Prof David Morley – A Visionary Whose Care for Sick Children Around the World Inspired So Many

Millions of children all over the world, many in very poor countries, are alive today and enjoy good health thanks to Professor David Morley, who died on 2nd July 2009 aged 86.

View David Morley - a Man with a Vision, a video honouring Professor Morley's life and work.

Brief history:

David Morley began his medical career as an undergraduate in Cambridge and then at St Thomas's Hospital, London. After graduating in 1947, he first learned about health care problems in the developing world during his national military service in Malaya. He worked for a short while in general practice, but then recruited by the Methodist Mission, he left the UK for rural Nigeria and began a career that would improve the health of millions. Professor June Lloyd of the British Paediatric Association described his work thus: “In the five years that he was in Imesi it is no exaggeration to say that he transformed the approach to the health care of children in the developing world. He showed that infant mortality could be cut by over 80 per cent, not by the introduction of modern medicine and the building of hospitals, but by education and use of locally available resources.”

David Morley started Under-Fives Clinics run by local personnel, he trained local women to immunise the children, and he devised the ‘Road to Health’ growth chart – all concepts which have spread around the world. When he arrived, measles killed 1 in every 20 children in Imesi-Ile. He tried a new vaccine from the USA, at first on 20 children, and then on all the children from 1962 to 65. By 1965 Imesi-Ile had become the very first community in the world to record the eradication of measles through vaccination.

Returning from Nigeria he worked first at the London School of Hygiene and Tropical Medicine and then took over a UNICEF-sponsored course on child health for developing countries. This led to the formation of the Tropical Child Health Unit at the Institute of Child Health in London. Later this became the Centre for International Child Health, CICH, which still follows David’s innovatory precepts.

A founder of new charities to improve children’s health:

Always concerned to find ways to improve children’s health in poor countries, David initiated activities which led to the setting up of two charities - Teaching Aids at Low Cost (TALC) and The Child-to-Child Trust.

Child-to-Child: Child-to-Child was an idea that came from a group of health professionals convened by David and Hugh Hawes: - that of spreading health messages through children. As David wrote:“Children working together learn to understand problems, find out more about them, discuss and take action, and review the action they have taken so they can do it better next time”. The messages were simple but essential for saving lives, such as:

The Child-to-Child Trust is now the leading organisation promoting the full participation of children in designing and implementing health programmes, including HIV/AIDS programmes, to influence their families and local communities.

TALC (Teaching Aids at Low Cost)

Health materials: Since Professor Morley started TALC in 1965 by sending out teaching slides to previous students from his garage, TALC has distributed millions of books, slides and accessories to health and community workers, throughout the developing world. TALC selects health books and materials which are particularly appropriate for resource-poor settings, and sends them to health workers across the world. The books are chosen as they are clearly written, well-illustrated and relevant to the conditions in which many health workers have to operate – ie., with limited access to sophisticated equipment or drugs. TALC also produces books or manuals in other languages, like Portuguese, Spanish or French.

Textbooks for African student nurses: Another TALC project initiated by David: - funding the supply of textbooks to nursing students in African colleges, has resulted in 80 nurse-training schools across 19 African countries being supplied.

eTALC CDs: An extremely popular project developed by Professor Morley was eTALC – the production and distribution of CD-ROMs to health workers unable to access the internet. Each new issue of the CD-ROM is warmly welcomed by health workers in hundreds of rural locations and to date TALC has produced and distributed 10 Issues, some 60,000 CDs !

An innovator who found new ways to tackle health problems:

David constantly sought simple low-cost solutions to the problems he encountered. There are so many examples of innovations he developed or improved. One was the Oral Rehydration spoon.

Oral Rehydration spoon (right): Diarrhoea killed one child in ten in poor countries. In the 1970s it was discovered that giving the child a mixture of sugar and salt could prevent this. Working from another colleague’s prototype, David devised a two-ended spoon with the correct measurement of salt at one end and sugar at the other for mothers to prepare the correct rehydration solution to give to their children. People found the coloured spoons attractive and they became prized possessions. In Kenya they were decorated with beads and, much to David’s surprise, parents hung some at the foot of their children’s beds to ward off evil spirits.

