Monday, July 23, 2007

Quote of the Day

On 02 April 07 I posted an article in my block on “How to be Creative”. I discovered that somebody very kindly took out a statement I made and called it “Quote of the Day.”

The quote is “The greatness of a person can only emerge when he has shown his ability to create, passion to pursue, courage to commit and capability to achieve”.

His comments were: Two questions (may be four) that might follow from the quote,

1. Do I want to be great?
2. Do I agree? Does it really have to show? To whom?


It is part of human nature to want to be noticed for what one has done. This does not mean that everyone wants to be “great”. It is also a good practice for any individual or community to show appreciation to those who have contributed or done a good deed. This is part of our culture which we should retain. Much is being done at present in this direction. The question is can we do more? Do we always know how to do what has to be done and to whom. What criteria can we adopt without causing contradictions?

We know that “Some people are born great. Others have greatness thrust upon them.” My quotation describes those who have earned their “greatness” many of whom never worked for this status. These include national awards, professional recognition, community honours etc. In the past “great” men were only recognized posthumously. I like to suggest that more of our unsung heroes who have contributed in whatever field should be acknowledged while they are still alive. This will encourage more people to be creative and contribute for the betterment of our society.

Thanks for the comments.

Lee Kum Tatt

Thursday, July 19, 2007

The Days When Singapore Panicked - Part 2

Outbreak of Barley Poisoning

The Queenstown constituency where many deaths occurred had Dr. Lee Siew Choh as their Member of Parliament from the PAP party. Dr. Lee was also the Political Secretary of the Ministry of Health which my Department reported to. Naturally he and everybody else wanted to know who was really responsible and how to get compensation for the deaths of the eight children and the illness caused to the other people. I was again given the task of finding the answer with the Ministry’s backing.

Could the Parathion come from (i) spaying in the field or (ii) could it be a contamination from the ship’s hold on way to Singapore or (iii) contamination from the local shops. We examined several bags of barley and found that only those with a certain marking were found to be contaminated with the poison. Some were very badly soaked. Barley with different markings or from cans were not affected. Further investigation showed that this consignment came from a European cargo boat. With the cooperation of the local European Embassy we were informed that the particular cargo boat would be going to Miri, Sarawak, for fuel on a Saturday. I flew to Miri with the First Secretary of the European Embassy and waited for 10 days for the boat that never came. I was supposed to question the captain and examine the boat’s log books. Could the ship’s captain or owner have been tipped off ? This, we would never know.

When the boat did not turn up after five days I wanted to come home. My ministry did not allow this and I had to stay on until my personal funds were exhausted. That was 10 days in the one horse town of Miri. We showed that we did everything possible to find the ones responsible. The boat never turned up in Miri.

What were my feelings towards this case? I was happy that I rose to the occasion and had isolated and identified the poison so quickly. More important I confirmed that the killer was in the barley and it was the deadly insecticide Parathione which was prohibited for use in Singapore. My only regret was that we did not succeed in finding who was really responsible. At least we could then get some compensation for the bereaved families. Our consolation was that we did everything possible under the circumstances.

No doubt I am very proud of the way this case was handled. The tension was very great and I am glad I survived it all. It showed that with some common sense and a little courage to do something different, or even absurd, can help a lot. I must have smelled a lot of the fumes from the extracts and felt very dazed for a few days that followed. But I am satisfied I rose to the occasion. I learned how uneasy it was for the head that wore the crown. Yet someone has to wear it.

I am grateful my medical colleagues provided the help I needed. Under these circumstances I was able to do more than my normal duty. That was the satisfaction I had from this case. This taught me the need for good networking and that multidisciplinary approach is important to solving life’s problems. Any undue delay on my part would have caused many dearly. We had not only pinpointed the barley as the culprit but also identified the ‘Killer” insecticide. We managed to calm a panic stricken public in time and saved many traders thousands of dollars and possibly many lives. I had done my best and my only regret was that I could not help in finding the captain of the European cargo boat guilty of negligence. Otherwise at least the families of the deceased children would have got some form of compensation. I could not have solved this case without the help of so many people, particularly the police and my medical colleagues and my staff. These people are some of our unsung heroes and we have many of them to thank for solving this case so fast.

