Fighting the Good Fight

Photos: courtesy

The 68-year-old specialist physician, Dr MB Zaman is a pioneer in the field of Histopathology and Cytopathology – used for the diagnosis of cancer worldwide. The term Histopathology is basically a microscopic examination of a piece of excised tumour, to determine the type/source of the tumour, and whether it is malignant or not. On the other hand, Cytopathology is a cell sample of the tumour, obtained as an office procedure by a 22-gauge or smaller diameter needle, for microscopic examination to diagnose cancer.

Starting off in 1993 till today, Dr Zaman has been conducting a total of ten workshops in Bangladesh, teaching the modern method of cancer diagnosis for the postgraduate students, young pathologists and also for the experienced pathologists of the country. He was the first, who introduced the technique of Fine Needle Aspiration Cytology (FNAC) for tumour diagnosis in Bangladesh. Later, he was assisted by two specialised expatriate pathologists Dr Monowar Hossain (from Canada) and Dr Humayun Kamal Islam (from USA) who are expected to be the future conductors of this workshop.

The goal is very simple, to elevate the standard of pathology service. Most importantly, Dr Zaman conducts the workshops free of cost and charges minimal registration fees at the Bangabandhu Sheikh Mujib Medical University (BSMMU). Such trainings abroad are very expensive as opposed to the course being taught here.

The course director has been coming and staying in Bangladesh accompanied by two of his established fellows and teaching 150 and more students on a regular basis. Over 300 pathologists attend his courses, learning about the latest and improved methods of practicing Histopathology and Cytopathology.

"Our future plan is to continue with these workshops and to look into the possibility of live web-casts of lectures through WebEx or similar portals, share and spread our knowledge," says Dr Monowar Hossain, one of the associates of Dr Zaman's Cytology workshops.

Now-a-days, in Bangladesh, the cancer diagnosis process has flourished to a great extent. But, in the late '80s, the scenario was different. The technique of Fine Needle Aspiration Cytology (FNAC) to diagnose cancer from a cell sample was not introduced back then. Also, there were no specialised teaching microscopes available; the quality of the microscopic slides was not that much optimal. In addition, the latest editions of the pathology books and current journals were not available at the postgraduate institutes.

According to World Health Organisation (WHO), in the 80s, every year about 0.2 million people developed cancer in Bangladesh. Eventually, WHO recommended the introduction of cancer screening and control in the country. Among the cancer patients, a large percentage was female, suffering from cervical cancer – that arises from the uterine cervix. But the test called 'Pap-smear cytology', the only proven method of early cervix cancer detection was almost non-existent in Bangladesh.

In February 1993, Bangladesh Society of Pathologists invited Dr Zaman to participate in the third congress of 'Asia Pacific Association of Societies of Pathologists' which was held in Dhaka, in collaboration with WHO. Through the first formal cytology workshop, he pioneered the teaching of the technique of FNAC for tumour diagnosis in Bangladesh.

"Within two years, Dr Zaman returned to BIRDEM with study sets to teach Pap-smear cytology", says Dr Farzana Tabassum, Assistant Professor of Department of Pathology at Ibrahim Medical College, Dhaka. "Early diagnosis of cancer was no more an issue, and successful cancer detection and diagnosis flourished rapidly."

Through these workshops, a change occurred for the better, and changes are still happening. There were donations made by many and purchases made of specialised microscopes, teaching microscopic slide sets. Furthermore, different kinds of books and journals related to this field were introduced by the faculties on each trip and disseminated to the students.

"The interest, enthusiasm and respect shown by the students are the driving force in continuing these teaching courses," says Dr Zaman. "There is a spiritual satisfaction."

Being very much a private person and avoiding publicity, Dr Zaman continues with the workshops with the help of others even after his retirement. His dedication and contribution in the field of cancer diagnosis is an outstanding achievement for Bangladesh.

Dr Zaman was born in a village called 'Shaldigha' in Sylhet. Academic excellence opened doors to full scholarships to study MBBS at the King Edward Medical College, Lahore.

A competitive US exam (ECFMG, now called USMLE) brought him to New York in 1970 for a postgraduate medical training. He became a specialist in Histopathology (5 years) and then completed a Fellowship in Cytopathology (1 year) in the world famous Memorial Sloan-Kettering Cancer Centre. He was reputed for his excellence in what he did and passed all the postgraduate exams which resulted in an offer of staff position in that institute.

In 1991, after moving to the northern suburb of New York, he became a Professor of Pathology at the New York Medical College. He was also the Director of the Training Programme and recruited a number of Bangladeshi Residents; a handful of them are nationally known Pathologists and accompany him to Bangladesh for teaching.

Dr Zaman has written 34 articles, eight reviews and several book chapters related to Cytopathology. Recently, he has published all the abdominal organ chapters in the book of Dr. Leopold Koss, who's book is the standard text of Cytopathology and a "must have" for the pathologists.