It was a Fermanagh man, Denis
Burkitt, who gave his name to
Burkitt’s Lymphoma, a variety of
cancer which is rife in central Africa.Burkitt, who spent his early years in Laragh before his family
moved to Dublin, was working as a surgeon in Uganda when he
came across several children suffering from fast-spreading
tumours in the head and neck.
After getting in touch with a host of hospitals across Africa, he
became the first to plot the previously unknown disease.
This week, his Fermanagh compatriot John Phillips travelled to
Malawi, where he will remain for six weeks overseeing a project
aimed at improving treatment and diagnostic tests for Burkitt’s
Lymphoma.
The Enniskillen paediatrician has seen the disease many times
during his work in Africa, where that form of cancer is common in
the hot, wet zones where mosquitoes are found.
Mr Phillips explains that both malaria and the Epstein Barr virus
play a part in the formation of the tumours, which affect the
B-lymphocytes in the body’s immune system.
Sufferers often end up with huge swellings in the face and eyes,
although Mr Phillips explains that the tumours can often appear
in other parts of the body such as the stomach, bones or thyroid
gland, and as a result may be difficult to diagnose. Most people
die within six months of the first symptoms if the cancer goes
untreated.
Injections of the drug cyclophosphamide can have dramatic
effects in some cases, shrinking the tumours in a matter of days,
but some patients don’t respond at all.
In Malawi, Mr Phillips is trialling a new treatment by combining
cyclophosphamide with another drug that has shown promise in
laboratory tests. He hopes that in combination the drugs will
cure many more people.
His former colleagues in Malawi are looking forward to the extra
help, Mr Phillips says as he prepares for departure. He has now
retired as a paediatrician in the Erne Hospital but spent much of
his career in Africa.
Born in southern India, Mr Phillips’s schooling took place in
Edinburgh but his early upbringing drew him to head back out
into the wider world once he had qualified as a doctor.
He explains that his father worked in the leather manufacturing
industry in India and his mother had been a teacher at the
Women’s Christian College in Madras. This upbringing made it
difficult to integrate in Scotland, not least because he couldn’t
kick a football.
After university, Mr Phillips investigated the possibility of medical
missionary work.
“Coming from abroad I had a wider understanding of the world. I
knew there were great needs elsewhere,” he says.
“In a lot of ways I was an outsider. I felt that this pointed me in
that sort of direction.”
The top priority was to find a unit that trained nurses and was run
on an ecumenical basis, he says.
This brought him to a hospital jointly run by the Anglican,
Methodist and Presbyterian churches in eastern Nigeria, where
sometime later Mr Phillips found himself in the middle of the
Biafran war.
The two-and-a-half-year conflict broke out when one part of
Nigeria attempted to secede from the rest. It was this war that
gave rise to the charity Medecins Sans Frontieres after people
recognised that preparations were vital to be able to cope when
such conflicts broke out.
“It was grim at times, especially when there is no obvious end to
it,” he says.
“The malnutrition was terrible, casualties, shortages, the
corrupting influences of war were dreadful.”
Ordinarily, the hospital staff worked extremely long hours and in
fact the conflict brought slightly more free time than before.
Normal activities such as training nurses and giving lectures
were suspended and a curfew was imposed. Fortunately there
was a library nearby and Mr Phillips spent many of his evenings
reading books by torch light.
After the war, he returned to Scotland and gained more
qualifications before heading to Malawi to a Church of
Scotland-backed hospital that offered obstetrics and paediatrics.
Two, sometimes three doctors treated 3,000 babies a year -
three times the workload of the Erne Hospital.
There was no X-ray and a very limited laboratory, and the doctors
found themselves turning their hands to all sorts of work -
teaching, keeping accounts, filling in data, writing reports and
making sure the staff were paid.
After 10 years there, Mr Philips became paediatrician in Lilongwe
Central Hospital in the capital of Malawi.
“That was a busy job too because normally half the population of
the country is in the paediatric age group and they are a lot
sicker,” he says. “Among the under-fives, more than 60 per cent
are seriously underweight.”
In 1986, Mr Phillips came across the mystifying case of a small
boy who just did not seem to respond to treatment. He was
treated for TB and a variety of other illnesses but simply didn’t
get better.
The last time Mr Phillips had been home in the UK he had
watched a TV programme about a strange new disease called
Aids. He carried out an HIV test which proved positive. The boy
died the same weekend - the first child in Malawi to be identified
as an Aids patient.
More and more cases appeared, although it was often
impossible to carry out a diagnosis. The hospital didn’t have the
tests and they weren’t very good anyway. Even when more tests
eventually became available, the priority was to use them for
screening blood and only the few left over could be used to test
the patients themselves.
“By 1988 or 1989 it was already exponentially occurring,” Mr
Phillips says.
At the time the World Health Organisation had a slogan “Health
for all by the Year 2000”. In lectures, Mr Phillips warned that “Aids
for all by the Year 2000” would be a much more achievable
objective.
By the time he left in 1994 the hospital had 220 beds, with one or
two doctors in charge, backed up with paramedics. Mr Phillips
was paediatrician for the northern and central region and spent a
fair bit of time travelling from district to district.
“Then Baroness Chalker said we weren’t cost-effective and paid
us off,” he says.
Enniskillen was the next port of call. Mr Phillips became the Erne
Hospital’s first resident paediatrician and this allowed the
Sperrin Lakeland Trust to set up a maternity unit.
These days Mr Phillips is retired. He is married to Sheila and
has two children, Rachel, who is studying medicine at Edinburgh
University, and Ross, who is at Portora and hopes to study
engineering in Bristol.
Mr Phillips plays chess and is an elder and Sunday school
teacher in Enniskillen Presbyterian Church. He is involved in
quite a few cross-community ventures, including Fermanagh
Churches Forum and Faith and Friendship.
As a former chairman of Enniskillen Together, he noticed that
almost all the people involved had lived outside Northern Ireland
at some time or other.
“The people had knocked around the world, got a much wider
view of things and realised we are very fortunate here in Northern
Ireland and there are much bigger differences and things to get
excited over then the difference between Protestant and Catholic.
We are all Christians,” he says.
“The divisions within the Church are a terrible negative witness.
“I don’t think that most Christians see what a priority it is for us to
be together.”
These divisions have real consequences for people on the
ground. Mr Phillips has always noted the tendency for churches
in places like India and Africa to compete over relief resources -
hence the early determination to work in an ecumenical project.
In the Biafran war, relief efforts were divided down the middle
between Catholic and Protestant agencies, he says. When
money is scarce there is a temptation to feed only those people
that belong to your group.
But at other times church groups found themselves working
together to tackle Malawi’s huge health crisis.
“We were able to come together and find we are all fighting in the
same direction. People found they were all good fellow
Christians,” he says.
Such efforts put Northern Ireland’s problems very much into
perspective.
“I just wish people would learn from history and not just learn
history,” Mr Phillips says.