Many developments have occurred in sickle cell disease and care over the last 50 years in Jamaica. The clinic population grew from 50–60 in the mid-1960s to 5500 in late 1999. During this period, the number of staff serving sickle cell patients increased from 2 to 28, comprising physicians, paediatricians, nurses, laboratory technologists, social workers, computer staff and statisticians. The physical facilities have improved greatly and data management has evolved from the typewritten long narrow paper strips in the late 1960s to sophisticated electronic patient management systems. The many physical resources and the superb opportunities of an ‘island laboratory’ have provided a unique basis for clinical research into the disease.