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Press cutting: Gynaecology sans Frontières
11 November 2006
Patients in Mulago Hospital, Kampala, often lie down in British beds, have x ray pictures taken on British machines, and have their operations on British operating tables.
He and his team have devised 12 projects there, including cervical cancer screening, prevention of postpartum bleeding, and neonatal resuscitation, which are set to continue for at least three years. They have also built a hostel for radiotherapy patients at Mulago Hospital and provided funding for a chair of palliative care at Makerere University, and in October they held a meeting in Kampala on women's health that involved 400 health professionals from all over the country.
So how did Jacobs arrive at his present position as founder and director of UCL's Institute for Women's Health and as an adviser to the Ugandan health service? …
"Although I found clinical medicine incredibly rewarding and important, it does not make fundamental change, and there will always be a constant flow of patients who need you. The best way to make real change and try to stop the flow of patients seemed to me to be research in prevention and screening," he says.
His enthusiasm for research was fuelled after he saw the dismal outcomes for many women with ovarian cancer on whom he operated at the Royal London in the 1980s. …
He struck on the idea of writing to the top 100 companies asking for financial support for the Gynaecology Cancer Research Fund, a charity he set up to fund his work and that now runs the Eve Appeal, which is dedicated to funding research into gynaecological cancers. …
Twenty years later Jacobs has lost nothing of his drive to "make life better for women with ovarian cancer." …
In 2001, with a grant of £22m from the Medical Research Council, Cancer Research UK, and the Department of Health, Jacobs set up what is thought to be the largest randomised controlled trial ever performed: the United Kingdom collaborative trial of ovarian cancer screening (UKCTOCS). Recruitment to the trial-which is designed to measure the reduction in mortality associated with screening as well as the morbidity, psychological impact, and cost-finished in 2005, resulting in 202 000 women being enrolled. …
With one of his lifetime's ambitions seemingly well on the road to being realised, Jacobs says that a call from UCL in 2003 to tempt him away from Barts was unexpected. But UCL has always had a "liberal sort of feel," says Jacobs, which appealed to him, and a reputation for outstanding academic excellence. He realised that his dream to "develop women's health more broadly" might flower at UCL, with its brand new partner hospital and state of the art research facilities. The extent of the opportunity was confirmed when the provost of UCL and the chief executive of UCL Hospital agreed to the establishment of the Institute for Women's Health as part of his move in April 2004.
"The challenge was to build an institute ... from lots of separate pockets of excellence in women's health which already existed. Since 2004 we have managed to establish a team of people working closely together, from basic scientists to clinicians, actively involved in a concerted strategy to develop the leading centre for women's health in the country," says Jacobs. …
Jacobs oozes satisfaction about the Ugandan project. Half a million pounds goes five times further in Uganda than in the UK, he says.
But his work in Uganda has not been without a great deal of soul searching. "We have asked ourselves whether it is ethical to do something that is not definitely sustainable. It is a difficult question to answer, but I have taken the view that we should take the chance to do something worthwhile now and work to make it sustainable, rather than have the chance and do nothing until sustainability is guaranteed. We have already made a tangible difference to the lives of some women and their babies, and so far it seems to have been the right decision."
Zosia Kmietowicz, 'BMJ'
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