Blasio Vincent Ndale Esau Oriedo

Dr. BV Oriedo was born to Esau Khamati Oriedo (d. 1 December 1992) and Evangeline Olukhanya Ohana Analo-Oriedo (d. 11 July 1982), both from western Kenya's Luhya tribe of Africa's Bantu lineage. His mother was a homemaker, a domestic economics educator, and an ardent advocate of women rights. Whereas his father was a consummate Kenyan statesman, politician (1910s – 1960s), and an anti-colonialism activist and freedom fighter who had been detained, 1952–1956, alongside Paramount Chief Koinange and Jomo Kenyatta (the first President of the Republic of Kenya), and a cadre of other anti-colonialists during the campaign for Kenya's independence from the British rule. Esau Oriedo was also an entrepreneur and trade unionist, a staunch crusader of Christianity's embrace of indigenous African cultures,[15] philanthropist, and a veteran of World War I and World War II as a soldier in the King's African Rifles (KAR) regiment of the British Army. Albeit enjoying a close relationship with his mother, the relationship with his father was estranged. He ran away from home as a child. His formative years were spent with his paternal uncle, Bernard Walter Amukhale Oriedo, who helped raise him. It has been argued that his uncle played an influencing role in Dr. BV Oriedo's decision to actualize a healthcare vocation even though his father had wanted him to pursue a business and political careers.

He received early education at government and mission schools, and sat, successfully with distinction, for Cambridge School Certificate in 1946 at the former Government African School at Kakamega in North Nyanza (present-day Kakamega High School at Kakamega in western Kenya).[18][Notes 1] He attended the prestigious Royal Institute of Medicine & Public Health (RIMPH), an elite conjoined Government College at Kabete in suburban Nairobi, Kenya which catered to cerebrally gifted scholars in East and Central Africa; where he pursued an interdisciplinary degree in medicine—with focus on public health, hygiene, and disease prevention medicine program. During his tenure of study at the Royal Institute of Medicine & Public Health, he secured an internship as a staff researcher assistant with the Division of Insect-Borne Diseases at Medical Research Laboratory, Nairobi. In 1950 he completed his college education at the RIMPH, graduating with high honours. In the same year of his college graduation he successfully completed the board certification exams, administered from London in Great Britain; he became a Licentiate of the Royal College of Physicians of London. The certification and licensure qualified him for a job classification of a senior public health officer — a rank exclusively earmarked for Briton or Caucasian medical expatriates possessing Great Britain medical degrees or analogous European qualifications. Moreover, his qualifications exceeded the requirements for employment by the Colonial Medical Service — the organization responsible for dispensation of healthcare services and policy initiatives in the British Overseas Territories.[38][39][40] Instead, he was appointed to an inferior position as an African assistant medical officer (AAMO).[41] He remonstratively rebuffed the appointment; in 1951 he was actualized as a senior public health officer with de jure commission which permitted him to serve across the East and Central African region. He also qualified for assignments under the auspices of the Colonial Medical Service.[38][42]^[ In 1954 he received academic fellowship to study tropical medicine & parasitological epidemiology[42] in the United Kingdom at the London School of Hygiene & Tropical Medicine. His research thesis was on the vector-borne tropical diseases; it focused on the epidemiology of East African leishmaniasis (kala-azar), and attained a DPH. In 1957 he was a recipient of an associate research scientist fellowship from Tulane University's Medical College's School of Public Health and Tropical Medicine at New Orleans in United States—he continued, fruitfully, to collaborate his work in East Africa with Tulane University until his precipitously inexplicable death in January 1966.[43] He was also a recipient of a research stipend awarded by the Dutch Royal Institute in the Netherlands; the institute actively promoted his research on the "vector-borne tropical diseases: epidemiology of East African leishmaniasis (kala-azar)” in the Netherlands and other European countries. He worked feverishly, with diligent acumen, effectively combining vocational duties and scholarship research with travel abroad to various international scholarly medical conferences and special proceedings to promote awareness of the tropical diseases in Africa; and to help stimulate funding for research and drug discovery to stem epidemics and other preventable diseases on the continent. An epic accomplishment for an under 30-year old native African at the apogee of European colonialism in East Africa! In 1959 he gained full membership to The Royal Society of Tropical Medicine and Hygiene—a London-based organization promoting the study, control and prevention of tropical disease, and facilitation of discussion and exchange of information among those interested in tropical diseases and international health, and the overall promotion of the work of those interested in these objectives. In 1962, through his collaborative research with Tulane University's Medical College's School of Tropical and Infectious Diseases, he was endowed with a prestigious extramural medical research grant from the NIH—an agency of the United States Department of Health and Human Services.[42][44]

