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This edition first published 2019
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“The wounded surgeon plies the steel
That questions the distempered part;
Beneath the bleeding hands we feel
The sharp compassion of the healer's art
Resolving the enigma of the fever chart.”
Four Quartets. IV. East Coker
T.S. Eliot, Nobel Laureate in Literature, 1948.
I first became interested in tropical medicine 50 years ago when I did an elective period as a medical student at Makerere University and Mulago Hospital in Kampala, Uganda. Searing medical images from that visit remain vivid to me to this day. One of the most enduring was the sight of six men in a male inpatient ward each having a tuberculous empyema drained. Another event was memorable: I was waiting to pay my respects to the Dean of the Medical School on the day I arrived when a man came down the corridor and sat down next to me. He asked what I was doing and I told him. I asked him what he was doing and he told me he was going “on a cancer safari.” I asked him, embarrassingly, if it was “anything to do with that Burkitt’s thing?” He turned and looked at me and said “I am Burkitt.”
Serendipity, however, played its role and I subsequently found myself in medical oncology and through that into hematopoietic stem cell transplantation. A number of coincidences occurred. One of my pathology lecturers at the Middlesex Hospital Medical School in London was Tony Epstein, who co‐discovered the Epstein‐Barr virus that Denis Burkitt was tracking and relating its location in Africa with that of Burkitt’s lymphoma. Later when I was at the Royal Marsden Hospital in London, Peter Clifford was an ENT surgeon there. In fact he removed our youngest daughter’s tonsils while my wife Pauline and I were working there. Peter had previously worked for many years in East Africa and realized that the only therapeutic approach to most cases of Burkitt’s lymphoma was the use of high‐dose chemotherapy. To apply this, however, he knew that he had to harvest and cryopreserve the patient’s marrow cells prior to the chemotherapy in order to infuse them after the chemotherapy in order to reconstitute the patient’s hematopoietic system previously destroyed by the chemotherapy. To perform this Peter hired Reginald Clift, who had been working in pathology in England. E. Donnall Thomas, who pioneered bone marrow transplantation in Seattle and who won the Nobel Prize in Medicine in 1989 for it, heard of this work and promptly hired Reg to work with him in Seattle. After the Marsden I spent five years on Don’s unit in Seattle and got to know Reg well. I’m not sure how many degrees of separation this amounts but it is certainly less than six.
Fast forward four decades: I left oncology and stem cell transplantation and went back to my original interest in tropical medicine. I enrolled in the spectacular East Africa course in Tropical Medicine and Hygiene organized each year by Dr Philip Gothard from the London School of Hygiene and Tropical Medicine and held over three months in Tanzania and Uganda. I had been working on a mesenchymal stem cell book with John Wiley Publishers over the preceding two years and during the African course I received an email from them asking if there was any other area of medicine that I would be interested in writing about. At this time we were learning on the course about rapid diagnostic tests and innovative cheap medical imaging technologies so I asked them if they would be interested on a book on these new and other exciting innovative developments in tropical medicine. It was on the course that I met David who agreed to edit the book with me and without whom this manuscript would never have materialized.
Sydney,
2019
Kerry Atkinson
After medical school and core medical training in the UK I went to work as a clinician at the Medical Research Council Unit in The Gambia, where I spent eight years. For the last four years I was in charge of the clinical services at the unit, which comprised a 40 bed medical and pediatric ward and an outpatient department which saw about 12 000 patients per year. In 1986 I moved back to the UK as a Clinical Senior Lecturer at the London School of Hygiene & Tropical Medicine (LSHTM) with an honorary Consultant Physician post at the Hospital for Tropical Diseases. I ran the DTM&H course at LSHTM for a number of years, and later helped Phil Gothard to set up the East African DTM&H course. My research has focused on sexually transmitted infections (STIs) and neglected tropical diseases (NTDs) in Africa and Asia, in particular on diseases caused by Chlamydia trachomatis and Treponema pallidum, which cause both STIs and NTDs.
London,
2019
David Mabey
We would both like to acknowledge the tremendous expertise, knowledge and willingness to contribute demonstrated by all the authors and co‐authors in this book. Any book is only as good as its content and we feel very lucky to have been able to tap the content that has been shared with us.
We would also like to thank the staff at Wiley for their capability in shepherding the book through each of its phases – Antony Sami, Metilda Shummy, Shalisha Sukunya, Ramprasad Jayakumar and especially Mindy Okura‐Marszycki who commissioned the book three and a half years ago.