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In 1995 I wrote a commentary in the Lancet based on a major lecture at the Royal College of Obstetricians and Gynaecologists by a Nigerian obstetrician. His theme—‘Poverty, deprivation and maternal health’—was exceptionally timely: the World Bank's structural adjustment programme was wreaking havoc on the health and welfare of people in sub-Saharan Africa, with especially vicious consequences for maternal and child health. Describing how countless women, through poverty, ignorance, neglect, and above all illiteracy, received no antenatal care and went on to die with chilling regularity, he quoted a Nigerian saying: ‘If you think education is expensive, try illiteracy.’  Those previously unfamiliar with Professor Kelsey Harrison's work needed little convincing that he was no ordinary member of their profession. His recently published autobiography reveals just how extraordinary his achievements are and why he has argued so passionately that the ability to read and write can turn mountains of maternal ill health into molehills. He was born in Abonemma in the Niger delta, brought up in an extended family that, remarkably, had prized female education since the early 1900s, and trained in medicine in Ibadan and London. Belonging to a minority tribe, he encountered ethnic animosity that threatened his livelihood; he suffered the horrors of the 1967-70 Civil War; and he regularly worked in hospitals that were cramped, pitifully equipped, and understaffed.  Yet Professor Harrison retained his determination to forge a successful academic career, one testimony being the hugely impressive Zaria Maternity Survey. Published in 1985 and covering nearly 23 000 consecutive births, this showed the starkly contrasting fates of the relatively few women who were educated and made use of health care services and the overwhelming majority who were uneducated, married off as children, and grossly deprived. Per 100 000 deliveries, maternal mortality rates were 40 in the first group and 2900 in the second, findings that highlighted the need for fundamental social change and convinced Harrison that training of (often illiterate) traditional birth attendants would not save maternal lives. He went on to initiate the Nigerian national task force on vesico-vaginal fistula and co-edit a standard textbook on maternity care in developing countries, and along the way he was honoured with Nigeria's premier award for intellectual attainment.  But nothing could have prepared him for his role as Vice Chancellor of the University of Port Harcourt, a position he occupied for three years from 1989. As if tackling financial and academic fraud, rampant theft and embezzlement were not enough, he encountered head-on the destructive effects of warring secret cults that had all but taken over many aspects of student life. Cult members, mostly from affluent backgrounds, were linked to a catalogue of crimes from examination malpractice and destruction of university property to violent assault; they were also behind an attempt to assassinate Harrison.  He now enjoys retirement in Finland—including the traditional sauna—but I am curious to know how he satisfies his enduring passion for wielding the willow. If his book doesn't tell us, it does show, beyond doubt, that some encounters during his remarkable life have not been entirely cricket...

An arduous climb: from the creeks of the Niger delta to leading obstetrician and university Vice Chancellor