“Focus on your patients and forget everything else.” Such is the advice of Doctors Chin Siang Ong and Sheryl Ang to medical volunteers working in areas hit by natural disasters. Few people spend the first weeks of marriage living 65 kilometres apart, but this is exactly what these two Singapore Red Cross medical volunteers did when they were deployed with the ICRC’s operations in Samar, the Philippines, earlier this year, a mere ten days after their wedding.
The newly-weds were interviewed by the ICRC in Kuala Lumpur after their mission.
Tell us briefly about your mission?
Chin Siang: The mission was part of the ICRC’s joint response with the Philippine Red Cross to Typhoon Yolanda (locally known as Haiyan). It lasted 23 days in January. We worked as volunteer doctors, both located on the island of Samar, but we were deployed about 65 kilometres apart. Sheryl was based at the Basey Emergency Hospital while I was stationed at the Balangiga Basic Health Care Unit.
Basey Emergency Hospital has an operating theatre, an emergency room and wards with nurses, X-ray facilities and basic laboratories. Balangiga Basic Health-Care Unit is a rural clinic run by a team of two doctors, midwives and nurses capable of delivering babies and basic procedures such as wound dressing and suturing. The unit also runs mobile clinics to rural and relatively hard to access surrounding villages (known as barangays). Both sites consist of makeshift tents pitched on indoor basketball courts.
What inspired you to volunteer for the Singapore Red Cross?
Chin Siang: We both wanted to help after hearing the news about the devastation caused by Typhoon Haiyan. I already had contacts with the Singapore Red Cross owing to my previous mission with the organization during the Bohol earthquake in October 2013. I was also free to go as I had already received approval from my hospital employer, MOH Holdings, to take two months of unpaid leave after completing my National Service in Singapore.
Also, we wanted to do something meaningful after our wedding on 28 December. Contributing our time and medical skills to those affected by Haiyan, and supporting the local health-care effort seemed the most appropriate course of action.
What were your main concerns before deployment?
Chin Siang: I prepared myself by reading up about the nature of the disaster to get a better understanding of the types of patients I would be seeing, as well as the area of deployment and the mission details. I also looked up my old notes on Basic Tagalog (the Filipino language), learnt from Filippino nurses working in the National University Hospital Singapore.
I also prepared my medical instruments and bought a small supply of medications, as well as some textbooks on rural, emergency and paediatric medicines in case I needed to consult them for rare disease conditions.
What were the challenges working in the field?
Chin Siang: Unlike my time in Bohol, which lasted a week, the mission to Samar was longer and my wife and I would be apart for the whole time. The rural nature and remoteness of Balangiga (about three hours distant from Tacloban) meant living in an area with a toilet that was only emptied every five to seven days, bathing in cold water, eating dry tech (freeze dried) food, and mobile phone reception and internet connection that was intermittent at best. The weather – continual rain at first – also posed difficulties in trying to dry clothes, so we were all delighted when the sun appeared towards the end of the second week.
What was your most unforgettable moment?
Chin Siang: A nine-year-old girl came to the Balangiga health unit late one night with a heart rate of more than 300 (the normal range is 70 to 120) and an oxygen concentration of less than 70% (normally 95% to 100%). She was unconscious and was having difficulty breathing. After resuscitation with intravenous fluids, antibiotics and oxygen, I took her to the Basey Emergency hospital where Sheryl and her team continued to look after her. After she recovered, I brought her back to Balangiga. It was very fulfilling that we could work together to help the young girl recover, and her mother was very grateful to us.
Sheryl: We also saw patients with diseases that we do not commonly see in Singapore; for example, leptospirosis, which is spread through contact with water, food or soil that contains urine from infected animals, such as rats. In another case, Sheryl tended a seven-year-old girl with a large umbilical hernia which she had had for the past four years, and who was malnourished because of it. And I saw a patient with very advanced tongue cancer that had spread to all the surrounding lymph nodes, where the tumours had eroded out to the skin.
What did you gain from the experience?
Chin Siang: I came to understand that there are limitations in practising rural medicine – that you have to consider the available local health-care resources as well as the patient’s socio-economic background. Often there is no access to blood tests or imaging, or the patient cannot afford such investigations, so you have to treat clinically based on history and physical examination only.
Sheryl: I have gained a lot in terms of knowledge, friendship and experience: knowledge of the devastation wrought by Typhoon Haiyan and the problems it brought the Filipino people in terms of access to basic health care. The friendship of fellow volunteers at Basey Emergency Hospital, from the Norway Red Cross and others from Iceland, Australia and Hong Kong, and well as the local nurses, translators and other health-care workers. And the experience of being part of an emergency rescue unit, learning how it functions and living in conditions which are far from what I am used to in Singapore.
Would you do it again? And what would your advice be for those wanting to do similar work?
Both: Yes certainly. Always seek opportunities proactively and if they arise, grab hold of them and don’t let go, because you may never get a second chance. Make time for it and inform your supervisors as soon as you know what you want to do. They will usually be supportive unless it adversely affects the care of current hospital patients, or your training. Use your annual leave if necessary.
Also, do not have any preconceived notions before you reach the field about the mission or the living conditions. That way you won’t be disappointed. Prepare for the unexpected and be mentally focused. Once you arrive, work with whatever you have and remember the goals of the mission at hand. Above all, focus on your patients and forget everything else.