I have never up until now thought of myself as a “Black Nephrologist” which is a bit like calling Gary Lineker a white footballer!
Now I am anxious about whether this reflects a woeful lack of insight on ethnicity on my part, but I refuse to feel guilty about that.
I loved working in Birmingham where I was appointed as a Consultant Physician and Nephrologist in 1981. The patients there really helped me, especially the ones from the black country. One bitter winter afternoon in the early 1980s doing a transplant clinic I was moaning to a patient that I could be in Ghana sunning myself. He told me “None of that. You are doing the same as I am doing- working for a wage.”
He worked as a foreman in the now defunct British Leyland which was then a major carmaker in Birmingham. I have never forgotten his advice. I have always loved looking after patients but have a special affection for the ones from the Black country who could be brutally honest but completely loyal. Together with my Consultant colleague and partner in Birmingham, Jonathan (now Sir Jonathan) Michael (JM) we have always been patient advocates before this became fashionable. We firmly believed, and still do, that we were unable to put value to a patient’s quality of life when it came to deciding on whether or not to offer life-saving treatment.
When we went to Birmingham in 1980, dialysis was not available to patients with diabetes, patients who had stroppy spouses or who did not first into an undefined norm. We spent our first few years breaking down these barriers and this included putting patients on CAPD as that was then paid for by General Practitioner colleagues. By the end of the 1980s, we had over 300 patients on CAPD. JM was the articulate one and engaged Edwina Currie, Junior Health Minister at the time on TV and radio to advocate for offering dialysis to patients. At the time we had to obtain permission to put any patient on dialysis. I remember one interview on Radio 4 when I said that I was sending a patient with diabetes and end-stage renal failure, who I was not allowed to dialyse, home to die. This was so she could be with her guide dog.
I was inundated with calls from the Regional Health Authority and by the end of that morning had been permitted to dialyse her. I had prised open the great British secret in that she received dialysis so her guide dog would not grieve! JM and I also persuaded the Renal Association to move from being a largely academic organization to one that embraced health care policy and advocacy. Here I remember with fondness past Renal Association (now the UK Kidney Association) Presidents, Professors David Kerr, Molly McGeown, Bill Asscher, Nettar Mallick and Stewart Cameron amongst many others who helped change the Renal Association into the active patient-focused organization it now is.
I was not unaware of the role ethnicity played in health care delivery and employment. I was a member of the Department of Health/Kings Fund Equal Opportunities Task Force 1986-1990 and of the Queen Elizabeth Hospital Nexus Project aimed at developing culturally competent services for ethnic minority communities from 1997-2000. As a Councilor at the Royal College of Physicians, I helped push back some particularly pernicious studies attributing MRCP results to ethnicity. I served on the Kings Fund General Council. For the Royal College of Physicians, I was successively West Midlands Regional Advisor, Chairman of the Renal Specialty Advisory (Training) Committee and a Councillor. Working with the International Society of Nephrology I helped develop nephrology training programmes in Africa. As Chairman of the Renal Association Clinical Trials Committee from 1993-2000 we were able to move multicenter studies into the mainstream of British Nephrology.
I have been aware of racists, but in the main have pitied them and certainly not let them divert me from my aims. To my younger colleagues, regardless of ethnicity, pursue your aims and dreams and treat all people with dignity.
“Jo was an inspiration to me and everyone he worked with and trained. By demonstrating kindess to his trainees, staff and especially patients, he was the perfect role model which many of us still try to live up to. His fierce intellect and his clear thinking is his calling card as is his determination to do the right thing. I am so grateful for having spent time working with him in many guises over the years” - Raj Thuraisingham, Divisional Director Specialist Medicine, Barts Health.
"Jo Adu was a founder of the Queen Elizabeth hospital Renal Service, one of the largest and highest quality comprehensive Kidney Units pioneering patient-centred care at a time when the NHS did not provide adequate resources to dialyse all those who might benefit. He has inspired generations of nephrologists with his calm dedication, focus on humanity, mutual respect and recognition of the importance of evidence-based practice. His research focus has led to substantial improvements nationally and internationally in the care of patients with lupus and vasculitis. Despite retirement, he has developed a nephrology training programme in Ghana to support a substantial local dialysis programme for a population with a high need for kidney care. His deep intellect and commitment to research methods has enabled Jo to develop an extensive international collaborative research programme with support from the UD NIH exploring genetic factors underpinning the high incidence of CKD and pre-eclampsia in people in West Africa and African Americans." - Dr Graham Lipkin, Past President Renal Association, National Renal GIRFT Co-Lead.
