FEATURES
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FEATURES
Sixty Days in the Gulf's Scientific Tower
By Prof. Talaat I. Farag
Photo Gallery by Fatma Jamal
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Dr. Sadika A. Awadi receives the Honorary Fellowship of the International Educators Without Borders (Ambassadors Research Foundation) from Dr. Rashid Al-Rashoud, and Prof. Talaat I. Farag (photo: Dr. Makia Marafie) |
In the Gulf region, people are experiencing an era of tremendous wealth, due to the substantial and exponential rise in the price of oil, which is known as the "black gold" (one barrel of oil >$140). In Kuwait, where the population of nationals is just one million, there are two noticeable landmarks--one is the natural resources that bore the wealth of the nation and the other a scientific feat that has drawn international attention. The Western world has grown to consider the Kuwait Medical Genetics Centre (KMGC), which was born in February 1979, as the "Modern Gulf Scientific Tower" whose accomplishments are both unique and significant throughout the region.
I had the pleasure of enjoying a sixty-day visit to this centre and attending the Second International Genetics Conference held in Salwa Hall of the extravagant Marina Hotel on 13-15 April. At the conference, Dr. Rashid Al-Rashoud, PhD (London), Assistant Undersecretary of the Kuwaiti Minister of Health, gave the opening remarks on behalf of HE the Minister. During the conference's opening ceremony, the Ambassadors Research Foundation bestowed on Dr. Sadika Al-Awadi the title of Honorary Fellow of the International Educators Without Borders. This was done in recognition of her truly exceptional and unique contributions to medical and community genetics in Kuwait, the Middle East region, and worldwide.
The conference, organized and chaired by Dr. Sadika, was attended by more than 400 participants from Algeria, Bahrain, Belgium, Canada, Egypt, Germany, Iran, Japan, Kuwait, Netherlands, Oman, Russia, Saudi Arabia, Syria, UAE, UK, USA, and Yemen. Of the participants, nineteen were professors: Fahd Al-Mulla, Eckhard Alt, David A. Collier, Michael Connor, Safaa El-Gamal, Mohsen El-Hazmi, Mona El-Ruby, Mohamed El-Sawy, Marita Isenmann-Klein, Talaat I. Farag, Joseph Gelesson, Najib Khaja, Slimane Laouamri, Kamal Naguib, Hussein Najmabadi, Imgard Nippert, Rabah Shawky, Catherine Staessen, and Seyed H. Tonekaboni. There were 122 papers and posters at the conference. Kuwait presented 11 papers, 26 posters (30% of total) and arranged a workshop on lysosomal storage diseases. The conference was sponsored by BADER Sultan & Bros Co., KUWAIT Investment Co., and Salmiya Medical Laboratories. There was also a fair for academic books, medicines, and scientific equipment during the 3-day conference.
Dr. Sadika Al-Awadi is the WHO Award winner for her research in the field of Down Syndrome. Her son, Omar Al-Awadi, who has trisomy-21, challenged her to devote her efforts in this field, and she is the founder of both the Kuwait Down Syndrome Society and the Kuwait Down Syndrome Club in Khaldiya. Interestingly, at the beginning and conclusion of the conference, exciting performances were presented by children with Down Syndrome from those organizations, led by Omar Al-Awadi. She is now writing a chapter about chromosomal abnormalities in Kuwait, in a new textbook co-edited by Dr. Aida al-Aqeel from Saudi Arabia.
More than 25 years ago, she founded the first neonatal biochemical screening in the Middle East, diagnosing and treating early cases of congenital hypothyroidism and phenylketonuria as a preventive tool for mental retardation (For a complete historiography of the KMGC, please visit this article). She presented, with her deputy, Dr. Laila Bastaki, Kuwait's recent experience at the Middle East and North Africa (MENA) Neonatal Screening Conference held in Egypt, at which Dr. Ala'a Farouk represented Kuwait.
Today the KMGC, which Dr. Sadika founded, is comprised of 67 doctors, technicians and administrators, working in the twelve units: six clinical genetics units, four laboratory units, a social services unit, and a unit for archiving and administration. Her centre has published more than 300 hundred publications from a region with a high inbreeding coefficient (total consanguinity rate: 54.03%, first cousins: 30.2%, and double first cousins: 2%). Having followed the development and evolution of the KMGC from its inception three decades ago, I am pleased and impressed to witness the remarkable growth of the center in all aspects. Every one of Dr. Sadika's crew deserves the highest recognition and salute for their unceasing commitment and continuous improvement.
