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Biographical entry Sreenevasan, Datuk Gopal Ayer (1922 - 2010)

DSPN 1988; JSD 1969; MB BS Adelaide 1952; ChM Liverpool 1962; FRCS 1962; FRCS Edin 1962; FRCSI 1962; FRACS (Urol) 1965; FACS 1970; FAMM 1973; FASM 1995.

21 November 1922
4 February 2010


Datuk Gopal Ayer Sreenevasan, or 'Sreeny' as he was affectionately known to his friends and colleagues, was a pioneering Malaysian surgeon and a powerful force in the development of the medical services in the country as a whole. It was largely due to his enthusiasm, hard work and expertise that the specialty of urology separated from general surgery in Malaysia, following the trend in more developed countries. He was responsible for training the first generation of pure urologists in the country and may therefore be regarded as Malaysia's 'father of urology'.

Gopal Ayer Sreenevasan was born in what was then Malaya on 21 November 1922, of parents and forebears from southern India. He was the son of Gopal Ayer Ramaswamy, an assistant commissioner for labour in the state of Selangor, and Mangalam Seetharama Ayer. Sreeny's father was awarded the MBE and OBE for his work. Sreeny obtained his primary education at Batu Road School, Kuala Lumpur, and then went on to study at the Victoria Institution. He wrote: 'My schooldays were unimpressive except for participation in inter-school debating competitions and winning several prizes for my school.'

Having decided to enter medicine as a career, and financed initially by his father, Sreeny turned to Australia, a country that was already developing undergraduate links with Asian countries, for his further education. In 1947 he sailed to Perth, where he completed the first year of a science degree at the University of Western Australia. He then entered the University of Adelaide in 1948, and was resident at St Mark's College for his clinical studies. Sreeny received tremendous encouragement from the master of the college, Bob Lewis and his wife, Betty. Just prior to sitting the fifth year exams in October 1951, he received the news that his father had died unexpectedly and he was urged to return home to Malaysia without delay.

It seemed unlikely that Sreeny would ever return to complete his medical degree. He turned to Bob Lewis for fatherly advice when he noticed advertisements in the local press requesting suitable applicants for the newly introduced Colombo Plan scholarships, which were designed to help students in less developed countries to study in Australia, Canada, USA and the UK. Lewis offered assistance without hesitation, sending the necessary recommendation and appropriate references to Kuala Lumpur. Sreeny was selected for an interview and was awarded one of the first Colombo Plan scholarships. He returned to Adelaide, passed his fifth year at a supplementary examination and then entered the final year. He graduated MB BS in February 1952.

After graduation, Sreenevasan took house appointments at the Royal Perth Hospital, Australia, during 1953 and 1954, before returning home to Malaya when he joined the government medical services. He was posted to Seremban General Hospital in the state of Negeri Sembilan, situated to the south of Kuala Lumpur. He worked with a general surgeon who had an interest in urology. After three years in progressive posts, in 1957 he obtained a government scholarship to pursue postgraduate studies in England, specifically to prepare for the FRCS diploma. By this time, the Federation of Malaysian states had gained independence from British rule.

In the UK, he attended postgraduate courses and was attached to surgeons in Liverpool who supervised his overall training in the UK. Arrangements were made for him to work in the urology unit at the Manchester Royal Infirmary under the watchful eye of Thomas ('Tommy Tucker') Moore, a general surgeon turned urologist. Sreeny increased his experience in urology, also keeping in touch with general surgery. In 1962 he passed his FRCS England, FRCS Edinburgh and FRCS Ireland, and obtained the ChM Liverpool - an impressive list!

When Sreenevasan returned to Malaysia with the ambition of specialising in urology at Kuala Lumpur General Hospital, he found that the majority of general surgeons still regarded urology as well within their own capabilities, and had to overcome a degree of prejudice. During a visit to Kuala Lumpur by the charismatic and well-known Australian surgeon, Sir Edward ('Weary') Dunlop, Sreeny mentioned his dream of the separation of urology from general surgery to the distinguished visitor. With his help and that of the Australian-Asian Association of Victoria, Sreeny went to Melbourne so that he could prepare for the Australasian fellowship in urology. Australia and Canada at the time were the only two countries in the Commonwealth offering this type of specialist training leading towards a recognised diploma. He took unpaid leave and, after studying at St Vincent's and the Royal Melbourne hospitals, he gained the fellowship of the Royal Australasian College of Surgeons in urology in 1965.

Sreenevasan therefore became the first pure urological surgeon with a specialty-registered diploma in Malaysia, his state work being performed at the Kuala Lumpur General Hospital. He had a vision that urology and nephrology should work together in geographical proximity, and that renal dialysis could benefit hundreds of patients. Perhaps at a later date even renal transplantation would become a reality. He received great encouragement from John Swinney of Newcastle-upon-Tyne, with whom he discussed his plans during a visit by the Royal College of Surgeons of Edinburgh's examining team to Kuala Lumpur.

Kuala Lumpur General Hospital, founded in 1870, underwent rapid expansion in four planned stages from 1962 to 1975 under the Malaysian Ministry of Health. The potential for gaining increased facilities for 'his' urological unit was not lost on Sreenevasan. He and a handful of other enthusiastic doctors seized the opportunity to start a urology unit at the hospital in the older buildings as they were vacated. Sreeny was given an allocation of two beds for males and another two for females. By dint of hard work and many long hours, and with the help of S M A Alhady and Ten Yoon Fong, and using a Kolff dialysis machine, haemodialysis was performed in the evening, after a busy day's work. With the help of the Ministry of Health and another colleague, R P Pillay, Sreenevasan started the Institute of Urology and Nephrology in 1968, again in the old hospital. As the surgical units moved into their newer premises, separate male and female urological wards and operating theatres became a reality with the provision of offices and other much-needed areas. Sreeny and his colleagues, based at the Institute of Urology and with modest expectations, started Saturday morning teaching sessions in the form of a 'journal club' and clinico-pathological and radiological conferences, in which pathologists and radiologists willingly participated.

