Angus McCraw: taking action to improve diagnosis

When biomedical scientist Angus McCraw began collaborating with the NNHF in 2011, his aim was to address a very specific set of challenges: the lack of skills, personnel and facilities to diagnose haemophilia in developing countries. Today, Angus has trained more than 190 lab technicians from 31 countries and provides ongoing advice to NNHF partners.

The consequences of a lack of adequate diagnosis are numerous. People living with haemophilia do not realise they have the condition. For those that are diagnosed, their diagnoses can be inaccurate, leading to incorrect care and treatment. Without the data to demonstrate accurate numbers of people with haemophilia, healthcare authorities are reluctant to allocate resources to ensure appropriate care.

Combining expertise with a tailored approach

Angus started working with the NNHF to develop a training programme focused on lab diagnosis in developing countries, explaining, “the people in these countries benefit from training because they very often don’t have the opportunity to have a specific training in the field of diagnosis of haemophilia and indeed the diagnosis of bleeding disorders.”

As a biomedical scientist, Angus has the technical expertise to deliver the training. Beyond this, Angus adapts his approach to suit the environments of those receiving the training. In some countries for instance, the frequency of power cuts could be problematic, therefore he advises some partners to purchase freezers capable of lower temperatures than those used in developed countries, to ensure reagents remain at the optimum temperature. He undertakes research before each training to understand which equipment and computer systems are available to participants.

Sustainable and tangible impact

Angus knows that sustainability is key to creating long-term change. He ensures those he trains have the knowledge and skills to go on to train others in their countries. From his long experience volunteering with NNHF, he has many post-training success stories to share, from numerous countries across continents: China has introduced an external quality assessment scheme for its labs; after training with Angus in South Africa, David Ofusu from Ghana arranged a locally led workshop covering six regions of his home country; Sem Samey is now training his peers in Cambodia following his training.

Those he has trained frequently comment on Angus’ patience, humour and kindness, as well as the tangible impact of the training: “Thanks to his efforts, we are now able to diagnose haemophilia cases in Malawi. This has literally saved the lives of many people with haemophilia, not to mention the improvement in the health-related quality of life of all confirmed cases,” says Dr Yohannie Mlombe from Lilongwe, Malawi.

Although he retired from his role at the UK’s Royal Free Hospital in London seven years ago, Angus has no intention of slowing down his efforts to improve diagnosis. “My dream for haemophilia is for all countries across the developing world to be able to diagnose haemophilia and bleeding disorders with confidence and to give a unified approach to diagnosis.”