**7. Experience in humans: potential toxicities of the different administration routes**

There are three possible administration routes for HP-β-CD: IV, IT, or ICV via an Ommaya reservoir. Some adverse events observed could be related to the administration route, the disease progression, or the cyclodextrin itself.

The review performed by the EMA regarding the use of HP-β-CD as an excipient indicated that the IV administrations had low toxicity, being the most prevalent issue of the renal toxicity, especially with high doses [51]. However, any patients showed renal toxicity with HP-β-CD therapy [32]. This was the first route employed, but later a change to IT route was requested due to the discovery that HP-β-CD not cross the BBB and only a little quantity is able to enter to the brain [21, 24, 25, 30].

Based on animal models, ICV route was proposed as an alternative with potential benefits and this route was chosen in the Phase I clinical trial (NCT01747135) using an Ommaya reservoir to facilitate the administration. Unfortunately, complications due to colonization by *P. acnes* led to change ICV route to IT [52]. Currently, IV route is being tested in two ongoing clinical trials, whereas IT route is analyzed in another ongoing trial and in the recently published trial [50].

Sensorineural hearing loss was present in all subjects of NIH-cohort (14 patients) and 2 of 3 RUMC-cohort, and according to the study results, it was associated with the administration of HP-β-CD. Moreover, the data obtained suggest that there is greater HP-β-CD ototoxicity in subjects who have not yet lost hearing due to NPD-C itself. Also, tinnitus was present in 6 of

Use of 2-Hydroxypropyl-Beta-Cyclodextrin for Niemann-Pick Type C Disease

http://dx.doi.org/10.5772/intechopen.71970

111

Until now, NPD-C treatment has been supportive and symptomatic with miglustat as the only disease-specific drug approved in some countries. HP-β-CD is a new option under investigation with two different products, Kleptose® and Trappsol Cyclo®, which are not chemically equivalent and therefore may not be biochemically equivalent or lead to comparable

Based on preclinical animal studies, HP-β-CD has been tested in humans affected by NPD-C during the last years. In compassionate use outside clinical trials, HP-β-CD has been administrated with either IV, IT, or ICV. Despite the positive results observed with IV HP-β-CD, there is no clear evidence to date that IV route has a clinical benefit in CNS symptoms of NPD-C as most of the reports combined IV and IT/ICV administrations. The reported cases of IT infusions obtained higher improvements reducing the disease

The results of a recently published clinical trial reproduced the findings observed with IT route. The trial has shown slowing of NPD-C progression in 14 patients with a dose escalation of IT HP-β-CD administrated monthly as well as in 3 patients with administration every

Some adverse events observed could be related to the administration route, the disease progression, or the cyclodextrin itself. The safety profile of HP-β-CD seems acceptable, being the loss of hearing (related to HP-β-CD) the most frequent adverse reported in the clinical trial and published cases. However, some severe toxicities have been reported including chemical

Furthermore, there are currently two IV HP-β-CD and one IT HP-β-CD ongoing clinical trials without published results. The findings of these trials will lead to an improvement in knowledge of HP-β-CD for NPD-C, setting the best route, dose, and posology. Currently, the short experience with HP-β-CD suggested that it could be effective in the management of NPD-C

We would like to thank Asociación para la Investigación, Desarrollo e Innovación en Farmacia

Hospitalaria (AIDIFH) for its economic support regarding the publication fees.

14 patients in NIH-cohort and 1 of 3 in RUMC-cohort [50].

formulations from a clinical development perspective.

2 weeks regarding a historical comparison cohort.

meningitis and fever although not in published clinical trial.

but the results of ongoing clinical trials will be definitive.

**8. Conclusions**

progression.

**Acknowledgements**

Megías-Vericat et al. reviewed the initial published cases of HP-β-CD treatment [32]. Regarding safety, 11 of 17 NPD-C patients included suffered AEs. Of the 17 AEs reported, 6 were related to the route of administration, specifically with the IT and ICV routes and 10 of them could be attributed by HP-β-CD. Six AEs associated to the route were: CNS bleed related to insertion of the Ommaya reservoir system in a patient treated with ICV HP-β-CD led to ICV administration suspended [34]; post lumbar puncture headache and vomiting resolved with switching a Whitacre spinal needles [41–43]; post lumbar puncture pain, headache, nausea, and vomiting resolved with symptomatic and postural treatment [44]; seizures with fever resolved without changes in treatment [40] and aspiration pneumonia; febrile syndrome; and candidiasis resolved with antibiotic and antifungal treatment [49].

