Neil Hamilton Fairley was born in the small Victorian town of Inglewood - about twenty miles north-west of Bendigo - a satellite boom town of pioneers in the goldrush days. He was one of four brothers who became doctors. The medical tradition continued in the family. Two of Neil Fairley's three sons qualified medically, one of whom was Gordon, who had been offered the position of foundation director of the Ludwig Institute of Cancer Research, University of Sydney, but who died tragically in 1975 from an IRA bomb explosion in a London street, before he could let it be known whether he wished to accept the appointment. One of Neil's brothers, Keith, was a Melbourne physician and a Fellow of the College, as also is Keith's son, Kenneth.
Neil was educated at Scotch College, Melbourne where he was dux. He graduated in 1915 from the University of Melbourne with first-class honours, and a reputation in sport, having won the Australian university high jump and represented Victoria in tennis. He became a resident medical officer at the Melbourne Hospital. At this early stage of his career he was involved in the investigation of an epidemic of cerebrospinal meningitis at Broadmeadows camp. From this work his first publications issued as two joint papers in a Commonwealth monograph.
Fairley enlisted in the AIF and left for Egypt in 1916 as the pathologist, with the rank of captain, in 14 Australian General Hospital. He encountered CJ (later Sir Charles) Martin, CMG, MD, DSc, FRS, professor of physiology at University of Melbourne, and by then director of the Lister Institute in London, who had initiated research of medical problems in the Middle East in 1915. This discipleship with Martin led to a lifelong enthusiastic acceptance of the fruitful symbiosis of clinical and laboratory observations which was characteristic of his whole career. It impressed on him the necessity of team work which he so successfully pursued in peace and war.
In Egypt schistosomiasis, a serious menace to the Allied troops, engaged his attention. Fairley identified antibodies in the serum of infected persons, and developed a complement fixation test which is still in use. Classical publications on schistosomiasis resulted, and also papers on the dysenteries and typhus. He became interested in the anaemia of chronic malaria and the potential for malaria to be responsible for military catastrophe. He reached the rank of lieutenant-colonel, was mentioned in dispatches, and in 1918 was awarded the OBE. He was then aged twenty-seven.
In London after the war, he worked with Martin at the Lister Institute, qualified as a Member of the Royal College of Physicians and took the Cambridge Diploma of Tropical Medicine. In 1920 Fairley returned to Melbourne to become first research assistant, briefly, to Dr Charles Kellaway, director of the newly established Walter and Eliza Hall Institute. His departure that year to the Tata chair of clinical tropical medicine in the projected University of Bombay opened new and wide horizons. However the plan for the department was abandoned, leading to his appointment to the Haffkine Institute. There he left his mark largely in the area of tropical sprue of which he became a victim but from which the physician `healed himself’. Fairley was the first to introduce a high protein diet for the disorder. Malaria and guinea-worm disease claimed his attention and resulted in further important contributions.
He had earlier married Violet Mary Phillips and had one son. Their marriage was dissolved. In Bombay he married Mary Greaves, his second wife and devoted life-long companion. After three years in India, suffering severely from tropical sprue, he returned to England and slowly recovered helped by his own treatment. Melbourne reclaimed him, and he rejoined the Hall Institute in 1926. Here he did notable work with Kellaway in snake-venoms, and with Harold Dew, a surgeon at the Melbourne Hospital (later Sir Harold Dew, professor of surgery, University of Sydney), on hydatid disease, developing the hydatid complement-fixation test.
Fairley returned to England in 1928, establishing himself as a consultant in tropical medicine in Harley Street, with an appointment to the teaching staff of London School of Hygiene and Tropical Medicine, and as physician to the Hospital of Tropical Diseases where he also became director of pathology. His research interests continued, notably in malaria. A series of visits to Macedonia to investigate the prevalent anaemia in the hyperendemic malarial areas led to his discovery of methaemalbumin, a previously unknown blood pigment resulting from intravascular haemolysis. This, perhaps his masterpiece in pure research, was the principal reason for his election to the Royal Society in 1942.
His stature grew not only as a researcher and lecturer (School of Hygiene and Tropical Medicine, Westminster Hospital Medical School, Royal Free Hospital) but as an eminent consultant. At the outbreak of World War II in 1939 he enlisted in the Second AIF, being appointed on 22 February 1940 consultant physician to the Australian forces in the Middle East with the rank of colonel. His stature was unchallengeable as a physician in tropical medicine and a researcher. He had the inestimable advantage of belonging to two worlds in several senses - clinician and scientist, Australian and expatriate in England - and he was also appointed as consultant physician in tropical diseases to the British forces in the Middle East.
The dysenteries - amoebic and bacillary - were rife in all war theatres of the Middle East. Working with JSK Boyd he established diagnostic methodology and set up the first chemotherapy clinical trials. It was soon evident that sulphaguanidine reduced mortality to insignificant numbers and provided a rapid cure - events which were to be of profound importance in the management of dysentery on the Kokoda Trail in New Guinea in 1942. When the AIF returned to Australia in 1942 after the entry of Japan into the War, Fairley was appointed Director of Medicine with Colonel HH Turnbull (an old Melbourne Hospital friend and colleague) and Colonel AS Walker as regional consultant physicians. Fairley was thus able to give his full attention to the principal secondary enemy - tropical diseases. His promotion to brigadier came through in 1942. He regarded himself always as a doctor-scientist in khaki and could never assume the `insolence of office’. Within the AAMC he was on easy terms with all the officers - his professional colleagues - regardless of rank or age. But never servile, he always felt free to speak, within the wide area of his professional competence, to the High Command.
