There has been a huge disregard for professional boundaries and ethical standards in Nigeria, especially as seen by the practitioners of Science Laboratory Technology (SLT) in Nigeria. In order to understand this malady that has so much ravaged our system, it may be necessary to give a general overview of the two bodies mentioned above.
The Medical Laboratory Science (MLS) Programme
Medical Laboratory Science (MLS) is a globally recognized health profession that has the university training, skills, competence, and licence to run diagnostic laboratory tests, quality assurance and other roles in the human healthcare system. In some countries like Nigeria, they may also be involved in animal health by way of laboratory testing. The profession is regulated by the Federal Government through the Medical Laboratory Science Council of Nigeria (MLSCN), under the Federal Ministry of Health. Medical Laboratory Scientists (Biomedical Scientists in the UK) the world over, specialise in any of the following specialties: Chemical Pathology, Haematology/Blood Transfusion Science, Medical Microbiology/Parasitology, Histopathology/Cytology. Medical Laboratory Science is a five (5)-year university programme, leading to the award of Bachelor of Medical Laboratory Science (BMLS) degree, after which the graduate MLS must undergo a one (1)-year compulsory internship training before embarking on the national service (NYSC). They have advanced academic (MSc and PhD) programmes, as well as National Fellowship (FMLSCN- Fellowship of the Medical Laboratory science Council of Nigeria) and West African Fellowship (FWAPCMLS – Fellowship of the West African Postgraduate College of Medical Laboratory Science), as is the tradition among all healthcare professionals.
The Science Laboratory Technology Programme
On the other hand, Science Laboratory Technology (SLT) is an amorphous group of people who work in the science and technology sector under the Federal Ministry of Science and Technology. The amorphous nature of SLT results from the fact that they are meant to serve as Technologists (technical staff) in every field under the Ministry of Science and Technology. In other words, SLT is not actually a profession but a conglomerate of people whose duty is to provide technical support to other professionals. Thus, a graduate of the SLT programme has to choose one of the following majors: Petroleum/Geology Technology, Physiology/Pharmacology Technology, Physics/Electronic Technology, Chemistry/Biochemistry Technology, Biology/Microbiology Technology, Food Technology, Biomedical Technology, etc. It is evident that SLT graduates are trained to support graduates of other fields especially in the research laboratory. They cannot in any way replace the core professionals in the science and technology sector. In other words, they are essentially “technical staff” of any organisation, since, for example, an SLT in Petroleum/Geology Technology cannot replace the Petroleum Engineer or Geologist in an oil firm, neither can an SLT in Chemistry/ Biochemistry or Pharmacology replace the Chemist/ Biochemist or Pharmacologist in any organisation.
There is no way an SLT in Biomedical Technology will understand and practise Physiology or Anatomy more than the graduate of Physiology or Anatomy. The SLT programme can be found in either a university (which awards Bachelor of Technology, B.Tech) or a polytechnic (which leads to the award of OND/HND). There is no formal internship training either in a hospital or any other facility).
The Medical Laboratory Science Council of Nigeria (MLSCN) Act
Incidentally, the MLSCN Act 11, 2003 [Cap M25 LFN, 2004] which established the Medical Laboratory Science Council of Nigeria, clears defines Medical Laboratory Science as: “(a) the practice involving the analysis of human or animal tissues, body fluids, excretions, production of biologicals, design and fabrication of equipment for the purpose of medical laboratory diagnosis, treatment and research; and (b) includes medical microbiology, clinical chemistry, chemical pathology, haematology, blood transfusion science, virology, histopathology, histochemistry, immunology, cytogenetic, exfoliative cytology, parasitology, forensic science, molecular biology, laboratory management; or any other related subject as may be approved by the Council;”.
Nigeria Institute of Science Laboratory Technology Act
On the other hand, the Act establishing the Nigeria Institute of Science Laboratory Technology (NISLT Act 12, 2003) does not define what SLT actually means (see Section 23 of NISLT Act). In fact, the practice guideline released by NISLT classified all their practice into Chemical, Physical and Biological laboratories. Absolutely nothing medical! Thus, SLT practitioners have no place in healthcare. In Fact, the Government has never classified them as part of “human resources for health”. The function of SLT is stipulated in Section 2 (2l) of the NISLT Act, which provides that NISLT is empowered to “conducting inspection of science laboratories in schools, post-secondary institutions, industries and research institutes in order to improve the professional standards”. Any attempt by SLT graduates to want to usurp the position of the owner of the field they are meant to support can only make them to appear as “meddlesome interlopers” in that discipline in the field of science and technology. This probably explains why SLT has no professional equivalent anywhere in the world! Readers can search the internet to see if SLT has any professional equivalent in the world.
The Federal High Court Judgement
On the 25th day of April, 2023, the Federal High Court, sitting in Calabar, Cross River State, Nigeria, presided over by Hon. Justice S.A. Amobeda, delivered a judgement in a quackery suit filed by the Federal Government against two SLT practitioners. The duo was accused of practising Medical Laboratory diagnostic services against the provisions of the Laws of Nigeria. The Judge acquitted them of the impersonation and quackery charge brought against them, stating that there was not cogent evidence before him to prove the charge of quackery in order to convict them. In other words, the Judge recognizes that they were not supposed to practise MLS but that the prosecution Counsel could not proffer compelling evidence to prove the charge of quackery before the Court. This judgement is the reason for the jubilations among SLT practitioners, and the spurious social media publications propagated by the SLT practitioners.