Among AEs related to HP-β-CD itself, loss of hearing was reported in four reported cases of IT infusions [41–45], although it proved reversible in two of them. These patients were administered with reduced doses of HP-β-CD after hearing recovery, two times in one of them. In other two patients, despite delaying the next dose, hearing loss was not reversed. This AE was also observed in animal studies with IT [18], ICV [53], and intracisternal [25] routes of administration. At the dosage employed, hearing loss is an expected AE, as well as a well-known NPD-C symptom. At the clinical trial recently published, loss of hearing was reported in all the participants [50].

Four patients suffered from fever two or more times after HP-β-CD administrations [37, 40, 46, 49]. In one case, fever was accompanied by seizures [40], whereas another patient showed an infusion reaction with fever and transient diffuse pulmonary cloudiness [37]. In one patient, after intermittent fever episodes, a diagnosis of chemical meningitis was made after bacterial meningitis was discarded. The IT-OR was withdrawn, and HP-β-CD was reintroduced 2 months later because the patient's condition worsened [46]. Other patient showed two episodes of chemical meningitis (bacterial meningitis was discarded in both cases) after IT and IT-OR HP-β-CD administrations, although both were resolved quickly and without consequences [49]. This AE could be related to the method of administration or disease symptoms and not to HP-β-CD. However, the chemical meningitis observed seems to be associated to the drug after analyzed with the Naranjo algorithm [49]. Some acute neurological effects after the infusion of high doses that resolve after few days were described by some investigators in conferences (but unpublished yet).

Regarding the results of the first clinical trial published, no serious AEs were observed [50]. Marked expected AE included: ototoxicity (14 of 14 patients) and post lumbar puncture headache (9 of 14 patients). Among unexpected AE included, post-administration unsteadiness and fatigue occurs at doses above 600 mg. The degree of impairment varied between subjects but usually was transient and occurred 24–72 hours after administration.

Sensorineural hearing loss was present in all subjects of NIH-cohort (14 patients) and 2 of 3 RUMC-cohort, and according to the study results, it was associated with the administration of HP-β-CD. Moreover, the data obtained suggest that there is greater HP-β-CD ototoxicity in subjects who have not yet lost hearing due to NPD-C itself. Also, tinnitus was present in 6 of 14 patients in NIH-cohort and 1 of 3 in RUMC-cohort [50].


Preface

One of the most interesting and at the same time most challenging fields of medicine and surgery has been that of organ donation and transplantation. It is a field that has made tre‐ mendous strides during the last few decades through the combined input and efforts of sci‐ entists from various specialties including surgeons, hepatologists, nephrologists, immunologists, ethicists, and infectious disease specialists. What started as a dream of pio‐ neers has become a reality for the thousands of our patients whose lives can now be saved and improved. However, at the same time, the challenges remain significant and so do the expectations, for what was once an experimental treatment could eventually become the fu‐ ture of medicine, as it involves most organs including the heart, lungs, eyes, liver, kidney, pancreas, and small intestine.

This book with the contribution of an excellent group of world authorities in the field of organ donation and transplantation presents the challenges involved including the ethical, legal, and medical issues in organ donation and the technical and immunological problems facing experts involved in the care of these patients. In addition to the knowledge shared, the authors provide their personal clinical experience making this book an extremely useful tool for every scientist and physician practicing in the field of transplantation. The book is divided into a section dealing with donation-related issues and challenges and another one where the different types of transplantation are presented. The chapters include information on the current state and different types of donation, the challenges identified in increasing donation, and the potential solutions. Chapters in both the organ donation and the trans‐ plantation section provide us with a combination of the technical and surgical aspects, as well as a glimpse of the opportunities offered by molecular and basic science in achieving progress in the field of tolerance.

We can learn from the history of transplantation and, at the same time, tackle the remaining critical questions, such as achieving tolerance, which represents the Holy Grail of medicine.

Overall, this book represents a true tour-de-force of a variety of topics having to do with organ donation and transplantation. It should be stressed that the intended audience are sci‐ entists, physicians and surgeons of different specialties, which all have in common an inter‐ est in transplantation, improving the lives of their patients.

