Life On The Job


Famous or Historic People

Professor Creswell Eastman, MB BS 1965 MD 1980 FRACP FRCPA FAFPHM ACCAM AO [30 March 1940 - ] - Endocrinologist

Portrait

 

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.

 

Career

1960 - 70s

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.

Returning to Australia in 1973, Cres became the Deputy Director of the Garvan Institute of Medical Research at St Vincents Hospital, Sydney. Concurrently, from 1975 to 1979 he was Foundation Head of Endocrinology and Diabetes at the Woden Valley and Royal Canberra Hospitals.

When Westmead Hospital opened at the end of 1978, Cres became the Foundation Head of the Department of Endocrinology and Diabetes shortly after, also serving as Deputy Director of the Division of Internal Medicine at Westmead Hospital. During his time at Westmead, he has also served as Chairman of the Westmead Hospital Medical Staff Council and was the driving force behind the establishment of the Westmead Hospital Research Foundation and Institute in 1997.

Cres’ research interests are focused predominantly in thyroidology, especially in the area of iodine deficiency disorders (IDD). He has directed major research projects into IDD in Malaysia, Indonesia and China.

in Lab
(Source: University of Sydney)

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.
Cres argues that to ignore this problem is to turn your back on the basic human rights of these people and that “the most important human right you’ve got is to realise the intelligence you’ve inherited from your parents.”



He was awarded the Otsuka Gold Medal by the Asia Oceania Thyroid Association in 1982 for his research into thyroid disease. In 1988, he was awarded a special Bicentennial Award by the Australian International Development Assistance Bureau (AIDAB, now AusAID) for his work from 1985 to 1992, leading and conducting a highly successful multi-million dollar Australian Overseas Aid project in China aimed at controlling and preventing iodine deficiency disorders in rural Chinese populations.

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.

Here in Australia, Cres has been Director of the Institute of Clinical Pathology and Medical Research (ICPMR) and Chairman of the Division of Laboratory Medicine at Westmead Hospital from 1989 to 2006. Concurrently, he has been Director of the Western Sydney Area Pathology Service and Chairman of the ICPMR Pathology Network, incorporating the pathology services of Western Sydney, Wentworth Area Health, Far West Area Health, Mid West Area Health, Central Coast Area Health and St Vincent’s, Sydney (Sydpath). He also maintains the role of Clinical Professor of Medicine in the Faculty of Medicine at the University of Sydney and remains in active clinical practice as a Consultant Physician in Endocrinology and as an Aviation Medical Consultant.

Between 1991 and 1994, Cres developed and implemented the plan to integrate all of the pathology services and laboratories in the hospitals of the Western Sydney Area Health Service into the single business and functional entity which currently serves over 2000 hospital beds and provides the largest public pathology service in NSW. In 1995 he was one of a small team that developed the ‘Hub and Spoke’ system to improve efficiency and access to Pathology services in NSW.

In 1997, Cres was appointed Director and Chief Government Analyst of the Division of Analytical Laboratories (DAL), located at Lidcombe in Sydney. The DAL provides all public health analytical services and all forensic medical services to the State of NSW.

Also in 1997 he developed the concept for a National Reference Laboratory for IDD for China, and raised over 1 million dollars from external funding agencies to establish this centre in Beijing, its function being to ensure quality assurance as a fundamental part of the IDD control efforts in China. Cres acts as the Principal Consultant to the World Health Organization (Western Pacific Region) in IDD. In recent years, he has undertaken numerous consultancies for the WHO and UNICEF in Asia, particularly China, Vietnam and Thailand.

 

in Tibet
(Source:
University of Sydney)

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.

Cres has been a member of numerous professional groups and committees. He is a past President of the Endocrine Society of Australia and now a Life Member. Since it was established in 1975, he has been a member of the Executive Council of the Asia Oceania Thyroid Association, currently serving as Vice President. He is a Board Member and Deputy Chairman elect of the International Council for the Control of Iodine Deficiency Disorders (ICCIDD) and was appointed ICCIDD Regional Coordinator for the Asia Pacific Region in April 2002.

