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Surinder Singh Bakhshi

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Surinder Singh Bakhshi
Bakhshi in 2022
Born1937 (age 86–87)
Dar es Salaam,Tanganyika Territory
NationalityBritish
EducationMakerere University,Kampala,Uganda
OccupationMedical officer of environmental health to Birmingham area (appointed 1977)
Years active1974–2003
Known forManaging community containment of smallpox during the1978 smallpox outbreak in the United Kingdom
Medical career
ProfessionPhysician
FieldPublic health
InstitutionsBirmingham Area Health Authority

Surinder Singh Bakhshi(born 1937) is a British writer and physician, who in 1977 was appointedmedical officer of environmental healthto theBirmingham Area Health Authority,where he led the successfulcontact tracingandquarantineeffort in the community during the1978 smallpox outbreak in the United Kingdom.

Bakhshi received his medical degree fromMakerere UniversityinKampala,Uganda. After completinghouse jobshe worked at a hospital by theZambeziin Zambia, before moving to the United States, where he held aRockefeller Fellowshipinpublic healthat theUniversity of Michigan.In 1974, after a medical posting that involved managing an outbreak ofcholeraamong refugees from Mozambique, he moved to England and in 1977 was interviewed for a medical officer appointment in Birmingham. In addition to his efforts in containing smallpox, he dealt with other outbreaks in Birmingham includinghepatitis A,hepatitis B,meningitisandtyphoid.

In retirement, Bakhshi publishedTuberculosis in the United Kingdom: A tale of two nations(2006) andSikhs in the Diaspora: A modern guide to the practice of Sikh Faith. A knowledge compendium for the global age(2008).

Early life and education[edit]

Surinder Singh Bakhshi,[a]known as Surinderjit to his friends,[2]was born in 1937 inDar es Salaamtoemigrants from India,Sohan Singh and Amrit Kaur.[1][3]His family werePunjabi Sikhsand had origins inRas Koh Hills,Balochistan (British India)(now in Pakistan), and during theinterwar yearshis parents left to work inEast Africa.[2]

After spending his early years in Dar es Salaam among a large Indian community, he gained admission to study medicine in 1960 atMakerere UniversityinKampala,Uganda, from where he graduated in 1965.[2][4][b]That year, he married Rajinder Kaur, hischildhood sweetheart.[1][2]

Early career[edit]

After completinghouse jobsBakhshi's first medical officer post was at a hospital inMongu,Barotseland.[2]Situated by theZambeziin Zambia, he treated mostlysnakebitesandtuberculosisin theBarotse population.[2][6]After three years there he moved to the United States after a brief period in managingimmunisationprogrammes in the Zambia and then taking a worldwide tour.[2]In the US, he held aRockefeller Fellowshipat theUniversity of Michigan,from where he completed a master's degree inpublic healthin 1971.[2][7]On returning to Zambia, he was appointed regional medical officer and became involved in containing acholeraoutbreak among refugees from Mozambique.[2]

In 1974, he moved to England, where his parents had already settled, and took up a post asregistrarinKingston upon Thamesbefore becoming senior registrar inGloucestershire,where he resided atSlimbridge.[2][4]

Birmingham[edit]

The Alpha Tower, Birmingham

In 1977, Bakhshi was appointedmedical officer of environmental healthfor the Birmingham Area Health Authority.[4][8][c]An account of his first year there is given inMark Pallen's bookThe Last Days of Smallpox(2018).[2]Bakhshi told him that on the day of the interview, he was told by the reception that "people like him" were not allowed to use the lift so he walked the 13 flights of stairs to his interview inAlpha Tower.[2]He recounted in an oral history and in interviews by Pallen and journalistSally Williams,that instead of the usual eight interviewers, there was surprise that an Indian had applied for the post and 20 turned up to interview him.[2][4][11]

After a two-hour interview in which he was hardly asked any questions as the interviewers spent most of the time asking each other questions, he was asked to wait before being informed that a decision was inconclusive, but when he arrived back home he received a call confirming he got the job.[2]He told Williams that "When I started work, people wouldn’t speak to me – not even my secretary, for a couple of weeks. I used to tell my wife, ‘I feel very sorry for them – they look at me and feel unhappy.’"[4]In that first year in post, he had to deal with an outbreak ofhepatitis Boriginating from an acupuncturist.[2]With his family home in Gloucester, he shared his time between Birmingham in the week and home for weekends.[2]His office was allocated in theUniversity of Birmingham Medical School,along the same corridor asAlasdair Geddes.[2]

