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date: 08 February 2023

Williams, Cicely Delphinefree

(1893–1992)

Williams, Cicely Delphinefree

(1893–1992)
  • Anne Pimlott Baker

Williams, Cicely Delphine (1893–1992), paediatrician and nutritionist, was born on 2 December 1893 at Kew Park, Westmoreland, Jamaica, the second daughter and fourth among the six children of James Rowland Williams (d. 1916), landowner and civil servant, and his wife, Margaret (d. 1953), daughter of Major-General W. T. Freke Farewell, Indian army officer. Her father's family had lived in Jamaica for fourteen generations since arriving on the island from Glamorgan in the seventeenth century, forming part of what she later described as the 'brutal and licentious plantocracy' (The Times, 18 July 1992). In 1906 she was sent to England to Bath High School for Girls. She was accepted to read history at Somerville College, Oxford, but was summoned back to Jamaica by her parents after the hurricane of November 1912 left them in straitened financial circumstances. She decided that she wanted to become a doctor and was accepted to read medicine at the University of Toronto, but in 1917 she managed to obtain a visa to enter England providing that she studied medicine at Oxford (owing to the shortage of doctors as a result of the First World War). She entered Somerville College in October 1917. In 1920 she was one of the first fifty women to be admitted to Oxford University degrees, with a third class in the first BA of the medical degree. After three years of clinical training at King's College Hospital, London, including the study of paediatrics with Sir George Still, she took her final examinations in 1923.

Williams's first job was as house physician at the South London Hospital for Women and Children in Clapham. It was followed by a similar appointment in Hackney at the Queen's Hospital for Children (in 1954 renamed Queen Elizabeth's Hospital for Children), where she came into contact with Helen Mackay, the first woman fellow of the Royal College of Physicians, and Donald Winnicott, the children's physician, both important influences on her career as a paediatrician. It was in Hackney that she first came across children suffering from malnutrition and diseases such as rickets caused by deficient diets. While working there she wanted to adopt an abandoned baby and take her home to her mother in Jamaica, but her brother, afraid of the scandal, forbade her. She then spent a year near Salonika, in Greece, teaching at the Quaker-run American farm school, and also worked in refugee camps with the children of Turks who had been repatriated to Greece. While there she met Dr Andrija Stampar, the pioneer of rural health care in Yugoslavia, another lifelong inspiration to her.

After returning to London in 1928 Williams studied for a diploma at the London School of Hygiene and Tropical Medicine, and in 1929 she joined the colonial medical service and was sent to the Gold Coast. After a few months in Accra she went to Koforidua to start a new maternal and child health centre, and in 1930 she went back to Accra to take charge of the Princess Louise Hospital. In the Gold Coast she was the first to identify and describe what she later named kwashiorkor (a local word meaning ‘disease of the deposed child’), an illness caused by a diet of roots and cereals leading to protein deficiency in very young children; the condition often developed when a child was weaned to make way for a new baby. She published her findings, based on the cases she had treated, in the Annual Medical Report of the Gold Coast for 1931–2, and on the advice of Helen Mackay submitted 'A nutritional disease of childhood associated with a maize diet' to Archives of Disease in Childhood in 1933: this formed the basis for her thesis for the Oxford DM degree in 1935. Williams first used the term kwashiorkor to differentiate the disease from pellagra in an article in The Lancet in 1935. But it took a long time for her conclusions to be accepted in medical circles in Britain, where it was thought that she was misdiagnosing cases of pellagra.

