Tribute by Professor Felix I D Konotey-Ahulu

Ebenezer Mensah Tagoe was born on Ghana’s Independence Day 6th March 1957. Like 3 of the 11 children born to my own parents Ebenezer had Sickle Cell Disease the hereditary cold rainy season rheumatism that Ga people call Tswetsweetswe (Chwechweechwe) known to us long before Europeans called it Sickle Cell Disease.

Parents of chwechweechwe children passed on the ache code to the child even when they themselves may not have the “ache” problem, because it takes 2 codes of “ache”, one from father, one from mother to make the child ache with cold season rheumatism.

Like in my own family those of us 11 children receiving an ache code from one parent and the normal blood code from the other parent do not ache in the rainy season. In other words, parents who are NORM-ACHE type like my own patients pass on NORM or ACHE code to a particular child, never both.

Ebenezer, as well as my 2 brothers and 1 sister got ACHE code from both our parents to produce double ACHE which combination makes the blood cells thicken under certain conditions to cause joint and body aches characteristic of Sickle Cell Disease.


Although it was being taught that sickle cell disease patients did not live beyond thirty years of age, Ebenezer lived longer than twice of 30 years because he quickly learnt that only certain events produced the serious pains (called crises) which he learnt to avoided – things like being caught in the rain, fever, and infections. He attended and spoke at all The International Conferences of Sickle Cell Disease Patient Achievers that I organised in 1993 at Royal Society of Medicine in London, 1995 in Accra, and 2010 also in Accra where he told the audience to much amusement that he had avoided painful sickle cell crisis in the previous 20 years by drinking 4 Litres of water every single day provided he could find a suitable place to pass water. He used to educate doctors in England. Ebenezer had trained as a professional pharmacist and worked in a London University Teaching Hospital where a Consultant Haematologist could not believe he had sickle cell disease until he tested his blood to find he possessed double ACHE codes making him ACHEACHE. His parents, like mine were healthy NORMACHE capable of donating NORM or ACHE codes to their children.
Ebenezer married a lady who was NORMNORM so that none of their children would have double ACHE Chwechweechwe or Sickle Cell Disease.


By doing so well professionally as a Pharmacist in a London Teaching Hospital Ebenezer proved that the sickle cell code (S) or gene was not the only thing his parents gave him. He received from his Mum and Dad codes for beauty, brilliance, sympathy, and kindness as well as the sickle cell codes so teaching doctors how wrong it was that they should advise parents to abort a pregnancy that tested had shown would produce sickle cell disease. Doctors today, today, today are aborting sickle cell disease pregnancies unaware that they could be aborting geniuses.

The International Conferences I organised were attended by great ACHIEVERS in Nursing, Teaching, Businesses, Pharmacy, and other professions. If the parents had aborted Ebenezer, could his brilliant children have been produced through a wonderful wife who helped him in his hereditary illness? Where did these children, now adults, get their brilliant genes from? He invited me and my wife in 1994 to their 10th Wedding Anniversary in England, and I was greatly happy when he named one of his sons after me for looking after him at Korle Bu.


We indeed salute the memory of one who achieved great things through suffering. At a time when younger people than him had been taken out of this life Ebenezer Mensah Tagoe lived to 65 years, defeated his last Enemy Death, and has gone into the GLORY to enjoy LORD JESUS CHRIST. My heartfelt Condolences, and my wife Rosemary’s go to his dear mother Mrs Janet Gifty Tagoe-Quayle and his brothers Prince Nwojo Tagoe, Jonathan Adokwei Tagoe, and George Felix Ankamah Tagoe, and also to the larger family.



O think to step ashore, and that shore Heaven,
To take hold of a hand, and that hand God’s hand,
To breathe a new air, and that air Celestial air,
To feel invigorated, and know it Immortality,
O think, to pass from the storm and tempest
To one unbroken smile,
To wake and find it GLORY!

My brother-in-law Emeritus Professor Emmanuel Quaye Archampong who has just woken up in GLORY having passed through the storm and tempest of this earthly pilgrimage was a Titan. Definition of Titan is “Person of super-human size or intellect or strength”. Allow me to tell the long story:

Right from Accra Academy, University College of the Gold Coast, which was then a University College of London University, then to University College of London proper (UCL) and through both Royal Colleges of Surgeons Edinburgh and London, Quaye Archampong shone very brightly. Sometimes so brightly, outshining all comers of different nationalities that he not only astounded his British Teachers but also brought up the very worst character in at least one English racist postgraduate teacher in an incident that is worth mentioning later to prove another side of Emmanuel Quaye Archampong, his attractive godliness.

1955: While in the middle of my pre-Clinical studies at the University College in London (UCL) I received an interesting letter from Legon. I noted the peculiar spelling of the surname “Archampong” of the writer who told me he had won a government scholarship to come to the same UCL to read MEDICINE. We began correspondence which resulted in him joining me the next year at the inter-Varsity Fellowship men’s hostel ALLIANCE CLUB at 2 Bedford Place, London WC1, just walking distance from UCL whose Anatomy Professor was none other than Professor J Z Young FRS (Fellow of the prestigious Royal Society), World-Number-One in Anatomy, and whose massive textbooks “The Invertebrates” and “The Vertebrates” were the ones used in every single university in the entire world.

1956: Archie as everybody called him began to top his Class of some 120 students from all over the world in Anatomy, Physiology, and Biochemistry the three major subjects for the 2-year Course that required studying and passing before “walking the Wards” of any medical school hospital to study the Clinical Medicine of learning what the patients were suffering from and how to treat them.

When the results of the “Second MB” at the end of the 2-year pre-Clinical Course came Archie did so well in each subject that the three professors (of Anatomy, Biochemistry, Physiology) were happy to invite him to stay on for another couple of years to do a SPECIAL DEGREE in their expertise. Archie chose to be with Professor J Z Young (Anatomy) with 10 other students – all White – picked from London University’s 9 other Medical Schools because they also excelled in the 2nd MB Examination.

That Incident: Although Professor J Z Young was “racially colour-blind” one of his senior postgraduate teachers so hated the idea that a Black African could outperform very brilliant White students that he did something that I can only describe as abominable. When Archie, totally shattered, was telling me this in The Alliance Club on returning from UCL in the evening he kept punctuating what he narrated with “Oh I can’t believe this!”, “I cannot believe what happened!” “Oh, I cannot believe this!”

He was more sad than angry, but I was more angry than sad. I asked him to report what happened to Professor J Z Young, but he flatly refused and looked forward to the next 3 years “walking the wards” at University College Hospital UCH) just across Gower Street. I had moved on from UCL to “walk the wards” at Westminster Hospital for my Clinicals while we both lived in the IVF Hostel Alliance Club in Bedford Place.

University College Hospital, Gower Street, London WC1

As a Clinical Medical Student Archie continued to shine remarkably in Medicine, Pathology, Surgery, Obstetrics and Gynaecology, and Psychiatry. After the 3 years of “walking the wards”, delivering babies, and visiting mental hospitals Emmanuel Archampong took the Final MB BS Exams with nearly a thousand other students from the 11 other Medical Schools comprising London University and was among the top 4 to be given Honours and Distinctions. To get Honours and Distinctions on graduating in a UK Medical School was (and still is) such a credit to the Medical School that “House Jobs” are guaranteed to those newly qualified doctors who brought such honour to the Medical School.

Professor of MEDICINE at UCH was then Sir Max Rosenheim, MD FRCP FRS President of the Royal College of Physicians, London, and Sir Max invited this Ghanaian genius to be his House Physician. Wao! Ghanaian getting what I considered the top House Job in all England?

Then what I consider a miracle happened.

Half-way through his 6-month House Job Dr E Q Archampong had a bleep call on his alert phone urgently to go and see a patient on the Private Wing of the hospital.

“Why?” Archie asked. “My Boss Professor Sir Max Rosenheim does not have a patient on the Private Wing”. The voice on the bleep insisted that it was the patient on the Private Wing that asked to see Dr Archampong urgently even though he was not one of the patients Archie was supervising.

Quickly he made his way to the Private Ward. As he entered the private single room, he saw a very ill man breathing heavily and beckoning from amidst the pillows. “Come close” he said. Archie recognised his voice. “Please forgive me, Archie. Forgive me. Some three years ago I deceived you and deprived you of a well-earned position. Please forgive me. I have carcinoma of the lung that has spread.”

“As soon as it happened, Sir, I realised what you had done. And I forgave you” Dr Archampong responded. The doctor sank back among the pillows. He died 2 weeks later. Archie was a staunch believer in The LORD JESUS CHRIST. He did truly forgive Dr XY the moment he realised the deception he inflicted on him.

Sunday Worship in London led to meeting future wife at Korle Bu

From The Alliance Club on Sundays, we used to go to All Souls Church, Langham Place, London W1 (Rev John Stott) in the morning, and to Westminster Chapel SW1 (Dr Martyn Lloyd-Jones) in the evening. Archie and I later settled at Westminster Chapel not only because Dr Lloyd-Jones had been a world-class Physician at St Bartholomew’s Hospital before he left to become preacher, but also because he was considered the greatest preacher of the 20th Century. Archie took brief respite from his busy house-job at UCH to attend the marriage ceremony conducted by Dr Martyn Lloyd-Jones on Easter Monday 1962 between Rosemary Moss and myself. The DOCTOR’s sermons so gripped and blessed us both that I brought hundreds of his tape recordings home to Ghana for weekly devotion in our home at Korle Bu on Tuesday evenings.

It was when my sister Catherine Awura-Atta was staying with us at 21 Slater Avenue on the Korle Bu Hospital Compound, and Dr E Q Archampong had returned from England as a Surgeon and wished to continue listening to Dr Martyn Lloyd-Jones’ sermons that the two of them met. And the rest is history.

GOD Almighty blessed Emma and Awura-Atta

She called him ‘Emma’ and he called her ‘Awura-Ata’. They were blessed with 5 children beginning with 2 adorable girls Eliz and Nana Ruth, plus 3 elegant boys David, Timothy and Ashirifi. Their mother Mrs Catherine Awura-Ata Archampong deserves FULL MARKS for raising 5 children through the most turbulent political periods in Ghana’s history with shortages of essential commodity. Queuing up for milk for the children? But difficulties did not derail her husband from hard work – teaching to produce doctors, operating sometimes far into the night, and being elevated to become Dean of the premier Medical School in Ghana.

Friends of The LORD JESUS CHRIST become enemies of GOD’s enemy – the devil. That was how I interpreted what happened soon after Emmanuel was made Dean of the Medical School. Suddenly a ferocious fire erupted in the Dean’s Office when he was not there. But for the timely arrival of Fire Engines, the entire Dean’s Block would have been burnt to ashes. Reminded me of what The LORD JESUS once said when something pernicious was done secretly: “An enemy has done this!” [Matthew chapter 13 verse 28].

Details of his monumental work in face of difficulties are mentioned elsewhere in other Tributes – University of London Master of Surgery, Fellowship of Royal Colleges of Surgeons of Edinburgh and of England, of Ghana Academy of Arts and Sciences, of West African College of Surgeons, Ghana College of Physicians and Surgeons, etc. The big Surgery book of over 1,300 pages he edited with Professor E A Badoe and Colleagues is a lasting monument for Africa. His contributions at International Conferences were enormous. As for teaching to produce doctors undergraduate and postgraduate, just look at the testimonies on WhatsApp to appreciate how highly Professor Archampong was regarded. He was rewarded with National and International Honours.

Compassion and Dedication to Duty.

When during one political upheaval with strikes and unruly soldiers invaded Korle Bu, harassing nurses and doctors many of whom fled their bungalows, as some very diligent doctors like Dr Dwomoa Adu and Dr Yaw Anim-Addo who initiated Artificial Kidney Service in the Medical Block, and Dr Ghosh of Maternity sneaked back quietly to monitor their patients, so Dr Archampong unnoticed by the soldiers would walk back from his parents’ home at Korle-Gonno to see patients he had operated upon. His compassion was proverbial. Whenever our young children were howling in pain after cutting themselves and bleeding playing in the garden at Korle Bu heard their mother say, “Uncle Archie is coming, I have called him”, miraculously all crying stopped, bleeding or no bleeding. Stitching wounds became painless. I had such confidence in him that when I was practising in London and rich Ghanaians flew across The Sahara asking me to refer them to the best surgeons for this and for that I sent most of them back to Archie in Accra with results of investigations. And they were extremely satisfied.

Family Man that will be hugely Missed

Amidst all the busy hectic routine – teaching, operating, meetings, conferences, writing articles and editing books, planning courses, administrative machinery of The Deanship, Archie found time for his family. Statement to me of Mrs Eliz Dadson, the eldest, the day their father left this Earthly Pilgrimage was as from all her siblings: Ruth Nana Anson, David, Timothy, Ashirifi, “Daddy was always there for us”. Indeed, he was. And my beloved Sister Catherine told me: “GOD called him!”

The pain is big, not only for the Archampong Family – Sister Victoria, Brother Augustus, and their families – but also for the Konotey-Ahulu Family – the families of Edna Soyannwo, Gritty Gboloo, Ruby & Jerry Djangmah, Helen & Emil Sachs, Ann and Kwesi Andoh, and my own family, Rosemary and Dawid, Carys and Lydia – we have all suffered this loss.

Archie’s Mother’s Perpetual Song – Trusting JESUS That is All

I knew Archie’s father played the organ for Church Service at Mamprobi Methodist Church, but I did not realise his mother was also musical. I can’t remember ever visiting their home in Korle Gonno without hearing his mother singing or humming this tune by Ida B Sankey [1840-1908] to words by Edgar Page Stites [1836-1921], which mysteriously came to me before I heard of Archie’s illness.

m: r f: m m: r d:- Simply trusting every day
d: l d: l sI d m r:- Trusting thru a stormy way;
m: r f: m r: d l:- Even when my faith is small,
sI d m sI: m m: r d Trusting JESUS that is all.
sI: m sI: m m: r r:- Trusting as the moments fly,
m: t d: d r: l t:- Trusting as the days go by,
d: d r: r m: m f:- Trusting HIM what e’er befall
sI: l sI m d m: r d:- Trusting JESUS that is all.

Ao, we do not weep like those who have no hope; we weep because we miss the very beloved husband, the Daddy, the grand Dad, the brother in law, the friend, the ..
We go on trusting The LORD JESUS CHRIST: That is all! 1 Corinthians 15 vs 18-19.






On May 20, 2022, I received a letter from University of Cape Coast, Ghana, hich began thus:

“The Times Higher Education 2022 World Universities Ranking adjudjed University of Cape Coast (UCC) as first in Ghana and West Africa, fourth in Africa and ranked first globally for citations. This great achievement of the University was made possible by dint of your scholarly contributions and commitment to the mission of the University.

“In showing appreciation, University Management has scheduled a special ceremony to award you for your invaluable support to the course of this institution … …”


My Acceptance Speech https://youtu.be/SewHhUBEkTo after being honoured on May 31 in Ghana included the great role BMJ played in my being more cited than any other to make “The Times Higher Education 2022 World Universities Ranking place University of Cape Coast where I am Kwegyir Aggrey Professor of Human Genetics “first globally for citations”.

EDUCATION comprises correcting errors as well as proclaiming new things and emphasizing important facts. I would like to think since 1965 when BMJ published three new things for me the five Editors in succession have enabled me to correct errors, challenge received wisdom, and even make known one invention (MPSI) I made in Clinical Genetics. How these Editors have helped me publications-wise is described here. Perhaps some aspects may help doctors half my age because some of what might be called “Minor Communications” contained such not-known-about-before information that they appeared in the CITATIONS.

My profound gratitude goes to Dr Hugh Clegg, Dr Martin Ware, Dr Stephen Lock, Dr David Smith, Dr Fiona Godlee, all who were very helpful to me in the past 59 years.

My detailed publications, minor and major, reflect why some continue to be cited decades after they originally appeared.

DR HUGH CLEGG 12th BMJ Editor 1947 to 1965: My first BMJ Communication was 18 June 1963 [1a]. In 1965 Dr Clegg published my “Varicose veins in pregnancy” [1b]; Torrential epistasis associated with symmetrical facial skin ulceration in sickle cell anaemia” [1c]; Colleagues and I from London’s Royal Free Hospital described “peripheral neuropathy from dialysis in end-stage renal failure” [1d]

DR MARTIN WARE The 13th BMJ Editor (1966-1975) published for me January 27, 1966 [2a]. Year 1969 was when he invited me to write “PERSONAL VIEWS” and paid me £100 for each, equivalent to 3 times my monthly Ghanaian Physician Specialist salary.

I wrote three: (i) Superstition and Phenomena in Africa [2b] (ii) Genetic Counselling in Sickle Cell Disease [2c], (iii) in 1975 he published my PERSONAL VIEW “Tafracher” the Ghanaian vital devulgarizing word [2d] https://bit.ly/3mJBMfm

Two Medical Memoranda in 1969, Ghanaian Family of 14 and 15 with not a single Normal Haemoglobin gene [2e 2f] continue to be quoted today 53 years later. Then in 1970 came “Haemolytic anaemia in pregnancy in Nigerians” [2g] and in 1971 “Malaria and Sickle cell disease” [2h].

In 1972 Dr Martin Ware rang me in Ghana to discuss an article three British doctors published with erroneous information, and which he later made the authors withdraw. He published my reactions to the authors’ article [2i 2j]. FULL MARKS to him for pursuing authors for truth. Another communication came on 28 October 1972 correcting dangerously wrong detection of sickle haemoglobin S, cited last month 50 years later [2k].

DR STEPHEN LOCK CBE 14th BMJ Editor (1975-1991) had dealings with me when AIDS was raging. In those days, articles submitted, refereed, editors’ decision, and publication took ages. But when I submitted my detailed fact-findings soon after a 6-weeks’ tour of several African countries to study grassroots epidemiology of AIDS it took just 18 days from submission date for Dr Stephen Lock to publish my “Clinical Epidemiology, not sero-epidemiology, is the answer to Africa’s AIDS Problem” [3a].

Reprint requests poured in from everywhere, 567 in all because what I described happening on my Continent was entirely different from the Media Mantra “Scientists blame African Green Monkey for AIDS in Africa, therefore Wear Condoms!” http://www.bmj.com/cgi/reprint/294/6587/1593.pdf [3a]
Dr Stephen Lock did make my voice heard not a few times 1977 [3b], 1980 [3c 3d – MPSI],1981 [3e], 1982 [3f – Sickle cell disease survey], 1984 [3g – Ethical issues in prenatal diagnosis July 21], 1985 [3h Ethnic minorities and sickle cell disease, 3i – Tribute to Prof. Hermann Lehmann], 1986 [3j – Epidemiology Correctly Defined] 1991 [3k Kwashiorkor Ghanaian tribal word origin, 3l – Penicillin prophylaxis in sickle cell disease, 3m – Morphine queried for sickle cell disease patients] – all these appear in my 434 minor and major Publications listed on www.konotey-ahulu.com or www.sicklecell.md [3n]

But what I cherished most was when Dr Lock in 2001 published the Genetic Index I invented, “MPSI”, which proved mathematically that procreation-wise females can never be the equal of males [3d].
Funny enough, Dr Stephen Lock’s last year as Editor was when I met the elegant lady who later became BMJ Editor, Dr Fiona Godlee. I had gone to BMA House to donate copy of my newly published Magnus Opus “THE SICKLE CELL DISEASE PATIENT” [3o 3p] to the Editor as I had just done to Lancet’s Editor [3q]. It was to her I gave the book to pass on to Dr Stephen Lock who was glad to see me because we both had learnt much from Professor Hermann Lehmann MD FRS in Cambridge.

DR RICHARD SMITH 15th BMJ Editor 1991-2004 published my Tribute [4a] to the remarkable Professor Dame Sheila Sherlock, the then Liver Queen of the world who with the recommendation of her husband Dr Geraint James MA MD FRCP, Teacher for the MRCP Exam of Therapeutics at Royal Postgraduate Medical School Hammersmith Hospital for the MRCP Exam, made me Research Fellow in her Department of Medicine at the Royal Free Hospital to work on the Renal Unit of the kidney giant Dr Stanley Shaldon MA MD FRCP in 1964-1965. Outcome of my research was one of the 1965 BMJ articles still quoted in 2022 on dialysis for end-stage renal failure. [1d]

Dr Richard Smith also published for me four clinical experiences for which I coined the word supra-scientific, for so each of them was, and still are. [4b].

A remarkable article by Didier Fassin and Helen Schneider [4c] revealing scientific misbehaviour in South Africa as contributing to AIDS havoc in the Black Population prompted me to respond with a 7,000-word article and 70 References which Editor Richard Smith did not reject, but published on line in its entirety [4d], available on http://www.rethinking.org/bmj/response_30917.html even today. I was 30th of 835 Responders from the year 2003 to 2005 when Dr Smith handed the Editor’s baton to Dr Fiona Godlee.

ENTERS DR FIONA GODLEE [16th BMJ Editor 2005-2021]
As soon as Dr Godlee assumed reins of the BMJ she stopped all Rapid Responses on AIDS in South Africa. I was crest-fallen because Responders had been inching nearer and nearer to what Leonard G Horowitz brilliantly dissected in 598 pages of his “Emerging Viruses: AIDS & Ebola – Nature, Accident or Intentional?” [5a].