> **Georgios Tsoulfas, MD, PhD, FICS, FACS** Associate Professor of Surgery Aristotle University of Thessaloniki Thessaloniki, Greece

**Section 1**

**Organ Donation**

**Section 1**

**Organ Donation**

**Chapter 1**

**Provisional chapter**

**Organ Donation**

**Organ Donation**

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

DOI: 10.5772/intechopen.75487

Organ transplantation is the only way of giving the gift of life to the patients with organ failure; however, the inadequate supply of organs, especially from deceased donors, has created a wide gap between organ supply and organ demand. Many organs from deceased donors are still not being used worldwide because of lack of information, education, and social system. Effective systems such as opt-out, donation after circulatory death, and donor action programs are needed to promote deceased donations. Counseling on organ donations must be an essential step of families of brain-dead patients. Standard practice should include that physicians call an Organ Procurement Organization coordinator before meeting with the families of potential donors. Tight screening for potential organ donor in intensive care unit, decoupling, and professional counseling are key components. The authorities have to consider the establishment of an opt-out system, and social

Progress in transplantation science and medicine has been impressive in the last decades. Nevertheless, transplantation activity is constrained by the shortage of organs. How can we maximize the utilization of organs that are abandoned from the deceased donors? The process for organ donation is a complex one involving medical, psychological, ethical, and social scientific aspect. Public opinion on organ donation and social maturity is also important factors for a stable and sustainable social system for organ donation. This chapter describes the essential knowledge, principles, and considering factors for the promotion of

> © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

http://dx.doi.org/10.5772/intechopen.75487

systemic efforts are needed.

**Keywords:** organ donation, deceased donor, promotion

Young-Nam Roh

**Abstract**

**1. Introduction**

organ donation.

Young-Nam Roh

#### **Chapter 1 Provisional chapter**

#### **Organ Donation Organ Donation**

#### Young-Nam Roh Young-Nam Roh

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.75487

#### **Abstract**

Organ transplantation is the only way of giving the gift of life to the patients with organ failure; however, the inadequate supply of organs, especially from deceased donors, has created a wide gap between organ supply and organ demand. Many organs from deceased donors are still not being used worldwide because of lack of information, education, and social system. Effective systems such as opt-out, donation after circulatory death, and donor action programs are needed to promote deceased donations. Counseling on organ donations must be an essential step of families of brain-dead patients. Standard practice should include that physicians call an Organ Procurement Organization coordinator before meeting with the families of potential donors. Tight screening for potential organ donor in intensive care unit, decoupling, and professional counseling are key components. The authorities have to consider the establishment of an opt-out system, and social systemic efforts are needed.

DOI: 10.5772/intechopen.75487

**Keywords:** organ donation, deceased donor, promotion


# Liberation, Empowerment and Decolonisation through Adult Education in Africa

Michael Omolewa, Ruphina U. Nwachukwu, Anne Ruhweza Katahoire

#### **Abstract:**

Adult Education is an interdisciplinary field that often includes a focus on social justice issues and thus prompts a liberation, empowerment, and decolonisation approach to adult education. The purpose of this chapter is to report findings from informed by the papers of Lalage Bown held by the Bodleian Library at the University of Oxford, and the British Library. The chapter explores the concepts and nexuses of liberation empowerment and decolonisation through Adult Education in Africa. It addresses liberation and empowerment in the life of Lalage Bown in Africa, and her life and family background. It also explores her perceptions on decolonisation and the key reasons why she fought for the oppressed through Adult Education during her stay in Africa. The paper examines Lalage Bown's work experiences in different universities in Africa – including Nigeria – Britain, and her new ideas, including her approach to colonisation, Colonial Development and Welfare Fund. Finally, it discusses Lalage Bown's Legacy.

**Keywords:** Colonialism; Decolonisation; Empowerment; Lalage Bown; Liberation

#### Introduction

Adult Education is an interdisciplinary field that often demands a focus on social justice issues such as freedom, decolonisation, and empowerment. From the outset in Africa, Adult Education was the veritable foundation force used as a strategy for rescuing people from the ravages and limitations imposed by society. Thus, Adult Education should be regarded as the foundation and essential driving force of social justice and thus, prompts a liberation, empowerment, and decolonisation of the citizens. The education of the adults liberates and empowers them to develop the competencies and traits to alleviate the problems of poverty, ignorance, misery, inequalities, exploitation, degradation, unemployment, and other societal problems.

Referee List (DOI 10.36253/fup\_referee\_list)

FUP Best Practice in Scholarly Publishing (DOI 10.36253/fup\_best\_practice)

Michael Omolewa, University of Ibadan, Nigeria<EMAIL_ADDRESS>0000-0001-8976-4581 Ruphina U. Nwachukwu, University of Nigeria, Nigeria<EMAIL_ADDRESS>0000-0001- 6618-1252

Anne Ruhweza Katahoire, Makerere University, Uganda<EMAIL_ADDRESS>0000- 0003-3520-070X

Michael Omolewa, Ruphina U. Nwachukwu, Anne Ruhweza Katahoire, *Liberation, Empowerment and Decolonisation through Adult Education in Africa*, © Author(s), CC BY 4.0, DOI 10.36253/979-12-215-0253- 4.13, in Maria Slowey, Heribert Hinzen, Michael Omolewa, Michael Osborne (edited by), *Adult Education and Social Justice: International Perspectives*, pp. 95-106, 2023, published by Firenze University Press, ISBN 979-12-215-0253-4, DOI 10.36253/979-12-215-0253-4

