Eastman, Creswell

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MB BS 1965 MD 1980 FRACP FRCPA FAFPHM ACCAM

Creswell (Cres) Eastman is a world-renowned endocrinologist with a primary interest in Iodine Deficiency Disorders. He is an international leader in projects to abolish IDD throughout the developing world, particularly Malaysia, Laos, Thailand, Vietnam, Indonesia, China and Tibet. He was the Foundation Head of the Department of Endocrinology and Diabetes at Westmead Hospital in 1979.

Cres completed his internship as a Resident Medical Officer at St Vincent’s Hospital, Sydney. He remained there and began his early training in Endocrinology under the supervision of Profesor Les Lazarus as the Littleshop Research Fellow in endocrinology at the Garvan Institute of Medical Research. In 1969, he became Registrar, before taking up another research fellowship, this time in asthma research at the Garvan. In 1971, he was awarded the Overseas Travelling Fellowship of the Royal Australasian College of Physicians and travelled to the Middlesex Hospital Medical School in London to train under John Nabarro and Professor Roger Eikins.

Returning to Australia in 1973, Cres became the Deputy Director of the Garvan Institute of Medical Research at St Vincents Hospital, Sydney. Concurrently, from 1975 to 1979 he was Foundation Head of Endocrinology and Diabetes at the Woden Valley and Royal Canberra Hospitals.

When Westmead Hospital opened at the end of 1978, Cres became the Foundation Head of the Department of Endocrinology and Diabetes shortly after, also serving as Deputy Director of the Division of Internal Medicine at Westmead Hospital. During his time at Westmead, he has also served as Chairman of the Westmead Hospital Medical Staff Council and was the driving force behind the establishment of the Westmead Hospital Research Foundation and Institute in 1997.

Cres’ research interests are focused predominantly in thyroidology, especially in the area of iodine deficiency disorders (IDD). He has directed major research projects into IDD in Malaysia, Indonesia and China. In an ABC documentary, Cres talks about his firsts visits to Tibet and his realisation that 13 per cent of the population were born with cretinism as the result of iodine deficiency. As he explains:

My association with Tibet began in the mid 1980s with visits out to the Tibetan Plateau in Qinghai. But on my first visit there, I had never seen as many people in villages with cretinism anywhere else in the world. So it was a massive problem, in fact it was absolutely overwhelming… It’s such a big problem in China because over two-thirds of the population live in rural areas, many of them having to just sustain themselves through what they grow. In other words, they are born, live and die within a few kilometres… most of the fields, most of the earth and the water are iodine deficient. And it doesn’t get in from imported foods or processed foods… So the higher the altitude, the more remote you are, the worse the problem is… If the average IQ of Tibetan children is only 85, and that’s what it was before this program started, and people with IQs of 85 can’t be educated, they don’t really get beyond primary school.[1]

Cres argues that to ignore this problem is to turn your back on the basic human rights of these people and that “the most important human right you’ve got is to realise the intelligence you’ve inherited from your parents.”[1]

He was awarded the Otsuka Gold Medal by the Asia Oceania Thyroid Association in 1982 for his research into thyroid disease. In 1988, he was awarded a special Bicentennial Award by the Australian International Development Assistance Bureau (AIDAB, now AusAID) for his work from 1985 to 1992, leading and conducting a highly successful multi-million dollar Australian Overseas Aid project in China aimed at controlling and preventing iodine deficiency disorders in rural Chinese populations. He continues to act as an adviser on Iodine Deficiency Diseases control to UNICEF, World Bank and WHO, and was appointed as Principal International Consultant in Endemic Diseases to the Ministry of Public Health of the Peoples Republic of China in 1997. He also holds a similar appointment to the Tibet Autonomous Region and is an Honorary Professor of Medicine of Tianjin Medical University in China.

Here in Australia, Cres has been Director of the Institute of Clinical Pathology and Medical Research (ICPMR) and Chairman of the Division of Laboratory Medicine at Westmead Hospital from 1989 to 2006. Concurrently, he has been Director of the Western Sydney Area Pathology Service and Chairman of the ICPMR Pathology Network, incorporating the pathology services of Western Sydney, Wentworth Area Health, Far West Area Health, Mid West Area Health, Central Coast Area Health and St Vincent’s, Sydney (Sydpath). He also maintains the role of Clinical Professor of Medicine in the Faculty of Medicine at the University of Sydney and remains in active clinical practice as a Consultant Physician in Endocrinology and as an Aviation Medical Consultant.