The Didier Fassin/Helen Schneider bombshell [4c] was full of Facts authenticated by Archbishop Desmond Tutu’s Reconciliation Exercise [5b] when scientists with Nazi proclivities confessed to wrongdoing. To halt Debate on an article that revealed “Parliamentarians rejoicing at how Blacks are dying from AIDS” [4a] caused Africans to mutter “Do we now have a Racist BMJ Editor?” But Dr Fiona Godlee was not at all racist. Two years on one Debate which could go on and on indefinitely? As former Editor of Ghana Medical Journal [5c 5d 5e 5f] I have admired the way Dr Fiona Godlee has navigated choppy journalistic waters. Paranoid African spectacles make me sometimes impatient with what I read in the BMJ, but as I put myself in her shoes, I admit freely she had done much better than I would have ever done. I gave her “Pluses” for making my voice heard very often in BMJ-on-line as indicated below:


I said EDUCATION involves correcting misinformation, teaching new things, underlining irrefutable facts, and challenging Received Wisdom.
“Kwashiorkor” – name we in my Krobo-Dangme-Ga mega tribe in Ghana [5g] have for centuries had for the childhood disease later described by Cicely Williams [5h 5i] – was the first article [224 in Publications List] of some 100 times in the BMJ that the Editor Dr Godlee permitted my voice to be heard from 14 May 2005 to 2021.

Researchers who cited me freely agree that the “List of Publications” found in www.konotey-ahulu.com or www.sicklecell.md [3j] reveals where Misinformation apart from that of Kwashiorkor in textbooks has been corrected.

For example, there has been widespread misinformation that sickle cells protect against malaria, when in fact malaria is known to be the greatest killer of children with sickle cell disease in Africa [3a 5k(284) 5l 5m].

I was born of Trait parents into a Sickle Cell Disease home with 3 sickle cell disease children of 11 offspring, enabling me as a doctor to place “The Sickle Cell Disease Patient” above “Sickle Cell Disease”. Malaria always brought on sickle cell crisis! To allow patients’ wellbeing, “Clinical Experience” which was with me from childhood was enhanced as a doctor to value it above “Haematological Experience” [5n].

Supernatural Phenomena, Darwinian Evolution, Public Health including Vaccinology form part of my publications list.

Dr Fiona Godlee continued to make my voice heard on several different topics allowing me to challenge Received Wisdom: Using my Publications List references to check, other articles are Human resources for health in Africa [234], Doctors as lapdogs to drug firms [260], Prenatal tests and abortion [261 331 334 417], Traditional Medicine [262], Stethoscope and Parkinson’s Kap’s sign [264 295], Sickle Cell Care centres [266], Four bodyguards for speaking scientific truth [271], Pharmacovigilance [272], Opiates for dying and sickle cell disease patients [273], Circumcision and alleged AIDS protection [275], Malaria [279 302 304 320], UK Sickle Cell Disease Patient mismanagement [280 293], Vaccines for genital warts [285], International Donors and conflicting interests [286 293], Conflicting Advice in Clinical Medicine [287 316], Haemodialysis, home and other [ 288 291 315], The soul is supra-scientific [294], NCEPOD Report Poor care of sickle cell disease patients in UK [296 300 357], Sickle Cell Disease Patient management [374 419], Internet Revolution [301], BMJ Archive and other [303 360], Genetic Testing HGC and Public Health [305 408], Blowing own trumpet [306], Fixed drug eruption [307
310], Abdominal aortic aneurysm [309], Free health care must demand responsibilities [311], Drug related deaths rising, and NICE [313 357 358], Honest nurses [314], Politics and Science [317], G6PD Deficiency [321], Genetic Code is supra-scientific [322], Editors and Peer review [324], Modern Genetics blind alley? [327], WHO and H1N1 Pandemic [329], Pain relief politics and economics [330], President Obama apologises over unethical Guatemala syphilis study [332], Nobel Laureate Robert Edwards [333], Physician Dr Geraint James [336], Ethics of gene replacement [337], Music and Tonal Language [339 340], Evangelical Christian appointment controversy [342], Scientific African Revolution through Facebook and Twitter [343], Belief in God ridiculed [301 344 345 346 399], Epistaxis [353], Wikipedia [356], NHS Hospital Delivery Care questioned [358], Pulmonary embolism [361 364], Liverpool Care and Assisted Dying [362 365], Clinical Guidance in Chemotherapy [367], Opiods in the UK [368], Osteomyelitis [370], Erectile Dysfunction [371], Ebola and HIV AIDS [384 385 386], Medical Ethics: Scientists abandon moratorium on germ line editing [387], Sickle cell hip pathology [388 421], Home Office VISA [391 392], Brexit and Democracy [393], International Medical Graduates and quality of care [401], Routine blood tests [403], International fraud and drugs [406], GOD mentioned in BMJ Editorial [409 410], Personal Faith [411], Aviation safety and scientific misinformation [418], Evidence, the human dimension [423], Transgenderism [424 424a], COVID-19 [427 428 429 432].

Is all this part of the reason almost every week, ACADEMIA (Oxford) and ResearchGate (Berlin) alert me that they have observed someone, somewhere, somewhen, has cited me in their publications?

It seems to me the only Minus I observed from Dr Fiona Godlee in a multitude of Pluses was when she allowed that tail-wagging-the-dog Editorial which suggested we replace sex-at-birth with gender later-on [424a]. Sharing in her huge success, I must mention Dr Kamran Abbasi (now Editor), Dr Peter Doshi, and Ms Sharon Davies. Well Done, Great Team, and Thank You!


1. Personal interactions in the past of an aged physician like myself (92 years on 12th July 2022) with a world class Medical Journal like the BMJ may well help in one way or other Consultants half my age, Registrars a third my age, House Officers quarter my age.

2. Tribal Information on Kwashiorkor, and Sickle Cell Disease Patients with Malaria, can expose scientific misinformation.

3. Received Wisdom must not just be accepted because it is trumpeted by so-called experts and accredited Committees and Organisations like WHO, NICE, and NIH..

4. It needs to be proclaimed to students and teachers that Science cannot be used by anybody however brilliant to explain everything.

5. That Science has no place for GOD has not prevented BMJ editorials on GOD.

6. Ethics is not part of science because lying scientists and scientific liars exist.

7. Editorial Integrity decade after decade has placed the BMJ top of the global Class.

8. Personal gratitude to the BMJ requires acknowledgement.

Conflict of Interest: None Declared, but Bias stems from longevity by the grace of GOD which has made my very first ever major article published in 1965 [Sicklaemic Human Hygrometers, Lancet 1965; 1: 103-104] cited in June and October 2022]
felix@konotey-ahulu.com Twitter@profkonoteyahul

Felix I D Konotey-Ahulu FGA MB BS MD(Lond) DSc(UCC) DSc(UH) FRCP(Lond) FRCP(Glasg) DTMH(L’pool) FGCP FWACP FTWAS ORDER OF THE VOLTA (OFFICER) Kwegyir Aggrey Distinguished Professor of Human Genetics University of Cape Coast, Ghana; Former Consultant Physician Genetic Counsellor in Sickle Cell and Other Haemoglobinopathies Korle Bu Teaching Hospital & Director Ghana Institute of Clinical Genetics and at Cromwell Hospital London SW5 0TU, and 9 Harley Street, Phoenix Hospital Group, London W1G 9AL [www.sicklecell.md] https://youtu.be/41a1FZSpHd4 & https://youtu.be/SevUBEHhTo for Awards on video]


1a Konotey-Ahulu FID. “Case of lightning burns” BMJ 1963; 1: 1547. June 18 1963 doi:10.1136/bmj.1.5344.1547 http://www.bmj.com/cgi/reprint/1/5344/1547-apdf

1b Konotey-Ahulu FID. Varicose veins in pregnancy. BMJ 1965; 2: 1065. doi:10.1136/bmj.2.5469.1065 www.bmj.com/cgi/reprint/25469/1065.pdf

1c Konotey-Ahulu FID. Torrential epistaxis associated with symmetrical facial skin ulceration in sickle cell anaemia. BMJ 1965 Oct; 2: 859-860. doi:10.1136/bmj.2.5466.859 http://www.bmj.com/cgi/reprint/2/5466/859.pdf

1d Konotey-Ahulu FID, Baillod RA, Comty CM, Heron JR, Shaldon S, Thomas PK. Effect of periodic dialysis on the peripheral neuropathy of end-stage renal failure. BMJ 1965; 2: 1212-1215 (Nov. 20) doi:10.1136/bmj.2.5472.1212 http://www.bmj.com/cgi/reprint/2/5472/1212.pdf

2a Konotey-Ahulu FID. Epistaxis in sickle cell anaemia (12 References). BMJ 1966; 1: 234. doi:10.1136/bmj.1.5481.234-a (January 27)

2b Konotey-Ahulu FID. Personal View (Superstition and phenomena in Africa). BMJ 1969; 2: 48 doi:10.1136/bmj.2.5648.48 http://www.bmj.com/cgi/reprint/2/5648/48.pdf (April 15, 1969)

2c Konotey-Ahulu FID. Personal View (Genetic counselling in sickle-cell disease). BMJ 1969; 3: 235 doi:10.1136/bmj.3.5664.235 [Substitute ACHE for ‘bad’ and ‘wrong’, and NORM for ‘good’] http://www.bmj.com/cgi/reprint/3/5664/235.pdf

2d Konotey-Ahulu FID. Tafracher – Personal View. BMJ 1975; 1(5953): 329. (Feb. 8 doi:10.1136/bmj.1.5953.329 http://www.bmj.com/cgi/reprint/1/5953/329.pdf Ghanaian Devulgarising word https://bit.ly/3mJBMfm

2e Konotey-Ahulu FID and Ringelhann B. Sickle-cell anaemia, sickle-cell thalassaemia, sickle-cell haemoglobin C disease and asymptomatic haemoglobin C thalassaemia in one Ghanaian family. BMJ 1969 Mar 8; 1(5644): 607-612. doi:10.1136/bmj-1.5644/607 http://www.bmj.com/cgi/reprint/1/5644/607.pdf

2f Bentsi-Enchill KK, Konotey-Ahulu FID. Thirteen children from twelve pregnancies in sickle-cell thalassaemia. BMJ 1969; 3: 762 doi:10.1136/bmj.3.5673.762

2g Konotey-Ahulu FID. Haemolytic anaemia in pregnancy in Nigerians. BMJ 1970: 2(5701): 112 doi: 10.1136/bmj.2.5701.112-a (April 11)

2h Konotey-Ahulu FID. Malaria and sickle-cell disease BMJ 1971 June; 2(5763): 710-711 doi:10.1136/bmj.2/5763.710-d

2i Konotey-Ahulu FID. Sickle Cell Trait and altitude. BMJ 1972; 1(5793): 177-78 January 15 doi:10,1136/bmj.1,5793.177-a http://www.bmj.com/cgi/reprint/1/5793/177-a.pdf

2j Konotey-Ahulu FID. Sickle cell and altitude. BMJ 1972;2: 231-232. 2k Konotey-Ahulu FID. Detecting sickle haemoglobin. BMJ 1972; 4: 239.

3a Konotey-Ahulu FID. Clinical epidemiology, not sero-epidemiology, is the answer to Africa’s AIDS problem BMJ (Clin Res Ed) 1987; 294(6587): 1593-1594 (June 20 1987) doi:10.1136/bmj.294.6587.1593 http://www.bmj.com/cgi/reprint/294/6587/1593.pdf

3b Konotey-Ahulu FID. Personal View: The spiritual and the psychological in Clinical Medicine. BMJ 1977; 1: 1595. (June 15) doi:10.1136/bmj.1.6076.1595 http://www.bmj.com/cgi/reprint/1/6076/1595.pdf

3c Konotey-Ahulu FID. English-speaking peoples. (Book Review: English Tests for Doctors by Dick Alderson and Vivienne Ward). BMJ 1980; 280 May 24: 1267-1268. doi:10.1136/bmj.280.6226.1267 http://www.bmj.com/cgi/reprint/280/6226/1267.pdf

3d Konotey-Ahulu FID. Male procreative superiority index (MPSI): The missing co-efficient in African anthropogenetics. BMJ 1980; 281(6256): 1700-1702 doi:10.1136/bmj.281.6256.1700 http://www.bmj.com/cgi/reprint/281/6256/1700.pdf http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1715685&blobtype=pdf |

3e Konotey-Ahulu FID. Problems of overseas doctors. BMJ Clin Research Ed; 282(6276 :1621-1622 doi:10.1136/bmj.282.6276.1621-a http://www.bmj.com/cgi/reprint/282/6276/1621-a.pdf 1981 May 16 1981

3f Konotey-Ahulu FID. Survey of sickle-cell disease in England and Wales. http://www.bmj.com/cgi/reprint/284/6309/112-a.pdf BMJ 1982; 284(6309): 112. doi:10.1136/bmj.284/6309/112a January 9, 1982.

3g Konotey-Ahulu FID. Ethical issues in prenatal diagnosis. BMJ Clin Res Ed 1984; 289(6438): 185. July 21. doi:10.1136/bmj.289.6438.185-a 6143955 http://www.bmj.com/cgi/reprint/289/6438/185-a.pdf

3h Konotey-Ahulu FID. Ethnic minorities and Sickle Cell Disease. BMJ Clin Res Ed 1985; 290(6476): 1214 http://www.bmj.com/cgi/reprint/290/6476/1214.pdf

3i Konotey-Ahulu FID. Tribute to Professor Hermann Lehmann CBE, MD, PhD, ScD, FRCP, FRCPath, FRSC, FRS. BMJ 1985; 291: 288-289. (July 27, 1985) doi:10.1136/bmj.291.6490.288

3j Konotey-Ahulu FID. Points: A boost for clinical research. BMJ April 1986, page 1081 “If, as I have always thought, the discipline of clinical epidemiology seeks to answer the questions How? Which? When? Who? What? Why? Where? Are we more likely
to get clearer answers in the north to questions relating to the south?” http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1340158&blobtype=pdf

3k Konotey-Ahulu, FID. Kwashiorkor. BMJ 1991, 302(6769): 180-181. Jan 19. (Explaining what this Ghanaian tribal word means) doi:10.1136/bmj.302.6769.180-chttp://www.bmj.com/cgi/reprint/302/6769/180-c.pdf

3l Konotey-Ahulu, FID. Penicillin prophylaxis in children with sickle cell disease. BMJ 1991; 302(6786): 1205-06. (May 18 1991) doi:10.1136/bmj.302.6786.1205-b (Commenting on paper by Cummins, Heuschkel & Sally Davies – Brit Med J 1991; 302: 989-90.) http://www.bmj.com/cgi/reprint/302/6786/1205-b.pdf

3m Konotey-Ahulu, FID. Morphine for painful crises in sickle cell disease. BMJ 1991, 302(6792): 1604. (June 29) doi:10.1136/bmj.302.6792.1604-c http://www.bmj.com/cgi/reprint/302/6792/1604-c.pdf (Comment on Professor Chamberlain’s recommendation of morphine in pregnancy in sickle cell disease – BMJ 1991; 302: 1327-30.)

3n Konotey-Ahulu FID. Website on Sickle Cell Disease Patient www.sicklecell.md and www.konotey-ahulu.com

3o Konotey-Ahulu FID. The Sickle Cell Disease Patient. The Macmillan Press Ltd.,1991 & Reprinted 1992. Republished 1996 by T-AD Co [See 3n below]

3p Konotey-Ahulu FID. The Sickle Cell Disease Patient. TETTEH-A’DOMENO COMPANY 1996, P O Box 189, Watford WD1 7NJ, England. ISBN 0-95- 9515442-2-
5 Foreword by Professor Roland B Scott MD, Howard University Center for Sickle Cell Disease. [643 pages]

3q Weatherall Professor Sir David FRS MD FRCP FRCPath. Lancet June 29, 1991 Volume 337 page 1590 says “The Sickle Cell Disease Patient” is a fitting tribute to a physician who has done as much as anyone to improve facilities to deal with this condition in Africa.

4a Konotey-Ahulu FID. Dame Sheila Sherlock’s Third World Dimension. BMJ rr 20 Jan 2002 http://www.bmj.com/content/324/7330/174.1.extract.reply#bmj_el_18859

4b Konotey-Ahulu FID. The supra-scientific in clinical medicine: a challenge for Professor Know-All. http://www.bmj.com/cgi/reprint/323/7327/1452.pdf Brit Med J 2001; 323(7327):14521453 Dec 22-29 doi:10.1136/bmj.323.7327.1452

4c Fassin Didier, Schneider Helen. The Politics of AIDS in South Africa: beyond the controversies. BMJ 2003; 326: 495 https://doi.org/10.1136/bmj.326.7387.495 March 1 2003.

4d Konotey-Ahulu FID. Wake-up call and need for paradigm shift. Brit Med Journal 2003 ‘Rapid E-Response’ to Didier Fassin and Helen Schneider’s article opened up for Education and Debate: – The politics of AIDS in South Africa: beyond the controversies. Brit Med J 2003; 326; 495-497 (1 March 2003). [7000 words with 70 references] http://www.rethinking.org/bmj/response_30917.html

5a Horowitz Leonard G. Emerging Viruses: AIDS and Ebola – Nature, Accident or Intentional? Tetrahedron, Inc. Rockport MA, 1998 ISBN: 0-92350-12-7

5b Maharaj Akaash. Desmond Tutu was right. The Truth and Reconciliation Commission. Report submitted October 28, 1998.

5c Konotey-Ahulu FID. Toxoplasmosis. Ghana Medical Journal 1970; 9: 67-68 (Editorial – 7 references)

5d Konotey-Ahulu FID. Vitamin A in Cholesterol biosynthesis and pathogenesis of atherosclerosis (Editorial) Ghana Medical Journal 1972; 11: 3-4.

5e Konotey-Ahulu FID. An International Sickle Cell Crisis. Ghana Medical Journal March 1972; 11: 4-8 (Editorial)

5f Konotey-Ahulu FID. The Tyranny of Fashion in Medical Journals. Ghana Medical Journal [Editorial], 1972; 11: 168-172.

5g Konotey-Ahulu FID. Issues in Kwashiorkor. Lancet 1994 February 26, Volume 343, page 548. [Lancet published picture of Dr Cicely Williams and me in Oxford at Somerville College when I accompanied Ghana High Commissioner His Excellency Annan Cato and Vice Chancellor University of Ghana Professor Akilagpa Sawyerr to confer Honorary DSc on the remarkable lady who first described Kwashiorkor using the Krobo-Dãngme-Gã Tribal word for the malady in the world Medical Journals. Correcting widespread misinformation about what my tribal name Kwashiorkor means I said in this Lancet communication “Kwashiorkor is the result of a social Pathology before it is outcome of a biochemical pathology”. It does not mean red hair!

5h “Mechanism through which Hb S protects against malaria” on pages 94, 95, 96 of Konotey-Ahulu FID The Sickle Cell Disease Patient. The Macmillan Press Ltd.,1991 & Reprinted 1992. Republished 1996 by T-AD Co [See comment on page 94 last paragraph: “One obvious puzzling question is why sickle cell homozygotes do not show the same clinical resistance to falciparum malaria as sickle cell Traits.

5i Konotey-Ahulu FID. The Sickle Cell Diseases: Clinical Manifestations including The Sickle Crisis. Archives Internal Medicine 1974; 133; 611-619. [Comprehensive]

5j Konotey-Ahulu FID. Effect of environment on sickle cell disease Environment in West Africa: epidemiological and clinical considerations. In Sickle Cell Disease. Diagnosis, management, education, and research. Abraham H et al. C V Mosby o, St Louis, pages 20-38.

224 Konotey-Ahulu FID There is nothing mysterious about Kwashiorkor. BMJ 14 May 2005 Rapid Response http://www.bmj.com/cgi/eletters/330/7500/1095#106854

234 Konotey-Ahulu FID Human resources for health in Africa. Is it national or international policies causing the brain drain? BMJ Rapid Response November 7 to Editorial by Adetokunba O Lucas “Health resources for health in Africa” BMJ 2005, 331: 1037-1038 http://www.bmj.com/cgi/eletters/331/7524/1037#120815

260 Konotey-Ahulu FID. Doctors must not be lapdogs to drug firms even more relevant in the Third World. BMJ Rapid Resp. November 12 2006 http://www.bmj.com/cgi/eletters/333/7576/1027#149040

261 Konotey-Ahulu FID. Refusing to provide a prenatal test for reducing later termination of pregnancy can it ever be ethical? BMJ
http://www.bmj.com/cgi/eletters/333/7577/1066#149662 BMJ Rapid Resp. Nov. 20, 2006

262 Konotey-Ahulu FID Recovering lost knowledge of traditional medicine by searching historical herbal texts for potential new drugs. http://www.bmj.com/cgi/eletters/333/7582/1314#152179 BMJ Rapid Resp. Dec. 26, 2006

264 Konotey-Ahulu FID My stethoscope’s bell and discovery of a new Parkinsonian physical sign (Kap’s sign) in clinical medicine, BMJ Rapid Response 6 Feb 2007.