Throughout his career he was tenured at the Ministry of Health and Housing, Nairobi, Kenya, and the Nairobi-based Division of Insect-Borne Diseases at Medical Research Laboratory under the auspices of the British Colonial Medical Services.[29][38] The inception of his epidemiological vocation dates to 1950 after he attained a diploma in public health and preventive medicine (DPH)from the Royal Institute of Medicine & Public Health. At that same period, at the age nineteen, he became the youngest native person in the East and Central African region to autonomously engage in active interdisciplinary medical research in epidemiology and parasitology.[44] After an efficacious completion of a London (Britain) administered board certification exams and licensure, he was actualized in 1951 to the rank of a senior (principal) public health officer under the auspices of the Ministry of Health and Housing, Nairobi, Kenya. Thus, becoming the first and the only native person, du jour, to hold such commission across the British East Africa Colony and Protectorate.[30] He was later to become the first native East African epidemiologist in the field of tropical medicine and infectious diseases. He served as an epidemiologist in dual capacity under the aegis of the Colonial Medical Services[8][38][45] and the Ministry of Health and Housing in the colonial and post-colonial Kenya. His consummate and pioneering parasitological epidemiology and medical research, and epidemiological mapping of pestilences and preventive modalities in the field of tropical medicine and insect-borne infectious diseases in East and Central African have received global acclaim and application. Antecedently, his interdisciplinary medical acumen; dedication to public service; selflessness; and ability to connect with local African villagers helped stem disease-epidemic outbreaks and save thousands of native lives; and to improve the quality of living across the East and Central African region and the Sudan. Mournfully, historiography focuses on either the European doctors or the non-white subordinates of the various African Colonial Medical Services, whereas non-white personnel, such as Dr. BV Oriedo who worked contemporaneously in higher status positions, have received very little attention or no acknowledgement.[46][Notes 3]

In 1950 he was selected to lead a handful of medical students from Kenya to attend the Conference of the World Health Organization on Malaria at Kampala, Uganda.

Albeit tenured both at the Nairobi-based Division of Insect-Borne Diseases at Medical Research Laboratory^{[Notes 6]}, and the Ministry of Health and Housing during and post-colonial British rule, he shunned the city comforts du jour in the interest of serving the aboriginal populations of the African Great Lakes region, going to the fore personally. He spent most of his time in disease-ravaged remote villages, meticulously implementing curative and preventative measures; recording observations and mapping out diseases, authoring and disseminating reports.[Notes 4]

His cerebral abilities and immense potential in the field of tropical medicine and infectious vector-borne diseases was, beforehand, recognized by Sir Philip Edmund Clinton Manson-Bahr, MD, (d. November 1966) of the British Colonial Medical Services and renowned for his contributions to tropical medicine; and the son-in-law of Sir Patrick Mason, the doyen founder of the field of tropical medicine. Sir Manson-Bahr enlisted the young researcher to assist in his work on tropical medicine and infectious diseases in East African^[21]; and later, elsewhere within the British Empire, largely under the auspices of the Colonial Medical Service—the personnel section of the Colonial Service, employing the healthcare professionals who tended to the health of both the colonial staff and the local populations of the British Empire.

