Lives of the fellows

Derrick Brian Jelliffe

b.20 January 1951 d.18 March 1992
MB BS Lond(1943) MRCP(1944) MD DCH(1945) DTM&H(1947) FRCP(1961)

Derrick (Dick) Jelliffe devoted almost the whole of his professional life to the problems of child care in the developing world. He was born the eldest of three medical brothers at Chatham, Kent, where his father - who was widowed early - was a civil servant with the Admiralty. After preparatory school in Malta, followed by Merchant Taylors’ School, Northwood, he graduated from the Middlesex Hospital, London, where he was successively house physician and medical registrar.

His long career in tropical paediatrics began in 1946; firstly as medical inspector in the Sudan Medical Service and then as lecturer, later senior lecturer, in paediatrics at University College, Ibadan, Nigeria, from 1948-52. He continued in increasingly prestigious appointments in or associated with the developing countries: in the West Indies 1952-54; in India 1954-56; in New Orleans 1956-59; and as UNICEF professor of paediatrics and child health at the University of East Africa, Uganda 1959-66. He was subsequently director of the Caribbean Food and Nutrition Institute, University of the West Indies and finally professor of public health and paediatrics in the school of medicine, University of California Los Angeles, USA. Concurrently with the last appointment he was head of the division of population and family health, School of Public Health 1972-90, University of California, and director of the International Health Program 1989-91. He learnt Sudanese Arabic early on and later became proficient in ‘medical’ Yoruba, Swahili, Luganda and French.

Perhaps it was the impact of the poverty, malnutrition and disease that Jelliffe saw during his first overseas appointment in the Sudan that motivated him to devote his career to the problem of paediatrics, which later enlarged to include child health. It was not conventional paediatrics, the emphasis being on the science, social aspects and cultural anthropology of child health and - especially - nutrition. By introducing simple public health and nutritional measures he became the driving force in the prevention of kwashiorkor and marasmus. He initiated the first department of paediatrics at Makerere medical school, Uganda, and established a rehabilitation unit - called ‘Mwanamugimu’ after the Uganda proverb ‘a beautiful flower grows from a healthy plant’ - in the old hutted Mulago hospital which was alongside the architecturally splendid new hospital. It was there that mothers learnt the basic principles of nutrition suitable for children recovering from malnutrition; being taught how to cultivate and buy suitable cheap foods, cook on fires raised from the ground (to prevent burns), to keep chickens and rabbits, as well as learning to build simple latrines and safe water supplies.

At nearby Lutete he established a health demonstration facility where he advised not just the mothers but also the more prestigious fathers, the family and community. Commercial growing of food was encouraged, including pineapples and pawpaws for the tourist trade. In this way, poverty and malnutrition were averted. It was a team effort, involving the Ministries of Agriculture, Community Development and Health, as well as religious and charitable bodies. Welding these disparate agencies into a combined effort was a notable achievement. Dick’s leadership and the elegance and charm of his wife, Pat née MacReady, earned them many friends. They went everywhere together, even into dense jungle, where Pat would appear as well turned out as at a cocktail party. They created an international network of like minded professionals, both medical and scientific, who shared their concern for the health and safety of children in the poorer parts of the world. They had no children of their own.

Socially, Dick and his wife were considerate and generous hosts. They would often entertain visitors in restaurants where the managers were well known to them and, even if unexpectedly they could not be present, they ensured that their visitors were well catered for.

Early in his career Dick recognized that hospital based paediatrics was not the way to tackle the needs of starving children. Clean water supplies, better sewage disposal and improved housing were the linchpins for healthier populations. To this end he organized innumerable symposia and gave countless lectures, with eyes fixed to the ceiling in a sort of Messianic trance which, nevertheless, would enthuse his audience to renewed action. He and Pat always promoted breast feeding and woe betide those who thought otherwise. ‘Commerciogenic malnutrition’ was one of many ‘Jelliffisms’. Sometimes he allowed his advocacy of mothers and children to overcome his critical faculties, which were considerable. As a result he found himself at odds not only with the politics of aid and multi-national food and drug companies but also with his scientific colleagues who accused him of being too subjective and partisan. But he was not afraid of being out on a limb and influenced the careers of many from all parts of the world.

Dick was a prodigious writer; one of my memories is of him sitting under a tree in Uganda scribbling with a short pencil at enormous speed. Whenever there was a free moment he would scribble cards, letters, and memos to his staff and colleagues - usually ending with ‘all bw’s Dick’. Diseases of children in the sub-tropics and tropics, with J P Stanfield, Geneva, WHO, 1955, became a classic book of reference and ran to several editions. Child health in the tropics: A practical handbook for medical and paramedical personnel, London, E Arnold; Baltimore, Williams & Wilkins, 1962, ran to six editions, as well as two in Spanish. All his later books were concerned with breast feeding and nutrition, most of which were written with his wife, and included Human milk in the modern world, Oxford; New York, OUP, 1978. He edited many journals and was the founder editor of the Journal of Tropical Paediatrics. He received 19 honours and special awards, ranging from the Baron von Rosenstein medal of the Swedish Paediatric Society to the ‘Jelliffes Award’ to him and his wife by WHO/UNICEF in Florence, Italy. He also examined worldwide.

It was not surprising that he became depressed at times when progress in child health seemed so slow, particularly in Africa where violence was destroying so much.

B M Laurance

[, 1992,305,177-78; The Lancet, 1992,339,1347]

(Volume IX, page 271)

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