By Annabelle Lee

Dr Ho Kim Wah struggled to sleep the night the movement control order (MCO) was announced.

A haematologist in charge of stem cell transplants at Hospital Ampang, he could not stop thinking about his three leukaemia patients whose lives were at stake.

They were scheduled for transplants that week but the latest travel restrictions spelt complications as their stem cells needed to be brought in from abroad.

The next morning, Ho rushed to Putrajaya to seek permission for the vital packages.

After spending hours at the Customs Department and Immigration Department counters, he was ultimately told that he needed approval from the Health Ministry.

This was March 17, just when the country began seeing triple-digit increases in Covid-19 cases.

Relaying his experience to Malaysiakini, Ho thought it was impossible to get the ministry’s attention at a time when its hands were full handling the virus outbreak.

Nevertheless, he tried. And waited.

“By the afternoon that same day, we actually got the letter from director-general Dr Noor Hisham Abdullah.

“I am very thankful to him because he entertained us during this period of time when he was so busy,” Ho said.

It is understood that deputy director-general Dr Rohaizat Yon also personally facilitated the paperwork.

In the nick of time

With the paperwork sorted out, the next hurdle was to get the stem cells to the hospital in time for the transplants on March 18, 19 and 20.

Delays were not possible as all three patients had already been primed for the procedure and desperately needed a transfusion of new blood cells.

The Ampang Hospital team of stem cell transplant doctors.

Before a stem cell transplant, recipients must be cancer-free and undergo a strong blast of chemotherapy to make room in their bone marrow for the transfusion.

“I had already given them chemotherapy so their white blood cells was at zero. If I did not infuse the stem cells into their body, their white blood cells would remain low for a very, very long time.

“A person with zero white blood cells does not have any immunity and they will get all sorts of infections. The patient will definitely die,” Ho explained.

Late at night on March 17, a trained volunteer from the Bone Marrow Donor Programme in Singapore hurried across the Causeway with one stem cell package just in time before the MCO came into effect.

Equipped with the official permits, she made a second trip for another one of the leukaemia patients.

Delicate and temperature-sensitive, stem cells must be hand-carried and delivered the same day a transplant is to be performed.

In both instances, Ho arranged for fellow haematologist Dr Azizan Sharif to pick up the packages from the volunteer in Johor Bahru before having them delivered to Ampang.

The third patient’s package had to be flown in from Thailand.

Ho remembered feeling nervous when the courier was held up for hours at the Kuala Lumpur International Airport and ultimately barred from entering the country.

With just hours to spare before the transplant, he had to immediately send a colleague, Dr Gilbert Wilfred (above, right), out in an ambulance to pick up the package from the airport.

A promise fulfilled

It has been a month since his stem cells arrived from Thailand, and 54-year-old Choo is grateful to the doctors, nurses and volunteers responsible for his second chance at life.

He also feels indebted to his anonymous stem cell donor.

“I am just like a newborn baby.

“I now have a second birthday, on March 19,” the father-of-two jested in a conversation with Malaysiakini.

Choo undergoing stem cell transplant.

Hailing from Kota Kinabalu, Choo was first diagnosed with leukaemia in 2018 and suffered a relapse last year. Undergoing a stem cell transplant was thus important to reduce the risk of another relapse.

Like his doctor, Choo felt worried following news about the MCO.

With his immunity compromised and transplant procedure up in the air, his sister flew in from Sabah after the announcement to be on standby as his back-up stem cell donor despite being a half-match.

Using stem cells from a half-match donor, meaning blood that is only a 50 percent genetic match, exposes patients to higher rates of rejection and infection.

Compared to using a true match, the mortality rate for such procedures can be up to 40 percent.

“I was in tears and I called my mum immediately after Dr Ho informed me that the stem cells had reached KLIA. I was so happy.

“I was lucky to have a big team of doctors by my side,” Choo said.

Choo, with his wife, one month after the stem cell transplant.

He has since been discharged and is recuperating well. He returns to the hospital for weekly follow-ups.

Back at the haematology ward, Ho felt humbled by the teamwork that enabled him to uphold his promise to his three patients.

“I promised them I would try my best.

“I tried my best and with all the help from everyone, we actually managed to get the stem cells in during the MCO period,” he said.