Between 1991 and 1994, Cres developed and implemented the plan to integrate all of the pathology services and laboratories in the hospitals of the Western Sydney Area Health Service into the single business and functional entity which currently serves over 2000 hospital beds and provides the largest public pathology service in NSW. In 1995 he was one of a small team that developed the ‘Hub and Spoke’ system to improve efficiency and access to Pathology services in NSW.

In 1997, Cres was appointed Director and Chief Government Analyst of the Division of Analytical Laboratories (DAL), located at Lidcombe in Sydney. The DAL provides all public health analytical services and all forensic medical services to the State of NSW.

Also in 1997 he developed the concept for a National Reference Laboratory for IDD for China, and raised over 1 million dollars from external funding agencies to establish this centre in Beijing, its function being to ensure quality assurance as a fundamental part of the IDD control efforts in China. Cres acts as the Principal Consultant to the World Health Organization (Western Pacific Region) in IDD. In recent years, he has undertaken numerous consultancies for the WHO and UNICEF in Asia, particularly China, Vietnam and Thailand. In 1999, he initiated and was the team leader of a UN (UNICEF and WHO) and Chinese Ministry of Health sponsored health care team that undertook a feasibility study in Tibet to develop and implement a plan to eliminate IDD in Tibet. He is now Chairman of the Project Coordinating Committee and Project Director of the AusAID and WHO sponsored ‘Tibet IDD Elimination Project’ (2000–2005). This is a multimillion dollar ongoing, collaborative project involving AusAID, the ICPMR, WHO, UNICEF, the Ministry of Health in Beijing and the Tibet Autonomous Government.

Cres has been a member of numerous professional groups and committees. He is a past President of the Endocrine Society of Australia and now a Life Member. Since it was established in 1975, he has been a member of the Executive Council of the Asia Oceania Thyroid Association, currently serving as Vice President. He is a Board Member and Deputy Chairman elect of the International Council for the Control of Iodine Deficiency Disorders (ICCIDD) and was appointed ICCIDD Regional Coordinator for the Asia Pacific Region in April 2002.

In addition to his ongoing work in endocrinology, he has developed a major interest in the education and training of clinicians in management, especially strategic and quality management. In 1991, he initiated the first comprehensive course in Australia for practising doctors to train in business management. The Management for Clinicians Program, (MFCP) is a two-week intensive residential course, sponsored by the University of Western Sydney, the University of Wollongong, the Western Sydney Area Health Service, the Faculty of Medicine of the University of Sydney and the NSW Department of Health. He served until 2002 as Chairman of the Steering Committee and the Faculty for the MFCP, incorporating visiting Faculty from Harvard University and the Henry Ford Health Care System from the USA. He introduced Total Quality Management to the ICPMR in 1990, and the ICPMR and its departments have won several awards in both the business and professional sectors, nationally and internationally, for achievements in quality management. In 1994, the ICPMR won a prestigious Commonwealth Government Technology Productivity Silver Award for the implementation of a sophisticated Laboratory Information System–the Cerner Pathnet Information System.

Cres was awarded Membership of the Order of Australia in 1994 for his contributions to Medicine, particularly in the field of Endocrinology, and was awarded the Premier’s Gold Service Award in 2002 for development of the NSW Forensic DNA service laboratory. In 2003, he was a NSW finalist for Senior Australian of the Year and in August 2004, he was honoured by Princess Maha Chakri Sirindhorn at a special ceremony in the Chitralada Palace, Bangkok for services to the improvement of the health of the people of Thailand.[1]

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Citation: Mellor, Lise (2008) Eastman, Creswell. Faculty of Medicine Online Museum and Archive, University of Sydney.

An alternate version appears in: Mellor, L. 150 Years, 150 Firsts: The People of the Faculty of Medicine (2006) Sydney, Sydney University Press.