In mid-1968, with the help of a Fulbright award, Sreeny went for a year to the USA. Six months were spent in Boston, Massachusetts, USA, mainly at the Massachusetts General Hospital with Wyland F Leadbetter. He then went to the west coast of the USA for a further six months to UCLA, working in Willard E Goodwin's unit. On hearing of the May 1969 race riots in Kuala Lumpur, one of the professors at UCLA offered Sreeny a position in the unit, but such was his commitment to his native Malaysia and the embryonic urology Institute in Kuala Lumpur, that he graciously declined the offer and returned home to continue his pioneering work. He sat and passed the examination for the fellowship of the American College of Surgeons and arrived back in Malaysia in time to help many of the injured who were still in hospital after the riots.

He was instrumental in obtaining a fellowship for one of his younger colleagues, Hussein Awang, to go to Sydney, Australia, to be tutored in renal transplantation, thus completing the unit's expertise. Between 1975 and 2010, some 650 patients received new kidneys.

The year 1974 represented a major milestone in the development of urology in Malaysia. Apart from the opening of the Institute of Urology and Nephrology at the General hospital, Sreeny also helped establish the Malaysian Urological Association (MUA). At a time when there were only four urologists in the country, Sreenevasan became its first president and continued in office until 1987, and David Chelvanayagam was its secretary. The other two urologists were Hussein Awang, a close associate of Sreenevasan, and E Proehoeman. The MUA now has 100 members and holds meetings similar to those of other urological associations and societies worldwide. Needless to say the repertoire of Malaysian urologists has expanded over the years and embraces modern non-invasive and robotic techniques.

At the Royal College of Surgeons of England Gopal Ayer Sreenevasan was awarded a Hunterian professorship in 1973 for his work on 'Bilateral renal calculi'. In his lecture he emphasised the place of renography, which greatly facilitates the decision as to which kidney should be operated on first. This lecture was published in Annals of the Royal College of Surgeons (Ann R Coll Surg Engl. 1974 Jul;55[1]:3-12), and was later included in the book Classic papers in urology (Oxford, Isis Medical Media, 1999). He was the second Asian surgeon to be appointed Moynihan Lecturer: Sreeny gave this prestigious lecture during the RCS visit to Kuala Lumpur in 1989. Once again it was on urinary stones, this time on the future use of extracorporeal shockwave lithotripsy. Sreeny ended his Moynihan lecture by quoting from a specially-taped interview with Leslie Pyrah, the doyen of British urology, who had worked with Moynihan. Pyrah described him as 'a charming man with a magnificent presence, always punctual - a very good teacher - a very good operator - very, very hardworking, very energetic. He once said a surgeon needs to have the wisdom of Aristotle, courage of a lion and gentle hands of a lady.'

Sreeny held many prestigious offices, including master of the Academy of Medicine of Malaysia (AMM) (from 1973 to 1976), president of the Malaysian Medical Association (from 1976 to 1977) and president of the Malaysian Urological Association (from 1975 to 1987). He was involved with the National Kidney Foundation of Malaysia since its inception, and became the longest-serving chairman (from 1974 to 2002).

Many honours and awards also came his way, including honorary membership of the Singapore Urological Association (1993), the distinguished alumni award of the University of Australia (1994) and the foundation fellowship of the Academy of Sciences in Malaysia (FASM) (1995). From the Malaysian state he received two honours: the Johan Setia Diraja (JSD) (in 1969) and the Darjah Setia Pangkuan Negeri (DSPN or Order of the Defender of the State - Knight Commander) in 1988.

Sreeny retired from state medical practice in 1974, but continued in private urological work at the Assunta Hospital, Petaling Jaya, Selanagor, until 2001 and at the Pantai Medical Centre, Kuala Lumpur until 2009.

Gopal Ayer Sreenevasan married Visalakshi Subramaniam in April 1954 in Madras. They had been introduced to each other by a very close family friend. Sreeny brought his wife from south India to Malaysia, and so unfolded a '56-year-old love story', as one of their daughters recorded. Visalakshi had obtained a BA degree in Sanskrit in from Benares University and then an economics degree at the Presidency College, Madras. They had two daughters - Swarupini (a university teacher) and Ambiga (a human rights lawyer) - and a son, Gopal (a barrister).

Gopal Ayer Sreenevasan died on 3 February 2010 after a short illness. He was 87. His wife Visalakshi died in May of the same year. He was survived by his three children and seven grandchildren (Gayathri, Gowri, Vidhya, Gokal, Sharanya, Anya and Milan). With his death the Malaysian medical fraternity lost its most illustrious man, a professional giant and a deeply religious man, who never looked for rewards in anything he did.

N Alan Green

Sources used to compile this entry: [Swarupini, Ambiga and Gopal Sreenevasan; The Malaysian Indian Journey (second edition, Kuala Lumpur, MDM Designs and Prints, 2011); Lumen The University of Adelaide Winter 2010 issue; 'Datuk Ambiga Sreenevasan, an international woman of courage' Ad Liberté 2 June 2012; Australian Government, Department of Foreign Affairs and Trade: Australia and the Colombo Plan 1949-1957 - accessed 24 October 2014; 'A tribute to the late Dato Dr GA Sreenevasan'Share: National Kidney Foundation Newsletter; Selvarajah, S and Khoo K K. History of medicine in Malaysia vol. II: The development of medical and health services (2008); 'Urinary stones in Malaysia - its incidence and management' Med J Malaysia. 1990 Jun;45(2):92-112].

The Royal College of Surgeons of England