In 1951 Sir Manson-Bahr invited him to attend the "Conference of Specialists on infectious tropical diseases: Filariasis in the South Pacific", held at Papeete, Tahiti, August–September, 1951; of which Sir Manson-Bahr was a principle organizer and interlocutor. Filariasis[Notes 5] was increasingly of concern in the colonial East Africa du jour.

The two men would subsequently foster a close friendship and collaboration in the field of infectious diseases and tropical medicine. Moreover, Sir Manson-Bahr in conjunction with the British Colonial Medical Services and the East African Bureau of Research in Medicine and Hygiene (East Africa High Commission) featured markedly in the meritorious efforts that earned him a 1954 research fellowship to study tropical medicine & parasitological epidemiology in the United Kingdom at the London School of Hygiene & Tropical Medicine.

In 1964 he was invited to panel of specialists at the XII International Congress of Entomology at London, United Kingdom.[27]

He promoted and nurtured coordinated approaches, amongst healthcare practitioners and related bodies, to facilitate the most effective seamlessly integrated dispensary and operations of healthcare, socioeconomic, and other social welfare services. He was presciently cognizant of the adverse socioeconomic, sociocultural, and socio-ecological consequences of disease or injury on individuals, communities and civil infrastructures, or organizations. He effectively synergized with all key stakeholders, in a robust and dynamic interdisciplinary bilateral or multilateral partnership, via a wholesome stakeholder-engagement whose desired key outcome was to formulate and implement disease prevention initiatives that were evidence-based, and both practicable and transformative, tailored towards the target-population, and outcome-driven. These initiatives were performance indexed— vis-à-vis, delivering measurable performance.

As of 1950 until his abrupt and inexplicable death in 1966, he is credited with stemming the tide of numerous endemic and pandemic diseases in the East and Central African regions and the Sudan; and a forfending of thousands of human lives. In 1959 he spearheaded an intensified malaria eradication campaign in the East African highlands that helped to reduce malaria epidemics in the region.[47][48][49][50][51][52]

In October 1952 the young BV Oriedo's skills were put to the test when he was tasked to lead efforts to stem a major epidemic outbreak of black fever disease in Kenya, and parts of Uganda.[30][31] The epidemic had also manifested itself in the Sudan. Kala-azar (black fever) or visceral leishmaniasis is a deadly parasitic disease endemic to the tropics, subtropics, and southern Europe. He took a hands-on approach relocated himself to the remote hinterland outpost District Hospital and Public Health Office at Kitui in Kenya; the region hard-hit by the epidemic. He devised a savvy strategy to stem the tide of the epidemic, and saved thousands of lives. In 1954 the disease was arrested.[1][Notes 6]

In 1954 Oriedo led a successful government campaign to stem typhoid fever epidemic in present-day Kenya and Uganda.[53] In the North Kavirondo region of Kenya's Mount Elgon District, Bungoma County was one of hardest-hit areas. The disease ravaged the ethnic Bukusu population. His efforts to halt the disease were recognized by the Bukusu people who honoured him as a great healer by granting him the honorary title of omukasa, a Bukusu chieftain. His accomplishment also earned him a research stipend from the London School of Hygiene & Tropical Medicine.

In the 1940s kwashiorkor was a yet ill-defined nutritional disorder in Africa.[54][55] Mortality-rates among children were disturbingly high. In 1960, based on his prior successful campaigns against epidemic disease outbreaks, colonial authorities gave Oriedo the job of creating a roadmap to guide and coordinate the kwashiorkor crisis management team. Using available data, he focused on the Kikuyu ethnic group, in one of the localities where the disease was rampant. The Kikuyu campaign was successful. The lessons learnt from the Kikuyu campaign gave impetus to an effective national strategy. One of the key elements of the programme was a national school milk program which provided a daily milk ration to children during morning and afternoon recesses. Teachers were required to check pupils for health and hygiene during physical education (PE) periods and schools were charged with keeping up-to-date student immunisation records.[Notes 7]

