Warren, Grace (1929 - )

Summary

Dr Grace Warren, a surgeon and missionary, challenged conventional wisdom by undertaking research and developing surgical procedures to better understand and treat neuropathic limbs caused by diabetes, leprosy or other nerve-affecting conditions.

Details

Though Warren was drawn to surgery as a student, she was trained in obstetrics, as females were unable to study surgery formally at the time of her medical education in the 1950s. On completion of her three hospital positions, St George, Queen Victoria in Melbourne and Geelong, providing good experience, hands on, in a wide range of medical areas, she completed her Diploma of Tropical Medicine and then took up a position in Korea as locum tenens at a women's hospital run by the Australian Presbyterian Mission. During her 18 months in Korea she developed a passionate interest in the treatment of sufferers of leprosy. Subsequently, her next locum position was at the Leprosy Hospital in Hong Kong, on the island of Hay Ling Chau. When she commenced there in 1959, the facility lacked a surgeon to staff their newly established reconstructive surgery unit, and so Dr Warren herself was trained in basic surgical procedures by a fellow physician. She was keen to master these skills and so augmented this training by reading all she could in text books. In the same year she hypothesized and then proved that by applying a plaster cast to a neuropathic foot for a prolonged period of time it was possible to heal fractures previously considered treatable only through amputation. Her skills in surgery also soon became apparent, and she rapidly became sought out to instruct doctors and surgeons in surrounding countries.

In 1962 she became a permanent staff member at the Hay Ling Chau Leprosy Hospital where she continued to successfully treat countless cases, all the while documenting her research and development of treatments. In 1972 she submitted this research work to the University of Sydney and was awarded a Master of Surgery. The Hay Ling Chau Leprosy Hospital was closed in 1975, but she continued to teach throughout Asia on behalf of the Leprosy Mission International until early in the 21st centaury. From 1964 this was fulfilled by constant traveling in order to teach all levels of local medical staff to be able to utilise the materials that they had available, to meet the needs of their patients. This proved much more satisfactory in spreading the modern methods of rehabilitation, than the old routine of send the senior medical officer, of the center, to one of the main Leprosy Teaching centers as all staff benefited and we could help them to adapt what they had available to minimise the needs to import materials etc. Hence reduce the financial costs needed to upgrade the leprosy service.

In 1989 she was officially retired from full time overseas service with the Leprosy Mission International, but because of repeat requests to go and help she continued to work overseas for many months each year until 2012, working in a total of 26 countries. In this period of time she acted as consultant and teacher for leprosy clinics in several states of Australia. From 1989 she found that during the intervals when she was in Australia she could share her experiences relevant to any other people with neuropathy, especially diabetic patients and others with foot problems due to loss of sensation or muscle power, eg CMT. This was a period when diabetes was becoming more common and the effects of the neuropathy were just being appreciated.

While still teaching throughout Asia, in order to spread the knowledge of the effective treatment she had pioneered she also took part in seminars, when in Australia, for Australian doctors and surgeons. This work culminated in the publication, with the co-operation of Professor Sydney Nade of The Care of Neuropathic limbs- a Practical Manual in 1999. Dr Warren continued to assist, consult and teach in surgery and Leprosy, in Asia and Australia, into her mid eighties.

Chronology

January 1954

Education - Graduated with MB BS, University of Sydney

1954

Career event - Junior Resident Medical Officer, St George Hospital, Sydney

1955

Career event - Resident medical officer at Queen Victoria Hospital for Women, Melbourne

1956

Career position - Registrar, Geelong Hospital, Victoria

1957

Education - Diploma of Tropical Medicine and Hygiene, University of Sydney

October 1957 - March 1959

Career position - Locum tenens for the superintendent of the Australian Presbyterian Mission Women's Hospital, Pusan, South Korea

May 1959 - 1960

Career position - Locum tenens at the Leprosy Hospital on Hay Ling Chau Island, Hong Kong

1960

Career event - Acting Superintendent of Hong Kong Leprosy Hospital

May 1960

Career event - Trip to teach leprosy and rehabilitation surgery in Taiwan

1961

Career position - Medical Superintendent of Hong Kong Leprosarium

1962

Career event - Became a full member of the Leprosy Mission International, working primarily as Superintendent at Hong Kong Leprosarium but also regularly travelling and teaching in other Asian centres.

