Professor Lam Sai Kit: Virus Warrior

The modern world is all too familiar with war in its many manifestations – real conflicts that pit nation against nation, contemporary marketing wars, corporate take-overs and so on – which are not necessarily positive in their resolution.

But there is at least one type of warfare that saves lives rather than destroys them, a ‘necessary war’ that can never end because it stands as the first line of defence against worldwide devastation. It is the fight to contain virulent strains of viruses which were responsible for 40 million deaths in 1918 (Spanish flu outbreak); one million each in 1957 (Asian flu) and in 1968 (Hong Kong flu); and hundreds of thousands in the 2009 H1N1 pandemic.

The economic costs of these viral outbreaks are equally catastrophic, although there are few studies that tote this up. One study that exists examines the West Nile virus epidemic which occurred in the United States in 2002, but it only covers the 329 confirmed cases of sufferers in Louisiana. That study estimated the cost to Louisiana covering nine months from June 2002 to February 2003 (inclusive of hospital care, non- medical costs and government agencies) at a staggering USD 20.1 million. In the light of these statistics, the case for constant vigilance speaks for itself and the work of ‘virus warriors’ all the more to be commended.

Outstanding among these warriors is Professor Lam Sai Kit, Emeritus Professor and Research Consultant with the University of Malaya whose soft-spoken manner and demeanour belie a tenacious spirit dedicated towards fighting – through identifying -  those nasty agents of disease.

Professor Lam Sai Kit’s career is an uplifting story  that began 40 years ago and still continues today as he has recently been contracted for another 3 years with the University of Malaya. Among the many roles he plays is that of managing a special research grant of RM600 million, designed to boost the University into the top 100 World Ranked Universities. And obviously it is in the area of medical and health sciences, including virology, that we can expect the drive to succeed, for he is recognised internationally and domestically as being among the top virologists who have ‘saved’ Malaysia from many a viral-based disease epidemic.

Sai Kit has received numerous awards and masses of accolades which have been widely reported in the newspapers. But perhaps not many alumni are aware that he is one of ACS Ipoh’s own distinguished sons, which makes his story a fitting beacon for all who wear the badge of the Alma Mater.

LOOKING BACK TO ACS

The Lam clan is distinguished for many achievements with Sai Kit’s being the latest. It began with grandfather Lam Looking, born in 1864 in Penang, schooled at Penang Free School who joined the Chinese Imperial Naval Arsenal in Fuzhou at age 18. He did so well that he was awarded the rank of Mandarin of the Blue Button for his service. On his discharge, he turned to tin mining in Kampar and grew his tin mine venture to great success employing 1000 workers at one point. From being the country’s first millionaire tin miner, Lam Looking expanded into property development, notably in Ipoh where he built the landmark Lam Looking Bazaar facing the Kinta River in 1933. There were also two mansions built in Gopeng Road but like the Lam Looking Bazaar, Kingsvilla, Kingslodge, and Borneo Motor Building these no longer exist today.

Both Sai Kit’s father – Lam Weng Yoon – and uncle had been educated at ACS Ipoh so naturally, Sai Kit followed suit when his turn came shortly after the Second World War ended. On recalling his primary school days in ACS, Sai Kit says that he is “grateful for the strict discipline and excellent education we obtained then.”

He remembers Rev. Ralph Kesselring, the school principal at the time, who was “a no-nonsense man with a heart of gold” and Miss Doris Lee, his Standard 3 teacher who was “one of the best loved teachers then”.

Conditions at ACS in 1946 were Spartan to say the least, given the country’s recovery from war. As Sai Kit recalls, “we did not have many classrooms in those days. The tuckshop and school hall doubled up for teaching. We had singing sessions led by the Daniel brothers, D.R. and Vincent also in the tuckshop, using the Silver and Golden Song Books. They were also instrumental in organising many plays especially the Shakespearian ones like Macbeth, King Lear, The Tempest, The Merchant of Venice.”

“What ACS lacked in the prowess of sports, we more than made up for in artistic talents,” he adds.

Thus the formative years rolled on. It was during these years that Sai Kit’s proficiency in Maths and Science was recognised and ‘firmly grounded’ by his teachers Mr. S. n. Nagara and Mr. P. Subramaniam, a glimmer of the illustrious future that was to come.

According to him, “both had the knack of making mathematical problems relevant to everyday life and situations which made it simple for us to understand.”

He recounts how one of his teachers would bring an apple to class to demonstrate fractions, halves, quarters. That strong foundation remains second nature to him as he has helped two PMR and SPM students prepare for their exams.

However, Sai Kit is quick to say that although he had some idea about what he wanted to be when he was still at school, it wasn’t quite a done deal until he went to university in 1957.

For those used to affluence today, it is unimaginable what sacrifices the Lam family must have made to fund his tertiary education since another sibling (his sister) was already being supported. His saviour was his grandmother and thus Sai Kit sailed off in the rickety cargo ship, the S.S. Chusan, to his destiny.

