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Born in Freetown, Sierra Leone on 11 March 1907, Cole went to the Government Model School in 1914 and then to Sierra Leone Grammar School in 1918. He entered Fourah Bay College in 1923 to read for the Durham University degree in Arts. He obtained his Bachelor of Arts degree in 1926 and was appointed as an Assistant Lecturer in mathematics in 1927 at Fourah Bay College. He obtained an Upper Second Class degree in Philosophy in 1928.
He came to England in 1928 and entered Newcastle-upon-Tyne Medical School. In 1933 he obtained his M.B, B.S. with First Class Honours. He began his medical career as a House Surgeon at Royal Victoria Infirmary, Newcastle. He set up his own General Practice in Newcastle in 1934. In 1943 he obtained a Doctorate in Medicine and was elected a fellow of the Royal Society of Medicine. In 1944 he passed the Master of Surgery examination, M.S. In October of that year he was elected a Fellow of the Royal College of Surgeons at Edinburgh and in November he became the first African and first black person to be elected a Fellow of the Royal College of Surgeons of England. He toured West Africa (Gambia, Sierra Leone, Ghana, Cape Coast, Gold Coast and Nigeria) during March to September 1945, as a member of the Colonial Office Advisory Committee for the Welfare of Colonial Peoples. In 1950 he moved his General Practice to Nottingham and was practising there until he joined the Nigerian Civil Service as a Consultant Surgeon in 1962. In 1964 he proceeded to Sierra Leone to work as Consultant Surgeon to the Sierra Leone Government. He returned to England in 1974. In 1962, Dr Cole lost his British nationality status, which was not restored until 1981.
With his wide interests in West African students and African affairs he became President of the Newcastle-upon-Tyne and North East England East and West Friendship Society. He was also the President of the Society for the Cultural Advancement of Africa. He became a Director of the West African Students Union and was a founder member of the West African Society and editor of its journal Africana. He became President of the League of Coloured People of Great Britain and Ireland and he also served as a member of the Advisory Committee of the Colonial Bureau of the Fabian Society from 1943-1950. From 1942 to 1958 he was a Member of the Colonial Office Advisory Committee on the Welfare of Colonial Peoples in the United Kingdom, the Colonial Advisory Medical Committee and the Colonial Economic and Development Council.
He married three times, Anna Isabel Brodie in 1932, Amy Manto Bondfield Hotobah-During in 1950 and Anjuma Josephine Elizabeth Wyse in 1980.
His published works include Kossoh Town Boy (Cambridge University Press, 1960); An Innocent in Britain (Autobiography) (London, 1988). Unpublished works include Black Paradise. Fiction includes Country Doctor and Black Swan.