Professor Creswell Eastman, MB BS 1965 MD 1980 FRACP FRCPA FAFPHM ACCAM AO [30 March 1940 - ] - Endocrinologist
Introduction
Creswell (Cres) Eastman is a world-renowned endocrinologist with a primary interest in Iodine Deficiency Disorders. He is an international leader in projects to abolish IDD throughout the developing world, particularly Malaysia, Laos, Thailand, Vietnam, Indonesia, China and Tibet.
Professor Eastman has devoted his life’s work into researching the consequences and outcomes of Iodine Deficiency and the thyroid health of pregnant women and their offspring, both nationally and internationally. Professor Eastman is recognised as a world leader into Iodine Deficiency and continues to head research studies in Australia, the South Pacific and Asia.
He is Clinical Professor of Medicine the University of Sydney and a practising Consultant in Endocrinology and Public Health. He retired in 2006 after 16 years as Director of the Institute of Clinical Pathology and Medical Research (ICP&MR) in Westmead Hospital and Director of the Division of Analytical Laboratories. Professor Eastman was the founding Head of the Department of Endocrinology and Diabetes at Westmead Hospital in 1979 and continued as Director until 1989. He is currently the Principal of the Sydney Thyroid Clinic at Westmead Private Hospital and Consultant Emeritus to Westmead public hospital.
Early Life & Education
Eastman was born on 30 March 1940 in Narrandera, New South Wales. He is the fourth child of Albert Edward and Margaret Mary Eastman. He gained his primary education at Woodburn and Lismore in Northern NSW and secondary schooling at Marist Brothers Boarding School in Bowral/ Mittagong, NSW. He studied medicine at the University of Sydney, graduating as a Bachelor of Medicine, Bachelor of Surgery(MBBS) in 1965 and was awarded his Doctorate of Medicine (MD) by research thesis in 1980.
Eastman is married to Annette, whom he met while a medical student, and has four children Katherine (Kate), born 1966; Damien, born 1968; Phillipa, born 1970 and Nicholas, born 1974.
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Career
Cres completed his internship as a Resident Medical Officer at St Vincent’s
Hospital, Sydney. He remained there and began his early training in
Endocrinology under the supervision of Profesor Les Lazarus as the
Littleshop Research Fellow in endocrinology at the Garvan Institute of
Medical Research. In 1969, he became Registrar, before taking up another
research fellowship, this time in asthma research at the Garvan. In 1971, he
was awarded the Overseas Travelling Fellowship of the Royal Australasian
College of Physicians and travelled to the Middlesex Hospital Medical School
in London to train under John Nabarro and Professor Roger Eikins.
1980s In an ABC documentary, Cres talks about his firsts visits to Tibet and his realisation that 13 per cent of the population were born with cretinism as the result of iodine deficiency. As he explains:
My association with Tibet began in the mid 1980s with visits out to the
Tibetan Plateau in Qinghai. But on my first visit there, I had never seen as
many people in villages with cretinism anywhere else in the world. So it was
a massive problem, in fact it was absolutely overwhelming… It’s such a big
problem in China because over two-thirds of the population live in rural
areas, many of them having to just sustain themselves through what they
grow. In other words, they are born, live and die within a few kilometres…
most of the fields, most of the earth and the water are iodine deficient.
And it doesn’t get in from imported foods or processed foods… So the higher
the altitude, the more remote you are, the worse the problem is… If the
average IQ of Tibetan children is only 85, and that’s what it was before
this program started, and people with IQs of 85 can’t be educated, they
don’t really get beyond primary school.
1990s
He continues to act as an adviser on Iodine Deficiency Diseases control to
UNICEF, World Bank and WHO, and was appointed as Principal International
Consultant in Endemic Diseases to the Ministry of Public Health of the
Peoples Republic of China in 1997. He also holds a similar appointment to
the Tibet Autonomous Region and is an Honorary Professor of Medicine of
Tianjin Medical University in China.
