"To thine own self be true and thou canst not be false to any
Professor Courtenay Bartholomew diagnosed the first case of AIDS in the English-speaking Caribbean. Founder and director of the Medical Research Foundation of Trinidad and Tobago, he has had an illustrious career in medical education and research, spanning over three decades. He was the first lecturer in Medicine and later the first West Indian Professor of Medicine at the UWI Faculty of Medicine in Trinidad. He was also the region’s leading gastroenterologist and was noted for his early research on the venom of scorpion stings and pancreatitis, a problem which was once rampant in the tropics. In later years, he became famous for his pioneering research on HIV/AIDS in the Caribbean.
Born in Trinidad and Tobago in November 1931, Courtenay Felix Bartholomew grew up in Port of Spain. He attended Nelson Street Boys’ R.C. School and then St Mary’s College in Port of Spain from 1942 to 1950. In 1948, he came third in the island in the Senior Cambridge Examination (London), winning a Cambridge House Scholarship. Although he wanted to become a doctor, he knew that his lack of proficiency in physics would prevent him from gaining a science scholarship and instead chose to study Latin, Spanish, Greek and English Literature for the Cambridge Higher School Certificate Examination. Afterward, he left Trinidad to study medicine in Ireland, in 1954. He was admitted to University College Dublin where he won the Medical Society Prize in Medicine and the O’Ferral Silver Medal in surgery at the final examinations. In 1965, he was awarded the Doctorate of Medicine by University College Dublin, the first Caribbean physician to obtain this degree from that institution.
Dr Bartholomew was a foundation member of the Irish Society of Gastroenterology in 1964. In 1966, he was appointed Research Fellow in the Department of Gastroenterology of the Royal Victoria Hospital, Mc Gill University in Montreal, Canada. There, he initiated research on disaccharidase deficiency in humans. The Medical Chief of Staff, Dr John Beck, was so impressed with the researcher’s polished methods and impressive results that he offered Bartholomew the position of Consultant Gastroenterologist of the Royal Victoria Hospital. However, on that same day, Dr Bartholomew received a telegram from Sir Eric Cruickshank, the Scottish Foundation Professor of Medicine of the University of the West Indies in Jamaica, begging him to return to his homeland of Trinidad and Tobago for the inauguration of the University of the West Indies’ first Medical School there. He accepted that offer instead and returned to Trinidad and Tobago in September 1967 to serve the Caribbean.
Dr Bartholomew’s skills were in high demand. It was not long after his return to Trinidad that Dr Bartholomew was offered yet another position, much higher than anything he had previously been granted. The retiring Medical Director of the United Nations, Dr Michael Irvine, was adamant on ensuring that his position was filled by a competent physician but also anxious to preserve the United Nations’ mandate of political neutrality. Irvine had been searching for an eminent Third World physician to fill his post and Dr Courtenay Bartholomew seemed to be that person. However, after consulting with the Government of Trinidad and Tobago, Professor Bartholomew chose to remain in Trinidad and Tobago to continue his service to the Medical School there, in his attempt to raise the standard of medicine in Trinidad and Tobago and throughout the Caribbean.
In 1970, he published a study in the British Medical Journal, which examined 40 cases of acute pancreatitis, caused by the sting of the Trinidadian scorpion, Tityus trinitatis. This scorpion is one of only two poisonous animals in the world whose venom produces this effect. In collaboration with his alma mater University College Dublin, Bartholomew conducted laboratory research studies on the effect of this venom on mice, guinea pigs and dogs. This research led to Bartholomew’s first internationally recognised research papers, which documented the aetiology and pathophysiology of acute pancreatitis induced by the venom of the Tityus trinitatis. This research has since been cited in several medical textbooks.
