July 2010

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Research: What is the Point?

As a research scientist, I am used to fielding questions about what value, if any, research should have in the Caribbean. A commonly expressed view is that scientific research is the expensive indulgence of richer countries and that our scarce resources should not be diverted from our many pressing social and health needs.

Although I disagree with that sentiment, I do agree with the latter point that we do have many pressing social and health needs in the Caribbean. But what are they? Exactly? We often talk about being in an “Information Age” but do policymakers have access to accurate, locally relevant information concerning our society’s issues? Research at its most fundamental is simply the art of extracting information that is not readily attainable. If I ask you to count the persons standing at a bus stop, that is a quick and mechanical task. But if I ask you to ascertain how many of those people at the bus stop have hypertension, then you will need to do some research (and will no doubt request a budget!).

Hasn’t it all been done before in richer countries?

The Caribbean is under-researched at most levels and policymakers are often forced to rely on dubious Ersatz research performed in different countries on different ethnic populations. Research from my Department, the Chronic Disease Research Centre of the Cave Hill Campus, has identified a major new risk gene for glaucoma, an eye disease, never before apparent in Caucasian populations. That is the sort of locally relevant information that is critical for policymakers to know how and where to target those scarce resources towards improved diagnosis and eye care. Research from my own laboratory has indicated that an inflammation gene present at 30X higher levels in black populations than Caucasians may explain the high incidence of inflammatory disorders in the Caribbean, such as systemic lupus erythematosus (SLE) and diabetic foot (predisposing to an amputation). The definitive genetic linkage study is currently ongoing, the Wound Healing Study (WHY study) in diabetes.

The WHY study in diabetes

Why do we have such a high prevalence of diabetic foot amputation in Barbados? Can we identify individuals who are predisposed to this dreaded complication of diabetes? Can we guide the surgeons to improved clinical outcomes? These are all questions that are addressed by the WHY study. Of particular interest to government and industry leaders, what is the economic impact of a diabetic foot in terms of additional health care cost and loss of productivity? Patient recruitment has begun on the WHY study and we are eagerly awaiting the results of this internationally ground-breaking study. I would like to invite the government and private sector to become involved as a partner in this University research, as we aim to translate academic outputs into practical clinical interventions for better diagnosis, prevention and care of diabetic foot.

A passion for research

I have a passion for research and despite being advised on more than one occasion during my career to focus, focus, focus … I just can’t help myself. The diseases and problems out there are just so diverse and important, that I find myself carrying out research in areas ranging from wound healing in diabetes, risk genes for inflammatory diseases, rheumatic inflammatory conditions, recovery from heart surgery, pandemic influenza virus surveillance, laboratory capacity building in the region for HIV/AIDS diagnosis, and research into sexual behaviour in the TIG sex study: a national survey in Barbadian girls aged 15-19 examining inter-generational relationships with older men.

The yardstick I always set myself when setting out in some new and exciting area of research is that I aim to present my research findings in the leading academic journals and international conferences in the field. If I succeed in that regard, then I cannot be accused of being a jack-of-all-trades (and master of none). I find research in the Caribbean tremendously energizing and challenging. We work in cumbersome governmental and University structures, but the quality of the individuals with whom I interact … they are just first rate. We have well educated populations with great potential in the Caribbean, but we commit the cardinal sin of not tapping into individual talents sufficiently … and talent will wither away when not appreciated.

What the Award means to me

The only reason I am able to carry off this prestigious VC’s Award for Excellence is that I am surrounded by talented people whom I enthuse and entrust with their own research projects. I am deeply honored to be receiving this Award on behalf of my many colleagues and collaborators, from the CDRC, my PhD students, the Queen Elizabeth Hospital, the Barbados Diabetes Foundation, the Ministry of Health, the Ministry of Youth Affairs, the National HIV/AIDS Commission, regional Ministries and laboratories across the Caribbean, and at every level across the University. I would not have the joy in my career if it were not for my family who support me despite my many “mad professor” moments.

I would like to see the VC’s Award act as a springboard to drive the next phase of development at the CDRC, away from abstract concepts of disease prevalence and mechanisms towards tangible patient benefits. This is a call for Caribbean stakeholders in health and the private sector to partner with us to translate our academic outputs into practical clinical interventions for the good of patients and society alike.