During the late 1950s and 1960s he championed, coordinated, and buoyed the campaign against malaria amongst African and Asian communities in East Africa where the disease epidemics was poignantly endemic and had exacted a heavy mortality toll. Those communities, especially the native African tribes were mostly remote and in disadvantaged settings. Preceding his efforts, those communities had received, at best, spasmodic attention from the colonial regime.[30][48][49][51][52][56] For instance, the 1961 heavy rainfall brought flooding and the rise of the outbreaks of malaria epidemics that extended deeply into the hinterland. He was a major force behind the resourcefulness in formulating and implementing an extensive public health control program; elements of the program entailed leveraging-in successful aspects from the Nairobi campaign of 1940 epidemic, scouting and mapping out the breeding sites, conducting entomological and epidemiological studies, oiling and larviciding of stagnant waters and bushes, and mass chemoprophylaxis administration.[30][50][52][57] The approach succeeded in containing malaria epidemics in several remote and disadvantaged settings amongst Africans and Asiatics communities.[Notes 8][58][59]

He was an unbendable crusader of an important performance indexed healthcare quality improvement program[Notes 9][30] which raised immunization coverage levels of inoculation preventable diseases by lessening missed opportunities to vaccinate, vigilant administration of accountability requirements, and the overall improved standards of practices for health wellness and fitness, at all levels, in the Eastern Africa region. In 1960 he was one of the key architects of a dynamical interdisciplinary multicomponent and multigenerational public health, a healthcare and hygiene strategy of long-term planning based on the application of preventative modalities that helped shift the medical science paradigm—in East Africa—away from the undue emphasis on curative means, and more so towards a balanced approach; that which seeks to adapt public health strategies that effectively integrates epidemiological, parasitological, and etiological knowledge with tactical and situational curative approaches.The desired key outcomes included the prevention of disease or infectious agents, disability, malnutrition, and mortality rate—especially among the vulnerable populations of children, youth, and young adults—by means of immunization, hygiene, nutrition (e.g., providing free fluid whole milk for school children as part of his campaign against kwashiorkor epidemic outbreaks), and dietary supplement with multivitamins, and by control of contagious, parasitic and related diseases. The antecedent healthcare and hygiene strategy received the commendation of the British colonial East African High Commission and the British Colonial Medical Services in London; the strategy was adapted by the commission and Kenya's Ministry of Health and Housing. The program forms the organizational rudiments of the present healthcare and hygiene strategy in East Africa.[60][61][62]

Dr. BV Oriedo, in person, conducted surprise compliance audits across mostly remote regions of Kenya and Uganda—he wrote meticulously cogent observations outlining his findings and recommendations for corrective measures, and a timeline for full compliance. In cases of systemic failures, he was known to summarily discharge the absconding individual(s).

A frontier statesman and a scientist he developed an interdisciplinarity pioneering approach that connected the struggle for political freedom in Kenya with fully integrated healthcare, intellectual, socioeconomic, and civil infrastructures; especially in the rural regions that bore the brunt of disease epidemics and its dire socioeconomic and sociocultural consequences. Antecedently, he embraced a revolutionary du jour epidemiological perspective towards the economic and intellectual consequences of disease or public health strategy across the East African region. Indeed, he understood that a viable independent Kenya would require not only a cadre of well-educated native professionals but also inevitably a sustainable robust and dynamic local healthcare and intellectual infrastructures able to fuel and drive a sustainable economic development, hence an equitable holistic wellness of all her peoples. To this effect, he ardently lobbied—albeit unsuccessfully—to adapt health care as an expressly stipulated right endowed under the new constitution of the nascent postcolonial Kenya. This prescient interdisciplinary consummate statesmanship made him distinct from the effusive political cadre of his contemporaries that are prominently chronicled with Kenya's freedom struggle.[32]

Throughout his career, Oriedo sought to regulate dubious folk medicine and mysticism that had remained a central sociocultural institution across East Africa.[63] He was a vocal critic of indigenous practices that placed the well-being of native communities in peril and easy prey for quacks. He recommended founding an ethnomedicine advisory board, at the national and provincial levels, under the auspices of the Ministry of Health and Housing; a board whose composition would include traditional healers and modern healthcare practitioners.[44]

In the 1950s Oriedo called for, and helped champion with the backing of Sir Manson-Bahr and B.A. Southgate, the creation of a peer-reviewed comprehensive healthcare reference database for East Africa akin to the United States National Library of Medicine. Similarly, he championed the creation of a robust and dynamic healthcare infrastructure in rural regions—a "National Reference Health Centre for Kenya".