In addition to his ongoing work in endocrinology, he has developed a major interest in the education and training of clinicians in management, especially strategic and quality management. In 1991, he initiated the first comprehensive course in Australia for practising doctors to train in business management. The Management for Clinicians Program, (MFCP) is a two-week intensive residential course, sponsored by the University of Western Sydney, the University of Wollongong, the Western Sydney Area Health Service, the Faculty of Medicine of the University of Sydney and the NSW Department of Health. He served until 2002 as Chairman of the Steering Committee and the Faculty for the MFCP, incorporating visiting Faculty from Harvard University and the Henry Ford Health Care System from the USA. He introduced Total Quality Management to the ICPMR in 1990, and the ICPMR and its departments have won several awards in both the business and professional sectors, nationally and internationally, for achievements in quality management. In 1994, the ICPMR won a prestigious Commonwealth Government Technology Productivity Silver Award for the implementation of a sophisticated Laboratory Information System–the Cerner Pathnet Information System.

Cres was awarded Membership of the Order of Australia in 1994 for his contributions to Medicine, particularly in the field of Endocrinology, and was awarded the Premier’s Gold Service Award in 2002 for development of the NSW Forensic DNA service laboratory. In 2003, he was a NSW finalist for Senior Australian of the Year and in August 2004, he was honoured by Princess Maha Chakri Sirindhorn at a special ceremony in the Chitralada Palace, Bangkok for services to the improvement of the health of the people of Thailand. (Source: University of Sydney)

 

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)


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.

Cretinism


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

The University of Sydney School of Medicine - Online Museum [Detailed Career Biography]

University of Sydney School of Medicine: Online Museum


ABC Health & Wellbeing: The Pulse

the Pulse
Asia & Oceania Thyroid Association

AO Thyroid Association
Iodine Global Network

IGN


How Cres Eastman saved a million brains
Australia Unlimited

Australia Unlimited
Prof. Creswell Eastman (Endocrinologist)

Wiki

 

Activities

What are the Endocrine Glands? How do they function? A Research Assignment


 MiddleMiddle  High SchoolSecondary
CriticalAustralian Curriculum General Capability: Critical and creative thinking
Personal and social capability
Australian Curriculum General Capability: Personal and social capability

IndigenousAustralian Curriculum Cross Curriculum Priorities: Aboriginal and Torres Strait Islander histories and cultures


1. Individually, you are to research one Endocrine Gland within a group of 4 - 5 students. Combine with another group (who has researched different glands) and use the Expert Jigsaw Strategy to share all the information about the Endocrine Glands. 

Here are the endocrine glands: Select one to study in detail. Endocrine glands

a. Pineal gland

b. Pituitary gland

c. Pancreas

d. Ovaries

e. Testes

f. Thyroid gland

g. Parathyroid gland

h.h. Hypothalamus

i. Adrenal glands

j. Thymus

2. List all the hormones produced by your gland you are studying. Describe the effects they have on the body. What happens when there is not enough hormone present?

3. Draw where your endocrine gland is located in the body.

4. Professor Eastman worked on Iodine deficiency disorders in the body. List all the functions of iodine and its affects on the body. Why is Prof. Eastman
so concerned about pregnant mothers and iodine deficiency?

5. Create a group Poster encouraging young women and pregnant women to have adequate iodine in their diets.

 

Resources to use

Endocrine glands and their hormones
WebMD
Kids Health
Better Health

Poster resources

Healthline
Australian Thyroid Foundation

 

Iodised salt in your diet?

PrimaryPrimary MiddleMiddle High SchoolSSecondary

CriticalAustralian Curriculum span lang="en-au">General Capability: Critical and creative thinking
Personal and social capability
Australian Curriculum General Capability: Personal and social capability

IndigenousAustralian Curriculum Cross Curriculum Priorities: Aboriginal and Torres Strait Islander histories and cultures

 

1. 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.

Ask your families what they know about the effects of having no iodine in their diet.

Collate the information from the class' survey. What did it show? How many families have and use iodised salt?

 

2. In groups 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) and analyse the Iodine Global Network's logo.

University of Sydney
(Source: University of Sydney - now off the USyd website. See beside for full transcript)


Examining patient in Tibet
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 Listen

Conversations
(Source: ABC Conversations with Richard Fidler) - Repeat 23 March 2020
Original story: 2 December 2015

 

IGN
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. How will you let teachers, parents and other students know the importance of having iodised salt in your diet? What will be your communication strategy?

 

Material sourced from
 The Conversation

Healthpages Wiki
University of Sydney
The Australian Thyroid Foundation
Wikipedia

side 5

side bar

side bar

sidebar

Jeweller side

side 5

side bar

side bar

sidebar

Jeweller side

side 5

side bar

side bar

sidebar

Jeweller side

side 5

side bar

side bar

sidebar

Jeweller side

side 5

side bar

side bar

sidebar

Jeweller side

side 5

side bar

side bar

sidebar

Jeweller side