Paediatric surgery in Jamaica: The major role of women in its development
For most of the 20th century, general surgeons in public hospitals had the responsibility of operating on children, which was often an unwelcomed burden.
Professor Reginald Carpenter in a 1983 edition of Surgeon suggested that paediatric surgery as a specialty commenced in Jamaica when paediatrician Dr Leila Wynter-Wedderburn became dissatisfied with informal arrangements that allowed any surgeon to perform surgery on children. This led her to partner with Dr Henry Uriah Shaw, a surgeon at the Kingston Public Hospital (KPH); she did the pre- and post-operative care of infants and children, while he did the surgery itself.
Sir Harry Annamunthodo, “Sir Harry”, a London-trained surgeon from British Guiana, who created history as the first West Indian to be appointed to a chair at the then University College of the West Indies (UCWI), now University Hospital of the West Indies (UHWI), performed challenging surgeries on newborns and regularly published his experience in international journals. He appointed Reginald Carpenter to oversee Ward 14 at UHWI, the first dedicated paediatric surgery service in Jamaica, on January 1, 1962. This preceded the opening of the Bustamante Hospital for Children (BHC) on November 6, 1963.
Women played a major role in the development of paediatric surgery in Jamaica.
Dr Monica Lewin, a Hampton School alumnus, who specialised in surgery at the Royal Free Hospital in London, was the first general surgeon based at BHC. During the 70s, Dr Lewin treated victims of interpersonal violence at the KPH and was praised in a May 8, 2021 edition of The Lancet for her work at BHC and KPH.
Both Dr Lewin and Sir Harry fled Jamaica due to violent events of the period experienced at close quarter.
Dr Leela Kapila was another woman surgeon who contributed greatly to the development of the specialty in Jamaica. She, in 1970, spent one year at BHC on secondment from Great Ormand Street Hospital, and was awarded the Order of the British Empire (OBE) and became president of the British Association of Paediatric Surgeons (BAPS) in 2000.
Dr William Dennis, who was the first Jamaican to be appointed specialist medical officer/chief of surgery at BHC (1976), was motivated to become a paediatric surgeon while working along with Dr Kapila in 1970. Dr William Dennis ran a busy and efficient paediatric surgery referral service at BHC, the success of which depended on committed support from Dr Yulera Sujathamma, a woman surgeon recruited from India in January 1976. Her service terminated at the time of his passing in 1999.
A major decision Carpenter made during his long period of leadership was the recruitment of Dr Venugopal Sivarajan, a supremely qualified Indian expatriate, whose high level of training and commitment to teaching set a high standard for the specialty.
In 1998 Professor Peter Raymond Fletcher and Dr Denis Duquesnay initiated a doctor of medicine training programme in paediatric surgery [DM (Paed Surg)] at The University of the West Indies (UWI). This programme had as its main aim the training of indigenous surgeons to international standards.
As graduates emerged, decentralisation of services became possible, and Dr Garfield Badal, one of the early graduates, chose to pioneer paediatric surgery in western Jamaica by serving at the Cornwall Regional Hospital. He was supported by two subsequent women graduates, Drs Karen Dunbar and Dionne Flemmings.
Presently there have been 15 graduates from the DM (Paed Surg) UWI programme and all work in the Caribbean. Nine of the 15 are women, which is unique for a programme training surgeons in any specialty.
Women graduates Dr Marissa Seepersaud and Michele Vincent head the main paediatric surgery units in Guyana and Barbados, respectively, and other women consultants head units at UHWI (Dr Simone Dundas Byles) and BHC (Dr Sarah Marshall -Nyles). Other women graduates include Drs Autrene Buchanan-Waite, Carolyn Pinnock-Jackson, Claudine DeSouza, and Naomi Tyasha Plummer.
The predominance of women among paediatric surgery graduates may be explained by a combination of factors: women now make up the majority of medical graduates from The UWI; the programme prioritises work/life balance, a feature women consider important; and women paediatric surgeons have high visibility in Jamaica.
The American College of Surgeons has recognised the impact of this training programme on Caribbean surgical practice and has elected its supervisor to their Academy of Master Surgeon Educators, an honour accepted on behalf of the entire DM (Paed Surg) UWI management team consisting of Drs Simone Dundas Byles, Colin Abel, Garfield Badal, and Noel McLennon.
Dr Newton D Duncan is the supervising professor of the paediatric surgery programme at The University of the West Indies and a member of the Academy of Master Surgeon Educators.