In 1953 and 1954, he was an invited panelist at the East Africa High Commission Scientific Conference under the aegis of the London-based Colonial Office of United Kingdom. On 11 January 1961, an abstract of the first series of his epidemiological medical studies of East African Leishmaniasis (kala-azar) was presented before conference on "The Epidemiology of Arthropod-borne Diseases", at Nairobi. The work was well received, and has enjoyed sweeping application and has been widely cited.[64][65][5][66][67][68][69][70][71][72] His work in tropical medicine, hygiene, and infectious diseases has been posthumously published by collaborators, such as fellow laureate Dr. BA Southgate, and others.[73][74][75][76]

In 1964 he was a recipient of a coveted medical research grant furnished by the US National Institutes of Health (NIH), Extramural Research Program. The grant was in support of his epidemiological, parasitological, and etiological research in tropical medicine and infectious diseases in East Africa. Oriedo's work has received global acclaim and application.[44]

Oriedo's Epidemiological and Parasitological Studies of East Africa Leishmaniasis led to the end of the October 1952 visceral leishmaniasis epidemic outbreak in Kenya. In 1952 he moved to the remote District Hospital and Public Health Office at Kitui to direct a campaign against a kala-azar epidemic outbreak. Kala-azar (black fever) or visceral leishmaniasis is a deadly parasitic disease in the tropics, subtropics, and southern Europe. The disease was first diagnosed in the Kitui region of Kenya in 1946. The Kitui epidemic threatened to wipe out entire ethnic Kamba villages. In 1954 the disease was arrested.

The disease remained ubiquitous in other regions of East Africa and the Sudan. Thus, with the encouragement and support of Sir P. E. C. Manson-Bahr and Dr. B. A. Southgate, he proposed a collaboration with Southgate and two other researchers at the Medical Research Laboratory's Division of Insect-borne Diseases at Nairobi to conduct epidemiological and parasitological studies of visceral leishmaniasis. The collaboration the foundation of his research studies at the London School of Hygiene & Tropical Medicine. His major collaborators were the London School of Hygiene & Tropical Medicine; Sir Philip Henry Manson-Bahr; East African High Commission's East Africa Bureau of Research in Medicine and Hygiene; the British Colonial Medical Services at London; Ministry of Health and Housing, Kenya; the Division of Insect-borne Diseases, Medical Research Laboratory, Nairobi; and Tulane University's Medical College's School of Tropical and Infectious Diseases in the United States.

His epidemiological and parasitological medical research and field observations of visceral leishmaniasis in East and Central Africa, and the Sudan revealed that under ceteris paribus male and female populations exposed to the disease experience different symptoms or sometimes no symptoms; further, the seropositivity rate was higher in females than the males; whereas, using the leishmanin skin test, higher prevalence in males has been recorded. His observations played a major role in the elucidation of the multi-etiological factors in the gestation of the disease; the delineation of which, is of the essence in precluding the misclassification of the induction and latent phases of the disease or infectious agents. Another key elucidation based on his work is that infected people are not needed to maintain the natural transmission cycle of the leishmania protozoan parasite; viz., the natural transmission cycle is sustainable by means of animal reservoir hosts along with sandflies. These findings helped pave the way for a more effective characterization of the incubation process of the disease through a more erudite complex multifarious modern epidemiological and parasitological approaches. This work has been widely cited and the complex multifarious approach widely applied.