Group photo at the conference (by Dr. Makia Marafie)
Interesting Observations:
During my stay in Ramada Hotel (Riggae) I noted the increase in very luxurious buildings, cars, beaches, malls, hotels, streets, restaurants, and markets with goods from around the world. In addition to the wonderful memories, my daily trips to the KMGC as a visiting consultant, I have collected some interesting scientific observations:
Seeing one of Dr. Laila Bastaki's case, of
a male patient with Tetrasomy X (49XXXXY), with a classical phenotype of a
Scottish male with the same condition I had examined with Dr. William Price in
Edinburgh in 1976.
Seeing with Dr. Makia Marafie, a father and two sons with Greig Syndrome with facial dysmorphology, hand and feet anomalies, and corpus callosum agenesis. We reported this Bedouin family Al-Jahra region with the international syndromologist Prof. Samia El-Temtamy in the American Journal of Medical Genetics (Volume 66 Issue 3, Pages 261 - 264).
Seeing with Dr. Maha Abu-Heneidi cases with Kabuki Syndrome, characterized by peculiar faces, skeletal anomalies and mental retardation (MIM 147920). A condition first delineated in Japan in 1981. Interestingly, 15 cases of this rare syndrome have been ascertained in the Kuwaiti population.
An interesting presentation by Dr. Hanan El-Bastawisy
of a family with Hereditary
Multiple Exostosis, which was ascertained in Al-Jahra Regional
Liaison-Community Genetics Program, founded by Dr. Sadika and myself three
decades ago, as the first community genetics center in the Middle East.
A Presentation by he consultant neurologist,
Dr. Asma
Al-Tawari, about lissencephaly. The first family with this congenital
neurological anomaly was reported in Clinical Genetics more than a decade ago
with Dr. Farah, a distinguished neurologist in New Zealand now (Farah,
S.; Sabry, M. A.; Khuraibet, A.; Khaffagi, S.; Rudwan, M.; Hassan, M.; Haseeb,
N.; Abulhassan, S.; Abdel-Rasool, M. A.; Elgamal, S.; Qasrawi, B.; Al-Busairi,
W.; Farag, T. I. (May 1997).
Lissencephaly associated with cerebellar hypoplasia and
myoclonic epilepsy in a Bedouin, kindred: a new syndrome?
51(5):326-330).
An interesting presentation by Dr. Ahmed Al-Aqeel, a
young clinical geneticist, about Alfi
Syndrome (deletion of short arm of chromosome 9). The first case of Alfi
Syndrome in Kuwait was reported in 1988 (Sadika A. Al-Awadi, Talaat
I. Farag, Siram Satyanath, T. S. Sundareshan, in the American
Journal of Medical Genetics,
Volume 29 Issue 1, Pages 217 - 219)
A poster about King Akhenaton and King Tut by a young Kuwaiti technician, Mohamed Dashti, discussing whether their phenotype is a pathology or pseudo-pathology!?
I enjoyed having scientific discussions with
the promising syndromologist, Dr. Amal Al-Wadaani, and meeting Dr. Reem Al-Daboos, who
studied clinical genetics at the University of London with Prof. Marcus Pembry,
who has established the first private clinical genetics
clinic in Al-Ahmadi province.
I enjoyed meeting Mr. Suleiman Al-Osman, who
helped Dr. Sadika to establish the first Kuwaiti cytogenetics lab, and the
first three Kuwaiti cytogeneticists, who have made excellent scientific achievements: Dr. Sawsan
Aboulhassan, Dr. Fawzia Mohamed, and Mrs. Amira Redha. They were instrumental
in training the exception staff whose progress I enjoyed witnessing.
They are: Mrs. Huzam Al-Khorafi, Hayat Al-Aboud, Haya
Al-Balool, Nawal Al-Hashash, Sumaya Al-Hajji, B. Quod, Mr. Ibrahim Al-Soliman,
and Mr. Jaber Al-Taho. Some the new generation of junior cytogeneticists who are doing an
excellent effort include: Mohamed Al-Ali, Zaineb Jawad, and Athari Al-Otaibi
(visit the Selected Study for her original research on microdeletion
syndromes).