This chapter draws attention to the role played by Adult Education in the empowerment of Africans from the last days of colonial rule. It explores how Lalage Bown, a graduate of Oxford University, was inducted into the Adult Education discipline following an internship programme in Adult Education at the same University. It examines aspects of the life of Lalage Bown and tries to explore some of the influences that may have led her to focus attention on Africa where she effectively promoted Adult Education. In 1949, she arrived in Ghana for her first leg of work before moving to Makerere College in Uganda, and later to the University College, Ibadan, which later became the University of Ibadan. From Ibadan, she moved first to the University of Zambia and thereafter to the Ahmadu Bello University, Zaria in Nigeria and finally, the University of Lagos, Nigeria. Lalage Bown made an unusual and unlikely decision to work in Africa and in the field of Adult Education despite her upbringing in elite educational institutions and the promise of comfort in life. Despite her birth and the privileges of colonial rule, she chose to stand by the victims of colonial rule and work for their liberation and empowerment. Lalage's choice was a result of her encounter with the post-war world in which many believed strongly that the injustices suffered under colonial rule had to end.

The study used historical and qualitative research methods, which involved the use of primary and secondary sources from the rich depositories of her work at the Bodleian Library in Oxford, the British Library in London, and the various places where she worked in Africa as well as narratives from those whom she met along her professional journey in Africa.

#### 1. Arrival in Africa: Work in Ghana and Togo

At just about the time of the graduation of Lalage, the Oxford Delegacy for Extra-Mural Studies had made the important decision to extend its work to some selected British colonies. This was at the age of massive involvement in the promotion of adult education by universities in the United Kingdom. T.L. Hodgkin, Secretary of the Delegacy for Extra-Mural Studies at Oxford University, launched the Extra-Mural programmes of his University in the Gold Coast, which later became Ghana in 1947 (Yousif 1967; Omolewa 1975a). This followed a period of consideration of the country to be used for the pilot programme of the University of Oxford in Africa. By February 1947, the Delegacy had resolved to «discover if there was any potential demand for the kind of adult education such as is met in Britain through courses provided by University Extra-Mural Departments in cooperation with voluntary organizations» (Bodleian Library MSS.Afr.s.1877, Box 2, File 2). An Extra-Mural Resident Tutor from Kent gave lectures from May to July 1947 on Economic History and Problems. Following the request by the local people to discuss politics rather than economics, the Delegacy introduced a course on "Problems of Government". The annual report stated that «The fear entertained that the initial enthusiasm everywhere displayed for the classes would be ephemeral, fortunately, proved unfounded. Everywhere sizeable groups of students emerged who soon showed that they would stay the course and would indeed certainly have undertaken longer and more ambitious courses of study if such had been available» (Bodleian Library MSS.Afr.s.1877, Box 2, File 2). David Kimble was appointed Resident Tutor in April 1948 and the University College of the Gold Coast took over the responsibility for Adult Education from Oxford University Delegacy for Extra-Mural Studies with effect from April 1, 1949.

David Kimble was appointed Director of the Department of Extra-Mural Studies and reported that considerable progress was made in Adult Education during the year, 1949 to 1950. This was the time that Lalage Bown arrived in Accra. David Kimble noted in his Annual Report for the year that:

Miss Lalage Bown, B.A arrived at the beginning of November, and took up residence in Accra, though she travels weekly around Togoland. Her enthusiasm has created such a demand across the Volta that she has undertaken a very strenuous programme, sometimes involving seven classes a week in widely separated places (Bodleian Library MSS.Afr.s.1877, Box 2, File 2).

Kimble had continued in his Report that visitors from the United Nations to Togoland had submitted in their Report their fascination with the work of Lalage Bown:

The mission watched a young English woman tutor introducing a group of Togoland youths and young women to the procedures of the British Parliamentary system by allowing them to play for themselves the role of government and opposition (Bodleian Library MSS.Afr.s.1877, Box 2, File 2).

Kimble further noted that «Miss Lalage Bown, B.A has maintained a successful weekly class in Accra entirely for women. Enthusiasm has persisted in spite of an awkward day and time» (Bodleian Library MSS.Afr.s.1877, Box 2, File 2).

She gave a talk on "You and Your Representative" as contribution to the broad theme on "Focus on the Constitution" at the Accra Community Centre, on Saturday 7th April, 1951. She was also involved with what was described at the time as "Activism in community development". In April 1953, under the auspices of the Department of Extra-Mural Studies, Lalage organised the Tongu-Rural Survey, involving volunteers who dedicated 2 weeks highlighting the needs of the community, including disease control, water supply, occupations, and prospects, to which the Chief Regional Officer reacted.

