People say that when you ask Kay about his experiences or achievements, he modestly goes mum and just passes his interviewer some of the papers he has published. And, true to form, we too were handed some of his Chinese and English monographs. What others describe as his outstanding contributions, he is apt to describe as trivial. But once you talk about the campaign for foreign medical aid, he starts speaking thoughtfully and at length, earnestly imparting instruction.

Kay is most frequently hailed for his successful research and development work in Nigeria to introduce soy products and thus help the local people overcome their lack of protein. For these efforts, he is known as the "father of African soymilk." For eight years beginning in 1971, at a time when Taiwan was still receiving private American aid, Kay was the first person from Taiwan to go and provide service in Africa. He went as an expression of his religious faith.

God's call

Kay was born into a Christian family. His father Kuo Hsi-hsin and his grandfather Kuo Ma-hsi were both ministers in the early days of the Presbyterian Church in Taiwan. During Kay's childhood, his father took him to live in Japan, and he attended the local schools. After he returned to Taiwan for college, he then went to Canada to attain a master's degree, and as a result he speaks Chinese, Japanese and English, and has been molded by several cultural traditions. It has given him a high tolerance for cultural differences. He says that perhaps the experiences of his youth were God's way of preparing him to serve in third world nations.

When he was 23, his fourth year in Canada, he took some knocks: in rapid succession he broke up with his girlfriend, lost his father, and dropped out of university. Under these adverse circumstances, he prayed continually, and started to hear a call from God to go to the developing world. Hence, after obtaining his master's, he went on to take classes in genetics, education and medicine that he thought would prepare him for work in developing nations. In 1971 he joined CUSO (Canadian University Service Organization) and went to Nigeria to serve under their auspices.

"I wasn't without feelings of anxiety and doubt," Kay recalls. "Subjectively, I felt that I wasn't bright enough, and I had little confidence that I was up to taking on this heavy responsibility. Objectively speaking, I wasn't a Canadian citizen, and I couldn't apply through their government foreign aid agencies. And since I didn't have a degree in theology, the route of church service was also closed to me." He notes that he had little medical training, but that God was pushing him in the right direction. In this instance, because he had a permanent residence visa in Canada, CUSO decided to relax its requirements and accept his application to be sent abroad.

"The moment when I landed in Nigeria," Kay recalls, "my doubts melted away, and I was certain that God wanted me there to work."

Improving on an old recipe

In Nigeria, Kay actively strove to understand the nation's medical and healthcare situation. Moreover, he went out on a limb, as a foreigner amid the authoritarian political atmosphere of Nigeria at the time, to write a paper expressing his personal opinions about medicine and education. The paper caused a lot of discussion, with impassioned arguments for and against that really stirred up the local government. He started out excited but ended up alarmed, not knowing if he was bringing good fortune or disaster upon himself. Every morning, he would organize his luggage to facilitate a quick exit if he was asked to leave.

Fortunately, after great debate the Nigerian government decided to accept his suggestions: They organized a national youth service corps and stipulated that college students from one tribe must perform their service in another tribe. The idea was to foster a service ethic among youth and promote cross-tribal understanding. Once they accepted Kay's medical and educational suggestions, the Nigerians also accepted his major discovery about nutrition, a discovery that would help to improve the problem of malnutrition among children.

Nigeria is split into three regions of rainforest, desert and grasslands. The diet in the rainforest consisted principally of starchy staples such as cassava. Moreover, there were various problematic customs, such as that elders would eat before the children and that those who worked would eat before those who didn't. As a consequence, mothers and children would only eat leftovers and children suffered from serious malnutrition, particularly a lack of protein.

"Almost one-half of all infants died before their first birthday," Kay recalls, "and those who survived had thin limbs and protruding bellies. This represented a serious health problem." Kay began to think about introducing the Asian custom of eating soy products to the area.

It turned out that people had long before suggested using soybeans to solve the problem of protein deficiency, but soy products never made inroads both because in a hot climate the bean is more prone to oxidation and decomposition, causing a sharp odor and bitter taste, and also because Nigerians had low tolerance of exotic foods. On second thought, Kay realized that if soy products were a staple of Asians, there was a well-developed culinary tradition worth learning from. And so he enlisted the help of the Japanese ambassador, and learned from the ambassador's cook how to make tofu and soymilk. After two years of repeated experimentation, during which time he "nearly gave up," Kay discovered that the Taiwanese method of creating soymilk through parboiling, which rids it of the offensive odor, only had to be tinkered with slightly to avoid the problems of oxidation and decomposition in the Nigerian climate.

"Unusually, the African magazine Tropical Pediatrics, which normally only published medical papers, was willing to publish my recipe," Kay recalls. "As a result, this method for making soy milk was quickly disseminated, and people were coming from all over to learn it from me." Women from many places volunteered to act as research assistants. They crammed into his dormitory single room, and in less than just three months came up with over 30 suitable recipes.

But then, after many years of promotion and research, he discovered that heavy consumption of soy products could lead to thyroid enlargement. To overcome this problem, at his own expense he went to study at Kyoto University in Japan, where he discovered a simple formula for adding iodine to the soymilk.

Helping others helps oneself

After having worked for eight years in Africa, Kay returned to Taiwan where he taught in the chemistry department of National Chang Hwa University until he retired. Throughout this period he worked tirelessly promoting a conception of Taiwan's duty to provide foreign medical aid. With the cooperation of Taipei Medical University, Kaohsiung Medical College and Chung Shan Medical College, he established TUSO (Taiwan Universities Service Overseas), which allows students, in a non-academic setting, to gain an understanding that the true spirit of medicine puts people at the center and does not distinguish between nations.

"Currently, only 35 people a year are allowed to perform foreign medical service in lieu of military service," Kay notes. "This is too small a number, and those performing this service shouldn't be limited to males of enlistment age." Having grown up amid affluence, young Taiwanese often have a utilitarian bias. By performing overseas service, they can learn that "those who give always get more in return." It should be a basic part of their education.

"Not just for youths, but for all of society, medical foreign aid is a case where helping others helps oneself." Kay points out that most of the world's poorest nations are in the tropics. In recent years the number of Taiwanese tourists heading for tropical countries has been steadily increasing. This fact combined with the 300,000 foreign workers in Taiwan means that tropical diseases are increasingly showing up here. Yet there are very few doctors in Taiwan who know how to treat epidemic diseases of the tropics. And so contracting a tropical disease in Taiwan is very much a life-threatening experience. Only by expending effort on research and prevention of tropical diseases, and at the same time increasing the numbers of doctors who perform service in the tropics, will Taiwan learn how to handle tropical diseases.

Theodore Kay describes himself as "dimwitted," reliant on determination and chance, achieving successes only by dint of repeated effort. "Credit for all I've done belongs with God," he says. Corinthians offers this teaching: "God chose the foolish things of the world that he might put to shame those who are wise. God chose the weak things of the world that he might put to shame the things that are strong."

Perhaps it's not a question of some people being dull and others bright, but rather a matter of the choices that people make both revealing their differences and exposing their greatness. With Kay's example, and with the other pioneers serving as guides, one can only hope that more and more Taiwan youths will elect to provide medical service overseas.

p.22

Theodore Kay, now nearly 70, has dedicated his lifetime to overseas medical aid. As a result of this choice he has had an exciting and unusual life. (photo by Jimmy Lin)

p.24

Life is hard in the tropical rainforests of Africa. Besides playing, children must also help husk cassava for the family's meals. (courtesy of the TRMPC)