lands of opportunity: diabetes in the caribbean a case study
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Lands of Opportunity: Diabetes in the Caribbean
A Case Study
Structure
Introduction• Historical Context:– MRC– Colonial Development– Chronic Conditions and Spread of Research
Interests
• Case Study – ERU and Diabetes• Conclusion – Postcolonial History of Medicine
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.
Structure
• Introduction
Historical Context:- MRC- Colonial Development- Chronic Conditions and Spread of Research
Interests• Case Study – ERU and Diabetes• Conclusion – Postcolonial History of
Medicine
Great Britain – MRC est. 1913Great Britain – MRC est. 1913
The Medical Research Council – A Whirlwind History
1913 – Committee to Research TB.
1920s – Structures National Policy under Fletcher.
1940s – Enlarged budget, extra weight.
Constructive ColonialismGreat Britain CMRC 1945-
1962
Great Britain CMRC 1945-
1962
Jamaica – UWI, est. 1948
- TMRU est. 1956
Jamaica – UWI, est. 1948
- TMRU est. 1956
War-time nationalism and post-war welfarism
Fast-track to modernity to mutually beneficial independence
Research and Universities integral
Colonial University-Colleges, 1948-9
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
Chronicity:Diabetes in the Colonies
Great Britain-MRC
&CMRC
Great Britain-MRC
&CMRC
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
prove of significance in the understanding of their development in Western communities.’
Uganda - Makerere University
College
Uganda - Makerere University
College
Structure
• Introduction• Historical Context:– MRC– Colonial Development– Chronic Conditions and Spread of Research
Interests
Case Study – ERU and Diabetes• Conclusion – Postcolonial History of Medicine
Epidemiological Research Unit, Jamaica
Plan for ERU orginated in Britain.
Chronic disease epidemiology growing influence in the 1950s.
Cochrane and Miall – Welsh studies.
Comparisons in LDCs – Jamaica.
Jamaica - Pilot
Studies, 1958- ERU est.
1962
Jamaica - Pilot
Studies, 1958- ERU est.
1962
Cardiff – ERU, Wales, 1960
Cardiff – ERU, Wales, 1960
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.
Epidemiological Research Unit, Jamaica
Decolonization in 1962.
Continued support.
British changes minimal – either epidemiological or institutionally
Unchanging discursive logic and conceptualizations.
ERU valued.
Jamaica - Pilot
Studies, 1958- ERU est.
1962
Jamaica - Pilot
Studies, 1958- ERU est.
1962
Great Britain- CMRC
ends 1962- TMRB begins 1962
Great Britain- CMRC
ends 1962- TMRB begins 1962
GM Bull, TMRB Memo, 1966
‘[though] the Epidemiological Research Unit has…been affected by the changing economy of the region…in 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.’
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
Trinidad – Poon King et.al. 1968
Structure
• Introduction• Historical Context:– MRC– Colonial Development– Chronic Conditions and Spread of Research Interests
• Case Study – ERU and Diabetes
Conclusion – Postcolonial History of Medicine
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.
Trinidad – Poon King et.al. 1968
Study
Trinidad – Poon King et.al. 1968
Study
Jamaica – TMRU, est.
1956- ERU est.
1962
Jamaica – TMRU, est.
1956- ERU est.
1962
Great Britain – MRC est. 1913
- CMRC 1945-1962-TMRB est. 1962
Great Britain – MRC est. 1913
- CMRC 1945-1962-TMRB est. 1962
Cardiff – ERU, Wales,
1960
Cardiff – ERU, Wales,
1960FIN