After seven years in the Gold Coast, Williams was transferred to Malaya in 1936 as paediatrician at Singapore General Hospital and lecturer in paediatrics at the Singapore medical school. She was one of the first to attack what she regarded as the exploitation of people in underdeveloped countries by unscrupulous manufacturers. In her lecture 'Milk and murder', given to the Rotary Club of Singapore in 1939, she condemned milk companies which promoted sales of tinned milk, leading mothers to give up breastfeeding. In the sultanate of Trengganu, in north-east Malaya, she set up village health centres, always stressing the importance of preventive as well as curative medicine. When the Japanese bombed Pearl Harbor in December 1941 she escaped from Trengganu with the other Europeans and made her way on foot through the jungle to Singapore, but after the occupation of Singapore in February 1942 she was interned in Changi gaol, where she was appointed dietician. She became commandant of the women's camp at the beginning of 1943, but in October she was arrested on suspicion of espionage by the Kempeitai military police and confined with other prisoners in a series of cages in appalling conditions for five months, before returning to Changi for the rest of the war. Her ordeal left her emaciated and stooping, with her red hair turned to white and suffering from beri-beri, but after recuperation on a postgraduate course at Johns Hopkins University in the United States she returned to Malaya as adviser in child health. Her report 'Nutritional conditions among women and children in internment in the civilian camp in Singapore' was published in Proceedings of the Nutrition Society in 1946: in this she noted that all twenty babies born in Changi were breastfed, and all survived.

In 1948 Williams was appointed the first head of the maternal and child health section of the newly founded World Health Organization in Geneva, and this was followed by her appointment as head of its maternal and child health department, south-east Asia region, based in New Delhi. She travelled widely, organizing conferences and campaigning against, among other things, the distribution of skimmed milk by UNICEF, because the product was deficient in vitamin A. When her mother became ill at the end of 1951 she resigned, and returned to Jamaica. She was there in 1952 during an outbreak of vomiting sickness: heading the team appointed to investigate the cause, she traced it to the ackee, a fruit which could produce a toxic state of hypoglycaemia. After her mother died in 1953 she returned to London, where she was appointed senior lecturer in nutrition at the University of London. She held this post until 1955. In her article 'Self-help and nutrition: the real needs of underdeveloped countries', published in The Lancet in 1954, she argued that malnutrition was often caused not by poverty but by lack of knowledge of the nutritional needs of the child. She contributed a new chapter, 'Children in the tropics', to the seventh edition, in 1956, of Sick Children, edited by Donald Paterson and Reginald Lightwood, and to the revised edition published in 1963.

From 1959 to 1964 Williams was visiting professor of mother and child health care at the American University in Beirut, and while there she worked with mothers and children in the Palestinian refugee camps as an adviser to the United Nations Relief and Works Agency (UNRWA). Ever since her years in the Gold Coast in the 1930s she had been interested in the control of world population; she always maintained that if mothers knew that their babies would survive, they would have fewer. She was overseas training adviser to the Family Planning Association for three years from 1964, and pointed out the irony of having spent most of her life trying to make the world safe for babies before now trying to make it safe from babies. She was visiting professor of international family health at the Tulane University School of Public Health in New Orleans, USA, from 1971 to 1975. She retired officially in 1978, but continued to address meetings on maternal and child health all over the world.

Many honours were awarded to Cicely Williams: she was appointed CMG in 1968; she was the first foreigner to receive the Joseph Goldberger award in clinical nutrition of the American Medical Association in 1969; she was the first woman to be elected to an honorary fellowship of the Royal College of Medicine, in 1977; and she was the fifth person to be awarded the order of merit, Jamaica, in 1975. In 1986 she was awarded an honorary DSc degree by the University of Ghana; the citation described her 'love, care and devotion to the sick children'. She died on 13 July 1992 in the John Radcliffe Hospital, Oxford, following a stroke. She was unmarried.

Sources

  • S. Craddock, Retired except on demand: the life of Dr Cicely Williams (1983)
  • Nutrition Reviews, 31/11 (Nov 1973) [special number marking the 80th year of Cicely D. Williams]
  • J. Kosky, ed., Queen Elizabeth Hospital for Children: 125 years of achievement (1992)
  • A. Dally, Cicely: the story of a doctor (1968)
  • The Independent (16 July 1992)
  • The Independent (25 Aug 1992)
  • The Independent (27 Aug 1992)
  • The Times (18 July 1992)
  • The Times (28 July 1992)
  • The Times (12 Aug 1992)
  • d. cert.
  • private information (2004)

Archives

Likenesses

  • photograph, 1950, repro. in The Independent (16 July 1992)
  • drawing, 1981, Somerville College, Oxford
  • photograph, repro. in Nutrition Reviews
  • photograph, repro. in The Times (18 July 1992)
  • photograph, repro. in The Times (12 Aug 1992)
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