He was already a pretty heroic figure — someone who had put Singapore on the map with his super-human feats — such as being the first to complete a marathon at the North Pole on a wheelchair.

He is also intelligent: a neuroscientist and medical doctor, a Fulbright scholar, among his academic successes.

But since The Straits Times broke the news of his illness, and his subsequent letter denying that he had acute myelogenous cancer (AML) — he doesn't, he has a different form of leukaemia called chronic lymphocytic leukaemia (CLL) — we have met a couple of times, and communitated by email much more frequently.

I now not only admire, but also like him very much.

You can admire a person for his successes and his feats. But such people are not necessarily likeable. Even charity work is sometimes done for the publicity it generates.

But after more than three hours last last week listening to William talk about his life since discovering he had cancer, his honesty, humanity and love of life came through with cutting clarity.

Yes, he does strive to set world records.

But the fact that he finished the Paris marathon, even though he was trailing so badly, tells a story — he wants to be first. But more than that, he wants to complete what he has started, even if it means he is the last past the finishing line.

With his nose bleeding like a leaky tap, no one would have faulted him for dropping out of the race. He sets such high standards for the rest of us to follow.

Is William, paralysed from the waist down since the age of two, disabled?

Not by a long shot.

Not when he has so much determination and tenacity.

His determination to be a model patient, compliant to all that his doctors want him to do, to give his fight against cancer his best shot, is a new height he hopes to scale.

People like Dr William Tan are perhaps put into this world to inspire the rest of mankind.

In the past, he has shown that a physical disability cannot stop a good man. He gives inspirational talks around the world. People sit up and listen to him, because of his achievements in spite of his paralysis.

He has already done much good. But perhaps the best is yet to come.

In how he fights his cancer, William could be a model for other cancer victims: don't take it lying down, fight it till the very end.

As he said, once he has decided on a course, there is no turning back, no matter how tough the going gets.

It was that single-minded determination that got him pushing a spiked wheelchair in the frozen waste of both the Arctic and Antarctica.

If he can inspire other patients, of cancer and other illnesses, to also do their best to beat their disease, then he would leave an even greater legacy.

These figures have been dragged down by the brilliant performance of the National University Hospital, where infections have been almost halved from four to 2.1 per 1,000 patients in that five-year period.

But what the figures don’t show is that the hospital has changed the way it counts MRSA infections.

Instead of reporting all cases, it started reporting only “new” cases. Nothing wrong with that, as the hospital wanted to know how many patients had actually caught the bug while in hospital.

A patient who has been colonised – that means the patient has the bug on his skin or in the nose, but is not sick with it – is regarded as having brought the bug in with him.
Should he undergo surgery, for example, and the bug then gets into his blood stream or organs, and he then gets infected, he is not counted as having hospital-acquired MRSA.

But because of this practice, NUH numbers which stayed at four or more per 1,000 patients from 2002-2004, started falling in 2005.

This raises the question of how much MRSA rates in public hospitals have really fallen by. And how these patients became colonised with the drug resistant bug in the first place.

Since MRSA is largely found within hospital walls, it would be reasonable to assume that the vast majority got it in hospital.

But over the years, these bugs have been leaking out into the community. How do these bugs get out? Is that another area that needs to be plugged?

A recent article on MRSA published by infectious diseases experts here claims that each of Singapore’s three largest hospitals sees “almost one death, six to nine new clinical infections and up to 60 new individuals colonised per week.”

Those are not small numbers.

Hospital-acquired MRSA infections are not a uniquely Singapore problem. It is seen all around the world. Only a handful of countries have succeeded in keeping numbers of infections low – at high cost and with all hospitals working in unison.

While there is no need for hospitals here to berate themselves, it is also not something Singapore should remain complacent about.

Other countries have shown that with the will to stamp it out and the resources to do so, it can be done. It is certainly something worth doing, since it will save much unecessary suffering and deaths.

But no single hospital can do it alone. Singapore is a small country and patients move from one hospital to another. Hospital workers, some of whom may carry MRSA, also move, bringing the bugs along with them.

As Tan Tock Seng’s Professor Chng Hiok Hee so rightly pointed out, patients and their visitors too help to spread the bug. All it takes is one weak link.

So while doctors, nurses and other healthcare workers need to be more stringent in hand hygiene – contaminated hands are the single biggest cause of MRSA transmission say experts – patients and their visitors too need to ensure that they do not spread the bug.

This could well be the reason patients in subsidised wards are at higher risk of catching the bug. All it takes is for one helpful patient going to the aid of another – putting a pillow straight, offering a cup of water – to spread the bug.

Public education is needed to teach people that hospitals are not clean places and that they must take care.

Scenes of children running around a ward during visiting hours are all too common. They do not know the danger they are putting themselves in.

Since the stories on hospital-acquired MRSA appeared in The Straits Times, many patients have called to share their experiences of how they caught unknown infections, not necessarily MRSA, in hospital.

One man complained that the patient in the next bed kept sneezing. One woman actually called from a hospital ward to say a patient placed in an isolation ward was walking around, and the nurses weren’t stopping her.

