World Health Organisation

Lord McColl of Dulwich Excerpts

Wednesday 2nd July 2014 Lords Chamber

[Lord McColl of Dulwich (Con)]

My Lords, I thank the noble Lord, Lord Ribeiro, for initiating this debate on a subject which I have always thought is of great importance. I ought to declare an interest because over the past 40 years I have worked in about 14 African countries doing operations, teaching various surgical techniques and helping to enhance surgical care and anaesthesia in realistic ways that they wanted and which were within their financial means.

I always tried to emphasise that organisations should be sustainable, especially in the sense that those they trained would not promptly emigrate to more lucrative climes. Some while ago, I was asked to devise the curricula for two medical schools in Libya, one in Tripoli and the other in Benghazi. I inquired whether they would like a system tailor-made for Libya or whether they just wanted to copy the West. Of course, they said that they wanted something tailor-made for Libya, which was very welcome. I took a team from Guy’s Hospital—there were about five or six of us—to help them to devise suitable curricula. When we presented it to the deans, the first question they asked was, “Will this be recognised by London University?”, and, of course, it would not, so it was rejected and they reverted to the usual western pattern. Needless to say, on graduation many of the students from those medical schools promptly emigrated.

People were very suspicious of me going to such a place as Libya. Indeed, the then Prime Minister, Margaret Thatcher, asked me, “Where have you been recently?”. When I replied that I had been to Libya, she retorted, “You what”?, so it was not a very popular thing to do. People became even more suspicious when I had to operate on Gaddafi’s father. It was the middle of the night. He was 103; I know that they are all 103 out there, but this chap looked much older than that to me, like a dried-up old prune out of the desert. At the end of the operation, we were standing around the old man’s bed, watching the pulse meter; it would go fairly regularly and then stop so that there would be a gap, and then another gap. I thought that this would be the moment where the pulse stops and the dictator takes his gun out and shoots the doctor—although I thought he would probably shoot the anaesthetist first. Gaddafi asked me, “How is my father?”. I said, “I have good news for you; your father is indestructible”. He laughed, and everyone relaxed. In any case, I have always liked to live dangerously.

Our next project was for people dying of AIDS in Uganda. We went out to set up a hospice at the invitation of President Museveni, because he had been impressed with the one that we had set up in Hackney for people dying of AIDS. The wonderful Minister for Overseas Development, Lynda Chalker as she was then, gave us enormous support to do this. We set up this hospice six miles outside Kampala on the road to Entebbe. As you all know, my noble friend Lady Chalker is much admired and respected in Africa; they always take her advice. She advised us not to have any in-patient beds. I think she must have known that the word “clinician” is derived from a Greek word meaning “bed”—that is why doctors are so obsessed with beds; clinicians are bed people. She advised us instead to concentrate on out-patient treatment. She said we ought to become a teaching centre for the whole of Africa, teaching people how to look after those who are dying at home. How wise she was. I returned to this hospice in Uganda recently and I was delighted to find that it was running extremely well, and run entirely by Ugandans, apart from one lady who was a Scot; she was the finance adviser. By the way, the word “economy” is from the Greek and implies housewifery, which is why ladies are the ones who understand finance.

The next project that I got involved with was a charity called Bridge2Aid in Tanzania. This is an amazing charity that has trained more than 300 emergency dental technicians. They are trained in two weeks to take teeth out; you may think that that is not adequate, but when we were medical students we only had three lectures on how to take teeth out, so in Tanzania they go a bit further. They become expert at taking out teeth and therefore relieve a great deal of dental pain and dental sepsis, which can kill. We give them a pressure cooker and a paraffin lamp to sterilise the instruments. Of course their skills are not recognised abroad so they do not emigrate. This is rather reminiscent of President Nyerere’s barefoot doctor scheme, mentioned by the noble Lord, Lord Ribeiro.

Of course I have been associated with Mercy Ships for many years. We concentrate on teaching the local people various operations and anaesthetic techniques. It has been very encouraging to see how they flourish. On board we had an American eye surgeon, Glenn Strauss, a wonderful trainer who trained a Togolese surgeon to do cataracts. Within a week or two, the surgeon had done 30 cataracts beautifully. That surgeon then taught the next Togolese surgeon, who happened to be his professor. The professor became expert in that, and in turn taught the next one. So we ended up with three competent eye surgeons doing cataract operations in Togo, one in the north, one in the south and one in between. They come back for a refresher course every so often.

I want to tell your Lordships about Gary Parker, an American who trained in north Wales at a very good maxillofacial hospital for about five years. He came to work on Mercy Ships for two months, just to see what it was like, and he liked it so much that he decided to stay a bit longer—24 years longer. He must be the most experienced maxillofacial surgeon in the world and he has trained so many Africans in these techniques.

I ought to mention a most outstanding president in Africa, Ellen Johnson Sirleaf in Liberia. She is one of the best presidents out there and the first lady president. She is an economist, she is tough, and she is doing an extremely good job.

For seven years one of our anaesthetists on board has been doing a great job running courses for anaesthetic providers. In the past two years we have been very fortunate in having on board the consultant anaesthetist Dr Michelle White, who gave up a hard-won consultant post in Bristol to work on the ship for three years. She has been invaluable not only in looking after patients and children but also in teaching. She has made an amazing sacrifice. It is so heartening to see such dedication to help developing countries to improve their healthcare and produce something that will last.