Wellcome Film of the Month: The Wellcome Trust in Thailand (1987)

This week we launched a 20 year review of research into malaria, coinciding with World Malaria Day. This film portrays the work of the Wellcome Trust-supported clinical research unit based in Mahidol University, Bangkok, Thailand. The film was made in 1987 and illustrates the ground breaking work led by this unit on cerebral malaria (the most fatal form of this disease), rabies and snake-bite.

The Wellcome Trust’s Major Overseas Programmes were established to create regional centres of clinical excellence with the objective of creating local health benefits for patients and clinical research developments that improve health globally, particularly in countries where tropical diseases are endemic.

At the time the film was made, there were five Wellcome Trust-funded regional centres with one unit and a number of related field stations in southeast Asia. These field stations have evolved into new centres in Vietnam and Laos with new challenges. The clinical research centre in Vietnam is led by Paul Newton with a focus on counteracting the emerging problem of fake antimalarial drugs that lead to drug resistance.

The film provides an insight into the research activities of the unit in Bangkok, which was established in 1979 by David and Mary Worrell from the University of Oxford. Within the region covered by the unit, there existed geographically significant pockets of disease due to political, social and economic factors. The field stations could study these issues at close hand.

In the northwest of Thailand, close to the modern Bridge over the River Kwai (the original bridge was made famous in the 1957 David Lean movie of the same name), are sapphire mines. The technique of open mining leads to pools of water forming in the rainy season and providing a breeding ground for malaria-carrying mosquitoes. It is the newest immigrants to the region, attracted by work, who are most severely affected as they have less immunity to these strains of malaria; there are scenes of a man who is unconscious with malaria affecting his brain. Apparently, 50 per cent of people with malaria of this type died at this point in time.

The film also outlines the various new drug treatments available. The field station which was originally based at Shoklo is now located at Mae Sot but retains its original name. The Making Of-Shoklo Malaria Research Unit-Thailand, a film made earlier this year by the Unit and our Public Engagement team, describes the unit’s activity and their collaborative approach with local communities – they support community engagement with health issues by using film. Three of its key achievements over the last two decades have been the description of the effects of malaria in pregnancy, the development of a system of antenatal care that has eliminated maternal malaria related mortality and the establishing the safety of artemisinin derivatives in pregnancy.

The 1987 film then continues by outlining the problem of rabies in Thailand. Stray dogs are shown being caught by dog catchers, then a woman with rabies is shown – she has hydrophobia (she is terrified of drinking water), symptomatic of the disease. Rabies is treatable with a vaccine developed by Louis Pasteur and Emile Roux in 1885. However, the treatment has to be given soon after exposure (the consequences of delaying treatment are evident in another film in the collection, Rabies, 1930, which depicts the tragic case of a young boy with rabies).. The rabies vaccines available in Thailand are derived from sheeps’ brains and are similar to those of Pasteur’s time. The research unit has shown that the expensive, but potent, vaccines can be used economically and effectively if injected into eight sites on the body.

In southern Thailand venomous snakes are a hazard to people. In this area there are rubber plantations and in the early morning the rubber tappers go barefoot to extract latex from the trees. There are a number of dangerous snakes in the region; kraits, cobras and vipers. A boy is shown who has been bitten by a Malayan pit viper and as long as the type of snake can be identified, then the correct anti-venom treatment can be administered. (Snake venom as a topic of interest to medical researchers is evident in another earlier film in the collection, Venomous snakes – medical aspects, 1950 which outlines the classification of snakes, many of which are not dangerous to people). A sample of the venom can be taken and then tested – some of these tests were pioneered by scientists at the Liverpool School of Tropical Medicine. The film suggests that in the future, it may be possible to genetically engineer vaccines to protect people most at risk of the deadly effect of snake venom.

More malaria films from the archive in this post. Read about our 20 year review of the malaria field in our World Malaria Day 2012 posts

Find out more about malaria research on the Wellcome Trust Malaria website.

You can see key malaria-related developments in this ‘Landmarks in malaria’ timeline [PDF 248KB].

Angela Saward, Wellcome Film

You can learn about the Wellcome Film project here. If you would like to make use of this archive footage in your own projects, please visit the Wellcome Library catalogue to download the original files, which are distributed under a Creative Commons Attribution-Non-Commercial 2.0 UK: England & Wales licence.