266 Konotey-Ahulu FID. Dedicated sickle cell centres. BMJ Rapid Response March 20, 2007 http://www.bmj.com/cgi/eletters/334/7591/477#

271 Konotey-Ahulu FID. Four bodyguards and the perils of unmasking scientific truths. BMJ 2007; 335: 210-211 July 28, 2007.

272 Konotey-Ahulu FID. Who should best pharmacovigilate in developing countries? 14 September 2007 http://www.bmj.com/cgi/eletters/335/7618/462#167455 Rap Resp to Editorial

273 Konotey-Ahulu FID. Opiates for pain in dying patients and in those with sickle cell disease. 11 October 2007 BMJ Rapid Resp. http://www.bmj.com/cgi/eletters/335/7622/685#177986

275 Konotey-Ahulu FID Male circumcision and alleged protection from AIDS. BMJ Rapid Response (Dec. 11) http://www.bmj.com/cgi/eletters/335/7631/1206#183100

276 Konotey-Ahulu FID. Ghana @ 50 UK Health Conference: A special report. Ghanaian Times Dec. 24, 2007, p. 24.

279 Konotey-Ahulu FID. Imported malaria in the UK: Unde venis? & Quo vadis?
http://www.bmj.com/cgi/eletters/337/jul03_2/a135#198874 BMJ Rap Resp 16 July 2008

280 Konotey-Ahulu FID. Current “hit and miss” care provision for sickle cell disease patients in the UK http://www.bmj.com/cgi/eletters/337/jul11_2/a771#199135 BMJ Rapid Resp. 22 July 2008

283 Konotey-Ahulu FID. Management of sickle cell disease versus management of the sickle cell disease patient. BMJ Rapid Resp.17 September 2008

284 Konotey-Ahulu FI D. Malaria and sickle cell: “Protection?” Or “No Protection?” – Confusion reigns. BMJ Rapid Response October 13 2008

285 Konotey-Ahulu FID. Vaccination for genital warts to prevent cervical cancer: principles first, please, before details. BMJ Rapid November 12 2008 http://www.bmj.com/cgi/eletters/337/oct23_1/a2186#204534

286 Konotey-Ahulu FID. Affordable Antimalarials: Do international Donors not have conflicting interests? BMJ Rapid Response November 25, 2008 http://www.bmj.com/cgi/eletters/337/nov12_1/a2495#205142

287 Konotey-Ahulu FID. Clinicians facing conflicting recommendations: Use common sense? http://www.bmj.com/cgi/eletters/337/nov28_2/a2530#205677 BMJ Rapid Resp. Dec. 5, 2008.

288 Konotey-Ahulu FID. Home haemodialysis just the thing for Africa’s wealthy patients. http://www.bmj.com/cgi/eletters/336/7634/3#186073 BMJ Rapid Response 8 January 2008

291 Konotey-Ahulu FID. But how much does maintenance haemodialysis cost in each country? BMJ Rapid Resp. 31 January 2008 http://www.bmj.com/cgi/eletters/336/7634/3#188633

292 Konotey-Ahulu FID. Domiciliary management is the way forward for AIDS management in Africa. [March 4 2008] Comment on “Reduced mortality with home-based HIV treatment in Uganda” Comment – Lancet 2008; 371: 703-705

293 Konotey-Ahulu FID. Do international donors genuinely desire to help solve Africa’s health problems? BMJ Rap Resp. 19 March 2008 http://www.bmj.com/cgi/eletters/336/7643/518#192285

294 Konotey-Ahulu FID. The soul is supra-scientific. BMJ Rapid Response 16 May 2008.http://www.bmj.com/cgi/eletters/336/7653/1132#195557

295 Konotey-Ahulu FID. The stethoscope is there for life and will remain for good. http://www.bmj.com./cgi/eletters/336/7653/1134#195928 BMJ Rapid Response May 28, 2008.

296 Konotey-Ahulu FID. Poor care for sickle cell disease patients: This wake-up call is overdue. BMJ Rapid Response May 28, 2008 BMJ 2008; 336: 1152 to Susan Mayor “Enquiry shows poor care for patients with sickle cell disease” on National Confidential Enquiry into Patient Outcome and Death (NCEPOD) REPORT “SICKLE: A Sickle Crisis? (2008) http://www.bmj.com/cgi/eletters/336/7654/1152a#196224 | http://www.info@ncepod.org http://www.ncepod.org

300 Konotey-Ahulu FID. Inquest into diamorphine deaths: Does NCEPOD sickle patients report warrant a similar inquest? http://www.bmj.com/cgi/eletters/338/mar03_3/b903#210208 BMJ Rapid Response March 7 2009

301 Konotey-Ahulu FID. Martin Luther’s Protestant Reformation as a retrospective mirror for the present Internet Revolution. BMJ Rapid Response March 25, 2009

302 Konotey-Ahulu FID. Fighting Malaria: Isn’t the best approach through Environmental Hygiene and Public Health? http://www.bmj.com/cgi/eletters/338/apr20_2/b1627#212782 BMJ Rapid Response April 26 2009

303 Konotey-Ahulu FID. British Medical Journal Archive since 1840. http://www.bmj.com/cgi/eletters/338/apr29_1/b1744#213088 BMJ Rapid Response May 2 2009.

304 Konotey-Ahulu FID. Combating malaria: Try public health measures in Africa too. BMJ 2009; 338:b 1971 doi:10.1136/bmj.b1971 (May 20) PMID: 19457959
BMJ Rapid Response 27 June 2009

305 Konotey-Ahulu FID. Human Genetics Commission (HGC) and direct to consumer Genetic Tests, leading to Genetic Counselling. BMJ Rap Resp. May 27, 2009. http://www.bmj.com/cgi/eletters/338/may15_2/b1995#214256

306 Konotey-Ahulu FID. Blow your own trumpet and be thoroughly scriptural.

307 Konotey-Ahulu FID. Fixed drug eruption with Paracetamol. BMJ Rap resp. to Charles Quartey-Papafio in BMJ 2009; 338: b2582 http://www.bmj.com/cgi/eletters/338/jun30_2/b2582#216215

309 Konotey-Ahulu FID. Abdominal aortic aneurysm screening for men: Please acknowledge a genetic dimension http://www.bmj.com/cgi/eletters/338/jun24-_2/b2307#216519 BMJ 10 July 2009

310 Konotey-Ahulu FID. Fixed drug eruptions. More of fixed rug eruptions. http://www.bmj.com/cgi/content/full/bmj.b2924

311 Konotey-Ahulu FID. Free health care for world’s poorest countries without pre-conditions? BMJ Rapid response Aug 7 [In response to Zosia Kmietowicz http://www.bmj.comcgi/eletters/339/aug05_1/b3177#218219 | http://www.bmj.com/cgi/content/full/339/aug05_1/b3177 BMJ 2009;339.b3177

313 Konotey-Ahulu FID. UK drug related deaths are still rising: So where is NICE? Sept. 6 2009 http://www.bmj.com/cgi/eletters/339/sep01_1/b3536#219836
BMJ Rapid Response to Susan Mayor on “UK drug related deaths are still rising 2 reports say” .

314 Konotey-Ahulu FID. Doctor cleared of asking nurse to give fatal dose to dying patient: More honest nurses, please 17 Sept. BMJ 2009; 339: b3812

315 Konotey-Ahulu FID. High index of suspicion with timely haemodialysis for hyperkalaemic cardiac arrest. Rapid Resp.5 Nov 2009.
http://www.bmj.com/cgi/eletters/339/oct23_1/b4114#224409 .

316 Konotey-Ahulu FID. Does rejecting a particular scientific opinion mean a rejection of science? http://www.bmj.com/cgi/eletters/339/nov04_1/b4563#224533 Rapid Resp.10 Nov. 2009.

317 Konotey-Ahulu FID. Harold Varmus and The Art of Politics and Science. http://www.bmj.com/cgi/eletters/339/nov17_3/b4848#225563 BMJ Rapid Response 20 November 2009

321 Konotey-Ahulu FID. Are patients with G6PD Deficiency to avoid eating prawns http://www.bmj.com/cgi/eletters/340/feb26_1/c1016#232266

323 Konotey-Ahulu FID. Malaria diagnosis and treatment in Ghana. BMJ Rapid Response 25 March 2010 http://www.bmj.com/cgi/eletters/340/mar05_1/c930#233389

324 Konotey-Ahulu FID. Peer review, yes, but good editors must have the last word. http://www.bmj.com/cgi/eletters/340/mar15_1/c1409#233845 BMJ Rapid Response April 2 2010

327 Konotey-Ahulu FID. Is modern genetics a blind alley? Not quite so in Europe, but probably yes i Africa http://www.bmj.com/rapid.response/2011/1102/modern-genetics-blind-alley-not-quite-so-europe-probably-yes-africa BMJ Rapid Response 19 May 2010

329 Konotey-Ahulu FID. WHO declares that H1N1 Pandemic is officially over: So do Ghanaians need to be jabbed with the vaccine? BMJ 12 Aug 2010 Rapid Resp.

330 Konotey-Ahulu FID. The politics (and economics) of pain relief in the West and Third World. 24 August 2010 BMJ Rapid Response to T Anderson http://www.bmj.com/cgi/eletters/341/aug11_2/c3800#240684 The politics of pain 11 Aug doi: 10.1136/bmj.c3800

331 Konotey-Ahulu FID. Antenatal screening for sickle cell disease and beta-thalassaemia. http://www.bmj.com/content/341/bmj.c5132/reply#bmj_el_242914 BMJ Rapid Response Oct 12 2010 [32 references]

332 Konotey-Ahulu FID. President Obama apologises over Guatemala syphilis study: International cooperative research in jeopardy. BMJ Rapid response October 17 2010. [16 references] http://www.bmj.com/content/341/bmj.c5494.full/reply#bmj_el_243183

333 Konotey-Ahulu FID. Genius of Nobel Laureate Robert Edwards goes beyond IVF. http://www.bmj.com/content/341/bmj.c5533/reply#bmj_el_243005 | www.embryologist.org.uk BMJ Rapid Response Oct 14 2010 [3 references]

334 Konotey-Ahulu FID. Antenatal sickle cell disease haemoglobinopathy screening.
http://www.bmj.com/content/341/bmj.c5243/reply#bmj_el_243447 BMJ Rapid Respo Oct. 25, 2010

336 Konotey-Ahulu FID. David Geraint James: Great Champion of Overseas Postgraduates. 18 Nov 2010 [Resp. to BMJ 341:doi.1136/bmj.c6400] See Ref 170 on Dame Sheila Sherlock 20 Jan 2002 http://www.bmj.com/content/341/bmj.c6400.full/reply#bmj_el_244903 | http://www.bmj.com/content/324/7330/174.1.extract.reply#bmj_el_18859

337 Konotey-Ahulu FID. Ethics of mitochondrial gene replacement is also ethics of acquired genetic inheritance. BMJ Rapid Response 19 November 2010

339 Konotey-Ahulu FID. Music (and Tonal Language) and the art of being human http://www.bmj.com/content/341/bmj.c6965.full/reply#bmj_el_246612 BMJ Rapid Response Dec 20.

340 Konotey-Ahulu FID. Music (and Tonal Language) and the art of being human II. http://www.bmj.com/content/341/bmj.c6965.full/reply#bmj_el_246615 BMJ Rapid Response Dec 20.

341 Konotey-Ahulu FID. Music (and Tonal Language) and the art of being human III. http://www.bmj.com/content/341/bmj.c6965.full/reply#bmj_el_246618. BMJ Rapid Response Dec 20.

342 “New appointment of evangelical Christian to drug advisory body sparks controversy” Please spare us emotive headlines BMJ Rapid Response 6 February 2011 http://www.bmj.com/content/342/bmj.d624/reply#bmj_el_249481

343 Konotey-Ahulu FID. Facebook and Twitter in bid to create African Scientific Revolution “mizraimically” BMJ paid Response 5 March 2011

344 Konotey-Ahulu FID Only fruitcakes believe in GOD? http://www.bmj.com/content/342/bmj.d2642/reply#bmj._el_260425
[See Correction in Reference 301] BMJ Raid Response 11 May 2011.

345 Konotey-Ahulu FID. Only fruitcakes believe in in GOD? Correction of inverted inheritance of solomonic genius. BMJ Rapid Response 12 May2011. [See Reference 300] http://www.bmj.com/content/342/bmj.d2642/reply#bmj_el_260496 BMJ Rapid Response 12 May2011. [See Reference 300]

346 Konotey-Ahulu FID. Is talking about God to be banned from clinical care? http://www.bmj.com/content/342/bmj.d3275/reply#bmj_el_261475 BMJ Rapid Resp. 2 June 2011.

353 Konotey-Ahulu FID. Epistaxis from sickle cell disease must not be forgotten www.bmj.com/content/344/bmj.e1097/rr/576087 BMJ Rapid Response 28 March 2012

356 Konotey-Ahulu FID. Should clinicians edit Wikipedia to engage a wider world web? At least two examples of inaccuracy dictate caution BMJ 14 August 2012 Rapid Response www.bmj.com/content/345/bmj.e4275/rr/598116

357 Konotey-Ahulu FID. Management of an acute painful sickle cell episode in hospital: NICE guidance is frightening1 Sept 7, 2012. www.bmj.com/content/344/bmj.e4063/rr/599158 [42 references]

358 Konotey-Ahulu FID. Almost a quarter of Royal College Fellows say their hospitals cannot deliver continuity care. And they boast of something called National Institute of Clinical Excellence? www.bmj.com/content/345/bmj.e4942/rr/601191 September 7, 2012 BMJ Rapid Response.

360 Konotey-Ahulu FID Bring back good quality paper in the print BMJ www.bmj.com/content/345/bmj.e6396/rr/610395 BMJ Rapid Response 23 October 2012

361 Konotey-Ahulu FID. Diagnosis and management of pulmonary embolism. www.bmj.com/content/346/bmj.f767/rr/633072 BMJ Rapid Response 26 Feb 2013

362 Konotey-Ahulu FID. Liverpool care pathway BMJ and Channel Four News: Majority expert choice does not mean best choice March 8 2013 BMJ Rapid Response to “Nine out of 10 palliative care experts would choose Liverpool care pathway for themselves” Krishna Chinthapalli BMJ 2013; 346: 1103 (March 2, pages 2-3) www.bmj.com/content/346/bmj.f1303/rr/634971

364 Konotey-Ahulu FID. Importance of history in the diagnosis of pulmonary embolism www.bmj.com/content/346/bmj.f1692 March 19 BMJ 2013; 366: F1692

365 Most religious followers support assisted suicide for the dying: Survey flawed through inadequate definition of “religious” and “terminally ill”. BMJ Rapid Response May 12 2013 www.bmj.com/content/346/bmj.f2855/rr/645095 – to Zosia Kmietowicz BMJ News www.bmj.com/content/346/bmj.f28555?sso 11 May: Most religious followers support assisted suicide for the dying.

367 Konotey-Ahulu FID. Opiods for chronic non-cancer pain – Chemotherapy – Clinical Guidelines: Where does ultimate responsibility lie? www.bmj.com/content/ 346/bmj.f2937/rr/651421 BMJ Rapid Response 25 June 2013

368 Konotey-Ahulu FID. Opiods in the UK: What’s the problem? Answer – Good Clinical Practice needs to cover all population groups including sickle cell disease patients. www.bmj.com/content/347/bmj.15108/rr/658208 BMJ Rapid Response 18 August 2013

370 Konotey-Ahulu FID. Acute osteomyelitis in African children unmasks sickle cell disease with salmonellosis http://www.bmj.com/content/348/bmj.g66/rapid-responses BMJ Rapid Response Feb. 1, 2014

371 Konotey-Ahulu FID. Erectile Dysfunction: Test, please, for Sickle Cell Disease. http://www.bmj.com/content/348/bmj.g129/rapid-responses Rapid Response to BMJ 2014; 348: g129 February 1,3 2014

374 Konotey-Ahulu FID. Management of sickle cell disease patient I the community BMJ Rapid Response 13 April 2014 [90 References] to Brousse V, Makali J, Rees DC: Management of sickle cell disease in the community. BMJ 2014; 348: g1765 doi:10.1136/bmj.g1765 http://www.bmj.com/content/348/bmj.g1765/rr/694233

378 Konotey-Ahulu FID. Perthes’ disease versus sickle cell disease hip. BMJ Rapid Response www.bmj.com/content/349/bmj.g5584/rr or http://bit.ly/1tGmuYm (18 Oct ) to Perthes’ disease by Peter Kannu & Andrew Howard, Brit Med Journal Oct 4 2014 Vol 349 pages 32-33.

384 Konotey-Ahulu FID. Ebola and Ethics: “Are vaccine trials going on somewhere in Africa?”. http://www.bmj.com/content/350/bmj.h2105/rr-5 BMJ Rapid Response 02 June 20

385 Konotey-Ahulu FID. Ebola and Ethics: Ghana Academy of Arts and Sciences and Ghana Government Suspend Ebola Virus Vaccine Trials. BMJ Rapid Response 14 June 2015 http://www.bmj.com/content/350/bmj.h2105/rr-7

386 Konotey-Ahulu FID. Ebola viewed through HIV/AIDS spectacles – What Africans think. BMJ Rapid Response. August 7 2015 www.bmj.com/351/bmj.h4142/rr-0 to Zosia Kmietowicz: Ebola vaccine trial results “extremely promising” says WHO. BMJ 351: h4192 July 31, 2015.

387 Konotey-Ahulu FID. Scientists call for moratorium on clinical use of human germline editing: A déjà vu of Ethical Caveat! www.bmj.com/content/351/bmj.h6603/rr-0 Rapid Response 16 Dec 2015 to Dr Michael McCarthy’s “Scientists call for moratorium on clinical use of human germline editing”. BMJ 2015; 351:h6603 http://www.bmj.com/content/351/bmj.h6603/rr-0

388 Konotey-Ahulu FID. Hip pain and radiographic signs of osteoarthritis: Sickle cell & other haemoglobinopathy differential diagnosis. British Medical Journal Rapid Response 8 January 2016 http://www.bmj.com/content/351/bmj.h5983/rr-2 to MJ Nieuwenjse and Rob G Nelissen BMJ 2015; 351 doI: http://dx.doI.org/10.1136/bmj.h5983 http://www.bmj.com/content/351/bmj.h5983/rr-2 (Published 2 December 2015)

391 Konotey-Ahulu FID. Will Home Office VISA Refusal Prompt West African Relatives To Vote Brexit? http://www.bmj.com/content/353/bmj.i3027/rapid-responses Rapid Response 10 June 2016

392 Konotey-Ahulu FID. Home Office VISA Refusal Prompt West African Relatives to Vote Brexit? Full Apology Now Received from Home Office. Rapid Responses June 22 2016 http://www.bmj.com/content/353/bmj.i3027/rapid-responses

393 Konotey-Ahulu FID. BREXIT: DEMOCRACY IS COUNTING HEADS REGARDLESS OF WHAT THE HEADS CONTAIN. http://www.bmj.com/content/353/bmj.i3551/rr-6 Rapid Responses June 30 2016

399 Konotey-Ahulu FID. The God Delusion title devalues sensible discourse. BMJ Rapid Response 19 October 2016.http://www.bmj.com/content/335/7629/1099.1/rr-0

401 Konotey-Ahulu FID International Medical Graduates and quality of care: What if quality of care in developing country is better than UK’s? BMJ Rapid Response March 1 in response to “International medical graduates and quality of care” by Aneez Esmail, Julian Simpson. 356:doi10.1136/bmj.j574 http://www.bmj.com/content/356/bmj.j574/rr-0

403 Konotey-Ahulu FID. Should we abandon routine blood tests? No, not when hereditary erythrocytopathy poses a real problem in a so-called multiracial population! BMJ Rapid Response to Alastair Faulkner et al and K. Siau on “Should we abandon routine blood tests?” No, do Abnormal Haemoglobin and G6PD tests routinely http://www.bmj.com/content/357/bmj.j2091/rr-15

404 Konotey-Ahulu FID. BMA AGM 2017 on Abortion – A damning verdict on my genetic defect and family members’ BMJ Rapid Response 30 June 2017 to Abi Rimmer and Rebecca Coombes on “BMA annual meeting: Doctors who carry out abortions should not face criminal sanctions, says BMA” 28 June 2017 BMJ 2017; 357: j1136 https://doi.org/10.1136/bmj.j3116 | www.bmj.com/content/357/bmj.j3116/rr June 28

406 Konotey-Ahulu FID. MEDICINES AND HARMS: Could international Fraud Unearthed In Ghana Be Happening Elsewhere? BMJ Rapid Resp 20 June 2017

408 Konotey-Ahulu FID. Genetic Testing and Counselling Towards Genetic Public Health. BMJ 2017;358:j4101 Dec 21 http:www.bmj.com/content/358/bmj.j4101/rr-0
Rapid Response to Allison Streetly 28 Sept 2017 A common definition on genetic testing – can we agree on one? Re: PRACTICE article by C Semsarian & J Ingles 21 September 2017 .http:www.bmj.com/content/358/bmj.j4101/rr-0

