Burkitt – Reminiscences of Michael Crawford
Reminiscences of Dennis Burkitt in East Africa by Michael Crawford
I worked at the Makerere Medical College between 1960 and 1965 teaching preclinical biochemistry and kick starting chemical pathology. That was an exciting period in biomedical research and I set up a research laboratory in an empty building next to the new Mulago Hospital – a fine, brand new hospital donated by the British Government as a farewell gift to celebrate Uganda’s independence as a protectorate in 1962. After returning to the UK in 1965 I maintained the laboratory and the research with Chester Beatty and then British Imperial Cancer Research Institute support until 1972.
Dennis Burkitt was a surgeon when my family and I first arrived. In 1961 he removed a cyst from my wife. Being a deeply religious person he knelt and said a prayer beforehand. During that period we got to know him and his wife Olive, quite well.
However, it was not long before he came up for retirement. Hugh Trowell had previously introduced him to the cancerous jaws of children he had seen. They were unoperable and Dennis reported the tumours in the British Journal of Surgery. When Dennis retired he went to see Jack Davis who was professor of pathology to ask his advice. Jack suggested he investigated these swollen jaws seen in children which led to their disfigurement and death. Having been already introduced to the swollen jaws by Hugh Trowell and written about the condition, he did not need encouragement.
Uganda was and likely is still a fascinating place for medical research. You can travel 100 miles from Kampala and the disease pattern of the locals was quite different. It was that stunning difference that led me into nutrition and health and some 46 peer reviewed papers which amongst other matters led to the discovery that the brain required omega 3 fatty acids in 1972.
The panorama of disease in Buganda was totally different to the UK. I suppose infant malnutrition with Kwashiorkor and marasmus is what people most think about. Yet the commonest cause of death from heart failure was endomyocardial fibrosis, a condition hardly heard of here in the UK. The commonest surgical emergency was volvulus and double volvulus of the sigmoid colon. Primary cancer of the liver was common amongst children. Dennis was fully aware of these differences and the contrasts from place to place. Hence when Jack offered to get some money to support a geographical enquiry Dennis was off in a brand new landrover like a shot to travel in Africa.
His many safaris studying the incidence of the cancer led to the conclusion it was confined to the mosquito belts which were quite distinct as they varied with altitude and climate. This finding required the drawing of many maps to illustrate this point. At a critical phase in his tours, the medical artist Roger Wellingham suddenly left. To alert the world to the possibility that there was a viral cause of this cancer required maps and more maps. A viral cause of cancer was quite unknown or experienced in the 1960s. My wife, Sheilagh had studied art in Paris and was in her own right a wonderful painter. She came to the rescue and was emplyed to fill the gap and indeed was responsible for most of the maps used for his research.
Following his publications and interaction with the UK Medical Research Council and NIH, USA, the first demonstration of a viral cause of the cancer was carried out at Makerere. The tumor in the jaw spread throughout the body of the children and was quite the nastiest bit of bilological adversity. It was named Burkitt’s Lymphoma. Dennis summarised the history in Cancer. 1983 May 15;51(10):1777-86.The discovery of Burkitt’s lymphoma. Burkitt DP. There are many maps in this summary doubtless mostly drawn by Sheilagh.
He ends this history with the humble remark;