Cres Eastman: Averting a human disaster in Tibet

18 October 2006
Two decades ago, endocrinologist Creswell Eastman journeyed into the mountain villages of the remote Tibetan Plateau. What he saw horrified him: more than one in ten babies was born with the stunted mental and physical growth of cretinism, caused by a lack of iodine in the food chain.

Iodine deficiency is a problem in many upland areas, where the trace element is leached from the soil. "But I had never seen so many people with cretinism anywhere else in the world," says Professor Eastman. "The people there were so kind and innocent, but suffering such a disaster."

He has been returning to Tibet ever since, and his ongoing project to eliminate Iodine Deficiency Disorder (IDD) has saved an estimated 700,000 children, 2 million women of child bearing age, and 170,000 new-born babies from the disease.

"People keep asking what drives me to go back," he says. "I suppose it comes back to the doctor in me, and a sense of responsibility."

The Tibet project has been described as an extraordinary success by the World Health Organisation, and he has earned a slew of awards including this year's Australian Medical Association Excellence in Health Care Award.

He was also memorably described as "the man who saved a million brains" by the ABC's Catalyst program.

But Professor Eastman says his greatest satisfaction comes from the place he has helped and people he has saved.

Working in the uplands of Tibet at heights of more than 5000m, altitude sickness is a constant problem. "I still remember the first time I was preparing to go there," he says. "The local health minister, who later became my friend, told me it would be the hardest thing I had ever done in my life.

"He told me I would put my life at risk. But at that that time I didn't appreciate what he was saying."

Lack of oxygen and swelling of the brain nearly cost him his life, and he was only saved by self-administered daily injections of a synthetic steroid used for severe altitude sickness.

"I don't see myself as being a very brave man," he says, "and in your dark moments you think, 'Well, am I really making a difference?'"

His question is answered by statistics. Iodine supplements in the mountain villages now reach 97 per cent of women and children. But still he has not given up, and he returns to Tibet each year on his annual leave, paying for his trips himself.

He feels there is still work to be done. "I don't want to act as a rescuer," he says, "I always work with the doctors there, and help them build their own capabilities."

He believes that a sustainable chain of medical treatment is the ultimate solution for iodine deficiency in Tibet. It's a strategy he introduced successfully 12 years ago in Beijing, where he helped to establish the National Reference Laboratory for Iodine deficiency disorders. Many doctors he worked with have now have started to train others.

His assistance to China has earned him the trust and cooperation of the government and people there. "Without that trust I would never have been able to carry out this work," he says.

Other Asian countries such as Laos, the Philippines, Thailand, Cambodia, Vietnam and Fiji have also benefited from his expertise in tackling iodine deficiency.

Having recently retired as director of the Institute of Clinical Pathology and Medical Research, Professor Eastman still lectures at the University while pursuing his diverse hobbies of flying and cooking.

He is also a consultant physician and endocrinologist at Westmead Hospital, and is vice-chairman of the International Council for Iodine Deficiency Disorders.

At the end of this month he will return to Tibet. "I won't stop until the sustainable medical treatment chain is established, and people there become entirely independent," he says.

Claudia Liu

Contact: Richard North

Phone: 02 9351 3720

Email: rnorth@media.usyd.edu.au