Red Cross Memories: Dr Ong Chin Siang

I had volunteered at the Bohol Earthquake with the Singapore Red Cross in October 2013.

Upon hearing the news of the devastation caused by Typhoon Haiyan in Nov 2013, my then-fiancée/now-wife, Dr Sheryl Ang, and I wanted to help. We were not able to leave immediately due to lack of leave and wedding preparations. After the wedding, I was free to go as I had already received prior approval to take two months of unpaid leave after completing my National Service, before returning to NUH in February 2014. Sheryl managed to get leave approved as well but only at a later date.

We wanted to do something meaningful after our wedding on 28 December 2013. 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. We decided to volunteer to provide medical aid to survivors of Typhoon Haiyan.

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 medicine in case I needed to consult them for rare disease conditions.

Just 10 days after our wedding, we were on a 23-day mission as part of International Committee of the Red Cross’ joint response with the Philippine Red Cross to Typhoon Haiyan. 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 had 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.

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 distance 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.

One of my most unforgettable moments was when a nine-year-old girl came to the Balangiga Basic Health Care 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.

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 attended to a seven-year-old girl with a large umbilical hernia which she had had for the past four years, and was malnourished because of it. I saw a patient with very advanced tongue cancer that had spread to all the surrounding lymph nodes, and the tumour had eroded out through the skin.

Through this experience, I came to understand that there are limitations in practising rural medicine – that you have to consider the available local healthcare 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.

We would certainly hope to do medical missions again if the opportunity arises.

If there is something we can tell other healthcare personnel who are keen to volunteer, we would encourage them to always seek opportunities proactively. If they arise, grab hold of them and do not 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 will not 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.