology services. < 10% have it 
  

Discussion with the MUST pathology department

We also discussed slide stains in Uganda. Interestingly, MUST uses H&E stain for the slides that they process. This is unique to this center and the reason for it is due to a group of Cuban medical professionals who sponsored much of the health center's early infrastructure, equipment, and tools. An advantage of H&E is that this stain can also be used for the interpretation of histology (tissue samples), whereas Diffquik (used by the rest of Uganda) is useful only for cytology samples. H&E is also used in HCIVs for malaria diagnosis. There is a learning curve for folks who are used to H&E interpretation to get used to interpreting Diffquik-stained slides, but based on examples of MUST graduates who move on to practice at other health centers in Uganda, this curve takes only about one month.

Finally, it was great to validate the product's use-case with the MUST pathology team - some of whom were hearing about Ekyaalo Diagnostics for the first time.

The following quotes were from the pathology team following our product presentation.

"This is a beautiful idea." 

"This intervention would also increase awareness of pathology services below the regional referral hospital level which is a positive thing."