409 Konotey-Ahulu FID. Personal Answer to The Question “Do you believe in God?” [48 References] BMJ Rapid Response to Savros Saripanidis “Do you believe in God?” Re: Kevin Barraclough “Do you believe in God? BMJ 319; doi.10.1136/bmj.7214.929a http://www.bmj.com/content/319/7214/929.2/rr-0

410 Konotey-Ahulu FID. There but for the grace of God …– Fiona Godlee’s Sanctified Common Sense [FGSCS] Rapid Response to There but for the grace of God F Godlee BMJ 2018; 360:k485 http://www.bmj.com/content/360/bmj.k485/rr

411 Konotey-Ahulu FID. “So You Know Where I am coming from (SYKWIACF”) Prefaces My Religious Belief Competing Interest. June 1 2018 BMJ Rapid Response https://www.bmj.com/content/361/bmj.k1558/rr-4

418 Konotey-Ahulu FID. Aviation Safety: Ghanaians recall media disinformation deriving from scientific misinformation, BMJ Rapid Resp. https://www.bmj.com/content/364/bmj.l735/rr-7 Mar 1 2019 to Partha Kar: Applying aviation safety to healthcare; are we missing the fundamental? Partha Kar 364:doi10.1136/bmj.l735

421 Konotey-Ahulu FID. Avascular Hip Necrosis: Sickle Haemoglobinopathy predominates worldwide. BMJ Rapid Response to Lamb JN et al 1 June 2019 Avascular necrosis of the hip BMJ 1 June Vol 365, p 325 (BMJ 2019; 365:l2178) https://www.bmj.com/content/365/bmj.l2178/

423 Konotey-Ahulu FID. EVIDENCE – Do not forget the hidden human dimension. BMJ 07 August 2019 Re: Holger Schunermann et al Distinguishing opinion from evidence in guidelines. BMJ 2019;366:L4606 July 19 2019 BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4606 https://www.bmj.com/content/366/bmj.l4606/rr-11 |

424 Konotey-Ahulu FID. How-When-Where Does Common Sense Scream “The Transgenderism Emperor Has No Clothes”? British Medical Journal 18 October 2019 Re: Deborah Cohen and Hannah Barnes. Gender dysphoria in children: puberty blockers study draws further criticism. BMJ 2019; 366:l5647 https://doi.org/10.1136/bmj.l5647https://www.bmj.com/content/366/bmj.l5647/rr-5

424a Cohen Deborah, Barnes Hannah. Gender Dysphoria in children puberty blockers study draws further criticism. BMJ 2019; 366: L5647 https://doi.org/10.1136/bmj.l5647

427 Konotey-Ahulu FID. COVID-19: Treatment with CLOROQUINE or Intravenous Vitamin C Requires Prior Exclusion of G6PD Deficiency! April 8 2020. Re: Ferner Robin E, Aronson Jeffrey K. Chloroquine and Hydroxychloroquine in Covid-19. https://doi.org/10.1136/bmj.m1432 .https://www.bmj.com/content/369/bmj.m1432/rr-21 BMJ 2020; 369.m1432 April 8 2020.

428 Ayettey AS, Quakyi Isabella, Ayettey-Annie Hannah NG, Sagoe Kwamena W, Ayettey-Adamafio Mary NB, Newman-Nartey Merley, Ayettey Brew Ruth NA, Nartey Nii-Out, Amoah Albert GB, Konotey-Ahulu FID. COVID-19: A Case for Hydrogen Peroxide Mouthwash and Gargle to limit SARS-CoV-2 Infection. BMJ July 2 2020 BMJ 2020; 368: m1252 : Re: What Treatments are being investigated? Elisabeth Mahase https://www.bmj.com/content/368/bmj.m1252/rr-27 BMJ 2020; 368.m1252 March 26, 2020.

429 Konotey-Ahulu FID. COVID-19: “Few can doubt we need a covid-19 vaccine as soon as possible ..” Really? 22 August Re: Fiona Godlee, EDITORIAL. 22-29 August Vol. 370. Less haste, more safety. BMJ 2020; 370.3258 Konotey-Ahulu FID https://www.bmj.com/content/370/bmj.m3258/rr-2

432 Konotey-Ahulu FID..COVID-19: “WHAT WE EAT MATTERS ALL THE MORE NOW” SHOULD ANTICIPATE OTHER NON-VACCINE ADVICE. Re: Fiona Godlee. EDITORIAL. What we eat matters all the more now. BMJ 2020; bmj.m370 December 1, 2020. https://www.bmj.com/contact/370/bmj.m2840/rr-5 .

To Sickle Cell Education Day in Maryland USA May 15, 2021

Sorry, your Registration Procedure was not geared to record my UK phone number so I could not join you to contribute something and to answer questions that could have cropped up. The following is rather lengthy.

My www.sicklecell.md shows how patients can overcome their Sickle Cell Disease and achieve great things in life. Introducing myself, listen to   Professor Helen Ranney MD PhD of Albert Einstein University College of Medicine in New York: “There is no single clinical experience in the United States comparable to that of Dr Konotey-Ahulu”.

She observed that I always placed “The Patient” above “The Disease”.

My book “The Sickle Cell Disease Patient” with 643 pages including 133 Illustrative Case Histories plus thousands of References, and the Foreword by Howard University’s famous Professor Roland Scott MD, describes all that patients require to help them stay out of the hospital and to achieve great things in life. Not Gene Therapy. Order the book from my website, discounted to £30. It deals with The Patient.

My Johns Hopkins Visits

I am no stranger to Maryland. Your Professors Lemuel Conley and Samuel Charache of Johns Hopkins University Medical College had invited me to do Grand Rounds more than once with them at Baltimore.

On one occasion I showed a slide to their students and physicians on “Sixteen Causes of Severe Jaundice in Sickle Cell Disease” which so impressed Professor Charache that he asked me to give him a copy of the slide. Some of their students who heard him quiz me on those Grand Rounds may well now be your present Physicians and Haematologists.

You can find the list of Sixteen Causes of Severe Jaundice in Sickle Cell Disease on page 174 (Table 13.7) of my Textbook analysing 1,500 Consecutive patients with Sickle Cell Disease in Ghana. I am prepared to send you a signed Complimentary copy of my book because of the friendship of Professors Conley and Charache in the past. Tell me where to send it by DHL (Address plus phone numbers). We were together on the WHO Expert Advisory Panel on Haemoglobinopathies in Geneva.

I was once gratefully surprised when Professor Samuel Charache gave me $150 on the spot in the Emergency Room in Baltimore for diagnosing Right Middle Lobe Pneumonia in a Sickle Cell Anaemia (SS) lady in sickle cell crisis, using “HIPPA” – the 5 Cardinal things taught me at Westminster Hospital School of Medicine, the University of London, by Sir Richard Bayliss MA MD FRCP, Physician of Her Majesty Queen Elisabeth II..

HIPPA stands for “History, Inspection, Palpation, Percussion, Auscultation”. After I announced the diagnosis aloud for nurses and doctors to hear, the lady was wheeled away to be X-rayed. When the diagnosis was then displayed on the screen, confirmed, and the $150 thrust in my hands I was hugely grateful because that amount of One Hundred and Fifty Dollars was equivalent to my 3 months’ salary as a Physician Specialist in Inflation-burdened Ghana. It was then I realised why several of the doctors we trained at home in exactly the way we were trained in the UK, found their way across The Atlantic to acquire Dollars that they sent back home to help relatives. Brain Drain meant Dollar Influx! Diagnose without X-rays and you get Dollars?


In later years I invited Professor Samuel Charache to International Conferences of Sickle Cell Disease Patient Achievers The First at The Royal Society of Medicine in London 1993, and the Second in Accra, Ghana, in 1995 when he saw adult Sickle Cell Disease Patients who had never been regularly blood-transfused, and who had graduated from universities. The Hydroxyurea that Prof. Samuel Charache popularized was, and still is, more Disease-oriented than Patient-oriented in that the drug aimed at producing Foetal Haemoglobin F to displace the Abnormal Haemoglobin S with the view to diminishing transfusion requirements. Our ACHIEVERS’ CONFERENCES were aimed at showing off adult patients who were never on regular transfusions as was commonly practised in the UK and the USA.

We have adult Sickle Cell Disease Patients in their Seventh and Eighth Decades of useful life. One Sickle Cell Haemoglobin C Disease (phenotype SC) grandmother, and Women’s Golf Champion, attained the age of 83 years before finishing her Earthly Pilgrimage. During her first pregnancy when repeated urinary tract infections precipitated sickle cell crises some physicians suggested she abort the pregnancy, as was often the practice abroad. She flatly refused, and I concurred with her decision in 1960 when Dr Fred Sai let me admit her to Ward A at Korle Bu Hospital. Being myself born into a Sickle Cell Disease family I knew relatives who carried pregnancies to term. We carefully nurtured Mrs L. O. till she was successfully delivered of Twins by Dr Kwesi Bentsi-Enchil our experienced Obstetrician Gynaecologist. The Trait Twins are now grandparents and successful professionals in their own thriving businesses.

MORAL: Sickle Cell Disease Patients can become ACHIEVERS without Management Practices involving Regular Blood Transfusions, Ante-natal Diagnosis and Terminations of Pregnancy, Morphine and Diamorphine for Sickle Cell Crisis Pain, Hydroxyurea daily to increase Foetal Haemoglobin Level, and Frequent hospitalisations. They can achieve great things right up to their Seventies and Eighties.


One ACHIEVER, D. A-B [SS (NORMACHE “AS” father x NORMACHE “AS” mother produced ACHEACHE)] trained to be a brilliant Nurse SRN in Ghana, went to Cold England to do Midwifery SCM, proceeded to the USA to specialise in Chemotherapy and wrote a Textbook. You can read the description of how she hydrated herself intravenously flying at over 30,000 ft more than once. See www.sicklecell.md BLOG “Lesson of the Week – Dorothy Amanor-Boadu SRN SCM – How I, a sickle cell anaemia woman, hydrate myself intravenously at 36,000 feet

Her advice in bold letters to fellow Sickle Cell Disease Patients: “The moral for other patients reading this article is this: ANTICIPATE PROBLEMS, AND PLAN HOW TO COPE WITH THEM! If necessary, cancel agreed plans (like a flight) in order to save your life. 

 Dorothy Amanor-Boadu attended all 3 SICKLE CELL DISEASE PATIENT ACHEVERS’ CONFERENCES in 1993 (London), 1995 (Accra), and in 2010 (Accra) for the Centenary of Herrick’s first description of Sickle Cell Anaemia in the USA. Great ACHIEVER that she is, she runs a Private Nursing Agency in Accra, and has authored a 186-page book entitled “CANCER CHEMOTHERAPY MANUAL” by DOROTHY S AMANOR-OWUSU. She was offered Bone Marrow Transplantation in the USA but refused. She does not think Gene Therapy is the answer either.

One hopes, GOD willing, Maryland Sickle Cell Disease Association can attend a 4th International Conference with their own ACHIEVERS. I was greatly saddened to learn that my good friend Professor Samuel Charache died on 29th January 2019 aged 89 years.


Listen to me interviewing Mr Ebenezer Tagoe with Sickle Cell Anaemia (SS), a great ACHIEVER now in his 7th Decade of life (born on Ghana’s Independence Day 6th March 1957). In 1993 & 1995 Professor Samuel Charache heard Ebenezer testify at both our SICKLE CELL DISEASE PATIENT ACHIEVERS’ CONFERENCES in London and Accra. At www.sicklecell.md  BLOG you can see him being interviewed live “Meet the Professor talking about Sickle Cell Disease patient live”. Mr Ebenezer Tagoe [SS=ACHEACHE (one S-ACHE gene from father, and another S-ACHE gene from the mother)] was counselled by me and he married an “AA=NORMNORM phenotype” lady. They had 2 “AS” Trait boys who graduated.

Ebenezer is now a qualified Pharmacist who had worked in a London Teaching Hospital, and now a successful businessman in Accra. While in London he was appalled by how many patients with Sickle Cell Disease were given Morphine and Diamorphine for Sickle Cell Crisis when he himself had never been introduced to it. He testifies that as he is a pharmacist, he has declined to take daily Hydroxyurea.

Ebenezer Tagoe is fortunate to have Doctors both in Ghana and England whom he described as “excellent” because they always listen to him. He was once going to be given Morphine after surgery in the UK to remove his gallbladder but he refused and asked to be given Ketorolac instead. At all 3 INTERNATIONAL ACHIEVERS’ CONFERENCES, Mr Tagoe announced that he avoided Sickle Cell Crises by drinking no less than 5 Litres of water a day. I now pass this information on to Maryland Sickle Cell Disease Association (MSCDA) members of which may like to contact him through me felix@sicklecell.md and he will be delighted to answer your queries.


Miss A. K. who is in her 6th Decade of life with Sickle Cell Anaemia is glad to answer questions through me. The only partial blood transfusion she has ever had was for hip replacement (aseptic necrosis). She keeps very well with haemoglobin level always between 7.5 and 8.5 grams per Deci-Litre which she is very pleased with.


Mr Ade Sawyerr with Sickle Cell Haemoglobin C Disease will answer queries about how to avoid sickle cell crises. He has valuable tips and I have taken him with me to answer questions when I am invited for Grand Rounds. Write to him through me.

Glucose 6 Phosphate Dehydrogenase (G6PD) Deficiency

This is one of the 16 causes of Severe Jaundice in Sickle Cell Disease. All new patients I saw in Ghana or UK or in Howard University Washington DC had G6PD enzyme level checked. Some good drugs harm patients with G6PD Deficiency as shown in – https://bit.ly/2sukoPWG6PD Deficiency in Ghanaians: How to recognise it”.  Have all the patients in MSCDA been checked for G6PD Deficiency?

In a way, I am glad I could not join the webinar across The Atlantic because I could not have contributed a tenth of what I have just written.

Finally, GENE EDITING (CRISPR) is woefully unrealistic: How can this deal with the 34,000 babies born every quarter of the year with abnormal haemoglobin genes from both parents in West Africa? Genetic Counselling with Family Size Limitation [GCFSL] is more realistic. See my answer to the Sickle Cell Disease mother married to Sickle Cell Disease man in Tema, Ghana, and who had 13 children all receiving an abnormal haemoglobin gene from both parents causing hereditary disease in all of them. They continued having child after child hoping the next one will avoid hereditary disease but because each Parent had nothing but an aching gene to offer, all the 13 children ended up with ACHE from father, ACHE from mother to be ACHEACHE disease phenotypes.  See on my website how I responded to Mrs D’s reasonable question: “But Doctor: How do we prevent this Nwiiwii (Sickle Cell Disease in Fante) coming in further pregnancies? Study the answer I gave the parents from the Video on my website www.sicklecell.md My invented kanad cubes are given free with every copy of the book – “kanad” stands for KONOTEY-AHULU NORM ACHE DICE

Felix I D Konotey-Ahulu FGA MB BS MD(Lond) DSc(UCC) DSc(UH) FRCP(Lond) FRCP(Glasg) DTMH(L’pool) FGCP FWACP FTWAS ORDER OF THE VOLTA (OFFICER) Kwegyir Aggrey Distinguished Professor of Human Genetics University of Cape Coast, Ghana; Former Consultant Physician Genetic Counsellor in Sickle Cell and Other Haemoglobinopathies Korle Bu Teaching Hospital & Director Ghana Institute of Clinical Genetics, and 9 Harley Street, Phoenix Hospital Group, London W1G 9AL www.konotey-ahulu.com and https://youtu.be/41a1FZSpHd4 which is Video with CITATION of Honorary DSc awarded me by the University of Hertfordshire.



Another great Ghanaian Physician has left us for good, but not really forever because much of what he did in life will be remembered for decades to come. Those who read international medical journals will recall the role DR REGINALD ADDAE & DR FRANK T DJABANOR played in SAVING BLACK PEOPLE FROM HUMILIATION.

And these two Ghanaian London-University-trained doctors did this by revealing as TOTALLY FALSE an international medical report which advised that

“If on certain African routes, a Negro traveller must take an unpressurized aircraft it would be wise to ascertain the sickling status before departure”.

imagine you and I being pulled out of a queue boarding an aeroplane to be tested at the airport for sickle cells. The FALSE international publication was so significant that within a week, the world’s leading Science Journal NATURE, and the leading British Newspaper THE TIMES elaborated the original false article and made their own recommendations. THE TIMES Science Correspondent even went further to recommend that all Black Air Crews should be grounded immediately.


The FALSE medical report was based on a Ghanaian nurse flying from Kumasi to Accra and who during the 45 minutes flight developed tummy problems. On arrival in Accra she was operated upon by a non-Ghanaian surgeon at the 37-General Hospital now called The Military Hospital. The report in the Medical Journal by 3 non-Africans who had never been to Africa, said the Ghanaian nurse was Sickle Cell Trait proven by the standard test called Haemoglobin Electrophoresis. This report caught the sharp eyes of the two Ghanaian Physicians at the Military Hospital even though “Military Hospital” was not mentioned in any of the international publications. Reggie Addae was the first to write to the international Medical Journal asking for proof that the nurse
was sickle cell trait (Haemoglobin Electrophoresis “AS”). Next to write for proof of what was said to have been performed at our Military Hospital was Dr Frank Djabanor. Dr Reginald Addae gave at least 8 (eight) criteria later known as “ADDAE CRITERIA” to be honoured before any clinical condition could be attributed to the Sickle Cell Trait (“AS”). Meanwhile, Kennedy Airport grounded their Black Pilots and Air Crews.


Professor Hermann Lehmann FRS of Cambridge University wrote to THE TIMES after reading its recommendation that all Black Air Crew should be grounded and pointed out that the Sickle Cell Trait “AS” did not constitute a disease phenotype, and that Sickle Cell Traits ran at the OLYMPIC GAMES at Mexico City, 7,000 ft above sea level, and thrashed the entire world. How could they have a disease? He began his letter of protest thus: “SIR – Your Science Report on December 9 1971 has suggested that all flight crews with SICKLE CELL TRAIT should be removed from flying duties and that all prospective Negro travellers should be screened for sickle cells”.

Dr Frank Djabanor whose protest letter followed Dr Reginald Addae’s said “Sickle Cells are not a Black Condition”, and that Europeans also had Sickle Cell Trait, sometimes “with higher percentages than anywhere in Ghana”. Listen to his logic:

“In some parts of Greece the prevalence of the Sickle Cell Trait is 30% (according to Professors Deliyannis and Tavlarakis, British Medical Journal 1955 volume 2 page 299); more than twice the prevalence in Northern Ghana.” Dr Frank Djabanor then continued with this telling point: “The forebears and descendants of these non-Negro possessors of the sickle cell gene are, doubtlessly, scattered over America and Europe today. How can we identify them, from their external features, to thrust upon them the ‘benefits’ of this advice?” If, “for their own safety” all Negro travellers should be screened, “Surely”, Dr Djabanor continued “the authors would not advocate that we
deny some sections of the world community the benefits of their suggestion”.

Dr Frank Djabanor went HOME to GLORY last year, and my TRIBUTE to him was titled: “Lt-Col [Retd] F FT Djabanor (1938 – 2019). Physician whose exposure of scientific falsehood saved Black People from humiliation. TRIBUTE: ACCRA & Odumase-Krobo 31st March 2019.

I made sure that his burial was marked in the British Medical Journal with a detailed account of what he and Dr Reginald Addae who now follows him to GLORY did for all black people. See https://www.bmj.com/content/364/bmj.I735/rr-7 Konotey-Ahulu FID.
“Aviation Safety: Ghanaians recall media disinformation deriving from scientific misinformation. British Medical Journal Rapid Response March 1 2019 to Partha Kar – Applying Aviation Safety to Healthcare – Are we missing the fundamentals? Partha Kar 364: doi 10.1136/bmj.I735


If some Ghanaians are inclined to think this TRIBUTE is too long, please remember what Dr Reginald Addae and his Colleague Dr Frank Djabanor achieved for us. One in every Five (5) of us Ghanaians reading this, or listening to it, is Sickle Cell Trait (“AS”). Scientists are continuing to claim that 20  percent of us have hereditary “DISEASE SICKLE CELL TRAIT. The British call it a “DISORDER”. The WHO IDM Chart calls it a “DISORDER”. White Experts who knew the truth, and who defended us Black people against Tafracher “scientific nonsense” (Hermann Lehmann, Bela Ringelhann, George Edington, etc) have died. Black Experts have also died (Alexander Boyo, Bill Laing, Teddy Christian, Komla Gbedemah, George Bonney, George Ankra-Badu etc). Now Frank Djabanor and Reggie Addae have also gone.
Those of us Ghanaians remaining who know both the scientific truth, and the “scientific lies” (Alexander Bruce-Tagoe, Joseph Kpakpo Acquaye, Samuel Kwadwo Owusu, Albert Amoah, Dwomoa Adu, Jehoram T Anim, Michael O Matekole, Adzei Klufio, E Q Archampong, Lade Wosornu, myself, etc) will continue to tell the world what Professor Hermann Lehmann FRS told the LONDON TIMES: “Sickle Cell Traits ran at the Olympic Games in Mexico City (where the Oxygen was thin) and beat the entire world”. We salute the Inseparable Duo Frankie and Reggie who have defeated their Last Enemy, Death, and arrived HOME in Heaven. Ao, Ayenyekoo!

