This is the thirteenth instalment of a series on the history of medicine in Singapore.
The British civil administration decided to take the opportunity to develop medical services. A ten-year Medical Plan was drawn up and approved by the Legislative Council in 1948. That year, the Rotary Tuberculosis Clinic in Tan Tock Seng Hospital (TTSH) was built.
In the 1950s, the resources of the hospitals, and in particular those of the General Hospital (GH), were being stretched to the limit, having to deal with increasing numbers of inpatients and outpatients as the population of Singapore grew. (The post-war years witnessed high birth rates, with the number of births increasing from about 10,000 in 1948 to a historic high of 40,000 in 1966.) Overcrowding of the wards was a very serious problem, and inpatients were occupying verandahs and corridors. In Kandang Kerbau Hospital (KKH), the situation was no better. Births averaged over 1,000 a month (13,238 for the year 1950) in the 240-bed hospital. The labour wards were so overcrowded that some patients delivered on trolley beds. To ease the shortage of beds, the length of stay of each patient was shortened from between ten to 12 days to just three days.
The Medical Plan was implemented in 1951. Special funds were also allocated for the fight against tuberculosis, and the BCG inoculation was introduced. Existing hospitals were expanded and new clinics were built for outpatient, maternal, child and infant services. Various ordinances regarding public health were enacted.
The Government realised that organised and well-equipped outpatient departments would be an alternative to treating a large number of patients without admitting them. Thus, the medical units in the GH began to form Specialist Outpatient Clinics for general medical cases, endocrinology, neurology, respiratory medicine and haematology. Medical officers of the Royal Army Medical Corps saw patients with skin diseases and venereal diseases. The Surgical Units ran small outpatient clinics for patient follow-up after discharge, and the Anaesthetic Unit ran outpatient clinics for patients with intractable pain. Patients with non-urgent surgical conditions generally had to wait for more than six months for operations. Therefore, a new surgical theatre block (now the site of the Singapore National Eye Centre) was built. In 1952, the Department of Orthopaedic Surgery was established at the Norris Block of the GH, while Prof JAP Cameron was appointed to the orthopaedics chair at the University of Malaya. In 1952, a School of Midwifery was set up at KKH, and that year saw over 15,000 births. (In 1978, KKH's School of Midwifery was transferred to the School of Nursing at the Singapore General Hospital [SGH] and the school building was demolished.)
In 1953, the foundation stone for a new extension wing of KKH was laid at Hampshire Road, across from the old wing in Buffalo Road, and this opened in 1955. The two wings were fondly known as the Tekka Hospital. By this time, there were over 22,000 births in Singapore. (The labour wards of the two wings witnessed a record of just over one million births from 1955 to 1997.) The old KKH building now houses offices of the Singapore Land Transport Authority, just adjacent to the Little India MRT station.
In 1953, the Medical Registration Ordinance was enacted and houseman-ship was made compulsory. 1953 also saw the commencement of the third year clinical training of Dr Kwa Soon Bee. Dr Kwa joined the Government service in 1955, and as a houseman, his salary was $400. In 1954, electroencephalography was introduced into the GH. That year, at KKH, a Domiciliary Aftercare Service (DAS) was started to cope with the high demand for beds. The DAS looked after women who had been discharged 24 hours after confinement. The patients were carefully selected and if their homes were found suitable, they were brought home by ambulance. Midwives would visit them at home and report any abnormality to the hospital for follow-up action. Each day, about 20 to 30 women were discharged to be cared for by this service.
In 1955, a Paediatric Unit of the GH moved into the newly completed Mistri Wing, built with funds provided by Mr NR Mistri. That year, Singapore was awarded the Kettering Shield for having the best Maternal and Child Health Service in the Commonwealth. Carotid angiography was used for the first time in 1955 at the GH. In August 1955, at the KKH, the Domiciliary Delivery Service was introduced. Women who had received antenatal care at the hospital were given the option of hospital delivery or home delivery, after assessment of the suitability of their homes for delivery. In September, the service saw the delivery of its first baby. The new extension wing at the KKH saw an increase in beds, new operating theatres, an X-ray department, and clinics for women and children.