Thus in January 1941 when the Greek campaign was being planned, in the face of stern criticism, if not petulance, by General Wavell, Fairley and Boyd finally persuaded him in an uncomfortable conference, that the proposed large-scale operation in Macedonia invited intolerable malarial casualties. Modifications were then made to mitigate the risk of malaria and although a military disaster followed, it was not a malarial catastrophe. Frequently and forcefully supported by General Burston, Majors E Ford and EV Keogh, Fairley had close contacts with General Blamey who held him in high esteem and to whom he gave invaluable and compelling advice on high medical strategy.
His unique contribution to the AIF, indeed the Allied cause, was to ensure the effective prosecution of the Islands campaign which was imperilled by malaria. Early in 1943, on his recommendation, interallied co-operation was strengthened when the Supreme Commander, General MacArthur, established a Combined Advisory Committee on Tropical Medicine Hygiene and Sanitation. Fairley was appointed chairman. A Medical Research Unit directed by Fairley was established at Cairns as a result of strong pressure from the DGMS, with the agreement of General Blamey and with the blessing of the Prime Minister, John Curtin. Fairley's unique knowledge, vision and tenacity were matched by his uncommon strength of character in delegation. He was inevitably based at Land Headquarters in Melbourne, and as Director of Medicine his parish took in the whole of Australia and the Islands - his responsibilities immense. His genius planned, devised, directed and, above all, won the complete confidence of those at Cairns Unit and its complementary unit in 2/2 AGH on the Atherton Tableland.
The details of the work are fully reported in the medical literature and in the monumental authoritative medical volumes of the official war history by Colonel AS Walker. It was proved beyond all doubt that atebrin in adequate doses (0.6 gramme per week) would suppress benign tertian and act as a causal prophylactic and cure for malignant tertian malaria. As a result, orders from General Blamey were promulgated to ensure that the proper dosage was taken and to place the responsibility with the unit commanders. The effects were dramatic. In some battle areas the malaria rate had been 2496 per 1000 per annum. The general rate fell from 740 per 1000 in December 1943 to 26 per 1000 by November 1944. Lord Mountbatten in Burma, Supreme Commander for South-East Asia, also adopted the Australian orders, and the control of malaria was a turning point in the tropical war in both Burma and the Islands.
After the War Fairley returned to the Hospital for Tropical Diseases, London and was appointed the first Wellcome professor of clinical tropical medicine at the London School of Hygiene and Tropical Medicine. He was knighted in 1950 and received honorary degrees from the Universities of Adelaide, Melbourne and Sydney, together with an honorary FRCPE. His many honours included the Moxon Medal of the Royal College of Physicians in 1948; the Mary Kingsley Medal of the University of Liverpool in 1949; the Manson Medal of the Royal Society of Tropical Medicine and Hygiene in 1950, the James Cook Medal of the Royal Society of New South Wales in 1951 and the Buchanan Medal of the Royal Society in 1957. The Royal College of Physicians, in association with the RACP, inaugurated in 1968 the Neil Hamilton Fairley Medal of which Colonel Ford (now Sir Edward) was the first recipient.
Serious illness in 1948 took its toll and he retired from his chair but continued with hospital work and lecturing to students. All Fairley's scientific papers are in the Basser Library, Australian Academy of Science in Canberra. His son, Dr J Hamilton Fairley, retains the private letters which will also ultimately go to the Basser Library.
As a man, perhaps Fairley's outstanding characteristics were his fine intellectual and scientific courage. In the face of appalling problems - scientific, medical and administrative - he never faltered. His tenacity was of the bulldog kind, his loyalty to his colleagues unshakeable. He had little interest in politics. He was a whole-hearted, whole-headed patriot from unwavering life-long conviction. His loyalty to the cause and his certainty of the correctness of his decisions are illustrated by his reaction to a senior physician later in the war in New Guinea, when questioned about the possible toxic effects of atebrin. Three cases of aplastic anaemia had occurred. `Could this be due to atebrin, sir?’ The immediate reaction was to warn the officer he would be placed under arrest if he repeated this inquiry. It can be argued that this was an unscientific if not arrogant response. On the other hand the malarial discipline orders were always at the mercy of rumour - some of it enemy inspired - and his first priority at that stage of the war was not objectivity and cherished scientific doubt but victory above all else. Nothing could be allowed to imperil malarial discipline. There was an endearing quality of naivety in his make-up which in turn induced a protective attitude by his close friends and colleagues whose admiration and collaboration were untinged with awe. Fairley was a great man who made a significant contribution to victory in the Pacific area. For the benefits he conferred on mankind by his life and work, he will be remembered as a physician of international repute.