In 1977, he was elevated to the post of Professor of Medicine of the University of the West Indies. Among his other significant research studies in Trinidad and Tobago was research on the seroprevalence of hepatitis A and B antibodies and the hepatitis B surface antigen in Trinidad and Tobago, based on a sample of 4500 randomly selected people. This was the largest hepatitis seroprevalence study in the Caribbean at the time and was conducted in collaboration with the Nobel laureate and discoverer of both the hepatitis B “Australia Antigen” and the hepatitis B vaccine, Dr Baruch Blumberg. The results of this study were instrumental to the Pan American Health Organization (PAHO) in advising the Government of Trinidad and Tobago about the need for a national hepatitis B vaccination program.
In 1982, Professor Bartholomew founded the Trinidad and Tobago Medical Research Foundation, dedicated to research on viruses, retroviruses, cancer and AIDS. Since then, he has served faithfully as the Director of that Foundation and he has a sixteen member full-time staff of doctors, nurses and laboratory technicians, financially supported by the Government of Trinidad and Tobago.
In 1983, Professor Bartholomew discovered the first known cases of adult T-cell leukaemia in Trinidad and Tobago and the southern Caribbean. Following this discovery, Professor Bartholomew and Dr Waveney Charles were invited to the National Cancer Institute of the National Institutes of Health in the United States by Dr Robert C. Gallo, who was credited with the discovery of the human T-cell leukaemia virus in 1980. Dr Gallo tested blood samples from these patients and confirmed that Trinidad and Tobago had an endemic of the HTLV-1 virus. Bartholomew became a collaborator in Dr Gallo’s research team, studying the clinical and epidemiological aspects of retroviruses. This collaboration was followed by many publications on the epidemiology of HTLV-1 in Trinidad and Tobago (based on stored sera from the 4 500 patients of the hepatitis A and B survey in 1982) and extensive family studies on those who were HTLV-1 antibody positive.
Also in 1983, Professor Bartholomew became a Member of the Royal College of Physicians of Ireland (MRCP) by examination. He was also awarded the MRCP degree by the Royal College of Physicians of London without examination, based on his curriculum vitae, and is the only doctor in the history of the Caribbean who has been honoured thus. In 1984, he attained the MRCP (Edinburgh) in internal medicine in the sub-specialty of gastroenterology.
Professor Bartholomew also published the first cases of HTLV-1 associated tropical spastic paraparesis/HTLV-1 myelopathy (TSP/HAM), infective dermatitis and polymyositis in the southern Caribbean. He was the first researcher in the world literature to report cases of patients who had both adult T-cell leukaemia and TSP/HAM at the same time, proving that the haematological disease and the neurological disease were caused by the same virus. He also discovered that HTLV-1 also causes facial palsy.
Under Professor Bartholomew’s advisement, the Ministry of Health of Trinidad and Tobago began screening all blood donors for HTLV-1 antibodies, eliminating a potential method of transmission of the virus in Trinidad and Tobago.
In 1983, Professor Bartholomew discovered and reported the first known case of HIV/AIDS in the Commonwealth Caribbean. He observed patients infected with both HTLV-1 and HIV-1, discovering that HTLV-1 /HIV-1 co-infection leads to faster progression to AIDS, a finding which was later confirmed by researchers elsewhere, particularly in Brazil.
In 1985, he was appointed Chairman of the Board of the National Institute of Higher Education, Research, Science and Technology (NIHERST) by the Government of Trinidad and Tobago, which was established to foster research and development in Trinidad and Tobago. In that year, he also aided PAHO by reviewing its regional guidelines for AIDS. In 1986, he was the consultant advisor on AIDS to the World Council of Churches in Geneva, Switzerland.
In 1998, because of the international reputation of the Medical Research Foundation, Professor Bartholomew was appointed by the International AIDS Vaccine Initiative in the USA to participate in the international canarypox vCP 1452 Phase II HIV vaccine trial. Vaccination of 40 volunteers was completed in 2004.
