Dr Jamie Rylance

Jamie is a consultant physician in Respiratory and General Internal Medicine. He has recently taken up a Wellcome Trust Clinical Fellow position on a project investigating the causes of harm from intravenous fluids in sepsis in Africa. He has a longstanding interest in acute care and infection in Low Income Countries. For two years he has worked in Tanzania as a Medical Officer with VSO. This work focussed on health service development, particularly on the quality of medical care given to critically unwell patients. His PhD was funded through the Wellcome Trust, and undertaken in Malawi.

Jamie is returning to Malawi to take up the new fellowship addressing the question: “how can we direct fluid therapy to those who stand to benefit from it, and away from those to whom fluids are likely to be detrimental?” The work will recruit patients with suspected infection and cardiovascular instability: they will be intensively monitored to identify changes in their macrovascular and microvascular perfusion and outcomes during and after initial fluid resuscitation.

Jamie co-directs the African Research Collaboration on Sepsis which investigates acute care for those with severe infection in Uganda, Malawi and Gabon. Experience of a semi- rural hospital has been massively influential: giving high quality care is partly resource dependent, but improvement must also be driven through a supportive and self-critical working environment. ARCS is exciting, as it has the potential to improve both local resources and training.