"The polio epidemic was a depressing period in the hospital, and the morale of everyone is at its lowest ebb. During the outbreak (mid-1958), schools were closed. With the cooperation of school teachers, we managed to give the vaccine to 250,000 pre-school and school children. The result was dramatic. The epidemic came to an abrupt end by December 1958."
A recollection by Professor ES Monteiro (b.1904 - d.1989)
Using the newly discovered oral Sabin to raise children's immunity to the crippling disease was a controversial decision as the international community was still sharply divided over its effectiveness. Until the Singapore vaccination campaign, the use of the oral Sabine was at a trial stage.
According to an article in a journal of the Department of Bacteriology, University of Singapore, Vol 6, no 2 June 1965, a poliovirus infection is indicated by minor illness (fever, headache, gastrointestinal "disturbance".) However, a small percentage of cases developed into a spinal cord motor neuron disease and crippled the child.
In the 1800s and early 1900s, cholera epidemics were common in Singapore, each lasting many years. One lasted 24 years (1899-1923) and left a death toll of nearly 2,700 lives. This might have been a critical factor in relocating the hospital from the swampy, low-lying Kandang Kerbau to its present site. In August 1873, the epidemic was brought under control. HL Randell, the principal civil medical officer of the Straits Settlements, recommended to the governor that the hospital and asylum remain there because of its favourable location. The Outram site was closer to town, spacious and sat on high and dry grounds that facilitated good drainage, reducing the chances of a cholera outbreak. Sepoy Lines thus became the permanent location for the General Hospital.
During the 1957 influenza epidemic, 80 per cent of the hospital's daily 2,500 cases were diagnosed to have the disease. In the seven years before the 1958 poliomyelitis outbreak, 404 infants and children were paralysed and 12 died. Then-clinician Professor Ernest Steven Monteiro (b.1904 - d.1989) recognised this ongoing threat and instituted the use of the yet-unapproved oral Sabin vaccine, which removed the risk of polio for 250,000 young children. Poliomyelitis would otherwise have a debilitating impact on today's "Merdeka Generation" - the generation of Singaporeans who contributed to the country's development in its vital nation-building years.
Clinical research by Professor Wong Hock Boon, then-Head of the University Department of Paediatrics at the hospital, allowed for rapid screening of G6PD-deficient babies at birth. Brain damage was avoided with early treatment. Observing how paediatric practice could be developed further, Parsi businessman Mr Navroji R Mistri donated a significant donation of $950,000 in 1952 to build a paediatric ward.
Malaria was considered to have been eradicated by the mid-1950s, and the occasional patient who was diagnosed with the disease was always thought to have been infected in another country. This view was held until 1964 when there was an outbreak of locally transmitted malaria. After that, the disease was made notifiable by law.
In 1969, 302 cases of malaria were reported in Singapore, 146 or about half of whom were diagnosed at the Outram Road General Hospital. This was equivalent to an incidence of 1.6:10,000 in the population (slightly above the average of 1.0:10,000/year). Some 87 cases admitted to the hospital were analysed, suggesting that malaria recurred regularly. Greater awareness of the disease as a cause of obscure fevers was needed, as was the tremendous diagnostic value of simple investigations like a blood film for malaria parasites in all fevers. The condition prevailed in three parts of Singapore, the distribution being influenced by race, age, sex, occupation, place of residence, and travel.
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