1972

Education - Master of Surgery for thesis on the healing of neuropathic bones, University of Sydney

1977

Award - Elected Fellow, Royal Australasian College of Surgeons

1982

Career event - Requested to go to the refugee camps on the Thai-Cambodian border to advise on case of leprosy patients - resulted in a trip every three months for about nine years to carry out rehabilitation surgery for leprosy and other refugees with deformities and disabilities requiring surgery that was not usually carried out by regular surgeons.

1983

Award - Elected Fellow, Royal College of Surgeons of England

1984

Award - Honorary Doctor of Medicine (MD), University of Sydney

1986 - 1987

Career event - Professorship of the Royal College of Surgeons of England, with presentation of the professional lecture in early 1987 entitled "The Conservative Management of the Neuropathic Foot"

26 January 1986

Award - Appointed Member of the Order of Australia (AM)

1989

Life event - Official retirement at the end of the year from the Leprosy Mission International, with arrangement to continue to travel as their representative as requested by field institutions.

1999

Career event - Published The Care of Neuropathic Limbs - a Practical Manual, written with Professor Sydney Nade

1999

Award - Inaugural Sir Edward Hughes Award of the Royal Australasian College of Surgeons

2005

Career event - Delivered the Weary Dunlop Memorial Lecture, Royal Australasian College of Surgeons.

2005

Award - Awarded the Star of Pakistan for Humanitarian Services in Pakistan, namely reaching and carrying out leprosy medicine for a period of over 37 years. Warren received the award in 2006 as she had been unable to travel to Pakistan in 2005.

2006

Career event - Published Autobiography Doctor No. 49, written with Leslie Hicks

Related entries

Published resources

Encyclopedia of Australian Science and Innovation Exhibitions

• McCarthy, Gavan; Morgan, Helen; Smith, Ailie; van den Bosch, Alan, Where are the Women in Australian Science?, Exhibition of the Encyclopedia of Australian Science and Innovation, First published 2003 with lists updated regulary edn, Australian Science and Technology Heritage Centre, Melbourne, Victoria, 2003, https://eoas.info/exhibitions/wisa/wisa.html. Details

Books

• Nade, S.; and Warren, G., The Care of Neuropathic Limbs - a Practical Manual (United Kingdom: Parthenon Publications, 1999). Details

