The acute shortage of hematologists in Sub-Saharan Africa has given rise to an urgent need for training to help address increasing cases of blood disorders, scientists say.
The World Health Organization (WHO) recommends one clinical hematologist per 100,000 people in every country to diagnose and treat patients with diseases of the blood and bone marrow. But African countries fall well below this target, according to Vernon Louw, head of the Division of Hematology at the University of Cape Town (UCT) and Groote Schuur Hospital, South Africa.
“Clinical hematologists have been needed for a very long time [in Africa] but there are very few training centers and training positions,” Louw tells SciDev.Net. “Several medical schools do not have a single clinical hematologist.”
South Africa, with a population of almost 60 million people, needs about 600 hematologists to meet the WHO target, but the country currently has fewer than 30 hematologists, according to a press statement by the UCT last month.
According to Louw, there is an urgent need to train hematologists on the continent. “Angola, Botswana and Namibia do not have a single clinical hematologist … while Malawi and Zimbabwe have just one each,” he says.
Louw explains that hematologists treat a very wide range of disorders and conditions, including cancers of the blood and bone marrow such as myeloma, lymphoma, leukaemia, anemia and thrombosis, which are very common conditions.
“In the past five to ten years, eight clinical hematologists have completed training at the [Division of Hematology at the UCT…and there are another four currently in training,” he tells SciDev.Net.
The goal, he explains, is to train African clinical hematologists and increase the alarmingly low number of specialists on the continent who are equipped to help treat and manage blood disorders.
“There is a massive population of patients out there with treatable and oftentimes curable cancers and diseases. If they are not seen and treated by an appropriately trained person, these conditions are often fatal,” Louw explains.
He tells SciDev.Net that the greatest challenge is inadequate funding for trainees, adding that in the past, his institution organized some outreach programs in African countries to help train hematologists but it was not successful.
He calls on policymakers to consider the selection of centers to train clinical hematologists in Africa by subregions including Southern, East and West Africa.
Walter Mwanda, professor of hematology and blood transfusion at the University of Nairobi, Kenya, says that one of the main reasons for this shortage is because there are no clear training paths for hematologists.
“Hematologists ideally belong to any of the following disciplines: internal medicine, obstetrics, pediatrics … and general [medicine],” Mwanda says.
He adds that currently after postgraduation, most clinical students tend to stick to subspecialties such as internal medicine, and are reluctant to specialize in hematology which would require further intensive training.
“This situation can be improved by stating the pathways of becoming a clinical hematologist, what work is involved and upward movement,” explains Mwanda, adding that there should also be sponsored programs to incentivise trainees and trainers.