Judith Darmady: supercharged childcare visionaryJohn Illman

London, UK

It is hard to imagine how a consultant paediatrician fromBasingstoke initially reacted to the horror of seeing children soundernourished it was hard to tell how old they were. There wasonly one spoon in each room, meaning that the strongest childrenhad the most food. The weakest were left to grab at titbits on afloor wet with urine. Toddlers with bone stick arms and legswere tied to their beds. Starving babies were unattended. Nakedolder children had shaved heads. The death rate was inevitablyhigh.

Romanian orphanages and internationalworkThis is what Judith Darmady found in 1990 in the remote villageof Ungureni, north of Bucharest, in one of Romania’s 29infamous orphanages for “incurables.” She had answered anappeal from the Romanian Orphanage Trust for a consultantpaediatrician who specialised in caring for children with specialneeds.How did Darmady react to the legacy of the 25 year regime ofrepression by Romania’s communist leader Nicolae Ceausescu?Did she wilt? She did not. A nursing friend, Jane Waldram,described Darmady as being “mentally built like a tank.” It washard to reconcile her irrepressible energy with her plump, shortstature (she was less than five feet tall) and her age. Most of her100 or so Romanian trips were made in her retirement. She alsohad a formidable reputation for rising to challenges.

Few challenges were more daunting than the 100 000 abandonedRomanian children classified as incurable. Fired by the Stalinisttheory that a large population would generate rapid economicgrowth, Ceausescu outlawed contraception and abortion, exceptin women over 40 with four or more children, and taxedchildless couples. The inevitable population explosion led tolegislation subjecting abandoned children to perfunctory testsat the age of three. Those who failed were deemed incurableand hidden away from public view.

john@jicmedia.org

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Knowing that something bigger was needed after her firstRomanian trip, Darmady set up the Ungureni Trust to pay forBritish physiotherapists, occupational therapists, special needsteachers, nurses, and junior doctors to help Romanian childrenand their carers. Everyone benefited. The British teams had theirhorizons stretched; the Romanian carers had their eyes openedto knowledge and training denied to them in the Ceausescuyears.The trust developed models of good practice for the region.These included establishing houses for disabled teenagers wholearnt farming skills and how to grow fruit and vegetables.Children were also taught basic but critical skills such ascooking, washing clothes, handling cash, and how to cross abusy road.The Ungureni Trust revealed another of Darmady’s strengths.Highly persuasive and a great charmer and motivator, she couldhave been a professional fundraiser. But she was primarily adedicated frontliner who demanded the same total commitmentfrom her teams. For example, one afternoon in Romania, justbefore Christmas, she was horrified to see two British colleaguesup a tree. In a rare loss of temper, she bawled, “What are youdoing up there? You’re meant to be working.” She pardonedthem immediately when they explained they were pickingmistletoe for the children.After the Ungureni orphanage closed in 2001, Darmady donated£50 000 (€56 400; $61 000) of her own money towards a centrefor the elderly. She is also believed to have paid for a Romaniansurgeon’s study tour in France and the USA. He is now aneminent surgeon who in turn is teaching surgery outsideRomania.

Other countriesRomania was but one of many countries on which Darmadystamped her mark in retirement. In Ecuador she evaluatedproposals and programmes for premature baby units. In Indiashe provided paediatric support aboard the Lifeline Express,the world’s first hospital train, which carried specialists toremote regions to treat conditions such as cataract and cleftpalate. Colleagues said that she would never go to an airportwithout meeting at least one acquaintance.

Darmady was also a founder member of the Basingstoke HoimaPartnership for Health charity, which established links betweenthe Hampshire Hospitals Trust and Hoima Hospital in Uganda.

Nowhere was Darmady’s resourcefulness tested better than inUganda. She arrived at a down-at-heel hotel with an erraticelectricity supply, needing a reliable power supply for her sleepapnoea device. Not for the first time, colleagues wonderedwhether this 75 year old doctor should be in East Africa at all.She was unperturbed. Disappearing to a nearby garage shereturned with a wry smile and a secondhand car batterythat—maybe against all odds—worked.

Early life and careerPerhaps she inherited her inventiveness from her father, Michael.He trained in pathology but led the construction and first clinicaluse of an artificial kidney machine in the UK, the introductionof central sterile supply services for hospital equipment anddressings, and the application in renal histopathology of thetechniques of microdissection and single nephronautoradiotherapy.With such a medical pedigree, it may seem surprising that Judithstood out as a kind, compassionate doctor and not a laboratorybased scientist. Her niece Lucy said, “She was a people person.She liked anything where people were central and was aninspirational fundraiser.” Retired hospital worker Jane Frankum,former mayor of Basingstoke and Deane, said, “She had nochildren herself and so all her patients became her children,without her taking anything away from their parents.”Educated at Godolphin School, Salisbury, where she was latera governor, Darmady qualified at St Bartholomew’s Hospital,London, in 1961. Dr D, as she became known to patients andparents, worked at the Cleveland Clinic, Ohio, between 1964and 1966.Darmady returned to the UK as a senior lecturer in child healthat Southampton General Hospital and as a research fellow atthe Institute of Child Health in London. Her interests includedcholesterol in infancy. In 1972 she took up her Basingstokeconsultancy. Her contract included community paediatricssessions, the first such contract in Wessex and perhaps in theUK.During her outstanding 23 years in Basingstoke, she developedextensive expertise in a wide range of conditions—includingcancers, cystic fibrosis, and disability—and raised concern aboutchildhood sexual abuse, resulting in the development ofspecialist services in Hampshire. In 1996 she became a foundingfellow of the Royal College of Paediatrics and Child Health.Darmady was as active in Hampshire in her later years as shewas internationally. In 2007, for example, she became a patronfor Home Start West Hampshire, which provided support tomore than 100 vulnerable families in 2017-18.In 2010 she became an OBE. In 2012 she was runner-up in theTimes Sternberg Award, which honours the achievements ofpeople over the age of 70. She will be remembered as a visionarywho brought together hundreds of healthcare professionals tocare for vulnerable children in some of the world’s mostdeprived regions.What made Darmady’s achievements more remarkable was thatshe had dyslexia. Numbers were a problem. Her Basingstokesecretary for 27 years, Ms Berry Lamden, resolved to “organiseJudith,” but was warned that “this would never happen.” Withhindsight she accepts that this was good advice.A spokesperson for United Aid for Azerbaijan said: “There aremany children all over the world who have better lives thanksto the influence of this amazing warrior.”

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Darmady leaves her sister, Sarah, and brother, John; two nieces,Lucy and Fiona; two nephews, Simon (a consultant anaesthetist)and Peter; and 22 godchildren.

BiographyJudith Mary Darmady (b 1935; q London 1961; OBE, MRCSEng, LRCP Lond, DCH Eng, FRCP Lond, FRCPCH), died fromcovid-19 on 13 April 2020Published by the BMJ Publishing Group Limited. For permission to use (where not alreadygranted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

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