Book Sections

• Joshua, J.; Schwarz, R.; and Warren, G., 'Radial Nerve palsy' in Surgical Reconstruction and Rehabilitation in Leprosy and other neuropathies, R Schwarz and W Brandsma, eds (Nepal: Ekta, 2004). Details
• Schwarz, R.; and Warren, G., 'Surgery of the nose and other aesthetic surgery' in Surgical Reconstruction and Rehabilitation in Leprosy and other neuropathies, R Schwarz and W Brandsma, eds (Nepal: Ekta, 2004). Details
• Warren, G., 'Surgery of Leprosy' in Primary Surgery, Vol. 1 Non-Trauma, King, Maurice, ed. (Oxford Medical Publications, 1990), pp. 508-526. Details
• Warren, G., 'Leprosy' in Surgery for all - A view from the developing world (Lahore, Pakistan: Ferozsons Ltd., 1992). Details
• Warren, G., 'Tendon transfers in the hand' in Atlas of Hand Surgery, Bruce Conolly, ed. (Churchill Livingstone, 1997). Details
• Warren, G., 'The Foot in Leprosy - Lessons for diabetes' in The Foot in Diabetes, Andrew J.M. Boulton, ed. (Wileys, 2000). Details
• Warren, G., 'Neuropathic feet' in Surgical Reconstruction and Rehabilitation in Leprosy and other neuropathies, R Schwarz and W Brandsma, eds (Nepal: Ekta, 2004). Details
• Warren, G., 'Lower Leg Transfer Procedures' in Text book of tropical Surgery, R Kamel and J Lumley, eds (2004), pp. pp 800-801. Details
• Warren, G., 'Mobility in Lower Limb paralysis' in Text book of tropical Surgery, R Kamel and J Lumley, eds (Westminster Publishing Co., 2004), pp. pp 799-800. Details
• Warren, G., 'Care on Neuropathic feet' in Text book of tropical Surgery, R Kamel and J Lumley, eds (Westminster Publishing Co., 2004), pp. pp 790-797. Details
• Warren, G., 'Appendix C - Skin Care/ Self-care Training' in Surgical Reconstruction and Rehabilitation in Leprosy and other neuropathies, R Schwarz and W Brandsma, eds (Nepal: Ekta, 2004). Details
• Warren, G., 'Appendix D - Removable Modified Total Contact Cast' in Surgical Reconstruction and Rehabilitation in Leprosy and other neuropathies, R Schwarz and W Brandsma, eds (Nepal: Ekta, 2004). Details
• Warren, G., 'Trial Walking' in Surgical Reconstruction and Rehabilitation in Leprosy and other neuropathies, R Schwarz and W Brandsma, eds (Nepal: Ekta, 2004). Details

