Pathology consultant lends expertise overseas
Dr Michael Coutts, Consultant Gynaecological Pathologist at Maidstone and Tunbridge Wells NHS Trust, has been working alongside a team of pathology professionals from the UK on a cervical screening programme in Moldova, supporting all areas of the new cervical screening process, from planning its development to welcoming its first patients.
Dr Coutts offered his expertise in histology, which is one step of the whole process, concerned with the tissue diagnosis of cancer and identifying precancerous states from biopsies.
A fundamental part of Dr Coutts’ involvement was providing training and education on screening and identifying abnormalities in cervical cells. Despite challenges posed by the country’s technical infrastructure, Dr Coutts delivered workshops and webinars to the majority of Moldovan pathologists working in the state sector. The quality of lab processing and medical interpretation has since dramatically improved.
As one of the poorest countries in Europe, Moldova required support in developing a cervical screening process for women which would improve the health of its public. The United Nations Population Fund (UNFPA), a branch of the UN concerned with women and children’s health, and the Ministry of Health of the Republic of Moldova approached the Royal College of Pathologists and the International Cervical Cancer Prevention Association (ICCPA) in 2016 for support in developing an effective cervical screening service.
In 2016, Moldova’s cervical cancer survival rate was only approximately 50% with the country seeing some 500 cases a year and 250 deaths, with a population of 2.8 million people. The UK sees 3,300 cases of cervical cancer per year with 850 deaths, despite a much larger population of 68 million.
In 2016 and 2017, Dr Coutts also welcomed pathologists from Moldova to shadow him on training placements. The visitors gained valuable insight into histological and pathological practice which they could feed back to their colleagues in Moldova. Since then, Dr Coutts has expanded his teaching to cover other areas of gynaecological cancer diagnosis including ovary, uterus and fallopian tube, so that these other types of cancers are more effectively managed by Moldovan clinicians.
Reflecting on the project, Dr Coutts said: “It has been a pleasure to work with colleagues in Moldova and to combine our expertise to effect real change. It is an honour to be part of this project of international development, and I would like to thank MTW for their support and flexibility. Without the Trust’s willingness to support my involvement in this project and accommodate our visitors from Moldova, its success would not have been possible.
“There is now a cervical screening process in Moldova, a wonderful achievement for the country and for those who worked on the project. Gynaecological cancer diagnosis in general is also improving. I look forward to continuing to work with colleagues from both the UK and Moldova to further improve the process and make a difference to health outcomes.”
Dr Dominic Chambers, Clinical Director for Pathology, said: “Dr Coutts’ international development work is a great altruistic effort to establish a cervical screening programme and raise the standard of gynaecological pathology overseas. It has been a pleasure to have fellow pathologists from Moldova within the department and with the use of distance learning Dr Coutts has also been able to operate a web-based lecture series. This is an excellent, innovative service and we are happy to support Dr Coutts with this.”
Dr Coutts’ support continues, as Moldovan colleagues continue to share cases with him to corroborate their findings with his professional opinion. Plans are developing to welcome more pathology colleagues to Maidstone Hospital to spend time with the teams and further their practice.