To choose at the outset of a promising medical career to spend it entirely overseas, in places where both the creature comforts and the technical facilities taken for granted at home must be forgone, was much more common in the 1940s than it is today. To stick with that decision, when political turmoil provided every excuse to return to Britain, was much less common. C.A. Pearson not only did that; he went on to do some of his most distinguished work in the final phase of his career, and in retirement, as an advocate of the paramount importance of generalist doctors in the promotion of health, especially in Africa and in China.
China was where Andrew Pearson was born, where his father ran a hospital, and where, after studying medicine in Liverpool, he returned in 1946 with the Methodist Missionary Society. He took a special interest in leprosy, translating Sir Leonard Rogers and Ernest Muir's standard textbook into Mandarin, and when in 1951 other missionaries were required to leave Pearson was given the option of becoming a Leprosy Adviser in Hubei Province. But China at that time was not the place for an expatriate to raise a family and he and his wife, Jean, regretfully took their leave. They were redeployed by the Missionary Society to Nigeria.
In 1952 Pearson was appointed medical superintendent of the Wesley Guild Hospital, a Methodist foundation at Ilesha in Western Nigeria where he stayed for 23 years. He was plunged immediately into the administration of a major building programme as well as heading a medical team that was consistently short-staffed. He had to be an architect, builder and plumber as well as a doctor.
The reputation of a hospital, however, derives not only from its facilities but primarily from the quality of its staff and Pearson built a greatly respected team of Nigerians and expatriates. One of his early colleagues was David Morley, who pioneered a revolution in child healthcare through the renowned weight monitoring programmes he developed in and around Ilesha. It was here that the first ever measles vaccine was given a trial and, in order that there should be no question of using the Nigerian population as guinea-pigs, Pearson typically insisted that his own four children should be included.
Ilesha became the centre of world attention for its innovative and effective approach to both preventive and curative medicine, and it was described by the Overseas Development Agency's health adviser at the time as "the model hospital". But, as in many countries, the role of non-governmental hospitals was reappraised following independence. Amid the coups and counter- coups that followed Nigeria's Biafran war, government grants were slashed and Ilesha's future was uncertain and precarious. In 1975 the hospital became part of the Ife University Teaching Hospital Complex.
Writing 20 years later, the present Chief Medical Director of the Complex, Professor R.O.A. Makanjuola, said that, at the time of the government takeover, "Dr and Mrs Pearson, and some other dedicated healthworkers, both missionary and Nigerian, were treated disgracefully." The Pearsons were undeterred and Andrew became Chief Medical Officer for the University of Ibadan's community health programme. He trained medical students in community healthcare and general practice. Then, in 1983, he became the Director of Training in General Practice at the National Postgraduate Medical College in Lagos.
Before leaving Nigeria in 1985, the Pearsons were made honorary chiefs. They retired to Bury St Edmunds but Andrew Pearson undertook consultancies in GP training and attended conferences in many countries. He had never forgotten his Mandarin and when China emerged from its isolation he jumped at the chance to return. Within the international GP organisation Wonca (the World Organisation of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians), he was instrumental in setting up two world congresses on rural health, one of which was held in Shanghai. On this and other occasions he had the joy of meeting old friends and colleagues who had survived the Cultural Revolution.
He was the author of numerous papers, on subjects as varied as leprosy and latrines construction, tuberculosis and training. In retirement he wrote the history of the Wesley Guild Hospital, Front-Line Hospital (1996) and a textbook, Medical Administration for Front-Line Doctors (1990).
He believed in the complementarity of community-based primary healthcare and district hospitals. In the debate within the medical profession about how to achieve the World Health Organisation's commitment to Health for All by the year 2000, he reasoned that a comprehensive health service depends on the allocation of adequate resources to both.
Always quietly spoken and courteous, Andrew Pearson argued firmly and persuasively for his convictions. Foremost among these was his Christian faith. He was a lay preacher for 48 years; the courage of his convictions made him a conscientious objector to military service in the Second World War and underpinned half a century of conscientious humanitarian service thereafter.