BUDDING VIROLOGIST

Sai Kit breezed through his first year in Maths and Science at the University of Western Australia, Perth and then in his third year, he did a double major in Biochemistry and Microbiology. The reason was that he was uncertain which attracted him more even though his sister Selena, encouraged him in the direction of bacteriology.

Messing with his head was also the buzz in the early ‘60s about new diseases caused by virus which could not be treated by antibiotics. As Fate would have it, Sai Kit had the opportunity for a teaching fellowship at the University of Queensland in which he opted to undertake a project on childhood measles. It was unknown then whether the measles virus is a DNA or RNA containing virus, hence his job was to ascertain its nucleic acid content.

That was the clincher for Sai Kit and it earned him a M.Sc. followed by a PhD scholarship at John Curtin School of Medical Research, Australian National University, Canberra. It was also the start of his love affair with the microscope.

By then, well and truly hooked by virus research, Sai Kit was reeled in by Tan Sri Professor T.J. Danaraj in 1966 even before he completed his doctorate course with an offer to return to Malaysia to join the new Faculty of Medicine that he was building up and he needed a virologist.

The “challenging experience, breaking new ground” as rosily painted by Professor Danaraj turned out to be all too real. Sai Kit recalls (with a chuckle) that he faced an empty laboratory on his return to Malaysia and the task of starting a new diagnostic virology unit using ‘innovative methods’  – a polite way of saying there was little money to invest in people or equipment.

Which he did despite the odds, making it the second functioning virus lab after the Institute of Medical Research.  His Department of Medical Microbiology rose to the occasion a year later, when the Hong Kong flu (H3N2) was rampaging through Malaysia. Panic had spread with every sneeze and cough, children and adults alike succumbed as fears of a new influenza pandemic seemed evident.

But was it the Hong Kong flu? That was the task Sai Kit and his team had to determine as quickly as possible. To the rescue came an equipment that the ever intrepid scientist Sai Kit had purchased earlier, an industrial-sized egg incubator which would continue to do its job remarkably well for the next 20 years.

In went dozens of 10 day old embryonated eggs inoculated with samples from patients and voila!  Within 3 days, the virus was isolated and clearly identified as the Hong Kong bug. This was a milestone as Malaysia emerged as one of the first countries in the region to isolate the virus outside of Hong Kong. It also marked another feather in Sai Kit’s cap as the Department was designated a WHO National Influenza Centre and remains so even to this day.

TWO MORE WHOs ON THE WAY

In the years following, Sai Kit was busy focusing on new tools to diagnose viral infections. Despite the initial reluctance of medical colleagues in providing samples for research, his tenacity and appeal to national wellbeing led to much progress being made.

One crucial factor which won over his colleagues was the deployment of rapid viral diagnosis. The quick turn-around time of the diagnosis would be a boon to health care givers where speed was of the essence for effective treatment. Briefly, this involved using an electron microscope and specimens provided could lead to a diagnosis of viral diarrhoea in just 30 minutes. With the use of an in-house ELISA technique, the dengue virus could be diagnosed within the same day. So successful has the ELISA technique become that it is now considered the gold standard against which other new tests are measured.

These achievements led to the Department being designated a WHO National Centre for Rapid Diagnosis in 1980 and a two year secondment in Geneva for Sai Kit  which opened a new world for him.

“Working for WHO opened my eyes. Instead of thinking of national or even regional health issues, I started to think of global health issues. It allowed me the fantastic opportunity to meet prominent virologists of the day, including Nobel Laureates and  Dr Vincent Deubel from the Institute Pasteur, Paris,” recalls Sai Kit.

“Through my close contacts then, I recently managed to persuade three Nobel Laureates to become University of Malaya Nobel Fellows and they serve as members of the UM High Impact Research Advisory Council, a set up that I manage with a research fund of almost RM600 million provided by the Ministry of Higher Education to UM.”

In the case of Dr. Vincent Deubel, their common interest in dengue and Japanese encephalitis led to strong collaborative research after Sai Kit’s return to Malaysia in 1984. This collaboration was to prove invaluable years later when JE swept through the Pacific region.

Simultaneously, through the 70s, Sai Kit had put together a team of specialists in the different branches of medicine and medical research to study dengue, the scourge of the Asia Pacific countries. In addition to many published papers, the team developed new methods to isolate the dengue virus thereby helping to reduce morbidity from dengue as well as develop an early warning system regarding outbreaks.

The work paid off once more in that the Department became a WHO Collaborating Centre for Dengue Fever and Dengue Haemorrhagic Fever in 1982. The centre is active today and provides consultancy services to countries in the Western Pacific region.

NO REST FOR THE WEARY

Given the mountains of work involved in virology even when there’s a ‘recess’ from the Mighty Mites – a good time to find out how new virus causes disease; understand how people get infected; originate ways to prevent infection; develop a vaccine – it would have been understandable if Sai Kit and his team remained in relaxed battle mode peering through the scope at the known villains.