As people become aware of the dangers of infection spreading, they will take greater precautions and this could help break the chain of transmission.

Hospitals now have alcohol rubs in all wards and at every bed, making keeping hands clean easy. Some even have them in the lobby and along corridors.

But these rubs are of no use if they are not used. Even among people who use them, not all use them correctly, often missing the back of hands, the wrist or the webbing between fingers.

While most hospital staff do use the rubs, few patients or visitors do. It’s time they did, if only to protect themselves.

What is needed is public education, so that visitors and patients do not become the weak link in the fight against infection.

Jamuna is now the proud owner of three teddy bears, lots of books and many toys - all gifts from well-wishers here.

Since her return in September, she has made new friends - including many who have come forward to help offset the cost of her stay here.

Some have paid for her air ticket, others have helped with the $1,000 a month rental of a room at a hostel close to East Shore Hospital where she is being treated. East Shore Hospital, is also helping out, providing mother and daughter with free meals when Jamuna is there for her daily physiotherapy.

But old friends, have not forgotten her either.

Some, including the many nurses who looked after her and her former conjoined sister during their first trip here in 2000, have been visiting the little girl and her mother.

This has meant a lot to her mother Madam Sandhya Shrestha, who is here alone with Jamuna.

It was too costly to bring more members of her family over, so Madam Sandhya has been coping alone with her daughter whose weak right arm and leg makes it impossible for her to stand or go to the toilet without help.

In the couple of days prior to her latest operation, many turned up at her hospital room to wish her well.

Salma Khalik (right) shows Jamuna photos that were
taken when ST visited her in Kathmandu during August.
ST Photo: Lim Wui Liang

One man came to East Shore Hospital to visit her was so emotional that he couldn’t help crying at the amount of pain the little girl has suffered.

On the day of her surgery on Wednesday, Raul and Tashii Gurung, two Singaporean children of Nepali descent, who have become fast friends with Jamuna, spent the morning playing with her on Wednesday, keeping her mind off the surgery she would be facing that afternoon.

Their mother, Mrs Alawiyah Gurung, who brought eight-year-old Jamuna back this time said summed up the scene in Jamuna’s hospital room describing it as a “boot camp”.

There were more visitors than the sofa, two arm chairs and the bed could accommodate, so some ot the visitors ended up sitting on the floor.

But no one minded.

In the long hours of waiting after Jamuna was wheeled into the operating theatre, they filled in the time by reading, playing Sudoku or electronic games. Except for four-year-old Tashii, who fell asleep after the excitement of the morning.

Around 7pm, five hours after Jamuna had been wheeled into the operating theatre, the high spirits were replaced by niggles of worry. Every now and then, someone would say “I’m sure it’s alright” or, if anything had gone wrong, it “surely would have happened early in the surgery.”

At 7:30 pm, the good news came: The operation had gone well and Jamuna was awake. 

A tension-releasing burst of laughter greeted the news that Jamuna’s first thoughts on waking up were about her dinner - because she had gone without lunch in preparation for the surgery.

Her cheer squad trooped up to the intensive care unit to peek through the glass window for a view.

It was even more emotional for Madam Sandhya, who had burst into tears at the good news and went to the bedside of her remaining daughter.

But amongst the euphoria at Jamuna’s sucessful surgery, the memory of Ganga was still fresh. 

She died in July – on a Tuesday - which was why Jamuna’s operation, originally scheduled for the day before, was pushed back one day to a Wednesday. 

The public hospitals in Nepal are crowded, not very clean and the staff harried.

In the private sector, where patients might have to pay half a months’s salary for a simple treatment, things are marginally better.

Dr Basant Pant, the neurosurgeon who has been keeping an eye on conjoined Nepalese twins Ganga and Jamuna since their separation and return to Nepal in 2001, is a private sector specialist.

He works a 14-hour day.

By 8 am, he’s at the Kathmandu Model Hospital where he heads the neurosurgical department. In the afternoon, he’s at the Norvic International Hospital where he ends the day at about 10 pm.

He does this six days a week. On Saturdays, the weekend day off in Nepal, he would pop into the hospitals for a quick check on patients in the wards.

Dr Pant had promised The Straits Times team an interview during our short stay in Kathmandu, but had difficulty slotting it into his busy work day.

After keeping us waiting for an hour, he suggested we don scubs – or surgical gear – and interview him in the operating theatre.

So there we were, in gowns and masks, told not to touch any of the sterile equipment, talking to the doctor as he was removing the tumour in millimetre bits.

He needed to remove a two centimetre tumour from a patient's spine.

During the half hour interview, we also had the chance for a close-up look at the exposed spinal cord and the small piece of remaining tumour stuck to it, which has caused some paralysis in the patient.

When we left the hospital at about 9pm, Dr Pant was just taking a break, leaving his assistant surgeons to close up the wound, before he returned to ensure that all was well.

Definitely an interview not about to be forgotten anytime soon.

Salma Khalik (left) interviews
Dr Pant in the operating theatre.
ST Photo: Lim Wui Liang