One of the contemporary adult educators, Paul Bertelsen, lamented during his presentation of the paper titled "The Relationship between Adult Education and Economic and Social Development in West Africa" at the 7th Conference of the Nigerian Institute of Social and Economic Research, at the University College, Ibadan on 19 December, 1960, that «Comparatively small amount allocated to adult education, suggesting that adult education is commonly regarded as of only incidental importance for economic and social development». He suggested that this may have been because «the benefits of adult education are so diffuse that it is extremely difficult, if not impossible, to keep track of them».

Lalage had enormous faith in the potentials of Adult Education, not only for empowerment through the acquisition of knowledge but also in assisting the adult learners have confidence in themselves and respect their individual talents and potentials (Bodleian Library MSS.Afr.s.1877, Box 1, File 2).

Lalage's strategy included the organisation of National Seminars, publication of newsletters, encouraging all the people involved in literacy promotion to be involved with programmes and activities and it was to be translated, eventually into an effective, active, and productive, adult education movement.

## 2. The Uganda Phase

Professor Lalage Bown joined the Department of Extra-Mural Studies at Makerere University College of East Africa in 1955. She served as a Resident Tutor in the Eastern Region of the country for two years and continued to maintain the vigour, zeal, focus, and energy that she had brought into the promotion of Adult Education from Ghana, then the Gold Coast. Again, her emphasis was on making sure that the students remained the centre of attraction and were made participants in the learning process. She taught the subject Introduction to Psychology to the students of Adult Education. In her notes to the students, she stated:

This is the second part of a course on Psychology and is planned to take five lectures to complete. Students are reminded that a study-course of this kind is a cooperative effort between students and tutor. Regularity of attendance is essential, and the work of the class needs to be supplemented by reading at home. At least half the time in each class meeting will be devoted to questions and discussion (Bodleian Library MSS.Afr.s.1877, Box 3).

Lalage also introduced to the students the course she entitled, "Some Political Problems". Here, she introduced, "Types of Constitution: Federal Constitution", and asked them to reflect on the roles and responsibilities of each component part of governance, explaining that «The work of a group of Ministers is to prepare a policy for the consideration of the lawmakers, and also supervise the carrying out of policy by the various departments» (Bodleian Library MSS.Afr.s.1877 Box 3). As usual, she was recognised for her work, which she pursued with great passion, energy, and excellence. Thus, during her first year as Resident Tutor in Eastern Uganda, she was reported in the 1956/57 Extra Mural Report to have set a track record:

Particularly encouraging was the strong development of extra-mural studies in the Teso District. It is indicative of the keenness that more students came from Teso to the first Annual Study Vocation than from any other district in East Africa. The arrival of over 70 people from the Eastern province at 5 am at Kampala Station was a sight that will be remembered (Bodleian Library MSS. Afr.s.1877, Box 3).

# 3. The University College, Ibadan

Lalage was invited to Nigeria in 1960 by Professor Ayo Ogunsheye, Head of the Department of Extra-Mural Studies at the University of Ibadan as Assistant Director. Ogunsheye was a graduate of the London School of Economics and Political Science of the University of London, and former Assistant Secretary of the Nigeria Union of Teachers.

The Department of Extra-Mural Studies that later changed to Department of Adult Education, started off with 12 classes inherited from the Oxford University Extra-Mural Delegacy in 1949. A year after establishment of the University College, Ibadan, the Department of Extra-Mural Studies was founded based on the recommendation of the commission on higher education in West Africa which was appointed by the British Government in June 1943, with Walter Elliot as chairman. This was in response to the criticism of the local institutions which were poorly staffed, and poorly equipped, and which offered programmes which did not lead to the award of a degree. The commission had advised that extramural work should be pursued by the university in West Africa to ensure that the university was not isolated from the community. The Department of Extra-Mural Studies came up with the objectives of translating the Elliot vision of adult education into programmes (Omole 2022, 3).

Lalage believed in the capacity of the African to lead institutions and she firmly supported Professor Ayo Ogunsheye, the African candidate for the position of Dean of Education at the University of Ibadan against Professor Andy Taylor, the candidate from New Zealand. Ogunsheye won the election in 1965.

She was fully involved with the establishment of the Faculty of Education at the University of Ibadan. She had been recruited as staff of the first Department of Adult Education which had been founded at the University College, Ibadan in 1949, and named at the time, Department of Extra-Mural Studies. The University College had invited Robert Gardiner, a Ghanaian Economist and Cambridge University educated scholar, as the first Director. When the proposal came for the establishment of a Faculty of Education in 1962, in which the Department of Extra-Mural Studies would be one of its constituents, Lalage made the case that Extra-Mural issues were wider than being placed in a single faculty of Education. In the end, it was agreed that the new Faculty would be called the Faculty of Education and Extra-Mural Studies.

