Dr Brian Allwood is a Consultant Pulmonologist at Stellenbosch University and Tygerberg Hospital, where he has been responsible for expanding the pulmonary hypertension service, and starting the first dedicated post-tuberculosis clinic in the country.
Dr Brian Allwood is a Consultant Pulmonologist at Stellenbosch University and Tygerberg Hospital, South Africa, where he has been responsible for expanding the pulmonary hypertension service, and starting the first dedicated post-tuberculosis (TB) clinic in the country, which explores the problems of post-TB lung disease.
Dr Allwood’s journey to improve and develop tertiary pulmonology services has had many highlights, despite difficult working conditions and minimal funding: “As a community, we have managed to raise the awareness of post-TB complications globally, and of this I am very proud. However, it is almost unbelievable that although TB has been a part of humankind for millennia, very little attention has been directed to the often devastating, long-term consequences of the disease.”
To address this need, the 1st International Post-Tuberculosis Symposium was held last year. Funded in part by The Union, the Stellenbosch-based symposium focused on advocating for people suffering with post-TB complications, defining the current state of knowledge, agreeing on the important aspects of post-TB lung disease, and steering future research. The symposium was a great success, attracting 68 delegates from 12 disciplines, with strong representation from advocacy groups.
Dr Allwood reflects on the event: “All delegates recognised that this symposium was the start of the post-TB journey. We saw just how little is known about the disease, which likely affects tens of millions of people around the world. It became very clear that much work is needed in research and advocacy, and that only by collaborative working are we going to be able to meet the overwhelming need.”
Dr Allwood is a South African Pulmonologist, trained at the University of Witwatersrand in Johannesburg and the University of Cape Town.
“Working as a South African clinician in a government hospital, TB is part of your everyday life. You can’t escape or ignore it. As a pulmonologist you see the impact and long-term effects that TB and other chronic lung diseases have, and there is a constant desire to improve the quality of life and wellbeing of those under your care.
“To meet some of the tertiary clinical needs we face, I started an interstitial lung disease service and pulmonary hypertension service at Tygerberg Hospital. I also sought further training and was awarded a fellowship in pulmonary hypertension at Massachusetts General Hospital in the USA, which has assisted me with some of the much-needed skills and insight to further my work in South Africa.”
Until recently, Dr Allwood has worked as a full-time clinical consultant pulmonologist with two colleagues at a 1450 bed teaching hospital. The work involved providing tertiary clinical and interventional pulmonology services for three million people and taught medical students and physician/pulmonology fellows. He also had a small research unit, with the primary interest being post-TB lung and pulmonary vascular diseases.
However, the recent emergence of COVID-19 has changed everything for Dr Allwood and has meant he was forced to suspend all pulmonology services, and to spend the last six months working full time in the COVID-19 ICU of the hospital. Despite this turn of events, Dr Allwood hopes to resume full pulmonology services in the next few weeks as the pandemic hopefully passes its peak in South Africa: “After we have all recovered from COVID-19, I am looking forward to getting back to pulmonology, where no two days are alike and the spectrum of pathology keeps you fascinated.”
Dr Allwood first became associated with The Union in 2017: “I think The Union fulfills an important role in advocating for diseases, such as TB, which occur in low- and middle-income countries, where 80 percent of the world’s population resides. It provides a space to meet, collaborate and respond to the respiratory needs of the world’s majority. It is an important voice.”
“Being a member connects me to a community of like-minded people. I always think of Nulda Beyers when I think of The Union. Although she was a researcher of significant calibre, she always managed to find time for a cup of coffee and gentle conversation with me, despite our busy research environment. Her approach to mentoring was refreshing and left a lasting impression, and I hope she has left some of that with The Union.” Honorary Member Prof Nulda Beyers started the Desmond Tutu TB Centre at Stellenbosch University in 1990, which has since grown to have a staff of hundreds, conducting wide-ranging research in TB and HIV.
Dr Allwood comments that there have been many mentors and colleagues along the way who have played a role in supporting his achievements, as well as his wife Taytum. Looking forward, post-COVID-19, he hopes to continue to improve the care that he gives to people with respiratory problems, improve clinical services through creative thinking and problem solving, explore the numerous unknowns of post-TB lung and other lung diseases, and build sustainable capacity in Africa to meet ever-expanding clinical needs.
However, he also remains philosophical about what drives him, and others, in our profession: “The world needs people who are passionate and work hard, take pride in what they are doing, and do it with integrity and without a sense of entitlement, but to make a real impact in the lives of those less fortunate than ourselves. The constant chasing after achievements and accolades for one’s own sake, is like pursuing the ‘pot of gold’ at the end of a rainbow: it will keep you busy but will never be enough and will ultimately leave you disillusioned and discontent.”