It was not to be. He recounts the instance of an outbreak of respiratory disease among the country’s racehorses that threatened to cripple the industry. Despite a vet’s help, and being nearly kicked by an animal furious at being peered up his blocked nose, the team identified the outbreak as equine influenza. The horse had been imported via Newmarket, London, without quarantine.

On a second occasion, the Sultan of Brunei sent the head of a very valuable, recently imported polo horse that had succumbed to viral encephalitis (JE). The team confirmed its death from Japanese encephalitis from the brain tissues. Both cases led to the recommendation that new arrival of horses should be quarantined and immunised against equine influenza and JE.

In 1990, Sai Kit’s team directed its focus towards emerging infectious diseases (EID). The spark had been lit back in 1984 when Sai Kit had spent two years at WHO in Geneva. There, intense debates had flourished regarding new global health issues and WHO subsequently passed a resolution on monitoring emerging infectious diseases as a priority.

Just as well. For in 1997, viral encephalitis erupted in Sarawak and Peninsula Malaysia. The team got on the job quickly and identified the culprit as the virulent enterovirus 71 or EV71. Fast on its heels in 1999 came the Chikungunya virus, presumably ‘imported’ by migrant workers and the deadly Nipah virus.

Much has been reported and written about these viral outbreaks in the media, bringing an even higher level of fame to the team at University of Malaya. As the general leading the charge, Sai Kit’s role was pivotal in the work to bring the outbreaks under control.

As acknowledged officially, the findings of the Nipah virus saved the government large sums of money that would otherwise have been spent on insecticides and JE vaccines. With proper control and management, the decline and elimination of the disease also helped the billion dollar industry to recover.

In as much as the modest Professor does not wish to be made a hero, it is undisputed that his contributions are highly regarded. Note those Fellowship Honours he has garnered  – honorary Fellowships from the UK Royal Societies, FRCPath London in 1991, FAAM from the USA in 1996, FIDSA from the USA also in 1996, FRCP from Edinburgh in 1999, FASc from Malaysia in 1996 and Honorary Professor from the Institute of Microbiology and Epidemiology, Beijing, China.

There were also awards galore to honour him: 9 national and international awards  including one Prince Mahidol Award for Public Health; a Knight of the National Order of Merit by France; a Russian Medal among others. Finally, the country woke up and in 1995, the Professor received his JSM from the Yang Dipertuan Agong and a Datoship from the Sultan of Perak in 2002. As the author of over 200 papers and scientific abstracts, he is a prolific writer and all these when taken in total attest to this gentle warrior’s devotion.

FROM ROCK AND ROLL TO PROF WHO ROCKS

The man who wields a powerful microscope is equally skilled in the kitchen, complementing his wife Annie’s hosting charms with a dish or two of his own such as red bean dessert. In his youth growing up at Kingsvilla on 2 acres of garden with 3 outdoor badminton courts, he was naturally persuaded to let the shuttlecocks fly but in his own words, “was never quite the sportsman but better at climbing the many fruit trees in the grounds.” And as some of his contemporaries would recall, he could rock and roll with the best of them at those innocent house parties of the ‘50s.

Despite his fame, Sai Kit is a loyal friend who stays connected with his former school mates and teachers like Chai Hon Chan. On a frequent basis, Sai Kit arranges reunion meet ups and dinners with old salts of ACS like George Cumming (of the formidable Cumming brothers at that time and today a grandfatherly talent on some TV commercials), Woo Heng Kee, Michael Yee Kim Shin, Too Wan Jin, Lew Wing Hing, Rita Sreenivasan (eldest daughter of Teerath Ram), Low Beng Poh (now in Hawaii), Teo Ee Teck, and a host of others. This grandfather-to-be who is eagerly awaiting his first grandchild  occasionally revisits the Alma Mater for ‘sentimental reasons’ as he says and has attended Alumni events where he shares many cherished memories.

In summing up his life’s work, Sai Kit has this to say:

“Certainly, ACS Ipoh provided me with a firm foundation and love of science which turned into a passion when I went to university. In life, we do not know what options are open to us and it is a blessing when we stumble into a career which we embrace wholeheartedly. My career, starting in 1966 when I joined University of Malaya till now, has been a labour of love.”

Perhaps, unwittingly, Sai Kit followed the precept of Sun Tzu, that master of The Art of War who said: “the greatest things in the world must be done while they are still small. For this reason, sages never do what is great, and this why they achieve greatness.”

Salud, Professor Lam, virus warrior extraordinaire.

A very young future virologist in 1953 as a member of Form 3 Literary Society.  Prof Lam is seated extreme left.

Prof Lam receiving his Cambridge Certificate on our famous ACS stage.

Prof Lam (extreme right) with classmates and teacher Dr. Chai Hon Chan (sixth from right) at the School’s 110th Anniversary.

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