The Pioneering Years
The Caribbean Institute for Health Research (CAIHR) has a rich history that dates back to the 1950's with the pioneering work of the late Professor Sir John Waterlow, a renowned physiologist, who was posted in Jamaica in 1945 by the British Colonial Office to conduct commissioned research on the high death rate of children under five years old on the island, as well as in Guyana and Trinidad.
In studying malnourished children in the Caribbean in the early 1950s, he had confirmed the same symptoms previously discovered in African children suffering from kwashiorkor (a severe form of malnutrition).
Establishment of the TMRU
By 1958, with funding support from the UK's Medical Research Council (MRC), Waterlow established the Tropical Metabolism Research Unit (TMRU) at the University of the West Indies and became its first Director. The new Unit comprised laboratories and a 16-bed ward aimed at researching the metabolic and physiological mechanisms of severe acute malnutrition.
The initial expatriate staff included the clinician John Garrow, who subsequently became a leading obesity expert, and the biochemist Joan Stephen, who became John's lifelong companion.
John Waterlow had developed a reputation for his hands-on approach to research, and often used equipment he constructed himself to study tiny biopsy samples of the livers of malnourished children
Working with his team, Waterlow is credited with using the then newly invented Araldite adhesive to build a microbalance sensitive enough to weigh 2mg samples, as well as a micro-respirometer much more sensitive than equipment used by biochemists at the time, to measure enzyme activities.
Seminal Achievement in Nutrition Research
The research to understand the cause of the children's condition, which involved fatty liver, oedema (swollen arms and legs), flaky skin and hair loss, loss of potassium from muscles and blood cells, and reduced protein synthesis, led to improvements in the treatment of malnutrition.The TMRU in partnership with Jamaica's Ministry of Health succeeded in reducing the child mortality rate from malnutrition from 25 percent when the unit opened to five per cent in the 1970s.
This was a remarkable achievement just at the turn of the 1970s that clearly demonstrated the immense value of translatable research to effective health policymaking and interventions, as well as established the TMRU's strength as a globally-relevant research entity.
The outcomes of the seminal research work in Nutrition carried out at the TMRU was captured in John Waterlow's obituary published in the UK Guardian newspaper:"Kwashiorkor was eventually shown to be the catastrophic influence of diarrhoeal or other common infection in children, who lacked the protective antioxidant vitamins and minerals in their diet, and not a simple consequence of protein deficiency, as had been initially believed. This discovery led to a phased treatment programme based on initial emergency treatment with antibiotics, electrolytes, vitamins and minerals, then stabilisation with modest feeding to allow repair, and only then intensive feeding to allow complete and rapid recovery."
Waterlow's successor in Jamaica, David Picou, ensured the treatment was adopted throughout the Caribbean and eventually by the World Health Organisation in its Guidelines for the management of malnutrition. Implementation of the guidelines has reportedly saved an estimated one million children's lives in Africa alone.
Time Passes: From TMRU, to TMRI, to CAIHR
From foundations laid in pre-Independence Jamaica, CAIHR today has grown into the leading research entity of its kind in the Caribbean, known for more than its pioneering work in Nutrition, but also in Child Development and Chronic Diseases such diabetes, hypertension, cardiovascular and Sickle Cell Disease.
These research outputs produced by the Tropical Metabolism Research Unit (TMRU), the Epidemiological Research Unit (ERU), the Sickle Cell Unit, and the George Alleyne Chronic Diseases Research Centre in Barbados were brought together under one corporate establishment called the Tropical Medicine Research Institute (TMRI) in 1999.
The establishment of the Institute was expected to create better opportunities for collaboration among researchers. By creating a single, administrative environment with the remit to increase consultation among academic staff, The UWI would facilitate collaboration between Units, make more efficient use of resources.
At the same time, there was also the official transfer of responsibility for the Sickle Cell Unit from the UK Medical Research Council to The University of the West Indies.
Fast-forward less than two decades later, and the TMRI has been rebranded as the Caribbean Institute for Health Research (CAIHR). As a specialised centre of The UWI, CAIHR’s primary focus is Caribbean, with a renewed mandate to increase research outputs in major areas affecting the health of regional populations, and in the number of trained health research scientists, while promoting more uptake and translation of research into healthcare policy, programmes and interventions.