Recently we have SARS and bird flu for the past few years. We have yet to find a solution to solve these problems. This showed how serious some incidents can be. Luckily we managed to solve our “Barley Poisoning” outbreak in record time for which we are proud. The incident taught me that we must do everything possible to nip the problem in the bud. A lot depended on ourselves and our attitude towards the work to be done. We must be confident and not be afraid to try to do what we think is right. If we were not pro active and positive we might cause some very serious consequences to ourselves and to others in the process especially when one is professionally in charge of the project. I learned many lessons from this case which affected my life and the lives of many others, especially those who are doing research and have something to do with solving problems. I will share some of these lessons I learned in Part Three of this series and discussed how I did what I did.

Lee Kum Tatt

The Days When Singapore Panicked - Part 1

On the morning of Monday 7 September 1959 I found two excited police officers waiting for me in the Government Department of Chemistry where I worked. They informed me that there were eight deaths involving children and 31 others had been admitted to the General Hospital on Sunday 6 September 1959. The affected families were 22 from the Queenstown-Alexandra area, three from Victoria Street, 2 from Silat Road and one each from the old Kallang Airport area, Lavender Street, Geyland and Braddell Road. The territorial spread was quite wide. The children’s ages ranged from 4 months to 16 years old.

It was obvious the children must have taken some kind of poison or toxin, but nobody knew what these were or where they came from. Understandably the families were too distraught to say much to the police or the press. There was not much of a lead we could follow. I had to assume that the cause of death must have come from the food they took. I requested the police to find out what food they had taken and we would try to put the pieces together and start from there. Three families said that their children had taken some home made barley drinks besides other kinds of food. That was the only common lead we had to work on. Our job was to identify the source of poisoning as soon as possible to prevent further deaths. To be sure we must isolate and confirm the poison/s responsible. This was not easy under the circumstances. If it is botulism or toxin it is outside the scope of the chemists to detect these toxins. The other common poisonous chemicals like cyanides, arsenic, carbon monoxide or some alkaloids were not considered as likely candidates. Our only clue was that the children could have been killed by the barley drinks. Ridiculous and far fetch this suggestion might be we had to make some kind of statement to calm the public.

The ministries of Health and National Development were in constant contact with us throughout the day to find out whether we had found anything. I felt the pressure to get results. Unfortunately even my director could not give me any advice on what to do. I had to use my initiative and judgment on how best to proceed. I had a new chemist Mr. Theng Chye Yam and two laboratory assistants,the late Mr. Pwee Sai Cheow and Mr. Ng Hon Wing to assist in the extraction of the possible poison/s from the various types of food that the police had collected . We also had the stomachs of the deceased children and several stomach washouts from those who were still in hospital. I decided to work on some 15 samples of food rounded up from the families. By then it was already well passed lunch time. We informed the Ministries that barley appeared to be a possible source of poisoning although we did not know for sure how the poison could have been associated with such a common and harmless drink like barley. Under the circumstances the Government accepted our postulation (absurd as this may seem at the time) and issued a general statement warning the public to stay away from barley until the investigation was completed. Our responsibility was a heavy one. Under the circumstances we were expected to say something and we have to make a calculated guess. What if we were wrong? This was a terrible thought I dared not even entertain. I was a young chemist, my image could be affected and that of the new PAP self Government too. I realized that I had to pull out everything I had to provide the answers whatever happened. Many eyes were focused on me and I must not fail. Brave words but how was I to do what had to be done?

At that point in time I did not know how long it would take to pin point the source of poison and confirm what it was. I was not even certain that the poison/s could be found or be identified from the samples we had. Because of the announcement many who had taken some barley sought admissions into hospitals .They had their stomachs washout and we in the laboratory were flooded with such samples. Such panic response was not unexpected. They did not however help in our investigation.

Amidst this confusion and excitement I was at a loss of where to start and the pressure to produce results was very great. I knew that normal chemical investigation and identification of unknowns like this would take a long time. We may not even have any results at the end of it all. I went home that day at 10.00 pm , exhausted.

