Andrew was an outstanding tropical clinician who never spared himself in the care of his patients, most of whom were poor and disadvantaged. He was born in Edgware, Middlesex. He came from a distinguished family. His grandfather, James Trigue Crowden, was a doctor. His father, Guy Pascoe Crowden, was professor of applied physiology at the University of London.
Andrew attended Felsted School in Essex and later St.Thomas’s Hospital Medical School, London. He qualified in 1948. After preregistration posts at St.Thomas’s and the Grosvenor Hospital for Women, he was called up for National Service in the RNVR. He served as surgeon lieutenant on HMS Bulawayo, Home and Mediterranean Fleets, and on HMS Wild Goose and HMS Wren in the Persian Gulf. He then became a medical officer in the State Medical Service, Bahrain, for two years from 1952. In 1954 he returned to London and was a senior registrar to Alan Woodruff [Munk’s Roll Vol.IX, p.602] at the Hospital for Tropical Diseases. While there he gained his membership of the College.
In 1956 he returned to Africa with the Inter-University Council as lecturer and later senior lecturer at the University of Khartoum and honorary consultant physician at Khartoum Civil Hospital.
In 1961 he moved to what was then Tanganyika where he was consultant physician at the Muhimbili Hospital, Dar es Salaam. In 1966 he was appointed senior consultant physician and honorary lecturer in medicine at Dar es Salaam faculty of medicine.
From there he went to work in 1969 for the government of Uganda at Jinja Hospital as consultant physician. When Idi Amin came to power, he was one of the many who were forced to leave at very short notice, leaving all his possessions behind. He lost his collection of Makonde sculptures and his precious library which included books he had inherited from his father and other rare books such as first editions of Richard Burton. His medical records were also lost.
In 1975 he became specialist physician at the Royal Victoria Hospital, Banjul, in the Gambia, where he stayed for ten years. His wide range of duties there included acting as consultant psychiatrist, visiting the psychiatric hospital. He provided a forensic service to the government which sometimes involved dealing with violent patients. He was fortunately on home leave from the Gambia during the coup in 1981. One of his patients, a convicted murderer, came with a gun to search the hospital for him. This man had failed to appreciate that he had been spared the death penalty because Andrew had declared him unfit to plead.
While he was in the Gambia, his services to the medical community in East and West Africa were officially recognized in 1977 when he was appointed OBE. He was the third member of his family to be so honoured; his father and brother preceded him. He chose to receive this honour in the Gambia. An unusually large number of Gambian and expatriate colleagues gathered with friends to congratulate him and show their appreciation of his work.
His last appointment in 1985, as a consultant physician to the government of the Seychelles at Victoria Hospital, Mahé, was less happy. Years of heavy smoking had damaged his health. He was invalided home with pulmonary tuberculosis in December 1986 and later had a coronary by-pass operation. He was eager to return to work, preferably in Africa, but by this time chronic obstructive airways disease severely restricted his activities.
He had no home of his own in England. He went to live in Stanmore with his mother who was becoming increasingly frail. This enabled her to continue living in her cottage. Together they had made a beautiful garden where Andrew cultivated many unusual plants which gave him much pleasure. He was knowledgeable about gardens, plants and their history. Andrew was able to enjoy some time in London, seeing colleagues and friends, visiting the Royal College of Physicians, enjoying museums and art exhibitions.
He published very little which he regretted as did those who knew and valued his wide experience. He perhaps never completely recovered from the disappointment of losing everything in East Africa. Many of his observations were included in official reports; he made environmental studies particularly on sodium requirements during his naval service in the Persian Gulf. Among the records lost in Uganda was a study on variations in malaria incidence in hospital patients. In the Gambia the responsibility of looking after the medical services in the main hospital in the country left him with little time or energy for collecting data or writing. He contributed to studies carried out at the Medical Research Council, Banjul, on hepatitis B and primary hepatocellular carcinoma in a prospective study of the effects of hepatitis B vaccination on liver disease.
He set high standards of practice with limited resources and was an advocate of appropriate technology. He gave wise advice to those who asked for it and was much consulted by senior health officials in the countries where he worked. He was generous in the encouragement and help he gave to younger colleagues. He regretted that young doctors who went to work in the tropics were often given so little credit for the experience they had gained when they returned to work in England. He was intolerant of what he called humbug, which included hypocrisy and all forms of self seeking at the expense of others, and was impatient with what he saw as foolishness.
He was unmarried. He was on close terms with his mother, brother and two sisters and their families. He was widely read and knowledgeable on many subjects. He loved books and had accumulated another large collection. He died while unpacking this in his new home in Dorset where he had been persuaded to move to be nearer his sister and her family after the death of his mother.
Andrew Ajdukiewicz
[Brit.med.J.,1997,315,818]