It is baffling that people who did not study any course under medical sciences, and whose supervising Ministry is the Ministry of Science and Technology, would want to run diagnostic tests that would be used to treat human beings. You cannot study “Technology” in the university or polytechnic and then find yourself performing functions of another profession, in this case, performing diagnostic tests, which the Laws and training all over the world have put under the domain of Medical Laboratory Scientists. Only God knows the number of persons who have the “SS” genotype today, especially in Ikom area of Cross River State and indeed Nigeria, simply because these SLT guys gave their parents results showing that they the “AA” genotype, which the Church or Court may have used as basis for the marriage that eventually produced sickle cell (SS) children. It will also be worrisome to think of the number of innocent persons being given antibiotics and other drugs based on the laboratory results generated by these SLT practitioners.
In a sane country, this matter would be of great concern to the government. But alas! This is Nigeria. It beats the imagination of any sane mind that someone who studied one Technology option or another, will rejoice in doing what they do not have the training, competence and licence to do, especially as affecting human life.
In the said judgement, the Hon. Judge stated thus “…after a careful examination of the totality of evidence before me, it is clear to me that the claim of the prosecution that the defendants were operating medical laboratory services outfit is not based on any cogent, credible and convincing evidence, but rather upon mere suspicion…the prosecution has failed woefully to establish the important ingredient of the offence of quackery and as such the offence of quackery cannot be sustained against the defendants…consequently, the defendants are hereby discharged and acquitted. I so hold”. It is thus clear that if the case of quackery was successfully established against these SLT practitioners, they would have been jailed. So, why would these SLT practitioners be charged by the government for quackery in the first place if they have the requisite training and licence to practise Medical Laboratory Science? What if this case goes to the Court of Appeal and there is conviction of these SLT practitioners? Clearly, SLT practitioners are not permitted under the Laws of Nigeria to run medical laboratory tests. One wonders why they had to go about telling Nigerians that the Federal High Court, Calabar division, has empowered them to practise “clinical laboratory practice”. This is a classic example of lack of commonsense.
The Way Forward
One could be wondering how these SLT guys got the idea of medical laboratory practice in the first place. It is a result of the unethical practices of some MLS practitioners over the years who allowed students of SLT, Microbiology, Biochemistry, Physiology, Anatomy, to do their so-called industrial training (IT) in medical laboratory facilities. This anomaly has been supported over time by some physicians, and heads of government and private hospitals just to spite the MLS profession because of the inter-professional rivalry in the health sector, just as they train so-called “auxiliary nurses” in their private hospitals. These students graduate and go to the hinterlands to practise quackery, as in the instant case which occurred in Ikom LGA of Cross River State. So, when it comes to quackery in the health sector, medical doctors, Medical Laboratory Scientists, Pharmacists and Nurses have in one way or another contributed immensely to the menace. The regulatory Councils for these professions (MLSCN, MDCN, PCN, NMCN) have, through poor regulation or pecuniary considerations, also contributed to the menace.
The Government also shares in the blame. It has failed to enforce the relevant Laws and Acts of the National Assembly in order to bring about sanity in the health sector. The Government has not mustered the political will to sanitise the health sector, nor has it enforced respect for professional boundaries and inter-professional respect and teamwork. It is time for the government to beam its searchlight on the health sector in order to root out the rot in that sector in the interest of the health of the masses. Also, the Medical Laboratory Science Council of Nigeria (MLSCN), Association of Medical Laboratory Scientists of Nigeria (AMLSN), Guild of Medical Laboratory Directors (GMLD), Association of University Academic Medical Laboratory Scientists (AUAMLS) and other stakeholders in the Medical Laboratory Science profession should be proactive enough to exercise their professional duty of protecting the health of the populace, which they swore on oath to do as practitioners. They should realise that nobody else will protect their professional boundaries for them. The practitioners of SLT should learn to practise within their mandate as enshrined in Section 2 of the NISLT Act, especially Section 2(l), which provides that NISLT is empowered to “conducting inspection of science laboratories in schools, postsecondary institutions, industries and research institutes in order to improve the professional standards” (hospitals, clinics or other health facilities are not mentioned here, neither is there a mention of diagnostic testing to be performed by SLT practitioners. They should focus on laboratories in secondary schools, higher institutions of learning and industries, as provided for them). The FG and some State Governments have issued several circulars and memos directing the SLT to focus on their area of practice. It seems that these directives have continually fallen on deaf ears. They should understand Section 18 (2) of MLSCN Act which provides that “Subject to the provision of this Act, no person not being a fully registered medical laboratory scientist under this Act shall be entitled to hold any appointment in the Public Service of the Federation or state or any public or private establishment, body or institution, if the holding of such appointment involves the performance by him in Nigeria or any act pertaining to the profession of medical laboratory sciences for gain.”.
And, Yes! There are many laboratories – but the medical laboratory is in a class of its own. The war against diseases can only be won (or lost!) in the medical laboratory. That explains why Section 19(1)(d) of MLSCN Act empowers the MLSCN Board to ensure “the maintenance of good standard of medical laboratory practice and services with respect to regulation and control of private practice including statutory inspection, approval and monitoring of all medical laboratories including those adjoined to clinics, private and public health institutions”. Anyone who desires to practise MLS should enrol for it in any university of their choice and obtain the BMLS degree and licence to practise.
Written by Dr. Kemzi Elechi-Amadi (BMLS, MSc, PhD, HMD, AMLSCN).
Dr. Elechi Amadi writes from Port Harcourt, Nigeria.
DISCLAIMER: The views expressed in this opinion article are entirely those of the authors and not in any way reflect the views of this blog