The nest day I decided to use white mice for the test on the 15 extracts where the poison could possibly be found. This was not a normal way a chemist work. I was never thought to be an orthodox person anyway. I had very few choices and the pressure to produce results was great. Professor Shumagaratnam of the Department of Pathology provided me with some white mice. I injected one mouse and it died instantly. Hurrah,! I exclaimed, only to be told that the mouse may have died due to trauma caused by me in injecting it. I then injected the extracts into numerous small pieces of cheese and fed them to the mice. It must have been common sense that made me do what I did. Luck was with me. After a few minutes one of the mice dropped dead. I repeated the experiment and obtained the same results on another mouse. Eureka, I shouted. The poison that killed the mice was from a barley extract.! We had not misled the Government, and the Government had not misled the people by their announcements. That released part of the pressure I had the day before.

I still did not know what to look for in that particular extract. I talked to the late Dr. Quah Quee Guan, Head of the East Pediatric Unit of the Singapore General Hospital (SGH).

She told me that certain muscular activities of the patients were affected which responded to atropine injections. This indicated that the poison, whatever it was, exhibited an anti-cholinesterase reaction to produce the observed symptoms.

It was already 7 pm on Tuesday 8th September 1959. . I was the only one left in the Department. I called the late Professor Robert Lin, Head of the Department of Pharmacology of the University. He was happy to assist me to check on anti-cholinesterase activity using a rabbit aorta, a standard experiment for medical students. By 9.00 pm we confirmed that the extract from the barely contained this poison which could have caused the death of the children.

What poison could this be ? I had to make a guess again. There were many possibilities. I chose to zero in on Florinated organo-phosphate insecticides. The insecticides, which Singapore imported in those days such as marathione, were not known to be that poisonous unless taken in large quantities. I decided to look for Parathione although I was not sure how this could have got into the barley. Furthermore Parathione was banned in Singapore then. Nevertheless I proceeded through the night and confirmed the presence of Parathione in the barley extracts by chemical methods on the morning of 9th September. An announcement was immediately made that the “killer’ has been found at 10.00 a.m. on Wednesday 9th September . The public anxiety which had been raised to a frenzy had at least been partially settled with this confirmation. I felt very good and much relieved but the stress and the fumes from parathione knocked me out for a few days after that.

I worked on the stomachs of the children, and confirmed the presence of Parathione .

After that I left the testing of the other extracts from the remaining food to Mr. Theng and my two other laboratory assistants. As I expected they got negative results from the more than 40 samples of other food taken from the families. This confirmed that we had not missed anything out.

After that the important issue to be settled quickly was how to control the barley containing the killer from being consumed and killing more people. Some suggested destroying all barley stock then available in Singapore. This was a panic measure which we advised against as it would cost the traders a lot of money. How then were we supposed to handle the situation? Who would be made responsible should we make a mistake? What if more people die? This was one time when I really felt the responsibility of my work and its pressure. We managed to solve it in record time by shear good luck and with the cooperation of some many kind people. I could not have solved the problem using pure chemistry alone. I learned many lessons from this experience and how to make my I.Q, E.Q. and A.Q. work together to achieve what we have to achieve.

The Government kept on announcing through the various media not to take barley until further investigations were completed. That was sufficient to stop people from buying and taking barley.

In the meanwhile working with the police, we rounded several samples of barley from shops in the affected areas. We noticed that only barley bearing certain markings on their gunny bags was found to contain the insecticide. Some bags were badly soaked with the insecticide. It was then obvious that only a certain batch of barley was the culprit. We recommended all remaining barley from that particular consignment be rounded up and destroyed. There was no resistance or negative response from the public on this issue.

What happened in Singapore also affected the Federation of Malaya. Several Federal Government health statements were reported by all State Health Departments. They also advised their public not to consume barley in any form until investigations are completed. Kuala Lumpur also reported 4 supposedly barley poison cases.

The question still remained to be answered was “ How did the poison get into the barley ?”

Who should be responsible for the deaths of our children? Please see Part Two on this series.

Lee Kum Tatt