Heartfelt Condolences to the loved ones – Sisters Regina, Amelia and adult children Gina, Wendy.


Oh think to step ashore, and that shore Heaven;

To take hold of a hand, and that hand God’s hand;

To breathe a new air, and that air Celestial air;

To feel invigorated, and know it, Immortality;

Oh think, to pass from the storm and tempest

To one unbroken smile,

To wake and find it GLORY!

Centenarian Sickle Cell Trait Genetic Testing

Hundred-Year-Old Sickle Cell Trait Accesses Genetic Services to Predict Risk of Hereditary Disease in Future Generations


Dr Emmanuel Evans-Anfom FGA MB ChB FRCS(Edinburgh) FWACS DSc (Salford Univ. Hon) FGCPS DTMH(Edinburgh) who was 100 years on October 7 2019 [1] was congratulated from Buckingham Palace. The Duke of Edinburgh Prince Phillip, PATRON of Ghana Academy of Arts and Sciences [GAAS] and its First President 1959 to 1961 when he was succeeded by Dr Kwame Nkrumah 1961 to 1966 as the Academy’s Second President, sent a message of Congratulations to Dr Emmanuel Evans-Anfom who was himself once 8th of the 19 Presidents of GAAS.


With Professor Henrietta Mensa-Bonsu FGA the present 19th President of GAAS chairing the Proceedings in a most competent manner, I considered myself greatly honoured and privileged to deliver a SPECIAL LECTURE not only preceded by introductory remarks of Professor Samuel Boakye FGA, Executive Secretary of the Ghana Academy of Arts and Sciences, but also by the impressive statement of Dr Emmanuel Evans-Anfom himself who can be seen and heard on Thursday 30th January 2020 here https://youtu.be/hV8NZJh1pg [2].


Day after the Lecture dedicated to Dr Emmanuel Evans-Anfom I visited the great man at home at Leonora Lodge surrounded by his family [demure wife Elise, elegant daughter Rachel and confident husband Dr Henry Baddoo, impressive sons Charlie and Nii Teiko] when, out of the blue, he said to me “Felix will you confirm my genotype?” – meaning would I find out if he was/is one of the 1 in 3 Ghanaians (like my parents) with an abnormal beta haemoglobin gene “S” or “C”? [References 3 to 32].

I asked Dr Henry Baddoo, Consultant Anaesthetist son-in-law to draw blood for me to bring back to the UK for examination in the only laboratory I know in Central London that will quantify not only haemoglobin fractions but also the level of Glucose-6- Phosphate Dehydrogenase red cell enzyme whose deficiency in Ghana is high, 1 in 4 hemizygote males XminusY, 1 in 6 to 1 in 8 females (heterozygotes XminusX and homozygotes XminusXminus ) – Partial and Full Deficiency [18 19 23 24 27 to 42]


I considered it serendipitous to be asked to confirm haemoglobin “genotype” just when BMJ was publishing such articles as “Promises and perils of using genetic tests to predict risk of disease” [43] and “Communities that prefer close blood marriages need more help to access genetic services”. [44] In the reliable Central London Lab I requested my “Konotey-Ahulu Profile Number 2” consisting of (a) Sickling Test, (b) Quantitative Haemoglobin Electrophoresis, (c) G6PD Quantitative value, (d) Haematological Values & ESR, and (e) Blood Group. I know of no other laboratory in the UK – Teaching Hospitals included – that can do these 5 tests for less than £100 (One Hundred Pounds Sterling).

RESULTS: (a) Sickling Test POSITIVE (b) Haemoglobin Electrophoresis “AS” with ‘S’ 38.1% (Hb S level being in the highest range of the 3 known Sickle Cell Trait ranges of ‘S’=20-28%, ‘S’=26-33%, ‘S’=34-39% [17 23 24 45 – 50]. Haemoglobin A2 3.0%, Haemoglobin F is 0.5% and the rest Normal Haemoglobin A. Red cell Glucose-6 Phosphate Dehydrogenase Enzyme level was 6.0 U/g [Normal Range 5.6 – 11.2].

VERDICT: Dr Emmanuel Evans-Anfom is therefore SICKLE CELL TRAIT “AS” with NORMAL G6PD. He readily gave me permission to publish the findings not only to help counter Misinformation, if not Disinformation, pervading the Internet based on flawed publications allowed in the best scientific and medical journals, but also to make this finding in a very alert Centenarian a MEDICAL MEMORANDUM.


The very well-thought-out articles of Ian Scott, John Attia, Ray Moynihan [43] and Naz Khan and Sarah Salway [44] do not adequately explain the sheer size and varying details of genetic epidemiology for which people worldwide request guidance to prevent hereditary pathology in their offspring. The former concentrate on genetic disposition to malignant conditions of breast, ovary, and prostate [43] while the latter concern themselves with genetic consequences of marrying relatives [44]. The genetic epidemiological burden discussed by these authors [43 44] amounts to a tiny-fractional-tip of the global genetic iceberg whose huge base is in the Mediterranean countries, Middle East, Asia, Canada, USA, South America, the West Indies and, notably, Africa where genetic red cell defects, namely Haemoglobinopathy (qualitatively ABNORMAL haemoglobin genes), Thalassaemias (abnormal quantities of NORMAL Haemoglobin genes) and genes for G6PD Deficiency abound world-wide. [18 19 24 27 – 42 51 52 53].


Can we also tackle this world-wide problem efficiently? In the UK 1 in every 25 people carries the Cystic Fibrosis gene. In Ghana 1 in every 3 of us carries either Hb S gene or Hb C gene (like my parents – father AC, mother AS just like Dr Evans-Anfom) with the result that 4 of 100 consecutive children born in Ghana suffer from hereditary aching disease ACHEACHE “SS”, “SC”, or “CC”. We proved this at Korle Bu Teaching Hospital genotyping 13000 consecutive births in a single year. [29], confirming the Hardy-Weinberg Equation [23 24(page 15)]. Yes, 1 in 3 of us in the Diaspora is Sickle Cell Trait “AS” or Haemoglobin C Trait “AC” needing tracing. [54]. Both Professor Graham Serjeant [52] in the West Indies and Professor Sir David Weatherall FRS [53] in Oxford acknowledge this global hereditary burden. For further emphasis, Cystic Fibrosis Carrier State is more than 8 times less than Sickle Cell Carrier State yet, as I [54] commented on Pascale Allotey’s excellent book-review [55] on “ethnicity and access to health care”, Lancet’s 7-part-series on Genetic Epidemiology came and went [56] “and not once was it mentioned that one in three west Africans in the UK has a β-globin variant gene whose unsuspecting owner needs to be identified and helped with genetic counselling and family size limitation.[54] I am sure that Ian Scott and colleagues [43] do not intentionally set out to create “the impression in our minds that genetic epidemiology, which has been my chief concern for decades [24 57-61] had little to do with us non-whites” [54], but a passing reference in their article to the African Diaspora situation [62] would not have been out of place.


Hampering realistic counselling is a combination of factors such as Poor Definitions (eg referring to “Trait” as “Disease” or “Disorder” as do the UK Genetics Council [63], Noke et al [64], NIH [65] plus Laboratory Errors like confusing Sickle Cell Trait with Sickle Cell beta-plus Thalassaemia [24, 53].
But chief of all culprits is Misinformation which if deliberate becomes Disinformation. This very important Misinformation Culprit was scrutinised comprehensively by me [66] when responding to the very instructive article of Semsarian and Ingles “A clinical approach to genetic testing for non-specialists” [67] together with Allison Streetly’s helpful comments [68] and needs not delay us further except to mention the remarkable opportunity
Centenarian Sickle cell trait Dr Emmanuel Evans-Anfom, the international hockey player who has flown hundreds of thousands of miles [1], has given us to debunk once and for all the “scientific” publications on Sickle Cell Trait that lack probity.


It is not clear how many of the following examples constitute Disinformation, that is Deliberate Misinformation, but students, doctors, and Science Correspondents of major International Newspapers, Radio Outlets, and Television reporting for the Media, and even GOOGLE and WIKIPEDIA need to look up every single published reference in the following examples so as to be aware of what has happened:
1. Sickle Cell Trait blamed for dying suddenly while exercising [69]
2. Broken bones in child from baby bashing put to Sickle Cell Trait [70]
3. Aggressive renal cancer “seen almost exclusively in young patients with sickle cell trait” [71 Elliott Vichinsky et al.]
4. “Complications associated with sickle cell trait” Tsaras et al [72] Flawed article!
5. Fifteen-year-old black girl sterilized because of sickle cell trait [24]
6. Black prisoners beaten to death in jail – Autopsy verdict “Sickle Cell Trait” [73]
7. “Fatal pulmonary infarction in sickle cell trait”. No electrophoresis done. [74].
8. Sickle Cell Disease (2 beta-globin gene variants) described with Sickle Cell Trait mentioned in the title of article [75]
9. Beware of symptomatic Sickle Cell Traits [76]
10. Flight from Kumasi to Accra (45 minutes) produces intestinal infarction in Sickle Cell Trait [77 to 86]
11. Sickle Cell Traits have their insurance loaded 150% [87]]
12. Pilot with Rhabdomyolysis from Sickle Cell Trait – no laboratory test [88]

Well did I object “Dangerously flawed diagnosis of sickle cell trait in compartment syndrome rhabdomyolysis” [89] and “Blaming sudden death on Sickle Cell Trait”? [90] For other references on Sickle Cell Trait Misinformation see References 91 to 94.


Who guides American Insurance Companies when a Massachusetts Law has such a statement as “the disease known as sickle cell trait?”.[95]. There really is no excuse for such scientific obfuscation when there are established agreed definitions in Haemoglobinopathy [96 97]. And Sickle Cell Trait continues wrongly to be written “SCT” by Noke [64] and the NIH [65] where National Foundation/March of Dimes of the USA invited me twice to do Grand Rounds in the days of Professor Rudy Jackson.

The only correct phenotype designation for Sickle Cell Trait is “AS”, never “SCT” – a confusion that Insurance Companies use to defraud people because “SC” is the known designation for Sickle Cell Haemoglobin C Disease. The Martin Luther King Jr Foundation protected me with 4 bodyguards in Philadelphia for my Keynote Address “Vital Difference Between Sickle Cell Trait and Sickle Cell Disease”.[98].


I appeal to the Editors of Lancet to pursue the authors Rhida A, Khan A, Al-Abayechi S, Puthenveetil V who published this: “Acute compartment syndrome secondary to rhabdomyolysis in a sickle cell trait patient” Lancet 2014; 384:2172 [88] without a shred of evidence for Sickle Cell Trait presented, and this resulted in the article going viral on the Internet, frightening people on Facebook when Whiskey Delta Charlie wrote this (QUOTE):

“Here is what’s possible if you are a carrier of Sickle Cell Trait Sept. 224:21pm2016 #sicklecellawarenessmonth #sicklecelltrait #exertion #Rhabdomyolysis http://dhmi.org/sickle-cell-trait-story/ September is Sickle Cell Awareness Month. Awareness to Sickle Cell Trait the gene responsible for creating Warriors who live with Sickle Cell” (UNQUOTE) plus illustrated ghastly pictures of rotting muscles of Rhabdomyolysis [99].


How many pilots might have had their job threatened Corona Virus or no Corona Virus by this flawed Lancet article is not known, but what is known is that previous Editors of Lancet pursued authors of an article supposedly proving that homosexuals and some central Africans shared a common gene Gc1f [100] the flawed Science of which I was the first to criticize as “leaving a lot to be desired” [101] until the authors withdrew it from publication with the confession “Erroneous data”. [102].

So why can’t the present Editors of Lancet pursue the authors of the “Sickle Cell Trait Rhabdomyolysis Pilot” article [88], ask them to produce the alleged “Sickle Cell Trait” pilot so we know exactly what happened? Are we likely to expect another “Erroneous Data” confession in the Lancet? [102]

Researchers that need to read about Sickle Cell Trait Misinformation and Disinformation are referred to the huge number of references on the subject [91-95 103].


It was not Black People who dared to mention Prejudice in relation to Science. To imagine that Genome Sequencing, for example, has the answer to everything including Genetic Counselling fails to take into consideration the human element in Science. During my SPECIAL LECTURE dedicated to Centenarian Dr Emmanuel Evans-Anfom [2] I drew attention to the remarkable article of Professor Sir (later Lord) Solly Zuckerman where he proved conclusively that there was much Prejudice and Pride in Science.[104], and I went on to mention the widespread declaration of Nobel Laureate Professor James Watson that the current Global Sequencing exercise would soon reveal that Africans had inferior intelligence. [105] He subjected himself to Genome Sequencing only to find that he himself was African [105], and I could hardly resist the observation on 4th December 2009 that “Watson, still alive today in USA was brutally reminded not only that there is but one human race, but also that African genes contributed to the Nobel Prize.in ‘Medicine or Physiology’ which he jointly won with Francis Crick and Maurice Wilkins on the DNA Double Helix in 1962”.[106] His ancestor was in Africa same time as my great-grand father Konotey-Adade? [107] There is, indeed, but one human race. [106]


In the African milieu Genetic Counselling has been done more from laboratory tests, and we must not rely on Genome Sequencing results from experts like Professor James Watson who know what they will find before they do the examination. Simple Haemoglobin Electrophoresis methods (Alkaline and Acid media) plus clinical acumen have helped us quantify our 1 in 3 genetic incidence and to describe new haemoglobins like Haemoglobin Korle Bu [108], Haemoglobin Osu-Christiansborg [109], and discover an adult African, a Nungua fisherman, with only foetal haemoglobin in his body [110], and also tell the world of a No-Enzyme-at-all G6PD Deficient man in Ghana. [33 34]. The colour test is unable to distinguish Sickle Cell Disease “SC” Phenotype from Sickle Cell Trait “AS”. [111]. Terms like “Up-to-date” [71 (Vichinsky)] and “Novel Clinical Significance” [69 (Key and Vimal)] regarding Sickle Cell Trait are more reflection of imperfect knowledge than, as we are urged to think, discovery of new knowledge. Like “SCT” written for Sickle Cell Trait, they are fraudulent Insurance Companies’ delight.


1. One often heard “Sickle Cell Disease – the hereditary disease of Blacks”. The past week found 1872 Turks POSITVE for Coronavirus. We must expect about 300 of them to be Sickle Cell Trait phenotype because Aksoy found 15% Turks to be Sickling POSITIVE. Indeed, 18% of Eti-Turks in southern Turkey have Sickle Cell Trait. [112], Choremis et al reported a high 30% Sickle Cell Trait incidence in Greece where Lake Kopais once was [113]. With 650 reported cases of POSITIVE COVID-19 just as one island was flooded with Greeks returning home, would it surprise anyone if about 150 of these white-skinned Greeks were Sickle Cell Trait “AS”. Thousands of relatives worldwide are Sickle Cell Trait “AS”. Like Ghana [114], there is also a high incidence of G6PD Deficiency in Turks, Greeks, Italians in the Mediterranean Region as a whole [ 30 42].

2. Reports from China claim that Vitamin C in large doses intravenously has had a remarkably beneficial effect on patients. Linus Pauling who won Nobel Prize for discovering the molecular structure of Sickle Haemoglobin S [115] popularised taking large doses of Vitamin C [116] for the common cold, and for cancer 117], a recommendation that was criticized because he was “just a PhD, not an MD doctor”.
A medically qualified doctor, Physician Dr Abram Hoiffer MD PhD FRCP (C) has given Linus Pauling’s Vitamin C anti-cancer claim respectability. [117] Professor Linus Pauling himself was present and listened approvingly when I gave the Keynote Address “THE VITAL DIFFERENCE BETWEEN SICKLE CELL TRAIT AND SICKLE CELL DISEASE” at the Dr Martin Luther King Jr Foundation Award Dinner in Philadelphia [98] I shook hands with the only person who got two (un-shared-with-anybody-else) Nobel Prizes. He did not seem to be a person who would have talked about Vitamin C through his hat. And, indeed, Vitamin C has been proven to kill tumour cells with hard-to-treat mutation [117].

But what has all this got to do with SICKLE CELL TRAIT in White people? ANSWER: Doctors in Europe who may follow Chinese intravenous Vitamin C therapy for Corona Virus must first find out which of their patients has G6PD Deficiency because such large doses of Vitamin C given intravenously can cause catastrophic intravenous haemolysis [41]. Ghanaian doctors who may be adopting Vitamin C intravenous therapy are advised to check Glucose 6 phosphate Dehydrogenase enzyme level before proceeding. The New York Hospital that has started using i.v Vitamin C [118] will do well to take my advice because one undetected G6PD Deficient patient who collapses on Vitamin C drip will have the Food and Drug Administration come down on them heavily to stop what in my not-so-humble opinion promises to prove once again that Linus Pauling was far from being naïve. If the Chinese wondered why some who received intravenous Vitamin C recovered, while others on the same regime bled from every orifice, I suggest they henceforth do Quantitative G6PD estimation on every patient before treatment is commenced. Greek and Turkish Sickle Cell Traits with G6PD Deficiency, if given large doses of Vitamin C would be misdiagnosed as suffering from Sickle Cell Anaemia “SS” in haemolytic crisis when, in fact, they were Sickle Traits “AS” with anaemia. [24] The G6PD enzyme level of Dr Emmanuel Evans-Anfom is NORMAL.

I very much trust our British-trained Ghanaian Physicians to screen all admissions (as we used to do half century ago on Medical Floor Two Korle Bu Teaching Hospital) for G6PD Deficiency and administer to those found POSITIVE for COVID-19, immediately, 1,500 mg of intravenous Vitamin C. This is the advice of someone (myself) who shook hands with the Genius “Sickle Cell Linus Pauling” on Wednesday 31st May 1972 in Philadelphia. Take meticulous notes, and publish weekly progress promptly.

3. Africans receiving news from China that Blood Groups reacted differently regarding proneness/non-proneness to the present COVID-19 infection, namely that those with Blood Group A fared worse than O patients in their response to treatment, may confuse (as they have often done) “Blood Group A” with “Haemoglobin Type A” and draw wrong conclusions about how Haemoglobin variants (Hb “S” included) can dictate prognosis in COVID-19 illness We must be very careful about News Headlines when it comes to epidemiology.


For example, after the “science” that homosexuals and some central Africans shared a common gene Gc1f had in Lancet on Saturday 2nd May 1987 [100] the BBC broadcast the information in its “SCIENCE IN ACTION” [119] the very next day 3rd May GMT 09.15. My objections to Lancet followed just days later Lancet [101]. But when the authors confessed their “Erroneous data” [102] some of us were waiting also for BBC to confess “ERRONEOUS SCIENCE IN ACTION.” We wondered why BBC WORLD SERVICE or the BBC HOME SERVICE Programmes did not carry Lancet’s withdrawal of the erroneous findings? Was this an example of BBC reflecting Lord Zuckerman’s diagnosis of “Pride and Prejudice” [104] in ‘Science In Action’? [119]


1. NEVER use SCT to stand for Sickle Cell Trait. It can be confused with “AS”; the “A” standing for normal Haemoglobin gene and “S” for abnormal sickle cell Haemoglobin, with “S” always less than 40% in the best laboratories. Facebook showed a man calling himself “Sickle Cell Trait” groaning from sickle cell crisis pain. When I commented “Ask your Doctor to do Haemoglobin Electrophoresis on you” he returned the next week to say he was “SC”, which is never Trait because “SC” is two Abnormal genes. Traits always have one normal beta-globin gene “A” plus one abnormal beta-globin gene. That is why I use the term “NORMACHE” for Traits, specifying what abnormal Haemoglobin gene the “ACHE” stands for. [See my “Competing Interest” below].