Lalage encouraged tutors of Extra-Mural classes to prepare syllabuses, stating that the purpose of the syllabus is to provide the students with a plan of the study areas to be covered in the course, so that they can see the bearing on one another of the topics to be discussed, and be able to organise better their own study. A good syllabus, like a good course, deals with a single important problem or aspect of a subject in a progressive way (Bodleian Library MSS.Afr.s.1877, Box 6, File 1).

She joined the Department to outline the Duties of Full-Time Tutors, to conduct tutorial, advanced or preparatory classes, keep accurate register of student's attendance, and assist in appropriate ways in the establishment of a voluntary adult education organisation. She also helped the Department to prepare the proposal to the Director-General of UNESCO for the establishment of The African Institute of Adult Education in the Department. She was promoted Deputy Director of the Department where she served until 1966.

# 4. Zambia

She moved to the University of Zambia in 1966 where she was made a Professor (*ad personam*). In Zambia, she continued with her usual work of serving as advocate for access to learning for those who were denied access to formal education. She also continued in the establishment of Extra-Mural centres in the country and training Extra-Mural tutors. She thus organised the Conference for Part Time Tutors and prospective Part-Time tutors held at Kasama, from June 30, to July 2, 1967, under the auspices of the Department of Extra-Mural Studies, University of Zambia. In 1970, Lalage introduced a programme entitled "Credit Unions and the Mobilisation of Savings" as a means of capacity building for income-generation, to empower learners of the Extra-Mural classes. She also prepared the Study material required for the proposed Certificate Course in Adult Education at her University. Her energy and zeal for the promotion of Adult Education were unlimited. She remained Director of Extra-Mural Studies in Zambia until early 1971 when she moved back to Nigeria.

# 5. Back to Nigeria

From 1971 to 1976, Lalage returned to Nigeria on her appointment as Professor of Adult Education and Chief Extension coordinator at the Ahmadu Bello University, Zaria, Nigeria. There, she was concerned by the quality and quantity of the Adult Education offerings, observing that:

the specific needs of the adult student at evening school have been sorely neglected. Unlike British evening schools with their wide spectrum of programmes, Nigerian evening schools have all too often been solely oriented towards examinations, while the syllabus tends to be accepted uncritically by students and teachers alike. Survival in the school system and the resultant certificate has tended to be main object, and this at the expense of true education for life (Bown 1969, 169).

She responded to the criticism and mounted more relevant Adult Education programmes. She undertook visits to all the Military Governors of Northern States and encouraged them to patronise the various Adult Education programmes mounted by her department. She left for the University of Lagos where she served as Professor and Head of the Department of Adult Education. From 1979 to 1980, she was Dean of the Faculty of Education at the University. That was her last posting in Africa before she returned to the United Kingdom after thirty-one years in Africa.

Perhaps her main legacy was being a member of the team from the UK that contributed to the process of the achievement of political independence of Africa through the cultivation of Africans by the use of Adult Education. Certainly, Extra-Mural work had provided access to higher education which would otherwise have been impossible for educated Africans who began to contend for positions of responsibility in government, commerce, and industry. These were also the Africans who began to express dissatisfaction with the prevailing conditions that denied them access to self-determination, and who began to form political parties and organise mass protests against colonial rule, building up the African public opinion and nationalist sentiment against continuing imperialism and British rule. It was in this context that Lalage would be appreciated as a supporter of decolonisation (Omolewa 1975b; Titmus et al. 1995).

# 6. Lalage and Follow-up Initiatives / Testimonies from African Countries

Lalage preserved the relationships that she built in the African countries where she worked, including at Makerere University. In 1983, she returned to Uganda as a Visiting Professor after nearly 30 years. She returned to the same Department, where one of her old colleagues from the Extra-Mural days, Jassy Kwesiga, was then Director. She found that a lot had changed since her earlier years and that the Department of Extra-Mural Studies had been transformed into a Centre for Continuing Education (CCE) amidst the social, economic, and political changes that had occurred after independence, and during the Amin era. Lalage, at the time, was Head of the Department of Adult Education at the University of Glasgow.