1978 smallpox outbreak[edit]

In 1978, around a year into his post, Bakhshi was tasked with leading the operational management of public health and containing community spread ofsmallpoxduring thesmallpox outbreak in Birmingham.[4][12]He first came to hear of smallpox in Birmingham on 25 August 1978 and the first meeting of the control of smallpox outbreak advisory committee took place that same day.[2]Under the chairmanship ofWilliam Nicol,Medical Officer to the Birmingham area, the committee includedHenry Bedson,Nicol Spence Galbraith,Geddes, and Bakhshi.[4][13]

Of the two main tasks of the committee; finding out how smallpox arose in the first place and identifying and containing spread of smallpox in the community,[2]Bakhshi's role, now designated "Outbreaks Liaison Officer",[13]wascontact tracingandquarantine,home visits to contacts,vaccinations,and antibody injections.[4][12]Pallen explains that Bakhshi secured unrestricted funding, the use of three floors of Birmingham'sHoliday Inn,the black cab service, food from local restaurants, and the recruitment of around 60 doctors, 40 nurses, 85 environmental health inspectors and associates, six officers for disinfection and near a hundred administrative staff.[2]Health records, media and radio were utilised to pin down almost all contacts and they were isolated within 24 hours.[2]With colleagues, he devised a method of categorising contacts and delegated to them either medical staff, health visitors or others accordingly.[2]Bakhshi took responsibility of visiting and dealing with the closest contacts of Janet Parker, the index case.[2]This included those that Parker lived with and the twofamily physiciansthat recently treated her.[13]

It was Bakhshi who informed theWorld Health Organizationin mid-October, seven weeks after the onset of the outbreak, that the outbreak was contained and the alert was lifted.[14]The containment efforts were successful,[12]and the official report on the outbreak would later state:[15]

We would like to record our appreciation of the speed and thoroughness with which Dr Nicol, the area Medical Officer, and his staff and also the staff of the Birmingham University medical School reacted to contain the spread of illness when smallpox had been diagnosed. Their action in dealing with the task of tracing isolating and vaccinating all close contacts of Mrs Parker, and in disinfecting all areas of possible contamination was impressive and contributed considerably to preventing a far wider spread of infection.

During his tenure as medical officer in Birmingham, he was responsible for containing other outbreaks includinghepatitis A,[4][16]meningitis,[17]andtyphoid.[18]

Later life[edit]

In retirement, Bakhshi publishedTuberculosis in the United Kingdom: A tale of two nations(2006) andSikhs in the Diaspora: A modern guide to the practice of Sikh Faith. A knowledge compendium for the global age(2008).[1]

In Williams' article inthe Guardian(2020) during theCOVID-19 pandemicon whether the 1978 smallpox outbreak could provide any lessons, Bakhshi's approach was considered personal and locally led, and he explained that "contact tracing and containment are in the genes of any public health doctor."[4]

Selected publications[edit]

Articles[edit]

  • Nicol, W.; Bakhshi, S.S. (April 1980)."Exotic Infectious Diseases: Smallpox".Royal Society of Health Journal.100(2): 41–47.doi:10.1177/146642408010000202.PMID6992193.S2CID37556538.
  • Bakhshi, Surinder Singh; Ali, Shaukat (1995)."Knowledge, attitude and behaviour of TB patients".Journal of Public Health Medicine.17(3): 343–348.ISSN0957-4832.JSTOR45160661.PMID8527189.
  • Bakhshi, Surinder S.; Hawker, Jeremy; Ali, Shaukat (August 1997)."The epidemiology of tuberculosis by ethnic group in Birmingham and its implications for future Trends in tuberculosis in the UK".Ethnicity & Health.2(3): 147–153.doi:10.1080/13557858.1997.9961823.PMID9426979.
  • Bakhshi, S. S. (1 September 1997)."Framework of epidemiological principles underlying chemical incidents surveillance plans and training implications for public health practitioners".Journal of Public Health.19(3): 333–340.doi:10.1093/oxfordjournals.pubmed.a024640.PMID9347460.
  • Hawker, Jeremy I.; Bakhshi, Surinder S.; Ali, Shaukat; Farrington, C. Paddy (16 October 1999)."Ecological analysis of ethnic differences in relation between tuberculosis and poverty".BMJ.319(7216): 1031–1034.doi:10.1136/bmj.319.7216.1031.ISSN0959-8138.PMC28253.PMID10521193.