2. AVOID the term “Heterozygote” which just means 2 different genes. Sickle Cell Trait “AS” is Heterozygote, but so also is “SC” which, to avoid calling a disease “Trait”, is correctly designated as “Double Heterozygote”. [23 24]


Let us thank Dr Emmanuel Evans-Anfom for enabling us to dismiss once and for all the fears of Professor James Bowman MD PhD, University of Illinois Professor of Medicine, Genetics, and Haematology when he lamented that “Persons with sickle cell trait will no longer be able to become ill or even die lest they find themselves subject of a case report” [120]

Competing Interest: I am the offspring of NORMACHE x NORMACHE Abnormal Haemoglobin parents (AS x AC) who had 11 children 3 of whom had sickle cell disease ACHEACHE (SC), 4 had Trait NORMACHE (2 AC & 2 AS) and 4 of us took no aching genes from our parents to be NORMNORM “AA” phenotype. Impossible it is to tell NORMACHE Traits from those of us who had no Hb gene variant except through blood test. Sickle cell disease phenotypes suffer hereditary cold-season Rheumatism – Tribal names Hemkom or Chwechweechwe – and are therefore physically identifiable. [24]

felix@konotey-ahulu.com Twitter @profkonoteyahul

Felix I D Konotey-Ahulu FGA MB BS MD(Lond) DSc(UCC) DSc (UH) FRCP(Lond) FRCP(Glasg) DTMH(L’pool) FGCP FWACP FTWAS ORDER OF THE VOLTA (OFFICER) Kwegyir Aggrey Distinguished Professor of Human Genetics University of Cape Coast, Ghana; Former Consultant Physician Genetic Counsellor in Sickle Cell and Other Haemoglobinopathies Korle Bu Teaching Hospital & Director Ghana Institute of Clinical Genetics, and 9 Harley Street, Phoenix Hospital Group, London W1G 9AL

Website www.sicklecell.md or www.konotey-ahulu.com

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58. Konotey-Ahulu FID. The Sickle-cell Diseases: Clinical manifestations including the sickle crisis. Arch Intern Med 1974; 133(4): 611-619 http://archinte.ama.assn.org/cgi/reprint/133/4/611-pdf

59. Konotey-Ahulu FID. Maintenance of high sickling rate in Africa: Role of polygamy. J Trop Med Hyg 1970 Jan; 73(1): 19-21 (38 References). [Traits who voluntarily restrict number of children they produce do diminish burden of abnormal haemoglobin disease (SS SC CC Sbeta-Thalassaemia Cbeta-Thalassaemia Thalassaemia Major SF CF Fbeta-Thalassaemia SKorle Bu SOsu-Christiansborg in the Ghanaian population. My MPSI shows that Males need more to heed this message for Voluntary Family Size Limitation].

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63. Human Genetics Commission (HGC-UK) and direct consumer Genetic Tests, leading to Genetic Counselling. BMJ Rapid Response May 27 2009. http://www.bmj.com/cgi/eletters/338/may15_2/b1995#214r56

64. Noke Melissa, Peters Sarah, Uiph Fiona. A qualitative study to explore how professionals in the United Kingdom make decisions to test children for a sickle cell carrier state. Europ Journal of Human Gentics 2016, 24: 164-170. 74. Noke Melissa, Peters Sarah, Ulph Fiona. A qualitative study to explore how professionals in the United Kingdom make decisions to test children for a sickle cell carrier state. Europ. Journal of Human Genetics 2016; 24:164-170. doi:10.1038/ejhg.2015.104 [Terms like “SC prevalence” and “not so benign nature of ‘SCT’” reveal ignorance of approved Terminology.

65. NIH (Bethesda) “ Sickle Cell Disease is the most common inherited blood disorder in the USA …” http://www.ghr.nlm.gov/condition/sickle-cell-disease [But as Sickle Cell Trait is written SCT when SC is known to be disease phenotype what interpretation do people in the USA put on the recently widely advertised NIH home-use-kit for checking for the gene? Especially when the commercial Haemoglobin S Test-Tube Colour-Test does not differentiate between Sickle Cell Trait “AS” (1 Normal gene + 1 Abnormal gene) and Sickle Cell Disease “SC” phenotype (2 Abnormal genes)?

66. Konotey-Ahulu FID. Genetic Testing and Counselling Towards Genetic Public Health http://www.bmj.com/contrent/358/bmj.j4101/rapid-responses BMJ Rapid Response 21 December 2017 to Semsarian C and Ingles J. PRACTICE [See below]

67. Semsarian C., Ingles J. A clinical approach to genetic testing for non-specialists. BMJ 2017; 358 doi: 10.1136/bmj.j4101. 28 Sept. 2017.

68. Streetly A. A common definition of genetic testing, can we agree on one? 18 October 2017 http://www.bmj.com/content/358/bmj.j4101/rapid-responses .

69. Key Nigel S, Derebail Vimal K. Sickle Cell Trait: Novel Clinical Significance. Hematology 2010: 418-422. “During exercise, Sickle Cell Trait appears to be a risk factor for sudden death and/rhabdomyolysis, particularly when the exercise is intense, and is performed at high altitude”

70. Kepron Charis, Somers Gino R, Pollamen Michael S. Sickle Cell Trait Mimicking Multiple Inflicted Injuries in a 5-Year-Old Boy. Journal of Forensic Sciences Volume 54, No.5, pp 1141 t0 1145 September 2009.

71.. Vichinsky Elliott P. Sickle cell trait. Literature Review UpToDate [Accessed 18 Feb 2011] http://www.uptodate.com/contents/sickle-cell-trait?view=print asserts falsely that “Renal medullary carcinoma is a rare and aggressive tumor that is seen almost exclusively in young patients with sickle cell trait.”

72. Tsaras, G, Owusu-Ansah A, Boateng FO, Amoateng-Adjepong, Y. Complications associated with sickle cell trait: a brief narrative review. American Journal of Medicine 2009; 122(6): 507-512. [The Ghanaian co-authors appear ignorant of what work had been done in Ghana (6 million Sickle Cell Traits) since 1953; See References 3 – 32]

73. Dyson Simon, Bosswell Gwyneth. Sickle Cell and Deaths in Custody. Whiting and Birch, London: June 2009; 230 pages “The misuse of Sickle Cell Trait to explain away sudden deaths”.

74. Malhotra Vinod, Ravi Prakash, Yeun Sook Choi, Bernard Chomet, Clifford G Pilz. Fatal Pulmonary Infarction in a Patient with Sickle Cell Trait. CHEST 1973; 64: 524-26. October 1973. “It is suggested that sickle cell trait should be considered in all Negro patients who present with suspected vaso-occlusive episode”. [Flaws in article: (a) How about the millions of white Greeks and Turks with Sickle Cell Trait? (b) Have the authors excluded Sickle Cell beta-Thalassaemia after quantitative electrophoresis? (c)
Is sickle cell haemoglobin C being referred to as Sickle Cell Trait. (d) Fatal pulmonary infarction occurs in Caucasian women on oral contraceptives. If a “Negro patient” was Sickle Cell Trait “AS”, and had been on contraceptives, why would she be prevented from having pulmonary infarction when white British women were also afflicted?]

75. Witkowska HE, Lubin BH, Beuzard Y et al. Sickle cell disease in a patient with sickle cell trait and compound heterozygosity for haemoglobin S and haemoglobin Quebec-Chori. New England Journal of Medicine 1991; 325: 1150-1154. [Note that the title of this article is incorrect: No human being can be said to have both Sickle cell trait and Sickle Cell Disease. The ‘AS’ pattern is sickle cell trait pattern, but this ‘A’ is not a true ‘A’ but the new haemoglobin called Quebec-Chori, producing a disease phenotype, not trait]

76. Konotey-Ahulu FID. World Sickle Cell Day 19h June 2014 http://bit.ly/1FuNXPi Beware of symptomatic sickle cell traits. Lancet, Feb 29, 1992, page 555. http://www.thelancet.com/journals/lancet/article/PII0140-6736(92)90377-F/fulltext

77. Green RL, Huntsman RG, Serjeant GR. Sickle cell trait and altitude. Br Med J 1971; 4: 593-595.

78. Addae R O. Sickle cell trait and altitude. BMJ 1972; 1: 53. [10 criteria (Addae’s Criteria) required to satisfy clinicians in regions where 1 in 5 people have the sickle cell trait that symptoms are due to the trait and nothing else.]

79. Djabanor F F T. Sickle cell trait and altitude. Brit Med J 1972; 1: 113

80. Konotey-Ahulu FID. Sickle cell trait and altitude. BMJ 1972; 1: 177-178.

81. Konotey-Ahulu FID. An international sickle cell crisis. [Editorial] Ghana Medical J; 1972; 11: 4-8 [A detailed account of how BMJ withdrew report]

82. Konotey-Ahulu FID. Sickle cell trait and altitude. BMJ 1972; 2: 231-32 April 22

83. Green RL, Huntsman RG, Serjeant GR. Sickle cell and altitude. Brit Med J 1972; 2: 294

84. Lehmann Hermann. Sickle cell and flying. The Times (London) 4 Jan 1972 That was when the “Science Editor” used false report on “Sickle Cell Trait and Flying” in BMJ to recommend grounding of all Black Air Crew.

85. Konotey-Ahulu FID. Aviation Safety, Ghanaians recall media disinformation deriving from scientific misinformation. BMJ Rapid Response March 1 2019; https://www.bmj.com/content/364/bmj.l735/rr-7 to Partha Kar: Applying aviation safety to healthcare – are we missing the fundamentals? Partha Kar 364:/doi10.1136/bmj.l735 :

86. Konotey-Ahulu FID. Lt-Col [Retd] Dr Frank F T Djabanor (1938 – 2019) Physician whose exposure of scientific falsehood saved Black People from humiliation. TRIBUTE. Accra & Odumase-Krobo 31st March 2019.

87. Konotey-Ahulu FID. Insurance and genetic testing. Lancet 1993, 341: 833. March 27 [See Reference 98 for when Dr Konotey-Ahulu was given 4 Body Guards in Philadelphia for stressing “Sickle Cell Disease is NOT Sickle Cell Trait and vice versa!” and thus upsetting Insurance Companies]

88. Rhida A, Khan A, Al-Abayechi S, Puthenveetil V. Acute compartment syndrome secondary to rhabdomyolysis in a sickle cell trait patient. Lancet 2014; 384:2172 [No evidence for Sickle Cell Trait was presented in this Lancet article].

89. Konotey-Ahulu FID. Dangerously flawed diagnosis of sickle cell trait in compartment syndrome rhabdomyolysis http://bit.ly/2d4t9Zd http://www.sicklecell.md/blog/index.php/2016/09/dangerously-flawed-diagnosis-of-sickle-cell-trait-in-compartment-syndrome-rhabdomyolysis-article/ [No evidence for Sickle Cell Trait was presented in the Lancet article (Reference 88)].

90.. Konotey-Ahulu FID. Blaming sudden death on Sickle Cell Trait? Flaws in article of Charis Kepron, Gino Somers and Michael Pollanen [Reference 37 above Exposed]. September 4 2011 www.sicklecell.md/blog/?p=105 or www.konotey-ahulu.com/blog/?p=105

91.Konotey-Ahulu FID. Sickle Cell Trait Misinformation and Disinformation. https://blog/sicklecell.md/sicklecell/sickle-cell-trait-misinformation-and-disinformation/ November 30 2011

92 Konotey-Ahulu FID. Further Communication on “Sickle Cell Trait Misinformation and Disinformation” and Sickle Cell Terminology: Disease or Disorder? April 6 2012 https://blog/sicklecell.md/sicklecell/further-communication-on-sickle-cell-trait-misinformation-and-disinformation-and-sickle-cell-terminology-disease-or-disorder/

93. Konotey-Ahulu FID. Sickle Cell Trait Confusion: Is it Deliberate? Or is this Ignorance? August 11 2017 https://blog.sicklecell.md/sicklecell/sickle-cell-trait-confusion-is-it-deliberate-or-is-this-ignorance/

94 Konotey-Ahulu FID. Sickle Cell Trait: As with statins when leading editors disagree please give principles same weight as details 20 September 2016 .http://bit.ly/2dy5fUJ/http://www.sicklecell.md/blog/index.php/2016/09/statins-when-leading-editors-disagree-please-give-principles-same-weight-as-details/

95. Beutler E, Boggs DR, Heller P, Maurer A, Motulsky AG, Sheehy TW. Hazards of indiscriminate screening for sickling. N Engl J Med. 1971 Dec 23;285(26):1485–1486 www.europepmc.org/articles/PMC178610 [Authors have commented on a Massachusetts Law which stated in part that “Every child, which the Commissioner of Public Health, by rule Law which stated in part that “Every child, which the Commissioner of Public Health, by rule or regulation, may determine is susceptible to the disease known as sickle cell trait or sickle cell anemia, shall be required to have a blood test”. [How on earth does one explain to the Americans that there is no such thing as “the disease known as sickle cell trait”? Making my African NORMACHE equal to ACHEACHE?]

96. Woodruff AW et al. Terminology of the Hereditary Haemoglobinopathies with haemoglobin variants. BMJ 1957; 1: 1235. .

97.. Boyo AE, Cabannes R, Conley CL, Lehmann H, Luzzatto L, Milner PF, Ringelhann B, Weatherall DJ, Barrai I, Konotey-Ahulu FID and Motulsky AG. Geneva WHO Scientific Group on Treatment of Haemoglobinopathies and Allied Disorders. (Technical Report) 1972; 509:83 pages. ]

98. Konotey-Ahulu FID. Four bodyguards and the perils of unmasking scientific truths. www.bmj.com/cgi/content/full/335/7612/210 doi:10.1136/bmj.39268.553021.47 BMJ 2007; 335: 210-211. [Day & Date: Wednesday 31st May 1972 – Philadelphia, Dr Martin Luther King Jr Foundation Award Ceremony for Outstanding Contributions in Sickle Cell Disease: Banquet – Dr Konotey-Ahulu’s Keynote Address was on ‘Difference between Sickle Cell Trait and Sickle Cell Disease’. Those also honoured present on the platform with me included Nobel Prize Winners Linus Pauling and Max Perutz, then Hermann Lehmann, Roland Scott, J V Neel, Bella Ringelhann, A C Allison, Bella Ringelhann, James Bowman, Helen Ranney, Charles Whitten, L Diggs, L Conley, Howard Pearson, Sam Charache, and Graham Serjeant.]

99. Whiskey Delta Charlie on Facebook 24 September 2016 If you are a Carrier of Sickle Cell Trait Here is what’s possible: #sicklecellawarenessmonth#sicklecelltrait #exertion #Rhabdomyolysis http://dhmi.org/sickle-cell-trait-story/ September is Sickle Cell Awareness Month. Awareness to Sickle Cell Trait the gene responsible for creating Warriors who live with Sickle Cell” (UNQUOTE) plus illustrated ghastly pictures of rotting muscles of Rhabdomyolysis.

100. Eales L-J, Nye KE, Parkin JM, Weber JN, Forster SM, Harris JRW, Pinching AJ. Association of different allelic forms of group specific component with susceptibility to and clinical manifestation of human immunodeficiency virus infection. Lancet 1987; 1: 999-1002.

101. Konotey-Ahulu FID. Group specific component and HIV infection. Lancet; 1: 1267.

102. Eales NJ, Nye KE, Pinching AJ. Group specific component and AIDS: Erroneous data. Lancet 1988; 1: 936.

103. Konotey-Ahulu FID. The Sickle Cell Disease Patient Website www.sicklecell.md

104. Zuckerman Sir Solly. Pride and Prejudice in Science. Aerospace Medicine 1974; 45: 638-347 (Also re-published with permission in Ghana Medical Journal 1975; 14 (No.1).52-60.105.

105. Professor James Watson: Verkaik Robert. Scientist who sparked racism has black genes. The Independent, London. 10 December 2007. [Re: DNA Nobel Laureate Professor James Watson]

106.. Konotey-Ahulu FID. There is but one human race. New African, London. December 2009, page 4. [Great-grandfather of Nobel Laureate Professor James Watson would have been on the African Continent exactly the same time as my own great-grand father Konotey-Adade born in 1820 (Generation V going back to 1670) [107]. Could the ancestor of James Watson have suffered enforced migration across The Atlantic? Born in 1928, if he is still alive at 92 years of age, would he kindly oblige to have his Haemoglobin Electrophoresis done to see whether he has a 1 in 3 chance of being (like my father and mother) phenotype NORMACHE “AS” or “AC”?

107. Konotey-Ahulu FID. Sickle Cell Disease in successive Ghanaian Generations for Three Centuries (Manya Krobo Tribe). References [23 and 24, pages 6 to 20]

108. Konotey-Ahulu FID., Gallo E, Lehmann H, Ringelhann B. Haemoglobin Korle Bu (alpha2 beta2 73 Aspartic Acid –> Asparagine), showing one of the two amino acid substitutions of Haemoglobin C Harlem. Konotey-Ahulu FID., Gallo E, Lehmann H, Ringelhann B. Haemoglobin Korle Bu (alpha2 beta2 73 Aspartic Acid –> Asparagine), showing one of the two amino acid substitutions of Haemoglobin C Harlem. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1468514 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1468514

109. Konotey-Ahulu FID, Kinderlerer, JL Lehmann H and Ringelhann B. Haemoglobin Osu-Christiansborg. A new chain variant of Haemoglobin A (beta 52 D3 Aspartic Acid to Asparagine) in combination with Haemoglobin ‘S’. J Med Genet 1971; 8(3): 302-305 http://lib.bioinfo.pl/pmid:5097135http://pubmedcentral.nih.gov/picrender.fcgi?artid=146917&blobtype=pdf

110. Kamazura H, Ringelhann B, Konotey-Ahulu FID, Lehmann H, Lorkin PA. The gamma chain in a Ghanaian adult homozygous for hereditary persistence of Fetal Haemoglobin. Acta Hematologica; 51: 197-184. .

111. Konotey-Ahulu FID. Detecting Sickle Haemoglobin. BMJ 1972; 2: 239 Nov 11; 4(5836) 376 See a Massachusetts law quoted below by Dr Beutler et al. Ref. [95]

112. Aksoy M. Sickle cell trait in Southern Turkey. Lancet 1955; 1: 589-90.

113. Choremis et al.. Blood Groups of a Greek community with a high sickling frequency. Lancet 1957; 2: 1333-1334.

114. 91. Konotey-Ahulu FID. The Sickle-cell Diseases: Clinical manifestations including the sickle crisis. Arch Intern Med 1974; 133(4): 611-619 http://archinte.ama.assn.org/cgi/reprint/133/4/611-pdf

115. Pauling Linus et al. Sickle Cell Anemia, a molecular disease. Science1949; 110: 543-8.

116.. Pauling Linus. Vitamin C and the Common Cold. Linus Pauling Institute Oregon State University. 1970.

117. Hoffer Abram, Pauling Linus. Vitamin C and Cancer: Discovery, Recovery, Controversy. 1979. [ISBN-10 1550820788 & ISBN-13 978-1550820782]

118. Mongelli Lorenn. New York Hospitals are treating coronavirus patients with Vitamin C. New York Post March 24 2020 https://nypost.com/2020/03/24/new-york-hospitalsreatingcoronaviruspatientswithvitaminc/?fbclid=IwAR0rO7trfM0j4GE53xuAnclKreZOtCp72X9qBpDT4fBpXb036t0qorg..

119. BBC SCIENCE IN ACTION Sunday 3rd May 1987 Dr Anthony Pinching interviewed about article in Lancet on Saturday 2nd May explaining why AIDS virus was spreading faster Central Africa than in the USA and how a gene Gc1f was common to homosexuals and Central Africans. The findings were found to be false, and withdrawn from publication, but BBC kept quiet about the “Erroneous Data”.

120. Bowman James. Ethical. Legal, and humanistic implications of sickle cell programs. INSERM 1975; 44: 353-378.

FOR EDUCATION OF DOCTORS: Painful Hip In Black And White Sickle Cell Disease Women

Painful hip in Black and White Sickle Cell Disease Women

The article in the British Medical Journal of Lamb JN, Holton C, O’Connor P, Giannoudis PV. Avascular necrosis of the hip. BMJ 1 June 2019, Vol 365, p 325 (BMJ 2019; 365:I2178) mentioned a woman who had two pregnancies presenting with painful hip due to avascular necrosis of the hip, but the authors neither associated the pregnancy with the hip problem, nor did they mention the nationality of the patient. They listed sickle cell anaemia among the factors that could cause the particular hip problem of avascular necrosis but there was nothing to show that the lady the authors wrote about had sickle cell anaemia which is known to occur in white as well as black patients.

I wrote to the British Medical Journal responding to the article, and required more information about the nationality of the patient, and whether haemoglobin electrophoresis was done to prove “sickle cell anaemia” (SS) or sickle cell haemoglobin C disease (SC) which latter, I said, was more to be associated with hip necrosis than the former because the blood was thicker in the “SC” than the “SS”. But when the article was published my queries were omitted, and information that would assist GP’s in the UK and elsewhere appeared to have been excised inadvertently even though the references to the information were retained: Konotey-Ahulu FID. Avascular hip necrosis: sickle cell haemoglobinopathy predominates worldwide. June 1 2019 https://www.bmj.com/content/365/bmj.l2178 BMJ Rapid Response to Lamb JN et al 1 June 2019, Vol 365, p 325 (BMJ 2019; 365:l2178.

I took advantage of BMJ publication a fortnight later June 15 asking whether MEDICAL FIRMS should come back – a “Firm” being the term used in the days I was a medical student over six decades ago to comprise a Team of doctors in a Teaching Hospital from Consultants down to House Officers and supporting staff in such a cohesive form as is missing today – I took advantage of this BMJ publication to bring back the sections that were missing in my June 1 article so that GP’s may see the true nature of hip problems in both black and white sickle cell disease women demonstrated admirably by Professor Malcolm Milne’s excellent Firm at Westminster Hospital on a postgraduate ward round in 1962.


Should we bring back THE FIRM? Yes, please! Firms Vary In Excellence: Pregnancy and Sickle Cell Hip Necrosis Revisited.