2000s
In 1999, he initiated and was the team leader of a UN (UNICEF and WHO) and
Chinese Ministry of Health sponsored health care team that undertook a
feasibility study in Tibet to develop and implement a plan to eliminate IDD
in Tibet. He is now Chairman of the Project Coordinating Committee and
Project Director of the AusAID and WHO sponsored ‘Tibet IDD Elimination
Project’ (2000–2005). This is a multimillion dollar ongoing, collaborative
project involving AusAID, the ICPMR, WHO, UNICEF, the Ministry of Health in
Beijing and the Tibet Autonomous Government.
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Iodine - I Atomic number 53 Atomic mass 126.9045 g.mol -1 Electronegativity according to Pauling 2.5 Density 4.93 g.cm-3 at 20°C Melting point 114 °C Boiling point 184 °C Vanderwaals radius 0.177 nm Ionic radius 0.216 nm (-1) ; 0.05 nm (+7) Isotopes 15 Electronic shell [ Kr ] 4d10 5s25p5 Energy of first ionisation 1008.7 kJ.mol -1 Standard potential + 0.58 V ( I2/ I- ) Discovered by Bernard Courtois in 1811 Iodine is a non-metallic, dark-gray/purple-black, lustrous, solid element. Iodine is the most electropositive halogen and the least reactive of the halogens even if it can still form compounds with many elements. Iodine sublime easily on heating to give a purple vapour. Iodine dissolves in some solvents, such as carbon tetrachloride and it is only slightly soluble in water. Applications Iodine is used in medical treatment as tincture and iodioform, it is employed in the preparation of certain drugs and in the manufacture of some printing inks and dyes. Silver iodine is used in photography. Iodine is added to almost all the table salt and is used as a supplement to animal feed. It is also an ingredient of water purification tablets that are used for drinking water preparation. For many of these uses iodine is turned into iodides. Iodine in the environment Iodine is added to nearly any kind of salt that is applied. It is an ingredient of bread, sea fish and oceanic plants. Iodine is naturally present in the ocean and some sea fish and water plants will store it in their tissues. Iodine can be found naturally in air, water and soil. The most important sources of natural iodine are the oceans. About 400.000 tonnes of iodine escape from the oceans every year as iodide in sea spray or as iodide, hydrichloric acid and methyl iodide, produced by marine organisms. Much of it is deposited on land where it may become part of the biocycle. There are some iodine-containing minerals, such as alutarite, found in Chile and iodargyte, found in Colorado, Nevada and New Mexico. World-wide industrial production of iodine is about 13.000 tonnes per year, mainly in Chile and Japan, plus small amounts in Russia and USA. Iodine is extracted from natural brines and oil brines, which have up to 100 ppm of the element or form chilean nitrate deposits. Known reserves of easily accessible iodine amount is around 2 million tonnes. Health effects of iodine Many medicines and cleansers for skin wounds contain iodine. Iodine is a building material of thyroid hormones that are essential for growth, the nervous system and the metabolism. Humans that eat little to no bread can experience iodine shortages. The function of the thyroid gland will then slow down and the thyroid gland will start swelling up. This phenomenon is called struma. This condition is rare now as table salt is dosed with a little iodide. Large quantities of iodine can be dangerous because the thyroid gland will labour too hastily. This affects the entire body; it causes disturbed heartbeats and loss of weight. Elemental iodine, I2, is toxic, and its vapour irritates the eyes and lungs. The maximum allowable concentration in air when working with iodine is just 1 mg m-3. All iodides are toxic if taken in excess. Iodine 131 is one of the radionuclides involved in atmospheric testing of nuclear weapons, which began in 1945, with a US test, and ended in 1980 with a Chinese test. It is among the long-lived radionuclides that have produced and will continue to produce increased cancers risk for decades and centuries to come. Iodine 131 increases the risk of cancer and possibly other diseases of the thyroid and those caused by thyroid hormonal deficiency. Environmental effects of iodine Iodine in air can combine with water particles and precipitate into water or soils. Iodine in soils will combine with organic matter and remain in the same place for a long time. Plants that grow on these soils may absorb iodine. Cattle and other animals will absorb iodine