Journal Articles

• Haverson, G.; and Warren, G., 'Tarsal Bone Disintegration in Leprosy', Clinical Radiology, 3 (1979), pp. 317 - 322. Details
• Nade, S.; and Warren, G., 'Ulcers in Diabetic Feet: An Orthopaedic not a Vascular problem', New Zealand Journal of Surgery, 70 (2000), 613 - 615. Details
• Taylor, P.; and Warren, G., 'The effects of Cocktail Anaesthesia on Blood Pressure', Leprosy Review, 44 (1972?), pp. 83 - 89. Details
• Warren, G., 'Radiographic examination of the feet', Leprosy Review, 44 (1973), pp. 131-138. Details
• Warren, G., 'A study of the Incidence and Outcome of foot weakness in Leprosy', Leprosy Review, 44 (1973), pp. 203-212. Details
• Warren, G., 'Letter - Re: Hypervitaminosis A and Leprosy neuritis', Leprosy Review, 44 (1973), pp. 220-222. Details
• Warren, G., 'The bacterial load in the noses of Chinese leprosy patients', Leprosy Review, 44 (1973), pp. 183 -185. Details
• Warren, G., 'Letter- Re: Bacilli In Nasal Mucosa', Leprosy Review, 46 (1975), pp. 136 - 137. Details
• Warren, G., 'Series of three articles on Leprosy Management, with special accent on Physiotherapy', Pakistan Journal of Physiology (1975-1976). Details
• Warren, G., 'Letter - Re: Toxicity of Clofazimine', Leprosy Review, 47 (1976), pp. 342 - 343. Details
• Warren, G., 'Clinical assessment and management of dapsone resistant Leprosy for the Field Worker', Leprosy Review, 48 (1977), 113-121. Details
• Warren, G., 'Series of over 10 articles, plus "Questions answered" column, on various aspects of leprosy care, in Partners-Magazine for paramedical workers.' (1977-1989). Details
• Warren, G., 'Letter - Re: Dapsone and nerve damage', Leprosy Review, 51 (1980), 94-97. Details
• Warren, G., 'The Surgical Conservation of the Neuropathic Foot', Annals of the Royal College of Surgeons of England, 71 (1989), pp. 236 - 242. Details
• Warren, G., 'Facial palsy - a Leprosy Surgeons View Point', Australia and New Zealand Journal of Ophthalmology, 18 (3) (1990), pp. 257 - 268. Details
• Warren, G., 'Save our Soles', Bulletin of the Royal Australian College of Surgeons, 11 (23) (1991), pp. 24-25. Details
• Warren, G., 'Conservative Amputation of the Neuropathic foot. The Pirogoff Procedure', Operative Orthopaedics and Traumatology, 9 (1997), 49 - 58. Details
• Warren, G., 'Report on Workshop on "The Neurologically Impaired Foot".', Leprosy Review, 72 (2001). Details
• Warren, G., 'Practical management of neuropathic feet', Tropical Doctor, 32 (2002), 201-205. Details
• Warren, G., 'Diabetic Neuropathy', Tropical Doctor (2002), pp. 194-5. Details
• Warren, G., 'A different approach to the care of the diabetic foot', Medicine Today, 4 (2003), pp 52-60. Details
• Warren, G., 'Controlling callus - Practical procedure', Medicine Today, 4 (4) (2003), pp 95-97. Details
• Warren, G., 'A different approach to the care of the diabetic foot', Medicine Today (2005), pp 52-59. Details
• Warren, Grace, 'A method of medical tarsorrhaphy for correction of Lagophthalmos and ectropion', Leprosy Review, 37 (1966), 217 - 218. Details
• Warren, Grace, 'Modern Advances in Leprosy Treatment', Far East Medical Journal, 2 (1966). Details
• Warren, Grace, 'Measurement of Skin Clearance in Leprosy Patients', Far East Medical Journal, 3 (1967). Details
• Warren, Grace, 'The Correction of Foot Drop in Leprosy', Journal of Bone and Joint Surgery, 50B (3) (1968), 629 - 643. Details
• Warren, Grace, 'A Preliminary Report of the use of B663', Leprosy Review, 39 (1968), 61 - 66. Details
• Warren, Grace, 'Problems of Rehabilitation of Leprosy Patients', Rehabilitation in Asia (1969). Details
• Warren, Grace, 'New Trends in Leprosy Treatment', Far East Medical Journal, 5 (1969). Details
• Warren, Grace, 'A Foot drop spring', Leprosy Review, 41 (1970), 100-102. Details
• Warren, Grace, 'The use of B663 in the treatment of Chinese Leprosy Patients with Chronic Reaction.', Leprosy Review, 541 (1970), 74-82. Details
• Warren, Grace, 'Patterns of Tarsal Bone Disintegration in Leprosy Patients. Thesis, Master of Surgery' (1971). Details
• Warren, Grace, 'Tarsal Bone Disintegration in Leprosy', Journal of Bone and Joint Surgery, 53B (4) (1971), 668 - 679. Details
• Warren, Grace, 'Facets of leprosy of Orthopaedic Interest', Australia and New Zealand Journal of Surgery (reprinted in same journal in 2008.), 40 (3) (1971), 296 - 298. Details
• Warren, Grace, 'Plaster casts', Leprosy Review, 42 (1971), 55 - 59. Details
• Warren, Grace, 'Are Deformities Stigmatising? A Surgeon's Approach', Leprosy Review, 43 (1972), 74-82. Details
• Warren, Grace, 'The Management of Tarsal Bone Disintegration', Leprosy Review, 43 (1972), 137-147. Details

Resources

• 'Warren, Grace (1928-)', Trove, National Library of Australia, 2009, https://nla.gov.au/nla.party-900057. Details

Teaching resources

• Tomlan, J.; and Warren, G., Making Polyethylene Resting Splints (Booklet) (London: ). Details
• Warren, G., Care of the Nerve Damaged Limb - TALC set with commentary (1984). Details
• Warren, G., Leprosy lesions in Skins of different colours. TALC slide set with commentary (1984). Details
• Warren, G., The assessment and management of neuropathic limbs. (USA: 1988). Details