BMJ’s Cover Page question 15 June 2019 “Should we bring back THE FIRM?” [1] helps me to draw attention to Professor of Medicine Malcolm Milne’s Firm at Westminster Hospital same period as that of Professor Harold Ellis who says of those days “The firms were wonderful”?.[2]. I totally agree. I knew both firms as a postgraduate chasing MRCP’s. In fact, Harold Ellis removed my appendix in August 1963, and you could hardly see the 1-inch long scar. Their Firms were remarkable; that was why I was peeved when the Grand Round of Professor Malcolm Milne that I described in response to Jonathan Lamb and Colleagues’ article on aseptic necrosis of the hip [3] was inadvertently removed. [4]. I reproduce below those sections edited out by mistake, even when their references were retained. GP’s that Lamb et al had in mind for education need these facts about the hip in sickle cell disease. Doctors must think “multiple pregnancies” when an African woman walks into their consulting room with a limp. They must take a detailed history of how long they have been in labour because Lamb and colleagues mentioned two pregnancies [3], but nothing about length of labour which, with legs in prolonged abduction, compromises blood supply to the femoral heads doing worse damage to the high haematocrit sickle cell haemoglobin C disease (SC) and sickle cell beta-thalassaemia (Sbeta-Thal) patients than in sickle cell anaemia (SS) [5-8].


Medical and Surgical Firms were not equally efficient. Which Medical Firm in the UK would assemble (like Professor Malcolm Milne’s did) the author of an article 8 years earlier (Joe Humble) [8] diagnosing sickle cell disease in a white lady (Greek), then ask an African postgraduate (myself) on Grand Rounds to examine her using clinical approach only (History, Observation, Palpation, Percussion, Auscultation) to arrive at a Clinical Diagnosis of “Sickle Cell beta-Thalassaemia with cholelithiaisis and avascular necrosis of humeral and femoral heads”, then turn to Dr Joe Humble: “Show us the Electrophoresis Strip”? That whole section of my Rapid Response a fortnight ago [4] was excised. I reproduce it so GP’s and others may learn from it. Read this together with my earlier response which stated: “the sickle cell gene frequency in some white people in Greece and in Eti-Turks is greater than that in my own country Ghana”. [4 7 8]. See the excised portion before “Jonathan Lamb et al list fewer conditions …”[4]:-

These and their offspring are scattered around the world including the UK. A white woman was correctly diagnosed by me 57 years ago exactly on Professor Malcolm Milne’s Westminster Hospital Postgraduate Grand Rounds using just History (“I come from Greece”), Examination (icteric eyes, scar in right hypochondrium, loss of left shoulder contour due to angulation, and frequent joint pains) as (in my own words) “Sickle Cell beta-Thalassaemia disease with cholecystectomy for pigment stones, and aseptic necrosis of the left humeral head”. Haemoglobin Electrophoresis was produced on the ward round to confirm my clinical diagnosis by Consultant Haematologist Dr Joe Humble [8, page 240] who 8 years earlier had identified the same lady as having sickle cell Thalassaemia [9].Trained in London University in the 1950’s by the likes of Sir Richard Bayliss (Queen’s Physician) I was trained as it were for the bush in order that I could make diagnoses without X-rays. The luxury of MRI did not exist. Fortunately, there are some GP’s in the UK today who can make this kind of clinical diagnosis on History and Examination alone.


Jonathan Lamb et al quite rightly mention pregnancy: “She had recently given birth to her second child”. [3] I would like to know how long she was in labour for because prolonged 2nd stage of labour we found in Ghana to be one of the precipitating causes of this condition in the multiparas. I once commented thus:
“The peculiar selection of the hip joint for such crippling pathology might have some eugenic significance [5 7 8]. Some of the Hb SC disease women with bilateral hip involvement complained of inability to separate their thighs for coitus, seriously endangering marital relationships, while many of the male patients with hip involvement find coitus impossible because body movement of any sort produces agonizing pain (Illustrative Case Histories 44, 46 and 48” [Ref 8 below].
I went on: “It seemed to me that in addition to priapism this is a further means that Nature has devised to limit dissemination of the sickle cell gene” [8, page 240].


1. What is the nationality of this lady? Ringelhann and I described in some detail Mediterranean and West African Haemoglobinopathy and G6PD Deficiency. [10]

2. How long was she in labour for in both pregnancies?

3. What does the Haemoglobin Electrophoresis show? I once described two Sickle Cell Haemoglobin D disease girls with an English father (“AD” phenotype) and Ghanaian mother (“AS” phenotype) [Case History 133 in Reference 8]. The “SD” phenotype can be as severe as the “SS” (Sickle Cell Anaemia). Another reason why Hb Electrophoresis is important even when Sickling Test is Negative is that in my 36 consecutive homozygous Haemoglobin C disease patients in Ghana “the 35th presented with hip pain”. [8]

Jonathan Lamb et al list fewer conditions that cause aseptic necrosis of the femoral head than the 25 that J E Nixon [11] listed in 1983 in the Journal of the Royal Society of Medicine, but their article [3] has admirably succeeded in alerting clinicians about this condition which afflicts not just Africans and Caucasians but the entire world. We await answers to the 3 questions listed above, but note that Sickle Cell Anaemia “SS” is not the same as Sickle Cell Haemoglobin C disease “SC”. Sickle Cell Trait is “AS” phenotype.

Competing interests: None declared Twitter @profkonotayahul

F I D Konotey-Ahulu MB BS MD(Lond) FRCP(Lond) FRCP(Glasg) DTMH(L’pool) DSc (Hon UCC) DSc (Hon UH) FGA FGCP FWACP FTWAS, ORDER OF MERIT (OFFICER). Kwegyir Aggrey Distinguished Professor of Human Genetics, Faculty of Science, University of Cape Coast, Ghana, and Former Director Ghana Institute of Clinical Genetics Ghana and Consultant Physician Genetic Counsellor in Sickle Cell and Other Haemoglobinopathies Korle Bu Teaching Hospital Accra, and at Phoenix Hospital Group, 9 Harley Street, London W1G 9AL.

1 BMJ Front Cover. Should we bring back THE FIRM? 15 June 2019. [365 379-420 No 82003 ISSN 1759-2151.

2 Ellis Harold. “The firms were wonderful” quoted with portrait in Abi Rimmer The Firm: could it fix teamworking and morale? BMJ 2019; 365: 14105 June 15 2019.

3 Lamb JN, Holton C, O’Connor P, Giannoudis PV. Avascular necrosis of the hip. BMJ 1 June 2019, Vol 365, p 325 (BMJ 2019; 365:I2178)

4 Konotey-Ahulu FID. Avascular hip necrosis: sickle cell haemoglobinopathy predominates worldwide. June 1 2019 https://www.bmj.com/content/365/bmj.l2178 BMJ Rapid Response to Lamb JN et al 1 June 2019, Vol 365, p 325 (BMJ 2019; 365:l2178.

5 Konotey-Ahulu FID. Hip disease in Africans, Lancet 1970; 1: 99.

6 Konotey-Ahulu FID. Hip pain and radiographic signs of osteoarthritis: Sickle Cell and other haemoglobinopathy differential diagnosis. BMJ Rapid response to Nieuwenhhuisje MJ, Nelissen RG. Hip pain and radiographic signs of osteoarthritis. BMJ 2015; 351:6262 (03 December 2015) BMJ 2015;351:h5983

7 Konotey-Ahulu FID. Pattern of Sickle Cell Disease in Accra. A Study of 1550 consecutive patients. Dissertation presented to University of London for the Postgraduate Diploma of Doctor of Medicine 1971. Awarded MD(London) February 1972.

8 Konotey-Ahulu FID. The Sickle Cell Disease Patient: Natural History from a Clinico-epidemiological study of the first 1550 patients of Korle Bu Hospital Sickle Cell Clinic. The Macmillan Press Ltd, London 1991 & 1992 and T-AD Co Watford 1996.

9 Humble JG. et al. A family illustrating the double inheritance of a sickle cell trait and of Mediterranean anaemia. J Clin Path 1954; 7: 201-208.

10 Ringelhann B, Konotey-Ahulu FID. Haemoglobinopathies and Thalassaemia in Mediterranean areas and in West Africa: historical and other perspectives 1910-1997 – A Century Review. Atti del’Accademia dela Science di Ferrara Haemoglobinopathies 1998: 74: 267-307.

11 Nixon JE. Avascular necrosis of bone: a review. J R Soc Med. 1983; 76: 681-692.


The painstaking way (pun intended) that “a doctor, a pharmacist, and a patent attorney” [1] have analysed the 2013 to 2018 “on going disputes around pregabalin” (British Medical Journal June 9 2018, page 358) needs commendation. I don’t comment on particular details because “Supreme Court decision is due soon” [1], but pertinent questions need answers. This excellent account implies how powerful Drug Licensing Authorities are. It is only after drugs have been licensed that MHRA, NHS, NICE, or BNF issue instructions.  Can we identify the composition of Licensing Bodies so we may hold persons to account individually when undesirable sequelae follow their decision to license a particular drug?

Adverse Clinical Consequences Following Licensing One Drug and Not Another    

I realised over 20 years ago the power Drug Licensing had in the UK when I began pointing out that Morphine and Diamorphine, through respiratory suppression, killed sickle cell disease patients in painful crises.  “If the patient dies” I said in Lancet “sickle cell crisis and chest syndrome will be recorded on the death certificate” [2 3]. When a UK Professor of Obstetrics & Gynaecology [4] advocated Morphine for sickle cell crisis patients in pregnancy, I said in BMJ: “The question that puzzles me is: Why do west African and West Indian patients with sickle cell disease who did without morphine in their countries have to be given morphine pumps during sickle cell crises when they come to the United Kingdom? In any case, in obstetrics what happens to foetal respiration when morphine is used?” [5]

Professor Elisabeth Goodman [6] found Ketorolac as good as Morphine with no   respiratory depression in vaso-occlusive crisis but Liesner, Vandenberghe and Sally Davies said “Ketorolac has no product licence in the UK for this indication” [7]

How extraordinary that a drug that did not kill patients had no Product Licence in the UK, but Morphine and Diamorphine that killed sickle cell disease patients as NCEPOD later confirmed [8] was, and still is, licensed “for this indication”! Indeed, despite NCEPOD’s damning patients-dying-from-Opiate-Overdose Report NICE issued Guidelines advocating Diamorphine intravenously in sickle cell crisis [9].

Cecilia Shoetan’s heart-rending BMJ report of her breathless 32-year-old sickle cell disease daughter dying within seconds when Diamorphine (licensed for this indication) was given intravenously in a London hospital while she stood watching [10] makes frightening nonsense of the NICE Guidance [11].

NHS ENGLAND and NHS SCOTLAND differ on Pregabalin?

The July 2007 Scottish Medicines Consortium (SMC) advice regarding Pregabalin differs from its April 2009 directive [12]. Meanwhile, NHS England had her own rules.  Witness the extraordinary situation in which NHS instructed doctors to depart from their usual prescribing for pain [13 14]. Who best should instruct doctors on prescribing practice? When Dr Margaret McCartney asked “Why do we have to prescribe branded Lyrica for pain?” [15] whom was she addressing? Well may Dr Laurence Leaver ask “With friends like NHS England, GP’s do not need enemies” [16].

Just 9 months ago we read “UK government to reclassify pregabalin and gabapentin after rise in deaths” [17]. Such reclassification is a forensic exercise. Disobey instructions and the Law could be after you. Can Freedom of Information identify individuals using “MHRA” or “NHS” or “The government” or “NICE” as cover to issue “not fit for purpose” guidelines? [18] Please investigate MHRA etc Competing Interest Declarations [19]. Pharmacovigilance in a developing country like Ghana has as many as 6 levels of vigilance and each level has potential for corruption [20]. Developed countries are no better, as Dr James Le Fanu exposes in his remarkable book recommended below.

The Le Fanu Legacy for Thoroughness

The name “Le Fanu” is music to Ghanaian ears. Korle Bu Hospital was planned and designed by Dr C V Le Fanu in the early 1910s in Colonial Gold Coast [21]. The outstanding Governor Sir Gordon Guggisberg [22] in 1919 “gave it top priority in his government’s building programme” [21] and when he opened it on 26 October 1923 he wanted it to “acquire a reputation second to none in the medical world”. One of the remarkable members of staff was another Le Fanu, Dr G E H Le Fanu who in 1909 led his laboratory in carrying out “a successful experiment to manufacture active vaccine lymph, locally, for small pox vaccination” [21]. Gold Coast Hospital, renamed Korle Bu Hospital, went on to do exploits including Dr Hideyo Noguchi’s Yellow Fever work. [21]. Meanwhile Dr G E H Le Fanu and colleagues including Dr Albert Hawe continued to tackle Tropical Diseases in a most thorough way [21 23]. Today, a Third “Thorough Le Fanu,” James, whose masterpiece “TOO MANY PILLS” is a ‘Must Read’ for every doctor mentions eight Big-Pharma companies that were fined a total of $Billion10.813 Dollars “for corrupt and illegal practices 2007-2012”. [24, page 25]


“Hospital drugs left 456 patients dead” was Daily Telegraph’s front-page head-line Thursday June 21 [25] plus an Editorial description of “fatal doses of diamorphine and other inappropriate drugs” in Gosport War Memorial Hospital. Note that when the NCEPOD Report of 2008 revealed that between January 2005 to December 2006 “Nine out of the 19 patients with sickle cell disease who had pain on admission and who then died had been given excessive doses of Opiods” [9] there were neither front-page newspaper-headlines nor calls for prosecutions as we hear today about Gosport.

Why the difference? ANSWER: Not because the victims were black, but because Morphine and Diamorphine are LICENCED “for sickle cell crisis indication” in the UK, raising this question:  Does the whole area of Drug Licensing (Pregabalin included) not need looking into urgently?  And when Dr James Le Fanu publishes in the BMJ that “Mass medicalisation is an iatrogenic calamity” [26] do we not wake up to the fact that the very first rung of the ladder to any medicalisation is DRUG LICENSING?

Finally: “Diamorphine has no accepted medical use in the United States” [27]

Competing Interest: I come from a sickle cell disease home: My Trait Parents had 11 children – 3 of us had sickle cell disease, hence my never-ceasing opposition to patient-management of pain that shortens life in anybody. [2 3 5 7 11 28 – 36].

felix@konotey-ahulu.com              Twitter@profkonoteyahul

Felix I D Konotey-Ahulu FGA MB BS MD(Lond) DSc(UCC) FRCP(Lond) FRCP(Glasg) DTMH(L’pool) FGCP FWACP FTWAS ORDER OF THE VOLTA (OFFICER) Kwegyir Aggrey Distinguished Professor of Human Genetics University of Cape Coast, Ghana; Former Consultant Physician Genetic Counsellor in Sickle Cell and Other Haemoglobinopathies Korle Bu Teaching Hospital & Director Ghana Institute of Clinical Genetics, and 9 Harley Street, Phoenix Hospital Group, London W1G 9AL.


1 Smyth Darren, Goldacre Ben, Croker Richard. Pregabalin: what the patent litigation means for doctors and big pharma. BMJ 2018;361:k2318 https://www.bmj.com/content/361/bmj.k2318.full?   BMJ June 09 2018

2 Konotey-Ahulu FID. Opiates for sickle-cell crisis? Lancet 1998; 351: 1438.
[“The question that puzzles me is: Why do west African and West Indian patients with sickle-cell disease who did without morphine in their countries have to be given morphine pumps during sickle-cell crises when they come to the UK?”]

3 Konotey-Ahulu FID. Opiates for sickle-cell crisis. Lancet 1998; 352: 651-652. [To David Bevan’s criticism (Lancet 1998; 351: p 1965) of white physicians who agree with Dr Konotey-Ahulu that opiates created addicts in hospital – “When I say routine opiates for sickle crisis are not the way to bring out these patients’ best potential in the long term I am glad to hear white physicians say the same…White physicians who, at the risk of being misunderstood by Bevan, voice their displeasure at what they see happening on their wards deserve commendation, not condemnation.”]

4 Chamberlain G. Medical problems in pregnancy: II. BMJ 1991; 302: 1327-30. (1 June)

5 Konotey-Ahulu, FID. Morphine for painful crises in sickle cell disease. BMJ 1991, 302(6792): 1604. (June 29 1991) (Comment on Professor Chamberlain’s recommendation of morphine in pregnancy in sickle cell disease – BMJ 1991; 302: 1327-30.) doi:10.1136/bmj.302.6792.1604-c


6 Goodman Elisabeth. Use of ketorolac in sickle cell disease and vaso-occlusive crisis. Lancet 1991; 338: 641-642.

7 Liesner RJ, Vandenberghe EA, Davies Sally C. Analgeisics in sickle cell disease disease. Lancet 1993; 3411: 188.

8 NCEPOD (National Confidential Enquiry into Patient Outcome and Death). Sickle: A Sickle Crisis? (2008) [Sebastian Lucas (Clinical Coordinator), David Mason (Clinical Coordinator), M Mason (Chief Executive), D Weyman (Researcher), Tom Treasurer (Chairman) info@incepod.org

9 NICE. Management of an acute painful sickle cell episode in hospital: summary of NICE guidance. BMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e4063 (Published 27 June 2012) BMJ 2012;344:e4063

10 Shoetan Cecilia. I lost my Sickle Cell disease adult daughter minutes after being given Diamotrphine intravenously when she could not breathe. BMJ Rapid Response 3 June 2008 http://www.bmj.com/cgi/eletters/336/7654/1152-a#196520

11 Konotey-Ahulu FID. Poor care for sickle cell disease patients: This wake-up call is overdue BMJ Rapid Response May 28 2008 BMJ 2008; 336: 1152 to Susan Mayor “Enquiry shows poor care for patients with sickle cell disease” on National Confidential Enquiry into Patient Outcome and Death (NCEPOD) REPORT “SICKLE:  A Sickle Crisis? (2008) http://www.bmj.com/cgi/eletters/336/7654/1152a#196224 | http://www.info@ncepod.org

12 National Formulary. Pregabalin. BNF 70. September 2015 – March 2016: p 400.

13 Byrne Paul AC. Doctors are warned not to prescribe generic pregabalin for pain control www.bmj.com/content/350/bmj.h1734 March 30 2015 (BMJ April 7 2015)

14 Barbour James Re: Margaret McCartney – Second use of patents – why do we have to prescribe branded Lyrica for pain? (July 8 2015) “recent direction from a member of NHS health authorities that pregabalin prescriptions for chronic pain www.bmj.com/content/350/bmj,h1724/rapid-responses

15 McCartney Margaret. Second use of patents: Why do we have to prescribe branded Lyrica for pain? BMJ2015;350:h2734. July 8 2015.doi:10.1136/bmj.h2734 pmid:25995105

16 Leaver Laurence B. With friends like NHS England, GP’s do not need enemies “pregabalin to change some to Lyrica, so that Pfizer can maximise their profits at the expense of NHS” www.bmj.com/content/350/bmj.h1724 (02 May 2015)

17 Hopkins H. UK Government to reclassify pregabalin and gabapentin after rise in deaths. (03 October 2017) www.bmj.com/content/358/bmj.j4441 Rapid Response to Gareth Laccobucci. UK government to reclassify pregabalin and gabapentin after rise in deaths BMJ 2017; 358: 4441 https://doi.org/10.1136/bmj.j4441 (Published 25 September 2017) BMJ 2017;358:j4441

18 Rost Felicitas, Wessely Simon. Depression in adults: campaigners and doctors demand revision of NICE guidance. BMJ 2018;361:k2681 [BMJ 23 June 2018, p 426]  “The latest NICE draft guidelines on adult depression is misleading, invalid, not fit for purpose, and potentially harmful to patients”. BMJ 2018; 361: k2681.

19 Hurley Richard. Former MHRA chair takes job at cannabis investment company. Rapid Response Re: Cannabis, cannabis everywhere: UK to review medical cannabis policy as Canada plans imminent legislation for all uses. BMJ 20 June 2018 361:doi10.1136/bmj.k2695 “Sir Breckenridge will help Sativa Investments liaise with the Home Office and the Medicines and Healthcare products Regulatory Agency (“MHRA”), which he has chaired, for the legislation of medicinal cannabis in the UK”.

20 Konotey-Ahulu FID. Who should best pharmacovigilate in developing countries? https://www.bmj.com/rapid-response/2011/11/01/who-should-best-pharmacovigilate-developing-countries 14 September 2007 [ http://oW.ly/Dq8g30dSHe0 ]

21 Addae Stephen. Evolution Of Modern Medicine In A Developing Country: Ghana 1880 – 1960 Durham Academic Press, Ltd., 1 Hutton Close, Bishop Auckland, Durham 1996 [On Governor G Guggisberg and Le Fanu C V & Le Fanu G E H]

22 Goodall HB. Beloved Imperialist – Sir Gordon Guggisberg – Governor of The Gold Coast. The Penland Press Ltd., 1 Hutton Close, South Church, Bishop Auckland, Durham 1998.

