Marilyn Hughes Gaston: a ground-breaking medical discovery

Aisha – Year 12 Student

Editor’s note: This short essay was recently entered into the GSAL Black History Essay Writing Competition, organized by The GSAL Journal and UPSoc to coincide with Black History Month. Open to all students in Year 10-13, the purpose of the competition was to encourage students to undertake independent research, think critically and communicate clearly about an aspect of black history of interest to them. The Competition Poster provides more information about the competition brief and success criteria. CPD

A prodigious 82-year-old African American devoted her career to medicine, which prompted her ground-breaking study that revolutionized the treatment of infants born with Sickle Cell Disease.

Sickle cell disease is an inherited blood disorder that affects red blood cells. Normally these blood cells are round and disc shaped; however, with SCD, they are sticky, and hook- shaped. This causes them to clog blood vessels, blocking oxygen and leading to major complications such as strokes and extreme pain. Over time, it can even cause death, especially in countries where treatment is not available. Approximately a thousand babies are born each year with SCD in America.

We were poor, we were uninsured, she was not getting health care… and that’s why she fainted. And from that point on, I knew that I wanted to do something to change that situation.

Dr Marilyn Hughes Gaston, on why she chose to become a doctor

Dr Gaston first became interested in the disease in 1964 whilst working at Philadelphia’s General Hospital. She was presented with a child who had SCD, his hand swollen from infection. This disturbing experience lead Dr. Gaston craving to find out everything about the disease and make a change.

Marilyn Hughes Gaston secured federal grants to study the disease and was able to put in measures for routine screening. This meant that if babies were screened for SCD at birth, penicillin could be given straight away to prevent septic infections and increase survival. She later became the deputy chief of the Sickle Cell Disease Branch. A year later her research led to SCD screening programs for children across the country, her work outlining the ease in which complications from SCD could be avoided.  This led to a significant reduction of morbidity and mortality in young children with sickle-cell disease around the world and has been applied to work in Africa where SCD cases are very high

Later advancements have been introduced such as in 1992 where scientists started a study of 299 people to see if hydroxyurea (a disease modifying treatment) could help children and adults with SCD. The study proved effective that hydroxyurea reduces the problems that SCD causes such as acute chest syndrome and can even help people live longer. It also showed that people who took hydroxyurea had little to no side effects and was safe for children as young as nine months old.

Although the study proved effective, mortality remained high in younger children who would of benefited from hydroxyurea if initiated early in life and were screened. This showed that although sickle cell disease has advanced and new treatments are developing as time passes, Dr Gaston’s discovery for newborn screening to be implemented as a measure in ensuring those who are identified can be treated as early as possible is still fundamental.

The first African American woman to direct a Public Health Service Bureau and a discovery which was crucial in laying the foundation principles for the pivotal shaping of change for sickle cell disease: Marilyn Hughes Gaston. Aisha


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