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Early Challenges

The hospital's early years presented endless medical challenges. There was a dire shortage of doctors, nurses as well as medical supplies and equipment. The earliest nurses were, in fact, male convicts, who also served as compounders, dressers and sweepers. On 1 August 1885, nuns from the French Convent responded to calls to care for the sick at the hospital. Fortunately, by 1900, four British-trained nurses arrived to take on the task at SGH.

In 1924, a four-year programme (including a final year for midwifery) was underway to train local nurses. Nursing was regarded as an unattractive profession then, for it entailed long hours with barely any days off. Trainee nurses also had to board at the nursing hostel.

In the early 1900s, the common diseases were malaria, venereal disease, tuberculosis, beriberi, pneumonia, dysentery, enteric fever and ancylostomiasis (hookworm disease).

Doctors were mostly generalists, visiting various wards to see as many patients as possible. Patients were admitted based on sex and economic status. In time, the hospital evolved to operate on the Unit System. 

This transformation led to patients being grouped according to their ailments, with a specialist team seeing to their specific needs and treatment. The first Medical Unit was headed by Professor Gordon A Ransome. This Unit System proved to be a systematic way of working, and soon, a Medical Unit II headed by Dr CE Smith, was started. It was later known as the Department of Clinical Medicine, with Professor ES Monteiro appointed as its head in 1949.

Following this system of organisation, three surgical units were established under Professor J.K. Monro, Mr B.M. John and Professor D.E.C. Mekie. A separate Ophthalmic Unit came under Dr AD Williamson, and a Paediatric Unit was headed by Dr Gopal Haridas.

Dr Haridas' work was particularly significant because his clinical interventions helped improve the lives of children who grew up to be the generation that helped in Singapore's nation-building years. Dr Haridas was also known for overseeing the eradication of cardiac beriberi, with his understanding of the benefits of vitamin B1.

A generous donation of $950,000 by Mr NR Mistri led to the expansion of the Paediatric Unit, which had started with two wards in Stanley Block. Up to the 1950s, malnutrition, and a wide range of infections happened on the scale of epidemics. An example was the poliomyelitis epidemic of 1958, during which 404 children were infected and paralysed, and another 12 lost their lives.  The Mistri Wing was dedicated to the care of sick children.[1] 

From Medical Units to Specialist Departments

Organising the hospital into medical units was critical in setting the stage for medical specialisation, including laboratory investigations and diagnostic testing. Medical Unit 1 led the way for electrocardiographic (ECG) services, with a portable ECG machine introduced in 1929. In 1963, the Medical Unit's Cardiac Laboratory was set up to investigate heart disease. It also pioneered the use of carotid angiography for the investigation of neurological disorders. In 1952, Professor Ransome secured a $50,000 donation that allowed him to acquire neurological x-ray equipment. The Unit also spearheaded advancements in nuclear medicine.

Medical Unit II was the precursor of the Departments of Cardiology and Renal Medicine. The Coronary Care Unit started in 1967 with only two beds, while the Renal Unit received a Travenol Twin coil artificial kidney machine, and by 1970, a Dialysis Unit was set up. Recognising the mounting pressure of ever-increasing demand, Medical Unit III was set up (known later as the Department of Medicine) to treat hypertension, cardiac, endocrine, neurological and dermatological complaints. In 1965, the Unit was declared open by Dr Gwee Ah Leng (b.1920 - d.2000), with Dr Seah Cheng Siang (b.1922 - d.1990) succeeding him in 1970. 

These nascent systems of organisation eventually paved the way for specialist centres -- the National Heart, Cancer, Eye and Dental Centres on SGH Campus today.[2]