23 Konotey-Ahulu FID. Some personal encounters with a remarkable physician (Tribute  to Dr Albert Joseph Hawe. OBE CBE MD FRCP DTMH). Ghana Med Journal 1979; 18: 88-90.

24 Le Fanu James. Too Many Pills – How too much medicine is endangering our health and what we can do about it. Little, Brown Book Group, London EC4Y 0DZ.

25 Daily Telegraph. Hospital drugs left 456 patients dead”. Thursday June 21 2018 Front Page. Editorial “Fatal doses of diamorphine and other inappropriate drugs”.

26 Le Fanu James. Mass medicalisation is an iatrogenic calamity. Profligate prescribing has brought a hidden a hidden epidemic of side effects and no benefit to most individuals. [PROVOCATIONS] BMJ 2018; 361: k2794. June 30, page 494.

27 [NOTE WELL]: Ballas S K. Sickle Cell Pain. IASP Press. Seattle, USA, page 168: “Diamorphine has no accepted medical use in the United States”

28 Konotey-Ahulu FID. Management of patients with sickle cell disease. African Journal of Health Sciences 1998; 5: 47[ Commenting on article of Sally Davies and Lola Oni (BMJ 315: 656 -60) “what I feel is more important in the day to day management of patients with a view to keeping them out of hospital, is clinical epidemiology which includes the circumstances of crises. … I fear Davies and Oni’s statement that ‘The Central Middlesex management protocol uses morphine infusions’ will make morphine the accepted drug for sickle crisis management. The consequences of such an approach are dire, especially when some UK hospitals are already making diamorphine their first choice”.]

29 Ringelhann B, Konotey-Ahulu FID. Hemoglobinopathies and thalassemias in Mediterranean areas and in West Africa: Historical and other perspectives 1910 to 1997 – A Century Review. Atti dell’Accademia dell Science di Ferrara (Milan) 1998;74: 267-307

30 Konotey-Ahulu FID. Opiates for pain in dying patients and in those with sickle cell disease. http://www.bmj.com/cgi/eetters/335/7622/685#177986 BMJ 11 Oct 2007

31 Konotey-Ahulu FID. Management of sickle cell disease versus management of the sickle cell disease patient. BMJ Rapid Response 17 September 2008


32 Konotey-Ahulu FID. Inquest into diamorphine deaths: Does NCEPOD sickle patients report warrant a similar inquest? BMJ Rapid Response March 7 2009


33 Konotey-Ahulu FID. Opiods for chronic non-cancer pain – Chemotherapy – Clinical Guidelines: Where does ultimate responsibility lie? www.bmj.com/content/ 346/bmj.f2937/rr/651421BMJ Rapid Response 25 June 2013

34 Konotey-Ahulu FID. Opiods in the UK: What’s the problem? Answer – Good Clinical Practice needs to cover all population groups including sickle cell disease patients. BMJ Rapid Response 18 August 2013 www.bmj.com/content/347/bmj.15108/rr/658208

35 Konotey-Ahulu FID. Management of sickle cell disease patient in the community BMJ Rapid Response 13 April 2014 [90 References] to Brousse V, Makali J, Rees DC: Management of sickle cell disease in the community. BMJ 2014; 348: g1765 doi:10.1136/bmj.g1765 http://www.bmj.com/content/348/bmj.g1765/rr/694233

36 Konotey-Ahulu FID. Management of an acute painful sickle cell episode in hospital: NICE guidance is frightening1 Sept 7 2012 [42 references]] www.bmj.com/content/344/bmj.e4063/rr/599158

My PERSONAL VIEW on Research Integrity: When scientists confess to lying

My PERSONAL VIEW on Research Integrity: When scientists confess to lying
Dr Francis Crawley writes in the British Medical Journal 6 November, 2018: “The retraction of scientific articles based on fraudulent representations of science is damaging to science”. [1]. The terms “Research Integrity” and “Fraudulent Science” hide underneath a human umbrella of “Lying Scientists” or (using polished language) “Scientific Liars”.


Great credit to these British Editors who pursued authors until they confessed uncomfortable truths leading to published articles retracted. I happened to be partly instrumental in unmasking in both these celebrated medical journals articles which (using Prime Minister Winston Churchill’s phrase) were full of “terminological in-exactitudes”, but which the Ghanaian in me would simply call “lies”.

In the BMJ example the then Editor rang me at Korle Bu Teaching Hospital to issue what amounted to an apology and to reassure me that the published fictitious Case Report would be withdrawn. This was done after the authors confessed to lying. What they said had happened in their Case Report had in fact not happened, because there was no Case(to)Report!

The second example of scientific erroneous data I was instrumental in unmasking was when the AIDS pandemic engulfed the world. The day my suspicions surfaced was when BBC WORLD SERVICE in its SCIENCE IN ACTION Programme May 3 1987 broadcast that the reason AIDS was rampant in Central Africa was that people there had inherited a new genetic factor that predisposed them and homosexuals to the virus. I had just finished touring the worst afflicted areas of my Continent at my own expense to study AIDS at the grassroots. I did the 16-countries’ trip expressly to study the epidemiology of the new disease at the village level. Both BMJ [2] and Lancet [3] published articles I submitted to them. No less than 4 other British International Journals including Journal of Royal Society of Medicine which even invited an Editorial [4], carried my novel epidemiological findings.

In my publications I told the world exactly why and how AIDS became rampant on my Enigmatic Continent, especially in my own Ghanaian Krobo tribe. Then, suddenly, there came a team of scientists from London University claiming that homosexuals and Central Africans shared a common gene that they blamed for the pandemic. I could not sit idly by when laboratory scientists could broadcast to the world what I considered to be false. The SCIENCE IN ACTION programme claimed The Lancet to be the source of its information. I read, and re-read the paper, and wrote to The Lancet whose august Editorial Team then comprised of Robin Fox, Imogen Evans, and David Sharpe. I called them “The Magnificent Trio” because I was invited to Lancet’s Offices 7 Adam Street, The Strand in London for interview to substantiate my African findings.

Mine was the very first correspondence in Lancet to criticize “the new research”. Stung by my statement that their research “leaves a lot to be desired” the authors wrote back to more or less rubbish what I said: “Konotey-Ahulu’s interpretation of our conclusions is at fault”. I kept quiet, and just let others continue with correspondence in Lancet. Some supported the homosexual/Central-African-gene “finding” while others including Dr S S Papiha from Newcastle University disagreed, supporting me. Professor A G Dalgleish from London University also commented. Meanwhile, the media had a field day. Science Editor of The Times (references available) went on, and on, about the genetics of why Africa was being decimated by AIDS.

Then, exactly 11 months and 3 weeks after the Lancet publication about which “The Magnificent Trio” allowed much correspondence doctors were amazed to read that because of “ERRONEAOUS DATA” (the authors’ own words) the article linking Central Africans and homosexuals was being retracted forthwith. Frankly, after decades writing in international journals, I have come to the conclusion that British Editors are head and shoulders above the Americans when it comes to retracting scientific misinformation. I once wrote to the USA correcting something about G6PD Deficiency occurring together with Sickle Cell Disease in the same patient, but it took more than 6 months for the New England Journal of Medicine to publish my concerns [5], by which time the original misinformation had taken root.


What was hugely worrying for us Africans was that although the scientists confessed to wrong doing in both the BMJ case and The Lancet, the media did not find it necessary to correct what had been said in SCIENCE IN ACTION or The Times. Indeed, it took Professor Hermann Lehmann FRS of Cambridge University writing to The Times (January 4 1972) to rebuke its Science Correspondent and ask why when misinformation had been confessed and withdrawn from the BMJ should articles continue to appear as if nothing had happened? The Times Correspondent (references available) continued also to publish the falsely claimed genetic proclivity of homosexuals and Central Africans to AIDS after the “Erroneous Data” confession.

It appears we Africans cannot win? Wrong! The number of cell phones pervading the Dark Continent is mind boggling! Refuse to correct Misinformation or Disinformation (defined as Deliberate Misinformation), and be sure to find it corrected on the Internet, and African drivers reading about it while filling their car tanks with petrol. The Media World has changed. Africans have handed in questions to be answered on Facebook “Meet the Professor talking about Sickle Cell Disease Patient Live” [6]. Those who miss the live programme can access the hour-long session later on YouTube. Let conventional media “forget” to correct confessed scientific in-exactitudes that had been retracted, and Twenty-First Century Social Media will NOT forget! Professor Lord Solly Zuckermann [7] and previous BMJ Editors Stephen Lock and Richard Smith [8 9] have written extensively about this very important matter.

[NOTE: References of names of authors who confessed to “erroneous data” after being challenged and have had articles withdrawn from BMJ and Lancet are withheld.]

Competing Interest: Having been Past Editor of Ghana Medical Journal for many years taught me to discern when authors’ research articles “left a lot to be desired”. [3]
felix@konotey-ahulu.com Twitter@profkonoteyahul
F I D Konotey-Ahulu MD(Lond) FRCP(Lond) DTMH(L’pool) Kwegyir Aggrey Distinguished Professor of Human Genetics, University of Cape Coast, Ghana and Former Consultant Physician Genetic Counsellor in Sickle Cell and Other Haemoglobinopathies, and Director Ghana Institute of Clinical GeneticsKorle Bu Teaching Hospital, Accra, Ghana and Phoenix Hospital Group, 9 Harley Street, London W1G 9AL [ www.sicklecell.md ]


1 Crawley Francis P. Research Integrity, Open Science, and Health Policy. BMJ Rapid Response 6 November 2018 https://www.bmj.com/content/363/bmj.k4309/rapid-responses

2 Konotey-Ahulu FID. Clinical epidemiology, not sero-epidemiology, is the answer to Africa’s AIDS problem BMJ (Clin Res Ed) 1987; 294(6587): 1593-1594 (June 20 1987)
http://www.bmj.com/cgi/reprint/294/6587/1593.pdf doi:10.1136/bmj.294.6587.1593

3 Konotey-Ahulu FID. AIDS in Africa: Misinformation and Disinformation. Lancet 1987; 2(8552): 206-208. July 25.

4 Konotey-Ahulu FID. An African on AIDS in Africa [Guest Editorial] The AIDS Letter – Royal Society of Medicine 1989 Feb/March, pp 1-3.http://www.konotey-ahulu.com/aidsinafrica/konoteyahulu/art1_cvref113.htm

5 Konotey-Ahulu FID. Glucose-6 phosphate dehydrogenase deficiency and sickle cell anaemia. New Eng J Med 1972; 287: 887-888. http://www.bmj.com/cgi/reprint/1/5793/177-a.pdf

6 Konotey-Ahulu FID. Meet the Professor talking about Sickle Cell disease patient live! Thursday 4th August 2016 7 pm On Line
https://www.facebook.com/events/1840398749523659/ | https://www.youtube.com/watch?v=TR-IENhqh5k

7 Zuckerman, Lord S. Pride and prejudice in Science. Aerospace Medicine 1974; 45: 638-647. [Describes a catalogue of frauds in Science over several decades]

8 Lock Stephen. Misconduct in medical research: Does it exist in Britain? BMJ December 10 1988, Volume 297, page 1531.

9 Smith Richard. Should research fraud be a criminal offence? The BMJ Opinion. December 9 2013 https://blogs.bmj.com [“A systematic review has shown that research misconduct is common, terrifyingly common. Anybody who is sceptical about research fraud should sign up to the brilliant Retraction Watch that will bring you several cases every week of scientific misconduct”]

Folic acid in Pregnancy: Birth Defects: Speech Embarrassment: Why abortion?

Tiny Folic Acid in pregnancy prevents huge African Linguistic Embarrassment too, but is abortion for prevention warranted?

In addition to the “birth defects such as spinal bifida and anencephaly” (BMJ 20 0ctober 2018) that “flour fortified with folic acid” [1 2] is expected to prevent when given in early pregnancy, I did state ten years ago that “a mere 500 micrograms daily is known to prevent cleft palate” [3] – a seemingly minor defect but which in the tribal setting constitutes a formidable social pathology [3 4].


How would any BMJ reader feel if when saying “I have scrubbed”, what is heard is “I have passed wind?” The extraordinary thing about this state of affairs is that the speaker is quite unaware that what was just heard was tantamount to blasphemy in Krobo/Dãngme-Gã Mother Tongue where every vowel not only has at least 3 reproducible pitches but also 2 distinct qualities – non-nasal and nasal [5]. Cleft palate phonates nasal and, coupled with any of the 3 distinct pitches, imparts 6 different meanings to the same consonant. I say that again: a vowel in my Tribal Tonal Language imparts 6 different meanings to the same consonant depending on its pitch and quality. [3-6]

“Osa” in Krobo/Dãngme (“Osha” in Gã) [Low High vowel-pitch sequence] means “you scrubbed”. Nasalise the second vowel, same pitch sequence, and you have said “You passed wind” [Osã and Oshã respectively]. Even using the tribal devulgarising prefix “Tafracher!” [7] can never excuse the utterance of such a thing in public. The embarrassment is complete. “It is, therefore” I once remarked “a social disaster of enormous proportions if when an African wants to say she has scrubbed, she is rather heard to say unmentionable things because of cleft palate. The need for early correction of this defect cannot be overemphasized. Any African baby with cleft palate stands in great danger of being ostracised in later life, and should be helped immediately” [4, page 10].


Nicholas Wald of the Wolfson Institute of Preventive Medicine at Queen Mary University of London is quoted by the BMJ as saying if it is officially confirmed that within weeks flour will be fortified with folic acid “the UK is taking an important step in preventive medicine and helping to avoid disability or termination of pregnancy” [1]. In a Parliamentary Written Question 114833 “Abortion: Cleft Palate” Jim Shannon (Strangford) asked the Secretary of State for Health on 21 November 2017 “how many abortions there were in each of the last 15 years in which the fetus had a cleft palate (a) palate or (b) lip, …” by residents in England and Wales [8]. Answering, Jackie Doyle-Price said that for all gestations there were 9 in 2013, 10 in 2014, 11 in 2015, and 9 in 2016.


Certainly Not! At least for one interesting reason: Dr Albert Joseph Hawe MD FRCP OBE CBE was the most well-known white Colonial Doctor the Gold Coast (now Ghana) had ever known for 50 years [9]. He was the doctor stationed at Akuse 10 miles from where I was born in Odumase Krobo, and it was he who so expertly looked after me in the early 1930’s when I was often sickly that my first words in English were “When I grow up I shall go to England. When I grow up I shall be a Dorkita like Dorkita Hor”. His contemporary in our British colony was Dr Cicely Williams who first described Kwashiorkor in my tribe [10 11]. I was amazed when I discovered that the white “dorkita” who had looked after me as a toddler was one of the two Consultants (the other was Ghanaian Dr Silas Dodu) whom I was assigned to work with as Medical Officer on my return from the UK after registration.

My second discovery was that the heavily nasal diction of Dr Albert Hawe was due to Cleft Palate/Lip the scar of repair of which was a prominent feature of his physiognomy! If this remarkable Englishman had been aborted he would not have been in Colonial Gold Coast to work in my tribe and help save my life. But in order that it might not be construed that cleft palate abortion practice in England and Wales had no equivalence in Africa thus proving our superior ethical stance in these things I, born with extra-digits deformity (Mendelian Dominant 1% incidence in Ghana) [12], need to mention what I once said in the BMJ [13] which Professor Sir David Weatherall FRS drew attention to in his excellent textbook “The New Genetics and Clinical Practice”[14]: My Krobo Tribe in south east Ghana cared little about extra digits which they just tied firmly at birth and watched them atrophy and fall off. My stubs are there for all to see today. The tribe east of us beyond the Volta River would rejoice at the sight of a new-born baby with extra digits – destined to be rich. The tribe west of us beyond the hills would drown a baby so deformed until the practice was stopped by missionaries and the Colonial government. The UK “scientific tribesmen” as I described them in the BMJ [13] might have suggested I be aborted alongside pregnancies with cleft palate and sickle cell disease’


Cleft-palated Dr Albert Hawe for over half a Century treated Ghanaians who then came to England and were told that it would soon be legal to terminate an up-to-term pregnancy because cleft palate had been unmasked through ultrasonography. A procedure that was legal by UK Law would be interpreted in the African mind as perfectly alright. Indeed, it is taught that haemoglobinopathy may be diagnosed prenatally and termination suggested to parents when some of my patients were far brighter than their siblings. [15]. World Class Clinical Geneticists Professor George Fraser [16] and Professor Sir David Weatherall [14] have always emphasized ETHICS in these considerations.

Competing Interest: Born with extra digits – a defect for which termination has been done in the UK [17] Twitter: @profkonoteyahul

Felix I D Konotey-Ahulu FGA MB BS MD(Lond) DSc(UCC) FRCP(Lond) FRCP(Glasg) DTMH(L’pool) FGCP FWACP FTWAS ORDER OF THE VOLTA (OFFICER) Kwegyir Aggrey Distinguished Professor of Human Genetics University of Cape Coast, Ghana; Former Consultant Physician Genetic Counsellor in Sickle Cell and Other Haemoglobinopathies Korle Bu Teaching Hospital & Director Ghana Institute of Clinical Genetics, and 9 Harley Street, Phoenix Hospital Group, London W1G 9AL. [www.sicklecell.md]


1 Limb Matthew BMJ Flour to be fortified with folic acid within weeks, say reports. BMJ 2018; 363:k4348.(20 Oct.) BMJ 2018; 363 doi  https://doi.org/10.1136/bmj.k4348     (16 Oct 2018)

2 Campbell D. Folic acid to be added to UK flour in effort to reduce birth defects.Guardian 14

Oct 2018 https://www.theguardian.com/society/2018/oct/14/folic-acid-to-be-added-to-flour-in-effort-to-reduce-serious-birth-defects.

3 Konotey-Ahulu FID. Social pathology of Cleft Palate in The African: Mathematical Precision of Pitch Gaps in Tribal Tonal Linguistics. Ghana Medical Journal 2008; 42: 89-91. (June 2008).

http://www.ghanamedassociation.org/ | http://www.pubmedcentral.nih.gov.articlerender.fcgi?artid=2631266 PMID: 19180210 [PubMed – indexed for MEDLINE] (vowel coloration omitted on this NIH site).

4 Konotey-Ahulu FID. Tonic SolFa Is The Foundation Of Tonal Linguistics. DRUMSPEAK (Supplement) International Journal of Research in the Humanities. New Series Vol 3. No. 1, May 2010. Faculty of Arts, Univ. of Cape Coast, Ghana. ISSN (0855-9945).http://bit.ly/bEdcc4

5 Konotey-Ahulu FID. Black people’s red faces and AIDS prevention. Lancet 2000; 355(9214):1559. PMID: 10801206 [African vowel has at least 6 meanings with consonant]

6 Konotey-Ahulu FID. The Remarkable African Ear: Phenomenon of Mid Pitch Arrest Phenomenon in Krobo-Dangme-Gã Tonal Linguistics of South East Ghana. African American Museum of Philadelphia Award Lecture May 5 2007


7 Konotey-Ahulu FID. Tafracher – Personal View. BMJ 1975; 1(5953): 329. (February 8)  http://www.bmj.com/cgi/reprint/1/5953/329.pdf         http://bit.ly/2bRQ7B1

8 UK Parliament. Abortion: Cleft Palate: Written question – 114833    (21 Nov. 2017)


9 Konotey-Ahulu FID. Some personal encounters with a remarkable physician. (Tribute to Dr Albert Joseph Hawe, OBE, CBE, MD, FRCP, DTMH). Ghana Med J 1979; 18: 88-90.

10 Williams Cicely. D. Kwashiorkor – a nutritional disease of children associated with a maize diet. Lancet 1935; ii: 1151-1152.

11 Konotey-Ahulu FID. Issues in Kwashiorkor. Lancet 1994, February 26, page 548.

12 Bonney GE, Walker M, Gbedemah K and Konotey-Ahulu FID. Multiple births and visible birth defects in 13000 consecutive deliveries in one Ghanaian hospital. In Proceedings of the Second International Congress on Twin Studies Part C Ed Nance W. Progress in Clinical and Biological Research 1978; 24 Pt B: 105-108.

13 Konotey-Ahulu FID. Ethical issues in prenatal diagnosis. BMJ Clin Res Ed 1984; 289(6438): 185. July 21. doi:10.1136/bmj.289.6438.185-a 6143955


14 Weatherall DJ. Ethical Issues and related problems arising from the application of the new genetics to clinical practice. In: The New Genetics and Clinical Practice. [Third Edition] Oxford University Press. Oxford 1991.

15 Konotey-Ahulu FID. Antenatal sickle cell disease haemoglobinopathy screening. BMJ

http://www.bmj.com/content/341/bmj.c5243/reply#bmj_el_243447  Rapid Resp. Oct 25 2010

16 Fraser GR. FIFTY YEARS OF HUMAN GENETICS – A Festschrift and liber amicorum to celebrate the life and work of George Robert Fraser. Wakefield Press, 1 Parade West, Kent Town, South Australia 5067 www.wakefieldpress.com.au

17 Yeoman Fran. Babies are aborted over an extra finger or club foot. The Times. May 29 2006.