Lands of Opportunity: Diabetes in the Caribbean

1
Lands of Opportunity Diabetes in the Caribbean

• A Case Study

2
Structure

• ? Introduction
• Historical Context
• MRC
• Colonial Development
• Chronic Conditions and Spread of Research
  Interests
• Case Study ERU and Diabetes
• Conclusion Postcolonial History of Medicine

3
Introduction

• Postcolonial Medicine usually approached from two
  different standpoints.
• Today - research (post)metropoles included.
• Diabetes as medium for this inclusion.
• Case study of the ERU as empirical example.

4
Structure

• Introduction
• ? Historical Context
• - MRC
• - Colonial Development
• - Chronic Conditions and Spread of Research
  Interests
• Case Study ERU and Diabetes
• Conclusion Postcolonial History of Medicine

5
The Medical Research Council A Whirlwind History
1913 Committee to Research TB. 1920s
Structures National Policy under Fletcher. 1940s
Enlarged budget, extra weight.
Great Britain MRC est. 1913
6
Constructive Colonialism
Great Britain CMRC 1945-1962
War-time nationalism and post-war
welfarism Fast-track to modernity to mutually
beneficial independence
Research and Universities integral Colonial
University-Colleges, 1948-9
Jamaica UWI, est. 1948 - TMRU est. 1956
7
ChronicityDiabetes in the Colonies
CMRC and MRC Membership Shared Colonies places
to expand interest Changing British epidemiology
new technologies bring new conditions of
interest New interest reflected in colonial
applications

• Great Britain
• MRC
• CMRC

8

Shaper, Application for Biochemical Studies,
Uganda, 1959
despite the known susceptibility of diabetics in
Europe and America to vascular disorders, these
complications are significantly uncommon in
Ugandan African diabetics. The biochemical
background to the absence of these changes in our
diabetics may well
Uganda - Makerere University College
prove of significance in the understanding of
their development in Western communities.
9
Structure

• Introduction
• Historical Context
• MRC
• Colonial Development
• Chronic Conditions and Spread of Research
  Interests
• ? Case Study ERU and Diabetes
• Conclusion Postcolonial History of Medicine

10
Epidemiological Research Unit, Jamaica
Plan for ERU orginated in Britain. Chronic
disease epidemiology growing influence in the
1950s.
Cardiff ERU, Wales, 1960
Cochrane and Miall Welsh studies. Comparisons
in LDCs Jamaica.
Jamaica - Pilot Studies, 1958 - ERU est. 1962
11
W.E. Miall, Application for Unit in Jamaica, 1959

• The results achieved during the first year of
  epidemiological work in Jamaica are so
  encouraging that we believe steps should be taken
  to exploit the opportunities for such research
  there and in the Caribbean generally on a larger
  scale.

12
Epidemiological Research Unit, Jamaica
Decolonization in 1962. Continued
support. British changes minimal either
epidemiological or institutionally

• Great Britain
• CMRC ends 1962
• TMRB begins 1962

Unchanging discursive logic and
conceptualizations. ERU valued.
Jamaica - Pilot Studies, 1958 - ERU est. 1962
13
GM Bull, TMRB Memo, 1966

• though the Epidemiological Research Unit
  hasbeen affected by the changing economy of the
  regionin this case, there remain many
  opportunities for continued and useful work.
  These lie primarily in a comparison of African,
  Indian, and other populations with the same stock
  living under less favourable conditions, in other
  tropical areas, and in studying the reasons for
  interesting difference in disease incidence in
  the Caribbean.

14
TMRB Diabetes Funding
Poon-King et.al. study in Trinidad, 1968.
Compared racial groups in Trinidad and South
Africa. Other research in Lawrence Tavern,
Jamaica in depth biochemical studies. De facto
monopoly of health-care services.
Trinidad Poon King et.al. 1968
15
Structure

• Introduction
• Historical Context
• MRC
• Colonial Development
• Chronic Conditions and Spread of Research
  Interests
• Case Study ERU and Diabetes
• ? Conclusion Postcolonial History of Medicine

16
Postcolonial Medicine Conclusions

• May be inaccurate to extend recent findings to
  all biomedical engagements.
• Including the post-metropole unmistakeable
  material and conceptual legacy.
• Restores colonial/post-colonial enterprise to
  centre of British history.

17
FIN
Cardiff ERU, Wales, 1960

• Great Britain MRC est. 1913
• CMRC 1945-1962
• TMRB est. 1962

Jamaica TMRU, est. 1956 - ERU est. 1962
Trinidad Poon King et.al. 1968 Study