when they eat these plants. Iodine in surface water will vaporize and re-enter the air as a result. Humans also add iodine gas to the air, by burning coal or fuel oil for energy. But the amount of iodine that enters the air through human activity is fairly small compared to the amount that vaporizes from the oceans. Iodine may be radioactive. The radioactive isotopes are formed naturally during chemical reactions in the atmosphere. Most radioactive isotopes of iodine have very short half-lives and will reshape into stable iodine compounds quickly. However, there is one radioactive form of iodine that has a half-live of millions of years and that is seriously harmful to the environment. This isotope enters the air from nuclear power plants, where it is formed during uranium and plutonium processing. Accidents in nuclear power plants have caused the release of large amounts of radioactive iodine into air. (Source: Lenntech) |
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Did You Know? Children born to mothers deficient in iodine can suffer a range of defects including mental retardation, deafness, and speech and physical impairments. This condition is called Cretinism. Cretinism is a congenital condition caused by deficiency of the thyroid hormone during prenatal development and is characterised by small stature, intellectual disability, deafness, mobility disorders and other forms of brain damage.  Over the past decades, Cres and his teams have been effective in Malaysia, Laos, Thailand, Vietnam, Indonesia, China and Tibet. His transformative work with populations in remote areas of China led him to be dubbed "the man who saved a million brains". During his first visits to Tibet, Cres discovered that 13 per cent of the population were born with cretinism as the result of iodine deficiency. In the course of his field work in Asia, Cres almost lost his life to altitude sickness. Cres' current focus is on the recurring problem of IDD in Australian and Thai populations. He is concerned that IDD may be affecting the ability of Australian children, and in particular, Indigenous Australian children, to perform at school. (Source: AABC - Conversations with Richard Fidler) |
Experiences & Opportunities
Awards and Achievements
- Order of Australia - Officer (AO) 2018,
- Member (AM) 1994 in the General Division of the Order of Australia
- 2014 Thailand Health Promotion Award 2006 AMA award for excellence in health care
- 2008 University of Sydney Alumni Award for Professional Excellence
Prof Eastman was awarded the inaugural Distinguished Service Award by Asia Oceania Thyroid Association (AOTA) President, Takashi Akazmizu (Japan) & AOTA Vice President, Teofilo San Luis Jr (Philippines) at the AOTA Annual Meeting in Sydney 2019, for his enormous contribution to improving outcomes for people living with thyroid disease and auto-immune conditions, both in Australia and throughout the Asia-Pacific region.
YouTube:
The Man who saved a Million Brains
https://youtu.be/G45Obt23xss
YouTube:
The Intricacies of Iodine with Rachel Arthur
(1hour - audio only)
https://youtu.be/-bZSS18b50E
Links
Iodised
salt in your diet?
Primary
Middle
SSecondary
Australian
Curriculum General Capability:
Personal and social capability
Australian
Curriculum General Capability:
Numeracy
Australian
Curriculum Cross Curriculum Priorities:
Aboriginal and Torres Strait Islander histories and cultures
Cooperative
Learning Activity
Context:
May is Thyroid Awareness Month. To help
promote knowledge about the importance of iodine in the diet, you are to
survey your households to see how many have and use iodised salt regularly
in their diet.
In addition, how many families buy "regular" [not organic]
bread? The Australian Government made it law to have iodised salt added to
all regular bread.
1. In groups of 3 - 4 students, create a survey using Survey Monkey about:
a. Ask your families what they know about the effects of having no iodine in their diet. [find out if they know anything about iodised salt in bread]
b. How many families have and use iodised salt as their regular salt?
Collate the information from the class' survey. What did it show?
2. In your group of 3 - 4 students, read the following article from the University of Sydney (see transcript beside image), listen to Conversations with Richard Fidler (50 mins) [below] and analyse the Iodine Global Network's logo.
Individually, use the Cornell Note-taking Method to take notes.
After reading, listening and analysing, compare notes within the group. Explain your notes to each other.
