Dr Wu Lien-Teh the Plague Fighter

2020 will be remembered as the time when the COVID-19 pandemic hit upon us. As the virus spread throughout the world, people were made to isolate themselves, the norm of working from home, the need to wear face masks, and the practice of social distancing.

Dr Wu Lien-Teh working with a microscope in his first plague laboratory in Harbin, China, 1911. Wu Lien-Teh Collection, PictureSG, National Library, Singapore

Not many realise it, but this is much a flashback of some of the practices that were pioneered 110 years ago by a brilliant Penang-born bacteriologist, Dr Wu Lien-Teh when he was responsible to deal with the Manchurian pneumonic plague during 1910–1911.

At that time, a deadly epidemic broke out in Fuchiatien (Fujiandian), the Chinese sector of the half-Russian town of Harbin in Northern Manchuria. Those who contracted the disease developed a high fever, a cough with blood-streaked sputum and purplish discolouration of the skin. Cases spiked, and almost all who were affected died within a few days.

Dr Wu and his assistant arrived in Harbin on Christmas Eve, 1910. The situation was depressing, temperatures were minus 30 degrees, the city had just two doctors and five dressers for a population of 24,000, and dead bodies littered the streets, making the primitive unsanitary conditions of the town even worse. Russian doctors suspected bubonic plague (which is spread by infected flea bites) and examined patients without a mask. They soon contracted the disease as well.

The families of victims were unwilling to provide the bodies of their loved ones for a post-mortem because of the Confucian tradition of mourning and burying the dead. The opportunity arose for Dr Wu when the Japanese wife of a Chinese innkeeper died, and Wu was able to perform the first-ever post-mortem exam in China. He found the presence of the plague bacterium Yersinia pestis and evidence that it was a pneumonic plague (spread through the air by human hosts).

Dr Wu Lien-Teh and a colleague carrying out fieldwork. To understand the effect of diseases on the body, they had to carry out live experiments, while being careful not to get infected themselves.
The plague outbreak in late 1910 spread with the use of railways. Medical staff gather in front of an inn. At the time, there were many confirmed and suspected cases, and there was a serious lack of medical spaces, leading to the use of inns as medical facilities.

Knowing that the disease was highly contagious and could spread from person to person through the inhalation of the bacterium, Wu formulated a strategy to control its spread. He had to do this quickly because many people were preparing to return from the city to their villages for the upcoming Lunar New Year, which would cause a further spread of the disease.

To keep the infected away from others, disused schools, warehouses, and other facilities like train cars were turned into isolation facilities. In addition, a new plague hospital was built while the old one was burnt down. Dr Wu also recommended the use of face masks so that people could protect themselves and others from the infection.

Despite all the isolation and movement control orders enforced by military troops, the infection and mortality rates continued to rise throughout January 1911. In addition, there was another problem in Harbin: dead bodies were piling up because the ground had frozen solid to a depth of two metres, making burial impossible.

Demonstrating the correct way to wear cotton and gauze masks during the second pneumonic plague in Manchuria (1920–21). Wu Lien-Teh Collection, PictureSG, National Library, Singapore.
Corpses were left unburied pose a huge health risk when rats, stray dogs would gnaw at the infected decomposing bodies and spread the infection further

In late January, when Wu visited the burial ground, he found rows of corpses and coffins a mile long, all unburied. This presented him with a most difficult and delicate situation. If the corpses were left unburied, they would pose a huge health risk in the coming spring when rats would gnaw at the infected decomposing bodies and spread the infection further.

The only way to quickly dispose of the corpses was to organise a mass cremation, but that would go against the tenets of Confucianism in a country where ancestor worship and visiting ancestral tombs had been viewed as an act of filial piety for centuries. Eventually, the containment measures began to have an impact and mortality rates started falling almost immediately. By 1 March 1911, the last case of the plague in Harbin was registered. In other cities, the outbreak lasted another month before it was finally contained. In all, the epidemic affected an area that stretched almost 2,800 km from Manchuria to Peking and reached Zhili and Shandong provinces. It lasted seven months and claimed some 60,000 lives.

Horse carts transporting corpses to the cremation ground in Fuchiatien, Harbin, 1911. China’s first outbreak of the deadly pneumonic plague occurred in this remote northern Manchurian region. Wu Lien-Teh Collection, PictureSG, National Library, Singapore.

Dr Wu Lien – The Person

His name does not exist in our school history books and he has never been accorded the recognition that he truly deserves. Yes, he was a Malaysian. He was named ‘Gnoh Lean Tuck’, officially registered by a school clerk who transliterated his name into Hokkien, although his Cantonese birth name was ‘Ng Leen Tuck’. Upon his arrival in Tianjin, China, he transliterated his name into Mandarin as ‘Wu Lien-Teh’ in 1908.

He was born in Penang on March 10th, 1879. In 1886, at the age of seven, Wu studied at the Penang Free School. Years later, he sat for the first of his four attempts at the Queen’s Scholarship examination. In 1896, the 17-year-old was finally awarded the scholarship and became only the third student from the Penang Free School to bag this prestigious honour.

He then went to England to study at Emmanuel College, University of Cambridge. He became the first ethnic Chinese to study medicine in a prestigious university. Wu successfully defended his thesis and, at age 24, had done everything necessary to fulfil the requirements and was awarded the prestigious degree of M.D. from Cambridge University.

Dr Wu Lien-Teh in a studio portrait with his second wife Marie (his first wife passed away in 1937) and their children, 1949. Wu Lien-Teh Collection, PictureSG, National Library, Singapore

Dr Wu returned to Malaya with his family in 1937, and resume his private medical practice at the Boon Pharmacy in Ipoh. Like most other Malayans, he also suffered during the Japanese invasion of Malaya. However, he was friendly with many of the Japanese commanders who sought his medical services. He finally retired from medical practice in 1957 at the age of 78. In mid-January 1960, he moved back to Penang where he was born but died a week later on January 21st, 1960, after suffering a stroke. He was survived by his second wife, Marie, two sons and three daughters.

The Times London commented on January 27th, 1960: “By his death, the world of medicine has lost a heroic and almost legendary figure and the world at large one of whom it is far more indebted to than it knows.” Wu gained great fame as a pioneering plague fighter and became the first Malayan nominated for the Nobel Prize in Medicine in 1935. Wu Lien-Teh Institute was opened on Dec 24th, 2015 with the aim are to researching infectious diseases and sharing the resulting knowledge with everyone.

The article was written by Muhammad Haizril Arif Md Mokhtar and Prof Victor Hoe for the speech by Prof Dr Victor Hoe during the Ceremony for the First Dr Wu Lien-Teh Public Health Award for the best Doctor of Public Health Graduate from the Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya

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