I enjoyed speaking to Dr. Bassam Qasrawi, the Palestinian-Canadian medical doctor who was in charge of the Mental Retardation Institute for a long period. During the Gulf Crisis, he left his home to live in the institute in order to take care of the patients at the centre. After retirement, he is now in charge of the Kuwait Handicapped Club, which trains athletes to take part in the Paralympics.
Recommendation Committee at the conference (photo:
Dr. Makia Marafie)
The
New Kuwait Medical Genetics Centre
In the Maternity Hospital, there is a new building under construction that will include the 12 units of the Kuwait Medical Genetics Centre. There is also an increase in ultra-specialization among the center's clinical geneticists--Dr. Sadika Al-Awadi ascertained nearly 2000 cases of Down Syndrome; Dr. Laila Bastaki focuses on neurogenetics and metabolic disorders; Dr. Makia Marafie deals with cancer genetics and tumors; Dr. Maha Abu-Heneidi, Dr. Hanan Al-Bastawisy and Dr. Amal Al-Wadaani deal with dysmorphology cases; Dr. Rezk El-Naggar, Dr. Sayed Gouda, Dr. Ala'a Farouk and Dr. Sherif Omar focus on community genetics and assessment committees for families that have members with special needs since the government is offering $5000/monthly for each such family, and double that sum for families with two affected persons. In the new centre, there will be four well-equipped genetics laboratories: a lab for conventional chromosomal banding techniques (Dr. Fawzia Mohammed), a molecular cytogenetics FISH lab (Dr. Sawsan Aboulhassan), a molecular lab (Dr. Ala'a El-Shafey, Dr. Fatma Higazi and Dr. Lula Al-Geryan), and a biochemical lab (doctors and technicians currently receiving training in the US).
The medico-social approach in the KMGC and the establishment of TEAM-work, is a landmark feature there (TEAM = Together Everyone Achieves More) and was clearly apparent in every study presented by Kuwait at the conference. The KMGC is constantly helping newcomers in climbing the scientific ladder.
A Visit to Al-Jahra Hospital
Thanks to Dr. Mohamed Oweida Al-Ajami, Head of the Paediatric Department at Al-Jahra Hospital, for inviting me to visit his department to enjoy fruitful scientific discussions with his team members, who are doing an excellent job. It was nice to meet my old senior paediatrician friends: Dr. Mohamed Al-Ghanem, Dr. R. Usha, Dr. Mohamed Al-Ghawabi, Dr. Samir Mady, Dr. Samir Saleh, and Dr. R. Uma. I also met the distinguished surgeons, Dr. Ali Noor and Dr. Mahmoud Wahby, and gynaecologists Dr. Maamoun and Dr. Obeid. We discussed together modern trends in genetic counselling, and the importance in answering the three classical questions: What is the matter? Why it happened? and How to manage it? Needless to mention, the SETRR-model (SERVICE, EDUCATION, TRAINING, REGISTRY, RESEARCH) was first born in Al-Jahra region.
A Visit to Kuwait Down Syndrome Club
At the end of my 60 days visit to Kuwait, I was invited to give a lecture to the families with Down Syndrome children at the Kuwait Down Syndrome Club in Khaldiya, I was pleased to notice the great effort done by Dr. Sadika and her son, Goodwill Ambassador Omar Al-Awadi with trisomy-21, to help other families.
As an old doctor who has practiced for 55 years and worked with those with special needs in the Middle East, Europe and North America, I was convinced that the effort of the three pioneering Kuwaiti women, Dr. Sadika Al-Awadi, Mrs. Munira Al-Mutawa (Secretary General of the Kuwait Society for the Handicapped), and Dr. Samira Al-Saad (founder and director of the Kuwait Center for Autism), to help those with special needs is truly UNFORGETTABLE.
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Photo Gallery by Fatma Jamal
Prof. Talaat I. Farag, MD, FRCP, FACP, FACMG is a former adjunct professor at Dalhousie University in Canada. He is the founder of The Ambassadors Research Foundation in 1998. Email: tfarag@dal.ca.