 (Source: University of Sydney - now off the USyd website. See beside for full transcript) Too hard to read this transcript? Click here for the Word doc  Professor Eastman examines a patient in Tibet |
Cres Eastman: Averting
a human disaster in Tibet By Claudia Liu 18 October 2006 Two decades ago, endocrinologist Creswell Eastman journeyed into the mountain villages of the remote Tibetan Plateau. What he saw horrified him: more than one in ten babies was born with the stunted mental and physical growth of cretinism, caused by a lack of iodine in the food chain. Iodine deficiency is a problem in many upland areas, where the trace element is leached from the soil. "But I had never seen so many people with cretinism anywhere else in the world," says Professor Eastman. "The people there were so kind and innocent, but suffering such a disaster." He has been returning to Tibet ever since, and his ongoing project to eliminate Iodine Deficiency Disorder (IDD) has saved an estimated 700,000 children, 2 million women of child bearing age, and 170,000 new-born babies from the disease. "People keep asking what drives me to go back," he says. "I suppose it comes back to the doctor in me, and a sense of responsibility." The Tibet project has been described as an extraordinary success by the World Health Organisation, and he has earned a slew of awards including this year's Australian Medical Association Excellence in Health Care Award. He was also memorably described as "the man who saved a million brains" by the ABC's Catalyst program. But Professor Eastman says his greatest satisfaction comes from the place he has helped and people he has saved. Working in the uplands of Tibet at heights of more than 5000m, altitude sickness is a constant problem. "I still remember the first time I was preparing to go there," he says. "The local health minister, who later became my friend, told me it would be the hardest thing I had ever done in my life. "He told me I would put my life at risk. But at that that time I didn't appreciate what he was saying." Lack of oxygen and swelling of the brain nearly cost him his life, and he was only saved by self-administered daily injections of a synthetic steroid used for severe altitude sickness. "I don't see myself as being a very brave man," he says, "and in your dark moments you think, 'Well, am I really making a difference?'" His question is answered by statistics. Iodine supplements in the mountain villages now reach 97 per cent of women and children. But still he has not given up, and he returns to Tibet each year on his annual leave, paying for his trips himself. He feels there is still work to be done. "I don't want to act as a rescuer," he says, "I always work with the doctors there, and help them build their own capabilities." He believes that a sustainable chain of medical treatment is the ultimate solution for iodine deficiency in Tibet. It's a strategy he introduced successfully 12 years ago in Beijing, where he helped to establish the National Reference Laboratory for Iodine deficiency disorders. Many doctors he worked with have now have started to train others. His assistance to China has earned him the trust and cooperation of the government and people there. "Without that trust I would never have been able to carry out this work," he says. Other Asian countries such as Laos, the Philippines, Thailand, Cambodia, Vietnam and Fiji have also benefited from his expertise in tackling iodine deficiency. Having recently retired as director of the Institute of Clinical Pathology and Medical Research, Professor Eastman still lectures at the University while pursuing his diverse hobbies of flying and cooking. He is also a consultant physician and endocrinologist at Westmead Hospital, and is vice-chairman of the International Council for Iodine Deficiency Disorders. At the end of this month he will return to Tibet. "I won't stop until the sustainable medical treatment chain is established, and people there become entirely independent,"," he says. |
Creswell Eastman being interviewed by Richard Fidler
Original story: 2 December 2015
What does this logo tell you about the thyroid and the brain?
3. Write down all the new facts and figures that you have learnt about:
a. Creswell Eastman that you didn't know from the other sources on this page.
b. His work
c. Why he received the Order of Australia
d. the connection between PM Bob Hawke and Prof Cres Eastman
e. Why it is said he saved millions of brains
4. Professor Eastman worked on Iodine deficiency disorders in the body.
List all the functions of iodine and its affects on the body. Share with your group.
4.
Discuss
Why is Prof. Eastman so concerned about pregnant mothers and iodine deficiency?
5. How will you let teachers, parents and other students know the importance of having iodised salt in your diet? The Indigenous community? Encouraging young women and pregnant women to have adequate iodine in their diets! What will be your communication strategy? Work this out between your group.
You can create ONE of the following within your group:
a. Create a video about the importance of iodine
b. Create an Infographic using one of the programmes listed here.
c. Create a cartoon showing the importance of Iodine in the diet using one of the programmes listed here.
Material sourced from
The
Conversation
Healthpages Wiki
University of Sydney
The
Australian Thyroid Foundation
Wikipedia
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