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A lasting legacy in Jamaica

Babies from the sickle cell cohort and their mothers (Copyright: Graham Serjeant*)

Babies from the sickle cell cohort and their mothers (Copyright: Graham Serjeant)

The MRC has two research units in The Gambia and Uganda but we haven’t made a habit of setting up units around the globe. So when External Communications Officer Stacy-Ann Ashley found out about our former units in Jamaica, she decided to take a look at its work, from malnutrition research to a sickle cell study that is still producing results today.

Last year the MRC turned 100, and with such a long history, I often find myself saying “I never knew that”. One such moment was when I found out that the MRC had units in Jamaica between 1958 and 1999. As a Jamaican, I was intrigued. So I did a little digging.

The first MRC unit in Jamaica focused on tropical metabolism. It opened in 1958 with laboratories and a 16-bed ward with the aim of researching the metabolic and physiological mechanisms of severe acute malnutrition.

The unit Director, Professor (later Sir) John Waterlow, had first arrived in Jamaica in 1945 when the British Colonial Office asked him to research the high death rate of children under five years old on the island, as well as in Guyana and Trinidad.

After completing this work he realised that there was much more work to be done, so he approached the MRC to fund a new Tropical Metabolism Research Unit (TMRU). During the unit’s 12 years of research, and with support from Jamaica’s Ministry of Health, the child death rate from malnutrition dropped from 35 to five per cent. Before Waterlow’s retirement and the unit’s associated closure in 1970 he also established a Masters course in Human Nutrition at the University of the West Indies (UWI), where the unit was based. The MRC then transferred all of the unit’s research data to the university so they could build on the research.

Once TMRU had become part of the university it began to focus on the new epidemic of obesity and chronic disease in the Caribbean. However, it maintained its research in malnutrition as this was still a major cause of child death around the world.

TMRU wasn’t the only MRC-funded unit in Jamaica. During the 1960s the Epidemiological Research Unit opened to study diseases prevalent in the island’s population. The unit was supported byArchie Cochrane, Director of the MRC Pneumoconiosis Research Unit in Wales andwas directed by his colleague, William (Bill) Miall. The units worked closely together to study the population differences in heart disease, blood pressure, pulmonary tuberculosis, arthritis and diabetes between the populations of Wales and Jamaica. By the time Miall returned to the UK in 1971 he had established a lasting legacy of epidemiological rigour in the Caribbean.

Again, the director’s departure led to the unit’s closure, and the building was renamed in 1973 to MRC Laboratories and refocused to research sickle cell disease. This new unit was directed by Professor Graham Serjeant who helped to develop the Jamaica Sickle Cell Cohort Study — the world’s first extensive newborn screening for sickle cell disease. The study began in 1973 at the island’s Victoria Jubilee Hospital and ended on 28 December 1981 — screening 100,000 babies in that time. The unit used the cohort to help map disease progression from birth, and improved care for those with the disease.

Following Professor Serjeant’s retirement in 1999, the MRC also transferred this unit and all its academic value to UWI. The decision to transfer units rather than closing them completely meant the university was able to combine both MRC units on October 1 1999 to form the current Tropical Medicine Research Institute (TMRI).

TMRI has since gone on to create an additional research unit in Barbados which focuses on chronic diseases. Today, those with sickle cell who were part of the cohort study are still followed up by scientists at TMRI’s Sickle Cell Unit. Additional core funding from the MRC has also helped researchers in Jamaica to provide advice to other countries on developing sickle cell treatments.

Professor Serjeant is also helping to continue the MRC’s research as the Chairman of the charity Sickle Cell Trust (Jamaica). He helped to establish the charity in 1986 and the dedicated Sickle Cell Clinic which opened in 1988. The Education Centre for Sickle Cell Disease opened in 1994 supported by funding from charity, and works as an outreach and training facility.

Investing in the medical research infrastructure in Jamaica has enabled the MRC’s impact to outlive its branded units. Like with many ofthe MRC’s research achievements that took place over the past century, they are still being built on by scientists today.

Stacy-Ann Ashley

With thanks to Professor Terrence Forrester, Chief Scientist of Solutions for Developing Countries at the University of the West Indies and Founding Director of TMRI and Professor Graham Serjeant, Chairman on the Sickle Cell Trust (Jamaica).

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