The birth of modern Singapore as we know it now is inextricably linked to the arrival of Sir Stamford Raffles on 28 January, 1819. It was not an easy beginning. Singapore then was little more than a fishing village, mostly covered by jungle and a few buildings and a few acres of land under cultivation. It had a population of about 1,000. (source: Caring for our People – 50 years of healthcare in Singapore)
The year was 1821 - two years after the landing of Sir Stamford Raffles in the sleepy fishing village, Singapore's first General Hospital started life in the humblest manner - a wooden shed in the cantonment where British troops situated near Bras Basah and Stamford Roads. Singapore grew rapidly.Western medical care in the early decades of Singapore’s founding was administered by doctors in military hospitals for the troops. Local inhabitants and immigrants sought treatment from their traditional doctors and healers.
Medical services were also strictly segregated along economic and social status, a result of prevailing discrimination. The General Hospital was the preserve of European soldiers, sepoys and the colonial government. The medical staff was made up of military doctors, consisting of an assistant surgeon and an assistant apothecary, assisted by a few medical subordinates. Nursing, if it could be called that, was usually the work of convicts, who clanked around the wards in their chains.
Government officials and the European community were luckier. They were treated in their homes by surgeons sent from the General Hospital. If they were very ill, they were treated in the homes of the surgeons. But in the early years, there was no hospital for civilians such as sailors who were not part of the colonial military establishment. Nor was there one for the local inhabitants.
At the time, diseases such as cholera, smallpox, enteric fevers, typhoid and venereal diseases were common. And treatment was rudimentary at best:Hospitals were often dilapidated, had few beds and suffered from chronic shortage of trained staff.
Over the next 60 years from 1821, the General Hospital was relocated and rebuilt five times, mainly because of the poor state of the buildings. For example, in Februrary 1827, the Residency Surgeon reported excitedly that the General Hospital had collapsed "on account of the decay of the temporary materials with which it was originally constructed." A directive was issued to build another hospital, but "with every regard to economy."
Conditions in the hospital were less than adequate. Only those in dire straits sought admission.
In 1831, the new Assistant Surgeon, Dr Thomas Oxley, arrived and proposed that a new general hospital for both Europeans and locals be built. But it was not until 15 March 1843 that the colonial government, which regarded Singapore as a financial burden and kept a tight lid on its budget, sanctioned the building of the fourth general hospital. Called the Seamen’s Hospital, it was built at Pearl’s Hill and opened in 1845.
Singapore was starting to thrive as a trading port, and ships’ captains were bringing sick crew members ashore for treatment, sometimes even leaving them behind when the ships set sail.
The most prevalent diseases of the time were fevers, diseases of the respiratory system, gastrointestinal complaints, rheumatism and veneral disease. When it was decided to admit mental patients from among the European community, there was some consternation amongst the hospital staff as it had originally no provision for management for this group of patients.
After more than a decade, the Hospital had to relocate. Pearl's Hill was commandeered for military needs and fortified. The Kandang Kerbau district was earmarked as the next home for the General Hospital.
The fifth General Hospital which opened in 1860 was often referred to by its component parts - namely, the European Seamen's and Police Hospitals. Unlike the previous hospitals, this one treated female patients as well. It saw an average of 40 patients a day, half of whom were Europeans. Their medical complaints were generally due to alcoholism and the tropical climate - fevers, rheumatism, bowel and liver complications, as well as venereal diseases. Most native patients were members of the police force suffering from wounds and injuries due to accidents. In 1865, the first female patients were admitted for gynaecological complaints and childbirth. Wards were set up on the basis of sex and economic status rather than on lines of treatment for specific diseases.
Records indicate that the General Hospital, though "a fine building", was not particularly well located, being on low ground and near "one of the most objectionable creeks" (now the Rochor and Bukit Timah Canals). Fate was to intervene once more and the next move, this time, to what would be the General Hospital's permanent site, was triggered by a cholera outbreak in Kandang Kerbau district in 1873.
The Japanese occupation forces took over the General Hospital for use by their troops in Southeast Asia.
However, the disruption from the war brought about a paradigm shift in the local medical community. With the expatriate doctors interned by the Japanese during the war, local doctors and staff assumed full responsibility in running the hospitals that continued to serve the locals. They proved themselves capable and became aware of the imperative need to unify the medical service with equal treatment of local and colonial doctors posted from Britain and India.
Just five years after gaining independence, Singapore was actively exploring avenues of economic development to ensure its sustainability. Initiatives were underway to make Singapore a liveable city, and healthcare systems and services had to keep pace with modern advances across the globe.
As the country was gripped by events like Konfrontasi, the Maria Hertogh riots, the Pulau Senang prison riot and the Hock Lee Bus protests, SGH continued to treat their respective victims.
SGH has undergone numerous transformations since its establishment nearly 200 years ago to keep up with the needs of Singaporeans. The iconic Bowyer Block, a National Monument in recognition of its national significance and rich history, is a standing reminder of how far we have come in advancing patient care.
