By Jasminee Sahoye
An expert on sickle cell disease says it can be controlled if babies are screened at birth and couples from vulnerable groups should be tested for the trait prior to having children.
Dr. Graham R. Serjeant, who has spent 46 years working with sickle cell patients around the world and researching the disease, is believed to be among a handful of doctors who specializes in the disease.
He tells The Camera that although the disease is common among people of African origin, the sickle cell trait is found among people in the Arabian Gulf and in parts of India. He adds that Uganda is described to have the highest trait frequency in the world with about 39-45 per cent of the population suffering from it.
“If you look at the disease in North America, South America and the Caribbean, most of the people with the disease are of African origin. But once you go around the Mediterranean, there are lots of people with white skin and blue eyes who have no hint of physical African features who also have the sickle cell trait. If you go to the Arabian Gulf, Saudi Arab, Baharain, Quatar, those countries even south of Iran also have the sickle cell traits. If you go Central India, it is a huge problem amongst the tribal people of India… So from Gujarat, Maharastra, Madhya Pradesh, Chhattisgarh, Orissa state, huge numbers are affected. Trait frequency among some of the tribal groups are up to 35-38 per cent. There is also a focus in the south of India in the north of Tamil Nadu and Kerala where the disease is very common,” he says.
Dr. Serjeant, who is from London, England says although sickle cell disease is a genetic disorder, it can be controlled. “To have the disease, you have to inherit the abnormal genes from mother and father. If one parent is absolutely normal, they cannot have a child with the disease.” He further states that if both parents have abnormal genes, “there’s a one in four chance that their child will have the disease. It’s also a three out of four that the child would be perfectly well.”
But what would have led this doctor to dedicate his entire professional career to working on sickle cell disease? He said he did his early training in Uganda and developed a love for it. So, while searching for a country where he could share his expertise, Jamaica needed someone. In 1966, he went to island where he continues to share his expertise until today. He serves as Chairman of the Sickle Cell Trust in Jamaica, a charity he started in 1986. “We built a dedicated centre at the University of the West Indies, and then built an education centre for sickle cell disease, where we have regular seminars, school groups would come in….”
Dr. Serjeant explains that what he learned from the text books while at medical school were not what he actually found in Jamaica. He soon found out that in the sickle cell clinic, there were people in their 40s, 50s and 60s when the text books stated that few people survived to early adult life.
He also found out that people who are sick in childhood and early adulthood life, as they grew older their health conditions improved. “They would disappear completely from medical attention and you would assume they died because people do not recover from a genetic disease. But in fact painful crisis had ceased, big ulcers are healed and they are working full-time. I did a study to find them in Jamaica and the conversation went like this, why did you miss your appointment 10 years ago, they either say, Doc, I was going to come tomorrow or some would say, Doc, as I get older, I get better and I see no reason to go to the hospital, so that was a surprise and I think everybody recognizes that is true.”