Born into a large and happy Bath family, with strong Christian connections going back to Neuchatel in Switzerland and to the West country, Clement Chesterman was a debonair and adventurous lad who early showed promise of great strength - of body, of character and of intellect. He had four years at Monkton Combe School, before entering Bristol Medical School in 1911. His interest in tropical medicine began when, as a medical student dresser in Serbia during the first world war, he treated victims of various tropical scourges. It was stimulated enormously during his apprenticeship to Major Philip Bahr in Palestine, where, as a lieutenant, Chesterman was responsible for a malaria diagnostic service and saw much typhus and dysentery. After demobilization, he enrolled for the last course in tropical medicine to be given at the London Dock Hospital, thereafter taking in his stride the Cambridge DTM&H and the London MD in tropical medicine.
Chesterman had two heroes - David Livingstone and Albert Schweitzer. He treasured ‘a few dead leaves’ from a tree in Central Africa under which Livingstone’s heart was buried, and some more leaves from a mango tree in Ujiji, where Livingstone met Stanley. His association with ‘le grand Docteur’ began in 1923, when, having read On the edge of the Primaeval Forest, he wrote a letter of appreciation to Albert Schweitzer as from his mission station at Yakusu, 2000 miles east of Lambarene, in the former Belgian Congo. Chesterman drew up an imaginary hospital case-sheet of a patient named Lazarus. Schweitzer acknowledged this missive and sent Chesterman a photograph inscribed ‘a mon collègue d’Afrique’.
Chesterman had turned his back on a promising academic career to follow in the footsteps of David Livingstone; he offered to serve as a Baptist medical missionary, and was appointed to Yakusu, near Stanleyville (Kisangani). He had caught his first glimpse of Africa as he travelled by ship to and from Serbia in 1915; this continent was to hold for him an irresistible fascination.
As he passed through Kinshasa in 1920, he was given a supply of a new drug for trypanosomiasis, in case he should find any cases in the district to which he was going. He did, indeed. In some of the riverside villages near Yakusu, a third of the population was suffering from the infection. Using tryparsamide carefully and methodically, Chesterman was soon hailed as a powerful medicine-man who could even conquer the dreaded bosingisi, and who could moreover do miracles with ‘the work of the knife’.
It was his early experiences in controlling sleeping sickness and in training medical auxiliaries that determined Chesterman’s whole orientation and his views on the role of a medical service in tropical Africa. Prevention is better by cure, he advocated, and the only way to encourage the adoption of Western medicine is by developing a programme of simple health posts manned by trained and supervised medical auxiliaries. In this respect, he was 50 years ahead of his time.
In 1936, Chesterman was called by the Baptist Missionary Society to leave his beloved Yakusu, and to assume the office of medical secretary with a base in London. With real reluctance, but with profound professional satisfaction, he left Yakusu: the whole of the Upper River was a healthier and happier place than when he had arrived in 1920. With trypanosomiasis almost eradicated, and yaws controlled (in the days before penicillin), and with thriving schools for the training of public health auxiliaries (infirmiers) and nurse-midwives, he had done a marvellous pioneering job. He had become very fluent in the local African language, Lokele, into which he had translated the well-known hymn ‘At even, e’er the sun did set, the sick, O Lord, around Thee lay’.
Although feeling somewhat restricted in his new administrative post, Chesterman entered into its duties with enthusiasm. He went to the World Council of Churches meeting in Madras in 1938, and managed to persuade a reluctant Ida Scudder to upgrade the Vellore Women’s Medical College and to admit men students, thus qualifying for government recognition.
At the outbreak of World War II, Chesterman joined a general practice in Buckinghamshire, but afterwards resumed his interest in tropical medicine and became a much respected consultant in this subject, greatly in demand by the Colonial Office, foreign governments and insurance companies. He was appointed lecturer in tropical medicine at the Middlesex Hospital, and was a very active member of the Royal Society of Tropical Medicine and Hygiene, taking every opportunity of contributing to the discussions at the monthly scientific meetings. He was elected vice president of the Society in 1951-1953, and president of the Hunterian Society in 1966-1967.
His Tropical Dispensary Handbook went through seven English editions, and sold well in French, Spanish and Portuguese translations. His knighthood in 1974, a little belated, gave tremendous satisfaction to his many friends, as did an honorary fellowship of the Royal Academy of Music.
Sir Clement was active in many ways quite apart from his large consultant practice in tropical medicine. He found time to be an active president of the Medical Missionary Association, and vice president of the Leprosy Mission; he was a faithful supporter of the Friends of Vellore, and was the indefatigable chairman of the Albert Schweitzer Hospital Fund in Great Britain. A great thrill to Chesterman came in 1955 when he organized the itinerary of Albert Schweitzer in England, which included a visit to Buckingham Palace (to receive the Honorary Order of Merit), to Cambridge University (to receive an honorary LLD) and to the Royal College of Physicians of London.
Chesterman was a great man, and a good man. He was blessed with a wonderful helpmeet of a wife, who predeceased him by two years, and gifted sons and daughters. He was master of the clever verbal quip and often amused himself during tedious committees by doodling and rhyming, and then entered the discussion with some apt phrasing that neatly embodied the decision that his fellow committee members were painfully groping towards.
He was a tireless and eloquent advocate of Christian medical missions; his book entitled In the Service of Suffering contained much of his thinking along these lines. He was a great encourager. He stimulated Charles Fisher to investigate a Yakusu-based Schistosoma (intercalatum), an investigation that earned Fisher a Bristol MD. Clement Chesterman died full of years, and full of good works. He was one of the last of the great medical missionaries.
SG Browne
[Brit.med.J., 1983, 287, 435: Lancet, 1603, 2, 353; Times, 27 July 1983]