THINGS THAT MATTER - The heights by great men reached and kept

“The heights by great men reached and kept
Were not attained by sudden flight,
But they, while their companions slept,
Were toiling upward in the night.” (Henry Wadsworth Longfellow)

The University of the West Indies is about to celebrate the contribution of our retiring Chancellor, Professor Sir George Alleyne. This is, in an official, calendar sense, the end of an era, since Sir George entered the fledgling University College of the West Indies in 1951 to study medicine, in the third year of our existence. In those 66 years he has seen the University grow from a temporary refugee camp-site for Gibraltar and Jewish refugees in World War II – a campus of wooden huts on an abandoned sugar estate, and a first intake of 33 medical students – to an internationally renowned multi-campus university with some 60 000 students. It has produced 18 current or past Caribbean Heads of Government, cutting edge medical research, and is, in the words of past Vice Chancellor Professor Nigel Harris, “first port of call for Caribbean information and research”.

Sir George Alleyne, by choosing UWI over the option of Cambridge or Edinburgh, the traditional medical schools for ambitious Barbadians, confirmed a life-long commitment to the development of the Caribbean – the British West Indies in those old colonial days, 15 years before Independence. And his long and legendary career has been divided into three parts – first his career at UWI, from Gold Medal student to leading research scientist, to Professor and Head of the Department of Medicine at forty. The second or middle part of his career was spent at the Pan American Health Organisation (PAHO), first as Chief of Research in 1980, until he retired after two terms as Director, in 2003. In that same year, fourteen years ago, he began his equally distinguished regime as Chancellor of the UWI.

This column is really about his contribution to health in the Caribbean and the Americas. It’s been his passion for sixty-six years, and the evolution of his thinking from bright eyed medical student, through cutting edge research to progressive public health leader, has been eloquently covered in his many speeches all over the hemisphere. And the most cogent and important of these speeches have been gathered together in a splendid book “Health & Development in our Time”, published by Ian Randle Publishers of Jamaica. I had the privilege and pleasure of editing, and it was a rewarding task, to share at first hand the insights of a progressive public health visionary, and following the evolution of his thinking while at the head of the powerful hemispheric health agency, PAHO.

His emphasis has always been on the essential principle of equity, by which he explains in his preface that there can be no essential right to health as a state of being, but emphasising that the justifiable rights are the sanitary and social measures that allow persons to enjoy health. In other words, our goal should be “Health CARE for all”. And he’s at pains to point out that health is a social science.

The book is divided into three parts – the Mona years, the PAHO years and the post-PAHO years. It begins with the brilliant and provocative Charles Duncan O’Neal Lecture “Medical Research in the Caribbean”, given at the Queen Elizabeth Hospital on November 16, 1979. This lecture was conceived by the late James Williams, legendary hospital director, and Professor Sir Errol Walrond, Dean of Medicine, as a celebration both of the opening of the hospital 15 years earlier and of the contribution of National Hero Dr. O’Neal to Barbados – long before his formal acknowledgement as a National Hero. The powers that be in our Hospital really should resuscitate this brilliant memorial lecture.

The final section includes a series of lectures on HIV/AIDS, while Sir George was UN Special Envoy for HIV/AIDS. The largest, middle section contains the “heavyweight, game changing” lectures, including “Health for All – from Vision to Action” (in Washington) and “Equity and Health”, given in Hamburg on the eve of the millennium. Of particular importance to me was his lecture at the formal opening of the Chronic Disease Research Centre (CDRC), on November 14th, 1998.

The Centre first opened its doors in 1992, but this was the occasion when the restoration of the historic building at Avalon was completed.

In that lecture Sir George referred to the importance of research institutions working in partnership with government. When I returned home, government support for research was the token $2,500 per annum towards the annual Caribbean Health Research Conference! My vision was inspired both by the example of medical research in Jamaica, and by the seminal studies of Dr. William Hillary in Barbados nearly 300 years ago, leading to his brilliant book on “Observations on the Changes of the Air and the Concomitant Epidemical Diseases of the Island of Barbadoes”, going through four editions. If Barbados had such a rich history of science and medicine in The Age of Reason, I reasoned, let’s build on it to create cutting edge research – hence my passion to establish the CDRC 25 years ago, and its success story today.

Sir George emphasised the need for presenting research information so that its message can be applied in planning and programming of health care. He saw the contribution that the CDRC can make to our health care – both here and regionally – indeed internationally, as the Barbados Eye Studies, Stroke Studies and other major research studies (on ageing, diabetes, lupus, pregnancy, health and nutrition status etc.) have all done. He expressed the expectation that research quality would be as good as anywhere else in the world, and the latest reviews of the University’s Research Centres have rated the Centre very, very highly and of global excellence. And the functional merger of the CDRC and the Public Health Group of the Faculty of Medical Services, under the new Director Dr. Alafia Samuels, will drive research, policy and public health interventions, “completing the journey from evidence to outcomes”!

“Health and Development in our Time” should be essential reading for all doctors concerned about our health care. It is available at the University Book Shop, and all proceeds are given by Sir George to the Medical Faculty at Mona.

Bouquets: To our magnificent sportsmen and sportswomen, boys and girls, performing brilliantly in CARIFTA games (record breaker and gold medallist Jonathon Jones), CARIFTA Swimming Championships (stars Nkosi Dunwoody and Danielle Titus) CARIFTA Chess Championship (Leigh Sandiford et al), and World Surf League at Drill Hall Beach (Josh Burke et al). I hope our swimmers will inspire more of us to take to the water for the healthiest exercise of all!

(Professor Fraser is Past Dean of Medical Sciences, UWI and Professor Emeritus of Medicine and Clinical Pharmacology. Website: profhenryfraser.com)