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To be chosen to deliver the keynote address at the Martin Luther King Jr Foundation's award banquet took me completely by surprise—and to find that four bodyguards had been assigned me shook me rigid. Nobel laureates Linus Pauling and Max Perutz, along with Hermann Lehmann, Roland Scott, A C Allison, Graham Serjeant, and I, were among a select few invited to Philadelphia to receive an award “for outstanding research in sickle cell anaemia.” But why was I asked to deliver the keynote address, with Pauling and other abnormal haemoglobin heavyweights on the platform?
Was it, perhaps, because a foundation commemorating a black person wanted to “show off” the only black African among those receiving the award? Was it, perhaps, because I was then director of the largest sickle cell disease clinic in the world? Or was it because I was the only person to have traced hereditary disease in his forebears, with named patients, generation by generation back more than three centuries? Or was it the statement made a few weeks back in New York by Professor Helen Ranney of the Albert Einstein University College of Medicine: “There is no single clinical experience in the United States comparable to that of Dr Konotey-Ahulu”?
Such “perhaps hypotheses” competed in my brain when I arrived in Philadelphia, that day in 1972. I walked out of the hotel to post a letter to my wife in Ghana. Just as I was about to cross a road, I heard a voice behind me: “Doctor! Doctor!! Do NOT cross that road. Where are you going?” The hugely built American (black) took the letter from me before dropping the bombshell: “I am one of your four bodyguards.”
The award organisers, who came within minutes of my call, explained that the text of my lecture alerted them to several problems. I had distinguished between sickle cell trait and sickle cell disease (sickle cell anaemia) because the terms were being used interchangeably, with disastrous consequences, by people who should know better. People with the trait (one abnormal gene) cope better than people with two normal genes with falciparum malaria, which kills sickle cell disease patients (two abnormal genes) quicker than people with two normal genes. I had questioned published work which claimed that black Army recruits exercising at an altitude of 4000 ft collapsed and died because of sickle cell trait. I had asked: “How could black sickle cell traits run and beat the whole world at the Olympic Games at Mexico City, at an altitude of 8000 ft (double the altitude at which people with sickle traits had been said to perish)?”
Why did I need four bodyguards? The award organisers thought I needed protection because I used data from an article by James Bowman, who had named seven insurance companies in the United States which loaded the premium of black people with sickle cell trait, thus making lots of money on healthy people, who needed to pay 150% for health insurance. I explained that in southern Ghana, where one person in five has the sickle cell trait, one in five sudden deaths in adults from whatever cause would be in people with sickle trait. Moreover, to make insurance recommendations for only “black” sickle cell trait, without mention of “white” sickle trait in people from Greece, Cyprus, Turkey, India, and Saudi Arabia—many of whom lived in the United States—was not medical science.
The award organisers advised me to leave names of the insurance companies out of my lecture. Even so, they could not run the risk that I would be bumped off before the lecture. I cannot remember being able to eat anything at the banquet, but I was glad to be able to shake hands later with the great and good. I left Philadelphia immediately afterwards—no sight seeing for me.
How dangerous is it these days to stand firm for scientific truth—or rather, how risky is it to criticise scientific untruths? The Ghanaian herbalist Nana Drobo was found with bullet holes in his head, not long after successfully treating a dying French man with AIDS who was sent to him from the Ivory Coast. And how safe is it to point out that some of the prescribed protocols for global malaria control are not the best answer to the problem? How many bodyguards would be adequate protection, when huge amounts of money are at stake in global health protocols? Money in itself is not sinful—rather, as it says in the Bible: “The love of money is the root of all evil.”