During her month-long visit, she challenged and encouraged colleagues at Makerere to critically re-examine the Centre's philosophy, given the changes that had taken place in the country and in the field of Adult and Community Education in Africa, and globally. Her passion and commitment to Africa's development and the potential role that Adult and Community Education could play in this process were the central focus. Her emphasis was on the role of Adult Education in developing communities in Africa and, more importantly, women's empowerment through Adult Education. She worked with colleagues in redefining the role of University Adult Education in Uganda. Drawing on her wealth of experience from Africa and elsewhere, she provided a much-needed critical external viewpoint that was both empathetic and challenging. A joint Report produced at the end of her visit made several recommendations, including the need for the Centre to focus more on Adult Education training and research at a university level.

This marked a new trajectory for University Adult Education in Uganda, emphasizing the study, profession, and practice of Adult Education through research, teaching, and training (CCE, Triennial Plan for 1981/84, in Atim et al. 2004). Shortly after, CCE was restructured into an Institute of Adult and Continuing Education (IACE) with three departments, one of which was the Department of Adult Education and Communication Studies (AECS). This marked a significant step towards offering full-time training programmes for professional adult educators.

Another important outcome of Lalage's visit was an arrangement supported by the British Council, that enabled seven academic staff members to pursue postgraduate studies in adult education in the UK from 1983 to 1989. The University of Glasgow was part of this arrangement. As Anne Ruhweza Katahoire, one of the beneficiaries from Uganda testifies:

Alice Ndidde and I got British Council Scholarships through the British Council to pursue our Master's degrees in Adult and Community Education at the University of Glasgow. We were privileged to be trained by Lalage as it was a rare opportunity to be taught by someone who understood the context we were coming from. I was inexperienced, having just completed my undergraduate degree. At Glasgow University Lalage very kindly helped me adapt and settle in very quickly. She invited me to different places, including her home, where she cooked African food, which made me feel at home. In addition to the mandatory courses on the Master's programme, Lalage gave me tutorials where she required me to read materials mainly on Africa. We would then meet and discuss them. The tutorials transformed my thinking about education and its role in transforming people's lives and communities in Africa. She challenged me to think more critically about my worldviews and assumptions about education. I read widely and thought hard in preparation for them and later realized that it was her way of challenging me to reflect more critically about my assumptions about education more generally and adult and community education more specifically. I enjoyed the materials I read especially those on women's empowerment through education in Africa. Lalage challenged me to think more critically about these issues and my positionality as an African woman. I attended my first International Adult Education Conference with her at the University of Bangor, where I met adult educators whose materials I had read. She seemed to know all of them and introduced me to some of them. She taught me the importance of developing professional networks. She graciously introduced me to adult educators who wrote about Africa and who had worked there and whom she thought I needed to know (Reflections by Anne Ruhweza Katahoire, chapter co-author).

With Lalage's support in the 1980s, Makerere was able to develop a critical mass of professional adult educators trained in the UK. This enabled the establishment of full-time academic and professional training programmes in Adult and Community Education. On Lalage's recommendation and as a follow-up to her visit in 1983, Professor John Oxenham, a then Senior Fellow at the Institute of Development Studies (IDS) at the University of Sussex, visited Makerere University in 1984 to conduct a planning workshop. He worked with the staff to develop a training course in Adult Education and Development. He participated in the initial round of the course, introducing the concept of designing learning for development. Thereafter, the course was offered annually as a twenty-week sandwich course. This series of courses were made possible through a grant from the German Adult Education Association (DVV), which annually sponsored most of the participants in the course. The training targeted trainers who then trained other development workers in the field. Its focus was on how to design/develop, implement, and evaluate adult education and development training programmes. The curriculum for this course was later expanded and developed into a full-time Diploma course in Adult Education.

Lalage set the stage and laid a firm foundation for the training of professional adult educators and educationists at Makerere University. She had long argued that Adult Education was a profession, as expounded in her publication with Okedara in 1981. In the face of programme restructuring and merging of courses at Makerere University, their argument was used to defend Adult Education as a field of study and a discipline worthy of academic research in Uganda. Their distinction between 'adult educationists', 'adult educators', and 'educators of adults' provided the much-needed conceptual clarity in distinguishing training curricula for the different cadres engaged in adult and community education. It also provided clarity regarding the positioning of the Department of Adult Education in relation to the other training institutions involved in training development workers. A Diploma in Adult Education was launched at Makerere University in 1988-89 designed for people working in adult education in development programmes. Nearly ten years later Bachelor of Adult and Community Education (BACE) was introduced in 1997-98, designed to create a cadre of welltrained decision-makers, designers, and implementers of Adult and Community Education programmes. Currently, the Department offers graduate training in adult and community education at both Masters' and PhD levels. Several of the younger staff in the Department are products of this training and are continuing to develop Adult and Community Education as a profession embracing new developments in the field. Lalage keenly followed the developments in Uganda and at Makerere and was always excited to hear about any new developments in the Department of Adult Education:

When we last met physically in 2014 after many years, she was excited to see me and to hear about the new developments at Makerere. We spent a weekend together at her home as always, she was in high spirits and full of energy. She took me for a walk around her neighbourhood, explaining the developments that were happening in the community. It reminded me of my student days when she took me to museums and explain the history of the buildings and artifacts. As her former trainees, Alice and I have carried her mantle and trained a critical mass of professional adult educators who now run the Department and adult education programmes at Makerere University. Others have established similar adult education training programmes at new universities in Uganda. I can say with confidence that her legacy lives on. Her trail in training 'adult educationists' can still be traced at Makerere University, Department of Adult and Community Education through those of us whom she taught and mentored. We likewise have taught and mentored the next generation of professional adult educators and have passed on her mantle to them (Reflections by Anne Ruhweza Katahoire).

# 7. Lalage and the Promotion of African Indigenous Knowledge and Values

Lalage had a positive attitude towards African indigenous knowledge and practices for which she showed respect. She was frequently dressed in the full African traditional dress. She also appreciated indigenous African languages customs and practices. She once defended the use of the pidgin English by Africans struggling with the use of English. She fondly celebrated the New Year festival in Accra, then in the Gold Coast, now Ghana. She attracted traditional dancers, drummers, poets, and court historians. In this way, she identified with the poor marginalized and the neglected, mostly rural population. She enjoyed the environment and was an Unconscious promoter on environmental conservation and heritage protection. She believed in the capacity of the African to develop their skills and expertise. She also related to both the young and the old male and female and refused to be drawn into the debate about the weakness of the Africa in the face of the powerful Imperial system of her days.

She was truly and completely sworn into the defence of African values and the promotion of African heritage. She loved Africa with a passion. It is therefore not a surprise that she decided to bring up twins who required help because they were abandoned and were orphans, Taiwo and Kehinde. She supported the education of the twins and stood in as their parents. Both became celebrated and successful, one serving as a University Librarian and the other a top Director at the Federal Ministry of Education in Nigeria.

Lalage belonged to the group of non-Africans who were committed to project African Studies. They described themselves as Africanists. It was to them that Africa owes the convening of the International Congress of University Adult Education, in Dar es-Salaam in June 1976 to which the President, Mwalimu Julius Nyerere, presented the keynote address titled Adult Education and Development, as further elaborated in the book by Budd Hall.

Lalage Bown, assistant director of the Department of Extra-Mural Studies was appointed to serve as Secretary of the committee. Lalage, while in Zambia, served as Joint Executive Secretary of the International Congress of Africanists with her friend Michael Crowder, the British Africanist, at the Second International Congress of Africanists, held from 11 to 20 December 1967 at the University of Dakar, Senegal. The theme of the Congress was Research in the Service of Africa.

# 8. Towards a Conclusion

Lalage Bown was born to make a difference to lives, peoples and she worked with persistence and determination to make the difference. Born into a life of privilege in the days of the Empire, Lalage had a choice to benefit from the imperial system and live a life of privilege and access to opportunities and positions offered by the system. The Empire brought resources, fame, and opportunities for postings to the colonies, and she would have been literally worshipped by the subjects who had no say in who governed them. She turned her back on those attractions of the world of privileges, favour, and opportunities. She was resolute and convinced about her choice. She was bold, courageous, brave, and adventurous to live a life among the people and be part of the communities. She made the choice of supporting self-determination or keeping the status quo and denying those who desired freedom and nationalism. It was also a period when it was not fashionable to be a woman, for women were vulnerable. It was also not a popular choice to make to support decolonisation at a time when there were advocates of retaining imperial control with the determination that the sun had never set.

She was a trail blazer in global Adult Education movement, and an eminent women's literacy advocate of a white British heritage. She contributed enormously to the liberation and decolonization of different African countries including the establishments and expansions of adult education programs in Ghana, Uganda, Zambia, and Nigeria, respectively. Lalage Bown was honoured with numerous awards and recognitions including the award of the order of British Empire (OBE) due to her dedication to the service of humanity through adult education. In 1997, a special issue of the *Journal of the Nigerian National Council for Adult Education* was dedicated to her and she was appropriately named the 'Mother of Adult Education in Africa'.

She dedicated her life's work improving education for the less privileged, especially women, seeking to bring university opportunities to the widest possible sections of society. Lalage was immersed in a tradition which regarded Adult Education as a catalyst for significant social change. She was a fierce defender of adult education, and her views were inspired by a post-war world in which many believed that the kind of injustices suffered under colonial rule had to end. She was a gentle feminist who fought for the liberation and empowerment of women and the oppressed.

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