In the year 2000, he was appointed as one of thirty members of the International Bioethics Committee (IBC) of UNESCO, at a time when the IBC was formulating recommendations on the human genome and stem cell research. He is the only scientist in the Caribbean to be appointed to the International Bioethics Committee of UNESCO. Professor Bartholomew was also a member of the Editorial Board of the Journal of AIDS and is also on the Board of the Journal of The Acquired Immune Deficiency Syndrome and Human Retroviruses, two leading American journals on retroviruses.
In 2005, Professor Bartholomew documented a case of
HIV-transmission through surrogate breastfeeding, alerting clinicians in
third-world countries (especially India and Africa) to this possible means
In April 2002, the Government of Trinidad and Tobago decided that all HIV/AIDS patients in the country would receive free antiretroviral drugs. The Prime Minister commissioned Professor Bartholomew to become Director of the nation’s HIV/AIDS treatment programme. The Centre, which treats over two thousand patients, is the largest of its kind in the Caribbean and is touted as one of the best developing nation HIV/AIDS treatment centres in the world, if not the best. In the beginning of 2006, Professor Bartholomew submitted a three year report (April 2002 – December 31, 2005) to the New England Journal of Medicine, documenting the progress of this Centre.
Professor Bartholomew has been guest lecturer on numerous occasions in scientific meetings and has over 75 publications in the scientific literature. He also has written chapters in seven textbooks of medicine. In spite of his extremely busy scientific schedule he is also a prolific author on the relationship between science and religion, having written eight books on this subject, four of which comprise a series called A Scientist Researches Mary.
This Icon is also featured in the Caribbean Icons in Science, Technology and Innovation Volume I and Trinidad & Tobago Icons Volume I:
Awards and Honours:
His awards and honours include:
Chaconia Gold Medal, for long service in the field of health and education in Trinidad and Tobago, 1975.
Man of the Year Award, Trinidad Express, 1985
Achiever of the Year Award, Trinidad Guardian, 1989
The International Society of Retrovirology Award, 1991
Professor Emeritus in Medicine, University of the West Indies, 1997
Charles C. Shepard Award for Scientific Excellence, Centres for Diseases Control (CDC), presented to the Medical Research Foundation of Trinidad and Tobago, 1999
2001 Republic Day Award, Citizens for a Better Trinidad and Tobago (CBTT), 2001
Honoured by the West Indian Society of Gastroenterology as the Father of Gastroenterology in the West Indies, 1991
Recognised for 25 years of distinguished service by Faculty of Medical Science of the University of the West Indies, Kingston, Jamaica, 1992.
St. Mary’s College Past Students’ Union Award/Induction into the St. Mary’s College Hall of Fame, 2003.
University of the West Indies HIV/AIDS Response Program (UWIHARP) Pioneer Award, 2005.
The National AIDS Coordinating Committee, Office of the Prime Minister, 2005.
Class of 2006/2007 Award, Department of Clinical Medical Sciences at the Faculty of Medical Sciences of the University of the West Indies in St. Augustine, 2006.
The Action of Tityus trinitatis venom on the canine pancreas in the book Animal, Plants and Microbial Toxins, Vol 2, 507-514, 1974 (Plenum Press, New York
HTLV as a co-factor in AIDS in the book Co-factors in AIDS and Progression to AIDS, 1988 (CRC Press, USA)
Adult T-cell Leukemia/Lymphoma and Tropical Spastic Paraperesis in Trinidad and Tobago in the book HTLV-1 and the Nervous System, 1988 (Alan R. Liss & Company, USA)
Retroviruses in The Caribbean in the Publication Profile of an Epidemic, 1989 (PAHO/WHO)
The Clinical spectrum of HTLV-1 Infection in Trinidad and Tobago in the book Human Retrovirology: HTLV, 1990 (Raven Press, USA)
Adult T-cell Leukemia in Trinidad and Tobago in the book Human Retrovirology: HTLV, 1990 (Raven Press, USA)
HTLV-1 and the Diaspora in the book AIDS: An African Perspective, 1991 (CRC Press, USA).
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