ThermoSpot: Hypothermia is a common problem in newborns. This is especially the case in low birth-weight and preterm babies. David had noticed this problem when he worked with newborns in West Africa. Despite the tropical heat, the body temperatures of babies separated from their mothers dropped dangerously, and many babies died. David told John Zeal, a thermometry specialist : "First, the device has to cost nothing--and I mean nothing; secondly, it must be capable of being understood and used by illiterate mothers.” And so the ThermoSpot was created. Using liquid crystal technology, John Zeal produced a small green spot with a smiling face which could be stuck onto the baby’s body. As soon as the baby’s body temperature dropped too low, the spot turned black.

Mothers equipped with a ThermoSpot indicator are taught, "If the dot stays black, immediately put your child skin to skin against you," Prof Morley explained. "The Kangaroo Mother Care Method of raising small babies is being adopted to some extent in Britain, and widely overseas, where babies are nursed between a mother's breasts, against her body. That's one way of keeping a baby's temperature at the right level, and it does not cost anything either!"

An inspiration to so many:

Almost everyone who met David Morley felt the impact of his concern for sick children everywhere. He inspired health workers all over the world. One typical example, which will have to stand for all the others, is of Dr. Natividad Clavano of the Philippines. In 1974, she travelled to the UK for postgraduate research into paediatric asthma. But in London she found that her supervisor, Professor David Morley had other ideas. “In discussion with her, I got her interested in the problems of under-5s”, Prof Morley recalled. “I didn’t have to convince her. I think she already had an understanding of the real problems of her country.”

As a result of David’s suggestions, Dr Clavano went back to her country, and began the fight against artificial milk and the companies whose forceful marketing of their products was causing thousands of infant deaths in the Philippines. As she described it later, she “closed the door of the nursery to the milk companies.” She carried out studies, became an active speaker and campaigner and influenced UNICEF into introducing the Baby Friendly Initiative in hospitals and maternities across the developing world. The results in the Philippines were dramatic: breastfeeding rates came back up and infant deaths were drastically reduced.

Some of the many honours conferred on Professor Morley:

2003 Beacon prize for lifetime achievement for contribution to child healthcare in the developing world
2002 Dawson Williams Memorial Prize, British Medical Association, in recognition of outstanding contributions to tropical paediatrics and child health in developing countries
1990? Honorary chieftaincy of Imesi-Ile and Ilesha people of Nigeria
1989 James Spence Medallist, The UK Royal College of Paediatrics and Child Health
1989 Commander of the British Empire (CBE)
1986 Honorary Doctorate, University of Uppsala in Sweden
198? International prize and gold medal, awarded by UNICEF in Italy
1982 King Faisal International Prize for Medicine
Professor Morley was also nominated for the Nobel Peace Prize

Professor David Morley, some publications:

Morley DC. (1960).Cold Injury among children severely ill in the Tropics. The Lancet. 1170-1171

Morley D. (1973) “Paediatric Priorities in the Developing World.” London, Butterworths

Morley D, Woodland Margaret, (1979). “See How They Grow.” London and Basingstoke Macmillan.

Morley D, Elmore-Meegan M. Brown R. (1994) Child weighing by the unschooled: a report of a controlled trial of growth monitoring over 12 months of Maasai children using direct recording scales. Trans. Roy. Soc of Med. and Hyg. 88. 635-637

Meegan M, Morley D, (1999) Growth Monitoring; Family participation: Effective Community
Development. Trop. Doc. 29 23-27

Morley D, Kennedy N. (2002) Hypothermia: Prevention at community level. Trop. Doc.22 23-24

Bell Emily, Bell Henry, Socrates Cecile, Morley David, Barsby Kate, Boon G. (2002) A Low Cost
Thermochromatic Thermometer to replace Glass and Mercury Thermometers. Trop. Doc. 32: 168-171

Professor David Morley CBE, MD, FRCP

Emeritus Professor of Child Health, University of London, Institute of Child Health,
Founder and Life President of TALC, Teaching Aids at Low Cost
Founder of The Child-to-Child Trust

 

 

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