From a young age, Manickavasagar Balasegaram aspired to be a doctor.

Born in April 1929 in colonial Malaya – at a time when education was deemed a privilege, instead of a right – he overcame all obstacles to earn a state scholarship and pursued medicine at King Edward VII College in Singapore, qualifying with an MBBS in 1955.

He joined the Kuala Lumpur General Hospital (GHKL) to begin his surgical career and earned the Fellowship of the Royal Colleges of Surgeons (FRCS) from both the English and Edinburgh Royal Colleges in 1960.

Well known for his dedication to medicine

‘Bala’, as he was known, was extremely hardworking as a young surgeon. At one point, he spent months without leaving the hospital, sleeping only a few hours each night in the hospital rest room while covering duties for a colleague who was away on training.

“I have a mistress – her name is surgery and she is very demanding,” he would say to his supportive wife, Jeyaletchimy.

His drive to improve healthcare was limitless and he diligently confronted endless challenges to develop the field of medicine in the country. Unable to secure government funds, he persuaded the Rotary Club and other organisations to provide donations and successfully set-up a modern intensive care unit (ICU) in Seremban hospital, dubbed the “first of its kind in south-east Asia.”

The birth of the ‘Balasegaram clamp’

The anatomy of the liver was still poorly understood back in the 1960s, and as a result of limited diagnostic and treatment procedures for liver trauma, many road accident victims who failed to secure their seatbelts would succumb to liver injuries.

Undeterred, Bala explored and studied the anatomy of the liver – injecting coloured rubber latex in cadaveric livers to unravel the complex blood vessel and biliary networks of the organ. With his knowledge, he began performing liver resection– an unprecedented procedure in the country – which markedly reduced mortality rates of patients afflicted with liver injuries. He also started the hepato-biliary centre in GHKL, which became a referral centre not just for Malaysia, but for the entire region.

Balasegaram liver retractor. Photo credit: Science Museum Group
Balasegaram liver retractor. Photo credit: Science Museum Group

He then designed a clamp to control liver bleeding, which was manufactured by Down Brothers in London. The ‘Balasegaram clamp’ is still used to this day, and is among other instruments Bala designed, but never sought royalties for.

His life-saving skill was acquired at the right time – on 13 May 1969, during the racial violence in Malaysia, Bala worked tirelessly with a team of health professionals to save the lives of victims, many of whom suffered from liver injuries.

A remarkable surgeon who put Malaysia on the map

Bala was also a man of discipline who ran a tight ship as the head of the surgical department in GHKL. Daily ward rounds would begin precisely at 8am, and cases listed for surgeries were rarely left pending, as the junior doctors would stay up to finish all work.

“In my ward, no-one is higher than the patient in front of you,” he would say to his team of doctors, and though his training was rigorous, he was highly respected as an academician and a mentor.

Global interest in his published work and research led to lecture tours in elite medical facilities across 25 countries. For many years, he was an examiner for FRCS Edinburgh as well as for the Royal Australasian College, and was a visiting professor for many universities around the world. Through his efforts, senior surgeons from international health facilities would also visit Malaysia to coach young doctors.

He became the first Asian to receive the Royal College of Surgeons in England’s Hunterian Professorship award in 1969, and the following year he became the first Asian be honoured the Jacksonian prize, the highest known award in surgery. He was also an honorary fellow of the Phillipine College of Surgeons (PCS), a fellow of the American College of Surgeons (ACS), the International College of Surgeons (ICS), the International Academy of Proctology (IAP) as well as the Collegium Internationale Chirurgiae Digestivae (CICD).

Bala continued serving the nation through private practice even after his retirement from government service in 1983. He passed away in 2014 at the age of 85. The Academy of Medicine of Malaysia established an annual memorial lecture in his prestige, but Datuk Dr Manickavasagar Balasegaram will be remembered by many as a distinguished doctor who dedicated his efforts to expand the frontiers of surgery. MIMS

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