Tamiwe Tomoka – Lead pathologist UNC-Mw cancer consortium

Tamiwe Tomoka is the lead pathologist for University of North Carolina (UNC)-Malawi Cancer Consortium providing diagnostic services for cancer to Kamuzu Central Hospital (KCH) and other hospitals both public and private in the north and central regions of Malawi.

She also renders pathology support to different research activities with interest in cancer at UNC-Malawi Project.

Being a doctor is not what this kind and selfless woman always aspired to be. In her early years of secondary school studies she dreamed of becoming an engineer.

“My interests switched to medicine later because I used to help in taking care of sick friends in school to the extent of being their guardian when admitted to Zomba General Hospital while waiting for their families. In addition we had a neighbour who was a nurse and I admired her a lot, but she used to advise that I should be a doctor instead,” says the mother of three boys.

She joined the pathology department at College of Medicine (COM) as assistant lecturer in 2005. In 2007 she went to University of Cape Town, Groote Schuur Hospital to specialise in anatomical pathology, and qualified as a specialist pathologist in 2011, becoming a fellow of the College of Pathologists South Africa (Anatomical Pathology).

When she came back to COM, she rose through academic ranks from assistant lecturer to senior lecturer in 2014 and head of department in 2015. In June 2016 she joined the UNC-Malawi project and took an honorary senior lecturer position with COM, offering teaching support in the discipline of pathology – the study of the scientific basis of disease.

Pathologists basically explain what the disease is, what causes it and how it happens [processes that happen in the body for the disease to manifest as symptoms and signs].

Tomoka is a medical doctor who specialised in anatomical pathology. As such she makes diagnoses of various diseases including cancer, by examining body tissues using specialised methods with the aid of a microscope. She also examines dead bodies to establish the cause of death, and conducts research in causes of disease with special interest in cancers.  She also does post-mortems but that is not a big part of her job at the moment.

With special interest in breast cancer research, the easy going and down to earth pathologist says: “I have worked on several research projects, including Malaria, cancer, especially HIV associated cancers, Tuberculosis just to mention a few as an investigator. I am still working on HIV associated cancers. However in the past year I realised that we have a lot of breast cancer cases in Malawi but there are minimal efforts in regards to research on this disease in our setting. Much of what we know is from studies from beyond Africa. What is it that drives the occurrence and behaviour of breast cancer in our setting? We do not know. So, I thought I should diversify and concentrate on breast cancer research.”

The UNC-Malawi Cancer Consortium has just started work on breast cancer on epidemiology, including risk factors, tumour biology, clinical correlates, treatment modalities and outcomes/survival.

The fact that pathology is the core of medicine and that she can make a definitive diagnosis on a patient because she is directly examining samples of their body tissues, is what she likes most about her job.

As much as pathology is a tough profession, Tomoka notes that it has reasonably flexible working hours.

“It is rare to have emergencies, night calls or sleep at the hospital in this job. It is great for those women who want to raise a family and have time for fun,” she says.

Although that is the case, she faces a couple of challenges. But as a woman who is smart and tough with mental stamina she always survives even in those situations that may be perceived as challenges.

“My biggest challenge is practising pathology in a resource limited setting. I am a rich resource and very talented with great knowledge but what I can offer is limited in our setting.

“However through projects, Malawi has made huge strides in the last five years in regards to pathology laboratory capacity building. But as a nation we can do better and need more efforts, especially from the Ministry of Health and other partners, including private,” she explains.

Married to Noel Tomoka, an accountant working for the National Bank of Malawi internal audit division, Tamiwe comes from a family of seven children where she is the fourth born.

She was the principal investigator (PI) for a project that facilitated establishment of pathology laboratories at Queen Elizabeth Central Hospital (QECH) and Lilongwe UNC/KCH. She has also been involved in training technologists and pathologists and two of them have since qualified.

She was also director for another project Helse Nord TB initiative with interest in TB epidemiology and laboratory diagnosis.

“It was when I was on this project that I enrolled for a Masters in Epidemiology with London School of Hygiene and Tropical Medicine which am finishing this year,” she narrates.

Her academic journey begun with primary school studies at St Pius and Blantyre Girls, and she proceeded to St Mary’s Secondary School in Zomba.

She then went to Chancellor College for two years before applying for admission into College of Medicine. She successfully graduated with Bachelor of Medicine and Bachelor of Surgery (MBBS) in Dec 2003, and interned at QECH up June 2005.

In her concluding remarks, Tomoka appeals to Malawians to appreciate the role of laboratory in the practice of medicine.

“Without the laboratory, there is no evidence-based medical practice. A laboratory is not only for research.  Therefore, when we are developing or designing health related programmes, the laboratory should not be sidelined.

“I would also like to encourage girls to remain in school and appeal to society to keep girls in school. For those that can afford, let us support the needy girls to get an education. But in our efforts let us not forget the boy child lest we breed monsters,” she cautions.

As a country, we have five practising Malawian pathologists with different interests in the field of anatomical pathology, one expatriate and one retired with a recent addition of another female pathologist Dr Yambaso Manda, a highly driven colleague now stationed at QECH.