In 1956, the School of Nursing and Nurses Quarters was opened on the GH grounds, and the Sisters' Quarters was opened in Kampong Bahru. (Before the war, nurses in Singapore were trained on the job. The Nursing Ordinance was enacted in 1949.) In 1957, the 45-bed Gleneagles Nursing Home (which was subsequently converted into Gleneagles Hospital) was opened. In 1958, the oral Sabin vaccine was introduced against poliomyelitis, which at the time was causing epidemics of infantile paralysis in Singapore. The Department of Pathology Building was opened in 1958, and the Institute of Health was founded for provision of preventive health services for children, as well as for training and research. Houseman's Quarters was opened in 1959. The first Burns Unit in Singapore was opened in 1959 at the GH. A government department of orthopaedic surgery was opened in the GH in 1959 with Mr DWC Gawne as head. At KKH, to meet the needs of newborn, nurseries were equipped for specialised care of sick and premature babies. Incubators were used for the first time in the premature baby nurseries and this helped to lower the infant mortality. In 1959, there were over 33,000 births. Thus, in the late 1950s and early 1960s, there was a period of intensive medical development never witnessed before.
In 1959, the Thomson Road Hospital1 was opened for the acute sick (it had originally been intended for the chronic sick). The history of Thomson Road Hospital is interesting. Two years after building commenced in June 1957, the hospital opened its doors on 20 May 1959 with a single ward, two doctors, and seven nursing staff. It was situated on the top of a hill in a swampy and sparsely populated area. It was designated as a hospital for the chronic sick and people in surrounding communities, and to accommodate any spill-over patients from the GH. Prof Seah Cheng Siang was the first Medical Superintendent and his team of doctors included Dr Andrew Chew Guan Khuan (later becoming Permanent Secretary for Finance and Head of the Civil Service, and Chairman of the Public Service Commission). Prof Lim Pin (later Vice-Chancellor of the National University of Singapore from 1981 to 2000) and Dr FJ Jayaratnam (later Head of Department of Medicine I of TTSH and Emeritus Consultant in Geriatric Medicine of Changi General Hospital [CGH]) received their postgraduate clinical training in the hospital. The School of Nursing for Pupil Assistant Nurse was opened within Thomson Road Hospital in September 1965. A surgical department headed by Dr Choo Jim Eng was set up. (Dr Choo, or Jimmy as he was popularly known, was born in 1923 and entered the King Edward VII College of Medicine in 1940, but his education was interrupted by the war. He was among the first batch of MBBS graduates from the University of Malaya, and obtained his Fellowship of the Royal College of Surgeons of Edinburgh in 1957. He worked in the GH, then became the foundation Head of the Department of Surgery, then Medical Director, then started the medical service of the Singapore Armed Forces Medical Corps, then became Head of the Department of Surgery in SGH in 1973, retired in 1985, and then became advisor to the Ministry of Health. I knew him as a man of great humility, and he was always approachable for advice. He died on 20 March 2003).
In 1968, the hospital was renamed the Thomson Road General Hospital. Prof Lee Yong Kiat was appointed the hospital's Chief of Medicine in 1971 and he was instrumental in developing the hospital's medical services. (Prof Lee was born 8 October 1928, graduated with an MBBS from the University of Malaya in 1954 and obtained his Membership of the Royal College of Physicians of London and Edinburgh in 1958. In the 1960s, he became Medical Superintendent of TTSH and KKH. In 1965, he obtained a Bachelor of Law and completed his medical degree. He then became a physician in Medical Unit III in SGH, became Head of the Department of Medicine of Toa Payoh Hospital in 1970, and was later appointed Clinical Professor. Prof Lee was known to be a very kind and fair examiner for the MBBS examination. He was then appointed Emeritus Consultant at CGH and had a special interest in the early history of medicine of Singapore. He authored the books The Early History of Medicine in Singapore [1978] and History of College of Medicine Building [1992].) To identify with the newly built satellite town that the hospital serviced, it was renamed Toa Payoh Hospital. On 15 February 1997, Toa Payoh Hospital was closed, amalgamated with Old Changi Hospital (OCH), and staff and patients were moved to a new hospital in Simei. CGH was officially opened on 28 March 1998. OCH was built in the 1930s at Netheravon Road in Changi Village, with an emergency department and the British commando barracks. OCH was not meant to be a hospital when it was first built. The British was planning to have a heavily guarded military location in the east of Singapore. The site was strategically selected for it is high on top of a hill overlooking the sea surrounding most of the east and south sides of the island. For about ten years before the war, the seven-storey-high building compound was used as military command quarters and barracks. During the Japanese assault on Singapore in February 1942, Changi was one of the first attack points. In a day or two, it was occupied by the Japanese army moving from Pulau Ubin. Soon after that, OCH was converted to a military hospital (Royal Air Force Hospital) where all the wounded soldiers and civilians were attended to. After the Japanese Occupation ended, it was converted back to its original self as a public hospital and later with a military ward on the third level. In 1976, the military hospital was renamed Changi Hospital. It was vacated in 1997; its services were merged with Toa Payoh Hospital and sited at the CGH. The building has been left vacant since then, and is locally (in)famous for being haunted. 1959 also saw the formation of SMA.