Books[edit]

Footnotes[edit]

  1. ^Sometimes misspelled as Bakshi.[1]
  2. ^The medical school at Makerere University in the mid-1960s had a wide network with reputable international specialist centres and experts.[5]
  3. ^The medical officer of environmental health was a relatively new post at the time, responsible to the local authority for preventing communicable disease and initiating appropriate measures. It largely replaced many duties of the formermedical officer of health,a statutory officer with responsibilities to the local authority in preventing disease, which was discontinued following the reorganisation of theNational Health Service Act of 1973.[9]The Birmingham Area Health Authority at the time was based inAlpha Tower,Broad Street,Birmingham.[10]

References[edit]

  1. ^abcdBakhshi, Surinder (2008).Sikhs in the diaspora: a modern guide to practice of the Sikh faith: a knowledge compendium for the global age.Birmingham, UK: Sikh Publishing House in association with Ramgarhia Sikh Temple.ISBN978-0-9560728-0-1.
  2. ^abcdefghijklmnopqrstuvwPallen, Mark(2018). "36. Saving a city from smallpox".The Last Days of Smallpox; Tragedy in Birmingham.Independently Published. pp. 114–122.ISBN9781980455226.
  3. ^"Sikhs in the Diaspora: A Modern Guide to the Practice of Sikh Faith: A Knowledge Compendium for the Global Age, Singh Brothers, 8172054475".8 July 2010.Retrieved20 September2022.
  4. ^abcdefghijWilliams, Sally (21 November 2020)."'It was a total invasion': the virus that came back from the dead ".the Guardian.Archived fromthe originalon 20 September 2022.Retrieved20 September2022.
  5. ^Foster, W. D. (1974)."Makerere Medical School: 50th Anniversary".The British Medical Journal.3(5932): 675–678.doi:10.1136/bmj.3.5932.675.ISSN0007-1447.JSTOR20470416.PMC1611695.PMID4609535.
  6. ^Bakhshi, Surinder (2006). "Prologue".Tuberculosis in the United Kingdom: A Tale of Two Nations.Leicester: Troubador Publishing Ltd. pp. ix–xii.ISBN978-1-905237-53-1.
  7. ^Directory of Fellows 1953-74.Population Council. 1974. p. 12.
  8. ^"13. General observatios".Parliamentary Papers, House of Commons and Command.H.M. Stationery Office. 1979. pp. 70–73.
  9. ^Walrond, H. A. (1978).The role of the medical officer in environmental health(PDF).Oxford University Press.ISBN0-19-721221-2.
  10. ^Bax, A.; Fairfield, S., eds. (2015)."What Midlands".The Macmillan Guide to the United Kingdom 1978-79.London: The Macmillan Press. p. 494.ISBN978-1-349-81511-1.
  11. ^Jones, Ellen (2018)"Conflict, community, and culture: an oral history of Sikh migrants in Birmingham, 1960-1979".University of Bristol Department of Historical Studies, p.28
  12. ^abcKang, Lydia; Pedersen, Nate (2021).Patient Zero: A Curious History of the World's Worst Diseases.Workman Publishing Company. p. 588.ISBN978-1-5235-1536-3.
  13. ^abcShooter, R. A. (July 1980).Report of the investigation into the cause of the 1978 Birmingham smallpox occurrence(PDF)(Report). London: H. M. Stationery Office. pp. 70–72.
  14. ^"Smallpox alert is lifted".Birmingham Mail.17 October 1978. p. 27 – viaBritish Newspaper Archive.
  15. ^Shooter, R. A. (July 1980).Report of the investigation into the cause of the 1978 Birmingham smallpox occurrence(PDF)(Report). London: H. M. Stationery Office. p. 2.
  16. ^Skidmore, S. J.; Bakhshi, S. S.; Beedle, R.; Kimberley, J. (April 1982)."An outbreak of infectious hepatitis investigated using radioimmunoassays for hepatitis A virus antibody".Epidemiology & Infection.88(2): 351–354.doi:10.1017/S0022172400070194.ISSN0022-1724.PMC2133844.PMID6278018.
  17. ^"Meningitis hits ninth in city".Birmingham News.11 February 1988. p. 13 – viaBritish Newspaper Archive.
  18. ^"Central News East: 04.03.1988: Typhoid Outbreak".MACE Archive.22 June 2017.Retrieved27 September2022.

External links[edit]

Retrieved from "https://en.wikipedia.org/w/index.php?title=Surinder_Singh_Bakhshi&oldid=1230933728"